What is the primary evaluation method for suspected hearing loss in children over three years old?

Audiometry is the primary evaluation method for suspected hearing loss in children over three years old because it directly measures the child’s ability to hear various sounds at different frequencies and volumes. This method involves engaging the child in a controlled environment where they respond to auditory stimuli, typically with a pure tone or speech testing. Audiometry is effective for children in this age group as they are usually able to follow instructions and indicate whether they hear sounds, making it a reliable assessment for determining the presence and extent of hearing loss.

Other methods, while useful in certain contexts, are not specifically designed for the direct evaluation of hearing acuity in children of this age. Tympanometry evaluates the middle ear function and can assist in diagnosing conductive hearing loss but does not assess the central auditory pathways or overall hearing sensitivity. Acoustic reflectometry is primarily used to detect middle ear disorders and is less informative about the broader aspects of hearing. Auditory-evoked potentials are more appropriate for assessing hearing in infants or children who cannot participate in behavioral testing, making them less suitable as a primary evaluation method for children over three.