Hearing Tests for Children

Newborn Hearing Screenings

A newborn hearing screening requires that newborn babies have their hearing screened before leaving the hospital. There are two types of newborn hearing screenings, both are painless and can be done while the baby sleeps:

Otoacoustic emission (OAE) screening:

This test records tiny sounds that the inner ear makes in response to clicks or chirps that are delivered through a small, flexible plug placed in the infant's ear. The screening is done on each ear and a passing result confirms that the infant’s inner ears are receiving sounds.

Automated auditory brainstem response (ABR):

This test records activity of the auditory nerve in response to clicks or chirps delivered through a small, flexible plug placed in the infant’s ear. This screening is a more complete test of the auditory system, and it requires small electrodes to be taped to the baby's scalp. The screening is again done for each ear and a passing result confirms that the infant’s brain is receiving sounds.

A significant number of infants fail their first hearing screening due to fluid that may still be present in the ear canal right after birth. If your infant doesn't pass the initial hearing screening, schedule a follow-up screening with a pediatric audiologist within a couple of weeks. The majority of infants will pass the second screening quite easily. For those who do not pass the second newborn screening, a diagnostic hearing test from your pediatric audiologist will investigate further.

Hearing Testing for Infants and Young Children

Visual reinforcement audiometry

Pediatric audiologists can test infants as young as six months of age behaviorally in a sound-treated booth using a test called visual reinforcement audiometry (VRA). VRA takes advantage of an infant’s reflexive head turn toward sound. In this test, a parent will hold their child on their lap while they sit on a chair in the center of the sound booth. The audiologist will play sounds or talk through speakers that are oriented to the left and right of the child.

There are specially-designed tests to assess hearing in babies and toddlers.

When the child hears the sound and looks toward it, he or she is rewarded with a visual reinforcement toy like a flashing light or dancing bear. The infant will usually stay engaged long enough for the audiologist to get a good indication of hearing ability for at least the better hearing ear. The visually-appealing toys lose their ability to hold the child’s attention once they are toddlers. Around the age of two, social praise will work for behavioral testing.

Play Audiometry

A pediatric audiologist will use a method of testing called play audiometry for toddlers and preschool children. It's a hearing test that is made into a game for toddlers. The parent or assistant will sit on the floor in the booth with the child and train them to respond to any sound they hear by doing a certain task, like putting a block in a bucket.

When the child correctly responds to a sound, the parent or assistant sitting with them will cheer with enthusiasm. Like the visual reinforcement described above, this age-appropriate social reinforcement will typically keep the child engaged long enough for the audiologist to get a good indication of hearing ability at least for the better hearing ear. If the toddler will wear earphones, ear-specific information can be obtained.

Once a child is school-aged, he or she can usually sit still, remain quiet and raise a hand in response to speech and tone stimuli in the sound booth. At this point, the child can easily wear headphones for ear-specific measurements and sit still for tympanometry and acoustic reflex tests, as described above for adult hearing tests.