If you think that your child has a hearing loss the first step is to speak with your medical practitioner to refer your child for an audiological evaluation.

Auditory Brainstem Response (ABR) Screening

This testing can be carried out from newborn to 6 months of age. The screening shows simply that a child’s hearing is not at a normal level. If a child refers/fails a screening test he/she will be referred for a more detailed evaluation. In recent years the legislation in California has recommended that all newborns be screened for hearing loss at birth. The Newborn Hearing Screening Program monitors each baby that is born in participating hospitals. NHSP makes appropriate referrals if the baby does not pass the hearing screen while inpatient.

Frequently asked questions about an ABR.

If your child needs to have an ABR with sedation, click here.

For ABR information in Spanish, click here. (PDF)

Behavioral Hearing Test

These tests usually require the child to respond to soft sounds in some way (verbally, by picture pointing, raising the hand or through a game). These tests can be fun and for infants and toddlers, a head-turn response to a test signal is usually the best and most reliable testing method.

Behavioral Observation Audiometry (BOA)

Used for children age 6-10 months of age. Child is placed in sound booth on caregivers lap and behavioral responses are observed to speech and warble tones in a soundfield (no headphones). Looking for subtle changes in breathing, eye widening or startle responses. Responses in the 40dbHL - 60dbHL.

Visual Reinforcement Audiometry (VRA)

Visual Reinforcement Audiometry (VRA) is a behavioral audiometric test obtained in a sound-treated room. The child is seated on a parent's lap or in a chair between two calibrated loudspeakers, or using earphones. When a sound such as a tone at a specific frequency, speech, or music is presented, the infant's eye-shift or head-turn response toward the sound source is rewarded by activation of a lighted mechanical toy mounted near the loudspeaker. The child's attention then is distracted back to the midline by an audiologist so that additional sounds can be presented. Any test performed through loudspeakers rather than earphones is called "soundfield" audiometry and does not test each ear separately; rather, soundfield audiometry yields an audiogram for the better-hearing ear if there happens to be an ear difference in hearing. However, if the child tolerates wearing earphones, then the test assesses hearing in each ear separately. For children age 7 months to 2 1/2 years.

Conditioned Play Audiometry-(CPA)

Conditioned Play Audiometry is a behavioral audiometric test obtained in a sound-treated room. The child wears headphones while performing this test. The child is shown how to perform a repetitive play task, such as placing a peg in a pegboard, each time he or she hears a sound. Accurate separate-ear audiograms by air and bone conduction may be obtained. If the child refuses to wear headphones or a bone conduction oscillator, the test can be administered in the soundfield. For children age 2 1/2 years to 5 years.

Conventional Audiometry

During this hearing test, the child raises his/ her hand, upon hearing a tone. Thresholds of detection for six frequencies in each ear are measured, through headphones.

If a hearing loss is present, the test is repeated through a bone conduction oscillator to determine whether the hearing loss is conductive, sensorineural or mixed in origin.

This test is typically done for children ages 5 years old or older

Otoacoustic Emission Testing (OAE)

This test provides a unique way to examine the function of the cochlea. Sounds are sent to the patient’s ear with a small loudspeaker. A microphone then records the response to the sound from the cochlea (known as an emission). This offers valuable information about the sensory hair cells in the cochlea.

Tympanometry

This test helps determine how well the eardrum and middle ear are functioning. A soft puff of air is delivered into the child’s ear and the amount the eardrum moves in response to changed in air pressure is recorded. If the eardrum does not move, for example, it could mean there is fluid behind the eardrum and otitis media with effusion may be present.

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