Hearing Screenings and Evaluations

The Audiology Department at Arkansas Children's provides expert comprehensive audiological services including identification and measurement of hearing loss, parent counseling and habilitation of children with hearing impairment. A certified audiologist is available for each session, and a pediatric otolaryngologist and a speech pathologist are available upon request. 

The mission of the our program is to provide comprehensive diagnostic and intervention services for children. The focus is on early identification, aggressive intervention and family involvement. Screenings and evaluations conducted by the Audiology Department include:

Auditory Brainstem Response Test (ABR)

What is an Auditory Brainstem Response test?

An Auditory Brainstem Response (ABR) test shows the brainstorm's response to sound. Different levels of loudness and pitch are used to determine approximate levels of hearing in each ear. The test does not require participation from the child. It is commonly done on infants and small children, or anyone who cannot participate with routine testing.

How is the test performed?

Four small electrodes will be placed on your child's head and sounds will be presented through an earphone to each ear separately while a computer analyzes the changes in the brain wave pattern in response to sounds.  The test is not painful or uncomfortable, but it is necessary for your child to be asleep in order to obtain clear recordings during the test.  You can be in the room with your child during the test, and the results will be explained afterward.  This test may be performed sedated or unsedated, depending on the age and health of your child.

Behavioral Audiological Evaluation

What is a Behavioral Audiological Evaluation? 

A regular (behavioral) audiological evaluation measures degrees of hearing for different tones. This test is performed in a sound-treated room to find out whether your child can hear soft sounds at all of the important levels for hearing spoken words clearly.

How is the test performed? 

The type of test will be chosen according to your child's age and abilities:

  • Visual Reinforcement Audiometry (VRA) observes head-turning responses to sounds, rewarding the responses with a lighted toy. This type of behavioral audiometry is typically used for children ages 6 months to 2 years.
  • Play Audiometry shows your child how to respond to sounds with a play task, such as placing a block in a bucket after hearing the sound. This type of behavioral audiometry is typically used for children above 2 years of age.
  • Older children can respond to sounds during the test by raising a hand, pushing a button, or by verbally responding to each sound.

Newborn Hearing Screening

Newborn-Infant Hearing Screening Programs are designed to identify hearing loss in infants shortly after birth. Hearing loss is one of the most common congenital anomalies, occurring in approximately 3 out of every 1000 infants. The state of Arkansas has implemented screening protocols within hospitals and birthing clinics and recommends that every baby have a hearing screening. (About 95% of hearing screening tests are done prior to discharge from the hospital or birthing clinics.)

What happens if my child failed the Newborn Hearing Screening or did not receive one at the birthing hospital?

If your baby is referred for more testing, it does not necessarily mean they have a hearing loss. The most common reasons an infant may need additional testing include:

  • Infant was too “fussy” at original screening
  • Middle ear fluid or infection
  • An ear canal blocked with debris
  • A permanent, mild or greater hearing loss

It is important that you return for the follow-up screening test before 1 month of age.

The Newborn Hearing Screening Program at Arkansas Children’s is available to re-screen the infant’s hearing if the infant does not pass the original hearing screening. If the infant was never given the Newborn Hearing Screening prior to discharge from the birthing hospital, we can also provide the original screening. If the infant does not pass the second hearing screen and middle ear fluid has been ruled out, then he/she is referred to one of our pediatric audiologists for diagnostic testing. This ensures that referrals are made in a timely manner to provide your baby with appropriate treatment and care. If your baby is referred for a diagnostic audiologic evaluation, it is important to have the evaluation as soon as possible.

We want to get the message out that it is "never too early" to determine how a baby hears. If undetected and untreated, hearing loss can lead to delayed speech and language development, social and emotional problems, and academic failure. By detecting hearing loss during the newborn period, families can be informed of their child's hearing status and effective treatment can be immediately initiated. Our program has been recognized as a national leader in the area of early detection of hearing loss, setting the standard for early diagnosis of infants in the state. We utilize the most advanced available computerized technology to develop an individualized amplification plan, including digital hearing aids, assistive listening devices and cochlear implants. Timing is everything--any child’s hearing can be evaluated with a high degree of accuracy.

Otoacoustic Emissions (OAE)

What is an otoacoustic emissions test?

Otoacoustic emissions (OAE) testing is a way to measure inner ear function. This test does not require that children tell or show that sounds are heard. Therefore, this test may be used to screen an infant's hearing or done on anyone. Otoacoustic emissions (OAEs) are measured with a soft earplug. It indicates whether the hair cells of the cochlea (inner ear) are functioning, and can be measured to be present or absent as long as your child has no wax or fluid in the ear.

How is the test performed?

The test is performed by a soft earplug being inserted into the ear canal. A series of clicks are presented. Otoacoustic emissions are "echoes" emitted by the cochlea (organ of hearing) in response to those sounds. The "echo" is measure with the probe in the ear canal to screen the child's hearing.


What is a Tympanometry test?

Tympanometry is a test of middle ear function and not a test of hearing thresholds. Tympanometry provides a measure of the health of the eardrum and the middle ear space behind it. It records the compliance of the eardrum as air pressure is introduced into the ear canal. The test is performed by placing a soft rubber tip into the ear for a few seconds.

The results of the tympanogram can help the pediatrician or otolaryngologist to assess middle ear fluid, Eustachian tube dysfunction, tympanic membrane perforations, and whether ear tubes are open or blocked.

When is this test performed?

A tympanogram is usually performed during your child's visit for any audiological evaluation.