Screening hearing test

Screening and Diagnosis of Hearing Loss

Hearing Screening

Hearing screening is a test to tell if people might have hearing loss. Hearing screening is easy and not painful. In fact, babies are often asleep while being screened. It takes a very short time — usually only a few minutes.

CDC Report: Infants with Congenital Disorders Identified Through Newborn Screening — United States, 2015–2017

Babies

• All babies should be screened for hearing loss no later than 1 month of age. It is best if they are screened before leaving the hospital after birth.
• If a baby does not pass a hearing screening, it’s very important to get a full hearing test as soon as possible, but no later than 3 months of age.

Older Babies and Children

• If you think a child might have hearing loss, ask the doctor for a hearing test as soon as possible.
• Children who are at risk for acquired, progressive, or delayed-onset hearing loss should have at least one hearing test by 2 to 2 1/2 years of age. Hearing loss that gets worse over time is known as progressive hearing loss. Hearing loss that develops after the baby is born is called delayed-onset or acquired hearing loss. Find out if a child may be at risk for hearing loss.
• If a child does not pass a hearing screening, it’s very important to get a full hearing test as soon as possible.

Full Hearing Test

All children who do not pass a hearing screening should have a full hearing test. This test is also called an audiology evaluation. An audiologist, who is an expert trained to test hearing, will do the full hearing test. In addition, the audiologist will also ask questions about birth history, ear infection and hearing loss in the family.

There are many kinds of tests an audiologist can do to find out if a person has a hearing loss, how much of a hearing loss there is, and what type it is. The hearing tests are easy and not painful.

Some of the tests the audiologist might use include:

Auditory Brainstem Response (ABR) Test or Brainstem Auditory Evoked Response (BAER) Test

Auditory Brainstem Response (ABR) or Brainstem Auditory Evoked Response (BAER) is a test that checks the brain’s response to sound. Because this test does not rely on a person’s response behavior, the person being tested can be sound asleep during the test.

ABR focuses only on the function of the inner ear, the acoustic (hearing) nerve, and part of the brain pathways that are associated with hearing. For this test, electrodes are placed on the person’s head (similar to electrodes placed around the heart when an electrocardiogram (EKG) is done), and brain wave activity in response to sound is recorded.

Otoacoustic Emissions (OAE)

Otoacoustic Emissions (OAE) is a test that checks the inner ear response to sound. Because this test does not rely on a person’s response behavior, the person being tested can be sound asleep during the test.

Behavioral Audiometry Evaluation

Behavioral Audiometry Evaluation will test how a person responds to sound overall. Behavioral Audiometry Evaluation tests the function of all parts of the ear. The person being tested must be awake and actively respond to sounds heard during the test.

Infants and toddlers are observed for changes in their behavior such as sucking a pacifier, quieting, or searching for the sound. They are rewarded for the correct response by getting to watch an animated toy (this is called visual reinforcement audiometry). Sometimes older children are given a more play-like activity (this is called conditioned play audiometry).

With the parents’ permission, the audiologist will share the results with the child’s primary care doctor and other experts, such as:

• An ear, nose and throat doctor, also called an otolaryngologist
• An eye doctor, also called an ophthalmologist
• A professional trained in genetics, also called a clinical geneticist or a genetics counselor

For more information about hearing tests, visit the American Speech-Language-Hearing Association website.

Get Help!

• If a parent or anyone else who knows a child well thinks the child might have hearing loss, ask the doctor for a hearing screening as soon as possible. Don’t wait!
• If the child does not pass a hearing screening, ask the doctor for a full hearing test.
• If the child is diagnosed with a hearing loss, talk to the doctor or audiologist about treatment and intervention services.

Hearing loss can affect a child’s ability to develop communication, language, and social skills. The earlier children with hearing loss start getting services, the more likely they are to reach their full potential. If you are a parent and you suspect your child has hearing loss, trust your instincts and speak with your doctor.

Hearing Screening

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Regular hearing screenings can help you maintain your hearing health. An audiologist can check your hearing and give you feedback on important next steps. Audiologists are health care professionals who provide patient-centered care in the prevention, identification, diagnosis, and evidence-based treatment of hearing, balance, and other related disorders for people of all ages. Visit ASHA ProFind to locate a professional in your area.

