Child Hearing Test Results Explained

There are many different types of hearing tests and what they all mean can be overwhelming for parents. Once you have concluded that your child has trouble hearing, the next step is to understand what level of hearing they do have. 

This will greatly affect the treatment options and resources you will need to get your child everything they need. Treating childhood hearing loss early is crucial to minimizing the long-term effects on their speech and social development. 

Hearing Tests vs Hearing Screenings

A hearing test can also be referred to as an audiological evaluation. These are made up of different tests for various parts of the ear. A hearing screening is a quick procedure used to rule out concerns. These are the routine hearing tests done at school or well visits with doctors.

The results of a hearing screening will either be pass or referral. The referral is sometimes referred to as a failed test but this means your child will need more in-depth testing by a pediatric audiologist

A licensed audiologist is someone who has been specially trained to evaluate hearing levels. Each evaluation is a different combination of tests to determine the diagnosis of hearing loss. The results of one hearing exam will tell the specialist what test needs to be run next. 

Objective Tests

These tests determine the function of the inner, middle, and outer ear. They also measure the function of the hearing nerve and the brain stem. These tests include:

  • acoustic reflexes
  • tympanometry
  • otoacoustic emissions (OAE)
  • auditory brainstem response (ABR)
  • auditory Steady State Response (ASSR)

Tympanometry

Tympanometry measures movement in the middle ear system. This is done to determine if there is any fluid or negative pressure in the middle ear that needs medical treatment. This information is helpful if the child is sick or has chronic congestion such as allergies. 

Acoustic Reflexes

Acoustic reflexes measure the ear response (reflex) of the middle ear muscles after being exposed to loud noises. This test uses the same equipment as tympanometry and only takes about one minute to finish. 

Otoacoustic Emissions (OAEs)

OAEs look at the function of the cochlea to determine cochlear hearing loss. When sound hits the cochlea, hair cells in this organ respond with an emission. This test can also be completed in a minute. A small probe is put into the ear canal and it emits the sound and measures the response from the cochlea. 

Present otoacoustic emissions are a sign of normal hearing and absent otoacoustic emissions are a sign of abnormal hearing

ABRs and ASSRs

These tests measure the hearing nerves’ response to sounds and how it transmits that information to the brain. A comprehensive ABR test can take one to three hours. Small disks are placed on the child’s ears and head. The child must be asleep for the response to be recorded. 

Results of these tests will be used to determine if the child has hearing loss as well as the level of hearing loss and the type of hearing loss. 

Subjective Tests (Behavioral Hearing Testing)

Subjective tests, also called behavioral tests, are used when the child is old enough to respond to sounds. They use headphones or speakers in a sound-treated room to eliminate environmental sounds. There are three types of behavioral tests:

  • Behavioral Observation Audiometry (BOA): these tests are mostly used with infants who cannot turn towards a sound as a sign of hearing. All responses to sounds are observed. 
  • Visual Reinforcement Audiometry (VRA): This hearing evaluation is used after the child is old enough to turn in the direction that they hear a sound. The response behavior is recorded. 
  • Conditioned Play Audiometry (CPA): These tests are used with older children. The child will put something into a container to show the responses to speech sounds

Children with hearing loss may do these tests using their hearing aid or cochlear implants to measure the hearing they have with their devices. 

A child’s hearing can change at any age so regular hearing screenings are important to do to determine if these more in-depth hearing tests are ever necessary. 

Audiograms

An Audiogram is where the results of your child’s hearing evaluation are recorded. The number across the top tells the frequency measured in Hertz (Hz). On the left side of the graph are low pitches and on the right are the high-pitched sounds

The numbers along the left side show the loudness measured with decibels (dB). The top are soft sounds and the bottom are loud sounds

There will be other symbols on the audiogram indicating which ear or what method the sound was played. These symbols will be decoded on the audiogram’s key. Families should receive copies of the audiogram to share with other doctors, as well as, people working with the child for treatment options

Ask Questions

Parents of children who have done hearing tests should always ask for the results to be explained each time the child has a hearing test. Nobody expects you to understand all of this without asking additional questions. You can always request to make another appointment to discuss the results of your child‘s hearing tests

If you do make another appointment, write down any questions you have that you want to ask the specialist about so that you don’t forget anything. 

Hearing tests are just the beginning of your child’s journey. Once you get the results of your child’s levels of hearing, treatment options can be discussed. 

Getting treatment for your child as quickly as possible is the best way to minimize the impact of hearing loss on language development. Even mild hearing loss in children affects their speech as well as their social skills. Two things that are in crucial developmental stages when your child is young. 

Reach out to us at Southwestern Hearing Centers to get your child tested. We take the time to make sure each family understands the results and individualized treatment options so your child is getting everything they need to thrive.