Hesperian Health Guides

Let’s Find Out How Well Children See and Hear

Background discussion

Some children cannot see or hear as well as other children. Often we do not know about this and the child says nothing. But because the child does not hear the teacher or see the blackboard, he may not learn as quickly as others. So he may try to hide in a corner. We can help him by letting him sit close to the teacher.

Also, babies who cannot hear well do not learn to talk or understand as early as others.

In this activity, the school children try to find out which young children and babies do not see or hear well, and need help.


One way to get children thinking about these problems is to ask questions like:

  • Do you know anybody who does not see or hear well?
  • Do you act differently with these people? Why?
  • How would you feel if you did not see well? Or hear well?

Games to help children understand the difficulties of poor hearing

chicken, fly, hammer, donkey, and person and noises they make

All the children are completely silent for 3 minutes. They listen very carefully to the noises around them. Afterwards, they write down or draw everything they heard.


One child plugs his ears while another tells a funny story to the group. Then one of the children plays ‘teacher’ and asks everyone, including the child who had his ears plugged, to answer questions about the story. Finally, they ask him what it felt like, not being able to hear the story well.

Ask the children what they can do to help a child to hear better. Their suggestions might include:

  • Have the child sit ‘up front’ close to the teacher.
  • Everyone can take care to speak slow, clear, and loud (but do not shout).
  • Use gestures or ‘sign language’ (if the child hears very little or not at all).
  • Watch people’s mouths and try to understand what they say. This is not easy if you do not hear the words. Have the children try it.
boy asking for a glass of water with gestures

Children who hear very poorly or not at all often cannot speak. This is not because they are stupid, but because they need to be able to hear in order to learn how to speak. This game will help children appreciate the difficulties of a child who cannot speak, and give the children ideas of how to ‘talk’ without words to a child who does not hear.

Play a game where someone explains something to others through acting only, without words. The others must guess what it is he is trying to say. The leader can start by acting out a simple phrase like: “I want a glass of water.” The children try to guess what the leader is doing. Next have the children take turns acting out different things and ideas. Start with easy phrases like:

girl siging she wants to go to sleep
  • I want to go to sleep.
  • Give me the ball.

And work toward more difficult ideas like:

  • I’m lost and can’t find my house.
  • I had a bad dream.

Discussion after the game:

  • Was it difficult to explain something without talking?
  • How did you feel when no one understood you?
  • What did the other children do to help you tell them what you wanted to?
  • Could they have done more? What?
  • How might you help children who cannot speak to communicate?

Explain to the children about sign language for the deaf. This is like the game in which children ‘talk’ with their hands. One form of sign language uses mostly the alphabet. Another form, which deaf persons prefer for ‘talking’ with each other, uses symbols for different actions and things.

alphabet in sign language
Alphabet sign language used in the USA. See more discussion of sign language.

If there is a deaf child in the school, or in the village or neighborhood, perhaps the children would be interested in finding a way to help that child learn to ‘sign’. Or they may want to learn themselves, in order to be able to ‘talk’ with the deaf child.

If 1 or 2 children in the class can learn to sign and then help translate spoken language into sign language, this can allow the deaf children to learn and take part more fully in the school and in the community. (See books to learn sign language.) Also see Chapter 31.

Games to help children understand the difficulties of poor sight

child blindfolded in the middle with nuts around and other children are trying to steal them

This game can help children understand both the importance of good hearing and the difficulties of not seeing.

  • The children form a circle. One child stands in the middle with her eyes covered. Around her feet are small stones, nuts, or other small objects.
  • The other children, one by one, try to creep up and steal these things.
  • If the child in the middle hears the ‘thief’, she points to him and he is out of the game.
  • The goal is to see who can steal the most objects without being heard.


One or more children are temporarily given poor or blurred vision in one of several ways:

thick lenses
a blinfolded child
Or, cover his eyes with a piece of tracing paper, wax paper, or other material that you can see through slightly. Put somebody's powerful eyeglasses on a child who needs no glasses.

