Hearing Tests for Children

Understanding Early Childhood Hearing Evaluations

Hearing is one of the most important senses in a child’s early development. It shapes how children learn to speak, understand language, think, and connect with others. Being able to test hearing as early as six months old is a huge step forward — it means we can detect potential hearing differences before they begin to affect speech or learning.

The first few years of life are especially critical for building the brain’s pathways for sound and language. Early detection allows families and professionals to step in quickly with the right support, giving children the best chance to thrive.

How Hearing Develops in Early Childhood

6–12 Months

By six months, babies start to recognise familiar voices and sounds around them. They’ll often turn toward noises, respond to their name, and babble with changing tones. These reactions are key indicators for audiologists when assessing hearing at this age.

By nine months, babies are usually able to locate where sounds come from and show preferences for certain voices or music. They may also begin to understand simple words or gestures.

12–24 Months

During the second year, children experience a big leap in speech and understanding. They start following simple directions, naming familiar things, and putting words together. Testing becomes easier since they can cooperate a bit more, although their attention spans are still short.

2–3 Years

By this stage, toddlers can usually follow two-step directions, talk in short sentences, and play simple games — making hearing assessments more interactive and precise.

How Hearing is Tested

Behavioral Observation Audiometry (BOA)

For babies around six to eight months old, audiologists observe how they react to specific sounds. Tiny changes — like widening their eyes, pausing their movements, or turning their head — can reveal how well they hear. It takes a trained professional to tell which reactions are meaningful and which are just random baby movements.

Visual Reinforcement Audiometry (VRA)

From about six months to two and a half years, hearing is often tested using VRA. The child learns to look toward a sound, and when they do, they’re rewarded with a fun visual (like a toy that lights up or a short video). This method helps determine hearing levels across different pitches important for understanding speech.

Conditioned Play Audiometry (CPA)

For children aged two and a half to three years, hearing tests become a fun game. When the child hears a sound, they might drop a block in a bucket or stack a ring. This playful approach keeps them engaged while still giving accurate results.

Objective (Non-Behavioral) Hearing Tests

Not all hearing tests rely on behavior — some measure hearing function directly:

Otoacoustic Emissions (OAE): A small probe is placed in the ear to play soft sounds and record the ear’s natural response. It’s quick, painless, and ideal for infants.

Tympanometry: This test checks how well the middle ear is working by gently changing air pressure in the ear canal. It helps detect fluid or blockages that might affect hearing.

Auditory Brainstem Response (ABR): Used when more detailed information is needed, this test measures how the hearing nerve and brain respond to sounds. Sensors are placed on the head while the child is resting or asleep, providing reliable results even if the child can’t actively participate.

Creating a Comfortable Testing Environment

A successful test depends on the child’s comfort. Pediatric hearing assessments take place in quiet, sound-treated rooms that are child-friendly — often decorated with bright colours and toys. Appointments are usually scheduled in the morning when children are alert and happy, with breaks allowed for feeding or play.

The Role of Families

Parents and caregivers are a vital part of the process. Before testing, audiologists explain each step so families know what to expect. During testing, parents often stay with their child, helping to keep them calm and focused. Afterward, the results are clearly explained — usually with simple charts and visuals — along with recommendations for next steps or further support if needed.

A Team Effort

Assessing hearing in young children often involves collaboration between several professionals. Audiologists may work with pediatricians, speech-language pathologists, and early intervention specialists to ensure the child’s hearing, speech, and overall development are all supported together.

Considering Cultural and Language Differences

Every family is unique, and hearing assessments are adapted to suit different languages and cultural backgrounds. This might mean using visuals that are more familiar to a child’s environment, providing interpreters, or explaining results in ways that align with family preferences and beliefs.

Technology and Innovation

Modern audiology is becoming more engaging and accessible. New tablet-based games, wireless devices, and even telehealth consultations are making assessments easier — especially for families in remote areas. Automated systems also help detect responses more accurately, improving consistency and reducing test time.

Pediatric hearing assessment from six months old combines science, play, and compassion. By understanding how young children respond to sound — and using both behavioral and objective tests — audiologists can identify hearing issues early, often before they affect speech or learning.

With skilled professionals, supportive families, and age-appropriate techniques, early hearing assessment gives every child the best possible start in developing strong communication and listening skills.