Screening and Testing
Screening and Testing Infants & Children
with a quick, painless test that can be done
while a baby sleeps. Shown here is an AABR set-up.
Speech and language skills start to develop early in a child’s life. Within months of birth, babies begin to hear and recognize the rhythm and melody of speech and often respond with cooing sounds when someone talks to them. An untreated hearing problem can slow the development of speech, language, thinking, and learning skills. Early screening, diagnosis, and treatment can help children who have hearing loss develop in ways that are more comparable to hearing children.
Most hospitals screen all newborns with one of two tests that are quick, painless, and often done while the baby is sleeping.
- Otoacoustic Emissions Test (OAE) - A small device connected to a machine is placed in the baby’s ear. The machine sends sounds to the inner ear. The “echo” of the sound coming from the inner ear is recorded. The machine analyzes the “echo” and compares it with normal inner ear function.
- Automated auditory brainstem response (AABR) - A small device that makes special sounds is placed in the baby’s ear and surface recorders are are placed on the head. A machine measures the hearing nerve's response to the sounds. It analyzes the response to see if it matches that of infants with normal hearing.
If a baby fails either of these tests, it is usually repeated. Keep in mind that an abnormal screening test result does not confirm a hearing problem. A full hearing evaluation is needed with a specialist—an audiologist or an ENT (ear, nose and throat specialist)—who deals with babies.
Parents can also watch for development milestones to monitor for signs of any possible hearing problem in their child.
The following responses are generally found in children with normal hearing:
- Newborns – usually respond (“startle” or jump) in response to a sudden loud noise. Will sometimes turn head in direction of sound.
- By 2 months – baby's hearing has improved. The baby should now able to hear sounds in different pitches, intensities and intonations.
- By 3-4 months – baby usually recognizes parent's voice, can vocalize consonant sounds (m, k, g, p, and b), and sometimes couples these sounds with vowel sounds.
- By 5-6 months – Baby may start laughing, and babbling sounds start sounding more like speech sounds.
- By 8-9 months – Baby starts to understand the relationship between words and gestures.
- By 11 -12 months – understands many words and is starting to learn names of body parts. Should be making simple words (like “Mama" or "bye-bye")
If you suspect any type of hearing problem in your child, talk with your pediatrician about getting your child a complete hearing evaluation.
If a child needs a full hearing evaluation by a specialist (an audiologist, or an ENT -- ear, nose and throat specialist), some or all of the following tests may be performed.
An infant or child may need a full hearing evaluation if:
- The infant or child does not seem to respond to sounds the same as other children, or is not developing skills similar to children the same age (based on reports by parents, teachers, or health professionals)
- Newborn screening tests suggested a potential problem
- The baby did not get newborn screening test in a hospital
- The child has many ear infections
- The child has certain diseases that can cause hearing loss (for example meningitis or other diseases)
- The child is diagnosed with another condition that sometimes includes hearing loss
A full hearing evaluation may include some or all of the following tests.
Test |
Age of infant/child |
What happens |
Diagnostic Auditory Brainstem Response |
under 6 months or older |
|
Visual Reinforcement Audiometry (VRA) |
6 months to 2 years |
|
Conditioned Play Audiometry (CPA) |
2 years to 4 years |
|
Tympanometry |
any age |
|