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5232 Dawes Avenue
Alexandria, VA 22311

COVID-19 Update: Masks are required for all visits.

Hearing Testing for Children

If there are concerns about the child’s hearing because of a family history of hearing loss, complications at birth, severe illnesses or suspicion by the parent that something is not right concerning the baby’s hearing, hearing testing should be conducted as early as possible to catch hearing issues during the important early period of development of speech and language. Waiting until the child is older is not recommended.  If treated early, the impact of a hearing loss on the development of the child’s speech and language will be minimized.   

Infants and very young children need to be tested with specialized equipment and procedures. These physiologic tests are not conducted at Lesner Hearing Center. We can provide you with a recommendation for centers in the region that conduct diagnostic testing for newborns and babies. Lesner Hearing Center provides hearing evaluations for children at 2 ½ years of age and older.

Test Methods for Young Children

For children at 2 ½ years of age and older, one test technique is called visual reinforcement audiometry (VRA). The child sits on a parent’s lap in a sound treated room facing the window. Tones are presented via earphones or through speakers, and lights are paired with the tones. Soon the child turns toward the light box when he/she hears the sound. There’s an animated stuffed animal in the light box, and it keeps the child responding to the sound for a good long time.

We also use a technique called conditioned play audiometry. The test is conducted with earphones or via speakers in a sound treated room. Another audiologist or a parent may assist during the test. An audiogram can be created using this method. We are cognizant of the child’s attention span and give breaks during the test as needed. We provide rewards that motivate the child to continue with the test activity until we have obtained an audiogram.

The speech reception threshold (SRT) is another test. We use words to measure the softest level that the child can reliably respond to speech by pointing to pictured items or repeating test words. Familiar words are presented in the sound room or via earphones at progressively softer levels until the speech reception threshold is established. The SRT corroborates the tonal tests. These tests have been used for many years and have yielded valid test results on children as young as 2 ½ years of age.  

If the child cannot be taught to participate in the test reliably, we will refer the child to another center that performs certain physiologic tests such as otoacoustic emissions, brainstem evoked response audiometry or electrocochleography. The child does not need to give behavioral responses for these tests. The audiologist or parents may choose to use both behavioral and physiologic tests.


We provide a physiologic test for the health of the middle ears using tympanometry. During this painless test, a small earplug attached to a pressure sensing device is inserted in the child’s ear canal. The pressure in the ear canal is varied and a recording of the mobility of the eardrum is created. With tympanometry, we can learn in less than a minute if the child has fluid behind the eardrums requiring an evaluation by the pediatrician or ear, nose and throat physician.