Paediatric Audiology

Visual reinforcement audiometry (VRA) is usually used to test hearing in children from about seven months of age up to two-and-a-half years old. During the test, your child will sit on your lap or a chair while sounds are presented. Your baby will be taught to link the sound to a visual reward through a computer screen lighting up. Once your child can associate the sound and the visual reward the volume and pitch of the sound will be varied to determine the quietest sounds your child is able to hear.

Children between two and five years old may have a play audiometry test. Sounds will be played through headphones or speakers and your child will be asked to perform a simple task when they hear the sound. This may vary from putting a ball in a bucket to completing a puzzle. Like VRA, the volume and pitch of the sound will be varied to determine the quietest sounds your child is able to hear.

Older children may have a test called pure tone audiometry. This is the test often used to screen a child’s hearing before they start school, when it is sometimes referred to as the “sweep test”. This is similar to a hearing test an adult might have. The sounds are played through headphones and your child is asked to respond when they hear them by pressing a button. By changing the level of the sound, the audiologist can work out the quietest sounds your child can hear. In addition to using speakers or headphones, a small vibrating device called a bone conductor is placed behind the ear. This device passes sound directly to the inner ear through the bones in the head, which can help identify which part of the is responsible for the hearing loss if your child is experiencing hearing problems.

Speech perception tests are used assess your child’s ability to recognize words. This can be performed in a variety of ways depending on your child’s age and ability. Some may be performed using voice and others may involve playing speech through headphones or a speaker. The child may need to identify words they hear by pointing at a toy, picture, or repeating what they hear.

Tympanometry is a test to assess how flexible the eardrum is. For good hearing, your eardrum needs to be flexible to allow sound to pass through it. If the eardrum is too rigid – for example, because there is fluid behind it (glue ear) – sounds will bounce back off the eardrum instead of passing through it, which results in hearing difficulties. During the test, a soft tube is placed at the entrance of your child’s ear. Air is gently blown down the tube and a sound is played through a small speaker inside it. The tube then measures the sound that’s bounced back from the ear.

A small earpiece which makes clicking sounds is placed into your child’s ear canals. These clicking sounds are picked up by the inner ear also known as the cochlea. If the cochlea is working normally, it responds by sending a sound back to the ear canal which is recorded by the earpiece. This test is extremely sensitive so that even the slightest hearing loss can be detected.