Testing Your Child's Hearing

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Today, there are many tests to help determine hearing levels in infants or children. No child is too young to receive a thorough hearing evaluation. In fact, hearing assessment can even be completed at birth.

While hearing screenings may be conducted by nurses or trained volunteers, a complete assessment of hearing in a child should only be completed by an audiologist.

The purpose of the audiologic evaluation is to determine if a hearing loss exists in one or both ears, to what degree, and to help determine what type. Test results are recorded on an audiogram.

The figure below is an example of hearing loss in the high frequency range. Many of the consonant sounds in speech are not audible.

Types of Audiological Evaluations

Behavioral hearing tests
These tests usually require the child to respond to soft sounds in some way (verbally, by picture pointing, raising the hand or through a "game").

Auditory brainstem response (ABR)
For newborns or infants and children who cannot reliably perform the behavioral test procedures, other more objective tests, such as ABR, can help determine hearing abilities. Clicks or tonal "pips" are sounded in the infant’s ears through earphones. The ABR provides information about the function of the auditory pathway to the level of the brainstem. The response to the clicks or tones are recorded, providing an estimate of hearing sensitivity.

Otoacoustic emissions (OAEs)
These tests provide a new and unique way to examine the function of the cochlea. Sounds are sent to the child’s ear with a small loudspeaker. A microphone records the response to the sound from the cochlea (known as an emission, or "echo"). This offers valuable information about the sensory hair cells in the cochlea.

Tympanometry (Acoustic Immittance Testing)
This test helps determine how well the eardrum and middle ear are working. A gentle puff of air is delivered into the child’s ear and the amount the eardrum moves in response to the change in air pressure is recorded. If the eardrum does not move, for example, it could mean there is fluid behind the eardrum and otitis media with effusion may be present.