For a child who has hearing loss, it’s important to regularly assess their ability to pick up sounds across the speech frequencies, together with the development of their language skills.
Assessing speech sounds
Known as the Seven Sound Test, or the “Ling Sounds”, these move from low to high pitches and cover the main sounds of speech: /ah/, /oo/, /ee/, /m/, /or/, /sh/ and /s/.
The sounds are produced by a listening and spoken language therapist or parent standing up to five metres away from the child. They will be asked to imitate the sound, or for very young children be observed for signs they have heard it.
Any changes to detection or imitation will be reported to the child’s audiologist. A child will produce the sounds they hear, so if they are hearing inconsistent or poor-quality speech, they will use the same when speaking. If issues are detected, further testing and changes to settings on hearing devices will then be explored. This also allows for monitoring of children who may not be receiving adequate access to sound through their hearing aids, to potentially progress to a cochlear implant assessment.
How we assess speech sounds is adapted depending on the child’s age:
- Babies and toddlers: Often a video is recorded of the sounds a child is producing; this is then reviewed and monitored for development.
- Kindergarten-age children and above: a formal assessment is used which asks a child to say a series of words; this is recorded and compared with what is expected for a child that age without hearing loss.
Children with hearing loss also require functional listening assessments, which evaluate how a child’s hearing is impacted by external factors such as background noise, distance and visual cues. These assessments are completed by parents/carers (or young people themselves once old enough) and provide a helpful snapshot of how effective a child’s hearing is in the “real world” outside of a clinical setting.
Assessing language development
In contrast, language assessments look at whether a child is understanding and using age-appropriate vocabulary and grammatical structures, which goes on to inform the content of the child’s ongoing listening and spoken language therapy.
How we assess a child’s receptive (what they understand) and expressive (what they say) language development is also dependent on their age:
- Babies and toddlers: Games and toys are used to monitor for words being produced, which is then compared with typical language development for a child the same age without hearing loss. Formal assessments, incorporating parent report are also used.
- Kindergarten-age children and above: a formal language assessment is undertaken which looks at what a child understands and says. The score from this assessment is then compared with other children of the same age without hearing loss.
The age of a child also determines the use of other assessments and whether further referral is required, including around social communication, cognition and fine or gross motor skills.