Hearing Tests for Children

Most people don’t know that you can test a child’s hearing, even though they are just a few days old!

No single test can assess all areas of hearing, so expect your child to have a few tests. Your child’s age and history will decide which tests are used. Don’t worry – all of the tests are safe and painless!

0 to 6 months:

Infants are not able to respond to soft sounds, so they need different hearing tests. We use otoacoustic emissions (OAE) and auditory brainstem response (ABR) to test their hearing. These tests work best when the infant is sleeping!

OAE - A small probe that sends out a quiet sound is placed in the infant’s outer ear.  We record an “echo” response from their inner ear. The computer estimates if the ear has detected the sound.

ABR - Small sensors are placed on the child’s head to check the electrical activity from their skin. A small earphone sends out quiet clicking sounds of differing loudness. The computer measures the changes in the electrical activity to figure out whether or not the sound has been detected. By changing the pitch and loudness of the click, we can estimate the infant’s hearing.

6 to 30 months:

We test this age group using a method called visual reinforcement audiometry (VRA). During this test, the audiologist watches the child’s head turns in response to voice or sounds of different pitch and loudness. The child is rewarded with a visual toy for their response. This test is often used together with OAE testing.

30 months to 5 years:

Children who are 2.5 - 5 years of age can be tested using play audiometry. Play audiometry is very similar to an adult-style hearing test. The difference is that the audiologist will play a game that involves the child doing a simple task (like placing a peg on a pegboard) when he or she hears a sound. Most children have fun and don’t even know they are being tested.

At this age, we can also start to look at how they respond to speech by asking them to repeat simple words.

5 years and older:

Testing children at this age is very similar to testing adults. Though they may need a little more encouragement and reward for listening, they are able to raise their hand when they hear a sound or repeat words, even when they are very quiet.

At any age, we can also test how well the middle ear works with a test called tympanometry. A small probe is placed in the child’s ear canal, and by changing the pressure in their ear canal we can measure the movement of their eardrum. This is not a test of hearing, but it can help the audiologist find out if they have fluid or infection in their middle ear. Children with chronic middle ear problems, commonly called otitis media, may also have hearing problems that need treatment.

Who should be referred?

Good hearing is very important for a child’s development and education. A child should be referred for a hearing test if there is any concern regarding the child’s hearing. Preschoolers, who have slow speech and language development, or speech that is difficult to understand, should be referred for a hearing test. For school-age children, common signs of  hearing loss include difficulty in school, or turning the volume up on the TV or computer.  

Click here for a guide to hearing milestones.

Who can refer?

Nova Scotia Hearing and Speech Centres (NSHSC) has an open referral policy whereby parents/caregivers, teachers, doctors and related professionals with parental consent may refer a child for assessment.

Click here to download the NSHSC referral form.

Who can refer?

Referrals and questions may be directed to your local NSHSC site.