Booth testing (an experience)

Recently our 5th kiddo had a check-up hearing test. I talked about what made me suspect a loss yesterday and wanted to talk about the test process today.

He had an ABR when he was 4 months old (since he was born at home there was no at-birth test). His first ABR test showed "something" but the audiologist was not sure if it was loss or fluid or a fluke.

Fast forward to the end of June. Caleb is 17 months old and I just KNOW something is up.

So we go in- do a booth test. Not my first choice since ABR is accurate and booth tests are... well... not. But as with most "professionals" the parents have no say.

We get into the booth and if you've ever been a booth test with a small child you know how it is. They first put tubes in each ear, play some sounds, call the child's name, then flash a picture on a screen on either side of them (train and condition). Once they feel the kid understands how this works (like Pavlov's dogs), then they start the test. Usually one audiologist in the booth with mom and child, and one out of the booth administering the test.

Once the test starts the audiologist outside of the booth will play a sound, wait a second and see if there's a response (either the child looks to the screens, looks up, or pauses whatever game he's playing), then they flash a picture on the screen as a "reward".

Here's the problem I have with booth testing at this age- the audiologist inside the booth is suppose to be engaging the child. Not so much that the child is distracted from hearing sounds, but enough that the child isn't looking at the screens BEFORE the sound goes off.

That's a challenge. So normally what the person in the booth ends up doing almost out of habit is stops when there's a sound, looks at the child, and says or face shows this question- "Did you hear a sound???"  Ok- some kids might not pick up on this subtle (or sometimes not so subtle) mark. But some kids are actually bright. And kids with hearing loss are often times much or visually aware then hearing kids so they pick up these marks very easily. They end up being conditioned to something other than sound= picture on the screen. They learn- funny face= picture on the screen.

Therefore booth tests are pretty often invalid.

Just as I'd suspected. Our outcome was "I think there might be hearing loss in high frequencies but I'm not sure so let's schedule an ABR in 2 months".

All in all, we don't care either way. Sure having another deaf child would be nice, but we're happy no matter. And I know without her telling me, Caleb has some loss so at this point it's more about what type of loss and how much.

We'll see... in August :)