The school year is already underway, and children are settling into new routines, classrooms, and daily activities. As parents get updates from teachers and spend more time observing their children’s routines at home, they may begin to notice changes in hearing, speech, breathing, sleep, or communication.

Some pediatric ear, nose, and throat (ENT) problems are easy to overlook. A child may not complain about hearing loss, nasal congestion, or poor sleep. Instead, parents or teachers may notice that the child seems distracted, frequently asks for repetition, speaks differently, snores, has trouble following verbal instructions, or appears unusually tired during the day.

Recognizing these signs during the school year can help identify potentially treatable problems before they continue to interfere with learning, communication, sleep, or participation in the classroom.

ENT Warning Signs Parents Should Watch For

1. Your Child Frequently Says “Huh?” or Asks You to Repeat Yourself

Does your child frequently say “What?” or “Huh?” even when you are speaking clearly? Do they turn the television or tablet volume unusually high?

These behaviors can sometimes indicate difficulty hearing. Children may not realize they are missing sounds and may compensate by watching faces, guessing words, or appearing distracted.

Hearing difficulties can become particularly noticeable in a classroom, where background noise can make it harder to understand a teacher or follow conversations.

If your child consistently seems to have trouble hearing, a hearing assessment can help determine whether there is an underlying problem.

2. Your Child Has Frequent Ear Infections or Hearing Changes

Ear infections are common in childhood, but fluid can sometimes remain behind the eardrum after an infection clears. This may temporarily reduce hearing, even when your child no longer has pain or fever.

Watch for signs such as:

• Frequent ear infections
• Complaints of ear pain or pressure
• A feeling of fullness or a “blocked” ear
• Difficulty hearing or responding
• Frequently asking others to repeat themselves

If ear infections or hearing concerns keep returning, an ENT specialist may recommend a hearing evaluation or additional testing.

3. Your Child’s Speech Is Difficult to Understand

Some speech differences are a normal part of development. However, speech that is consistently difficult for parents, teachers, or other people to understand may deserve professional evaluation.

Hearing problems can sometimes affect speech and language development. Children need to hear sounds clearly and consistently as they learn to recognize and produce speech.

If you are concerned about how your child speaks, pronounces words, or understands language, discuss your concerns with your pediatrician, an audiologist, a speech-language pathologist, or an ENT specialist.

4. Your Child Frequently Breathes Through Their Mouth

Mouth breathing during a cold is common. Persistent mouth breathing, however, may be associated with nasal congestion, allergies, enlarged adenoids, enlarged tonsils, or other upper-airway problems.

Look for:

• Mouth breathing during the day
• Chronic nasal congestion
• Sleeping with the mouth open
• Difficulty breathing through the nose
• A persistently stuffy or nasal-sounding voice

Ongoing nasal obstruction is worth discussing with an ENT provider, particularly if it is affecting sleep or daily activities.

5. Your Child Snores Regularly or Sleeps Restlessly

Occasional snoring can happen when a child has a cold. Regular loud snoring deserves more attention.

Parents should be particularly alert for pauses in breathing, gasping or choking during sleep, restless sleep, unusual sleeping positions, sweating during sleep, or significant daytime tiredness.

These can be signs of sleep-disordered breathing. Poor-quality sleep can be associated with a child’s daytime mood, behavior, attention, and concentration.

If your child regularly snores or you notice breathing interruptions during sleep, speak with their pediatrician or an ENT specialist.

6. Your Child Struggles to Follow Verbal Instructions

A child who repeatedly struggles to follow spoken instructions may not necessarily be “not listening.”

Pay attention to whether your child has more difficulty understanding you when there is background noise or when they cannot see your face. If they follow visual or demonstrated instructions more easily than verbal ones, hearing may be one factor to consider.

You may also hear from a teacher that your child frequently needs instructions repeated or has difficulty following verbal directions in the classroom.

A hearing assessment can help determine whether your child is hearing speech clearly. However, difficulty following instructions can have many possible causes, so a pediatrician or other appropriate professional can help determine what evaluation may be needed.

7. Your Child Has Persistent Nasal Congestion

A constantly blocked nose can make it harder for a child to breathe comfortably and may contribute to mouth breathing or disrupted sleep.

Common causes include allergies, recurrent infections, enlarged adenoids, and other nasal conditions.

If your child regularly has nasal blockage, ongoing nasal discharge, or difficulty breathing through their nose, an evaluation can help determine the cause and appropriate treatment.

When Should Your Child See an ENT Specialist?

Consider discussing an ENT evaluation with a pediatric ENT specialist if you notice:

• Frequent requests for repetition or suspected hearing loss
• Recurrent ear infections
• Persistent ear pain, pressure, fullness, or drainage
• Speech or language concerns
• Chronic nasal congestion or mouth breathing
• Regular loud snoring
• Pauses, gasping, or unusual breathing during sleep
• Persistent voice changes
• Difficulty hearing or following verbal instructions at home or school

You do not have to wait for a teacher to identify a potential problem. If something about your child’s hearing, breathing, sleep, or communication seems unusual, bringing it up early can help determine whether further evaluation is needed.

Pediatric ENT Care in Louisville and Southern Indiana

ENT Care Centers provides pediatric and adult ear, nose, and throat care throughout Louisville, Kentucky, and Southern Indiana, with locations in Louisville and Jeffersonville.

Pediatric services include evaluation and treatment for ear infections, hearing concerns, sinus and allergy problems, tonsil and adenoid conditions, and other ENT issues.

If you have noticed changes in your child’s hearing, breathing, sleep, communication, or classroom experience since the school year began, a pediatric ENT evaluation can help identify potential problems and determine the appropriate next step.

Medical disclaimer: This article is for general educational purposes and is not a substitute for an examination, diagnosis, or individualized medical advice from a qualified healthcare professional.