Even a mild hearing loss can affect a child’s ability to develop speech appropriately. At Clear Choice Hearing and Balance our Audiologists are well trained to help identify hearing loss early so as to avoid any preventable speech delays. We provide our patients with up-to-date technology to accurately perform hearing diagnostics and a safe, fun, and energetic environment that will keep you and your child at ease during the appointment.


Risk Factors for Congenital Hearing Loss

  • Family history of permanent hearing loss in childhood
  • Maternal infections during pregnancy or delivery (Toxoplasmosis , Syphilis, HIV, Hepatitis B, Rubella , CMV, Herpes simplex, and others)
  • Physical problems of the head, face, ears, or neck (cleft lip/palate, ear pits/tags, atresia, and others)
  • Ototoxic medications given in the neonatal period
  • Syndrome associated with hearing loss (Pendred, Usher, Waardenburg, neurofibromatosis)
  • Admission to a neonatal intensive care unit greater than 5 days
  • Prematurity (< 37 weeks)
  • Hyperbilirubinemia

3-3-6 Rule

  • 3 weeks: A new born should have a hearing screening before leaving the hospital or within the first three weeks of life.
  • 3 months: If the child did not pass the initial hearing screening steps should be taken with the audiologist and pediatrician to make sure any permanent hearing loss is identified by this time.
  • 6 months: Intervention should start as soon as possible if a permanent hearing loss is found. Treatment for hearing loss can be most effective if it’s started before a child is 6 months old.


  • Parent/caregiver concern regarding hearing
  • Delays in speech/language development
  • Recurrent middle ear infections or one episode lasting < 3 months
  • Head trauma associated with loss of consciousness or skull fracture
  • Bacterial meningitis and other infections (mumps, encephalitis, viral labyrinthitis)
  • Exposure to potentially damaging noise levels
  • Ototoxic medications received at any time



Non-sedated Auditory Brainstem Response (ABR)

  • The Auditory Brainstem Response (ABR) uses a computer to measure the child’s hearing nerve in response to certain sounds. It is performed by applying electrodes to the skin, around the ear. Sounds are made through the child’s ears through insert headphones and the electrodes measure the nerves response to the sounds.
  • An ABR test is safe and does not hurt
  • This testing should be completed when the child is very quiet. Nap time and feeding times are ideal for testing accuracy.
  • The test will take 1-1.5 hours

Distortion product otoacoustic emissions (DPOAE)

  • DPOAEs are responses generated when the cochlea is stimulated simultaneously by two pure tones.
  • Initial newborn hearing screenings use DPOAE testing to determine if a child needs further hearing evaluations.
  • To perform a DPOAE test, the audiologist with place a probe in the patient’s ear. The probe will emit a series of tones. The results will be either: pass or fail.
  • The test will take 2-3 minutes. The more quiet the patient is the faster the test can be completed.

Visual reinforced audiometry (VRA)

  • VRA is a behavioral test for evaluating hearing in toddlers and children too young for normal hearing evaluations.
  • Lighted toys are placed 90-degrees to each side of the child to “train” the child to look toward the direction of the sound that is presented by the audiologist. The audiologist reduces the intensity of both the sound and visual stimuli until she determines your child’s minimum hearing threshold. She will continue using different pitches in both ears until the audiogram is complete for your child.
  • This test is best used with children 6 months- 3 years old.

Conditioned play audiometry (CPA)

  • CPA makes a game out of the hearing test. The audiologist will provide an activity for the child to participate in to respond to the stimuli that is presented.
  • Blocks, balls, pegs, rings, and tablet games are used to elicit a response.
  • CPA is a behavioral test for evaluating hearing in children from ages 2-5 years old.


  • During a Tympanometry test, an audiologist inserts a pressurized probe into your child’s ear. It measures the ear drum’s response to changes in pressure.
  • Tympanometry is often used to detect the presence of otitis media.
  • A normal result means there is normal middle ear mobility. Meaning, measurements are normal and the eardrum is moving normally.
  • An abnormal tympanogram may reveal the presence of fluid in the middle ear or a perforation in the tympanic membrane (ear drum). It can also show such things as an excessive wax build up or scarring from frequent ear infections.

Cerumen removal

An audiologist will first perform otoscopy using an otoscope to visualize the ear canal and ear drum. If wax is impacted or the ear drum is not visible, the audiologist will use a light up curette to visualize and safely remove the wax.

Central Auditory Processing Disorder evaluations(CAPD)

  • Central auditory processing is how your brain responds to what your ears hear. Children who have difficulty with auditory processing usually have normal hearing, but often have difficulty hearing in background noise, difficulty remembering instructions, and difficulty understanding people when they speak quickly.
  • CAPD can be performed on children 6 years and older.
  • If your child is diagnosed with ADD/ADHD please keep them on their medications for this testing.

Pediatric hearing aid fittings

We provide children with the most up to date hearing technology. Working with the proper hearing aid manufacturers for your child. Hearing is important to education. We will work closely with the child’s pediatrician and educators to be part of a team effort to provide the child the best opportunity for success.



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