Our team aims to ensure early identification and treatment for each child that we evaluate at CHKD.

There are several types of tests that we use in order to assess your child’s hearing. Our audiologists choose the appropriate tests based on factors such as age, level of comfort and cooperation, and developmental concerns. For your child’s hearing test appointment, the audiologist may use one or more of the following tests.

Types of Tests

Visual Reinforcement Audiometry (VRA)

The child is trained or conditioned to turn or look towards a sound source, i.e. loudspeaker. When the child gives the desired response, this is reinforced or rewarded by a toy that lights up or animates. This test is conducted in the sound booth and the child typically sits on a parent’s lap. Earphones may be worn depending on the child's cooperation. This test is most often used for children ages 6 months to 3 years. 

Conditioned-Play Audiometry

For this test, the child is taught to throw a ball/block in a bucket or put a peg on a board in response to hearing a sound. The sound is transmitted through earphones while the child sits independently or on a parent's lap in sound booth. The child may be assisted in the game by another audiologist or audiology student. This test is most often used for children ages 3-5 years. 

Comprehensive Audiometry (Puretone and Speech Audiometry)

The child is asked to respond each time a tone is heard through the ear phone. The elicited response may be raising a hand, saying a catch word, or pressing a button. The child may also be asked to repeat a list of words. This is typically used for ages 5 years and up. 

Tympanometry/Acoustic Immittance

This test helps to determine how the middle ear is functioning, by assessing the movement/mobility of the eardrum, pressure in the middle ear space, the middle ear’s muscle reflex. To perform this test, a small probe is placed in the child’s ear canal and a slight pressure is applied. Tympanometry is obtained as part of the audiological evaluation on children of all ages.

Otoacoustic Emissions (OAE) Testing

Otoacoustic Emissions (OAE) testing assesses the function of the cochlea or inner ear. To perform this test, a small probe is placed in the child’s ear which plays a series of sounds. The probe then records the otoacoustic emission which is a sound produced by the ear in response to the stimulus. It is very important for the child to be quiet and relatively inactive during this test. OAE testing is most often obtained as part of the audiological evaluation on children of all ages. It is specifically used as a screening test on newborns/infants.

Auditory Brainstem Response (ABR)

The ABR test measures the brain’s waveform EEG activity in response to sound. Electrodes that temporarily adhere to the child’s forehead and scalp are used to record these brain waves, and the sounds are transmitted through earphones.  This test is often ordered for children who are difficult-to-test or children who are too young to be tested behaviorally. 

Unsedated (sleep-deprived) ABR

Often utilized for children less than four months of age. The child brought to the test in a sleep-deprived state so that he/she will sleep naturally during the test. 

Sedated ABR

Often utilized for children over four months of age. The child is sedated in coordination with nursing and medical staff for the ABR test.