Audiological Testing Plan

Before going to the appointment, make a plan for preparing the student to participate in each assessment that will be done by the audiologist. Note if an interpreter will be needed for the visit.

Name of Student:

DOB:

Name of Audiologist:

Address:

Telephone: ( )

Method of Payment:

Medicaid: ______

Parent’s Insurance: ______

School Purchase Order: ______

Transportation: ______

______

Yes, a current parent permission for audiological testing is on file.

Yes, an otological assessment is recommended.

Yes, the Informal Auditory Skills Inventory has been completed.

Will a staff member accompany the student (and family) to the audiologist? Who?

How will the audiologist be represented to the student (e.g. object symbol, “ear doctor”)?

Previous testing

The family has been contacted about any previous testing that may have been done and asked to share copies of previous testing results with the audiologist and team.

Files have been reviewed for previous testing information or anecdotal information related to hearing.

Vision or hearing devices used (Please bring any devices to the audiologist’s visit.)

Device / Date prescribed / Wears currently? / Comments

What follows is a list of possible hearing tests that the audiologist may choose to do with the student.

Test Name / Test Description / How will student be prepared for test?
External Exam
External Exam
Completed on all individuals. / Doctor will look at the outer part of the ear (pinna) and use an otoscope to look inside ear canal and at the eardrum(if possible). He will also take a thorough history.
Passive Testing
Tympanometry
May be used with young children, infants and also children who are multiply disabled to determine if there is fluid in the middle ear. Children with a history of recurring ear infections should have this test conducted. / The child sits quietly while a probe is placed in the ear canal. The flexibility of the eardrum is measured. This is a test of middle ear functioning. Sometimes it can be used to test neurological functioning.
Oto Acoustic Emissions Audiometry (OAE)
May be used with young children, infants and also children who are multiply disabled to determine if there is a sensorineural hearing loss. / The child is asleep or calm. A probe is placed in the ear canal. The response of the cochlea to the sound is measured. The child must not have any middle ear problems for this test to work. This tests only the functioning of the cochlea and should be done before a hearing aid is fitted.
Auditory Brainstem Response Audiometry (ABR)
May be used with young children, infants and also children who have multiple disabilities to determine if there is a sensorineural hearing loss. / Sensors are placed on the child’s head and small earphone inserts are placed into the ear canals to deliver the sound. The test requires no direct response from your child. For best results, your child must be asleep.
Interactive Testing
Behavioral Observation Audiometry (BOA) May be use with infant and toddlers and some children with multiple disabilities who demonstrate a recognizable response to sound. / Sounds of known loudness and pitch are presented to the child. Changes in behavior, such as startling, crying, quieting, widening of the eyes, etc. are noted.
Visually Reinforced Audiometry (VRA) or Conditioned Orienting Reflex Audiometry (COR)
Use with toddlers and children with multiple disabilities who can demonstrate a clear response to sound. / Sounds are presented to the child. The child looks or moves towards the sound sources and is reinforced with animated toys or some other reinforcer.
Play Audiometry
Use with toddlers and children with multiple disabilities who can demonstrate a clear response to sound. / Sounds are presented to the child. The child is taught to make some enjoyable response, such as throwing a beanbag, whenever the sound is heard. Correct responses are highly reinforced with praise.
Conventional Audiometry / Pure Tone Testing
Use with children/adults who can listen and raise a hand or finger in response to tone. / Sounds are presented to the child. The child is instructed to raise a hand whenever the sound is heard.
Other
Other

Notes and other information

1

Appendix D-2 Developed by Region 12 Deafblind Stakeholder Committee, 2002.