Audiology & Hearing

child hears with headphones

Even mild hearing loss can affect a child’s ability to speak and understand language, as well as impact behavioral development. Nemours' audiologists use state-of-the-art technology and innovative testing techniques to assess your child’s hearing sensitivity. We can evaluate and treat hearing at any age, beginning at birth.

Read More About Audiology

Hearing loss in children occurs in an estimated three out of every 1,000 babies born in the United States each year. At Nemours, we are dedicated to finding the best solutions to address each child’s hearing impairment, and we’re committed to counseling and educating families to be advocates for their children in the community.

We have board certified audiologists who are licensed with specialized experience in pediatric audiology.

Our audiologists help diagnose and develop treatment plans for children with hearing disorders such as:
  • hearing loss  
  • (central) auditory processing disorder (APD)
  • auditory neuropathy spectrum disorder (ANSD)
  • balance (vestibular) and dizziness disorders

At Nemours/Alfred I. duPont Hospital for Children and a number of Nemours Children’s Clinic locations in the Delaware Valley and North and Central Florida, we are also able to provide children with hearing impairment special services.

These services include:
  • prescriptions for hearing aids and other assistive and/or amplification devices as well as instruction on the use, care and maintenance of these devices
  • cochlear implant, programming and therapy
  • counseling for families regarding adjustment to hearing aids and cochlear implants
  • specialized programs for children diagnosed with central auditory processing disorder or auditory neuropathy spectrum disorder
  • working with a child’s school and teacher to ensure proper classroom equipment and modifications are in place

We look forward to forming close relationships with our patients and monitoring their progress over time.

Newtown Square

Nemours duPont Pediatrics, Newtown Square

Main Line Health Center
3855 W. Chester Pike, Suite 280
Newtown Square, PA 19073
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For Appointments: (302) 651-4200
For Information: (610) 557-4800

Hours: Monday–Friday: 8 a.m. to 5 p.m.
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For Appointments: (302) 651-6043

  • Susanne Abate, AuD, CCC-A
  • Annemarie Cox, AuD, CCC-A
  • Rebecca Huzzy, AuD, CCC-A
  • Yell Inverso, AuD, PhD, CCC-A – manager of audiology
  • Jessica Loson, AuD, CCC-A
  • Sarah Zavala, AuD, CCC-A
  • Emily Zwicky, AuD, CCC-A
What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
New Patients

Bring these forms for your first appointment:

Returning Patients
Forms & Resources
New Patient Forms
Returning Patient Forms
Resources for Patients & Families

Hearing loss and auditory disorders can cause delays in a child’s speech, language and cognitive development, so early identification and management of auditory problems and hearing loss in children is important.

Onsite pediatric Audiology services are provided at Nemours duPont Pediatrics, Newtown Square by audiologists from Nemours/Alfred I. duPont Hospital for Children. Our board-certified audiologists are specially trained to perform evaluations on children for children from birth to age 21 with hearing, balance and other ear-related problems. We utilize the most up-to-date equipment and innovative pediatric assessment techniques to determine your child’s hearing sensitivity and management needs.

Working as a Team to Help Your Child

Our audiologists also serve as integral members of several multi-disciplinary and research teams throughout Nemours for:

This team approach allows us to gather as much information as possible, to make sure your child receives the most appropriate care.

Hearing Conditions We Treat

Our services include assessment, management, and monitoring of children with conditions such as:

(Central) Auditory Processing Disorder

We are the Delaware Valley’s only hospital-based referral for children with (Central) Auditory Processing Disorder (CAPD). Children with CAPD have no problem hearing, but they do have difficulty interpreting and storing words that are heard because the ears and brain do not fully coordinate.

Auditory Neuropathy Spectrum Disorder

We have a specialized program for children with Auditory Neuropathy Spectrum Disorder (ANSD), an auditory nerve disorder that can make it difficult for children to hear or distinguish one sound from another. Our program targets diagnosis, treatment, and research.

Hearing Loss

About 3 in 1,000 babies are born with hearing loss (also called hearing impairment), making it the most common birth defect. A hearing problem can also develop later in life. Our program is designed to closely monitor children with hearing loss. We collaborate with our Nemours Otolaryngology (Ear, Nose & Throat) department to ensure that your child receives an appropriate work-up and investigate the possible cause of your child’s hearing loss. We may also recommend a genetics consultation, imaging, and vestibular (balance) evaluation, depending on your child’s needs.

Hearing Evaluations for Children

Our audiologists conduct full hearing diagnostic evaluations in sound-treated rooms with specialized, state-of-the-art equipment. The methods used to test a child’s hearing will depend on the age of the child, the child’s ability to cooperate, developmental, and health status.

