HEARING TESTS FOR CHILDREN
- NEWBORN HEARING SCREENING
Reneé Verson Audiologists are the monitoring Audiologists for the Port Elizabeth in-hospital baby hearing screening program.
- FREQUENTLY ASKED QUESTIONS:
How is new-born hearing screening performed?
A baby’s hearing is screened by means of a test known as the Otoacoustic Emissions Test (OAE) or Automated Auditory Brainstem Response Test (AABR).
What is an Otoacoustic Emissions (OAE) test?
- This test is an objective assessment of the outer hair cells of the cochlea.
- This test is quick and non-invasive.
- The test works on the principle that a healthy cochlea in the inner part of the ear will produce a faint echo when stimulated with sound.
- A small rubber probe is placed in the baby or toddler’s ear and soft click sounds are presented at different pitches. If the cochlea is functioning properly, the probe will detect echos. A result of Pass or Refer is obtained.
- Pass: the hearing is within acceptable limits and re-assessment of hearing is recommended at 12 months.
- Refer: the baby will require a second hearing assessment within 2 – 6 weeks.
Reasons for a ‘Refer
- Birth fluid in the ear canal.
- Ear canal does not allow effective probe fitting in the ear.
- Baby was unsettled during the test.
- Temporary hearing loss (e.g. fluid in the middle ear).
- Permanent sensorineural hearing loss.
What is an Automated Auditory Brainstem Response (AABR) test?
The AABR test assesses the cochlea to include the auditory nerve.
- The test is quick and non-invasive.
- The test measures how the auditory nerve responds to sound.
- Three small sensors, attached to an earphone, are placed on your baby’s head using a jelly-like substance. The machine makes a soft clicking sound. As the baby listens to the sounds through the ear cup, the sensors record and measure how your baby’s brain responds to the clicks. A ‘Pass’ or ‘Refer’ result is obtained. This test may take up to 3 minutes or longer to complete per ear.
- Pass: The hearing is within acceptable limits and re-assessment of hearing is recommended at 12 months or if there are any other concerns.
- Refer: The baby will require a second hearing screening within 2 – 6 weeks.
Reasons for a ‘Refer’
- Birth fluid in the ear canal.
- Baby was unsettled during the test.
- Temporary hearing loss (e.g. fluid in the middle ear).
- Permanent sensorineural hearing loss.
What are the advantages of these tests?
- The tests are quick and results are obtained immediately.
- Can be conducted while your baby is asleep.
- Does not hurt your baby.
- Results are accurate.
- Can also detect a mild hearing loss or hearing loss in one ear.
- Can be performed in hospital before discharge.
- Toddler to Pre-School (1 - 3 years)
After newborn hearing screening at birth, a follow-up monitoring assessment is recommended at 1 year of age. Thereafter periodic hearing screening should follow at age 5, 6, 7 and 8 years.
Parents should keep in mind that a critical speech and language developmental stage occurs between the ages of 2 years and 3½ years. This is an important time for ears to be open and hearing. If any sign of selective listening or lack of listening response from your child is noted, be sure to contact your Audiologist for an appointment. Make sure your child can hear everything.
- FREQUENTLY ASKED QUESTIONS:
How do you test a toddler?
Tests will depend on your child’s age and level of co-operation.
This may include:
Otoscopic Examination
- Looking into the ear.
Tympanometry
- This is an objective assessment of middle ear functioning.
- This test is quick, non-invasive and takes a couple of seconds to perform.
- A soft rubber tip is placed at the entrance of the ear canal. The child will hear a low humming sound and experience a slight feeling of pressure.
Otoacoustic Emissions (OAE) test
- This test is an objective assessment of the outer hair cells of the cochlea.
- This test is quick and non-invasive.
- The test works on the principle that a healthy cochlea in the inner part of the ear will produce a faint echo when stimulated with sound.
- A small rubber probe is placed in the baby or toddler’s ear and soft click sounds are presented at different pitches. If the cochlea is functioning properly, the probe will detect echoes. A result of Pass or Refer is obtained.
