Audiologic examination should be conducted in children having a risk factor for hearing defect.


Indications for audiologic evaluation of a child:

(1) neonatal risk factors (see below)

(2) after certain infections (see below)

(3) with congenital malformations of the head and neck (see below)

(4) with delayed speech and language development (see below)

(5) after head trauma associated with loss of consciousness or skull fracture

(6) with a family history of hereditary or unexplained sensorineural hearing loss

(7) neurofibromatosis type II


Neonatal risk factors:

(1) low birthweight ( < 1,500 grams)

(2) asphyxia

(3) seizures

(4) intracranial hemorrhage

(5) assisted ventilation lasting 5 days or more

(6) hyperbilirubinemia sufficient to warrant exchange transfusion

(7) ototoxic drugs

(8) Apgar score <= 4 at 1 minute or <= 6 at 5 minutes


Infectious diseases:

(1) proven or suspected intrauterine infection (cytomegalovirus, rubella, syphilis, herpes simplex, toxoplasmosis)

(2) bacterial meningitis

(3) recurrent or persistent otitis media with effusion


Congenital malformations in the head and neck:

(1) anomalies of the first and second brachial arch (microtia, auricular dysplasia, micrognathia)

(2) anomalies of the neural crest or ectoderm (widely spaced eyes, pigmentary defects)

(3) anomalies of eustachian tube development


Delayed speech or language development:

(1) developmental disabilities (mental retardation, cerebral palsy, autism, blindness, neurodegenerative disorders)

(2) parenteral or caregiver concerns about possible hearing, speech, language or developmental delay


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