Paediatric Hearing Tests

Before we conduct your hearing assessment your audiologist will sit down with the child’s legal guardian/parent/family member and discuss the reason that brought you to our clinic in the first place. It is important for us to understand the individual needs of our patients and help us to customise our approach to your particular needs. We will also ask you questions about pre-, peri- and post-natal health aspects which may relate to your child’s hearing. This part of your hearing assessment usually takes around 10 minutes.

The audiologist will have a look in your child’s ear using an otoscope to assess the health of the outer ear canal and the ear drum. If required we can use a video otoscope which allows us to take a picture or video of what we have seen. This is useful for onward referrals to other hearing health professionals or to use as reference in the future. This part of your hearing assessment may only take a couple of minutes.

Next your audiologist will assess your child’s hearing sensitivity to different pitches of sound. Audiometry is a non-invasive and painless procedure to measure hearing sensitivity of an individual. The hearing test is performed using sounds of single frequency, tested at various intensity levels and determining the lowest loudness level that the person is able to hear in each frequency. The tone of a single frequency, called pure tone, is presented into the ear canal through an earphone. The testing is done across different frequencies ranging from 125 Hz to 8000 Hz*. The sounds presented at the external ear, travels through the ear canal, middle ear, inner ear and then through the auditory nerve to be processed in the brain.

This test in conducted in a spacious, state-of-the-art audiometric booth. Standard headphones, or the insert earphones are used during the assessment. You will be required to give a response when hearing a tone, by pressing a button. The lowest loudness level heard by you for each frequency is recorded and is called a Threshold. Thresholds are determined for tones with frequencies starting at about 125 Hz and increasing in frequency by octaves or half-octaves to about 8000 Hz*. Thresholds are defined as the point at which a sound elicits a response 50% of the time that it is present.

Hearing tests of the right and left ear are done independently. Air conduction testing using earphones and bone conduction testing are carried out to determine the type of hearing loss. Bone conduction testing is done with the help of the oscillator fixed to a headband, positioned behind the ear. This part of your hearing assessment can take 10-15 minutes.

*Frequencies tested may vary depending on the child’s age and cooperation during the assessment.

Once the Pure tone audiometry has been completed your audiologist will assess your child’s ability to discriminate words in quiet at different speech presentation levels. They will be asked to repeat these words out loud and to guess if they are not certain. Your child will also be asked to repeat sentences in the presence of competing background noise**. Both of the Speech Audiometry test results can then be compared to normative data. These assessments are used as a cross check for the Pure Tone Audiometry results and help us to understand how your child’s hearing sensitivity may impact their ability to discriminate speech in quiet and in background noise. This part of your hearing assessment will take another 5-10 minutes.

** Assessment of sentence discrimination in the presence of competing background noise depends on child’s age and level of cooperation during the assessment

Your audiologist will also assess the function of the ear drum and -middle ear structures. This assessment is objective and does not require your child to respond. Your audiologist will place a small probe with a soft tip into each ear. First, we will conduct Wide Band Tympanometry: They will hear a series of sounds and feel a slight pressure change. This allows us to assess whether the ear drum is intact and whether the middle ear structures are functioning properly. It also allows us to assess how well the middle ear structures absorb sound.

Next we will check for Stapedial/Acoustic Reflexes. They will hear a series of louder sounds and the equipment will measure the presence or absence of a reflex in response to the sounds presented to each ear. This part of their hearing assessment will take about 5 minutes.

Your Audiologist will place a small probe with a soft tip into each ear separately. Your child will hear a series of sounds and the equipment will automatically record sounds generated from within the Cochlea (Inner Ear) across 500 Hz to 10 000 Hz. In conjunction with audiometric testing, OAE testing can be completed to determine early changes in the behavioural responses obtained during subjective testing and as a cross check for the subjective part of your hearing assessment. Studies have found that exposure to noise can cause a decline in OAE responses even before these changes cause a measurable loss on the Pure Tone Audiogram. This part of their hearing assessment will take approximately 5 minutes.

Your audiologist will discuss the results from the different assessments carried out. They will discuss the results with you in relation to your reason for coming to see us. If indicated, they will also discuss with you onward referrals to other hearing health care professionals. Depending on the results of your assessment they may also discuss communication strategies that could be useful.

Your audiologist will, at your request, send a report to you and/or other hearing health care professionals summarizing the relevant history, results from your assessment and discussions during your appointment.