Understanding Your Child’s Hearing Development

The auditory system is fully developed by 26 weeks of pregnancy, but it continues to mature during the first two years of a child’s life.

Hearing can be affected by various conditions, with otitis media and glue ear being the most common in young children. These conditions are closely linked to the development and structure of the eustachian tube during early childhood.

• In infants and young children, the eustachian tube is shorter, more horizontal, and less efficient at ventilating the middle ear. This makes it easier for fluid to build up, leading to issues like glue ear or infections such as otitis media.

• As children grow, the eustachian tube becomes longer and adopts a more vertical orientation. This natural development improves drainage and ventilation of the middle ear, reducing the likelihood of fluid accumulation and related problems.

What Happens During Your Child's Appointment

We want you to feel informed and comfortable about what happens during your child’s visit. Below is a step-by-step overview of the assessment process:

Paediatric Hearing Assessment

In addition to the tests and procedures outlined, a thorough medical history will be taken, which includes any concerns you, as a parent, may have.

This information is collected in a confidential manner and stored securely in accordance with GDPR standards.

• Birth history: Premature birth, complications at birth, or developmental milestones.

• Family history: Any history of hearing loss or ear infections.

• Past medical history: Frequent ear infections, previous surgeries, or chronic conditions.

• Current health concerns: Ongoing illnesses, medications, or allergies that may impact hearing.

• Developmental history: Speech and language development, academic performance, and social interaction related to hearing.

This comprehensive medical history allows the audiologist to accurately assess your child’s hearing and provide the most appropriate care.

Audiometry: Testing Your Child’s Hearing

The way we test your child’s hearing (audiometry) depends on their age and developmental stage. We adapt the process to ensure it’s both effective and engaging for your child.

1. Ear Examination

• We will start by examining your child’s ears to check for any abnormalities.

• Using a video microscope, we’ll look to ensure the ear canal is clear of blockages like earwax and check the health of the eardrum (tympanic membrane).

• You’ll be able to see the images of your child’s ear on the screen during this process. If needed, we’ll take photos of the eardrum and save them for future reference.

    2. Tympanometry

• Tympanometry is a quick test to measure how well the middle ear is working.

• A small, soft probe is placed in your child’s ear, creating a gentle seal.

• The probe changes the air pressure in the ear canal while playing a tone and measures how well the eardrum moves in response.

• This movement tells us how flexible the middle ear bones (ossicular chain) are, which is important for sound transmission.

• It’s important for your child to stay still and quiet during this test, as crying, talking, or laughing can affect the results.

          3. Otoacoustic Emissions (OAEs)

• If the tympanometry results show the middle ear is functioning well, we may perform an additional test called otoacoustic emissions (OAEs).

• Using the same probe, we play soft clicking sounds into the ear. The probe’s microphone then measures the tiny echoes produced by the inner ear.

• This test helps us determine if the outer hair cells in the inner ear are functioning properly.

• It’s important to note that OAEs measure how the ear responds to sound but do not assess how the brain processes sound.

4. Play Audiometry

• Play audiometry is suitable for younger children, typically starting from around 18 months, although it may also be used for older children who need a more engaging approach.

• This test is done without headphones initially, using a pediatric audiometer to assess whether your child can hear sounds in at least one ear.

• Your child will be taught to respond to a sound by doing an activity, like placing a block on a tower every time they hear a tone. This makes the process fun and easy for them to participate.

• Once your child is comfortable with the game, we may introduce headphones to check each ear individually and continue using the same activity to gauge their hearing ability.

5. Screening and Frequency Testing

• For younger children, we typically screen a range of frequencies at 15 dB, which is the volume level of soft speech. This helps us determine whether their hearing falls within the normal range.

• If the results indicate normal hearing, it suggests that your child should be able to hear sounds necessary for speech development, provided their brain processes these sounds correctly.

6. Testing for Older or More Mature Children

• For older children or those who are developmentally ready, we use a test similar to the one conducted for adults.

• With headphones, your child will listen to sounds and press a button or raise their hand when they hear them.

• This method allows us to measure their hearing thresholds—the softest sounds they can hear at different frequencies, giving us a detailed picture of their hearing ability.