Audiology Info

Newborn/Infant Hearing Screening

In this office, we use an otoacoustic emissions (OAE) test to evaluate newborn and infant’s hearing. As the baby rests quietly, a small probe tip (like an earplug) is placed into the ear canal and two tones are simultaneously presented. Once the cochlea (organ of hearing) processes the sound, an electrical stimulus is sent to the brainstem. In addition, there is a second and separate sound that does not travel up the nerve but comes back out into the infant’s ear canal. This “byproduct” is the otoacoustic emission. The emission is then recorded with the microphone probe and represented pictorially on a computer screen. The audiologist can determine which sounds yielded a response/emission and the strength of those responses. If there is an emission present for those sounds that are critical to speech comprehension, then the infant has “passed” the hearing screen. This test can take as little as 5 to 8 minutes if the infant is in a quiet, peaceful, resting state. If an infant fails the hearing screen, it is unknown if there truly is a hearing loss, how much hearing loss is present, or whether or not the hearing loss is permanent or correctable. However, if hearing loss is suspected, your child will be referred for an additional physiological test (know as auditory brainstem response testing) to determine the type and severity of their loss.

Comprehensive Hearing Evaluation

A hearing test is performed with the patient in a sound treated room, while the audiologists uses a piece of equipment called an audiometer to deliver sounds through either headphones, insert earphones (soft sponge material), speakers, or a bone oscillator (a headband with a vibrating piece placed on the bone behind the ear). The patient is instructed to respond by either raising their hand or pressing a button on a responder. For younger children, more age appropriate strategies are utilized (explained below). This test measures the softest sound detectable (intensity) across a range of frequencies (pitch). This testing determines the type and degree of hearing loss. During the evaluation, speech testing is also performed, in which the patient is asked to repeat a list of words to determine their speech reception thresholds (softest decibel level a person can correctly repeat back spondee words) and speech discrimination abilities.

Visual Reinforcement Audiometry

Visual reinforcement audiology (VRA) testing evaluates the hearing of infants from six months to two years. Sounds of varying intensity and speech are presented to one of two speakers as the child sits on a parent’s lap. If a sound is heard by the child, then he or she turns toward the appropriate speaker and is rewarded by a visual stimulus, such as an animated toy conditioned play audiometry or a flashing light.

Conditioned Play Audiometry

This test is appropriate for children from two to five years of age. The child is instructed to listen for a sound and to respond when a sound is heard by doing varying tasks, such as placing a block in a bucket or placing a peg in a pegboard. Headphones may be worn by the child for this type of testing. Once the child is conditioned, threshold of hearing can be determined by decreasing signal intensity to the softest point that the child still performs the task. Speech thresholds (described above) are typically obtained by having the child identify pictures, objects or body parts.

Middle Ear Analysis

Using a procedure called tympanometry, the audiologist obtains an objective measurement of middle ear mobility of the eardrum, the volume of the external ear canal, and pressure within the middle ear system. The data obtained provides middle ear analysis information related to several pathological conditions of the middle ear, most commonly acute otitis media (ear infections). This allows for a more collaborative diagnosis and assures the most accurate treatment or management strategies.