Hearing Loss

Children are evaluated for hearing loss based on developmental abilities. Various tests are available to assess:

  • Whether hearing loss has occurred
  • Degree of hearing loss
  • Type of hearing loss

The evaluation is tailored to each child to make the test as efficient as possible. The testing may include:

  • Behavioral Observation Assessment (BOA) — These tests are conducted on infants by a specially trained audiologist who observes the child's body and head responses to sounds.
  • Electrophysioglogic tests — These help determine an infant's hearing levels based on electrical information from the auditory nervous system. They're used when behavioral tests don't provide a complete picture of a child's hearing.
  • Visual Reinforcement Audiometry (VRA) — At about 6 to 7 months of age, normally developing children can turn toward a sound source. Children at this level are tested either with earphones or in a sound booth with speakers. This testing is generally quite accurate in determining hearing levels.
  • Conditioned Play Audiometry — By approximately 2-and-a-half to 3 years old, most children can be tested using this technique. Earphones are placed on the child and he or she is conditioned to play various games when the test tone is heard.
  • Traditional or Standard Audiometry — This testing is used with older children and adults. The method requires the patient to press a response button or raise a hand when the test tone is heard.
  • Tympanometry or Acoustic Immittance Testing — This test is used to assess the status of the middle ear and related structures. Tympanometry measures the movement of the ear drum (tympanic membrane). This information is used in the diagnosis of middle ear disease or other problems that might alter ear drum movement.
  • Acoustic Reflexes — Measuring acoustic reflexes helps us determine whether the middle ear muscles are properly reacting to loud sounds. This test can also be used in establishing young children's hearing status and or to identify other hearing problems.
  • Auditory Brainstem Response Audiometry (ABR), or Brainstem Evoked Response (BSER) — This measures how the brainstem responds to sound. The results can provide general information regarding hearing sensitivity. This test is also used for neuro-diagnostic purposes to determine if the brainstem is transmitting sound properly.
  • Otoacoustic Emissions (OAEs) — This test determines cochlear (inner ear) function. Emissions are usually present if hearing is normal or there is only mild hearing loss. Emissions may not be detected if there is a conductive hearing loss, middle ear involvement such as an ear infection, or more than a mild sensorineural hearing loss. This is a quick procedure that doesn't cause any discomfort.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers


Pediatric Audiology Clinic
1825 Fourth St., Fifth Floor, 5C
San Francisco, CA 94158
Phone: (415) 353-2101
Appointment information

Cochlear Implant Center at Mission Bay
1825 Fourth St., Fifth Floor, 5C
San Francisco, CA 94158-2351
Phone: (415) 353-2464
Fax: (415) 353-2603
Appointment information

Cochlear Implant Center at Mount Zion
2380 Sutter St., First Floor
San Francisco, CA 94115
Phone: (415) 353-2464
Fax: (415) 353-2603
Appointment information

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