common children's audiology QUESTIONS

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Objective Hearing Assessments: measures how well the auditory pathway is working and it does not need for the child to respond to sounds.  These tests include:

Otoacoustic emissions (OAE):  This is the first test carried out during the Newborn hearing screening  and it tests how well the cochlea (outer hair cells) is working.  A poor response on OAEs does not mean the child is deaf, OAEs are very sensitive to noise or fluid in the ears.

Auditory Brainstem Response (ABR): Sensors are  placed on the child’s head and behind the ears. Different pitches of sounds are  then played using headphones and the activity of the auditory nerve is picked up. This test is carried out while the child sleeps.

Behavioural Hearing Assessments:  involve the child listening to different sounds as part of a game.

Visual Reinforcement Audiometry (VRA):  Suitable for children aged 6 months to about 2 years old. The child sits on a little chair or a parent’s lap and is conditioned to turn to a sound coming from speakers to be rewarded with a toy puppet or screen. 

Play/ Pure Tone Audiometry (PTA):  The child will be conditioned to do a task such as putting a man in a boat or pressing a button every time they hear a sound. The sounds can be played through headphones or speakers and the audiologist can find out the quietest sound the child can hear at different frequencies (pitches of sounds).

Bone conduction testing:  A small vibrating device is placed behind the child’s ear and the sound passes directly to the inner ear through the skull bypassing any blockages such as wax or glue ear. This can identify if the hearing loss is conductive (the issue is in the outer or middle ear) or sensorineural (the issue is in the inner ear).

Tympanometry: A small probe is gently put in the ear and causes a change in pressure which should move the eardrum in and out. If the eardrum is not moving freely it might be due to fluid behind the eardrum which is commonly called Glue Ear or any other issue with the middle ear. Glue ear can cause a temporary hearing loss. 

Speech Discrimination testing:  Different tests are used (depending on the age or ability of the child) to check the minimal levels they can identify speech by repeating words or pointing to pictures/toys with and/or without lip reading.

Yes, you will receive the report and all the results of hearing tests carried out on the day such as Audiogram, Tympanogram and Otoacoustic emissions.

We can see children of any age for Otoacoustic emissions testing (Newborn screening) and Tympanometry.

For the behavioural testing we can see children from 2-3 years old (depending on ability and developmental age) for Play Audiometry whether using headphones or via a speaker. 

- Your child’s history will be taken.

- The full battery of hearing tests will include: ear examination, Tympanometry, Otoacoustic Emissions and Behavioural testing such as: Pure Tone / Play Audiometry using headphones (for ear specific ear) or a handheld audiometer (testing both ears together). Bone conduction testing will be performed if needed.

- Discussion of results and recommendations.

Some children will benefit from having a follow up appointment in 3 months to monitor the hearing and middle ear status. 

Depending on our findings, some children will need a referral to the Ear, Nose and Throat specialist or Audiovestibular Physician for further management.

A conductive hearing loss due to Glue ear will in most cases improve. 

A sensorineural hearing loss is permanent and in some rare cases depending on the cause of the problem, can be progressive.