By Olivia Ruggiano, Au.D
Pediatric Audiologist at Boulder Medical Center
When a child shows signs of speech delay, difficulty responding to sound, or developmental concerns, one of the most important first steps is a comprehensive hearing evaluation. Hearing plays a foundational role in speech, language, social skills, and learning, so understanding a child’s hearing status helps guide every other step in their developmental care.
Why Is a Hearing Evaluation the First Step in Checking Speech or Developmental Delays?
A hearing evaluation is essential because even mild or temporary hearing differences can affect:
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- Speech clarity
- Language development
- Social interaction
- Behavioral responses
- Learning and attention
- Progress in early intervention or therapy
Hearing differences are treatable in many cases, and early identification provides developmental teams with the accurate information they need to support your child.
What Signs Suggest My Child Should See an Audiologist?
Parents may consider a pediatric hearing evaluation when a child:
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- Doesn’t consistently respond to sound
- Is not meeting speech or language milestones
- Has been referred for a developmental or autism evaluation
- Has frequent ear infections
- Has a diagnosed medical condition that may affect hearing
- Shows social or learning difficulties that could be tied to hearing
Audiologists are often among the first professionals involved in developmental assessments because they help determine whether hearing is a contributing factor.
How Does a Pediatric Audiologist Evaluate Hearing?
Pediatric audiologists use developmentally appropriate, child-friendly methods to assess hearing. These tools help identify or rule out hearing differences:
Otoscopy
A small light is used to examine the ear canal and eardrum.
Tympanometry
A soft probe checks middle ear movement and detects fluid or pressure issues.
Otoacoustic Emissions (OAEs)
A painless test that measures inner ear function, often used for infants and toddlers.
Behavioral Hearing Tests
The method depends on developmental age:
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- Visual Reinforcement Audiometry (VRA): ~6 months–2.5 years
- Conditioned Play Audiometry (CPA): ~2.5–5 or 6 years
- Conventional Audiometry: ~6 years and older
These tests help determine the type (conductive, sensorineural, mixed) and degree (mild to profound) of any hearing difference.
How Does Hearing Affect a Child’s Development?
Research consistently shows that even mild hearing loss can impact:
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- Speech production
- Receptive and expressive language
- Early literacy
- Learning and classroom performance
- Social-emotional development
Because many developmental signs overlap with hearing-related symptoms, ruling out hearing differences helps provide clarity for families and clinicians.
What Happens After the Hearing Evaluation?
Results from the hearing evaluation guide the next steps:
If Hearing Is Normal
Families can proceed confidently with speech therapy, developmental evaluations, or autism assessments.
If a Hearing Difference Is Found
The care plan may include:
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- Medical evaluation with an ENT
- Speech-language therapy
- Hearing aids or bone-anchored devices
- Cochlear implant evaluation
- Assistive listening technology
- Communication supports, like sign language or AAC
- Referrals to early intervention or developmental specialists
Audiologists collaborate closely with pediatricians, SLPs, OTs, PTs, early intervention teams, and developmental specialists to ensure coordinated care.
How Does Specialized Training Support Children With Developmental Disabilities?
Dr. Olivia Ruggiano’s background includes advanced training in the evaluation of children and young adults with developmental disabilities and complex medical needs. Through specialized interdisciplinary education, she gained experience in:
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- Modifying hearing tests for children with sensory or behavioral differences
- Supporting families navigating complex medical or developmental concerns
- Providing trauma-informed, sensory-aware care
- Collaborating with developmental and medical teams
This training ensures that hearing evaluations are accessible, compassionate, and tailored to each child’s abilities.
Why Start With an Audiologist?
A hearing evaluation provides clear, objective information about a child’s hearing—information that directly shapes developmental, speech, and behavioral assessments.
Early hearing evaluation helps ensure that children receive the right support at the right time.
It is one of the most meaningful steps families can take when they have concerns about their child’s communication or development.
About Dr. Olivia Ruggiano, Au.D
Dr. Ruggiano is an audiologist serving patients ages 6 months to 50 years old in Boulder and Louisville, Colorado. She offers specialized training in pediatric audiology and conducts hearing evaluations, child-friendly testing, and hearing assessments for children with developmental and complex medical needs.
Resources
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- Get to know Dr. Olivia Ruggiano
- Call (303) 440-3050 for an appointment