IDENTIFYING HEARING LOSS IN CHILDREN: SOME BASIC EVALUATIONS
When parents notice a problem with their child's hearing, their child
may need to have a hearing test and other evaluations. Some of these tests
are described below, along with a discussion of why the test information
is important to understanding and managing a child's hearing loss.
Audiological Evaluations
Behavioral Tests
Behavioral hearing evaluations are used with children who are old enough
to respond to sounds either by turning their head or by playing a game.
Behavioral testing typically takes less than 1 hour to perform.
Behavioral tests give three main pieces of information. First,
they measure the degree or amount of hearing loss. Second, they can help
in locating the problem-in the middle ear, inner ear or some combination
of the two. Third, behavioral tests provide information about how the hearing
loss will affect your child's ability to communicate. Sometimes testing
indicates that a hearing aid could help a child. To see if this is true,
behavioral testing is done while the child wears a hearing aid.
Behavioral tests usually include:
Threshold testing-measures the quietest tones or speech that
a child can hear
Word recognition testing-measures a child's ability to understand
speech at comfortable loudness levels
Middle ear testing-as part of the behavioral evaluation, a child's
middle ear might be tested for the presence of fluid or some other problem.
(The results are presented in a diagram called a tympanogram.)
Auditory Brainstem Response Evaluation
For some infants and children, behavioral testing does not provide reliable
results. In such cases, an Auditory Brainstem Response Test (ABR) may be
recommended. The ABR test can provide useful information about the type
and amount of hearing loss, the effect on communication abilities, and
the functioning of the hearing nerve.
The ABR test consists of sounds that are presented to a child's
ears through earphones while the child sleeps quietly in a crib or in a
parent's arms. The responses are measured through small electrodes taped
on the infant's head and then analyzed by computer. Testing usually takes
less than 1 hour.
Otoacoustic Emissions
Another procedure measures otoacoustic emissions-sound that is "sent out"
by the inner ear. A tiny microphone is placed in the ear canal and the
sounds are analyzed by a computer. The test can help in determining if
the child has a hearing loss. As with ABR testing, OAE testing does not
require a child's active participation and usually takes about 15 minutes.
Vestibular Evaluation
The vestibular system is part of the inner ear and provides us with our
sense of balance. It can be affected by some of the same problems that
cause hearing loss. A vestibular evaluation may help confirm the cause
of the hearing loss, and can provide information about the development
of motor skills. There are several tests that could possibly be recommended;
all of them stimulate the vestibular system in some way and measure its
responses by computer. Vestibular evaluations usually take about 1 hour
to complete.
Medical Evaluations
Otolaryngology
An otolaryngologist (ear, nose and throat doctor) completes a medical evaluation
of the hearing system and obtains a comprehensive medical history. If a
hearing loss is present, the otolaryngologist will be able to determine
if medical or surgical treatment can improve it. If a hearing aid is needed,
this doctor provides medical approval for its prescription.
Communication and Developmental Evaluations
Because hearing loss affects speech and language development and can affect
academic performance, communication skills should be evaluated by a speech/language
pathologist or an audiologist who is knowledgeable in the speech and language
development of hearing-impaired children. Developmental skills and academic
performance may be evaluated by a psychologist or a developmental specialist;
this provides information about a child's ability to learn. All this information
will be useful in developing an educational or family service plan.
Other referrals could be made based on results from these evaluations.
These might include neurology, physical therapy, occupational therapy or
social work. If you have questions or concerns, or would like additional
information about any of the evaluations described here, contact us at
(850) 584-3277 or email us at JDRussell@gtcom.net.
INFORMATION FROM Boys Town National Research Hospital,
Omaha, Nebraska