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Visual reinforcement audiometry (VRA)
How it is done: During VRA testing, a child is seated on an adult’s lap in a sound proof booth. Auditory stimuli are presented and the child is trained to turn to the sound and is then rewarded with an animated toy or video. The sounds, or auditory stimuli used are tones, noise bands, and speech stimuli and can be presented by earphones, loudspeakers, and bone conduction.
Who it is for: Children from 6 months of age to 2 ½ years can be tested using visual reinforcement audiometry.
What it will show: By using this technique, it is possible to obtain information about the child's hearing thresholds across frequencies.
How it is done: Play audiometry is a game-like activity where the child is taught to do a specific task, such as dropping a block in a bucket, every time a sound is heard.
Who it is for: Children from 2 to 5 years of age
What it will show: As with VRA, it is possible to obtain detailed information about the child's hearing thresholds across frequencies in both ears. At this age, children often accept earphones more readily, so that ear-specific information can be obtained. If needed, bone conduction testing can be completed, as well. Hearing thresholds will typically be plotted on an audiogram.
Conventional Audiometry
Also known as: pure tone audiometry
How it is done: A child is seated in a sound proof booth and sounds are presented by earphones. The child is taught to raise a hand or press a button each time a sound is heard. The softest sounds that the child can hear, called hearing thresholds are recorded.
Who it is for: By the age of 5 years, children are able to reliably respond using conventional audiometry.
This method is used through adulthood.
What will it show: Hearing thresholds are measured in each ear using headphones or earphones, and bone conduction, if necessary. Hearing thresholds will typically be plotted on an audiogram.
Medical Evaluations
Family physician
A child’s family physician is crucial in monitoring a child for middle ear problems and hearing loss. A family physician will routinely treat a child with antibiotics if an ear infection is diagnosed. In addition, the physician will refer the child to an otolaryngologist if the middle ear problems are persistent. A family physician is also responsible for monitoring a child’s development. Speech and language delays are the most common sign of hearing loss in children. If speech and language delays are suspected, the family physician will refer the child for a hearing evaluation to determine if hearing loss is a factor.
Otolaryngology
An otolaryngologist (ear, nose and throat doctor) completes a medical evaluation of the hearing system and obtains a comprehensive medical history. If a hearing loss is present, the otolaryngologist will be able to determine if medical or surgical treatment can improve it. If a hearing aid is needed, this doctor provides medical approval for its prescription. American Academy of Otolaryngology— Head and Neck Surgery
Medical Genetics
The purpose of a medical genetics evaluation is to determine, if possible, the cause of a hearing loss. It also may rule out any medical problems which could accompany a hearing loss. This evaluation involves a full family medical history, a physical exam of the child, a review of birth and delivery records, and, possibly, hearing tests for other family members. Based on findings of this evaluation, other tests may be recommended.
Intervention for Children with Permanent Hearing Loss
Fitting appropriate hearing aids or other sensory devices is one of the first steps in helping an infant with hearing loss. Today's advanced technology allows for the successful fitting of hearing aids on very young babies. Because language skills begin to develop within the first few months of life, it is important to fit a child with hearing aids as soon as possible.