Have the child try to read from a book with letters of different sizes. Do the same on the blackboard. What trouble does he have? How close does he have to get? Does he read aloud from his book as well as the other children?

A blind folded child tries to read
blind folded child touching a tree

The children are in pairs. One is blindfolded, the other is her guide. The guide takes the blindfolded person for a walk, letting her feel different things and taking care of her.

After the game, discuss:

  • How did it feel not to be able to see?
  • What did your guide do that was helpful? Not helpful? What might she have done better?
  • Did you trust your guide?
a blinfolded child touching another child's face

One child is blindfolded. He tries to recognize his friends by feeling them.

Similar feeling games can be played trying to identify different things by feeling them.

Nose smelling leaf, tomato, coffee, banana and a flower.

Blindfold the children and have them identify things by their smell: things such as orange, tea leaves, banana, and local herbs.

After the children play these different games, explain to them that because blind people cannot see, they often develop outstanding ability to identify things through hearing them, feeling them, and smelling them.


It is important to find out as early as possible if a child cannot hear or see well. Older children can do some simple tests with their baby brothers and sisters. A class or group of children can also test the seeing and hearing of younger children, such as those in nursery school or the first year of elementary school.

Testing the hearing of babies (4 months old and older)

Baby turns as woman shakes rattle behind his head.
  • Children can notice if their baby sister responds to different sounds, high and low, loud and soft. The baby may show surprise, make some movement, or turn her eyes or head toward the sound. Notice if the baby responds to her mother’s voice when the baby does not see her.
  • Or make a rattle from seeds or small stones. Creep up and shake it behind the baby’s head, first on one side and then the other. See if the baby is surprised.
Hands scraping spoon against cup, small child looks towards noise.
  • Then call the baby’s name from different places in the room. See if the baby responds.
  • To test if a baby hears some kinds of sound but not others, do this. Sit at arm’s length from the baby, and to one side. When she is not looking, make different kinds of sounds. Say “Ps” and “Fth” to test for highpitched sounds, then “Oooo” for low-pitched sounds. For other high pitched sounds, crinkle a thin, stiff piece of paper or rub a spoon inside a cup. For other low pitched sounds, watch if the child notices the noise of a passing truck, a train whistle, a cow’s ‘moo’ or low notes on a musical instrument or drum.

If the baby does not show surprise or turn her head with any of these sounds, she may have a severe hearing problem If she responds only to certain sounds, but not to others, she has some hearing. But she may not be able to understand language well because she cannot tell certain words apart. As a result, she may not speak as early or as clearly as other children and will need special help. (See Chapter 31.)

Testing the hearing of young children (a game)

  • An older child stands several meters from a line of younger children.
  • Behind each young child stands an older child with pencil and paper
    Boy says words at different volumes, small children next to adults with paper.
  • The first child says the name of an animal VERY LOUDLY
  • The young children whisper the word to their older partners.
  • The older children write it down.
  • Then the first child names other animals, each in a softer and softer voice, until he is whispering.
  • After about 10 animals have been named, and the words that the younger children heard have been written down, compare the different children’s lists.
  • Repeat this 2 or 3 times
  • Any child who has not heard as many words as the others, or has not heard them correctly, probably has a hearing problem.

What to do for the child with a hearing problem

  • Let the child sit at the front of the class where he can hear better.
  • Be sure everyone speaks clearly and loudly enough. But do not shout because shouting makes the words less clear. Check often to make sure the child understands.
  • Have one child who hears well sit next to the one who hears poorly—to repeat and explain things if necessary.
  • Always try to look at the child while you are speaking to him.
  • If possible, the child should be examined by a health worker—especially if he has pus in an ear or frequent earache.
Girl looking into smaller boy's ear.


They can regularly look to be sure that there is no pus or small objects inside. If they see anything wrong they should tell an older person, who should take the child to a health worker.


