The Audiology Offices provides audiological care to the pediatric population. Undiagnosed hearing loss can be especially damaging to children, since hearing plays an integral role in the development of speech and language skills. Pediatric hearing loss is broken down into two categories: congenital and acquired. Congenital hearing loss is present at birth and may be caused by genetic factors, infections or illness. Acquired hearing loss is any type of hearing loss that appears after birth. This type of hearing loss can be caused by ear infections, illness, head injury and exposure to a loud noise.
Diagnostic Hearing Services
Many of the hearing exams used with adult patients are subjective and require the patient’s cooperation. Purely objective tests must be used with children.
Newborn hearing screenings are performed before the child leaves the hospital. This screening consists of two test: auditory brainstem response (ABR) and otoacoustic emissions (OAEs). ABR measures the auditory nerve’s response to sound. Soft earphones are placed on the newborn’s ears and three electrodes are placed on the newborn’s head. A series of clicks or tones are played and the electrodes pick up the nerve’s response to the sounds. The otoacsoutic emissions measure the cochlea’s response to sound. A small probe, which contains a speaker that generates sounds and a microphone that can pick up the echo of the OAEs, is inserted into the ear canal. A series of sounds is broadcast through the probe. Any OAEs that are produced are then picked up by the microphone.
These tests are performed while the newborn is sleeping and only take five to ten minutes to complete. If the newborn does not pass the tests they will be referred to an audiologist to have more detailed tests performed. This should be done before the child is three months old.
Pure tone audiometry can be converted to test patients between six months and five years old. Headphones are not used; the sound is broadcast through speakers in a sound booth. Instead of asking the child to raise their hand whenever they hear a tone, they are trained to complete play-like activities.
Visual reinforcement audiometry is used with children between six months and two years of age. The child is trained to look toward the sound source. Every time they correctly complete this task they are rewarded with a visual reinforcement, such as watching a toy move or a flashing light.
Conditioned play audiometry is appropriate for children two to five years of age. When they hear a sound they are trained to perform an activity, such as putting a block in a box or placing a peg in a hole.
Tympanometry is used to determine how well the middle ear is functioning. The child is seated and a small rubber tip is inserted into the entrance of their ear canal. This creates a buildup of air pressure within the ear canal. A graph called a tympanogram is then created, which measures the movement of the patient’s eardrum and middle ear function. This information can be used to determine if there is fluid in the middle ear, a malfunction of the ossicular chain (bones in the middle ear), a perforated eardrum or a stiff eardrum.
Acoustic reflex testing is used to determine how well a child’s middle ear is functioning. An acoustic reflex is the response of the small muscles in the middle ear when exposed to a loud sound. The volume level at which an acoustic reflex occurs is used to confirm the results of other hearing tests.
If it is determined that the child has hearing loss, there are a wide range of treatment services available, including:
- Hearing aids
- Cochlear implants
- Speech therapy
- Assistive listening devices