Improving Your Health and Wellbeing

What Is the Difference Between Behavioural and Objective Hearing Testing in Children?

by Ernest Smith

If your child seems to have hearing problems, then your GP might refer them to an audiologist for tests. Your child could have various tests depending on their age and potential problem.

Audiologists often run behavioural or objective tests on babies and younger children. How are these two testing methods different? Which tests is your child likely to have?

What Are Behavioural Hearing Tests?

Behavioural tests use reaction to sound to evaluate hearing health. They measure whether a child can hear different sound levels and frequencies from different directions. As babies and younger children can't understand or explain their hearing difficulties, these tests use physical tells as a communication tool.

For example, when an audiologist tests a baby, then they make noises at different frequencies to see if the baby responds. If the baby tries to turn towards the sound or gives a physical sign that they have heard it, then they have some hearing at that level. If the baby doesn't respond, then the audiologist can start to build a picture of the potential problem.

Behavioural tests work on babies, toddlers and older children. As children get older, these tests can become more complex. For example, audiologists sometimes use play audiometry tests to help older children stay focused. Here, a child makes a move on a game whenever they hear a sound.

What Are Objective Hearing Tests?

Objective hearing tests work on a scientific model. They use specialist medical equipment to test various parts of the hearing system. Your child won't have to be actively involved in these tests because they don't use behavioural reactions as a measure.

Some objective hearing tests are simple. For example, if your audiologist suspects that your child has a deep-seated ear infection, then they can run a tympanometry test. This test uses a small rubber device to measure whether the eardrum moves when air is in the ear. If it doesn't, then it might be under pressure from fluid from an infection.

However, some objective tests are more complex. For example, an auditory brainstem response test uses electrodes on the head to monitor electrical activity responses to sounds in the auditory system. Your child usually needs to be asleep or lightly sedated for this test.

Which Hearing Tests Will Your Child Have?

Some children follow one of these two testing regimes while others have tests from both sides. For example, an audiologist might run behavioural tests to start with. If they spot a problem, then they might move on to objective tests to get the data they need to make an accurate diagnosis.

Every child is different here. Tests will be based on their age and the nature of their hearing problem. To find out more about your child's tests, contact your audiologist's clinic.