Pediatric Hearing Evaluation & Rehabilitation

Children, including newborns, are prone to hearing loss and it is very important to diagnose it early on and provide treatment in order to avoid further complications. AUM offers comprehensive treatments for pediatric hearing loss. We have a separate team to treat pediatric hearing loss that involves separate diagnostics and provision of hearing aids.

Pediatric hearing loss can be due to various reasons including:

Assessment/ Evaluation

  • Behavioural Observation Audiometry (BOA)

This test involves presenting sounds to a baby and observing their responses. The behavioural responses for various stimuli such as Pure tones (presented in free field), clap sounds, name call and other environmental sounds are presented and responses are recorded. Behavioural responses include increased heart rate, body movements, eye movements, and sucking rate are considered.

This test can be accompanied with other electrophysiological tests to determine child’s hearing ability. Age range for this test is 0-6months.

  • Visual reinforcement audiometry (VRA)

This test is performed for children who in age range of 6 months- 2years. It is a key behavioural test for young children. In this test child’s visual responses for Puretone stimuli are recorded .It is central to completion of the diagnostic process for those hearing impaired infants identified by newborn screening. Furthermore, contemporary paediatric amplification fitting methods rely on solid foundations of measurement to ensure the validity and reliability of hearing aid fitting.

  • Conditioned /Play Audiometry

In this test the child is conditioned to give response for the Puretone stimuli presented through headphones. The Play method is used to record responses. This test is helpful in determining the hearing threshold for younger children where traditional Pure Tone Audiometry is difficult to perform. It can be performed for children who are above 3years of age.

  • Pure tone Audiometry

It is the key hearing test used to identify hearing threshold levels of an individual, enabling determination of the degree, type and configuration of a hearing loss. Thus, providing the basis for diagnosis and management. PTA is a subjective, behavioural measurement of hearing threshold, as it relies on patient response to pure tone stimuli.

  • Speech audiometry(SA)

Speech audiometry has become a fundamental tool in hearing-loss assessment. In conjunction with pure-tone audiometry, it can aid in determining the degree and type of hearing loss. Speech audiometry also provides information regarding discomfort or tolerance to speech stimuli and information on word recognition abilities.

In addition, information gained by speech audiometry can help determine proper gain and maximum output of hearing aids and other amplifying devices for patients with significant hearing losses and help assess how well they hear in noise. Speech audiometry also facilitates audiological rehabilitation management

  • Immittance Audiometry(IA)

The purpose of impedance audiometry is to determine the status of the tympanic membrane and middle ear via tympanometry. Different middleear infections can be differentiated by the type of tympanogram obtained.

ASHA (Americian Speech and Hearing Association) recommends High Frequency Immitance Audiometry for children ,as the middle ear of children (mass dominant) is different from that of adults.

  • Electrophysiological Evaluation

As children cannot respond to the subjective evaluation of hearing , electrophysiological evaluation procedures are followed which doesnot require child response.

Brainstem Evoked Response Audiometry (BERA) /Auditory brainstem response audiometry(ABR), this test is a neurological test that is done to check the functioning of the auditory brainstem with external stimuli. With the help of an earphone, sounds of clicks are transmitted into the ear of the child and the hearing sensitivity is measured along with the functioning of the auditory brainstem. The responses are elicited in the waveform measured by surface electrodes typically placed at the vertex of the scalp and ear lobes.

Otoacoustic Emissions (OAE) , are sounds of cochlear origin, which can be recorded by a microphone fitted into the ear canal. They are caused by the motion of the cochlea's sensory hair cells as they energetically respond to auditory stimulation. OAEs provide a simple, efficient and non-invasive objective indicator of healthy cochlear function and OAE screening is widely used in universal new-born hearing screening programmes. As part of the audiological diagnostic test battery, OAEs can contribute to differential audiological diagnosis

Auditory steady state response(ASSR) is an auditory evoked potential, elicited with modulated tones that can be used to predict hearing sensitivity in patients of all ages. It is an electrophysiologic response to rapid auditory stimuli and creates a statistically valid estimated audiogram. The ASSR uses statistical measures to determine if and when a threshold is present and is a "cross-check" for verification purposes prior to arriving at a differential diagnosis.

  • Cochlear Implant Candidacy Evaluation

Not all children with hearing loss are benefited with hearing aids, many times even after proper hearing aid fitting and post fitting therapeutic approach child may not be able to develop language appropriately. For those individuals who are not benefitted with Hearing aid Cochlear implant is the option.

A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so they may be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound.

The candidacy evaluation includes the complete Audiological test battery along with the hearing aid benefit and other surgical profiles.


Hearing aids require precision and customization to maximize results for patients. Too soft and the child won’t benefit from wearing the instruments, but too loud and things may become too distorted or even worse, intolerable. Since each ear hears uniquely, even on the same head, we have to consider individual differences when fitting technology. This may or may not work depending on the individual characteristics of each ear. This is where a real-ear measurement comes into play.

Real-ear measurement is a tool that allows us to slip a small microphone probe into the ear past the hearing aid, and measure how much volume the hearing aid is actually providing the ear. The reason that it is important to be measuring the sound this deep in the ear, and not in a test box, is because each ear shape is unique and sound may resonate differently in a small vs. large canal. The real-ear measurement then allows us to set the hearing aid to a target level based on the hearing test.


  • Auditory Verbal Therapy

Auditory-Verbal Therapy is a specialized type of therapy designed to teach a child to use the hearing provided by a hearing aid or a cochlear implant for understanding speech and learning to talk. The child is taught to develop hearing as an active sense so that listening becomes automatic and the child seeks out sounds in life. Hearing and active listening become an integral part of communication, recreation, socialization, education, and work.

AVT is a parent centered approach that encourages the use of naturalistic conversation and the use of spoken language to communicate.

AVT Maximizes the use of the child's aided residual hearing for the detection of sound.