School hearing tests and when to have them

The importance of school hearing tests

School hearing tests and when to have them

Hearing tests for children are a vital health service as a loss of hearing can delay your child’s development.

Paediatric hearing assessments should be performed by Audiologists who have experience testing children and have a good understanding of paediatric protocols.

The importance of having your child’s hearing tested before the start of the school year

It is important to have your children’s hearing tested before the school year starts because the negative aspects of untreated hearing loss are quite significant.

Hearing loss can affect children in the following ways:

  • Delayed speech and language
  • The speech and language lag, in turn, causes learning problems that result in reduced scholastic performance
  • Impaired communication abilities can often lead to poor social skills and reduced self-esteem.

You can see why getting your child’s hearing tested is so important.

There are many signs that indicate a child may have a hearing loss and would require a hearing assessment:

  • Difficulty understanding or following instructions
  • Child doesn’t respond or responds incorrectly to directions
  • Asks for repeats often and watches lips
  • Speaks loudly
  • Sensitive to loud sounds
  • Delayed speech
  • Regular or recurrent ear infections
  • Family history
  • Poor school performance

Not all hearing healthcare clinics provide hearing tests for children. Audiology Trio perform comprehensive hearing tests for children from 3 1/2 years+ of age in the clinic in Kippa-Ring and throughout Brisbane at our visiting sites.

It is the start of a brand new year, and what a great way to start by being pro-active with your child’s hearing. Having your child’s hearing tested now is the perfect time before school starts.

Paediatric hearing tests have various protocols depending on the age of the child. The following will explain each one.


Queensland has the Healthy Hearing Program – a hearing screen offered to all newborns in public and private hospitals. This screen uses an ABR (auditory brainstem response) test.  We place tiny headphones over the baby’s ears and electrodes on the forehead and cheeks.  Click tones are then played through the headphones and the child’s response is measured. If the newborn fails the test then the child will be referred to an audiologist for further testing.

0 – 6 months

A child will be referred on for further testing if they fail the newborn screen.

This further testing includes:

  • ABR full test: A longer and more comprehensive form of the screen version
  • Otoacoustic emissions (OAE): OAE is a measure of cochlear status, in particular hair cell function
  • Tympanometry: Tympanometry is a measure of middle ear status
  • Behavioural Observation Audiometry (BOA): This form of testing involves trained and experienced Audiologists observing subtle behavioural changes in the baby to various auditory stimuli.
    • The stimuli can be presented via a speaker or headphones
    • Responses to stimuli may include an increase or decrease in body movement (gesture), eye-widening, searching, localisation, quieting or vocalisations.  To louder stimuli: startle responses, blinking, and head/limb reflex are all very common.

6 months – 3 years old

When the baby can sit up unassisted, the following tests should be performed:

  • Otoacoustic Emissions
  • Tympanometry
  • Visual Reinforcement Audiometry (VRA)
    • VRA involves an obvious turn of the head when an auditory stimulus is presented
    • The child needs to be conditioned first conditioned to the task
    • The child sits on a parent’s lap facing the Audiologist
    • The Audiologist distracts the child – this is a learned skill as the aim is to distract the child enough but not too much causing them not to respond to the stimulus
    • A tone is played through the speaker – when the child turns toward the sound she will be rewarded by a “puppet show” – a lit compartment with a puppet
    • Once the child is conditioned then the “testing” Audiologist can alter the intensity of the stimulus to determine hearing thresholds at specific frequencies.
    • If the child is able to tolerate them, the test can be conducted under headphones to obtain individual thresholds.

3/3.5 – 6 years old (prep/school-age hearing tests)

This age group is not “black and white” when it comes to protocols for hearing tests.  The aim is to get a repeatable and reliable result while working with a young child who is an individual. In this age group of children, there is a wide range of personality traits and behaviours that need to be taken into account when performing a hearing test.

In this age range we often need to make a game of the test, and thus this form of testing is often called “Play Audiometry”.  The “play” aspect is to keep the child engaged and interested in the activity. The child is instructed to “Place the block in the hole…” or “Clap your hands…” or “Put another block on the tower when you hear the tone”.

  • Speech Audiometry: Speech audiometry is a measure of the child’s ability to hear speech
  • Tympanometry

Contact Audiology Trio today to book your child’s hearing test today.