Physiologic and behavioral approaches to pediatric hearing assessment.

A behavioral approach is the first choice for hearing assessment in infants and children. It is the only true test of hearing. Physiologic measures are not tests of hearing, only indicators of auditory function. The use of physiologic measures in estimating hearing levels makes some presumptions regarding the concept of hearing. As such, these measures are used when a definitive statement about hearing cannot be made on the basis of behavioral audiometric results, or when other factors (e.g., age or developmental delay) preclude obtaining reliable behavioral information.