Hearing Evaluation and Diagnosis

Your baby’s hearing evaluation is made up of several different tests to measure how much your baby can hear in each ear and whether the hearing loss can be corrected by surgery or managed by devices, such as hearing aids.

Be Prepared

Bring someone with you to the scheduled hearing evaluation appointment. A family member or close friend can support you when the results are shared and if a treatment plan is explained. If your baby is diagnosed with hearing loss, the news can be a surprise or shock and this may be an emotional time. It can help to have another person with you to offer support.

How Do You Test a Baby's Hearing?

You won't be able to test your baby's hearing at home. You'll need a pediatric audiologist to run a set of tests using specialized equipment. Your audiologist will explain the purpose of each test and what it means for your baby's hearing. These tests include auditory brainstem response (ABR) and otoacoustic emissions (OAE). They're gentle, safe, and won't cause your baby any discomfort or pain.

Depending on the age of your baby, they may be tested using behavioral audiometry. For this testing, you and your baby will most likely go into a soundproof booth together and your pediatric audiologist will present sounds and observe your baby's responses. Since you'll be with your baby throughout the testing you can observe the responses as well.

Find an Audiologist

There are several ways you can find an audiologist. Try using a directory from the American Academy of Audiology (AAA) or the American Speech-Language-Hearing Association (ASHA).

What the Test Results Mean

Your pediatric audiologist will talk to you about the results of your baby's hearing evaluation. They'll be able to clearly explain what the testing does and doesn't tell them about your baby's hearing.

Diagnosing hearing loss takes more than just one testing session. Depending on a number of factors, your audiologist may ask you to schedule another appointment for further testing. If your baby's hearing is in the normal range, they'll provide information about future hearing screenings if needed.

If your baby is diagnosed with hearing loss, a lot of information will be shared with you. Your audiologist will discuss what type of hearing loss your baby has, how severe it is, and how to get started with the right devices so your baby can hear.

Audiogram

An audiogram is a visual picture that shows what speech sounds your child can hear at the time of testing. You'll learn about your child's audiogram which will help you better understand their hearing loss.

Range of Hearing Loss

You'll learn if their hearing loss level is mild, moderate, severe, or profound. With advances in hearing technology, even babies with profound hearing loss, often identified as deaf, are learning to listen and talk.

Type of Hearing Loss

There are two basic types of hearing loss – conductive and sensorineural.

• Conductive hearing loss is caused by problems in the outer or middle ear, such as an ear infection, wax buildup, or a problem with how the ear is formed. This may be corrected with medical treatment or surgery.
• Sensorineural hearing loss means the problem is in the inner ear or cochlea – the part of the ear that receives, organizes, and transfers sound through nerves to the brain. This type of hearing loss is permanent, which means that it can't be corrected with surgery, but listening and talking are still possible with hearing devices, such as hearing aids or cochlear implants.

Location of Hearing Loss

Your baby may have hearing loss in only one ear (unilateral) or both ears (bilateral).

Cause of Hearing Loss

In many cases, the cause of your baby's hearing loss may be unknown. If possible, your pediatric audiologist and ear-nose-throat doctor (ENT) will help determine a cause.

Generally, there are two types of causes. Hearing loss can be caused by hereditary or genetic factors that have different likelihoods of occurrence. Hearing loss can also be caused by environmental events such as lack of oxygen at birth, infections, head trauma, or medications. Sometimes, it's both genetic and environmental factors that cause hearing loss.

Timing of Hearing Loss

The timing can vary. If the hearing loss is present at birth or shortly thereafter, it's known as congenital hearing loss. Hearing losses that happen after the child has started to learn to talk is known as acquired hearing loss.

Other Professionals You May Need

Typically your baby is referred to a medical doctor who specializes in childhood ear and hearing problems – like an ear-nose-throat (ENT) doctor or an otologist. They'll examine your baby to see if there's a medical solution to their hearing loss. Your baby may be referred for other diagnostic tests, such as X-rays or MRI scans, to further define the type and source of the hearing loss.

Ongoing Audiology Services

After diagnosis and hearing device fitting, you’ll return often for audiology services. At first these appointments may be more frequent to make sure your baby or child has access to all the sounds of speech through their devices. These frequent appointments are important for your pediatric audiologist to assess your child's hearing and their devices so any change or drop in hearing can be detected quickly.

Seeing the pediatric audiologist on a regular basis is key to creating the best listening and spoken language outcomes for your baby. As they grow, the visits will usually become less frequent. Your audiologist will guide you on how often you and your baby need to return for appointments based on their hearing devices and health.

You’ll return often in the first year for new earmolds. Earmold fittings are critical to your baby’s success with their hearing aids.

If you ever suspect a problem with the hearing device or a change in your baby’s hearing, contact your audiologist quickly. It’s not unusual for hearing loss to progress but there are still hearing technology options for your baby to hear.