What Is Audiology Evaluation, Who Performs It and How?

Do you think she can't hear well? Does she respond to noises and speech? When my daughter was about that age, she was speech delayed, so we did that whole thing. Yes, it was a special doctor. They had a sound booth that they put her (us) in and made sounds from different directions. They watched to see if she looked in the direction if the sound. They also strapped her down with a straight jacket and cleaned out her ears, which was completely traumatic and she was horrified of any doctors office after that for many years. BTW... my daughter was fine, she just wasn't "ready" to talk. When she finally decided to speak, she did it in full sentences!

you go to an audiologist ... my ENT sent us there, we sat in a room like a sound booth (recording studio) and they had two speakers with lights on them at either side of the room. If the kiddo responds by looking in that direction (diff sound levels) then all is well, if they need to they will proceed with other tests that do involve putting things in thier ears, this sucks let me tell you what, but it has to be done. by the end of it all my son needed tubes, adnoids removed and is doing very well now passes all his tests with flying colors.

you need to take your child to an audiologist for a comprehensive hearing exam.

your ped was just checking the response of the tempanic (sp?) membrane - not hearing function.

To find out about my son's hearing problem I first took him to his regular doctor (He doesn't go to a pedi, we all see a family doctor) and they did a simple test with him raising his hand to different tones. With that they could see that there was a problem that needed further evaluation by an ENT.
If you are concerned I would suggest that you find an ENT yourself if a referral is not needed for insurance purposes. They can do a very through test to see if there is and what type of hearing loss it could be.
Best Regards,
C.

Your daughter had a tympanogram done in her pediatrician's office - this is used to measure pressure in the ear, and can be used to diagnose ear infections, for example. It is not a substitute for a thorough evaluation, which you should have done by a pediatric ENT. At your daughter's age, she will probably be taken to a sound-proof room (she can sit on your lap) and the audiologist will use a series of tones to determine her threshold for hearing and if both ears are functioning properly. More detailed tests can be done when the child is older, and verbal, that are even more accurate, which include wearing headphones and repeating words. These tests cannot be done in a regular pediatrician's office, you really do need a specialist for this one. Good luck!

It's likely your daughter had the tympanogram, but I think that's strange that a pediatrician would be doing such a test. I thought only audiologists were qualified to read those tests. A tympanogram measures ear pressure which tells the doctors if the bones in the middle ear are moving correctly. If a child has frequent ear infections, the middle ear can get gunked up, and the bones will sometimes move sluggishly or not at all, which effects hearing. Good news is that this can be corrected, but it sounds like your daughter doesn't have that issue.

Your daughter is too young to do a traditional hearing test, but they do have ways to do testing in young children using kid-friendly prompts. They can also do a text that allows them to check neurologic activity to determine if your daughter's inner ear is working properly. These neurologic tests are done by an audiologist, not neurologist. All specialized tests for hearing should be done by an audiologist who specializes in helping children.

My son has auditory processing disorder and had numerous ear infections as a child. He always passed the hearing tests at the pediatrician's office, and at school, but when he was 6-1/2 we took him to an audiologist (of our own accord, the pediatrician said he was fine). It was discovered he had a mild conductive hearing loss, which is an issue with the bones in the middle ear. Thankfully it was correctable. He had to go to another audiologist to be diagnosed with auditory processing disorder, which is an issue with how the brain processes nerve signals of hearing (often called dyslexia of the ears). I only tell you all this because I feel our pediatrician let us down, and I wish so much he had told us earlier to get the audiology exam. I would listen to your neurologist.

HTH,
B.

We took my son to have his hearing testing at about 15 months because he failed every hearing test he had ever had (but he was speaking well) and he passed the test just fine. They took just into a room, put some things in his ears, and watched his different reactions to different noises.

Your post has me thinking though, my daughter didn't start speaking at all until 18 months (now she talks your ears off at 2) and they were not concern about that until about 17.5 months. It is an expensive test, so maybe wait a couple months and see what her language does then.

My guess is the doctor is not concerned about her hearing at this point. Does she respond to your voice? And from across a room? A doctor does a simple hearing test, but I believe you need a referral (sp) to see the audiologist, I think your doctor probably doesn't think it is necessary.

My son was evaluated. He had to go in a special room where they had speakers set up. When he heard a sound he would move his head towards the loud or sharp sound. They do it in intervals of sound and pitch. No pediatrician can do a full audiological evaluation.

Please get a more extensive audiology report the one done in the doctor's office is just NOT good enough. If you have insurance call UCLA immediately and ask for a more extensive test. Dr's are not equipped to do an deeper exam (it doesn't hurt). If you have no insurance please call the John Tracy Clinic they do it for free however the wait can be three months. It is very important!

Penny Amic CEO/Clinical Director
Special Beginnings, Inc.
An Early Intervention Network

If your daughter has a speech delay, you should see an audiologist and have her hearing tested, and also have an evaluation by a Speech therapist. If she has more than one issue, I would switch from a neurlogist to a Developemental Pediatrician. It may take you a long time to get an appointment, but they will call in every area of assessment that she needs, from speech, to Occupational therapy, cognative, neurological, psychological, physical, social, genetic...everything she needs, all rolled into one report for you, so that you do not have to guess. Pediatricians are not all good case managers for developmental issues, you need a specialist to be sure that you are not missing anything. My guess is, your pediatrician checked to see if she had fluid in her ears, which is not the only cause of hearing loss.

Continue with the other scattered appontments until you can get in to see a Developmental Pediatrician, you can start therapy for the things you see now, like speech, or motor issues. Start as much therapy as you can as soon as you can.

For young children, they will probably do an ABR, when they numb her ears and put an electrode in the ear canal to measure brain activity. It is difficult, but not imposible, to get behavioral hearing assessments done at her age, but they may try. This can't be done in a doctors office, only an audiologist would have the means to do these.

You are right to trust your gut on this, get more, rather than less evaluation. Pediatricians are there for your day to day issues, development is a specailty, and Developmental Pediatricans are the ones to see.

Good luck.
M.