Hearing loss in children Hearing loss at birth: Significant effects on development of speech and language. May start to become more obvious as child grows. Even mild hearing loss can have significant effects. Risk factors for neonates: Low APGAR scores, family history, syndrome, illness, craniofacial disorders, in-utero infection and medications. Universal hearing screening: Based on high-risk registry.

Objective tests for neonatal and infant hearing screening/testing ABR OAE Tympanometry Acoustic reflexes Important to use age-appropriate norms and to multiple tests whenever possible.

Behavioral hearing tests in children Important to know normal responses to differentiate them from children with problems. Responses: Voluntary or involuntary movements, vocalization, electrophysiological. Thresholds typically higher because of the nature of the response.

Behavioral methods for testing children upto 2 years of age Behavioral observation audiometry (BOA): For very young children (First 6-8 mths of age). Present various stimuli and observe child’s reaction. Sound-field audiometry: For older children (upto 2 years) Use of multiple loudspeakers, present stimuli, observe responses. Conditioned orientation reflex (COR): Pair auditory stimulus with visual stimulus till child associates the two. Visual reinforcement audiometry (VRA): Use reinforcers to encourage correct responses.

Behavioral methods for testing children between 2-5 years of age Can use stimuli with greater frequency-specificity. Use warble tones (frequency-modulated pure tones) Speech audiometry using picture responses. Pure tone audiometry in some cases. Play audiometry: Example: Placing blocks into a bucket when a tone is heard.