By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My sons, who are 6 and 3, have been able to hum and sing on key since before they were 2. Why can’t my almost-5-year-old daughter carry a tune? Do most children grow to recognize pitch?

I don’t want to sign her up for singing lessons for fear it might squelch her delight, but it’s difficult to listen to her. I fear the day when peers tell her she’s off-key. For the record, my husband and I are musical, and I was able to sing harmony when I was 4.

A. Your 5-year-old may not be able to carry a tune, but that doesn’t mean she is tone-deaf. Amusia, the medical name for tone-deafness, is an impaired ability to discriminate between pitches. The brain pathway responsible for pitch perception doesn’t fully connect with parts of the brain involved in sound perception and production, according to a recent study. About one in 20 people are tone-deaf. Many who can’t carry a tune can still distinguish pitches, another study says.

Telling the difference between pitches is only part of singing on key, which also requires the ability to remember pitches and to reproduce them. Many off-key singers have another problem. They can differentiate pitches and remember them, and their voices work fine, but they can’t combine these skills. In effect, they lack the aural equivalent of hand-eye coordination.

Perfect or absolute pitch is the ability to identify individual pitches without a reference, like a pitch pipe or a piano. Only one in 10,000 people have absolute pitch. Relative pitch allows you to identify pitches after hearing them. Most people, including most musicians, have relative pitch.

Children’s rapidly developing brains are malleable; we bet that musical training at a young age can make a difference. We share your concern about spoiling your child’s musical joy. It’s hard to learn anything, or to overcome a personal obstacle, without hope.

We suggest you find a music teacher (perhaps with a background in speech and language pathology) who is experienced with young children, and who will take on this challenge with patience and respect.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at

Reprinted with permission from the authors.