More about Pediatric Audiology

Jane Madell
October 5, 2021

cochlear implant baby hearing lossWhen I was supervising new audiologists I always recommend a very old book about diagnosis. It was a book by Helmer Myklebust and was entitled AUDITORY DISORDERS IN CHILDREN: a manual for differential diagnosis. It was published in 1954.

Myklebust was  a professor of audiology in the School of Medicine at Northwestern University and Director of the Children’s Hearing and Aphasia Center. It was one of my textbooks in Pediatric Audiology. (No comments about my age please – I was not yet an audiology student in 1954 but not far off. )

Just last week I recommended it again to a group I am mentoring. Since it was published in 1954 it is outdated. The terminology is not current and etiology of some of the disorders are clearly wrong. For example, this is one of those books that described the cause of children like those on the autistic spectrum as refrigerator mother’s. We know that this is not the case. If it is outdated, why do I recommend it? If we can get over the terminology problems etc, we can learn a lot from this book.

I do not know another book which really discusses the different auditory disorders in children in such a clear way that a person interested in diagnosis can distinguish the different auditory disorders. The book discusses all clinicians involved in working with children with hearing loss and detailed history – some items are not included in most histories audiologists take, and maybe that should be reconsidered.

The disorders Myklebust discusses are Auditory Disorders due to Peripheral Deafness, Auditory Disorders due to Aphasia, Auditory Disorders due to Psychic Deafness and Auditory Disorders Due to Mental Deficiency.

Most pediatric audiology courses focus on Auditory Disorders Due to Peripheral Deafness. ANSD has been added but is the primary focus. We no longer use the term Aphasia to describe children except those who have had an identified insult to the brain and a different disorder than aphasia in adults. In this book aphasia in children is described as loss of language once obtained. It may be predominately expressive or predominantly receptive or affecting both areas.  The next category is Auditory Disorders Due to Psychic Deafness.  This includes children with childhood schizophrenia or autism. The final category is auditory disorders due to mental deficiency – another term we no longer use. Each chapter has many pages describing how to identify each disorders.

There is a large section of the book on test methods. I do not recommend considering the test methods as a suggestion about how to test but it is fun to read what was current in 1954.!!!

Why do I recommend that you read the book? We should not assume that every child we see in the clinic has either normal hearing or a peripheral hearing loss. There are other ways hearing affects auditory behavior. By understanding all the types of possible auditory disorders we really are going to do a better job of identifying children sitting before us and planning for their treatment. Audiologists are the expert in diagnosing auditory disorders.

We can provide critical assistance to families if we look at all aspects of a child’s behavior. I was just told that the books are available very cheaply on Amazon. It is worth it to give it a shot.  


  1. As a child, I realized the moment I knew, what I didn’t know I was missing. The second time, I knew I was bus left in 5th grade Math class. My struggle ensued to College as my Mother sat with me in the President’s office ( seeking readmission from low gpa suspension ). The words he uttered ” She is highly intelligent, I don’t know why she isn’t passing ” echoed for many years. One day, I was reliving that moment, pondering how hard I struggle, when I realized what I now believe is imperative for everyone. How could an educated College President not know what I knew as a child, that I don’t know what I miss. Why was no one understanding that I was pleading for help, to learn and succeed.

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