General Diagnostics

Typically, hearing evaluations begin with general diagnostics, or behavioral testing, in one of our sound-proof booths. These tests include:

Behavioral Audiometry
Hearing tests based on child’s age and functional level:
  • Children 6 months to 3 years: Visual Reinforcement Audiometry (VRA). The child is seated on the parent’s lap and sound is transmitted through the soundfield speakers, looking for localizations or changes in behavior. This is not an ear-specific test, but reflects the sensitivity of the better ear.
  • Children 3-5 years: Conditioned Play Audiometry (CPA). The child wears either insert earphones or supraaural headphones and responds to ear-specific stimuli through the use of a game (i.e. putting a coin in the bank etc.).
  • Children 5-18 years: Standard Behavioral Testing. The child wears insert or supraaural earphones and responds to stimuli by repeating a word or pressing a button.
Tympanometry & Middle Ear Muscle Reflex (MEMR) Testing

Tests eardrum flexibility and reflexes of the middle ear muscle. While not a hearing test, it is helpful in identifying middle ear problems, such as fluid collecting behind the eardrum.

The child’s ears are evaluated with an immittance bridge, by placing a soft tip in the ear which then assesses eardrum movement, middle ear pressure, and the reflex of the middle ear muscle. This does not require a response from the child, although they need to sit quietly for this brief evaluation. 

Otoacoustic Emissions (OAEs)

Measures the function of the outer hair cells, or the “natural amplifiers,” which lie inside the cochlea.

During an OAE test, a soft tip is placed in the child’s ear canal, which transmits sound to measure the outer hair cell function in the cochlea.  This can be obtained in seconds on a sleeping infant or an older child who is able to sit quietly.

A normal recording is associated with normal outer hair cell function and this typically reflects normal hearing although in some cases the hearing loss may be due to problems in other parts of the hearing pathway.

Specialized Hearing Tests

If your child need further testing beyond the behavior hearing evaluation, our audiologist may recommend one of the following diagnostic tests.

Auditory Brainstem Response (ABR)

This diagnostic test evaluates functioning of the auditory (hearing) nerve, and can be used as a predictor of hearing level. It measures whether the auditory nerve transmits sound from the inner ear to the lower part of the brain and how loud sounds have to be for the brain to detect them. It’s done while the baby/child is asleep (if 3 months or under) or sedated (over 3 months of age).

ABR testing is commonly performed on:
  • babies that have failed their newborn hearing screening two times and have been medically cleared of middle ear fluid
  • children who are uncooperative for behavioral testing
  • children who cannot be reliably tested in a behavioral manner (i.e developmental delay, syndrome-related, etc.)

Testing is performed by placing soft electrodes on the baby/child and an insert tip in the ear canal, which sends a click sound to the ear. Audiologists then measure the neural response and determine the child’s threshold of hearing. It lasts approximately 1-2 hours.

(Central) Auditory Processing (CAP) Evaluation

This type of testing help diagnose (Central) Auditory Processing Disorder, where the child has difficulty processing what is heard because the ears and brain do not fully coordinate.

CAP testing is for children age 7 and older, to evaluate what happens to an auditory signal once it leaves the peripheral system (cochlea) and travels to the brain.

It is conducted in the test booth and requires the child to listen and respond to various exercises. It is for children with normal intelligence and normal hearing, who exhibit difficulties processing information (i.e. trouble hearing in noise, difficulty following multi-step directions, poor reading/spelling/language skills, oral comprehension problems etc.) This evaluation takes approximately 3 hours.

Auditory Neuropathy Spectrum Disorder (ANSD) Evaluation

Assesses the function of the auditory (hearing) nerve. Abnormal nerve function can make it difficult for children to distinguish one sound from another and understand speech clearly.

Audiological testing includes Otoacoustic Emissions (OAE), Middle Ear Muscle Reflex (MEMR), and Auditory Brainstem Response (ABR) evaluation.

Testing for ANSD is appropriate when:
  • parents report their child is having difficulty understanding speech clearly, especially in the presence of background noise
  • behavioral testing reveals absent middle ear muscle reflexes and decreased speech discrimination testing in quiet and noise
  • speech and language development is a concern -- children with this disorder can have speech that ranges from mildly distorted to absent

Rehabilitation and Treatment

If your child is diagnosed with hearing loss or other hearing impairment, our audiologists will make appropriate recommendations based on your child’s specific needs and impairment.

Your audiologist at Newtown Square will work with our extended Audiology team at duPont Hospital for Children to provide your child comprehensive rehabilitation and treatment.