Early identification of hearing loss and intervention are critical for a
child, significantly increasing the child’s chances of developing spoken
language. Research demonstrates that untreated hearing loss typically results
in speech-language delays, ultimately resulting in reduced academic
achievement, social isolation, behavioral problems, and poor self-esteem.
Our team aims to ensure early identification and treatment for each
child that we evaluate at CHKD.
There are several types of tests that we use in order to assess your
child’s hearing. Our audiologists choose the appropriate tests based
on factors such as age, level of comfort and cooperation, and
developmental concerns. For your child’s hearing test appointment, the
audiologist may use one or more of the following tests.
Types of Tests
Visual Reinforcement Audiometry (VRA)
The child is trained or conditioned to turn or look towards a sound
source, i.e. loudspeaker. When the child gives the desired response, this is
reinforced or rewarded by a toy that lights up or animates. This test is
conducted in the sound booth and the child typically sits on a parent’s lap.
Earphones may be worn depending on the child's cooperation. This test is most
often used for children ages 6 months to 3 years.
Conditioned-Play Audiometry
For this test, the child is taught to throw a ball/block in a bucket or
put a peg on a board in response to hearing a sound. The sound is transmitted
through earphones while the child sits independently or on a parent's lap in
sound booth. The child may be assisted in the game by another audiologist or
audiology student. This test is most often used for children ages 3-5 years.
Comprehensive Audiometry (Puretone and Speech Audiometry)
The child is asked to respond each time a tone is heard through the ear
phone. The elicited response may be raising a hand, saying a catch word, or
pressing a button. The child may also be asked to repeat a list of words. This
is typically used for ages 5 years and up.
Tympanometry/Acoustic Immittance
This test helps to determine how the middle ear is functioning, by
assessing the movement/mobility of the eardrum, pressure in the middle ear
space, the middle ear’s muscle reflex. To perform this test, a small probe is
placed in the child’s ear canal and a slight pressure is applied. Tympanometry
is obtained as part of the audiological evaluation on children of all ages.
Otoacoustic Emissions (OAE) Testing
Otoacoustic Emissions (OAE) testing assesses the function of the
cochlea or inner ear. To perform this test, a small probe is placed in the
child’s ear which plays a series of sounds. The probe then records the
otoacoustic emission which is a sound produced by the ear in response to the
stimulus. It is very important for the child to be quiet and relatively
inactive during this test. OAE testing is most often obtained as part of the
audiological evaluation on children of all ages. It is specifically used as a
screening test on newborns/infants.
Auditory Brainstem Response (ABR)
The ABR test measures the brain’s waveform EEG activity in response to
sound. Electrodes that temporarily adhere to the child’s forehead and scalp are
used to record these brain waves, and the sounds are transmitted through
earphones. This test is often ordered for
children who are difficult-to-test or children who are too young to be tested
behaviorally.
Unsedated (sleep-deprived) ABR
Often utilized for children less than four months of age. The child
brought to the test in a sleep-deprived state so that he/she will sleep
naturally during the test.
Sedated ABR
Often utilized for children over four months of age. The child is
sedated in coordination with nursing and medical staff for the ABR test.