Visual Reinforcement Audiometry (VRA)
- This is a subjective behavioural test assessing your child’s response to sound and speech.
- This test is performed in a sound proof booth.
- Your child sits on your lap and is conditioned to respond to sounds by receiving a visual reward.
- This test is performed using speakers or headphones, depending on your child’s age and co-operation.
All of the above tests are used to obtain an overall picture of your child’s functional hearing ability.
DISCLAIMER: IT IS IMPORTANT TO NOTE THAT CHILDREN IN THIS AGE GROUP MIGHT NOT ALWAYS BE WILLING OR ABLE TO PARTICIPATE IN THE ABOVE ASSESSMENT. IN THIS EVENT THE CHILD MIGHT REQUIRE REPEAT TESTING OR MAY BE REFERRED FOR DIAGNOSTIC TESTING UNDER SEDATION.
One of the typical problems identified in this age group includes Otitis Media (middle ear infections)
Otitis Media, better known as middle ear infection, is one of the most common illnesses amongst children under the age of 5.
During the infection the child’s middle ear is filled with fluid. This causes a distortion in the sound reaching the child’s inner ear. As a result your child experiences a temporary hearing loss. Untreated allergies and exposure to secondary smoke increases the child’s risk of developing an infection.
When a child suffers from chronic middle ear infection his/her hearing abilities may fluctuate. This may put the child at risk for developing poor listening skills which in turn can influence:
- Speech and language development
- Reading, writing and mathematical abilities
- Academic performance
- Attention
- Emotional and social development
- FREQUENTLY ASKED QUESTIONS: MIDDLE EAR INFECTION
What are the signs and symptoms of middle ear infection?
- Complaining of painful ears
- Visible discharge from the ear that may be foul smelling
- Hearing difficulty
- Complaining of a full or blocked ear
- Fever, nasal congestion and irritability
- Balance problems or dizziness
- Rubbing or pulling on the ears
What to do if you suspect that your child has an ear infection?
- It is recommended to consult with an Ear-, Nose- and Throat Specialist or your Paediatrician who will be able to diagnose and prescribe the correct treatment.
- An Audiologist will also be able to identify the presence of a possible middle ear infection and determine whether or not a hearing loss is developing as a result of recurrent infections.
- Preschool and school aged (4 years and up)
It is very important to ensure that your child can hear well during the initial schooling years. This is the time when phonics, reading and spelling is introduced forms the foundation for future academic learning. It is also often the time when other problems such as Auditory Processing difficulties or Attention difficulties are identified.
- FREQUENTLY ASKED QUESTIONS:
How do you test children in preschool?
TESTS WILL DEPEND ON YOUR CHILD’S AGE AND LEVEL OF CO-OPERATION.
THIS MAY INCLUDE:
Otoscopic Examination
- Looking into the ear.
Tympanometry
- This is an objective assessment of middle ear functioning.
- This test is quick, non-invasive and takes a couple of seconds to perform.
- A soft rubber tip is placed at the entrance of the ear canal. The child will hear a low humming sound and experience a slight feeling of pressure.
Otoacoustic Emissions (OAE) test
- This test is an objective assessment of the outer hair cells of the cochlea.
- This test is quick and non-invasive.
- The test works on the principle that a healthy cochlea in the inner part of the ear will produce a faint echo when stimulated with sound.
- A small rubber probe is placed in the baby or toddler’s ear and soft click sounds are presented at different pitches. If the cochlea is functioning properly, the probe will detect echoes. A result of Pass or Refer is obtained.
Play Audiometry
- This is a subjective behavioural test assessing your child’s response to sound.
- This test is performed in a sound proof booth.
- You accompany your child into a sound proof booth where they are then conditioned to respond when a sound is heard. This is done in the form of a game.
- This test is performed using headphones or speakers, depending on your child’s age and co-operation.
Speech Audiometry
- This is a subjective test assessing your child’s response to speech.
- A young child is often asked to follow instructions and identify pictures or objects. As they become older and their receptive language improves they are asked to repeat words.
- This test is again performed using either headphones or speakers, depending on your child’s age and co-operation.
