Nemours Children's Clinic, Jacksonville South
14785 Old St. Augustine Road
Jacksonville, FL 32258
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Phone: (904) 697-3600
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Nemours board-certified Audiologists provide audiological testing and evaluations for children with hearing, balance, and other ear-related problems at Nemours Children’s Clinic, Jacksonville South.
Call for an appointment to find out about scheduled days and available testing. (Hearing aid fittings are done downtown at Nemours Children Clinic, Jacksonville.)
Early identification and management of hearing loss and auditory disorders is crucial to minimizing delays in speech, language and cognitive development. At Nemours, we use the most up-to-date equipment and innovative pediatric assessment techniques to determine your child’s hearing sensitivity and management needs.
We also take a multi-disciplinary approach for our many of our services, collaborating with our Nemours ENT (Ear, Nose and Throat) specialists and others, to gather the information and details needed to assist your child most effectively.
We are North Florida’s referral center 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.
Our Pediatric Vestibular team offers advanced testing and treatment for balance problems (dizziness, falling or the sensation of falling, headaches, disorientation, or nausea) caused by problems of the inner ear. Our state-of-the-art and pediatric-friendly equipment helps pinpoint the cause of the problem, to provide appropriate treatments and recommendations.
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.
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 hearing loss in children. We collaborate with the ENT (Ear, Nose and Throat) department to investigate the possible cause of your child’s hearing loss. Along with a thorough ENT and Audiology consultation, evaluations by other specialties, including genetics, imaging, and vestibular (balance), may be recommended, depending on your child’s needs.
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.
Typically, hearing evaluations begin with general diagnostics, or behavioral testing, in one of our sound-proof booths. These tests include:
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 sitting quietly is required for this brief evaluation.
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.
If your child need further testing beyond the behavior hearing evaluation, your audiologist may recommend one of the following diagnostic tests.
This diagnostic test evaluates functioning of the auditory (hearing) nerve, and can be used as a predictor of hearing level. It is done while the baby/child is asleep (if 3 months or under) or sedated (over 3 months of age).
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.
This type of testing help diagnose 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 (e.g., trouble hearing in noise, difficulty following multi-step directions, poor reading/spelling/language skills, oral comprehension problems, etc.). This evaluation takes approximately 3 hours.
This testing 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.
This testing is conducted the same way an ABR is done but looks at a different part of the response. The disorder occurs when sound enters the inner ear normally, but the transmission of signals from the inner ear to the brain is impaired —which is typically exhibited by present OAEs (Otoacoustic Emissions from the outer hair cells, or the “natural amplifiers,” which lie inside the cochlea) and absent or impaired ABR (Auditory Brainstem Response). We routinely do this evaluation as part of a diagnostic ABR and CAP (if warranted) to rule it out, but the test can be done independently without proceeding to do a threshold search.
Our balance system is made up from 3 areas in our bodies: the inner ear, the eyes, and our proprioception (use of muscles and joints to maintain body position). Nemours audiologists are part of a comprehensive, multi-disciplinary team that can assess symptoms of balance problems (dizziness, falling or the sensation of falling, disorientation, or nausea), help identify their cause, and develop a successful course of 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.
Hearing Aids: If hearing aids are necessary, Nemours audiologists are qualified and experienced in the evaluation, fitting and management of hearing aids for children of all ages, including babies as young as three months. As part of our program, we closely monitor your child’s hearing loss and hearing aid care.
Frequency Modulated (FM) Systems: 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.
We offer two implantable hearing devices for children, age 5 years and older, with conductive or mixed hearing loss. These devices can also benefit children with single sided deafness — and both devices can be worn in a softband prior to age 5 years or if implantation is not desired.
Cochlear Implant: 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.
Our speech and language pathologists work one-on-one with children to teach or re-teach speech and hearing skills. We can provide these services to children regardless of their primary language at home. Our speech and language services for children with cochlear implants involve a technique called auditory-based therapy. Our program is delivered by therapists and follows a set of guiding principles that include an emphasis on early and consistent amplification, intense family participation, and therapy that focuses on developing speech through natural development patterns.
The methods used during therapy sessions are taught to parents, who will continue the training at home in their child's natural environment. The goal is to maximize the use of your child’s residual hearing in order to develop expressive speech that is melodic and natural. The program emphasizes the meaning and pragmatics of language, rather than articulation – which means language is shaped, or “caught,” rather than taught. The results are children who have natural-sounding speech and language, are excellent communicators, and are at a cognitive level similar or equal with their hearing peers.