Clinical Guidance Document: Assessment of Hearing in Infants and Young Children

This clinical guidance document describes recommended practices for the assessment of auditory function in children. The most appropriate protocol will be individualized for each child based on their developmental and/or chronological age and other relevant factors. Thus, test procedures needed to address this population are diverse. The scope of practice and responsibility of the audiologist is to determine the appropriate test procedures to use for each child.

Tools and Materials

Key Points

The following areas make up the pediatric audiological assessment test battery and are addressed within this document:

• Behavioral observation
• Visual reinforcement audiometry
• Conditioned play audiometry
• Speech audiometry
• Physiologic assessments, including
  • Acoustic immittance, including tympanometry and acoustic reflex testing
  • Otoacoustic emission testing
  • Auditory brainstem response
  • Auditory steady state response audiometry

  For final determination of type and degree of hearing loss, results from behavioral, physiologic, and electrophysiologic testing should be combined. Any discrepancies among these procedures should be investigated and explained. For infants, very young children, and some children with severe developmental disabilities, participation in behavioral measures may not be possible. Because electrophysiologic testing can be performed at earlier ages than behavioral measures, electrophysiological results may need to stand alone for a period of time. However, as soon as the child is able to participate, behavioral threshold measures should be obtained and used to cross-check prior results.

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  Whether serving on a clinical document development panel or participating as peer reviewers, volunteers have regular chances to deepen their engagement with the Academy and make important contributions benefiting the field of audiology. If you are interested in clinical document development, please volunteer to express interest and submit a CV to the Academy’s guidelines staff by email. To view the list of guidelines and strategic documents in development and to learn more about the Academy’s clinical document development process, visit the Academy’s Practice Resources website. Information from interested members is accepted on an ongoing basis, and members will be contacted as clinical document volunteer openings occur.