A hearing screening is a quick test to see how well you hear different sounds. You either pass or fail the screening. If you pass and have no other hearing concerns, then you can continue with regularly scheduled hearing screenings. If you fail, or if you have other concerns about your hearing, then you may need more in-depth testing to see if you have a hearing loss and what treatment options may be right for you.

You can have a hearing screening at any age. Most states have newborn hearing screening requirements in place. Children get screenings at school or at the doctor’s office. Adults can go to the doctor or local health fairs for a screening.

You should ask your doctor for a hearing screening if you have concerns about your or your child’s hearing. An audiologist can give you a more complete hearing test if you fail the screening. This is called an evaluation, and you should have it done as soon as possible after the failed screening.

Newborns and Infants

Today, most hospitals screen babies’ hearing shortly after birth. Failing the hearing screening does not mean that your baby has a hearing loss. Not all babies pass the hearing screening the first time. Your baby can get a second screening to verify the results.

Hearing screenings for newborns and infants are simple and painless. Your baby rests or sleeps during the test. The two common screening methods for babies are otoacoustic emissions (OAEs) and auditory brainstem response (ABR).

What happens if your baby fails the hearing screening? You would take your baby to see an audiologist for a complete hearing test. It is important to find out--as early as possible--if your baby has a hearing loss. You can get your baby help with their hearing so that they can use and learn from the sounds around them.

Even if your baby passes the screening, he may have problems hearing later. If you have a family history of hearing loss or if you think that your child has trouble hearing, talk to your doctor, and ask for a hearing test. You may be able to get a screening through your local school district or health department. Contact your local Early Intervention program to ask about screenings, testing, and treatment for hearing loss.

Older Children and Adults

A pure-tone test is the most common screening for older children and adults. You may remember putting on earphones and raising your hand when you heard a beep. This is a pure-tone test. Your child should get a screening in school every few years. You should get your hearing checked on a regular basis as well. Hearing loss may happen as you get older. Regular screenings will help you keep track of your hearing and get help when you need it.

Take care of your hearing like you take care of the rest of your body. Get your hearing screened. See an audiologist if you have any concerns.

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Hearing tests for children

The hearing test helps to determine if there is a hearing loss, whether it affects one or both ears, what degree and type of hearing loss, and whether the hearing loss can be treated or corrected by technical means (for example, hearing aids, cochlear implants and assistive devices). technologies) and how this hearing loss will affect the child and their ability to communicate.

Various types of hearing tests

Audiological screening

Audiological screening usually only detects the presence of a hearing loss in a child. Screening procedures are fast, reliable and painless. If the child does not pass the screening test, they are referred to a specialist for a more detailed examination.

Objective hearing tests

These methods do not require the child to react or participate when they hear a sound. They are usually performed on infants and young children, children with developmental disabilities or non-contact children; in cases where the results of other tests are inconsistent or unreliable, as well as to confirm the results of behavioral testing. nine0004

• Acoustic stem evoked potential (ASEP): the sound is reproduced through headphones, the reaction to sound stimuli is recorded. The analysis of the obtained recordings makes it possible to assess the sensitivity of hearing.
• Otoacoustic emission method (OAE): The OAE method provides information about the functioning of sensory hair cells inside the organ of hearing (cochlea). Sound signals are fed into the already through a miniature speaker, and the microphone records the reaction of the snail to the sound. nine0019
• Tympanometry: This test method provides information on the functional state of the tympanic membrane and middle ear. An air jet is directed into the ear under a small pressure, and the intensity of the tympanic membrane vibrations is recorded in response to a change in air pressure. This test helps to determine if there is a hole in the eardrum, as well as to detect the presence of fluid in the middle ear.

Behavioral hearing tests

Behavioral tests provide information about how a child hears sounds of different frequencies and reacts to them. Sound signals are given through headphones or speakers. The audiologist monitors and records the child's reaction to the quietest of the reproduced sounds and, based on the data obtained, builds a graph called an audiogram.

