Hearing Testing
Normal Hearing in Children
between 0-3 months, the child: | between 3-6 months, the child: |
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between 6-9 months, the child: | between 9-12 months, the child: |
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How is Hearing Tested?
- Audiogram
- Otoacoustic emission (OAE) testing
- Auditory brainstem response (ABR) testing or Brainstem Auditory Evoked Response (BAER) testing
Pure tone testing, represented by an audiogram, is the foundation of an audiological evaluation. Pure tone test results are used to confirm normal hearing or describe the configuration and severity of hearing loss. Most pure tone testing is performed in a sound-treated booth using headphones, through which tones are delivered. The patient is instructed to raise her or his hand or push a button when a tone is detected. With children or special-needs adults, play or visually-reinforced techniques can be used to assess responses to the tones. Screening using pure tone testing by audiometer should be conducted in a sound-treated booth or quiet area.
The Human Hearing Chart to the left shows human hearing in hertz frequencies and the range that audiograms test. The range of hearing that the audiogram represents is shown on the chart in the shaded area labeled “AUDIOGRAM.” You can view a larger version of the Human Hearing Chart (


Otoacoustic emission (OAE) testing is often used to test hearing in babies and small children and is the method most commonly used in newborn screening programs. The OAE involves placing a small probe in the baby’s ear that measures an active response, generated from the inner ear or cochlea, to clicks presented in the frequency range of about 800-4000 Hz. This test can only determine if normal cochlear function is present – it cannot specify the degree (mild, moderate, severe, or profound) or type (conductive or sensorineural) of hearing loss, if present. The range of hearing tested by OAE is shown on the human hearing chart in the shaded box labeled “OAE” (top near the middle). Many pediatricians and early intervention specialists use OAE to screen for hearing loss.
When conventional testing cannot be done, the ABR (aka Brainstem Auditory Evoked Response or BAER) is used. This is especially helpful with young children or older children with developmental delays that make behavioral testing unreliable. It can be performed on young infants during a natural sleep state. For older infants and toddlers, it is usually done with sedation because a child must be completely still during the test. ABR involves recording the brain’s activity in response to clicking sounds, in a frequency range from 500-4000 Hz, delivered to the child’s ear. The intensity of the sound can be increased up to about 105 dB. Compared with the broad range of human hearing, the frequency range of this test is somewhat narrow. However, the range that is tested encompasses the common frequencies that are needed for speech and language development. The ABR is not a hearing test but rather a test of the auditory-neural response to sound. ABR test reports may be complex but will include a summary that should include the clinical relevant findings and their implications for hearing and follow-up. See an example of a Child ABR Report (

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Infant receiving an ABR hearing test. Image from the Provincial Health Servces Authority of Canada website. Permission requested. |
Normal adult ABR curves. Reprinted with permission from Journey into the World of Hearing, www.cochlea.org, R. Pujol et al., NeurOreille Montpelier. |
Who Can Provide Pediatric Hearing Testing?
Costs and Insurance Coverage
Resources
Information & Support
For Professionals
American Academy of Audiology
Resources for professionals who test, treat, and provide care to the deaf or hard of hearing.
Utah Medicaid Audiology Provider Manual
Utah Medicaid Program, past and current Audiology Provider Manuals.
Genetics in Primary Care Institute (AAP)
Contains health supervision guidelines and other useful resources for the care of children with genetic disorders; American
Academy of Pediatrics.
For Parents and Patients
Support
Family Voices
A national, nonprofit, family-led organization promoting quality health care for all children and youth, particularly those
with special health care needs. Locate your center or F2F HIC (Family-to-Family Health Information Center) by state on this
site.
AUDIENT Alliance for Accessible Hearing Care
The AUDIENT Alliance for Accessible Hearing Care Program is designed for individuals whose income is above the government's
established poverty levels, but still find it difficult to afford quality hearing care.
General
Hearing Tests (My Baby's Hearing)
Overview of hearing testing in children; Boys Town National Research Hospital.
Practice Guidelines
Harlor AD Jr, Bower C.
Hearing assessment in infants and children: recommendations beyond neonatal screening.
Pediatrics.
2009;124(4):1252-63.
PubMed abstract / Full Text
Joint Committee on Infant Hearing.
Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs.
Pediatrics.
2007;120(4):898-921.
PubMed abstract / Full Text
Tools
2017 Bright Futures Periodicity Schedule (AAP) ( 119 KB)
Recommendations for preventive pediatric health care; American Academy of Pediatrics.
Guidelines for Medical Home: Reducing Loss to Follow-Up in Newborn Hearing Screening (AAP) ( 160 KB)
One-page algorithm for follow-up of the newborn hearing screen beginning with the first newborn pediatric patient care visit
National Center for Medical Home Implementation, sponsored by the American Academy of Pediatrics.
Services for Patients & Families in New Mexico (NM)
Service Categories | # of providers* in: | NM | NW | Other states (5) (show) | | ID | MT | NV | RI | UT |
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Audiology | 275 | 2 | 29 | 51 | 7 | 24 | 53 | |||
CSHCN Administration & Programs | 7 | 1 | 1 | 1 | 2 | 1 | 7 | |||
Early Intervention for Children with Disabilities/Delays | 163 | 2 | 153 | 24 | 28 | 14 | 54 | |||
Speech and Hearing Services | 117 | 1 | 24 | 27 | 5 | 14 | 10 |
For services not listed above, browse our Services categories or search our database.
* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.