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.

Nemours duPont Pediatrics, Philadelphia
Audiology, a Department of Nemours/Alfred I. duPont Hospital for Children

833 Chestnut St. E., Suite 300
Philadelphia, PA 19107
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For Appointments: (888) 495-5218

Hours: Monday and Friday: 8 a.m. to 4:30 p.m., Tuesday: 8 a.m. to 5 p.m.,
Thursday: 8 a.m. to 4 p.m.
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View Doctors
  • Rebecca Huzzy, AuD, CCC-A
  • Stacy Szymkowski, AuD, CCC-A
  • Jessica Loson, AuD, CCC-A
  • Andy Lau, AuD, CCC-A
  • Sarah Zavala, 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
You may also bring (if available):
  • any past test results related to hearing
Forms & Resources
Resources for Patients & Families

Auditory disorders and hearing loss in children can cause delays in speech, language and cognitive development. So it's important to diagnose and treat these pediatric audiology problems early on.

Nemours audiologists (specialists in pediatric hearing) from Nemours/Alfred I. duPont Hospital for Children come to Nemours duPont Pediatrics, Philadelphia to provide expert evaluations and care for children from birth to age 21 with hearing or other ear-related problems. We use the most up-to-date equipment and innovative pediatric assessment techniques to determine your child’s hearing sensitivity and recommend the most appropriate management plan.

A Team of Pediatric Audiology Experts to Help Your Child

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

This team approach allows us to gather as much information as possible, and ensures that your child benefits from our wealth of experience across many areas.

Hearing Conditions We Treat

Our services at Nemours duPont Pediatrics, Philadelphia include pediatric audiology assessment, management and monitoring of children with conditions such as:

Auditory Neuropathy Spectrum Disorder

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.

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. We designed our program at Nemours duPont Pediatrics, Philadelphia to be able to closely monitor children with hearing loss. We collaborate with our Nemours/Alfred I. duPont Hospital for Children Division of Otolaryngology (Ear, Nose & Throat, or "ENT") colleagues to ensure that your child receives a thorough 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, Philadelphia

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 your child’s age, ability to cooperate, and 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

Behavioral audiometry are hearing tests that 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 will 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 a bank).
  • 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 & Middle Ear Muscle Reflex (MEMR) Testing

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 a brief time.

Otoacoustic Emissions (OAEs)

This pediatric audiology test measures the function of the outer hair cells, which are the natural sound amplifiers inside the cochlea.

During an otoacoustic emissions (or "OAE") test, we place a soft tip in your child’s ear canal that transmits sound to measure outer hair cell function. This can be obtained in seconds in a sleeping infant or an older child who is able to sit quietly.

Specialized Hearing Tests at Nemours duPont Pediatrics, Philadelphia

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

Auditory Brainstem Response (ABR)

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 younger than 3 months of age) or sedated (if older 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., children with developmental delay or syndrome-related hearing loss)

We perform ABR testing 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 (nerve) response and determine your child’s threshold of hearing. This testing lasts approximately one to two hours.

If your child requires sedated ABR testing, we can arrange for it to be done on an outpatient basis at either Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., or The Alfred I. duPont Hospital for Children Surgery Center, Bryn Mawr, which is located within Nemours duPont Pediatrics, Bryn Mawr.

Auditory Neuropathy Spectrum Disorder (ANSD) Evaluation

A series of tests can be used to assess 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 testing for ANSD includes otoacoustic emissions (OAE), middle ear muscle reflex (MEMR) and auditory brainstem response (ABR) evaluation.

This type of testing may be used 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 ANSD can have speech that ranges from mildly distorted to absent)
Central Auditory Processing (CAP) Evaluation

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 multistep directions, poor reading/spelling/language skills, oral comprehension problems, etc.) This evaluation takes approximately three hours.

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.

Hearing Aids

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.

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.

Cochlear Implant Support

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.