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Hearing Health Test

Infants and Children

A child is more likely to be born with or develop a hearing loss if any of the following risk factors are present at birth:


Admission to a NICU unit for greater than 48 hours
- Stigmata or evidence of a syndrome associated with a hearing loss
- Family history of hearing loss
- Craniofacial abnormalities such as ear pits or tags
- In utero infection such as CMV, rubella, toxoplasmosis, herpes

A child is at risk for developing a progressive or delayed onset hearing loss if any of the following risk factors are present as an infant:

- Parental or caregiver concern regarding hearing, speech, language and/or developmental delay.
- Family history of permanent childhood hearing loss.
- Stigmata or other findings associated with sensorineural or conducive hearing loss or eustachian tube dysfunction.
- Postnatal infections associated with sensorineural hearing loss including bacterial meningitis.
- In utero infections such as cytomeglovirus, herpes, rubella, syphilis and toxoplasmosis.
- Neonatal indicators-specificallly hyperbilirubinemia at a serum level requiring exchange transfusion, persistent pulmonary hypertension of the newborn associated with mechanical ventilation and conditions requiring the use of extracorporeal membrance oxygenation (ECMO).
- Syndromes associated with progressive hearing loss such as neurofibromatosis, osteopetrosis and Usher's syndrome.
- Neurodegenerative disorders, such as Hunter syndrome or sensory motor neuropathies, such as Friedreich's ataxia and Charcot-Marie-Tooth syndrome.
- Head Trauma.
- Recurrent or persistent otitis media with effusion for at least 3 months.

Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs
Joint Committee on Infant Hearing, American Journal of Audiology Vol. 9, 2000.

If any of the above risk factors apply to your child they should be assessed by an Audiologist.

About 50% of children with hearing loss do not have any of the above risk factors. Therefore it is important to observe the behaviour of your child in response to their environment:

If you answer YES to one or more of the following your child should be assessed by an Audiologist

Newborn (Birth to 6 Months)

- Does not startle, move, or cry to loud unexpected sounds.     YES     NO
- Does not awaken to loud noises      YES     NO
- Cannot be soothed by voice alone      YES     NO
- Does not turn his/her head in the direction of your voice by 4-6 months     YES     NO

Young Infant (6 through 12 months)

- Does not point to familiar persons or objects when asked      YES     NO
- By 12 months does not understand simple phrases such as "wave bye-bye", " clap hands" by listening alone     YES     NO

Infant (13 through 2 years)

- Is not alert to environmental sounds     YES     NO
- Does not respond to sound and locate where sound is coming from     YES     NO
- Cannot imitate and use simple words for familiar people and things around the home      YES     NO
- Is not showing consistent growth in the understanding and the use of words to communicate     YES     NO
- Two year old cannot repeat words or phrases and does not use short phrases when talking     YES     NO
- Child does uses gestures only to communicate     YES     NO

Child (Three Years and older)

- Speech is not like other children of similar age     YES     NO
- Does not listen to TV at a normal volume     YES     NO
- Seems unable to understand verbal questions or instructions     YES     NO


Hearing Loss can develop at any time. Sudden changes in hearing are usually quite obvious, however, many hearing problems develop slowly over time and other people may be aware of a your hearing difficulties before you are.

If you answer YES to one or more of the following you should be assessed by an Audiologist

- Do you often need to ask people to repeat what they have said?     YES     NO
- Do you typically have trouble understanding a conversation or mishear people in a group or in the presence of background noise?     YES     NO
- Does it seem that people are regularly not speaking clearly or are ‘mumbling’?     YES     NO
- When watching television do you need to set the volume higher than other people to hear comfortably?     YES     NO
- Do you become frustrated or even totally avoid some social occasions because there is too much noise or you cannot keep up with the conversation?     YES     NO
- Can you become tired or stressed after you have been listening or in a conversation for an extended time period?     YES     NO
- Do you find you need to be close to the speaker at meetings, seminars, restaurants or in religious services to understand?     YES     NO
- Do you need to maintain eye contact or see people’s faces to understand what they are saying?     YES     NO
- Do you find it difficult to localize where sounds are coming from?     YES     NO
- Have your family or friends questioned whether you have a hearing problem?     YES     NO

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