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What are hearing
tests all about?
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Your child may need a hearing assessment at some stage in their lives. For little ones, this may be a daunting prospect, but our team of paediatric audiologists are ready to make the appointments as fun - as possible. By TSH Audiologist Anita Tran.
At TSH, the Hearing Services team is able to see children from six months old to 18 years old. Our team currently comprises six audiologists, each of whom has many years of experience and training in working with paediatrics.
They will ensure that your child and their families feel safe and comfortable from the moment that they meet in the waiting room. Audiologists will aim to make the appointment be as fun-filled as possible, tailoring tests and toys to your child’s individual needs and interests.
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The most common reasons why a child is seen for a hearing test are the following:
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Parental concerns – the child may be showing signs of not hearing or responding to sounds or speech, child may be requiring frequent repetition in conversation, they may be needing audio on TV or a tablet increased to hear it better.
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Suspected delays with the child’s speech and language development – child may not be talking at a developmental age they’re expected to; may not have as many words as they’re expected to, may not be putting words together yet; their speech might be unclear.
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Multiple ear infections – ear infections (Otitis Media) are very common in young children. Middle ear fluid resulting from Otitis Media may impact their hearing. The signs of this are often quite subtle and can be missed by parents.
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Listening and learning difficulties or concerns in the classroom.
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Failed school/kindy hearing screenings.
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Failed newborn hearing screenings (if they weren’t followed up directly after this at birth by the hospital).
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Family history of hearing loss.
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Common referrers for a hearing assessment: self-referral, speech pathologists, GPs, ENT specialists, child health nurse, paediatricians, school teachers, daycare educators.
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"While audiologists are experts in hearing, listening and ear health; we recognise that parents know their child best.
Audiologists will help provide information to families about their child’s hearing needs in a way that families feel empowered and able to make an informed decision about their child."
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Otoscopy: looking in your child’s ears with our light/torch (otoscope). The audiologist will look at the appearance of the child’s ear drums, ear canals and outer ear (the part of the ear we can all see)
Tympanometry: a tool that measures the function of the middle ear and how well sound is being transmitted through this part of the ear. It is a very quick test, lasting seconds, which draws “pictures” of their ears.
Otoacoustic Emissions: Another relatively quick tool that measures sounds that can be generated by the cochlea (inner ear hearing organ) in response to another sound that is played to your child’s ear. It is a very sensitive test, so it does rely on your child being very still and quiet, so it’s a great idea to assist with your child sitting still - perhaps even using some distracting toys.
Behavioural hearing testing: This hearing test measures the softest sounds your child can hear at different pitches/tones. The pitches/tones we try and test are the ones that are most important to hear soft speech sounds. The type of hearing test we use will depend on your child’s age or developmental age. All our hearing tests are conducted in a sound booth.
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Visual Reinforcement Audiometry: The audiologist plays sounds through a machine from outside the sound booth and will observe the child’s reactions to the sounds through a window. Often, there may be a second audiologist or designated distractor inside the booth with the parent and the child to help distract the child so they remain engaged with the sounds and activity.
Whenever your child responds to the sounds they hear (eg: they may turn their heads towards the sounds or the response may be more subtle like stilling or certain eye movements), the audiologist will turn on some screens with animations or turn on puppets to “reward” the child for hearing the sounds. It’s important that the parent remains as neutral as possible during the test and not point sounds out to the child but it’s also just as important to really encourage and praise the child when they do successfully hear each sound too!
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Play audiometry: For children at least three years of age, this type of hearing test involves the child wearing a set of headphones and responding to certain sounds in a play-based environment. For example, they may put a toy in a bucket each time they hear a sound or place a peg on a pegboard. Kids might like to see their parents playing the game as well to help build confidence, or simply to make it more fun and engaging.
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Pure tone audiometry: This type of hearing test would be the same type of test an adult would be able to do. Using the same sounds again as VRA and Play Audiometry, this time your child would be comfortable with pressing a button each time they heard a sound. Usually, children are primary school aged when we do this test and, depending on your child’s needs, the audiologist may be inside the booth with them or sitting outside (while the parent still remains inside the booth with their child).
Speech discrimination testing: These types of tests assess how well your child can hear speech sounds rather than tones. When the child is between the ages of 3-6 years old, we may use a picture pointing game and ask the child to point to certain pictures. The audiologist may start with their voice at a soft level and often they will cover their mouths to remove any visual cues. When the child is over six years old, they may hear some words through headphones and will be asked to copy or repeat what they’ve heard.
At the end of the appointment, all the results obtained will be communicated immediately to the parents and guidance towards any type of treatment/intervention plans for their child will be discussed together.
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Audiologists will provide a written report with the results to the parents and any other referrers (such as GPs, ENTs, other agencies involved with the child’s management).
Recently, Audiology Services has become formally recognised by Medicare and families are able to get a Medicare rebate for an audiological assessment. To be eligible for a Medicare rebate, it does mean your child will require a GP referral for the hearing test, which should be brought to the appointment on the day or sent through prior to the appointment.