Service details

At all initial appointments a member of the team will take a full history, examine your child’s ears and conduct an assessment of their hearing and middle ear function. The diagnostic hearing assessment will be tailored to the child’s age and developmental stage. Newborn babies are required to be settled in order for the hearing assessment to be carried out. For older babies and children, the tests are made as fun as possible to encourage the child to participate. The test procedure will be explained to you during the appointment. The degree and nature of any hearing loss is confirmed as quickly as possible (which sometimes may take more than one visit) and the effect of any hearing loss on the child is evaluated. The results will be fed back to you and a management plan will be agreed upon.

To prepare your child for their hearing assessment in the audiology department, you may find it helpful to watch a video with them, following a patient's journey through their audiology appointment.

VIDEO: What to expect at your appointment (Peace Children's Centre)

Types of Hearing Tests

If your child was referred to our service via the newborn hearing screen, they will most likely have their hearing assessed using the Auditory Brainstem Response (ABR) test. The test involves 4 sensors (electrodes) being placed on the baby’s head and sounds are played into the ear via a small earphone. This test is usually performed for infants under 3 months of age. ABR testing is an objective measure of how well sounds travel along the hearing nerve pathways from the ear to the brainstem. It is a sleep electroencephalogram EEG hearing test. The ABR compares changes in brain activity to the timing of repetitive sounds to determine whether a particular intensity of a sound can be heard. An ABR does not give any information about how the auditory information is interpreted by the brain. 

As your child develops, we will assess their hearing using behavioral hearing tests. These use toys and play as part of the assessment and involve your child listening for differed sounds as part of a game.

After ABR the next type of hearing assessment used is Visual Reinforcement Audiometry (VRA). This test can be performed from as early 6 months of age corrected age, however most children are not developmentally ready for this test until closer to 8 months corrected age. During the test your child is seated on a parent/carer's lap or on their own chair. Using a machine called an audiometer, sounds of different frequencies and loudness are then played through speakers. The infant's head-turn response towards the sound source is rewarded by activation of an animated puppet or light display. The child's attention is then engaged back to the midline so that additional sounds can be presented. This process is repeated to obtain minimum response levels to different sounds. The test can check the full range of hearing but doesn’t give specific information about each ear. To gain information about each ear individually, testing is done with small earphones. 

VRA is used until a child is old enough to perform Play audiometry at approximately 2.5 years of age. For play audiometry, the child is shown how to perform a repetitive play task, such as placing a man in a boat, each time he or she hears a sound. This can be conducted in the sound field or via headphones and is used to identify hearing threshold levels of an individual, helping to determine the degree, type and configuration of a hearing loss.