Pediatric Audiology at Spaulding Center for Children Sandwich
No infant or child is too young for a hearing evaluation. Our pediatric audiologists have the specialized training, skills, and equipment to provide diagnostic audiologic evaluation for children of all ages, including our very youngest listeners, newborns!
We are proud to be one of only 20 facilities in Massachusetts approved by the Massachusetts Department of Public Health (MDPH) for audiological evaluation of infants and young children. MDPH’s rigorous standards assure you that our audiologists have expertise in pediatrics, use developmentally appropriate procedures and interventions, and provide child and family centered care. Our staff works closely with families, schools, early intervention programs and other developmental specialists to ensure that you, and the important members of your child’s team, understand the results of your child’s evaluation.
What to Expect
Parents often worry that a child might not be ready or able to participate reliably in the evaluation. Don’t worry! We understand kids and will customize procedures and expectations to your child’s developmental and individual needs and abilities. There is no need to prep your child for the evaluation but trying on headphones or earbuds at home while playing a game or listening to music may minimize any fear of our earphones. If earphones are too scary for your child, we will use calibrated loudspeakers to test your little one’s hearing.
Evaluations are scheduled for one hour except where noted. Younger children need a parent or guardian to stay with them in the sound suite. Please bring another adult to stay with any other siblings or other children you plan to bring. No other children will be allowed in the soundsuite.
Spaulding's Approach to Pediatric Audiology
We will choose from the following audiological procedures based on your child’s individual needs during a typical evaluation to find the softest sounds your child hears or can respond to:
- Visual Reinforcement Audiometry (VRA) – Hearing levels are established by using animated toys or computer generated images to train your baby to locate sounds presented through calibrated loudspeakers and/or earphones. Most often used with infants who are developmentally over 6 months of age and young toddlers.
- Conditioned Play Audiometry (CPA) – Children are taught to “play a game” while responding to calibrated sounds through earphones or calibrated loudspeakers. Your child may throw a ball in a bucket, put a peg in a pegboard or complete another game while listening for sounds. Typically used with older toddlers, young children or an older child who needs a “fun” task to stay interested in listening.
- Speech Audiometry – Assesses the softest level an infant or child is able to detect or recognize speech and, when developmentally appropriate, how clearly a child hears speech in quiet, and sometimes, in noise.
- Select-A-Picture Audiometry – Standardized picture pointing tests are available to assess how softly and/or clearly a child hears speech for children who are not ready, or too shy, to repeat words.
- Traditional Audiometry – Children who are developmentally over 5 may be trained to press a button or raise their hand when they hear a sound.
- Tympanometry – A soft tip is placed in your child’s ear briefly to check for possible problems affecting the ear canal, eardrum or middle ear system that may not be detected by routine ear check or otoscopy, such as “silent” middle ear fluid. Tympanometry is quick, painless and objective.
- Acoustic Reflex Measures- Used with tympanometry, small reflexes from your child’s ear may be measured in response to certain sounds, providing additional information about the function of your child’s ear and hearing.
- Distortion Product Otoacoustic Emissions (DPOAEs) – A soft earphone placed in your child’s ear will play sounds to the ear over several minutes. A healthy ear will respond by producing its own soft sounds that are picked up by the microphone in your child’s ear. DPOAEs can provide information about possible range of hearing but do not measure hearing. DPOAEs require the child or infant to sit quietly for a few minutes and are painless. Our team will help distract your child if sitting quietly is a challenge!
- Otoscopy – A quick ear check is important to identify any obvious ear health concerns and to assure that wax blockage or a foreign object is not present.
- Auditory Brainstem Response (ABR) Audiometry (also called BAER and BSER) – ABR testing is recommended for anyone developmentally under 6 months of age and older infants and children when additional data is necessary that cannot be obtained via more traditional procedures (e.g., VRA, CPA). For some children the data is necessary to confirm normal hearing. For others the data is necessary to confirm hearing loss and provide important diagnostic data about the type, location in the ear and degree for each ear.
- Auditory Processing Evaluations (also known as Central Auditory Processing or CAP Evaluations) – Some children, despite normal or near normal hearing, still have difficulty “processing” auditory information. Typically, auditory information, such a teacher speaking to a classroom, or a parent talking from another room, is instantly heard and recognized or understood. Children with auditory processing disorders often have less efficient auditory systems that delay or distort auditory information making recognition more difficult. This inefficiency is typically more noticeable when the auditory system must work in difficult listening situations, such as in the presence of background noise. A child may have a delay or disorder in the ability to distinguish tiny differences in speech sounds that are used to help speech understanding in quiet or in difficult listening situations.
- Hearing Aid Evaluation and Assessment - If your child or baby has a hearing loss, the hearing aid evaluation can provide answers to several questions specific to your child’s hearing loss and listening needs, including, will my child benefit from amplification, does my child need one or two hearing aids, what hearing aid style is best for my child, what features are important for a child, what accessories are needed or desired, and what are the benefits and limitations of amplification. Once your child has been fit with amplification the hearing aid evaluation can assess the benefit of amplification using a variety of tests and verify that the hearing aids are programmed and fit properly to optimize speech perception.
- Assistive Listening Device (FM/DM) Selection and Assessment - Children with hearing loss or auditory processing disorders typically benefit from the use of assistive technology in the classroom where it is difficult to hear the teacher optimally due to competing noise. Our audiologists will make recommendations for specific equipment based on your child’s hearing loss, school placement and use or non-use of amplification.
- Evaluation of Auditory Rehabilitation Status - For infants and children with hearing loss, our audiologists will assess auditory skills and function before or after the use of amplification to help determine an appropriate plan of intervention.
- Auditory/Aural Rehabilitation – For infants and children with hearing loss, our audiologists may provide therapy or training to improve auditory perception, communication strategies, language skills and/or assistance with management of hearing aids and assistive devices.
- Young Musician’s Program – Does your child play an instrument? Sing or play in a band or orchestra? Our young musician’s program monitors hearing and auditory function to identify potential problems early and provide instrument specific recommendations for hearing conservation and protection.