The Eckelmann-Taylor Speech and Hearing Clinic’s audiologists and graduate student clinicians provide pediatric services that aim to diagnose and treat hearing disorders and auditory problems in children of all ages and abilities. We collaborate with caregivers, speech-language pathologists, physicians, and educators to support healthy hearing in children. Our goal is to encourage children and caregivers and provide resources that will guide them towards hopeful solutions and treatment plans.
“I love the staff and students here! Everyone is helpful and knowledgeable, and they are eager to assist my son with his hearing aids in any way they can. I feel that the quality of care he receives here is better than any other audiologist office we have visited.”—Current ISU client
Components of Pediatric Hearing Evaluations
Graduate clinicians will review all medical and educational documents received prior to the appointment and utilize time at the beginning of the appointment to ask the caregiver and child details about hearing health, birth history, communication abilities, and other developmental milestones.
Otoscopy is a visual examination of the ear canal and tympanic membrane (eardrum) to check for excess cerumen (wax), visibility of pressure (PE) tubes if applicable, and overall health of the outer ear. For this procedure, the graduate student clinician will utilize an otoscope that provides light and magnification to the ear canal and eardrum.
Tympanometry examines the function of the middle ear by changing pressure in the ear canal and measuring movement of the eardrum. For this procedure, the graduate student clinician will place a small ear piece in the child’s ear for a few seconds to “take a picture” of the eardrum. This test also provides assessment of PE tube function in children who have had them placed by a physician.
Otoacoustic Emission Testing (OAE)
Otoacoustic emission testing provides objective information of the inner ear (cochlea) function. For this procedure, the graduate student clinician will place a small, soft probe in the child’s ear, which will deliver a series of quiet sounds. The child will not need to say or do anything during this 1-2 minute test.
Speech audiometry assesses the ability to hear and understand speech. The child will be asked to repeat words down to the softest level detected. They will also be asked to repeat words at a comfortable listening level to determine word recognition ability. Picture identification of words, or body part identification, may be utilized depending on the child’s age, and speech and language abilities.
Pure-tone audiometry, which includes air and bone conduction, determines presence, type, severity, and configuration of hearing loss. Air conduction audiometry determines degree of hearing sensitivity (normal, mild, moderate, severe, or profound) by measuring thresholds, which are the lowest levels the child may hear at different frequencies. Bone conduction audiometry also is used during this portion of testing. For this procedure, a small headband will be placed behind the ear on the mastoid bone. It measures hearing thresholds, and determines type of hearing loss (sensorineural, conductive, or mixed).
Behavioral Hearing Test Procedures (depending on developmental age)
- Visual Reinforcement Audiometry: The child will turn their head each time a signal is presented. The child is rewarded by an animated toy or video, revealed on the side of the sound. Most often, a parent or caregiver is needed to sit with the child in the sound booth. There will be a graduate or undergraduate student assistant in the booth to keep the child focused. (Developmental age 9 mos-2 years)
- Conditioned Play Audiometry: The child is taught to place a peg on a board, or place a block in the bucket when the signal is presented. If needed, a parent or caregiver is welcome to sit with the child in the sound booth. A graduate or undergraduate student assistant will keep the child focused on the play task while listening for the signals. (Developmental age 2-5 years)
- Conventional Audiometry: The child is tasked to press a button or raise a hand when the signal is presented. (Developmental ages 5+)
Interpretation and recommendations
Any clinical findings related to the child’s main listening difficulties and hearing health will be discussed. Appropriate recommendations and treatment options will be provided by the graduate student clinician and certified audiologist. The clinicians will provide resources and information regarding intervention services provided through the clinic and other local providers. Referrals to visit an Ear, Nose, and Throat (ENT) physician will be made if further medical evaluation or treatment is needed.
“The best parts of pediatric diagnostic testing and treatment are being able to give parents answers, and see little ones faces light up when they first clearly hear their families!”—Megan Hemmer, AuD
Newborn Hearing Screenings and Evaluations
The Joint Committee of Infant Hearing (JCIH) issued a position statement that requires all infants who do not pass the initial hearing screening and the subsequent rescreening should have appropriate audiological and medical evaluations to identify any hearing loss no later than 3 months of age. Our clinic will provide the information needed to abide by these policies and take the appropriate steps dependent on test results from the appointment. Please refer to the resources listed below for additional information regarding the JCIH Position Statement.
Auditory brainstem response (ABR)
Auditory brainstem response (ABR) testing measures auditory nerve reactions in response to sounds, which allows us to detect hearing loss and estimate hearing sensitivity. It is an assessment option for children too young for behavioral testing. Ideally, infants less than 6 months of age are tested in a sleep-deprived state, however, our audiologist will attempt sleep deprived testing on a case-to-case basis for slightly older children. Our clinic provides sleep deprivation instructions for caregivers to follow prior to the appointment, so that he or she will sleep during the ABR testing.
Parent Instructions for Sleep Deprived ABR
- Children must sleep for testing to be completed.
- Children should be SLEEP DEPRIVED for this test
- Keep your child awake as late as possible the night before and wake early the day of testing.
- Do not allow them to nap, especially in the car on the way to the appointment. If driving from a distance, a helper may be needed to keep your child awake and alert during the drive.
- Hold your child’s last feeding and bring it with you. Once you arrive and your child has been prepared for the test, you will be able to sit comfortably with your child and feed him/her and allow him/her to sleep.
Children need to sleep for 45 minutes to an hour to obtain good test results. If your child does not sleep or awakens early, testing may need to be rescheduled.
While the child sleeps, the audiologist and graduate student clinician will place electrodes on the forehead and ears, which collect nerve responses to the presented sounds. The audiologist will ask that everyone in the room is quiet and cell phones are on silent mode. This test may last up to 2 hours.