How hearing loss is measured

Sounds have different pitches, called frequency, and different volume levels, called sound intensity. The unit of sound frequency is hertz (Hz), the unit of sound intensity is decibel (dB). The range of frequencies we hear includes both low (250 Hz) and high frequencies (8000 Hz). The range of sound intensity levels we perceive ranges from 0 dB (very quiet sound) to 120 dB (very loud sound). A hearing test is a determination of how quiet sounds in each frequency range we can hear. nine0004

Audiogram

The results of a hearing test are recorded on a graph called an audiogram (a visual representation of a child's hearing sensitivity). An audiogram shows the quietest sounds a child hears. Sounds are quiet and loud, as well as low-frequency and high-frequency. The graph shows both the volume and the frequency of the sound. The area of ​​very quiet sounds is at the top of the graph, and the area of ​​very loud sounds is at the bottom of the graph. Low frequencies are located on the graph on the left, high frequencies on the right. nine0004

Degrees of hearing loss

Degree of hearing loss refers to the severity of hearing loss. In children, hearing sensitivity is usually described as an average.

• Normal hearing: 0 to 20 dB
• Mild hearing loss: 21 to 40 dB
• Moderate hearing loss: 41 to 65 dB
• Severe hearing loss: 66 to 90 dB
• Profound hearing loss: 91 dB or more

Hearing loss often affects the ability to understand speech. In particular, a person stops hearing consonant sounds /p/, /k/, /f/, /x/ or all sounds like /t/, /sh/ and /s/. nine0004

Frequently Asked Questions about Hearing Tests

Why does my child need a hearing test?

Your child may need a hearing test for several reasons:

• Your child did not have an audiological newborn screening or an audiological screening at school
• You, your loved ones, or your child's teacher are concerned that your child is having trouble hearing or following directions
• Your child reported hearing problems
• Your child is having ear surgery
• Your child is about to undergo medication that could affect hearing

How often should my child have a hearing test?

Your child's hearing may change over time. Some forms of hearing loss are transient and treatable, while others are irreversible. In addition, the severity of some forms of hearing loss can change (both for better and for worse), while other forms of hearing stay the same over time. Therefore, it is recommended that children diagnosed with hearing loss be screened at least once a year to be able to monitor for possible changes. If the child is small, or the hearing test was previously incomplete or did not give an unambiguous result, then several visits to the doctor for a hearing test may be required during the year. nine0004

Who will test my child's hearing?

A pediatric audiologist with expertise in infants and young children will perform a comprehensive hearing examination. He will discuss the test results with you, answer your questions, and explain the next steps to evaluate and, if necessary, correct your child's hearing loss.

How do children hear

hearing loss nine0004

Help your child

Hearing screening for newborns and young children

Given the importance of early detection and timely correction of hearing impairments, the hearing screening program for all newborns is currently being implemented in more than 50 countries. Hearing screening of newborns is an integral part of the program for the early detection and correction of hearing impairments in children, aimed at improving the quality of life of children with identified impairments by preventing secondary speech disorders, speech delay, poor academic performance and psycho-emotional disorders. nine0004

Standards for the implementation of the program for the early detection and correction of hearing impairment in children were formulated by the Joint Commission on Children's Hearing (USA) in 2007 and are generally accepted throughout the world. This is the so-called “1-3-6 Principle”, according to which:

• Hearing screening is carried out for all newborns until they reach the age of 1 month , optimally until they are discharged from the maternity ward
• Audiological diagnosis (determining the degree and nature of hearing impairment) with positive screening results, i.e., detection of hearing impairment, is performed on all children until they reach the age of 3 months
• Rehabilitation of hearing impairment (hearing prosthetics) for all children with identified irreversible hearing impairment begins no later than they reach the age of 6 months

Programs for early detection and correction of hearing impairments in children are not currently implemented in Ukraine. In this regard, objective auditory screening has been established at the CSR AURORA Medical Center based on the use of the most reliable screening method - registration of short-latency auditory evoked potentials (SEPs). This screening method detects hearing loss caused by damage to the middle ear, inner ear, auditory nerve and brainstem. nine0004

Hearing screening based on ABR registration is carried out using modern equipment by experienced specialists of the AURORA Center, the screening results are evaluated by an otolaryngologist-audiologist. Depending on the screening results, recommendations are developed on the tactics of managing the child.

In case of a positive result of the screening test, indicating the likelihood of a hearing impairment in a child, we recommend a diagnostic hearing examination to identify the nature and degree of hearing loss, determine treatment and diagnostic tactics. nine0004

If the screening test is negative, the doctor may recommend follow-up with a follow-up screening in a few months to detect possible late hearing loss after reviewing the pregnancy and childbirth history. This is especially important if the child has certain somatic and genetic diseases.