Prisma Health Pediatric Otolaryngology–Greenville

Auditory brainstem response

ABR testing is a painless electrophysiological test that provides the audiologist with information about the inner ear and auditory nerve. Electrodes are placed on the infant’s forehead and earlobes which record neural responses as different auditory stimuli are presented through small insert earphones. The ABR provides information on the degree, type, and configuration of a hearing loss. This information is used to help fit hearing aids and determine cochlear implant candidacy.

Auditory steady state response

ASSR is another electrophysiological testing using the same electrodes, which provides more frequency-specific threshold information for infants who have severe to profound hearing losses.

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Otoacoustic emissions

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A cochlea that is functioning normally not only receives sound, it also produces low-intensity, measurable sounds called OAEs. When greater than mild loss of hearing is present, OAEs are absent. A small soft tip housing a sensitive microphone is placed in the ear canal to measure OAEs.

Immittance measures

Include tympanometry and acoustic reflex testing to assess the function of the eardrum and middle ear bones. The mobility of the eardrum can be measured, and the middle ear can be checked for the presence of fluid. Acoustic reflexes protect our inner ear from loud noise. The presence or absence of the reflex can help determine the type and severity of hearing loss.

Behavioral audiometry

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As a child matures and is able to provide hearing results behaviorally, hearing information can be measured with greater specificity. During audiometric testing, the audiologist finds the lowest intensity level (threshold) at which a child can detect sound at different frequencies or pitches. From this information, a graphic representation of the hearing loss, called an audiogram, is created. The hearing loss will typically be classified as mild, moderate, moderately severe, severe, or profound.

For infants 6-36 months of age, visual reinforcement audiometry is the test method of choice. In VRA assessment, the infant/child is seated on a caregiver’s lap in a soundproof booth. The child is trained to turn toward a lighted, movable toy when they hear a sound. This method typically results in obtaining a measurement of hearing for the better ear.

An older toddler can be trained for conditioned play audiometry. In this assessment, the audiologist teaches the child to drop a ball in a bucket or engage in some other fun response activity when they hear a tone presented through earphones. This method of testing usually results in an ear specific measurement of hearing.

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