How Hearing Problems Are Identified In Children

The sooner hearing loss is detected and treated in a child, the better the outcome. When not identified early, hearing loss in children can hinder a child's language and social development. But knowing what the warning signs are and getting the appropriate screening for your child can help prevent severe hearing loss and developmental problems.

Signs of a Hearing Problem

Symptoms that may indicate a hearing problem include your child:

  • Talking loudly or not pronouncing words correctly

  • Failing to follow simple directions

  • Doing poorly in school

  • Not seeming to pay attention to what you say

  • Turning the volume on the television up high

Another sign that a toddler or younger child may have hearing problem is not responding when you call his or her name.

Types of Hearing Tests

While there are a number of diagnostic tests audiologists use to check for hearing problems in children, they typically use particular tests for different age groups.


The automated otoacoustic emissions (AOAE) test is used to screen for hearing problems in newborn infants. An earpiece is placed in the infant's ear canal to measure how well the inner ear responds to sound. The test can help detect damage to the cochlea or the presence of fluid in the middle ear.

If the results from this test aren't clear or the doctor suspects a hearing problem, a second screening test – automated auditory brain stem response (ABR) – may be necessary. Performed when an infant is sleepy, small sensors (or electrodes), which detect how the hearing nerves respond to sound, are placed on the baby's head and neck. Quiet clicking sounds are then played through headphones. Although neither the AOAE or ABR test can diagnose hearing loss with a certainty, each test helps determine whether a baby may need further hearing evaluation.


For children up to 2 ½ years old, health care professionals use visual reinforcement audiometry to test hearing. When an infant's eyes shift or his or her head turns in response to sound, a lighted mechanical toy is activated as a reward. Once the child associates the sound with the reward of the toy lighting up, the tester varies the volume and pitch of the sound.


Audiologists use play audiometry to test the hearing of preschoolers between the ages of 2 and 5 years old. The tester instructs the child to perform a task, such as putting a puzzle together or placing a peg in a pegboard, when he or she hears the sound that is played through headphones or speakers. To determine the quietest sounds the child can hear, the tester varies the volume and pitch of the sound.

School-Age Children

Once children are school age, they are administered a pure-tone audiometry test to screen for hearing problems. The tester plays sounds through headphones at different frequencies and volumes. A child is instructed to press a button when he or she hears the sound. The test evaluates whether a child's hearing is within normal limits.

In some cases, instead of using headphones, an audiologist may perform a hearing test by placing a small vibrating tool behind the ear. Known as a bone conduction test, sound is passed directly through the mastoid bone in the skull to the inner ear nerves. This test may be used if a hearing specialist suspects a hearing loss in the early stages.  

For more information, contact Desert Knolls Hearing Center or a similar location.