Medical Services >> Therapeutic Outpatient Services >> Audiology
Pediatric audiologists at Franciscan Hospital for Children provide comprehensive evaluation and management for infants, children, and adolescents. The Audiology Program is accredited by the Medicaid Hearing Aid Program, DPH Hearing Aid Program and Hearing Evaluation Program for Infants and Toddlers.
The Audiology Program provides the following services:
- Comprehensive Audiological Evaluations
- Auditory Brainstem Response Testing (ABR)
- Distortion Product Otoacoustic Emissions(DPOAE) testing
- Auditory Processing (AP) Evaluations
- Hearing Aid Evaluations
- Counseling, advocacy and follow-up
- Educational Consulting
- Custom Swim Molds
To schedule an appointment with an audiologist or to inquire about our services, please call 617-254-3800 ext. 5110.
Comprehensive Audiological Evaluations
During a comprehensive audiological evaluation the audiologist measures degrees of hearing for different tones (pitches) which are critical for speech-language development and communication. Through this evaluation we answer the question: “What does my child hear”. A tympanogram is usually performed during this evaluation to determine if your child has any middle ear problems.
How is the evaluation performed?
- The type of testing conducted is determined by your child’s age and developmental abilities:
- Visual Reinforcement Audiometry – the child responds by turning toward tones, speech and music presented through speakers or earphones; the audiologist reinforces these responses using lighted toys.
- Conditioned Play Audiometry – the child is taught to play a simple game that involves placing blocks or toys in a box in response to hearing a sound.
- Older children can respond to sounds by raising their hand and repeating words.
Auditory Brainstem Response Testing (ABR)
For some infants and children, behavioral testing does not provide reliable results. In these cases and Auditory Brainstem Response Test (ABR) testing is used to measure the hearing sensitivity. The ABR can provide useful information about the type and amount of hearing loss, the effect on communication, and the functioning of the hearing nerve.
The most common age for this testing is birth to six months, however, this test is also used for very young children and older patients who cannot be tested reliably by conventional means due to cognitive and/or developmental impairments.
This test is performed while the child is sleeping. It identifies the softest sounds that the child can hear at various pitches and evaluates how well sounds travel along the hearing nerve pathways from the ear to the brainstem.
How is the ABR performed?
- Three stickers are placed on your child’s head and neck, connected to leads going to a computer. Sounds are presented to the ear through insert earphones while the computer analyses the brain wave responses to the sounds.
- The test is done while the child is sleeping.
How long does the test take?
- ABR evaluations take approximately 2-3 hours.
- You will know the results immediately at the end of the test.
Distortion Product Otoacoustic Emissions(DPOAE) testing
Distortion Product Otoacoustic Emissions (DPOAE) is used to determine if the tiny hair cells in the inner ear are functioning. It is a short test (~ 2 minutes) that is measured by placing a miniature microphone and ear phone in the ear canal. Sounds are presented and a response from the inner ear is recorded. The child does not need to respond in any way; they only need to remain still. For young children, toys and other visual distractions are used to keep help them remain quiet.
When is this test performed?
- DPOAEs may be performed during your child's visit for an ABR or as part of your child's comprehensive audiological evaluation.
A common cause of hearing loss in children is middle ear dysfunction. Problems such as fluid in the middle ear, a small hole in the eardrum, or problems with the small bones in the middle ear can cause hearing loss that is typically treatable.
Tympanometry is a brief test that measures middle ear function. It is performed by placing a small rubber earphone is placed in your child's ear canal; eardrum movement is measured in response to air pressure changes. Tympanograms are used to determine whether your child has middle ear problems needing medical attention.
When is this test performed?
- A tympanogram may be performed during your child's visit for an ABR or as part of y our child's comprehensive audiological evaluation.
Auditory Processing (AP) Evaluations
For some children, the outer, middle and inner ear appear to function normally, but they still have difficulty understanding speech in certain situations or learning in school.
Auditory Processing (AP) Evaluations assess the child's ability to listen in background noise, understand speech that is not quite clear, and organize what is heard. AP evaluations help us understand Òwhat we do with what we hearÓ.
AP evaluations are administered to children 7 years of age and older who have normal hearing and normal cognitive development but often have difficulty listening and understanding what is said, have difficulty following multi-step directions, or have learning problems.
AP evaluations determine how a child performs on various tests designed to stress the auditory system, such as listening in background noise, listening to more complex information and temporal sequencing.
Results are compared to age level peers.
Recommendations are provided for parents and teachers.
Counseling, advocacy and follow-up
What happens if my child is identified with a hearing loss?
If a hearing problem is found, the audiologist and your pediatrician will arrange for your child to be seen by an otolaryngologist (ear, nose and throat physician) and will guide you to other services to help your child communicate.
The audiologist will also:
- Monitor your child's hearing
- Provide counseling regarding the hearing loss
- Recommend hearing aids and refer you to a Hearing Aid Specialist to maximize your child's residual hearing.
- If your child has a severe to profound hearing loss in both ears we will refer your child for an evaluation and consultation at a Cochlear Implant Center.
- Refer your child for speech/language assessments.
- Provide your family with community and educational resources for children with hearing loss.
Hearing Aid Evaluations
Although FHC does not directly dispense hearing aids, the audiologist will assess the need for appropriate hearing aid technology based on your child's hearing loss and work with you to find a hearing aid dispenser.
The audiologist will also make recommendations for assistive listening devices for school and home.
Audiologists are available to consult with schools on classroom acoustics, seating arrangements, assistive devices and teaching strategies for children with hearing loss or auditory processing difficulty.
Custom Swim Molds
Patients with a perforation (hole) or PE tubes in their eardrum often are instructed by their physician to keep water out of their ears. Custom swim molds can be made and fitted for this purpose.
Should my child's hearing be tested?
Your child should have his or her hearing test if he or she did not pass the newborn hearing screening test in one or both ears. If your child passed the newborn hearing screening test, your baby's hearing should be tested again if there is a reason why your baby might develop a hearing loss or if you have any concerns.
Potential reasons why your child may develop a hearing loss:
- Infections at birth
- Being on a ventilator for a long time
- Having repeated courses of IV antibiotics and diuretics
- Having received ECMO therapy
- Having a syndrome associated with hearing loss
- Having a family history of hearing loss in childhood
- Injuries or traumas to the head or ears
Additional reasons why your child's hearing should be tested:
For babies, your child's hearing should be checked if:
- Your child has frequent ear infections.
- You feel that your child is not responding to sounds normally.
- Your baby does not startle or jump to loud sounds
- Your baby does not stop sucking or crying when there is a new sound
- Your child is not beginning to speak or understand words at the usual age. (See milestones of hearing)
For children, your child's hearing should be checked if:
- Your child's speech is difficult for most people to understand
- Your child often asks for things to be repeated
- Your child seems to watch your face closely when you talk
- Your child seems inattentive at home or school
- Your child does not communicate as well as other children the same age
- your child often responds to a question with an unrelated answer
- Your child prefers the TV or radio louder than others in your family
- Your child has had many ear infections
- Your child responds inconsistently to sound
Below are links to websites containing information about hearing and communication disorders:
Alexander Graham Bell Association for the Deaf www.agbell.org
American Speech-Language-Hearing Association www.asha.org
American Academy or Audiology www.audiology.com
American Society for Deaf Children www.deafchildren.org
Boys Town National Research Hospital www.boystownhospital.org
My Baby’s Hearing www.babyhearing.org
Self Help for Hard of Hearing People, Inc. www.shhh.org