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 a tablet Procedures measure outer, middle, and inner ear problems, including perforated ear drums, "fluid in the ear," inner ear hearing loss, and perceptual problems.

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 (currently not available at Appalachian Audiology)

Hearing Aid Fitting using DSL probe microphone measures

Remote Microphone Systems

Custom Swim Molds for children with PE tubes or eardrum perforations

Hearing Tests for Adults

A diagnostic hearing evaluation is individualized, based on the history you (and/or your famiy) provide, the reason for the test, and the health status of the individual being tested. The test takes place in a large sound booth with a very large window facing the audiologist.

Testing meets the State of Tennessee's requirements for a hearing evaluation:

Air conduction

Bone conduction

Word discrimination in quiet and with background noise

Frequency specific measurement of tolerance to loud sounds

Otoscopy

At least eight frequencies are measured, depending on the severity of the hearing loss. The frequency range is 125 Hz to 20,000 Hz. Tympanometry and acoustic reflex testing is added to the test protocol if indicated.

A diagnostic hearing test is necessary to fit an individual with hearing aids, to quantify a sudden hearing loss or to provide helpful information to the physician who referred for a specific reason.

The audiologist will interpret the results, answer questions, and provide you with specific goals and recommendations.

An auditory processing test may be recommended for people with normal hearing sensitivity but difficulty hearing in some environments.

With cognitive decline or delay, short attention span, motor delay, pre-verbal ability, fear of new places, or touch aversion come a need to modify the typical test battery and speed of procedures.

We have physiologic tests available for both children and adults that provide information on hearing sensitivity without a need for a verbal response.

We provide a quiet environment for testing and will go at the pace needed to get accurate information.