Kim Malsam-Rysdon, Secretary of Health

Diagnosing a Hearing Loss with Medical
and Audiological Evaluations

Medical Evaluation

It is recommended that a medical evaluation is done to identify any possible medical conditions that may be interfering with the hearing screening results. This medical evaluation may consist of different types of testing and a series of questions. The medical evaluation may include a medical history, physical examination, laboratory testing, or consultation with other doctors.

Medical History

  • family history of childhood permanent hearing loss not related to a medical condition
  • condition of mother during pregnancy such as
    • infections
    • certain types of medication that may have affected the hearing
  • condition of the baby after birth such as:
    • Infections from the mother during delivery
    • 48 hours or more in the neonatal intensive care unit (NICU)
    • low birth weight
    • anomalies of the head, face or ears
    • jaundice (yellowing of the skin) & needing a blood transfusion
    • bacterial infections such as meningitis
    • ECMO - a special blood exchange

Physical Examination

  • physical appearance - any change of structure with the ears, head or face such as cleft lip and palate, or size of the head

Laboratory Testing

  • testing to detect an infection
  • type of x-rays showing a delay in physical development
  • testing of the heart function
  • testing to identify any inherited traits causing hearing loss

Consultation with Other Doctors

  • Otolaryngologist - specializes in caring for the ear, nose and throat (ENT)
  • Ophthalmologist - specializes in caring for the eyes
  • Cardiologist - specializes in caring for the heart
  • Nephrologist - specializes in caring for the kidneys

Audiological Evaluation

A hearing specialist, called a Diagnostic Audiologist will be able to determine if a baby has a definite hearing loss. These professionals have the background and the appropriate equipment to detect a permanent hearing loss.

An Auditory Brainstem Response (ABR) hearing screener along with other testing methods will be used as part of the evaluation. The ABR plays sounds into the baby's ears. Band-aid like electrodes are placed on the baby's head to measure the brain responding to the sounds. This test can detect damage to the inner ear, nerves and the sound’s pathway to the brain. If the baby passes the ABR test, no further testing is needed. However all babies should be watched for hearing loss as they grow.

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