Pediatric Hearing Services

Our Audiologists at Stony Brook specialize in pediatric hearing assessment and management.  Pediatric Audiology is a specialized field requiring a high level of expertise to accurately determine the presence, type and degree of hearing loss.

Pediatric hearing services at Stony Brook include infant screening and comprehensive outpatient testing, assessment of toddlers and young children, cochlear implant evaluation, surgery, programming and management and testing of school-aged children. 

Infant Screening and Comprehensive Testing

Approximately 3 in every 1,000 infants are born with hearing loss.  New York State requires that all infants are screened for hearing loss prior to hospital discharge.   The Joint Committee on Infant Hearing (JCIH) is a national group of professionals that recommend best practices to the medical community. 

Stony Brook Medicine follows the recommendations of the Joint Committee on Infant Hearing for inpatient and outpatient screening and outpatient comprehensive testing.

Infant Screening

We provide a 2 stage screening in the Newborn well-baby nursery to include an Otoacoustic Emission (OAE) as an initial screening followed by an Auditory Brainstem Response (ABR) if the infant fails the OAE screening. This 2-stage screening reduces the number of babies that unnecessarily fail, and therefore, decreases the number of babies that need to return following discharge home.  Infants in the Neonatal Intensive Care Unit (NICU) are at a higher risk for different types of hearing loss, some of which can only be identified by ABR screening.  That is why Stony Brook follows the recommendations of the JCIH, and screens all NICU babies with ABR.

A small number of our infants fail the inpatient screening. These babies will return in 2-3 weeks for an outpatient screening. Both OAE and ABR screenings may be performed during the outpatient screening.

See our forms section (Newborn Outpatient Screening Instructions) for further information.


Q. What is an Otoacoustic Emission (OAE) and Auditory Brainstem Response (ABR)?
A. OAE- A soft rubber tip is placed in the ear canal.  A sound is presented to the ear and the ears response is picked up by the computer.
ABR- Small sensors are placed on the face and neck. Sounds are presented using foam tips in the ear canal and responses from the ear and hearing nerve are picked up by the sensors.  ABR measures how the ear and the nerve respond to the sounds and provides a level of hearing.
Q. Can performing the hearing screenings cause my baby any discomfort or future problems?
A. No. The test only measures what is naturally occurring in the ear.  It does not hurt or harm your baby in any way.
Q. My baby failed the newborn hearing screen while in the hospital. Does this mean my baby has a hearing loss?
A. Failing the screening only means that your baby requires further testing. There are many reasons why a baby may not pass the screening. Some include temporary problems such as, debris in the ear canal or fluid in the middle ear. However, some babies that fail may have a permanent hearing loss that requires assistance. For this reason, follow-up outpatient screening and comprehensive testing will be needed.

Infant Outpatient Comprehensive Testing

Stony Brook has the most up-to-date specialized equipment needed to perform comprehensive infant hearing testing should the baby fail the outpatient screening.  This test is called a frequency- specific ABR.  Stony Brook Speech and Hearing is one of the few centers that perform this specialized testing.  See our forms section (Pediatric Auditory Brainstem Response Instructions) for further information about the test.  

The frequency-specific ABR will provide information about the degree and type of hearing loss.  It will also allow us to decide, with the family, the best hearing options for the baby.  


Q. Is my child too young for a hearing test?
A. With state of the art equipment available at Stony Brook, we can test children at any age.

Early diagnosis is essential (by 3 months of age), so that each child has the best chance of developing normal speech and language.  Untreated hearing loss will impact a child’s speech and language, educational and social development.

Q. At what age can a child be fit with a hearing aid?
A. Children can be fit at 1 month of age.  Research shows that infants who receive hearing aids and education prior to 6 months of age develop language at a near normal rate; however, those fit after 6 months of age almost always show delays in language development.

Older Infants, Toddlers and Young Children

Toddler with TherapistAt about 8-12 months of age, infants begin to respond to soft sounds.  It is at this time that we can begin to test children’s hearing by looking at responses, such as head turns towards a sound.   In order to provide the most accurate and complete testing, Stony Brook Speech, Language and Hearing Department uses a 2 audiologist team approach for testing older infants, toddlers and young children.  Our experience, coupled with allowing ample time with each child, enables us to assess hearing in even the most difficult to test children. 

Two methods are used to assess this age group: Conditioned Orienting Reflex (COR) and Conditioned Play Audiometry (CPA).

COR- Used for ages 8months to 2 years.  The child is taught to look towards a reinforcer (toy or TV screen) when he/she hears a sound.  The child sits on his parent’s lap during the testing.

CPA- Used for ages 2.5-5 years.  The child is taught to put a toy in the bucket or place a puzzle piece when a sound is heard. 

A tympanogram is part of all hearing tests.  It will identify eardrum and middle ear problems such as fluid in the ear or wax blocking the ear canal.   Performing a tympanogram is quick and easy.   A soft rubber tip placed in the ear canal measures how the eardrum moves in response to sound waves. 

The OAE is also a part of most pediatric hearing tests.

The hearing test in this age group takes from 30-45 minutes.

Rarely, children will require further testing to assess hearing thresholds.  An ABR with sedation may be recommended after our Audiologists perform a regular pediatric assessment.  This test is performed in the Ambulatory Surgery Center under the supervision of a Stony Brook ENT.  


Q. My child does not speak, how will he/she know what to do?
A. The tests are designed for young children.  They do not have to speak to learn the task.
Q.  My child has a disability, can the hearing be tested?
A. Our Audiologists are able to test almost all children, even those with a disability.
Q. My doctor has recommended an ABR test for my 2 year old. Is it appropriate to perform an ABR test on a 2 year old child?
A. The best tests for a 2 year old are COR or CPA along with other tests. If your child has been tested by our audiologists and we are unable to obtain hearing results in this manner, then we may recommend an ABR.  The ABR for this age group requires sedation.

School-Age Children

Any degree of hearing loss can be educationally handicapping for children.  A child with mild hearing loss can miss up to 50% of classroom discussions.  Unmanaged hearing loss can affect a child’s speech, language, educational, social and emotional development.  At Stony Brook, a comprehensive hearing test will determine if a child has normal or reduced hearing.  We will measure the degree and type of hearing loss if one exists.  The Audiologist will make recommendations for management depending on the results of the test.

Some children have difficulty processing or interpreting auditory information despite normal hearing.  This is called an Auditory Processing Disorder.  Click for this information.

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