According to the American Speech-Language-Hearing Association, or ASHA, toddlers should have hearing tests when requested, required by law or when there are indications that a test is needed. The Individuals with Disabilities Act requires all states to operate early intervention programs for infants and toddlers. State programs must provide evaluation and diagnosis of potential disabilities, including hearing loss. IDEA requires states to provide hearing tests for all infants and to provide the tests to toddlers as indicated. States are required to provide services to children with diagnosed hearing loss.
Testing for Hearing Loss
Hearing loss affects a child's ability to learn language and delays emotional, social and cognitive development. Early screening for hearing loss can lead to early intervention, treatment and reversal of hearing loss in some cases. When hearing tests detect permanent hearing loss, the resulting services enable children to learn communication skills and receive education and other services that are designed to meet their needs. Hearing tests help children with hearing loss receive the services they need to reach their full potential.
Risk Factors and Testing
Infants may pass mandatory hearing tests and still require testing every six months until they are three years old if risk factors indicate a need. Risk factors for hearing loss include premature birth, family history of permanent hearing loss, development delay and concerns about speech and language development. Often, parents and others may observe that a child has the symptoms of hearing loss such as failure to imitate sounds and lack of response to sound. Other factors that indicate hearing tests include persistent ear infections, head trauma and specific syndromes, diseases and anatomic disorders.
Behavioral Hearing Tests
A Conditioned Play Audiometry test is a behavioral test for children two to three years old. The CPA hearing test, conducted as a game for toddlers, uses an electrical machine to transmit sounds into the child's ears through earphones. Toddlers are asked to perform a simple activity each time a sound is heard. Older toddlers may be asked to make a simple response each time they hear a sound.
The Visual Reinforcement Audiometry, or VRA, test is also a behavioral test and is used for children who are seven months to three years old, developmentally. The audiologist trains the child to look toward the source of sound. For a correct response, the child is rewarded with a visual reinforcement such as flashing light or a moving toy. Both tests require the child to cooperate. For children unable or unwilling to cooperate, audiologists may use alternative procedures such as auditory brain stem response.
Tympanometry
According to ASHA, tympanometry is a procedure and not test. Tympanometry is used when a child cannot be tested due to age, developmental delay or medical conditions. Tympanometry, also called impedance audiometry, measures the function of the middle ear by observing the movement of the eardrum when sound and air are introduced into the child's ear canal. This procedure is often performed in doctors' offices and is effective at diagnosing fluid behind the eardrum. Children must be able to remain quiet and very still to undergo this procedure.
Tips
Organizations such as the American Board of Audiology and the American Speech-Language-Hearing Association certify audiologists. Many states require that audiologists apply for licensing.
