HEARING TEST FOR CHILDREN

In the first few years of life hearing is a critical part of a child’s social, emotional and cognitive development. Even a mild hearing loss can affect a child’s ability to develop speech and language and interact with others.

Most children born with hearing impairment can be diagnosed through hearing screening before they leave the hospital. But in some cases, hearing loss may develop later caused by ear infections, virus or other health ailments. It is important to have your child’s hearing evaluated if you suspect signs of hearing loss.

Our audiologists are highly experienced in performing hearing tests for children from as young as 12 months, with most having over 10 years’ experience working with children.

Medicare rebate for Audiology from 1 April 2023. See Rebate section below for more info.

Types of Hearing Loss

Hearing loss is established according to how much hearing has been lost and which part of the ear is affected. There are many types and degrees of hearing loss. The level of hearing loss is classified as mild, moderate, severe or profound.

There are two main types of hearing impairment: ‘conductive’ and ‘sensorineural’. Having both types is called a ‘mixed loss’.

The most common in children is conductive hearing loss which occurs when something interferes with sound waves travelling through the outer and middle parts of the ear to the inner ear.

It can be caused by a wax blockage, middle ear infection (otitis media), a fluid build-up in the middle ear, or damage to the tiny bones in the middle ear. Conductive hearing loss may be either temporary or permanent.

Sensorineural hearing loss is caused by a problem in the innermost part of the ear or in the nerve which carries hearing, the ‘auditory nerve’. It can be caused by abnormal inner ear development, a physical injury to the inner ear or damage to the ear caused by illness.

Sensorineural hearing losses are usually permanent. Sometimes the problem with the inner ear also causes problems with balance. For this type of loss, you will be referred to your GP for a referral to an ENT and to a government funded hearing service provider for children with permanent hearing loss.

Signs of Hearing Loss

Children experiencing hearing problems would not know they are having difficulty with hearing, as to them it becomes the norm. However, the following signs may point to a problem with hearing as your child develops: –

• Does not respond to loud sounds or their name being called

• Your child does not turn towards the source of a sound

• Limited or poor speech

• Has difficulty with pronunciation and sounds

• Request’s people repeat their words or conversations frequently

• Difficulty with learning

• Frequently inattentive, especially in a classroom

• Speaks loudly

• Listens to digital devices and TV at levels louder than what others require

How Do We Test Children’s Hearing

Hearing tests for children differ from testing an adult. Children’s hearing test can be either a physical test or a response-based test. The audiologist will determine the best method for conducting the hearing test based on the child’s age and ability.

Age-based testing described below is a guidance only.

Middle Ear Function Tests

The most common type of hearing loss children experience is due to a middle ear disorder such as middle ear infection. Tympanometry is a quick test that can assess the function of the middle ear and fluid build-up. All children receive a middle ear test as part of their hearing assessment.

12 months to 3 years

Visual Reinforcement Orientation Audiometry (VROA) is used to assess the hearing of a child aged from 12 months to 3 years. The child is conditioned to turn towards an animated and illuminated puppet when they hear a sound. Again, this test can be performed in free field or under headphones.

Infants under 12 months can have their hearing assessed by observing the infant’s reactions to a variety of noise makers. The infant will startle, pause or look around to certain sounds. However, objective test such as Auditory Brainstem Response Testing and Otoacoustic Emissions are the preferred method for assessing a young infants hearing.

3 years+

Play Audiometry is used for pre-school children where the child plays a “listening” game. The child places a block in a bucket when a “whistle” is heard.

The whistle responses are used to determine his or her performance under headphones to assess each ear on its own, or with a free field speaker to assess the better ear.

5 years+

Pure Tone Audiometry under headphone conditions (same as adult hearing test) is used for older children. The child is seated in our soundproof hearing booth (door can be closed or open, depending on child’s preference) with a remote control. Each ear is played a beeping sound as the audiologist moves through the different levels of frequency and decibels. The child presses the button on the remote if they hear a beep.

Results of the test is provided as an audiogram report with the child’s hearing plotted to indicate normal hearing threshold (20db or lower).

Types of Testing

Air Conduction (AC) Pure Tone Audiometry – this test measures your child’s AC pure tone hearing thresholds and is plotted on a Pure Tone Audiogram.

Bone Conduction Pure Tone Audiometry – this test measures your child’s BC hearing thresholds and infers information. BC test used with AC test infers the nature of hearing loss – sensorineural or conductive.

Free Field (FF) Pure Tone Audiometry – this test measures your child’s response to warble tones presented from a free field speaker. FF audiometry is mostly preformed on younger children who will not wear headphones. FF audiometry provides information about the overall hearing and does not provide individual hearing information.

Speech Audiometry – this test measures your child’s ability to discriminate speech. The test may use live voice or recorded voice and can be administered under headphone or in free field. The type of speech audiometry test used is determined by the age of the child. Immittance Audiometry – these are objective tests that measures the function of your child’s middle ear.

Otoacoustic Emissions (OAE) Test – OAE are specialised cochlear function tests that may be necessary to perform on younger children. This test is recommended for all infants. OAE provides information about the function of the hearing sensory organ, the cochlea.

Auditory Processing Disorder (APD)

APD is where a child can detect sounds at normal levels but cannot process the sound information accurately. When this occurs in children it can lead to learning difficulties and sometimes behavioural issues.

View Auditory Processing Disorder for more information and fees.

Referral for Child Hearing Test

You do not require a referral from your GP or specialist to book an appointment for a hearing test for your child. If you do have a referral, please specify this at time of booking and bring your referral form or letter to the appointment. See Medicare rebate below.

Age Limitations at Some Clinics

Hunters Hill and West Pennant Hills clinic from 3 years and above.

Fee

Rebates

Medicare: Medicare rebates from $35.40 available with some audiology services if you have a referral from a Medical Practitioner. You must claim the rebate from Medicare directly.

Health Fund: HiCaps is not available, thus check with your Health Fund to see if audiology is covered under your policy. Receipt with the clinician’s provider number will be provided for you to claim the full cost on your health fund.