Hearing assessments

When your child attends their appointment, they are booked into the clinic at reception. The child is then called in with their parent/carer to see the clinician.

As it is important to reduce background noise asA girl and her mum walk through a doorway much as possible during hearing assessments it is helpful if as few relatives/carers as possible accompany the child during the test and no other children if possible.

Children’s hearing can be assessed in a number of different ways depending on the child’s age and ability. None of the tests are painful and more details about each test are shown below.

You will be told the results of the hearing test the same day and will be given a written summary.

Subjective hearing tests:

Distraction test

The distraction test is ideally used for babies who are developmentally six to eight months old and assesses the ability of the baby to hear a sound then turn to locate it.

The sounds are produced to the right or left behind the baby out of their field of view. Various sound stimuli are used such as rattles, voice, drum and warble tones. The loudness of the sounds produced are varied to try and establish the minimum level that the baby is able to hear.

Visual reinforced audiometry (VRA)A baby in a dress is sat on their mothers knee

This test is suitable for infants from six months to two years old. If successful, we can measure the level of your child’s hearing across the speech range in each ear separately.

The child is presented with a sound from one of the loudspeakers from the left or right, as the child turns to the sound they are presented with a visual reward in the form of an illuminated puppet in the box. In order to obtain ear specific hearing thresholds the child may wear headphones or have small insert phones placed in the ear canals to generate the stimulating sounds.

Play audiometry

Play audiometry is suitable for pre-school children of 20 months to five years old (developmentally). The child must be able to understand simple instructions and commands.A happy little girl holds an object to her ear and listens to it

A game is played in which the child must perform an action when a sound is heard. This could take the form of putting toy people in a boat or building a tower from blocks. The child may listen to sounds from a loudspeaker, wear headphones or have tiny probes inserted into the ear canals (inserts) during the test. Sounds at various frequencies are presented to the child and gradually reduced in loudness.

Pure tone audiometry (PTA)A boy in a red t-shirt listens through headphones during a hearing test. He is holding a stick with a button to push with his thumb. You can see the results of the test on a laptop screen.

School age children are generally able to manage this test. Tones of varying frequency and intensity are played through headphones or insert phones. The child must press a hand held button for as long as they can hear a sound.

The loudness of the sounds are reduced until the child stops responding, this is the threshold of hearing. The threshold of hearing is plotted creating an audiogram.

Objective hearing tests

Otoacousic emissions (OAE)A baby sits on their mothers knee while having a hearing test

This is the same test that most newborn babies have as part of the new born hearing screen. Your baby needs to be settled and the room very quiet for this test which takes just a few minutes. The audiologist will explain what the results mean after the test.

Auditory Brainstem Response (ABR)A little baby with a dummy in is wearing headphones while sitting on his mothers lap

Your baby will need to be asleep for this test and the test room kept very quiet throughout the test. The test may take up to 1.5 hours. Please bring everything you need to settle your baby / child to sleep once they have been prepared for the test.

Facilities

Sheffield Children’s Hospital has seven soundproof test rooms containing all the equipment required to carry out the range of audiological tests described above, plus a specialised vestibular test room.

Results of the hearing assessment are explained and a decision is made about the next step. You will be given a patient information leaflet, or copied into the clinic letter and will be advised who will be sent a copy of the clinic letter.

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