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Understanding Pediatric Auditory Responses and Hearing Loss Identification in Children

This article explores pediatric auditory responses and highlights the significant effects of response types in children compared to adults. It delves into the various methods for identifying hearing loss in infants and children, emphasizing universal newborn hearing screening and objective testing methods such as OAEs and ABR. It discusses the implications of auditory processing disorders in children with normal hearing and intelligence, outlining effective management strategies in educational settings. The prevalence of measurable hearing loss in U.S. children is also examined, along with issues related to nonorganic hearing loss.

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Understanding Pediatric Auditory Responses and Hearing Loss Identification in Children

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  1. Pediatric Assessment Summer 2007

  2. Auditory Responses • In adults, response type was unimportant • With children, it can have significant effects • Possible responses cover a WIDE range of behaviors • Children do not typically respond to sounds at threshold, but only to sounds more clearly audible: Minimum Response Levels (see Table 8.1)

  3. Identifying Hearing Loss in Infants under 3 Months of Age • Infant hearing screening was historically done only with those “at risk” for hearing loss. • In the last 15 years, UNIVERSAL newborn hearing screening has come into wide use – on a state-by-state basis. • Objective tests used to screen: • OAEs • ABR

  4. Testing Young Children • Reflexive reactions (e.g.,Moro within 2 mos) • Behavioral Observation Audiometry: thru 6-8 mos • Conditioned Orienting Reflex/Visual Reinforcement Audiometry from 4 months • Play audiometry (18 months and up) • Operant conditioning audiometry • Electrophysiologic Tests • OAEs, Aud Evoked Responses

  5. Visual Reinforcement Audiometry SPEAKER LIGHT-UP, ANIMATED REINFORCERS DISTRACTER TOY

  6. Auditory Processing Disorders “How the ear talks to the brain and how the brain understands what the ear is telling it.” -- Musiek

  7. The Child with APD • has normal hearing • has normal intelligence • has trouble using auditory input • cannot learn well through audition alone • will have difficulty in noisy, open classrooms • may have difficulty attending to sound for any length of time

  8. Management • Classroom Modifications • Remediation Activities • Compensatory Strategies • Each child is unique -Blanket recommendations don’t work

  9. Identifying Hearing Loss in the Schools • 14.9% of US children aged six to nineteen have a measurable hearing loss in one or both ears (Niskar et. al., 1998) • Screening programs mandated by states at specific grade levels.

  10. Nonorganic Hearing Loss in Children • Feigning a hearing problem, most commonly for attention. • More common in 10 to 14 year olds, • But may appear in younger children as well.

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