Hearing test

If your child is referred for a hearing assessment, they will be seen by one or two members of the audiology team. The type of assessment they will have will be based on their age and ability. Audiology assessments can be categorized in to two main types, behavioural and objective assessments.

What is a behavioural assessment?

A child’s behaviour change in response to sound is watched, the way in which we do this will be dependent on age and ability.

What assessment will be completed on my child?

Age 0 to 4 months – Objective tests are completed as babies are not ready to give reliable behavioural responses to sound until they are a little older.

A baby sitting on their mother's lap while having a hearing test done

Age 4 to 8 months – This age group are sometimes too active for some objective tests and not yet ready for behavioural testing. The assessments completed will be based on an individual basis.

Age 8 to 30 months – Visual Reinforcement Audiometry (VRA)

This technique is used to measure the Minimum audible level at different pitches. The child is seated between the visual reinforcement reward boxes and speakers are attached to those boxes. To condition the child a sound is played from one of the boxes, as the child turns to sound they are presented with a visual reward in the form of an illuminated toys in the box.

A child completing a hearing test to measure their minimum audible level. The child is sat in front of a box with their head turned towards the object in the box.

Age 30 months to 48 months – Play Audiometry

Play audiometry is preferred for children who can understand simple instructions and commands. To determine the hearing threshold, a game is played in which children perform an action when sound is heard. This could take the form of putting toy men in the boat or stacking cups.

Age 48 months – Play audiometry with headphones or Pure tone Audiometry

Play audiometry is performed under headphones when children able to tolerate headphones and are quite ready for ear specific testing.

A child with headphones on and interacting with a nurse

What are Objective hearing tests?

  • Auditory brainstem response (ABR) testing measures the response to sound along the auditory nerve. A child needs to be very still and settled for this test, ideally asleep. The appointment can take up to 2 hours.

.A child sitting still on their mother's lap with a device to measure the response to sound is attached to the child's head

  • Otoacoustic emission testing measures response from the outer hair cells in the inner ear. It usually takes a few minutes if child is quite and still.

A child with an earphone in one of her ears while nurse looks at the meaurements

  • Tympanometry: Measures eardrum movement in response to pressure and can tell us if a child has any middle ear fluid (glue ear).
  • Middle ear reflex: testing measures the contraction of a middle ear muscle in response to louder sounds. The audiologist will carry out this test during the appointment if required.

A nurse looking at the child's ear