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.
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.
New JerseySpecialty Care
For Appointments: (888) 495-5218
For Information: (610) 557-4800
- 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
- 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
- any previous hearing result if you would like them to be considered
Bring this form for your first appointment:
- Patient Presents Without Legal Guardian (PDF)
Note: A parent or legal guardian must be with a child for a first visit.
- Patient Presents Without Legal Guardian (PDF)
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Note: A parent or legal guardian must be with a child for a first visit.
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 pediatric audiology 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:
- auditory neuropathy spectrum disorder
- (central) auditory processing disorder
- balance and vestibular assessment (at duPont Hospital for Children only)
- cleft palate
- cochlear implants
This team approach allows us to gather as much information as possible, to make sure your child receives the most appropriate pediatric audiology care.
Hearing Conditions We Treat
Our services at Nemours duPont Pediatrics, Newtown Square include pediatric audiology assessment, management and monitoring of children with conditions such as:
We are the Delaware Valley’s only hospital-based referral for children with (central) auditory processing disorder (or “CAPD,” for short). Children with CAPD have no problem hearing, but they do have difficulty interpreting and storing words that are heard because the ears and brain don’t fully coordinate.
We have a specialized program for children with auditory neuropathy spectrum disorder (or "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.
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. We designed our program at Nemours duPont Pediatrics, Newtown Square to closely monitor children with hearing loss. We collaborate with our Nemours Division of Otolaryngology (Ear, Nose & Throat, or “ENT”) colleagues to ensure that your child receives an appropriate work-up to determine 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 at Nemours duPont Pediatrics, Newtown Square
Our audiologists conduct full hearing diagnostic evaluations in sound-treated rooms with specialized, state-of-the-art equipment. The methods used to test your child’s hearing will depend on the age of your child, ability to cooperate, stage of development and current health.
Typically, hearing evaluations begin with general diagnostics or behavioral testing in a sound-proof booth at Nemours duPont Pediatrics, Newtown Square. These pediatric audiology tests include:
Hearing tests at Nemours duPont Pediatrics, Newtown Square are based on your child’s age and functional level:
- Children 6 months to 3 years — visual reinforcement audiometry (or "VRA"). Your child will be seated on your lap while sound is transmitted through the soundfield (directional) speakers. We’ll look for one-sided reactions 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 (or "CPA"). Your child will wear either inserted earphones or supra-aural headphones (headphones with pads that press against the ears) and will respond to ear-specific stimuli through the use of a game (e.g., putting a coin in the bank, etc.).
- Children 5-18 years — standard behavioral testing. Your child will wear insert or supra-aural earphones and respond to stimuli by repeating a word or pressing a button.
Tympanometry and middle ear muscle reflex (or “MEMR”) testing looks into eardrum flexibility and reflexes of the middle ear muscle. Although it’s not designed to be a test of hearing, it’s helpful in identifying middle ear problems, such as fluid collecting behind the eardrum.
Your child’s ears will be evaluated with an “immittance bridge,” which assesses eardrum movement, middle ear pressure and the reflex of the middle ear muscle. We simply place a soft tip in your child’s ear — this doesn’t require a response from your child, just the ability to sit quietly for this brief evaluation.
This pediatric audiology test measures the function of the outer hair cells, or the “natural amplifiers,” which lie inside the cochlea.
During an otoacoustic emissions (or “OAE”) test, we place a soft tip in your child’s ear canal which transmits sound to measure the outer hair cell function in the cochlea. This can be obtained in seconds in a sleeping infant or an older child who is able to sit quietly.
A normal recording is associated with normal outer hair cell function. 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 at Nemours duPont Pediatrics, Newtown Square
If your child needs further pediatric audiology testing beyond the behavior hearing evaluation, our audiologist may recommend one of the following diagnostic tests.
An auditory brainstem response (or “ABR”) is a diagnostic test that evaluates the 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. We perform this test while your child is asleep (if 3 months of age or less) or sedated (more than 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.)
We perform ABR testing at Nemours duPont Pediatrics, Newtown Square by placing soft electrodes on your child and a soft tip in the ear canal, which sends a “click” sound to the ear. Our audiologists then measure the neural response and determine your child’s threshold of hearing. This testing lasts approximately one to two hours.
This type of testing helps diagnose (central) auditory processing disorder, in which a child has difficulty processing what’s heard because the ears and brain don’t 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.
We conduct this testing in the test booth and require your child to listen and respond to various exercises. CAP testing is for children with normal intelligence and normal hearing who exhibit difficulties processing information (e.g., trouble hearing in noisy environments, difficulty following multi-step directions, poor reading/spelling/language skills, oral comprehension problems, etc.) This evaluation takes approximately three hours.
This test assesses the function of the auditory (hearing) nerve. Abnormal nerve function can make it difficult for children to distinguish one sound from another and to understand speech clearly.
Pediatric audiology 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 pediatric audiology specialists will make appropriate recommendations based on your child’s specific needs.
If hearing aids are necessary, Nemours audiologists are qualified and experienced in the fitting of hearing aids for children of all ages, including young babies. As part of our program, we closely monitor your child’s hearing loss and hearing aid care.
For some children with hearing loss or hearing impairment, background noises and distance can interfere with hearing and understanding. FM amplification systems can be used by children with hearing aids as well as those children who are not candidates for hearing aids.
A cochlear implant is a surgically implanted device for individuals with severe to profound hearing impairment who receive little to no benefit from hearing aids. The procedure does not restore hearing. What it does is transmit sound information past the damaged cochlea directly to the nerve of hearing. We provide a comprehensive Cochlear Implant and Auditory Rehabilitation Program, giving long-time support to children and families with ongoing therapy and involvement before and after surgery.