Paediatric Hearing Tests

Children learn language by listening to the people and sounds around them. When hearing is
reduced, they may miss important speech sounds and words needed for communication development. Early identification and management of hearing loss can support a child’s speech, language, learning, and overall development, and prevent social and communication difficulties.

Signs of a hearing loss in children

If your child is experiencing any of these symptoms, or if you have concerns about their hearing in general, book a comprehensive hearing assessment.

• Has delayed speech or language development compared to other children of the same age
• Experiences difficulties at school or childcare
• Has frequent ear infections
• Has difficulty following instructions, paying attention or behavioural problems
• Tugging on the ears
• Speaking loudly
• Mispronouncing words
• Asking people for repeats
• Asking for the TV or music to be turned up loud
• Struggling to hear people from a distance
• Easily distracted when people are talking
• Tired and irritable or appears confused in the presence of other noise

Risk factors for hearing loss in children

• Family history of early, progressive or delayed onset hearing loss
• Congenital infections – Cytomegalovirus (CMV), rubella, toxoplasmosis, syphilis, and herpes
• Complications at birth
  • NICU stays >5 days
  • Prematurity (<32 weeks)
  • Low birth weight (<1500 grams)
  • Severe jaundice requiring blood transfusion
  • Ototoxic medications e.g. Aminoglycosides
  • Assisted ventilation
• Craniofacial malformations e.g. Micotria/atresia
• Recurrent or persistent ear infections
• Head trauma
• Chemotherapy
• Postnatal infections – Meningitis, measles, and CMV

Before a hearing test, your True Hearing Audiologist will start by asking questions about your child’s history, health and development to gain a broader understanding of their lifestyle and health. True Hearing offers comprehensive hearing assessments for children from 8 months of age. The type of testing can vary and may involve a combination of approaches and is usually based on the developmental age of the child.

Visual Reinforcement Audiometry (VRA): 8 months – 3 years

Visual Reinforcement Audiometry (VRA) is a commonly used test for babies and toddlers. The testing process relies on behavioural conditioning to sound presentation with the use of animated toys and screens as a visual reward. The major sounds of speech are tested at different intensities (or volumes) to provide an overall picture of hearing ability.

Play Audiometry: 3 – 5 years

Play Audiometry is typically considered for young children from 3 years of age. A repetitive play task, such as placing a peg in a board when they hear a sound, is used to assess their hearing. Headphones (for individual ear testing) are encouraged at this age.

Pure Tone Audiometry: 5+ years

Older children typically perform pure tone audiology (PTA), which is the test of choice for adults. Sometimes minor modifications may be required, but all the important sounds of speech are tested to each ear separately whilst wearing headphones. Their responses to sound might be clapping, raising their hand or pressing a button.

Speech Testing

Speech testing is used to assess a child’s ability to hear and understand speech and complements other parts of the testing process. Various forms of speech testing can be considered depending on the child’s developmental age. The task might involve identifying the names of common objects or body parts, or repeating recorded speech material presented to the ear separately under headphones.

Tympanometry

Tympanometry is an automated test that measures the movement of the eardrum and provides information on the state of the middle ear. It is performed after a visual inspection of the ear using a special torch, called an otoscope.  Tympanometry is a useful test for diagnosing common conditions such as Eustachian tube dysfunction, middle ear fluid ( “glue ear” ), eardrum perforations, or to check that grommets are working. Tympanometry is performed as part of the routine assessment, except if clinically contraindicated.