Does your toddler need a hearing test and you’re unsure what to expect? Hear and Say Audiologist, Sharon Bruna sits down to explain how the process works.
“Having a hearing check is usually a fun, positive and painless experience for toddlers or young children,” said Sharon.
“There are two main types of hearing tests for this age group – behavioural testing and objective (electrophysiological) testing. The latter is typically used to test hearing for babies under six months of age, but both tests have their advantages and it’s useful to have results from both types of tests to confirm hearing levels in young children.
“Objective testing doesn’t require a response from the child, and is similar to the hearing screening most newborns have called an Auditory Brainstem Response [ABR] test. For older babies and toddlers, we use behavioural testing. This is where children do something that lets us know they have heard the sound. This type of testing has the advantage of telling us the complete picture about the function of the auditory pathway.”
Behavioural hearing tests (six months to five years)
Visually Reinforced Orientation Audiometry (VROA)
A ‘puppet test’ or VROA is often used with children under three years of age. This involves the child learning to turn towards a speaker whenever a loud sound is presented. When the child looks to the speaker, a puppet is shown as a reward. Children quickly understand that when they hear the sound, the puppet will appear if they turn to the source. Once a child has learnt to turn to the sound at louder levels, we can check for the softest sound they can hear.
Individual ear results can be determined if the child will wear headphones during the test. Most children enjoy this game, and it’s possible to get a full graph of hearing in each ear on most children at this age.
VROA is used until the time where a child’s ability to concentrate enables us to move on to play audiometry, usually around two-and-a-half to three-and-a-half years of age.
Play audiometry can be used for children between three to five years of age. This requires the child to listen for whistles or beeps while wearing headphones, and perform a fun task such as putting a coin in a piggy bank or a piece in a puzzle.
Making a “game” of the hearing tests keeps the child’s interest and enables a full picture of the hearing in each ear to be gained in around 15 to 30 minutes.
Another part of the assessment is called the ear pressure test or tympanometry, which looks at how well your child’s ear drum is moving. This involves putting a small plug in the ear and varying the pressure in the ear canal to check for any congestion or fluid behind the eardrum.
The pressure test is painless but does feel a little strange for young children. A parent/carer is typically asked to hold and reassure the child for this test, which only takes a few seconds to complete.
Preparing your toddler
You can prepare your toddler for these hearing tests by offering them headphones to listen to a favourite song or story before the appointment. Explain they are going to play some fun listening games and we will check in their ears with a light.
You can use a small torch to look inside their ear and playfully say, “What’s in your ear?” If they’re old enough to mimic you, give them the torch and let them look in your ear, too.