Johns Hopkins All Children's Audiology Pediatric Hearing Evaluations

We use a variety of methods to test children’s hearing, depending on their age and developmental level.

Your child’s hearing can be tested at any age, including as a newborn. All babies born in Florida have a hearing screening following birth, typically before leaving the hospital.

Children at a developmental level of 6 months of age are most often tested in one of our state-of-the-art sound booths. We use various techniques including game-like activities to gather information about their hearing. 

Because our master’s and doctorate level audiologists work only with children, we can recognize the subtle listening behaviors in children to help provide an accurate diagnosis. Our team looks for all of your child’s potential listening behaviors and uses play to engage the child and obtain a clear picture of his or her hearing. Our audiologists also are experienced in hearing testing for children with special needs.

Infant hearing screening and assessment

If your baby is identified with hearing loss, our audiologists will help you evaluate the options for follow-up testing. We can assist with referrals to our pediatric otolaryngologists and other medical specialists as needed.

We provide follow-up screening and diagnostic services for newborns and infants. We use specialized testing to determine how a baby hears so that we are identifying any concerns as soon as possible. If a risk factor for a future change in hearing is identified, such as certain chronic illnesses or treatment with specific medications, our audiologists can monitor your child's hearing as he or she grows.

Components of hearing evaluations

A hearing evaluation helps to determine the amount and type of hearing loss your child has. An evaluation may include several kinds of tests, depending on your child’s needs. Some of the tests we provide include:

Auditory brainstem response testing

Auditory brainstem response (ABR) testing can be used to determine hearing sensitivity without the input of the child. ABR testing is a primary test used to evaluate newborn hearing. It may also be used with older babies and children who are unable to complete more standard testing.

During testing, ear tips placed in the ear canal will present different types of sounds at different levels of volume. Electrodes, which are like small, sticky bandages, are placed on the forehead and behind the ears, and will pick up the response of the hearing nerve. The electrodes help determine if the hearing nerve is sending a message that the sound was detected at a certain volume. The response does not tell how a sound was heard or how it was processed but it will show the levels at which a sound is identified, showing whether the child would hear that particular sound at normal levels or if a hearing loss is present for that sound.

Results from ABR testing are clearer and more reliable when the child is quiet, ideally sleeping. Some children will tolerate the required electrodes and ear tips, and the test can be complete when they are awake and playing quietly or watching a video. Testing may also be completed with anesthesia.

ABR testing can also be used to diagnose auditory neuropathy spectrum disorder (ANSD). ANSD is a unique type of hearing impairment in which sounds are not transmitted to the brain from the ear the same way every time. It can affect a child's ability to hear and understand speech clearly and to learn to speak.

Otoacoustic emission evaluation

Otoacoustic emission (OAE) evaluation uses a small microphone in the ear tip to detect sounds that are created when the cochlea, which is the main organ of hearing, is stimulated by sounds. When the cochlea is functioning normally, OAEs can be measured, providing information about the health of the cochlea. This test may be used as part of testing for a newborn or for an older child.

Behavioral hearing evaluations

This type of testing identifies the softest sound your child can hear to determine his or her level of hearing loss. The specific tests used depend on your child’s age or developmental level.

For young children, we look at whether they physically turn toward sounds coming through speakers in a test booth at different volumes (this is called visual reinforcement audiometry). Their responses show how their better ear responds or how the ears work together. If a child will tolerate, the same test may be completed with earphones placed in the ear canals, while the child is observed for turns to the side of the presented sound.

Children who are developmentally older may participate in a game of listening. The child will be taught to perform a task each time they hear a sound, such as placing a peg to build a tower with each sound heard. Children who can maintain attention to the task may be asked to respond with a standard hand raising technique when a sound is heard (this is called pure tone testing). The child will be asked to respond by repeating single words or by identifying what is said using a picture board (called speech reception threshold). The child may also be asked to repeat short words, at a comfortable listening level. This test (called speech discrimination testing) shows how words are understood at a normal volume of speech.

Central auditory processing disorder evaluation

Children with central auditory processing disorder often do not have difficulties hearing soft sounds, but they have difficulty processing what they hear. They may have trouble distinguishing among words with similar sounds, especially when there is background noise. A battery of tests is used to determine your child’s processing abilities. Learn more about central auditory processing disorder testing and treatment.


Tympanometry tests the way the ear drum moves. A soft tip is placed in the ear canal and sends a small puff of air to the ear canal. The result can show us if there is any problem with how the ear drum functions, such as whether there is fluid or possible infection behind the ear drum.

Contact Us

Medical records may be faxed to 727-767-8998.


For more information on hearing evaluations or to schedule an appointment, call 727-767-8989.

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