hearing-tests-for-children

Why this test may be ordered

• Routine hearing screening is recommended for all newborns by 1 month of age, before school entry, and as part of regular health checkups for school-aged children.
• Complete hearing tests are needed if a child does not pass a newborn screening test (by 3 months of age), has a high risk for developing hearing loss (e.g., family history, certain infections), or shows signs of hearing loss such as not startling at loud noises, not turning toward sound after 6 months, not saying simple words by 12 months, unclear speech, not following directions, often saying 'Huh?', turning TV volume too high, or learning problems.

Preparation and collection

No special preparations are needed. It may help to tell the child what to expect, such as that they will hear sounds, and letting them try on headphones if available.

Hearing tests depend on the child's age and ability to follow instructions. For newborns, infants, and very young children, tests can be done while the child sleeps. For older children, audiometry tests are used with headphones or speakers in a sound booth.

There is no risk to having hearing tests.

Understanding results

Screening test results are reported as pass or fail. A pass indicates normal hearing for the screening; a fail indicates the child may have hearing loss and needs more complete testing. Complete hearing test results show the type and severity of hearing loss.

• Screen-negative (pass): The child's hearing appears normal for the screening. No further testing is usually needed until the next routine screening, unless there are ongoing concerns or risk factors for hearing loss. Limitation: Screening tests cannot diagnose hearing loss. A pass does not guarantee normal hearing in the future, especially if the child has risk factors. Next step: Continue routine hearing screenings as recommended. If you have concerns about your child's hearing or if your child has risks for hearing loss, talk with your child's provider about getting more complete hearing tests.
• Screen-positive (fail): The child may have hearing loss and needs more complete testing to confirm and determine the type and severity. Limitation: Screening tests cannot diagnose hearing loss. A fail does not confirm hearing loss; it indicates the need for further evaluation. Next step: Your child should have complete hearing tests as soon as possible, but no later than 3 months of age for newborns. Your child's provider will usually refer you to a hearing specialist, such as a pediatric audiologist or pediatric otolaryngologist (ENT).

• Screening tests are not diagnostic; they only indicate whether further testing is needed.
• A pass on a screening test does not rule out hearing loss, especially if the child has risk factors or if concerns persist.
• Complete hearing tests are needed to diagnose the type and severity of hearing loss.

What to do next

If your child's hearing screening test shows normal hearing, continue routine screenings. If you have concerns about your child's hearing or if your child has risks for hearing loss, talk with your child's provider about getting more complete hearing tests. If complete tests show hearing loss, treatment options depend on the type: conductive hearing loss may be treatable (e.g., removing wax, draining fluid, surgery); sensorineural hearing loss is permanent but may improve with hearing aids or cochlear implants. Other support includes working with communication professionals, education, assistive devices, and support groups. Talk with your child's primary care provider or hearing specialist for guidance.

• What type of hearing loss does my child have?
• How severe is the hearing loss?
• What treatment or support options are available for my child?
• How often should my child's hearing be rechecked?
• Are there any specialists I should see?

Evidence source

U.S. National Library of Medicine: hearing-tests-for-children