Pure tone audiometry is the key hearing test used to identify hearing threshold levels of an individual, enabling determination of the degree (how much hearing loss exists), type (site of lesion) and configuration(frequencies or pitches that are affected)  of a hearing loss, thus, providing the basis for diagnosis and management. PTA is a subjective, behavioral measurement of hearing threshold, as it relies on patient response to pure tone stimuli. Therefore, PTA is used on adults and children old enough to cooperate with the test procedure.

Speech Audiometry

Like Pure tone audiometry, speech audiometry provides information concerning sensitivity to speech materials and acuity or understanding of speech at supra-threshold levels. Speech audiometry has become a fundamental tool in hearing-loss assessment. It can be used diagnostically to examine speech-processing abilities throughout the auditory system, and it can be used to crosscheck the validity of pure-tone thresholds

Depending on the developmental level of the child, one or more of the following test procedures supported by other audiological tests may be used to determine hearing sensitivity and acuity:

Behavioral Observation Audiometry (BOA)

This test is carried out by observing changes in a child's behavior and activity upon the presentation of controlled sounds, such as change in the breathing rate, eye-widening, cessation in activity, quieting, and startling etc., However, due to the fact that behavioral changes may be subtle, it is not recommended to heavily rely on this test results.

Visual Reinforcement Audiometry (VRA)

VRA is a behavioral audiometric test obtained in a sound-treated room. The child is seated on a parent's lap or in a chair between two calibrated loudspeakers, or using earphones. When a sound such as a tone at a specific frequency, speech, or music is presented, the infant's eye-shift or head-turn response toward the sound source is rewarded by activation of a lit mechanical toy mounted near the loudspeaker. The child's attention is then distracted back to the midline so that additional sounds can be presented. Any test performed through loudspeakers rather than earphones is called "sound field" audiometry and does not test each ear separately; rather, sound field audiometry yields an audiogram for the better-hearing ear if there happens to be an ear difference in hearing. However, if the child tolerates wearing earphones, then the test assesses hearing in each ear separately. For children age 7 months to 2 1/2 years

Conditioned Play Audiometry

Conditioned Play Audiometry is a behavioral audiometric test obtained in a sound-treated room. The child is conditioned to listen to auditory stimuli and respond to the sound by participating in a specific repetitive play task, such as dropping a small ball in a pocket, each time he or she hears a sound. Accurate separate-ear audiograms by air and bone conduction may be obtained. If the child refuses to wear earphones or a bone conduction oscillator, the test can be administered in the sound field. For children age 2 1/2 years to 5 years

Speech Audiometry

Like pure tone audiometry, however, this test utilizes speech materials as a stimulus, in order to determine the child's ability to respond to speech-like sounds or identify spoken words. Mainly three tests:

Speech Reception Threshold: This threshold is established by presenting one- or two-syllable words (ice cream, cowboy, tooth brush etc.), and having the child either identify a corresponding picture or object or repeat the word.

Speech Recognition Testing: This test determines a child's ability to listen to one-syllable words at a normal conversation level or comfortable listening level and repeat the words accurately or point to a corresponding picture.