Audiology Services

young siblings

Customized hearing health care from newborn to seventeen years.

Pediatric audiology refers to the testing, identifying, and monitoring of hearing acuity, speech understanding and processing, and pathologies and disorders related to the auditory and vestibular systems in individuals from birth to seventeen years of age. Clinicians with expertise in this field understand that working with pediatric patients is not simply completing the same tasks for an adult; just for a smaller person. Competently diagnosing and treating hearing loss requires time, patience, understanding a child’s needs and comfort levels to successfully obtain results, and for children who are in the stages of learning language, it is crucial for best practices to be implemented for optimal success and keeping on pace with developmental milestones. 

Please review the below conditions we treat, services we provide, what to expect at your first visit, when should a pediatrician be involved, and additional resources. 

Contact RHSC to schedule an appointment and learn more about our Pediatric Audiology Services: Call (585) 271-0680, email info@rhsc.org​, or fill our our 
Contact Us Form​​.

Pediatric Audiology

Children learn approximately 90% of their language from incidental learning, meaning that most of the words they know are not directly taught to them, but are overheard as their parents and family members speak to them in the grocery store, the car, or while making dinner at home [1Doyle, Melanie and Dye, Linda. (2002). Mainstreaming the Student who is Deaf or Hard-of-Hearing Retrieved on June 14, 2013 from: http://www.handsandvoices.org/pdf/mainst_cal.pdf]. Early identification and intervention of hearing loss is crucial, and some children may be born with normal hearing but exhibit a progressive hearing loss later in life. 

 

Whether a hearing loss or disorder is identified at fifteen days old or fifteen years old, RHSC is ready to meet the needs of your child. As an Early Intervention provider, we work with children from birth to three to dispense, program, and maintain hearing aids and bone oscillating hearing devices, as well as hearing assistive technology for hearing aids, cochlear implants, and non-surgical bone oscillating devices. When children age out of Early Intervention and may begin attending a daycare or program within their school district, RHSC assists with the transition of obtaining and maintaining Hearing Assistive Technologies for the daycare/school setting from ages three to five. As daycare turns to into elementary, middle, and high school, RHSC continuously shifts to meet the technological changes in these settings, working with Bluetooth and other wireless protocols to allow students to access information directly from their tablets, computers, and cell phones into their hearing devices for maximal improvement of hearing in practically any situation. Although it seems our pediatric patients go too quickly from being infants and toddlers to teenagers and adults, we are here to meet there needs through all stages in life. 

We Treat
 

Conditions We Treat and Services (could add….):

  • Hearing Assistive Technology (HATs) (DM/FM equipment) fittings, troubleshooting, and maintenance for settings such as school, therapy, or at home use. 

  • Custom earplugs to prevent ear infections and water exposure for children prone to swimmer’s ear or with anatomical complications exposing the middle ear. 

  • RHSC is a certified CAPDOTS provider to improve auditory processing abilities https://capdots.com/

  • RHSC is enrolled as an Early Intervention provider, helping families with no insurance coverage and/or limited capital obtain hearing equipment and HATs for their children. 

  • **for hearing aid options for peds, I would put Oticon OPN Play and Phonak Sky pages

  • ***For the “Newborn Screenings” we could say we are a provider enrolled in the Early Hearing Detection and Intervention Program through New York State and complete Universal Newborn Hearing Screenings. -----we only do OAE right now through so do we need to say anything about that? 

  • RHSC works with Monroe County and surrounding school districts to provide HAT equipment, with some availability for onsite support. ****not sure if we can say this? 

Your First Visit

What to Expect At Your First Visit:

  • The audiologist will ask several questions at the beginning of the visit to gain further insight into the reasons for the appointment and to learn more about your child. While the provider asks questions, they will gently work to establish a rapport with your child and get them to feel comfortable in the room. Questions will likely be related to family history of hearing loss and hearing disorders, your child’s health history, prenatal and birth history, ear infection and allergy history, how they respond to environmental sounds, and his/her current communication and language skills. 

  • Depending on your child’s abilities and behaviors, testing methods may vary.

