Hearing tests for children

Hearing tests check how well your child hears. There are many types of hearing tests. Your hearing specialist (audiologist) may use one or more tests, depending on your child's age and the problem.

Your child may have hearing tests as a newborn in the hospital or as part of a well-baby or well-child visit, or because you believe your child may have a hearing problem. The tests may also be used to find the type of hearing loss your child has and how severe it may be.

Before starting any hearing tests, the hearing specialist may check your child's ear canals for earwax and remove any hardened wax. The wax can make it hard for your child to hear the tones or words used during testing.

For some tests, your child will need to wear headphones.

Auditory brain stem response (ABR) testing

In this test, electrodes are taped to your child's scalp and on each earlobe. Clicking noises are then sent through earphones. The electrodes monitor the brain's response to the clicking noises and record the response on a graph.

Otoacoustic emissions (OAE) testing

OAE testing is often used to test newborns for hearing problems. For this test a small, soft microphone is placed in your baby's ear canal. Then a small probe that bends easily is placed in your child's ear to play sounds. The microphone detects the inner ear's response to the sound.

Conditioned orienting responses (COR) or visually reinforced audiometry (VRA)

These tests are used to check younger children. A sound is played toward the child through loudspeakers. The child looks toward the sound to show that they hear it. The child is rewarded by seeing a toy on the speaker move or a light go on.

Tuning fork tests

The tuning fork is struck to make it vibrate and produce a tone. Sometimes the tuning fork will be placed on your child's head or behind your child's ear.

Audiometry tests

These tests check how well your child can hear.

In pure tone audiometry, a machine called an audiometer plays a series of tones through headphones. The tones change in pitch and loudness. The person giving the test will reduce the loudness of a tone until your child can no longer hear it. Then the tone will get louder until your child can hear it again. If your child can hear the tone, your child will signal by raising a hand or pressing a button.

The headphones will then be removed. A special vibrating device will be placed on the bone behind your child's ear. Again, your child will signal each time they hear a tone.

In play audiometry, the child responds to the tone they hear by a play activity, such as dropping a block or putting a toy in a container.

Speech reception and word recognition tests

In these tests, your child hears a series of simple words spoken with different degrees of loudness. Your child is asked to repeat the words. The specialist measures the level at which your child can no longer hear the words well enough to repeat them.

Tympanometry

This test measures how flexible the eardrum is and how easily it vibrates and sends sound through the inner ear. It is often used to check for fluid in the middle ear. The soft tip of a small tool is placed into your child's ear canal and is adjusted to get a tight seal. Sound and air pressure are then directed toward the eardrum. The test isn't painful. But your child may feel a slight change in pressure.

• Try to have your child avoid loud noises for 12 to 16 hours before these tests.
• Tell the doctor if your child takes or has taken antibiotics that can damage hearing, such as gentamicin.