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Hearing Screening Tests

What are the different types of hearing tests?

In order to evaluate your child's hearing, your child's physician will perform a complete medical history and physical examination. In addition, there are many different types of hearing tests that can be used to check your child's hearing. Some of them may be used on all ages, while others are based on your child's age and level of understanding.

Hearing tests for the newborn and infants

Evoked otoacoustic emissions (EOAE)

A test that uses a tiny, flexible plug that is inserted into the baby's ear. Sounds are sent through the plug. A microphone in the plug records the otoacoustic emissions (responses) of the normal ear in reaction to the sounds. There are no emissions in a baby with hearing loss. This test is painless and is usually completed within a few minutes, while the baby sleeps.

Auditory brainstem response (ABR)

A test that uses electrodes (wires) attached with adhesive to the baby's scalp. While the baby sleeps, clicking sounds are made through tiny earphones in the baby's ears. The test measures auditory nerve's activity in response to the sounds. As in EOAE, this test is painless and takes only a few minutes.

If the screening tests identify that your child has a possible hearing loss, further testing is needed. It is recommended that all babies with hearing loss be identified by 3 months of age so that treatment can begin before the baby is 6 months old, an important time for speech and language development.

Hearing tests for children > 6 months of age (developmentally)

6 months to 2 1/2 - 3 years

Evaluation of hearing may include the above mentioned tests, along with the following:

Play audiometry, between 2 1/2 - 3 years to 4 - 4 1/2 years

Your child usually wears some type of earphones. This test is a game. The toddler is asked to do something with a toy (i.e., touch a toy, move a toy) every time the sound is heard. This test relies on the cooperation of the child, which may not always be given.

Hearing tests for older children

Evaluation of hearing for children older than 3 to 4 years may include the above mentioned tests, along with the following:

Pure tone and speech audiometry, 4 yrs - adult

A test that uses an electrical machine to transmit words or sounds at different volumes and pitches into your child's ears. Your child wears some type of earphones. The child is asked to repeat words and raise a hand or push a button when a sound is heard.

Tympanometry (also called impedance audiometry)

A test that can be performed in most physicians' offices to help determine how the middle ear is functioning. Tympanometry is not a hearing test, but helps to detect changes in pressure in the middle ear or the presence of fluid that may affect hearing. This may be a difficult test to perform in younger children because the child needs to sit very still and not cry, talk or move during the test.

Reviewed by: Steven D. Handler, MD, MBE
Date: April 2009

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