Various tests will be performed depending on your child’s age and ability. We are an autism friendly service and have specialist clinics where we are able to assess children. Most of the tests are based around play. Generally, before testing, we will ask some questions to get some background information about your child’s hearing and development.
Visual reinforcement Audiometry (VRA)
VRA is the preferred test for a child between the developmental age of 6-36 months but can be used for older children if felt appropriate. It involves your child either on your lap or sitting on a small chair watching a member of the team playing with a range of toys. Sounds are transmitted from loudspeakers and your child is observed to see if they respond. If they turn to the sound they are “rewarded” by the appearance of a lighted and/or moving toy. The test is then repeated until a full assessment is completed. This assessment does not test each ear individually but can give a good impression of overall hearing levels. If ear specific information is needed the test can be performed using special inserts which are painless sponge like ear phones that sit just inside your child’s ear.
Distraction Testing
This type of test can also be used from a developmental age of 6 months and is sometimes used to gain additional information if responses to VRA are not consistent. Your child again sits on your lap or on a small chair. Sounds are introduced using a range of hand held devices. Your child will be distracted by a member of the team to keep their attention while an Audiologist introduces sounds of different frequencies and volumes and monitors your child’s responses.
Free field Performance Test
If your child is able to follow instruction (usually around the developmental age of 30 months) they may be asked to complete an action (such as put a toy man in a boat) when they hear a sound. The sounds will again be introduced at different frequencies and different volumes either from a hand held speaker or through loud speakers. As for VRA this gives an assessment of the overall hearing levels.
Play / pure tone audiometry
This test (usually from a developmental age of 36 months) involves your child wearing headphones by which sound can be introduced to each ear individually. As part of this test your child will either be asked to press a button to confirm when they hear a sound or may be asked to perform a task with a toy similar to free field performance testing. Sometimes the test is also performed with a special headphone that sits on the bone behind one ear as this can give helpful additional information in some cases.
Speech discrimination testing
This range of tests allows the team to gain additional information about how your child uses their hearing and listening skills and can be used from around a developmental age of 24 months. Each test involves your child being asked to listen and identify a range of toys or pictures to determine at what level your child is able to distinguish between similar sounding words. The words are either delivered by the voice of one of the team or an automated voice system may be used.
Oto-acoustic Emissions Test (OAE)
Your child is likely to have had a new-born hearing screen which is known as OAE Oto-acoustic Emissions test. This test only takes a few minutes and may be repeated as part of your child’s assessment. A tiny earpiece will be placed in your child’s ear and a quiet test sound will be played through it. If the results are not clear it doesn’t necessarily mean that they have a hearing loss. It could be due to background noise or the condition of the ear i.e. fluid or wax. In this case further assessment may be required.
Tympanometry
This is a test that shows the amount of movement of the eardrum. A small soft probe is placed into the ear, a sound / puff of air is emitted and the eardrum may or may not respond. For good hearing the eardrum should be flexible to allow sound to pass. This test doesn’t determine ability to hear but helps the audiology team to establish if there is any fluid in the middle ear.
Examination
As part of your child’s assessment the Doctor or Audiologist needs to look into your child’s ear enabling them to check if the eardrum is clear and look for any abnormalities.
Children with additional / complex needs
For children with additional needs we can adjust the test procedures to suit your individual child. The hearing test may not be completed in one appointment, often a few visits will be needed to gain a full assessment.
- Remember you know your child and how they react better than anyone. Your input during the Audiology assessment is extremely valuable to us.
- Please let us know if there is a better time of day to see your child. We will always do our best to accommodate your requests.
- If your child has any noisy toys / or other items that they seem to respond to, it would be really useful if you could bring them with you to your appointment.
- Is there a position that your child is most comfortable in? For example, do they prefer to stay in their pushchair or lie down?
Please do not hesitate to contact us if you have any queries, concerns or requests. We may not be available straight away but will always call you back as soon as possible.