  • Otoscopy – a light with a magnifier is used to inspect the outer ear, ear canal, and appearance of the eardrum for abnormalities. 

  • Tympanometry – a silicone-like dome is gently pressed to the ear canal opening to change pressure in the ear canal space to measure how the eardrum and middle ear bones move back and forth, which is required for sound to travel through the hearing system. Your child may feel a slight pressure change as if going up a steep mountain or while ascending/descending in an airplane.

  • Acoustic Reflex Threshold Testing – If possible, as this test requires minimal to no physical movement and relative quiet, a silicone-like dome is placed in your child’s ear to measure the transmission of sound from the ear canal through the lower brainstem. Your child will hear beeping noises that start soft and gradually increase in volume. 

  • Distortion Product Otoacoustic Emissions – If possible, as this test requires minimal physical movement and relative quiet, a silicone-like dome is placed in the ear canal to measure the health and function of the outer hair cells located in the inner ear. Your child will hear different tones and can watch the data appear on the screen of the equipment. 

  • Pure Tone Air Conduction Testing – Presenting a variety of tones to each ear through the air, with sounds being presented in the ear canal. This testing may be completed in the open room through speakers if a child is unable to tolerate headphones or insert earphones (earbuds), but is a last resort as the information would not be ear specific. This testing measures how soft your child can here the pitches that are used in speech. Responses from this test are plotted on an audiogram, and show if someone has normal hearing or a hearing loss.

  • Pure Tone Bone Conduction Testing – Presenting a variety of tones to the ears, with sounds being presented to the mastoid bone, located behind the cartilage of the outer ear. A headband is placed on your child’s head, and he/she is instructed to respond to the sounds when he/she hears them. This testing measures the response of the inner ear by sending vibration through the bones to the fluid of the cochlea (inner ear). Unlike air conduction testing, this method is unobstructed by any blockages in the outer ear or middle ear (i.e., wax build up, middle ear fluid/infection) and can determine if the hearing loss is attributed to a possibly treatable and non-permanent pathology/blockage, or if the hearing loss may be permanent and located in the inner ear. 

    • Visual Reinforcement Audiometry – a method of pure tone testing for children about six months to two years old that involves conditioning your child to turn to lights and dancing toys when he/she hears a sound. Testing involves playing the soft tones, and rewarding your child by showing the toys and lights, but only if they turn to the sound.

    • Conditioned Play Audiometry – a method of pure tone testing for children about two to five years old, which makes a game of responding to the tonal stimuli. Your child is conditioned to put blocks, gems, toys, etc. into a bucket when they hear a tone.

    • Conventional Audiometry – a method of pure tone testing for children about five years and older. Your child will be asked to raise their hand to very soft sounds that are presented. 

    • In some cases, such as if a child has inconsistent responses, responses seem to be elevated compared to functional ability, or a child is not able to complete the testing, the responses may demonstrate a false-positive hearing loss. In these cases, an Auditory Brainstem Response (ABR) test may be recommended to obtain objective measures of your child’s hearing ability. ABR testing uses electrodes placed around the head to measure brain wave responses to sound at varying volumes. ABR testing is not considered to be the gold standard for obtaining information, and is only recommended as a last resort. 

  • Speech Recognition Threshold Testing – To establish consistency, your child will be asked to repeat a closed set of words (i.e., cupcake, ice cream, baseball, etc.), point to pictures of these words, or point to their body parts, if your child is able, to determine the softest volume your child can still understand the words. This threshold is expected to be quite similar to the average responses to tonal findings. 

  • Word Recognition Testing – If age/ability appropriate, your child may be asked to point to pictures or repeat words (i.e., show me the ball; say the word shoe). This testing determines your child’s ability to discriminate speech sounds (i.e., moon vs noon). 

 
Pediatrician 
Involvement

When to see our primary care physician (Pediatrician)

 

***we do not do wax removal, but we can run tests to indicate whether a wax blockage or middle ear fluid may be the cause of a hearing loss. 

 
Resources
 
  • Video of how we hear, and explains all the parts of the ear: Click Here 

  • Ear Infections, Swimmer’s Ear, CAPD, Hearing Loss in Children: