Early Signs of Hearing Impairment at 18–24 Months

By 18 to 24 months, hearing is the doorway to talking — when words and responses lag, your ears-first instinct is exactly right.

In short

By 18–24 months a toddler should turn to their name, follow simple instructions, and use a growing handful of words. Early signs of hearing impairment include not responding to soft sounds or their name, very few or no words, not following simple spoken requests, and relying heavily on watching your face or gestures. These are signs to check promptly — not to panic — because hearing is very treatable when caught early.

Signs to watch at 18–24 months

Listening and responding

• Doesn't turn to their name or to everyday sounds unless they can see you
• Doesn't startle or react to loud sounds, or seems to "tune out"
• Needs the TV or music much louder than the rest of the family
• Responds inconsistently — better in quiet, much worse with background noise

Talking and understanding

• Very few or no clear words by 18 months; not combining two words near 24 months
• Speech sounds unclear or limited compared with peers
• Doesn't follow simple spoken instructions without gestures ("give me the ball")
• Watches your lips and face intently to understand

Everyday clues

• Frequent ear infections, ear-pulling, or fluid (common, very treatable causes)
• Stopped babbling or using words they once had — act on any loss of skills

Why early action matters

These years are the richest window for spoken language, so even mild or fluctuating hearing loss can quietly slow words. Many causes — like glue ear — are temporary and treatable. A simple, painless hearing test (audiology) confirms what's happening, and speech therapy supports language alongside any medical care.

The Pinnacle way

A clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre under qualified clinician care — our AbilityScore® is a clinician-administered structured assessment that maps listening, language and play to guide a clear plan. Learn more about hearing impairment and how speech therapy builds early communication.

Trusted sources

Aligned with WHO ICD-11, CDC "Learn the Signs. Act Early." milestones, the Indian Academy of Pediatrics, and the American Academy of Pediatrics (HealthyChildren.org).

Next step — if your toddler isn't responding to sound or words as you'd expect, book a hearing and developmental check. Reach the Pinnacle team on WhatsApp: +91 91001 81181.

This is general information, not a diagnosis — a clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre under qualified clinician care.