Newborn hearing screening

Since 1933 it is mandatory for every baby born in the United States to have a newborn hearing screening (NHS). This procedure must be done in the hospital before the baby is discharged. In Costa Rica, the mandatory NHS law was recently adopted; however, there are only a few hospitals that are truly undertaking this procedure. The common practice in Costa Rica is for the pediatrician to request an appointment with the audiologist to have the baby’s hearing tested. The NHS is a very simple procedure that takes about 15 minutes and is performed while the baby is sleeping.

Hearing screenings


The hearing screening is a very simple procedure in which a person listens to different tones. The test takes about 15 minutes and cannot be considered a diagnostic test. If, for any reason, the patient doesn’t hear one or more tones, it is necessary to complete a comprehensive evaluation to confirm or rule out hearing loss as soon as possible.


A hearing screening is recommended:

  • For children: when they enter 1st grade

  • For adults: in cases where the employees of factories or similar are exposed to loud sounds (85dB o more) for certain periods of time.

Adult diagnostic hearing evaluation

The diagnosis of hearing loss requires a complete battery of tests, including:

  • Otoscopy

  • Tonal audiometry

  • Speech testing

  • Determination of the most uncomfortable level (UCL)

  • Tympanometry

  • Eustachian Tube Dysfunction test

  • Stapedial (Acoustic) Reflex measurements

Adult hearing-aid fittng

In our clinic we offer different hearing aid brands so you can choose the one that fits your life style. Our goal is to make you feel comfortable with your hearing aids. Some of the technologies our hearing aids offer are:

  • Digital circuit

  • Automatic compression of loud sounds

  • Special program for tinnitus

  • Adaptive program that adjusts automatically based on the environment

  • Connectivity for cellphone/tv/Ipod

  • Waterproof nanotechnology

Pediatric diagnostic hearing evaluation


The specific tests chosen for the diagnosis of hearing loss in children will highly depend on the age of the child. Given that with children it is very easy to misdiagnose hearing loss, it is extremely important for the audiologist to have expertise in pediatric audiology.

The following are tests performed with kids according to their age:

0-6 months:
  • High frequency tympanometry

  • High frequency Stapedial (Acoustic) Reflex threshold

  • Otoacoustic Emissions (OAE)

  • Click Auditory Brainstem Response (ABR) with identification of the cochlear microphonic

  • Frequency-specific ABR (at least 4 frequencies)

6 months – 2 ½ years:
  • Tympanometry

  • OAE

  • Stapedial (Acoustic) Reflex Threshold

  • Visual Reinforcement Audiometry (VRA)

2 ½ – 5 years:
  • Tympanometry

  • OAE

  • Stapedial (Acoustic) Reflex Threshold

  • Conditioned play audiometry (CPA)

  • Speech testing based on the child’s vocabulary

5 years +:
  • Tympanometry
  • OAE

  • Estapedial (Acoustic) Reflex Threshold

  • Regular audiometry

  • Speech testing based on the child’s vocabulary

Pediatric hearing-aid fitting

Hearing-aid fitting in children is of special care. It is extremely important to get real-ear measurements and also provide special characteristics like:

  • Tamper proof battery doors
  • Light that lets you know if the hearing aid is working
  • Durability
  • Cleaning and maintenance kit
  • Color options
  • FM capability
Cochlear implants

The cochlear Implant is a device that consists of 2 parts:

  • Internal part: Placed inside the patient’s skull during surgery
  • External part: Goes on the outside and connects to the internal part through a magnet.

If hearing-aids are not clear and loud enough to help a person hear better, a cochlear implant might be the best option. However, cochlear implants are not for everyone. A patient that is interested in getting a cochlear implant must go through a rigorous protocol to determine if he or she is a good candidate.