Hearing Tests, Pediatric

A hearing test is a test to check for hearing loss in one or both ears. A hearing screening is a quick and simple hearing test to see whether more in-depth tests are needed. If your child passes the screening, this means that he or she does not have hearing loss. If the results of the screening show that there could be a problem, your child may need to see a hearing specialist (pediatricaudiologist) for more detailed testing and evaluation.

Hearing loss can affect a child's ability to reach developmental milestones, including language and communication goals. Knowing early that a child has hearing problems can help the child's health care provider take steps to treat the problem. This will help the child reach his or her development goals.

What are the different kinds of hearing tests?

• Otoacoustic emissions (OAEs) testing. This test uses an earphone to measure OAEs, which are vibrations produced by tiny hairs in the inner ear (cochlea) in response to sounds. OAE testing can also help detect blockage in the outer ear or fluid in the middle ear.
• Auditory brainstem response (ABR) testing. This tests the function of the inner ear (cochlea) and how it sends signals to the brain. In this procedure, small discs attached to wires (electrodes) are placed on the head to record how the brain responds to sound. This test is painless. Your child must stay very still and relaxed during the test. ABR testing may be done:
  • While your infant is napping.
  • After giving your child medicine to make him or her sleep (general anesthetic). This may be necessary for young children who have a hard time staying relaxed and still.
  • While your older child is awake, if he or she is able to sit quietly without moving.

• Pure-tone testing. This test records the softest tones that your child can hear at different pitches (frequencies), from low to high. Your child may wear earphones for this test and be asked to raise a hand or push a button after hearing the tone. The test may involve visual rewards or playful activities to help your child complete the test.
• Speech testing. This test records the faintest speech sounds that your child can hear. This also tests your child's ability to hear words and repeat them back at a normal speaking level.
• Tests of the middle ear, such as tympanometry. These tests show whether there is:
  • Fluid in your child's middle ear.
  • Wax buildup.
  • Problems with the eardrum, muscles, or air circulation in the middle ear.

How is a hearing test completed?

Most infants get hearing screenings in the hospital before they go home after birth. Most children and adolescents get hearing screenings at school and at checkups with a health care provider. Many hearing tests are done in a room with special equipment. Some tests, such as speech testing, are done in a noisy environment to see if your child can block out background noise.

• Ask questions about your child's symptoms and medical history.
• Check inside your child's ears with a lighted instrument (otoscope).

Follow these instructions at home:

• Limit exposure to loud noises for several hours before your child has a hearing test.
• If your child is having ABR testing under general anesthesia, follow instructions from your child's health care provider about how to prepare your child for the procedure. These instructions may include eating and drinking restrictions.
• Before the test, let your health care provider know if your child has:
  • A cold or an ear infection.
  • Earwax buildup.
  • Recent injury.
  • Recent noise exposure, such as listening to loud music with headphones.
  • Medical symptoms, such as headache, memory problems, or fatigue.

What are some questions to ask my child's health care provider?

• How will my child's testing be done?
• What are the risks of the test?
• When will I get the results?
• Would you explain the test results?
• Will my child need more testing?

Summary

• A hearing test is a test to check for hearing loss in one or both ears. A hearing screening is a quick and simple hearing test to see whether more in-depth tests are needed.
• Many hearing tests can be completed to assess hearing loss. These include otoacoustic testing, auditory brainstem response, pure-tone testing, and speech testing.
• Hearing loss can affect a child's ability to reach developmental milestones, including language and communication. Early assessment and intervention are important to help children meet development goals.