A hearing test in children is often recommended since difficulty hearing can result in speech and learning delays, though the issue can often be fixed if caught early. Tests for newborns are usually different from tests for older children, as the latter type often uses behavioral responses rather than just automatic responses. For example, in the typical hearing test in children, the child is asked to respond in a certain way when he hears a sound. This type of exam is usually followed up by tests that use computers to determine how the ears process the sounds, much like during an infant hearing screening.
Behavioral screenings are considered ideal for children because they can ensure that the brain is processing the sounds, rather than just making sure that they are heard by the ears. In most cases, the child is asked to raise their hand or look to the side when a noise is heard in one ear. It can also be turned into a game, referred to as conditioned play audiometry, in which the child places a peg on a board when a sound is heard, Typically, earphones are required for this type of hearing test in children, since the use of regular speakers makes it difficult to know in which ear the child heard the noise.
Most appointments that result in a hearing test in children also include speech tests, which ensure that the child can process speech rather than just sounds. The child is usually placed in a soundproof room, and then asked to repeat the words he hears, which are usually said in a soft tone of voice that gradually increases until the child states that he can hear it. This test is particularly important before the child enters school, as he will need to be able to hear the teacher and his peers in order to succeed.
Such tests are usually followed by screenings that rely on a computer, especially when the child is either too young or uncooperative to react well to behavioral tests. The otaacoustic emission test examines the response that the cochlea, or inner ear, produces. It requires a microphone and speaker to be placed in the ear, at which time sounds are produced, and the responses from the cochlea can be recorded and displayed on a monitor. This allows an audiologist to see which sounds got a response so that it is clear how well the child can hear.
The auditory brainstem response test involves putting several electrodes on the surface of the child's head while he wears earphones. Sounds are then placed into the earphones so that the electrodes can record the response created by the hearing nerve. This results in waveforms showing up on the monitor, allowing the audiologist to see at what loudness level the child is able to hear. This hearing test in children is usually performed when they are either sleeping or sedated, since even the smallest movement can skew the results.