Testing of Our Pediatric Patients
We know that our pediatric patients are not just short adults.
The evaluations that we do are designed with the understanding that children cannot be expected to complete complex commands and have incredibly short attention spans. Rest assured we know what we’re doing when it comes to our youngest patients.
Otoacoustic Emissions Testing
Otoacoustic emissions (OAE) screening allows hearing testing within the first days of life. Newborn screening is simple and painless, and could make a significant difference to a child’s future. OAE screening procedures for newborns and infants do not require the baby to respond. A miniature earphone and microphone are placed in the ear, sounds are played and a response is measured. The normal ear responds with an echo that is picked up by the microphone. When a baby has a hearing loss, no echo can be measured. OAE screening procedures can screen each ear individually. About 10 percent of babies do not pass the hospital OAE screening. This is likely due to a blockage of the ear canal with birth fluids or debris, fluid in the middle ear, or movement and/or crying during the test. Most babies will pass the follow-up hearing testing, however, it is very important to take your baby for follow-up testing. This is the only way to be sure that your baby is hearing. Newborns that do not pass the hospital screening are typically referred for a follow-up audiologic evaluation. If your child does not pass the follow-up hearing test, he or she may then be referred for more in-depth audiological and medical assessment by the time they are 3 months old. These assessments will verify the presence of hearing loss and help identify options for treatment. Important note: Please be aware that OAE is only a screening tool. It screens out higher pitched hearing losses and may miss a mild hearing loss or a reverse hearing loss.
Visual Reinforcement Audiometry
Once a child reaches the age of 6-7 months to 2+ years old, sounds are presented through a speaker or earphone. The child is trained to look toward the sound. When the child looks to the sound, he sees a moving toy or a flashing light. As children mature they may be asked to point to pictures in a book, body parts, i.e. eyes, ears, nose, fingers, or objects in the room. OAE testing may be utilized at this age if the child will tolerate the device in his ear for up to two minutes (the device is a small rubber tip and sometimes little ones just don’t want to still for 2 minutes!) If a child will not tolerate headphones, sounds can be played through loudspeakers, however, only the better ear is tested, and a hearing loss in one ear may be unidentified.
Auditory Processing Program
Our exceptional, friendly staff is one of our greatest assets, and we are proud of their long-time association with our office. Patients tell us often how well we work together as a team.
We pride ourselves on staying on the cutting edge of hearing healthcare and great patient communication. Each of our staff members is motivated to achieve the best results for our patients in a calming and comfortable setting.
Signs & Symptoms
A child who has an auditory processing disorder may demonstrate a number of behaviors. Many of these behaviors are also seen in other disorders, such as ADD, ADHD, and PDD. For that reason, it is very important to note that, upon observing any of the following signs in a child, we cannot just assume a child has an auditory processing disorder. Instead, if the following behaviors are observed in your little one, careful testing will need to be completed to arrive at an accurate diagnosis. That being said, a child with an auditory processing disorder…
- May ask for repetition of what you say often–you may notice him saying “what?” or “huh?” frequently.
- May not like being read to by others.
- May not respond right away when spoken to by others.
- May be easily distracted, especially in noisy environments, because he has a hard time blocking out background noise.
- May have a hard time following more than one direction at a time, especially in noisy places such as a grocery store, a restaurant, or a daycare.
- May have difficulty listening to and following directions in group settings such as school.
- May be overwhelmed or even frightened in noisy environments.
- May have a hard time remembering things.
- May have a hard time hearing the difference between words that are very similar, such as “cat” and “cap.”
- May have difficultly using spoken language.
- May have difficulty with pre-literacy skills such as phonemic awareness (knowing what a certain letter sounds like) and rhyming.
- May struggle with language-related school tasks, such as spelling, vocabulary, reading, and writing.
- May get tired easily due to the energy and concentration required to sort through the sounds that are coming his way.
- May struggle with behavior and/or self-esteem due to the frustration of not being able to meet the expectations of others.
The diagnosis of an auditory processing disorder is made by an audiologist with specialized knowledge of auditory processing. Although an auditory processing disorder can be suspected at younger ages, children are most easily diagnosed after the age of seven. To make the diagnosis, an audiologist will first make sure that the child does not have a hearing loss. Then, the audiologist will have a child participate in a variety of tasks that require him to listen to sounds, words, and sentences and respond in different ways. A child’s performance on these tasks can help an audiologist determine if a child has a true auditory processing disorder. The audiologist might also use some tests that can determine just how the child’s brain responds to auditory information.
Other professionals may play a role in diagnosis as well. Speech-language therapists can administer language testing to carefully assess a child’s use and understanding of language and psychologists may be involved to rule out disorders such as autism, cognitive delays, ADHD, or ADD.
What to Do
There are many strategies available to help children with auditory processing disorders. Most importantly, it is essential to get an accurate diagnosis so that you can access services for your child. Speech-language pathologists and audiologists can work with children with auditory processing disorders in a variety of different ways. Some specialists may work with children to help them learn to hear sounds more accurately and follow directions of increasing length in increasingly distracted environments. Others may use specially developed and acoustically modified computer programs such as FastForWord to retrain a child’s brain to process sound more accurately.
What’s more, teachers and parents can play a role in helping a child with an auditory processing disorder cope by implementing the following strategies:
- Seat the child close to the front of the class where he can better hear and attend to a teacher,
- Allow the child to wear a special assisted listening device which makes the teacher’s voice just a bit louder,
- Give the child time in to recharge in quiet, calm environments,
- Recognize and prepare for difficulties in noisy environments such as restaurants, classrooms, gyms, and supermarkets,
- Limit loud TV and music in the house, especially when a child is being asked to concentrate or participate in conversation,
- Give only one direction at a time or pause between directions to give the child time to process what is being said,
- Ensure that you have the child’s attention before speaking,
- Check to make sure a child has heard and understood something before expecting him to follow a direction, and
- Use visual supports such as pictures whenever possible at home and in school.
Auditory processing disorders can be hard on children, families, and teachers alike. With the proper treatment and coping strategies in place, however, there is much hope for everyone involved.