Hearing Tests for Children

HealthLinkBC File Number: 
Last Updated: 
January 2014

Children start to learn speech and language from the moment they are born. A child’s world is full of sound. Babies who hear well learn a lot about the world through sounds. If your child cannot hear well, they may have trouble developing language skills and learning to talk.

Hearing also plays an important role in the social and emotional growth of children. It is important to recognize the signs of hearing loss early to prevent or lessen any concerns.

Why does my child need to have their hearing screened?

Every year, about 100 babies (1 in 400 births) are born in B.C. with permanent hearing loss. For babies who need special care at birth, about 1 in 50 are born with permanent hearing loss.

For most babies with hearing loss, there are no obvious signs to tell us. It is impossible to tell how well your baby can hear by watching his or her response to everyday sounds. That is why it is important that every baby undergo newborn hearing screening.

What routine screening will my child receive?

Hearing tests are important for newborn babies and families because much can be done if hearing loss is found early in life.

In B.C., all babies can have their hearing screened through the BC Early Hearing Program. Your baby’s hearing screening may happen in the hospital before you go home or in your community soon after birth. Most babies born in hospital are screened before they leave the hospital. If your baby did not receive screening, contact your local public health unit.

The screening test is very safe and it will not hurt your baby. Soft sounds are played in your baby's ears, while a computer measures the responses. Screening is best done at least 12 hours after birth and with your baby resting quietly or asleep.

What can I do if I think my child has hearing loss?

Hearing loss can be hard to detect. Mild hearing loss is sometimes mistaken for other concerns, and it may cause a child to appear distracted or withdrawn. In older children, parents are often the first to notice if there is a concern.

Hearing loss can develop at any time in childhood. It is important to realize that some babies do not have hearing loss at birth but can develop it later. Even if your baby passes the newborn hearing screening it is important to continue to pay attention to his or her response to sounds and early attempts to talk.

If you have concerns about your child’s hearing, contact your local public health hearing clinic or your family health care provider.

See your health care provider right away if your child has any of the following:

  • ear discharge (runny ear);
  • earache (pain in the ear);
  • bad smell from the ear canal;
  • reddened skin around the ear;
  • an object in the ear canal; or
  • an injury to the ear.

What hearing tests will my child receive?

Tests for infants and toddlers

  • Auditory Brainstem Response (ABR) A child needs to be asleep to do this test. Sounds are presented to the ears using small earphones. Small sensors are placed behind each ear and on the forehead to measure response from the hearing nerve. The test can be done as your child is asleep naturally, or with the use of a mild sedative if needed.
  • Visual Reinforcement Audiometry (VRA) This test is mostly used for babies over 6 months of age. This test checks your baby's natural head turn to look for the source of sounds. Your baby is taught to turn to sounds using toys that light up.
  • Conditioned Play Audiometry This test is mostly used for toddlers over 3 years of age. Your child is taught to play a game, such as put a peg into a peg board, every time they hear a sound.

Tests for children 4 years of age and older

  • Pure Tone Audiometry Your child responds to sounds by raising a hand or pressing a button. Sounds at different volumes and pitches are presented through headphones.
  • Speech Audiometry Your child will either repeat words or point to pictures. This test can be combined with pure tone audiometry to give a more complete picture of your child’s hearing.

Tests for all ages

  • Tympanometry This test measures the movement of the eardrum and detects fluid in the middle ear. This test can also detect other problems of the middle ear.
  • Otoacoustic Emissions (called OAE) A small soft tipped earpiece is placed in the outer part of the ear. Sounds are sent into the ear. When the ear receives the sounds, the inner part known as the cochlea makes a response called an Otoacoustic emission which can be measured. Present emissions usually mean good hearing.

Is hearing loss temporary or permanent?

Hearing loss can be temporary or permanent. Conductive hearing loss is usually temporary, sensorineural loss is usually permanent. Most hearing loss in young children is temporary or medically treatable.

A test by an audiologist will determine what type of hearing loss your child has. An audiologist is a person who has special training in hearing testing and treatment.

For More Information

For information on hearing loss in children, see HealthLinkBC File #71a Hearing Loss in Children, or contact your local public health office.

Visit the Provincial Health Services Authority web page for the BC Early Hearing Program at www.phsa.ca/our-services/programs-services/bc-early-hearing-program.

Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.

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