In order to get a comprehensive picture of your child’s hearing more than one test should be taken into consideration. But what test should be conducted?
Here’s everything you need to know about getting your child’s hearing tested:
There are many tests that can assess your child’s hearing. Some tests are more comprehensive than others, but each test provides valuable information about the overall picture of your child’s hearing.
Typically, the age of your child will determine what tests are needed. However, please know that your child’s cooperation and developmental abilities also factor into which tests the audiologist may choose.
There are two main kinds of hearing tests: objective and behavioral. Both objective and behavioral tests are beneficial and typically the results of both are taken into consideration when making a hearing loss diagnosis.
Objective hearing tests do not require your child to respond or participate when he or she hears a sound.
These tests are generally used for infants and young children, children with developmental disabilities, children that will not cooperate, when other tests are inconsistent or unreliable, and to confirm results of behavioral testing.
Examples of objective hearing tests include:
Auditory Brainstem Response (ABR): An ABR is typically completed for infants and children who cannot reliably respond to behavioral hearing tests. An ABR provides information about the function of the auditory pathway to the level of the brainstem. Technically an ABR is not a hearing test, but is used to detect hearing loss. A sound (click, chirp, or toneburst) is played in the ears through earphones and the response to the sounds are recorded. These recordings are analyzed and provide an estimate of hearing sensitivity.
Otoacoustic Emissions (OAEs): OAEs provide information about the function of the sensory hair cells inside the hearing organ (cochlea). OAEs can be used as a screening tool or as a diagnostic test. Sounds are sent into the ear with a small tip and a microphone records the response of the sound from the cochlea.
Tympanometry: Tympanometry provides information about how well the eardrum and middle ear are working. A gentle puff of air is delivered into the ear and the amount the eardrum moves in response to change in air pressure is recorded. This test can help determine if there is a whole in the eardrum, if there is potential fluid in the middle ear, and if a P.E. tube is open of closed.
Acoustic reflexes: Acoustic reflexes provide information about how a muscle in the middle ear contracts in response to loud sounds and helps confirm the presence of hearing loss and possible pathologies. A tip is placed in the ear and a noise is played at the same time as a loud tone stimulus which elicits a reflex.
Behavioral hearing tests require your child to respond when he or she hears a sound. These tests are generally used for children who can sit still and are interested in the hearing test.
Examples of behavioral hearing tests include:
Visual response audiometry (VRA): VRA is typically completed for children 6 months to 2.5 years of age or older children that do not respond to CPA and pure tone audiometry. VRA provides information about how the child hears and responds to sounds across different pitches. Sounds are presented through headphones or a loudspeaker. Children will naturally turn their heads in respond to the sound and are reinforced to keep listening and turning their head with an animated toy or video.
Conditioned Play Audiometry (CPA): CPA is typically completed for children 2.5 years of age to 5 years of age. CPA provides information about how the child hears and responds to sounds across different pitches. Sounds are presented through headphones or a loudspeaker. Children will engage in a game activity every time a sound is heard. One example is having children drop a block in a bucket when they hear a sound.
Pure tone audiometry: Pure tone audiometry is typically completed for children 5 years of age and older. Pure tone audiometry provides information about how the child hears and responds to sounds across different pitches. Sounds are presented through headphones or a loudspeaker. Children are asked to push a button or raise their hand when they hear a sound.
“Here, they are testing how he hears without his #hearingaids on in a sound treated test booth. The audiologist sits in the booth next to us and delivers various sounds at various pitches through the earphones Julian has on. Then he was tested on speech discrimination, or how clearly he recognizes speech. The audiologist speaks single words and Julian has to repeat what he thinks he has heard. She has to cover her mouth, because he knows how to read lips, and at one point he told her “Can you stop cobering you mouf? I can’t see what you saying?” 😂” – Thanks to @myorganizedchaos for sharing this sweet moment! #lifeison
A hearing test can help determine if a hearing loss is present, if one or both ears are affected, the type of hearing loss, the degree of hearing loss, if the hearing loss can be treated medically (e.g. P.E. tubes) or with hearing technology (e.g. hearing aids, cochlear implants, and assistive technology), and how this hearing loss will affect your child and his or her ability to communicate.
The status of your child’s hearing can change over time. Some hearing losses are temporary and can be treated medically while other hearing losses are permanent.
Further, the severity of some hearing losses can change (either become better or worse) while other hearing losses remain stable overtime. Therefore, it is recommended that children with established hearing loss have a hearing test at least once a year to have a current picture of the child’s hearing.
If your child is younger or hearing tests have been incomplete or inclusive this might require multiple hearing test appointments in a year.