If your child has any of the following symptoms or risk factors, he may be referred for a hearing evaluation:
- Shows a lack of attention or response to sound (See my blog post “Could My Child Have a Hearing Impairment?“)
- Speech is delayed or difficult to understand
- Family history of congenital hearing loss
- Premature birth, or child was in NICU (Neonatal Intensive Care Unit) as an infant
- Frequent ear infections
- The child contracted meningitis or cytomegalovirus
Who will evaluate my child’s hearing?
Your child should be referred to a pediatric audiologist, who has specialized training in childhood hearing loss. The audiologist may be part of a clinic where several hearing specialists work together. Or your child may be tested at a local hospital.
How will my child be tested?
There are several options, depending on your child’s age, symptoms, and ability to be a willing participant in the examination:
Infants
Auditory Brain Stem Response (ABR) and Auditory Steady State Response (ASSR) are two tests which are usually conducted simultaneously. An infant may be given a mild sedative to sleep through the examination. Two tiny earphones are placed in the child’s ears, and electrodes are placed on his head. This does NOT hurt your child. The earphones emit clicks and tones. The child’s brainwaves are then measured and averaged by a computer. Since there is a clear pattern that most children with normal hearing have, if your baby has a significant hearing loss the results will be apparent.
Otoacousitc Emissions Test (OAE) is also conducted on infants while asleep, holding still, or sedated. Sounds are emitted into a probe through the ear canal, and the echo-response of the inner ear is recorded. This is a brief, painless test, although a frightened child who is crying will need sedation to conduct the test properly.
Toddlers and Young Children
Behavioral Tests are conducted, where a child is carefully observed during an examination to see her response to various tones, speech patterns, and distinct pitches and frequencies. My son Kyle was tested in a sound-proof room, where he sat with an adult assistant. The assistant quietly occupied him in various activities such as playing with blocks. Then, in several locations around the small enclosed room, sounds were emitted which activated toys: a monkey playing cymbals, a monster dancing, etc. If Kyle looked up from his play to see what made the sound, the audiologist made note of it. Even slight glances in the direction of the sound were signs of hearing.
Hearing tests are an important step in getting your child the best medical and educational help available. If a hearing loss is ruled out, you can explore other possible contributors to your child’s speech or developmental delays.