If you think a hearing loss may be present the first step is to ask your medical practitioner to refer your child for an audiological assessment. This assessment will determine whether a hearing impairment exists and to what degree. No child is too young to receive a thorough hearing evaluation and today's technology allows testing of newborns.

Hearing screening

This is testing which can be carried out at any age. Hearing screening usually shows simply that a child's hearing is not at a normal level. If a child fails a screening test, he / she will be referred for a more detailed assessment. In recent years the importance of hearing screening for infants has been recognized. There is now legislation in many countries recommending that all newborns are screened for hearing loss. When hearing loss is identified early appropriate support measures can also begin early.

Behavioral hearing tests

These tests usually require the child to respond to soft sounds in some way (verbally, by picture pointing, raising the hand or through a "game"). These tests can be fun and for infants and toddlers, a head-turn response to a test signal is usually the best and most reliable testing method.

Auditory Brainstem Response (ABR)

For newborns or infants and children who cannot reliably perform the behavioral test procedures, other more objective tests, such as ABR, can help determine hearing abilities. Clicks or tonal "pips" are sounded in an infant's ears through earphones. The ABR provides information about the function of the auditory pathway to the level of the brainstem. The response to the clicks or tones are recorded, providing an estimate of hearing sensitivity.

Otoacoustic Emissions (OAEs)

These tests provide a unique way to examine the function of the cochlea. Sounds are sent to the child's ear with a small loudspeaker. A microphone records the response to the sound from the cochlea (known as an emission). This offers valuable information about the sensory hair cells in the cochlea.

Tympanometry (acoustic immittance testing)

This test helps determine how well the eardrum and middle ear are working. A gentle puff of air is delivered into the child's ear and the amount the eardrum moves in response to change in air pressure is recorded. If the eardrum does not move, for example, it could mean there is fluid behind the eardrum and otitis media with effusion may be present.