Diagnostic Audiology Program Overview

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The Diagnostic Audiology Program at Boston Children's Hospital provides expert, comprehensive evaluation and management of infants, children and adolescents with various degrees of hearing. Our specially trained audiologists conduct diagnostic tests to assess hearing disorders, provide guidance to parents and families, and recommend appropriate care for your child's hearing. 

Your Child's Audiology Clinic Visit

Your child's Audiology clinic appointment will take approximately 1 hour. Please arrive on time to ensure that we can perform a full evaluation and provide appropriate recommendations and referrals for follow up. The test room should be quiet, so we ask that siblings only attend the session if another adult is able to come with you.

We will tailor your child's hearing assessment to his or her individual needs, with developmentally-appropriate behavioral and objective measures.

Behavioral Measures

Behavioral measures record your child's actions in response to sound. We use behavioral measures to:

  • Determine the presence, type and degree of hearing loss
  • Assess your child's ability to hear and understand speech information
 Test  What it measures  How it is done
 Visual Reinforcement Audiometry (VRA):Typically performed between the developmental ages of 6 months to 2 years* This test reliably measures your young child's responsiveness
to speech and tones.
 Sounds will be played through speakers and/or earphones.We will teach your child to respond to sound with a head turn.Then, we will reinforce the behavior with lighted/animated toys.
Conditioned Play Audiometry (CPA): Typically performed between the developmental ages of 2-4 years* This test measures your child's responsiveness to speech and different sounds. It also measures your child's ability to understand age-appropriate words. Your child will listen to different sounds and speech and will be taught to perform a play task after hearing a sound.

Conventional Audiometry: 
Typically performed with children developmentally age 5 and older*
This test evaluates your child's hearing sensitivity for speech and tones. It also assesses your child's ability to understand speech information in various situations. Your child will respond to sounds by pressing a button or raising his or her hand.
*Developmental age is a way to express your child's ability to perform certain tasks and functions.

Objective Measures

Objective measures record how your child's auditory system responds to sound.

Test  What it measures How it is done
 Tympanometry and acoustic reflexes  These tests help confirm or rule out problems with the ear drum and middle ear space. We will place a small earphone in your child's ear canal. The earphone will measure ear drum movement in response to the changes in the air pressure.
Otoacoustic emissions (OAEs)
 This test assess the function of the hair cells in the inner ear. It is used to screen for significant hearing loss in infants, and to monitor the effects of drugs that can damage hearing.  We will ask your child to remain still and quiet for a few minutes. sounds will be presented through a small earphone and a response from the inner ear is recorded.
Auditory Brainstem Response (ABR)
 This test assess electrical activity from the auditory nerve and the auditory pathway in the lower part of the brain. It determines the presence, type and degree of hearing loss.  This test is performed while your child is asleep or under general anesthesia, if necessary. Sound is presented to each ear and we measure the response.

After completing your child's hearing evaluation the Audiologist will give you the results of the hearing test. If there is a hearing loss, the audiologist will:

  • Monitor the hearing loss.
  • Provide informational counseling to you and your family regarding the hearing loss.
  • Recommend hearing aids, communication strategies and ways to maximize the use of residual hearing, as appropriate.
  • Refer your child for additional language or developmental assessments as needed.
  • Direct you to community resources for educational or financial assistance.
  • Answer any questions you may have at any time.

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944