Hearing Tests for Children: A Complete Guide

Hearing plays a vital role in a child’s development — it supports language, communication, social interaction, and learning. The American Academy of Pediatrics recommends newborn hearing screening before leaving the hospital or within the first month of life. Additionally, children should have their hearing checked regularly as they grow.

Types of Hearing Tests for Children

Hearing tests for children require specific techniques compared to adults. Some tests are suitable for all ages, while others are adjusted based on a child’s age and developmental ability.

• Newborns:
  • Otoacoustic Emissions (OAE):
    A quick, non-invasive test that measures sound produced by the inner ear in response to gentle clicks. A small earphone is placed in the baby’s ear to deliver soft sounds while a microphone records the response. It is painless and only takes a few minutes.
  • Auditory Brainstem Response (ABR):
    Measures the electrical activity of the auditory nerve and brainstem in response to sound. Electrodes are placed on the baby’s head, and soft clicking sounds are played through earphones. This test is also quick and painless.

  Babies with hearing loss should be identified by 3 months of age, allowing treatment to begin before 6 months for optimal speech and language development.

• Infants:
  • Behavioral Observation Audiometry (BOA):
    Observes a baby’s responses to sounds through earphones or speakers. The baby is seated on a caregiver’s lap while the tester notes responses such as eye or head movements.
• Toddlers:
  • Conditioned Play Audiometry (CPA):
    Uses play-based activities — for example, placing a toy in a bucket — to encourage responses to sound. It helps determine the child’s hearing threshold. Suitable for children older than 2 years.
  • Visual Reinforcement Audiometry (VRA):
    Trains the child to turn toward the sound source, rewarding correct responses with visual cues like lights or animations. Suitable for children aged 6 months to 2 years.
• Older Children (Over 5 Years):
  • Pure Tone Audiometry:
    The child listens to tones of various pitches and volumes through earphones and responds when they hear the sound.
  • Tympanometry (Impedance Audiometry):
    Evaluates middle ear function by detecting changes in air pressure. It doesn’t measure actual hearing but helps identify middle ear issues. The child must stay still during the test.

When Are Hearing Tests Performed?

• Within the First Month of Life:
  Newborn hearing screening is usually done before leaving the hospital. Babies born at home should be screened within the first month.
• From 6 Months to 5 Years:
  Additional hearing tests are often performed as part of developmental assessments or when there are concerns about a child’s hearing.

It’s essential for parents to detect hearing issues early, as they can affect speech, language, social, and educational development. With early intervention, most children with hearing loss can learn to adapt and thrive. Many schools now also require hearing tests before enrollment to ensure equal learning opportunities for all children.