Pediatric Hearing Test

The goal of a pediatric hearing test is to obtain information regarding hearing levels from children who are unable to respond in the same manner that older children and adults respond. This is done in one of two ways depending on the age of the child. For infants and young toddlers, aged 5 months to about 2.5 years of age, Visual Reinforcement Audiometry (VRA) is used. Children aged 2.5 to 4 years are tested using Conditioned Play Audiometry. During VRA testing the child is seated on the parent's lap, in a high chair or seated alone. The child must be able to sit upright and turn their head from side to side. A test assistant is seated facing the child to keep their attention forward between auditory stimuli. VRA uses lighted and/or animated toys that are flashed on simultaneously with the presentation of an auditory signal (warble tones, narrow band noise or speech) during a conditioning period.

Audiology Services ABR and Stacked ABR (Audiology Brainstem Response) Adult Acoustic Immittance ASSR Audiogram Electrocochleography ENG Instructions HINT Hearing Device Center Otoacoustic Emissions Pediatric Hearing Test Pediatric Acoustic Immittance Posturography

Once the child is conditioned, the toy is activated immediately after the child turns toward the signal. The auditory signal is presented either through speakers on the right or left side (sound field) or, if the child will accept them, through foam insert earphones. The softest level that the child responds to the auditory signal is recorded on the audiogram. Sound field testing provides information about the hearing level of only the better ear while insert earphone testing provides information about the hearing levels of each ear.

During Conditioned Play Audiometry the child is seated at a small table across from a test assistant and is instructed to place a toy in a bucket or game when a sound is heard. Typically, auditory signals are presented through insert earphones but may also be presented through sound field speakers. Initial sounds are presented well above the child’s expected threshold to familiarize the child with the task. Once the child is conditioned and understands the task, progressively softer sounds are presented until the child’s threshold is found.

Depending on the age of the child and their willingness to repeat words, a speech reception threshold (SRT) or speech awareness threshold (SAT) may be obtained. A SRT is the softest level at which the child can understand speech. The child may be asked to point to body parts, objects or pictures or to repeat two syllable words to obtain an SRT. The SAT is the softest level of speech that the child can hear. The SAT may be obtained by having the child respond to soft speech in the same way they respond to the tones for either conditioned play or VRA.

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