Infants and children
Hearing problems, even those that are mild, can delay your child's
speech and language development. Early screening for
hearing loss can help prevent a variety of learning,
social, and emotional problems that can be related to speech and language
development.1
Hearing tests may be a part of a well-child
appointment. In most hearing tests, your child responds to how well he or she
hears a series of tones or words (subjective testing). Hearing is also tested
by examining your child's ears or by using an instrument to measure how the
ears react to sound (objective testing). In objective testing your child is not
asked to respond to sounds. The Committee of Practice and Ambulatory Medicine
and the American Academy of Pediatrics have recommended that:2
- Newborns' hearing should be tested with a
hearing test (objective testing).
- Children ages 1 through 12 months
should be tested by asking you about your child's hearing.
- Children at 15, 18, and 24 months and 3 years should be tested
subjectively.
- Children 4 years old should be tested
objectively.
- Children ages 5 to 10 years old should be tested
objectively at 5, 6, 8, and 10 years old.
- Children and teens ages
11 to 21 should be tested objectively at 12, 15, and 18 years old and be tested
subjectively at the other yearly checkups.
Birth to 28 days
If your newborn has one or more high-risk factors, it is
particularly important to have these hearing tests. These risk factors
include:3
- A family history of hearing
loss.
- Certain infections of the mother during pregnancy. These
include
toxoplasmosis,
rubella,
genital herpes, and
syphilis.
- An ear or other face or skull
abnormality, such as
cleft lip and
palate.
- Jaundice that
requires a blood transfusion.
- A birth weight less than
1.5 kg (3.3 lb).
- Bacterial
meningitis.
- Low
Apgar scores (0 to 3 at 5 minutes, or 0 to 6 at 10
minutes).
- Problems breathing.
- Having had
mechanical ventilation for more than 10
days.
- Using medicine that may cause hearing loss (ototoxic
medicines) for more than 5 days.
- Having physical features that are
often seen with a disease that results in hearing loss, such as
Down syndrome.
29 days to 24 months
When your child is between 1 month and 24 months old, a hearing
test is important if your child has:
- Any of the newborn risk factors listed
above.
- Received a blow to the head that causes a broken
bone.
- A disease often seen with hearing loss, such as
mumps or
measles.
- A disease of the brain or nervous
system, such as Charcot-Marie-Tooth syndrome, which can result in muscle
weakness, primarily in the legs and sometimes in the hands.
Call your doctor if at any time you suspect your child has a
hearing problem, such as if your baby does not seem to respond to loud noises
or your young child is not making sounds or talking at the expected
ages.
An
audiologist may check a baby's hearing using several
different methods. One method, called otoacoustic emissions (OAE) testing, is
done by placing the small, soft tip of an instrument in a baby's ear canal to
measure the inner ear's response to sound. In auditory brain stem response
(ABR) testing, sounds are emitted from the soft tip of an instrument placed in
the baby's ear canal. Three small electrodes placed on the surface of the
baby's head record the brain's response to the sound. Both tests are best
performed when the infant is quiet.
After 6 months of age, your child may be tested with conditioned
play audiometry (CPA). In this kind of testing, children respond to a number of
different high-pitch and low-pitch (frequency) sounds, as well as to speech.
Most provinces and territories in Canada offer newborn hearing
tests for babies born in hospitals. Also, many health organizations and
physician's groups recommend routine screening. Talk to your doctor about
whether your child has been or should be tested.
Adults
Adults are
tested at their regular checkups. Subjective tests are
generally used.