Children of all ages are evaluated for hearing problems. No child is too young to have a hearing evaluation. Audiometric evaluations are followed by family counseling with our audiologists. When necessary, we refer for medical evaluations, any additional professional assessments, and to other treatment programs or schools. Referring physicians are kept informed of audio logical evaluations and recommendations.
To make an appointment, please call 314-577-5671.
Signs and Symptoms
Your child should be evaluated by an audiologist if he or she:
- Failed or missed the newborn hearing screen
- Had an illness or condition requiring 5 days or more in a Neonatal Intensive Care Unit (NICU)
- Has a history of in utero infection, such as cytomegalovirus, herpes, toxoplasmosis or rubella
- Has frequent ear infections
- Has a speech/language delay
- Is not responding typically to speech or sounds in the environment
- Has family history of hearing loss
- Has been treated with ototoxic medications
- Failed a hearing screen at school or at the pediatrician’s office
- Often says “what” or “huh”
- Listens to the television or radio at a loud level
- Complains of not being able to hear
- Responds to questions inappropriately
- Has any known disorder or syndrome associated with communication difficulties
Common Diagnoses and Treatment
Read more about hearing loss here
Preparing for Your Visit
Our audiologists will review your child’s hearing and medical history, so it is helpful to review any previous hearing tests, know the status of the newborn hearing screen, and relay any medical conditions to an audiologist.
If you have other young children, it is best to leave them with a caregiver, so that you may give your attention to your child during testing. If you must bring other children with you, another adult will be needed to care for them during the visit.
Please note that if your insurance requires a referral, the referral must be brought with you at the time of your appointment.
Behavioral hearing tests take approximately one hour. We create a playful environment in our sound booth with games, toys, and puppets for the younger children. There are no shots given, and our testing is generally pain free. We do attempt to test using earphones for most children and use a small earplug for Tympanometry.
Tympanometry - measure of middle ear function
Approximate Duration: 5 minutes
A soft probe is inserted into the ear canal. Your child will hear a buzzing sound as the air pressure is changed in the ear canal.
The movement of the ear drum is then displayed on a graph called a Tympanogram.
Acoustic Reflexes - measure of the tiny ear muscle that contracts when a loud sound occurs
Approximate Duration: 15 minutes
The same soft probe that was used in Tympanometry is used for this test. Your child will hear moderately loud sounds and feel some slight pressure in the ear.
Auditory Brainstem Response (ABR) - measure of how well sounds travel along the hearing nerve pathways from the ear to the brainstem
Approximate Duration: 1-2 hours
Electrodes are placed on your child’s forehead and behind his or her ears. Small earphones will then be placed to deliver sound to your child’s ears.
Your child will need to be asleep during this test. Young children under the age of three months are not usually sedated, and the test is performed while the infant is naturally sleeping, following a feeding. Older children will need to be sedated in order to remain asleep and still during the test. This sedation is administered using an IV by a sedation nurse.
Specific instructions regarding your child’s test will be mailed home when an appointment is made.
Distortion Product Otoacoustic Emissions (DPOAE) - measure of inner ear function
Approximate Duration: 10 minutes
Because it is very important for your child to be quiet and relatively still for this test, the audiologist will try to quietly distract your child during the test. A soft, squishy probe is inserted into the ear canal and various beeps and buzzing sounds are heard. The equipment is “listening” for an echo from the inner ear.
Visual Reinforcement Audiometry (VRA) – measure of hearing levels in children 9 months to approximately 2.5 years old
Approximate Duration: 30 minutes
During Visual Reinforcement Audiometry (VRA) testing the child is typically seated on the parent's lap in a chair between two speakers (or using earphones). The child must be able to sit upright and turn their head from side to side. When a sound such as a tone at a specific frequency or speech is presented, the child typically will turn their head or shift their eyes toward the sound.
The child’s response is rewarded by a reinforcer such as a lighted mechanical toy or puppet. An audiologist or test assistant that is seated facing the child then distracts them back to midline (away from the speaker) so that additional sounds can be presented. Once the child is conditioned or understands the task, progressively softer sounds are presented.
Conditioned Play Audiometry – measure of hearing levels in children 2.5 to approximately 4 years old
Approximate Duration: 30 minutes
During Conditioned Play Audiometry a child is seated across from the audiologist or test assistant and is instructed to place a toy in a bucket or a peg in a board when a sound is heard. Sounds are presented through earphones but may also be presented through sound field speakers. Initial sounds are presented at an audible level to familiarize the child with the task. Once the child is conditioned or understands the task, progressively softer sounds are presented.
Learn more about your child's health in our KidsHealth library and resource center.
Meet the Team
Sarah Duncan, MS, CCC-A, Lead Audiologist
Maria Cabonce, MA, CCC-A
Carole Mange, AuD, CCC-A
Julie McAlister, MS, CCC-A
Laura Ortmann, MS, CCC-A
Kenny Marciniak, AuD, CCC-A
Sarah Borton, AuD, CCC-A
Joan Baker, Audiology Technician
Vivian Collins, Administrative Assistant
Marlene Gravat, PT, Director