Hearing test appointment (children)

Testing your child's hearing

We can use a variety of tests to assess how much hearing your child has.

The tests we use will depend on your child’s age and stage of development.

We may need to perform several different tests over more than one appointment. This will help us to build up a clear picture of your child’s hearing.

Types of hearing test

Tympanometry (all ages)

• We use tympanometry to check how well the moving parts of your child's middle ear are working.
• We gently hold a soft earpiece in their ear canal. We use a pump to cause the pressure of the air in the ear canal to gently change. Your child's eardrum should move freely with the change in pressure.
• This test is quick to perform and can be done on most children. We do not use it for some conditions, including excessive ear wax.

Oto-acoustic emissions/OAE (newborn to approx 4 months)

• We use the otoacoustic emission test for newborn screening. It works on the principle that a healthy inner ear (cochlear) will produce a faint response when stimulated with sound.
• We place a small earpiece in your child’s ear and play a clicking sound. If your child's cochlear is working, the earpiece will pick up the response and record it on a computer.
• We can record an OAE quickly, but it is affected by background noise, excessive ear wax and middle ear fluid.
• We can use this test on any age group, but in our experience, a child older than 4 months is usually unable to sit still for long enough for us to perform it.

Auditory brainstem response/ABR (newborn to approx 4 months)

• We use this test for babies who have not had a clear response on their newborn hearing screening. It can take up to 2 hours.
• It measures sounds sent from your child's inner ear (cochlear) through the auditory nerve to their brain.
• This test can take up to 2 hours.
• We lightly scrub the skin on your child’s forehead and behind both ears. Then we put three sensors on the skin.
• We deliver sound through an insert or headphone, and record the response on a computer. We can then interpret the results to find the quietest level of sound being picked up by your child's hearing nerves.
• For an accurate result your child must be asleep during the test, as other brain or muscle activity will interfere with the results.
• ability to record the response from the hearing nerve.
• We can use this test on any age group, but in our experience, a child older than 4 months is usually unable to sit still for long enough for us to perform it.

Visual response audiometry/VRA (approx 6 months to 2.5 years)

• During this test we play sounds of different frequencies and loudness to your child, either through speakers or insert phones.
• When your child hears the sound they will turn their head and this activates a visual 'reward', such as a video or a puppet lighting up. 
• At first we play the toy and a loud sound at the same time, so your child learns to associate the reward with the sound. In this way, your child will learn to turn through a process known as 'conditioning'.
• Once your child is 'conditioned', we only activate the reward when your child turns their head for the sound.
• This type of test allows us to test a well-conditioned child more quickly, at more frequencies and at lower sound levels.
• It is possible to perform this test on a 6 month old, but some children are not developmentally ready until they are 9 months or older.
• There may also be a short period where a child is too old for VRA but not yet ready for PTA (see below). In this situation, the audiologist will discuss games you can play at home to train your child for their next appointment.

Pure tone audiometry/PTA (approx 3 years and above)

• From about the age of 3, we actively involve children in their hearing tests.
• During a PTA test we play sounds of different frequencies and loudness, either through a speaker for younger children, or headphones for older ones.
• We show younger children how to move a toy (for example putting a man in a boat) each time they hear a sound.
• We ask older children to press a button in response to sounds.