Most babies who are ‘deaf’ hear something. They need help in learning to listen. The children may think of games to help babies listen and learn.

Girl sitting on lap of adult.

For example:

  • Sing to babies, and teach songs to young children.
  • Tell them stories and change voices to sound like different people in the story—loud, soft, angry.

Testing if a baby sees (for a child over 3 months old)

Baby on hack looking at hanging object, sitting baby with candle in front of him.
  • Children can notice if the baby begins to look at things held in front of him, to follow them with his eyes, to smile at mother’s face, and later to reach for things held out to him.
  • Hang a bright colored object in front of the baby’s face and move it from side to side. Does the baby follow with his eyes or head?
  • If not, in a fairly dark room, move a lighted candle or torch (flashlight) in front of the child’s face. Repeat 2 or 3 times.

If the baby does not follow the object or light with his eyes or head, probably he does not see. He will need special help in learning to do things and move about without seeing. Other children can help. (See Chapter 30.)

Testing how well children see (4 years old and older)

A group of older children can make an eye chart. They can cut out black ‘E’s of different sizes and paste them on white cardboard.

Large letter E.
Also make one large 'E' shape out of cardboard or other material.
Eye-chart with the letter E in different directions.
4.4 cm high
2.2 cm
1.5 cn
1.2 cm
.8 cm

DVC Ch47 Page 453-3.jpg
Children making an eye chart. (Mexico)
Girl with eye chart on palm tree, boy at a distance carrying a large letter E.
Horse grazing in the shape of a downward letter E.
Girl holding a horseshoe in the shape of the letter C, looks at chart with letter C in different directions.

First let the children test each other, one eye at a time. Hang the chart in a place where the light is good. Then make a line about 3 meters from the chart. The child to be tested stands behind the line, holding the cut-out ‘E’ and covering one eye. Another child points at different ‘E’s’, starting from the top.

Ask the child being tested to hold the cut-out ‘E’ so that its legs’ point the same way as the ‘E’ on the chart. When he gets to the bottom, or can no longer see, have him cover the other eye and start over. If the child can easily see the ‘E’s on the bottom line, he sees well. If he has trouble seeing the second or third line, he sees poorly.

  • To make the testing more fun, you can use horses in the shape of ‘E’s.
  • Make 5 cards using different size horses. Make the sizes the same as those shown for the letter ‘E’ in the chart at the top of this page.
  • Or use a chart with ‘C’s. Ask the child either to hold a horse shoe in the same position as the different ‘C’s on the chart, or to tell you for each ‘C’ which way the horse shoe is going.

To test children who are mentally slow, deaf, or have trouble communicating, you can use pictures of different things they recognize. Hold up one picture at a time and have the child either name it or point to a similar picture-or the real object. For example, you can make a set of cards with pictures like this:

Chart with a shoe, a cup and a horseshoe.

Boy with a shoe, cup and horseshoe he points to as woman holds up pictures of each.

After the children practice testing each other, they can test the eyesight of those in the younger grades and the children who will be starting school soon.

Looking at each other’s eyes for signs of problems

Woman looking at eyes of boy.

Start with questions to get the children interested. For example:

  • Are your eyes the same as your classmates? Shiny? Clear?
  • How about the eyes of your younger brothers and sisters?
  • Can you see well in the dark? Or do you often stumble at night?
  • Do a child’s eyes look dull? Are there any unusual spots or wrinkles? If so, see a health worker.

Many children in different parts of the world become blind because they do not eat foods that make their eyes healthy. Eating yellow fruits or dark green leafy vegetables helps protect the eyes. Some extra cooking oil added to food also helps.

Good eye on the left, red eye with pus on the right.

If children’s eyes are red or sore, you can suggest that they wash them often with clean water with a little salt in it (no saltier than tears). This may help eyes get better and keep the flies away. If they do not get better soon, see a health worker.

For more information on eye problems and blindness, see Chapter 30.

This page was updated:27 May 2020