Hearing Evaluations

Infants, Toddlers, and Young Children

Did you know that one to three of every 1,000 children are born with some degree of hearing loss? UTHSC pediatric audiologists follow the Joint Committee on Infant Hearing (JCIH) Guidelines which recommend that hearing be screened by one month of age, diagnostic testing be completed by three months of age, and intervention begin no later than six months of age. Be assured, no child is too young to test!

Our pediatric audiologists specialize in children. We provide a complete battery of diagnostic tests for children birth to age 18, which can accurately diagnose various types and degrees of hearing loss. Our comprehensive services include:

• Case History - Your child’s written case history will be reviewed and you will be able to verbally give us more information regarding his/her hearing and your concerns.
• Otoscopy - Using an otoscope, we look in your ears to assess the outer ear and the eardrum.
• Tympanometry and Acoustic Reflex testing - A probe is placed in the ear canal; your child will feel slight pressure for a few seconds and hear beeping sounds.  This tests the health of the middle ear.
• Oto-acoustic emissions - A probe is placed in the ear canal and presents sounds into the ear canal.  A special computer measures sounds that come back out of the ear canal.  This gives information about the organ of hearing, the cochlea, which is located in the inner ear.
• Traditional behavioral testing in a sound booth with earphones, including,
  • Visual Reinforcement Audiometry (VRA) - Your child will be taught to turn his/her head to look at a toy when a sound is heard though earphones.
  • Conditioned Play Audiometry (CPA) - Your child will be taught to respond to sound by playing a game such as throwing blocks in a bucket.
• Results - The results of all tests will be reviewed with you at the end of the hearing evaluation, and recommendations will be made regarding treatment options.
  The type of assessment selected depends on the age and skill level of your child.  Appointments for hearing evaluations usually take at least 1.5 hours and, in order for complete results to be obtained, more than one appointment may be necessary.

Infants under six months will be evaluated using objective measures, meaning tests that do not require him/her to respond. Our Audiologists frequently see babies who failed their newborn hearing screen, require follow-up due to conditions experienced during a NICU stay, or exhibit a risk factor for late-onset hearing loss. We routinely report results to the state’s Newborn Hearing Screening/Early Hearing Detection and Intervention Program on babies who need follow-up testing.

Infants who are sitting without support and visually tracking will be evaluated using subjective and objective assessments. Our clinic uses traditional VRA as well as video-supported VRA.

Children who are approximately age two and can follow a two-step command are often ready to be tested using CPA, which is an effective assessment tool for gathering accurate results while holding a child’s attention. 

Older Children and Adults

You can expect an appointment for a hearing evaluation to last approximately 1.5 hours and consist of the following:

• Case History - Your written case history will be reviewed and you will be able to verbally give us more information regarding your hearing concerns.
• Otoscopy - Using an otoscope, we look in your ears to assess the outer ear and the eardrum.
• Tympanometry and Acoustic Reflex testing - A probe is placed in the ear canal; you will feel slight pressure for a few seconds and hear beeping sounds.  This tests the health of the middle ear.
• Puretone Audiometry - This is the traditional hearing test in a sound booth with earphones that helps us determine the softest sounds that you can hear. You will hear a series of tones/beeps and raise your hand each time you hear the tone.
• Speech Testing - You will be asked to repeat back a series of words to determine the softest level of speech that you can hear and how well you understand speech when it is at a comfortable level for you.
• Results - The results of all tests will be reviewed with you at the end of the hearing evaluation, and recommendations will be made regarding treatment options. 

Resources Tennessee Department of Health Newborn Hearing Screening/Early Hearing Detection and Intervention Program National Centers for Hearing Assessment and Management Meet Specialty Providers: Infants, Toddlers, and Young Children Erin Plyler, AuD, CCC-A Kelly Yeager, AuD, CCC-A Older Children Jen Hausladen, AuD, CCC-A Beth Humphrey, AuD, CCC-A Erin Plyler, AuD, CCC-A Kelly Yeager, AuD, CCC-A Adults Steven M. Doettl, AuD, CCC-A Brittany Grayless, AuD, CCC-A Jen Hausladen, AuD, CCC-A Beth Humphrey, AuD, CCC-A