Testing Your Child's Hearing

By Kathryn Stover, AuD

Virginia Head & Neck Surgeons, PC

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Testing Your Child's Hearing

Babies and young children learn to communicate through imitation. Effective hearing and speech are important for playing, learning, and socializing. The most vital period for speech and language development occurs between birth and four years old. If hearing loss is present, speech and language skills can be compromised.

If left untreated, a child with hearing loss will not be able to communicate successfully, resulting in possible speech/language delay, academic struggles, and poor social skills.

Fortunately, most hearing losses can be treated either medically or with modern technology. The earlier treatment starts, the more successful it will be.

Hearing loss can be temporary or permanent and vary in degree (mild to profound). Temporary losses, called “conductive” losses, are usually the result of medical conditions involving the outer and middle ear spaces.

Untreated ear infections, middle ear fluid, ear drum perforations, and wax impaction are a few common examples. Hearing loss in children that is temporary can often times be treated with medical treatment or minor surgery.

Permanent hearing loss involving the inner ear or auditory nerve can be present at birth or be acquired after birth. Some common causes of “sensorineural” hearing loss in children are the result of a family history of hearing loss, a genetic syndrome, infections during pregnancy, premature birth, excessive noise exposure, head injury, or serious childhood infections such as mumps, measles, etc. Treatment through the use of hearing aids or a cochlear implant device may be recommended, according to the degree of hearing impairment.

Hearing test procedures vary by age. Newborns and toddlers are generally tested using physiologic tests such as otoacoustic emissions (OAE) or auditory brainstem response (ABR). These tests assess how well the hearing pathways are working and require no response from the child.

Children from two through five years of age are assessed using either behavioral observation audiometry (BOA) or conditioned play audiometry (CPA). Both require cooperation and responses from the child. Since the above age groups can be challenging to work with, it is best to have an audiologist who specializes in pediatric testing administer the testing.

Children over five years of age can be tested using traditional test methods of responding to speech and pure tones (raise hand, push a button) to determine the threshold of audibility.

After your child has been tested, recommendations for medical treatment and/or amplification are given, depending on the nature of the results.