Auditory Brainstem Response (ABR, BAER)
- This test measures the brain wave activity that occurs in response to clicks or certain tones. It is also used to identify hearing loss that can occur in the brain or brain pathway. At Kennedy Krieger, ABR can be administered under natural sleep conditions or during moderate sedation using a nasal spray. During sedated procedures, a child's vital signs are monitored by a nurse and a physician is immediately available, if needed. This test is most suitable for individuals who cannot complete traditional testing methods due to age, developmental level or health challenges.
Comprehensive Audiological Evaluations
- These assessments determine a child’s ability to hear using tests that require participation from the child and those that do not. Behavioral testing method is selected based on the child’s age and developmental level, and can include:
- Visual Reinforcement Audiometry (VRA): The child hears a sound presented through either a speaker or a headphone/earphone, is taught to turn toward the sound and is then rewarded with a video or light up toy.
- Conditioned play audiometry (CPA): The child is taught to provide a play response (dropping a block in a bucket, stacking a peg, etc.) each time they hear a sound.
- Conventional audiometry: The child responds to a sound by raising their hand, pushing a button or saying a word.
- These evaluations also include measures of speech recognition/discrimination, in which a child repeats back or points to a picture of the word they heard.
- Hearing screenings typically take place prior to speech and language evaluations to ensure a child’s middle ear status and hearing are adequate for the evaluation to take place. A screening consists of a combination of tympanometry and behavioral testing. Screenings are most appropriate for children who have no prior risk factors for hearing loss.
Acoustic Immittance Measures (Tympanometry and Acoustic Reflexes)
- Tympanometry is a test that creates changes in the air pressure in your ear canal in response to a low-pitched tone. The measurement can tell us if there is a problem with the middle ear like an ear infection, middle ear fluid, Eustachian tube dysfunction, a hole in the eardrum, etc. It does not require a response from the child, but does require a small earbud to be placed in the ear in order for the measurement to occur.
- Acoustic reflex measures are obtained by presenting loud sounds of varying pitches to the ear. In response, a muscle in the middle ear space contracts. This measurement can provide additional information about the status of the middle ear, the organ of hearing and the hearing nerve.
Otoacoustic Emissions Testing
- This is an evaluation of the cochlea (the organ of hearing in the inner ear). Sounds are presented in the ear and the echo of the vibrating inner hair cells that travels back through the ear is then measured by a tiny earbud. This measurement does not require a response from the child, but does require a small earbud to be placed in the ear and for the child and environment to be relatively quiet during testing.
If your newborn fails the hearing screening, it does not always mean that your baby is hearing impaired. There are multiple reasons why a baby will fail a test, including fluid in the ear, movement, crying or too much noise in the room. In fact, most babies who fail the test have typical hearing. However, if your newborn does fail the hospital screening test, it is extremely important to have follow up diagnostic testing performed by an audiologist who is experienced with working with infants. Our clinic offers a state-of-the–art test called Auditory Brainstem Response (ABR) that is specifically designed to perform a diagnostic screening for newborns who fail the hospital hearing screening, as well as for older children if there is a suspicion of hearing loss that cannot be confirmed through more conventional hearing tests. The ABR test is safe and does not hurt. In fact, for children younger than six months of age, the test can usually be done while the baby is napping. Learn more
Kennedy Krieger Institute Audiology fits a wide range of hearing aid styles and manufacturers, chosen based on a patient’s unique needs. We use both objective measurements (electroacoustic analysis, probe microphone measurements) and developmentally appropriate behavioral tests to assess hearing aid function and benefit.
Auditory Processing Evaluations
These evaluations assess how the brain processes auditory information. These tests require listeners to attend to speech and other auditory signals and respond to them, and are typically performed on children ages 7 and up. People with auditory processing disorder tend to complain of difficulty hearing in background noise, following multi-step instructions, localizing sound sources and discriminating between similar sounding words, while still exhibiting normal hearing on diagnostic testing. Before scheduling your child for an auditory processing evaluation, please make sure they can meet the following criteria:
- Is your child at least 6 years old? (Please note that there are several tests that are not normed for children under 7/8, so a full evaluation may not be able to be completed at 6).
- Will your child tolerate wearing headphones/earphones for an extended period of time?
- Can your child follow instructions (raise your hand when you hear the beep, repeat the word the man says, etc.)?
- Does your child know their right from left?
- Can your child sit still and participate in testing (with breaks as needed) for up to two hours?
- Is your child’s speech mostly understandable to those who don’t know them?
Clinical Services: Inpatient Services
Comprehensive audiological services are provided to inpatients in conjunction with interdisciplinary evaluations and upon referral by the attending inpatient physician.