Pediatric Hearing Assessments
You’ve been told that your child needs to have their hearing checked. This can be a scary time especially when your baby is just a few days old. We understand how you’re feeling and rest assured we’ll promise to answer all your questions and to make sure your visit with us is as stress free as possible. Regardless of your child’s age, there are safe, effective and accurate tests that can be used to determine how well your child hears. Newborns and Infants In the United States, approximately 3 of 1,000 babies are born with hearing loss. Prior to the development of new technology in hearing testing, parents had to wait until their child was old enough to take a formal hearing test in order to check for hearing loss. Many children were not identified with significant hearing loss until the age of two or older. Otoacoustic emissions (OAE) screening allows hearing testing within the first days of life. Newborn screening is simple and painless, and could make a significant difference to a child’s future. OAE screening procedures for newborns and infants do not require the baby to respond. A miniature earphone and microphone are placed in the ear, sounds are played and a response is measured. The normal ear responds with an echo that is picked up by the microphone. When a baby has a hearing loss, no echo can be measured. OAE screening procedures can screen each ear individually. About 10 percent of babies do not pass the hospital OAE screening. This is likely due to a blockage of the ear canal with birth fluids or debris, fluid in the middle ear, or movement and/or crying during the test. Most babies will pass the follow-up hearing testing, however, it is very important to take your baby for follow-up testing. This is the only way to be sure that your baby is hearing. Newborns that do not pass the hospital screening are typically referred for a follow-up audiologic evaluation. If your child does not pass the follow-up hearing test, he or she may then be referred for more in-depth audiological and medical assessment by the time they are 3 months old. These assessments will verify the presence of hearing loss and help identify options for treatment. Important note: Please be aware that OAE is only a screening tool. It screens out higher pitched hearing losses and may miss a mild hearing loss or a reverse hearing loss. Infants and Toddlers Visual Reinforcement Audiometry (VRA) Once a child reaches the age of 6-7 months to 2+ years old, sounds are presented through a speaker or earphone. The child is trained to look toward the sound. When the child looks to the sound, he sees a moving toy or a flashing light. As children mature they may be asked to point to pictures in a book, body parts, i.e. eyes, ears, nose, fingers, or objects in the room. OAE testing may be utilized at this age if the child will tolerate the device in his ear for up to two minutes (the device is a small rubber tip and sometimes little ones just don’t want to sit still for two minutes!) If a child will not tolerate headphones, sounds can be played through loudspeakers, however, only the better ear is tested, and a hearing loss in one ear may be unidentified. Ages 3 – 4 At three to four years old the child can usually respond to a sound by placing a block in a bucket, pegs in a board, etc. With earphones on or in both ears, the child is taught to wait, listen, and respond. Ages 5 and up Most children once they reach the age of 5 can be tested using the same methods used with adults. The identification and diagnostic process is closely linked with a comprehensive program of early intervention, insuring the availability of important auditory information during the early, critical years of hearing development.