Children's hearing tests - Leeds Teaching Hospitals NHS Trust

The Hearing and Balance Centre at Leeds General Infirmary is able to provide a hearing assessment service for children of all ages. If you feel that your child has a hearing problem your GP is able to make a referral directly into the Hearing and Balance Centre for a hearing test.

Your Child’s Visit for a Hearing Test

At your appointment you will be seen by a member of our specialist paediatric audiology team.

Firstly we will take a history to find out about the problems your child has been having with their hearing. Following this we will undertake a thorough hearing test. The exact type of test we choose will depend on the age of your child. We will normally be able to explain the results and help you to decide what should be done next.

Visual reinforcement audiometry (VRA) can be used to test children form 7 months to 2.5 years of age. During the test your child will sit on your lap or on a chair. Sounds will be played from speakers or earphones and your child will be encouraged to turn, a toy will light up in order to encourage them and keep their interest. The level of the sound played through the speakers will be varied in order to find out the quietest sound your child can respond to.

Play audiometry can be performed from 2 to around 5 years of age. During the test your child will be encouraged to perform a simple task when they hear a sound, such as putting a brick in a box or a man in a boat. Sounds will either be played through a speaker or through headphones and the level varied to find the quietest sounds they can respond to.

Over 5 years of age children generally perform pure tone audiometry which is similar to the type of hearing test an adult may have. Sounds will be played through headphones and your child will be asked to press a button when they hear a sound. As with other tests the level of the sound is varied in order to determine the quietest sound your child can hear.

Tympanometry can be performed on children of all ages and is a test undertaken on most children attending for hearing assessment and is sometimes referred to as a ‘pressure test’. Your audiologist will place a soft rubber tube at the entrance of your child’s ear and air will be gently blown down the tube. The test is used to see how well your child’s eardrum moves and whether there may be fluid behind it stopping sound from passing to the inner ear as easily as it could.

If the hearing test shows that your child has a hearing problem the results should be able to show the reason for any hearing loss. In general most hearing losses identified in such appointments are temporary in nature and are the result of fluid build up behind the eardrums, sometimes called ‘glue ear’. Some hearing losses identified at this age can be permanent and are the result of problems with the inner ear or the nerves that carry information about sound to the brain. Such hearing losses are called sensorineural hearing losses.

My child has a temporary hearing loss

The majority of hearing losses identified in children are temporary. In such cases the inner ear and nerves sending information to the brain work normally, however there is a blockage preventing the sound from reaching the inner ear.

The most common cause of temporary hearing losses in children is fluid build up behind the eardrum in the middle ear and is sometimes called ‘glue ear’. Fluid in the middle ear makes it harder for sound to pass to the inner ear, and as a result sound has to be louder in order for a child with glue ear to hear it.

For many children with glue ear the fluid clears away on its own over time, however if it does not children will often be treated with grommets by an ear nose and throat consultant. In some cases hearing aids may be offered to help for a short while. A child with a temporary hearing loss may have problems with their speech and language development, have poor concentration at school, or appear to have problems with their behaviour.

If you are concerned your child may have a hearing problem your GP can arrange a hearing assessment at the Hearing and Balance Centre, Leeds General Infirmary.

My child has a permanent hearing loss

The video below explores some of the experiences of families with children that have a hearing loss.

Generally permanent hearing losses are sensori-neural. Sensori-neural hearing losses are the result of a problem with the inner ear that detects sound, or the nerves that carry sound signals to the brain. There can be different levels of hearing loss that can be described as mild, moderate, severe and profound. Hearing losses can also affect pitches of sound differently, for example a child may be able to hear some low pitched (bass) sounds better than others. Your audiologist will be able to explain which sounds your child can hear and the severity of their hearing loss.

When a child is identified with a permanent hearing loss we will make referrals to other services:

DAHIT (Deaf and Hearing Impaired Team) – offer educational support to promote the educational inclusion and achievement of children and young people with a diagnosed hearing loss.
Speech and language therapy – to provide additional support where required.

When a child has been identified with a permanent hearing loss we can also arrange investigations into the possible causes. This can be useful for you as parents/guardians, especially if you are planning to have more children in the future, however it is especially important in the future when it is likely that your child will ask about their hearing loss.

Most babies and children identified with permanent hearing losses will be offered hearing aids to help them to hear sound, especially speech that goes on around them. It has been shown that by fitting hearing aids as soon as possible it gives children with permanent hearing loss the best chance of developing good speech and language skills.

The NDCS (National Deaf Children’s Society) provides fantastic information for families of children with hearing loss. Their publication ‘You and your family‘ is especially helpful.