Your child’s healthcare provider can use a wide range of hearing tests to determine how your child hears at any age. Depending on the age of your child, your pediatrician will choose from different behavioral tests depending on your child's level of participation and his understanding of the tasks required to evaluate his hearing. There are also certain medical tests that can be performed at any age to help determine if the various parts of your child’s ears are functioning properly, which will help determine your child’s hearing ability.
All babies born in the United States receive a hearing screening prior to being discharged from the hospital. If your baby does not pass the screening test, further diagnostic testing will be needed to determine the presence and degree of hearing loss.
Some of the different hearing tests your baby may receive include:
- Otoacoustic emissions (OAE) – In this test, a small earphone will play sounds into your baby’s ears. A healthy inner ear will respond with otoacoustic emissions (responses), which can be recorded with a tiny microphone inside the earphone. OAE testing takes only a few minutes and is painless.
- Auditory brainstem response (ABR) – This test measures the response of your baby’s hearing nerve to sounds played through earphones. Responses are measured through small sticker electrodes placed on your baby’s skin. Testing is conducted while your baby sleeps. It can take a few minutes for a simple screening test or more than an hour for more detailed diagnostic testing. As with OAEs, the ABR test is painless for your baby.
- Tympanometry – This test measures the movement of the eardrum and can help determine how your child’s middle ear is functioning. Tympanometry does not measure your baby’s hearing, but it can detect any changes in pressure in the middle ear, fluid behind the eardrum, or a hole in the eardrum – all of which can affect your baby’s hearing.
Ideally, all babies with hearing loss will be identified by 3 months of age so treatment can begin before the baby is 6 months old. These early months are an important time for your child’s speech and language development.
Evaluating hearing in infants and toddlers may include the use of the above tests, as well as a behavioral test called visual reinforcement audiometry (VRA). In this test, your child is trained to look toward a toy or short video in response to a sound source. VRA testing is possible once your child is able to sit independently and is most often performed with children between 6 months and 30 months of age.
Hearing evaluation in preschoolers may include any of the above tests, as well as conditioned play audiometry (CPA). During a CPA test, your child is asked to respond to sounds by playing a simple game, such as throwing a block or stacking a tower. Testing is usually performed through earphones and requires your child’s cooperation. This testing is most often performed with children between 30 months and 4 years of age.
Evaluating hearing in school-age children may include the above tests, but most often is similar to the hearing test used for adults, called conventional audiometry. In this test, your child is asked to respond to sounds played through earphones. Testing resembles adult hearing testing (e.g., raise your hand when you hear a beep) and requires your child’s cooperation. This testing is most often performed on children 4 years of age and older.