Hearing and speaking

Photo of a mother with daughter and son

Our hearing is particularly sensitive to sounds that we make ourselves – for instance, when we speak, shout or sing. To be able to use our own voice, we have to be able to hear it ourselves.

Hearing and speaking are very closely linked. They allow us to communicate through speech. But to be able to speak, we have to be able to hear as well.

Our ears receive sound waves and change them into signals that are sent along the auditory nerve to the brain. The brain processes them and we then hear something. This involves some parts of the brain that we also use when we speak. If somebody is unable to hear from birth, they will find it very difficult to learn how to make sounds that others can understand as speech.

Why do we hear speech particularly well?

Sound waves can be created by many different things, such as a piano string vibrating and the vibrations of the vocal cords in our throat.

How well we can hear something depends both on the sound pressure level and on the pitch – or, more precisely, the frequency of the sound waves. The sound pressure level is measured in decibels (dB), and frequency is measured in hertz (Hz).

Our hearing is particularly sensitive to frequencies generated when we speak. As a result, we can understand spoken words and sentences even at relatively low sound pressure levels.

Speech development relies on hearing

Children learn the language spoken around them by listening and “parroting” – and then hearing their own voice. They can even learn several languages and speak them fluently later.

But they can only learn language in this effortless way if their hearing works, too. If a child born with severe hearing loss or deafness doesn't get the right treatment, their speech and language skills will develop more slowly, or not at all. This can affect their ability to learn, as well as their general personal and social development. The term “deaf and dumb” is no longer used today because it's often found to be offensive.

How can people communicate without hearing?

If people with hearing problems start using a hearing aid or prosthesis (cochlear implant) early enough, they will often still manage to pick up acoustic impulses like spoken language, and then learn to speak themselves. Even if you can't hear properly and the problem isn't treated, you can learn how to communicate in other ways. These are often used in addition to hearing aids and cochlear implants. One example is sign language: This involves expressing words and sentences using signs and movements made with your hands, as well as facial expressions. So you see the language rather than hearing it.

Another form of communication is lip-reading. Here deaf people can work out what other people are saying by closely watching their mouth when they speak. With targeted speech therapy, they can also learn to make sounds with their mouth and throat, and then communicate with spoken language – with some limitations.

People who can lip-read can also communicate with hearing people who don't know sign language. But it's difficult to say which of these two types of communication is better suited.

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Brennan-Jones CG, White J, Rush RW et al. Auditory-verbal therapy for promoting spoken language development in children with permanent hearing impairments. Cochrane Database Syst Rev 2014; (3): CD010100.

Fitzpatrick EM, Hamel C, Stevens A et al. Sign Language and Spoken Language for Children With Hearing Loss: A Systematic Review. Pediatrics 2016; 137(1): 1-17.

Health Quality Ontario. Bilateral Cochlear Implantation: A Health Technology Assessment. Ont Health Technol Assess Ser 2018; 18(6): 1-139.

Lenarz T, Boenninghaus HG. Hals-Nasen-Ohren-Heilkunde. Berlin: Springer; 2012.

Monteiro CG, Cordeiro AA, Silva HJ et al. Children's language development after cochlear implantation: a literature review. Codas 2016; 28(3): 319-325.

Morzaria S, Westerberg BD, Kozak FK. Systematic review of the etiology of bilateral sensorineural hearing loss in children. Int J Pediatr Otorhinolaryngol 2004; 68(9): 1193-1198.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on February 7, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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