Which of the following hearing tests is not performed in infants?

INI-CET EXAM -2025

Child Health Nursing (Pediatrics)

Medium

Appeared in: INI-CET EXAM -2025

Explanation

Pure Tone Audiometry (PTA) is a subjective behavioral test that requires the patient to understand instructions and signal when a sound is heard.
Infants are developmentally unable to provide this type of conscious, cooperative response.
This test is typically reserved for children aged 4-5 years and older, who can reliably participate in the testing procedure.

Option A: Otoacoustic Emissions (OAE) is a standard, non-invasive hearing screening test performed on newborns and infants. It is an objective test that does not require any response from the baby.
Option B: Brainstem Evoked Response Audiometry (BERA), also known as Auditory Brainstem Response (ABR), is an objective test used to assess the hearing pathway from the inner ear to the brainstem. It is a key diagnostic tool for infants, especially those who fail the initial OAE screening, and can be done while the baby is asleep.
Option D: Free-field audiometry is a form of behavioral testing used for infants and young children (typically 6 months to 2.5 years). It involves presenting sounds through speakers and observing the child's reaction, such as turning their head towards the sound (a technique called Visual Reinforcement Audiometry).

Visual 1: Table: Comparison of Pediatric Hearing Tests - A table showing different hearing tests (OAE, BERA, VRA, Play Audiometry, PTA), the principle behind each, the type of response measured (objective vs. behavioral), and the typical age range for which each test is appropriate.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Hearing assessment methods in infants and children as background academic context rather than a clinical decision trigger.
Early detection of hearing loss is critical for a child's speech, language, and cognitive development. The '1-3-6' rule is a guideline: screen by 1 month, diagnose by 3 months, and begin intervention by 6 months.
Nurses play a vital role in ensuring newborns undergo hearing screening before hospital discharge and in educating parents about the importance of follow-up if the infant does not pass.
What if? If an infant fails both OAE and BERA tests, it indicates a high probability of sensorineural hearing loss. The next step is a comprehensive audiological evaluation to determine the degree of loss and plan for early intervention, such as hearing aids or cochlear implant evaluation.

How to Approach the Question

First, understand the question is asking which test is not suitable for infants. This is a negative-framing question, so you are looking for the outlier.
Consider the developmental capabilities of an infant. They cannot follow complex instructions or provide voluntary, conditioned responses.
Evaluate each option based on this consideration. Differentiate between objective tests (which measure a physiological response without the patient's cooperation) and subjective/behavioral tests (which require a conscious response).
OAE and BERA are objective tests, making them suitable for infants.
Free-field audiometry relies on a natural reflex (head turn), making it suitable for slightly older infants.
PTA requires a learned, voluntary response, making it unsuitable for infants. This identifies it as the correct answer.

Concept Tested & Keywords

Concept Tested: Hearing assessment methods in infants and children.
Stem keywords: hearing tests, infants
Lead-in keywords: not performed
Negative lead-in flag: The question asks to identify the test that is NOT used for infants.

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