Services For Infants and Toddlers

Newborn Hearing Screenings & Hearing Tests for Young Children

Infants, toddlers, and preschoolers are referred for a variety of reasons: the baby may have failed the hospital newborn hearing screening, the infant may have a persistent ear infection or delayed vocalizations, the toddler may show delayed speech or language, or the school-age child may have failed the school screen.

The most important reason for a pediatric referral for a hearing test is parental concern.

Children are never separated from their parents for the hearing test. None of the tests hurt. Children are tested with pediatric procedures involving games, light up rewards, and fun on the iPAD.

Procedures measure outer, middle, and inner ear problems, including perforated ear drums, "fluid in the ear," hearing loss, and perceptual problems. Procedures include tympanometry, acoustic reflexes, visual reinforcement audiometry, play audiometry, bone and air conduction, and otoacoustic emissions. Infants receive the Distortion Product Otoacoustic emission test and/or ABR and high frequency tympanometry. For children born with absent or underformed ears, hearing can still be quantified.

Services for children include:

• Newborn hearing screenings and evaluations reported to TDH Infant Follow-Up Program

• Visual Reinforcement and Conditioned Play Audiometry

  • Visual Reinforcement Audiometry (VRA) is a test used in the sound booth with the child seated on the parent's lap.  When an interesting sound is presented thru a speaker or an earphone, the child, by head turn, will orient to the sound and is then “rewarded” with an animated toy that lights up in a box. This is a good test for babies aged 6 months to 18 months.  Normal hearing babies will consistently turn to sounds as soft as 0-15dB.  This enables the audiologist to measure hearing levels in each ear at many pitches or frequencies.

  • Older babies and toddlers may respond to the more challenging conditioned play audiometry (CPA).  Depending on the motor skills, a baby is taught to respond with a toy each time she/he hears a sound.  They think this is a lot more fun!

• Tympanogram

  • Tests of the middle ear are quick and painless. A tympanogram indicates if the eardrum is moving back and forth correctly, if there is a hole ( perforation) in the ear drum, and/or if fluid is gathering in the middle ear.  Abnormal results usually indicate a (temporary) conductive hearing loss in that ear. Sometimes, the abnormal results point to a problem with the movement of the ossicles, the three tiny bones In the middle ear.

• Otoacoustic Emissions

  • Appalachian Audiology can test hearing in newborns as young as a few hours old using a diagnostic test called Otoacoustic emissions. Two types of otoacoustic emission testing are available at Appalachian Audiology:  Distortion Product and Transient Evoked otoacoustic emissions.  Both tests capitalize on the discovery that a normal cochlea, the hearing organ in the inner ear, will generate a sound in response to a sound, and the generated sound can be recorded at every pitch with normal hearing sensitivity present.

• ABR Testing

  • The Auditory brainstem evoked response equipment has Bluetooth compatibility which permits some movement and sedation is not necessary.

• Hearing Aid Fitting using DSL probe microphone measures

• FM / Remote Microphone Systems

• Custom Swim Molds for children with PE tubes or eardrum perforations