Getting your child's hearing checked: what to expect

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Parents often joke about their kids zoning out when they're asked to tidy their room, yet having super human hearing powers at the very mention of chocolate on the other side of the house.

While selective hearing is a common childhood quirk, genuine hearing problems can have serious consequences. Our ability to hear impacts the way we speak, communicate and learn.  From birth, we use sound to help interpret our environment.  Poor hearing limits our ability to engage fully with our surroundings.

In the past, hearing problems in children were often identified only when speech problems started to appear [CO2] (around two and a half years of age).  However, [CO3] most Australian states and territories have now introduced Universal Neonatal Hearing Screening where every child is screened for permanent hearing impairment at birth.  The earlier hearing problems are detected and treated, the better the developmental outcome for the child.

Children are expected to reach hearing milestones from a very young age. From newborn to eight weeks of age, babies should startle or widen their eyes at sudden noises nearby. Noise should also wake or stir them from sleep.

As a child grows, it's important to pay attention to developing hearing issues. There are certain age related milestones babies, toddlers and children must reach. If they don't reach these milestones further investigation, such as a hearing test, may be needed.

While most babies have their hearing assessed at birth, good hearing at this stage doesn't rule out future issues.  Illnesses (such as ear infections), loud noises, hereditary conditions and injuries can cause hearing problems down the track.

If you suspect your child may have a hearing problem, start with seeing your GP.  If your GP believes further investigation is required, your child may undergo tests to assess their hearing.  Parents needn't worry about these assessments. While there are various ways audiologists can test a child's hearing, depending on the child's age, first and foremost the experience is to be fun not scary.

For infants younger than seven months, and older children who cannot respond to sound, behavioral observation audiometry (BOA) is carried out. High, mid and low frequency noisemakers are used and the child's responses (like startling, or stirring or waking from sleep) are noted. 

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From seven months to three years of age, visual reinforcement orientation audiometry (VROA) is used to test children. Sounds of various frequencies are played and it is noted when the child turns towards the speaker. Once the child has turned to the speaker the child is reward by seeing a puppet.  More than one audiologist is usually involved in this testing.

Play audiometry is used to test the hearing of children from three years of age, and for children who wear a hearing device. When the child hears a tone, they put a marble in a marble race, press a computer key or put a piece in a puzzle.  There is a lot of praise for the child! 

Although the testing is designed to make the experience enjoyable, parents can still prepare their child for the test.  Using headphones to listen to music is a great way to get your child ready for wearing headphones.  If your child is willing to wear headphones, an audiologist can gather more information from the assessment.

After the testing has taken place, the results are explained in easy to understand terminology and language.  If the audiologist believes there is a hearing issue, your child may receive a recommendation to review their hearing in 12 months.  They may also receive a referral to an ear, nose and throat specialist or to Australian Hearing (a government organisation that provides hearing-related rehabilitation services for all children under the age of 26). 

It's important to investigate any concerns you may have about your child's hearing as an undiagnosed hearing issue has a direct effect on speech and language development.  Depending on the age of the child, this could have a negative impact on learning.  A hearing issue can affect the child's ability to read and write, socialise at school and develop social skills needed to function in society.

Further reading:

https://www.hearing.com.au

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