Regardless of your child's age, there are safe, effective and accurate tests that can be used to determine how well your child hears.

Newborns and Infants

In the United States, approximately 3 of 1,000 babies are born with hearing loss.

Prior to the development of new technology in hearing testing, parents had to wait until their child was old enough to take a formal hearing test in order to check for hearing loss. Many children were not identified with significant hearing loss until the age of two or older. Otoacoustic emissions (OAE) screening allows hearing testing within the first days of life. Newborn screening is simple and painless, and could make a significant difference to a child's future.

OAE screening procedures for newborns and infants do not require the baby to respond. A miniature earphone and microphone are placed in the ear, sounds are played and a response is measured. The normal ear responds with an echo that is picked up by the microphone. When a baby has a hearing loss, no echo can be measured.
OAE screening procedures can screen each ear individualy.

About 10 percent of babies do not pass the hospital OAE screening. This is likely due to a blockage of the ear canal with birth fluids or debris, fluid in the middle ear, or movement and/or crying during the test. Most babies will pass the follow-up hearing testing, however, it is very important to take your baby for follow-up testing. This is the only way to be sure that your baby is hearing.
Newborns that do not pass the hospital screening are referred to Northwest Area Education Agency for a follow-up audiologic evaluation. If your child does not pass the follow-up hearing test, he or she may then be referred for more in-depth audiological and medical assessment. This should occur no later than 3 months of age. These assessments will verify the presence of hearing loss and help identify options for treatment.

A small number of babies born with normal hearing may develop a hearing loss after the newborn period. This condition may result from various illnesses, from genetic causes, or from certain medications.

Some children may experience fluctuating hearing loss due to middle ear infection and/or fluid. It is important to continue with regular hearing check-ups to monitor your child's hearing ability.

  • Important note: Please be aware that OAE is only a screening tool. It screens out higher pitched hearing losses and may miss a mild hearing loss or a reverse hearing loss.

Infants and Toddlers

Visual Reinforcement Audiometry (VRA)

Once a child reaches the age of 6-7 months to 2+ years old, sounds are presented through a speaker or earphone.

The child is trained to look toward the sound. When the child looks to the sound, he sees a moving toy or a flashing light.

As children mature they may be asked to point to pictures in a book, body parts, i.e. eyes, ears, nose, fingers, or objects in the room.

OAE testing may be utilized at this age if the child will tolerate the device in his ear for up to two minutes
If a child will not tolerate headphones, sounds can be played through loudspeakers, however, only the better ear is tested, and a hearing loss in one ear may be unidentified.

Conditioned Play Audiometry (CPA)

At three years old the child can usually respond to a sound by placing a block in a bucket, pegs in a board, etc. With earphones on or in both ears, the child is taught to wait, listen, and respond.


A visual inspection is made of the ear canal and eardrum using a speculum like instrument. Excessive wax or placement of PE tubes is visible.

School-aged students

Recent studies suggest that an average of 131 of every 1,000 school age children have some degree of hearing loss that affects learning and development.

The student is instructed to raise his or her hand (or touch their ear) when a tone is heard. Screening detects hearing loss greater than 20 dBHL in the frequency range from 500 through 4000Hz.

If the student does not pass the initial screening he or she is referred to the audiologist for more in-depth audiologic assessment.

The audiologist returns to the school within four weeks to determine the type and degree of hearing loss.

The audiologist reports to the parents and school with recommendations for management of the hearing loss, and educational implications.


Tympanometry introduces air pressure in the ear canal which makes the eardrum move. A special machine measures how much the eardrum moves and the amount of pressure in the middle ear. It may also indicate the presence of an opening in the eardrum or excess wax in the ear canal. Tympanometry along with a battery of tests helps determine whether the child's ears need to be examined by a physician.