Frequently Asked Questions-Hearing

Parents frequently have questions about their child's hearing and speech-language development. With the help of an audiologist or speech-language pathologist, it is possible to evaluate your child's hearing, speech and language skills.

Common questions about hearing

What are some signs of a possible hearing loss?
Children with normal hearing generally demonstrate a number of common behaviors. If your child is not displaying these behaviors, it may be a sign of a possible hearing loss or other condition. Parents are encouraged to discuss any concerns with a pediatrician.

Birth to three months

• Startles or cries at loud noises.
• Awakens at a loud sound.
• Quiets to the sound of a familiar voice.
• Smiles in response to voice.
• Soothed by quiet soft sounds.

Three to six months

• Looks toward a sound or speaker.
• Smiles when spoken to.
• Enjoys rattles and other toys that make sounds.
• Becomes scared by a loud voice or noise.
• Responds to "no" and changes in tone of voice.

Six to nine months

• Responds to his or her name, ringing telephone or someone's voice, even when it's not loud.
• Listens to people talking.
• Responds to "no" and changes in tone of voice.
• Babbles and makes many of different sounds.
• Looks at things or pictures when someone talks about them.

Nine to 12 months

• Turns or looks when name is called.
• Listens to people talking.
• Response to simple requests such as "give me" and "come here."
• Understands "bye-bye."

12 to 18 months

• Points to objects or familiar people by name.
• Enjoys games like peek a boo and pat-a-cake. 
• Imitates and says two to three word sentences.
• Knows 10 to 20 words.
• Points to body parts when asked.

What are some signs of possible hearing loss in a school-aged child?

• Asks for information to be repeated or frequently says "what?" 
• Turns ear toward the speaker or the sound source.
• History of chronic ear infections.
• Turns the volume up on the TV or radio.
• Teachers may report the child is misbehaving or having trouble hearing.

What causes hearing loss or hearing disorders?
Causes of hearing loss may include family history, health problems at birth, genetic disorders, syndromes, certain types of drug therapies, persistent middle ear fluid or chronic ear infections, exposure to loud noise or head trauma.

What should I do if I have concerns about my child's hearing?
Contact Central Scheduling at Children's Hospital of Wisconsin to make an appointment for a hearing test in the Audiology Clinic at (414) 607-5280 or toll-free (877) 607-5280.

Who will test my child's hearing?
Your child will see a pediatric audiologist. In addition, referrals may be made to an ear, nose and throat physician (otolaryngologist) or a speech-language pathologist.

How old does my child have to be to have a hearing test?
It is never too early to test your child's hearing. In fact, your baby should have a hearing test at birth before you leave the hospital. If your baby was or will be born in a hospital that does not screen newborns for hearing loss, ask your pediatrician to arrange for your baby's hearing test. Your child's age and developmental level determine the type of hearing test he or she receives. 

What are common types of hearing tests for children?

1. Immittance testing is an important and painless test that provides the audiologist with information regarding eardrum mobility and middle ear function. The audiologist will explain that he or she will take a "picture" of your child's ear. A small plastic tip is placed in the child's ear to make an airtight seal. Changes in air pressure are made and measurements are taken with a special instrument called a tympanometer. If the child has ear tubes, this test helps determine if the tubes are in place, open and working properly. If the child does not have tubes, this test helps to determine if there are any signs of fluid or other problems in the middle ear. Reflex action of the ear, called acoustic reflexes, also are measured.
2. Visual reinforcement audiometry typically is done between 6 months and approximately 3 years of age. In a special booth, the child is seated on a parent's lap with speakers on either side of the child.  Using special equipment, speech and different sound frequencies are transmitted at precisely measured loudness levels. When the child hears the voice or sounds though the speakers and looks in the direction of the sound, an animated light-up toy appears. Using this type of visual reinforcement, the child eventually learns to look towards the source or direction of the sound when he or she hears it. The audiologist is able to determine the loudness levels necessary for the child to hear.
3. Conditioned play audiometry typically is used with children who are three to five years of age. Headphones are placed on the child's ears and different frequencies are transmitted. The child is taught to perform a task, such as placing a block in a bucket, every time he or she hears a sound. In addition, the child's ability to hear and understand speech may be evaluated. In this case, the audiologist transmits words at different loudness levels, and the child must demonstrate whether he or she heard and understood the word by pointing to a picture or by repeating the word back to the audiologist. This test allows the audiologist to determine the quality of hearing in each ear.
4. Bone conduction testing evaluates the inner ear or nerve portion of the ear. A small vibrating device is placed behind the child's ear, and he or she is asked to repeat or identify words, or respond to sounds at different frequencies.  The results of this test are compared to those obtained through conditioned play audiometry or visual reinforcement audiometry to identify the type of hearing loss.