Hearing Evaluations, Tests, and Treatment
All children’s hearing should be screened shortly after birth to make sure that hearing loss is identified as early as possible. However, even for children with normal hearing, a hearing evaluation is an ongoing process, as certain types of hearing loss fluctuate or start later in childhood. For example, middle ear infection is one of the most common childhood illnesses and frequently causes a mild hearing loss. A mild hearing loss can have a significant impact on a child’s development and can be difficult to detect by informally observing a child’s reaction to sound.
It is important that a child’s hearing is assessed when there are risk factors associated with hearing loss present, or when parents are concerned about their child’s hearing abilities.
Hearing Evaluations for Children
A professional hearing evaluation consists of several tests designed to evaluate different aspects of the hearing system. It is important to do a few tests to confirm the diagnosis of hearing loss and not to rely on the result of only one test. Hearing tests are conducted in a sound proof room with ear phones to obtain ear-specific information. The following tests are included in a hearing evaluation:
- Hearing-related case history – the audiologist asks several questions relevant to your child’s hearing history.
- Otoscopic examination – the audiologist examines your child’s ear canals and ear drums with a light especially designed for ears.
- Tympanometry – the audiologist measures the function of your child’s middle ear cavity with a tympanometer. It provides useful information in the case of middle ear infection or a conductive hearing loss. This test is objective – it doesn’t require a behavioral response from your child.
- Oto-acoustic emissions – the audiologist measures the function of your child’s inner ear by placing a probe in his or her ear canal and producing click sounds. The inner ear echoes the sound back into the ear canal and the probe measures the echoes. This test doesn’t require a response from your child either.
- Auditory brainstem response testing – the audiologist measures the waveforms of the auditory nerve pathways in the brainstem in response to sound through electrodes placed on a child’s head. This test is best performed on sleeping children and doesn’t require a behavioral response from your child.
- Pure-tone audiometry – the audiologist measures a child’s behavioral response to different sounds during this test. There are different variations of pure-tone audiometry for different age groups, based on their concentration span and physical abilities.
- Speech perception tests – the audiologists measures the child’s reaction to speech with different methods based on the age of the child.
Professionals Involved in Hearing Evaluations
An audiologist is the trained professional who is responsible for hearing evaluation and rehabilitation. She works in close contact with otolaryngologists (medical doctors who specialize in diseases of the ear, nose, and throat).
Treatment for Hearing Disorders
Some hearing disorders can be corrected by treating the underlying cause of the hearing loss with medication or surgery. The otolaryngologist will make recommendations regarding medication and surgery. When the hearing loss is permanent, the audiologist will assist the parents in choosing a hearing aid for their child and provide follow-up care, hearing training, and educational support to the family. In children who have a severe to profound sensorineural hearing loss, the audiologist in consultation with the otolaryngologist might recommend a cochlear implant (insertion of electrodes in the inner ear during surgery). Children with hearing disorders almost always need help from speech-language pathologists to help with speech-language disorders resulting from hearing loss.