If a hearing loss is suspected and a child is referred to an audiology clinic they may have some of the following tests. A child identified with a hearing loss, may have hearing tests repeated at intervals to enable their hearing to be monitored. If a child has hearing aids, this will enable an audiologist to ensure the hearing aids are giving maximum benefit.
Visual Reinforcement Audiometry (VRA)
This is generally used with children from the age of six months old until two and a half years. It uses an audiometer to play sounds of different volumes and frequencies through loudspeakers. When a child is at first presented with a sound they are encouraged to respond and turn towards the source with the presentation of a visual reward such as a toy lighting up. After this process is repeated a few times, the test can then be used to identify the quietest sounds a child can hear. It can also be used with small earphones to test each ear individually.
This may be used with children from around the age of two and a half years. It again uses an audiometer to play sounds through a loudspeaker or through headphones. A child is shown how to respond to a sound they hear by performing a simple task such as placing a peg in a board, they are then presented with further sounds at different volumes and frequencies.
Pure Tone Audiometry
This can be used with children over the age of three years. Sounds are played through headphones and the child is asked to respond when they hear them, for example by pressing a button.
Speech discrimination test
This test is used to assess the child’s ability to recognise and discriminate words without any visual information. Younger (pre-school) children are asked to identify pictures, toys or objects, while older children may be asked to repeat words or sentences. The words may be played through headphones or a loudspeaker, or spoken to a child.
This is a test which can be used on children of all ages to show how flexible the eardrum is. For good hearing the eardrum needs to be flexible in order to let sound pass through it into the middle ear space, and from there into the inner ear. If the eardrum is too rigid (e.g. if there is middle ear fluid ‘glue’ behind it), the sounds bounce back off the eardrum instead of passing through it.
To perform tympanometry, the tester places a small tube with a soft rubber tip at the entrance to the ear. This allows gentle air pressure changes to be applied. If the instrument shows that most sound is bounced back, the tester will know that a child has glue ear.