Hearing Evaluations for Children
The audiological methods used to test children are often different than those used for adults, and yet our audiologists are trying to obtain the same information. Sometimes, young children are given a more play-like activity to indicate response. The most common techniques involve visual reinforcement audiometry (VRA) and conditioned play audiometry (CPA).
Visual reinforcement audiometry is the method of choice for screening children between 6 months and 2 years of age. The child is trained to look toward a sound source. When the child gives a correct response (e.g., looking to a source of sound when it is presented), the child is "rewarded" through a visual reinforcement. Example rewards include getting to watch a toy that moves or a flashing light.
Conditioned play audiometry can be used as the child matures and is commonly used with toddlers and preschoolers (ages 2–5). The child is trained to perform an activity each time a sound is heard. The activity may involve putting a block in a box, placing pegs in a hole, or putting a ring on a cone.
Visual reinforced audiometry and conditioned play audiometry both rely on the child’s participation and willingness to respond to sound. Additional tests, which are objective, are often used with the VRA or CPA or in lieu of the behavioral tests if a child is not a willing participant
Otoacoustic emissions (OAEs) are sounds given off by the inner ear when the cochlea is stimulated by a sound. When sound stimulates the cochlea, the outer hair cells vibrate. The vibration produces a nearly inaudible sound that echoes back into the middle ear. The sound can be measured with a small probe inserted into the ear canal. Otoacoustic emissions are present when there is normal hearing.
Tympanometry is another objective test that evaluates the middle ear space. A probe is inserted into the ear canal and sound and pressure is introduced. If the is no blockage in the ear canal and middle ear space, our audiologists can determine if the middle ear is functioning correctly.
The Auditory Brainstem Response (ABR) test gives information about inner (cochlea) and brain pathways for hearing. This test is also sometimes referred to as auditory evoked potential (AEP). The test can be used with children or others who have a difficult time with conventional behavioral methods of hearing screening.
The ABR is performed by pasting electrodes on the head—similar to electrodes placed around the heart when an electrocardiogram is run—and recording brain wave activity in response to sound. The child will be rest quietly or sleep for this test.
Our office is not equipped to offer ABR testing. If our audiologists feel a child requires this test they refer the family to a clinic that offers it.