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Pediatric Hearing Evaluation

Most children hear and listen to sounds from birth. The most important time for a child to learn language is within the first 3 years of life. Your baby actually begins to develop speech and language skills during the first 6 months of life by listening and imitating the speech sounds they hear as you are talking to them.

About 2 or 3 out of every 1,000 children in the United States are born deaf or hard-of- hearing. Children born with a hearing loss do not have the same opportunity to hear sounds around them and develop early language skills, so it is important to detect and identify a hearing loss as early as possible.

In Ohio, all newborns complete a hearing screening before leaving the birthing hospital. If your baby does not pass the hospital screening, you will be referred to a pediatric diagnostic center, like Columbus Speech & Hearing Center for a more thorough hearing evaluation. This testing should be completed before your baby is 3 months old. During the evaluation, three different tests will be used. The tests must be completed while your baby is asleep or very still:
  • Auditory Brainstem Response (ABR) - An ABR tests how the auditory or hearing nerve carries sound from the ear to the brain. The test is performed by placing four small electrodes on your baby’s head to detect responses and sounds are played through small, soft eartips that are placed in the baby’s ear canals.
  • Otoacoustic Emissions (OAE) - An OAE tests if the inner ear is responding appropriately to sound. A small, sponge earphone is inserted into your baby’s ear canal and a series of sounds are emitted to measure an “echo” response that occurs in normal hearing ears.
  • Immittance Test An immittance test checks to make sure the eardrum and bones in the middle ear are moving normally by placing a soft tip in the ear canal with small changes of pressure in the ear canal.
We will ask you to bring your baby to their appointment ready for a feeding and a nap. By depriving your baby of nap time before the test, most babies will sleep through the testing.

The tests are completed in a quiet room. Your child may be held in your arms or lie in an infant carrier during the test. ABR testing must be completed while your child is asleep or is very relaxed and still to ensure that the baby’s movements do not interfere with the test.

Once the testing has been completed, the audiologist will review and interpret your child’s test results and contact you within two business days with the results of your child’s evaluation.

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Even though early hearing tests are designed to detect hearing loss as soon as possible, some children may not develop a hearing loss until later in childhood. If your child passed the hearing screening completed at birth, you should continue to monitor how they are responding to you and the sounds around them. If you think your child may have a hearing loss, contact us at 614-261-5452 and schedule a hearing check for your child.

How Does Your Child Hear and Talk?

Every child is unique and has an individual rate of development. This chart represents, on average, the age by which most children will accomplish the listed skills.

Hearing and Understanding

Birth-3 Months
  • Startles to loud sounds.
  • Quiets or smiles when spoken to.
  • Recognize your voice and quiets if crying.
  • Increases or decreases sucking behavior in response to sound.

4-6 Months
  • Moves eyes in direction of sounds.
  • Responds to changes in tone of your voice.
  • Notices toys that make sounds.
  • Pays attention to music.

7 Months-1 Year
  • Enjoys games (peek-a-boo and pat-a-cake).
  • Turns and looks in direction of sounds.
  • Listens when spoken to.
  • Recognizes words for common items like “cup”, “shoe”, “juice”.
  • Begins to respond to requests (“Come here”, “Want more?”).

1-2 Years
  • Points to a few body parts when asked.
  • Follows simple commands and understand simple questions (“Roll the ball”, “Kiss the baby”, “Where’s your shoe?”).
  • Listens to simple stories, songs, and rhymes.
  • Points to pictures in a book when named.

2-3 Years
  • Understands differences in meaning (“go-stop”, “in-on”, “big-little”, “up-down”).
  • Follows two requests (“Get the book and put it on the table”).

3-4 Years
  • Hears you when you call from another room.
  • Hears television or radio at the same loudness level as other family members.
  • Answers simple “who?”, “what?”, “where?”, “why?”, questions.

4-5 Years
  • Pays attention to a short story and answers simple questions about it.
  • Hears and understands most of what is said at home and in school.


Birth-3 Months
  • Makes pleasure sounds (cooing, going).
  • Cries differently for different needs.
  • Smiles when sees you.

4-6 Months
  • Babbling sounds more speech-like with many different sounds, including p, b and m.
  • Vocalizes excitements and displeasure.
  • Makes gurgling sounds when left alone and when playing with you.

7 Months-1 Year
  • Babbling has both long and short groups of sounds such as “tata upup bibibibi”.
  • Uses speech or non-crying sounds to get and keep attention.
  • Imitates different speech sounds.
  • Has 1 or 2 words (bye-bye, dada, mama).

1-2 Years
  • Says more words every month.
  • Uses some 1-2 word questions (“where kitty?” “go bye-bye?” “what’s that?”).
  • Puts 2 words together (“more cookie”, “no juice”, “mommy book”).
  • Uses many different consonant sounds at the beginning of words.

2-3 Years
  • Has a word for almost everything.
  • Uses 2-3 words to talk about or ask for things.
  • Speech is understood by familiar listeners most of the time.
  • Often asks for or directs attention to objects by naming them.

3-4 Years
  • Talks about activities at school or at friends’ homes.
  • People outside family usually understand child’s speech.
  • Uses a lot of sentences with 4 or more words.
  • Usually talks easily without repeating syllables or words.

4-5 Years
  • Voice sounds clear like other children’s.
  • Uses sentences that give lots of details.
  • Tells stories that stick to topic.
  • Communicates easily with other children and adults.
  • Uses the same grammar as the rest of the family