Children are referred to us for hearing assessment for a number of reasons. The most common reasons include:
· They are referred from the Newborn Hearing Screening Programme
· Parents have concerns about their child’s hearing
· Teachers have concerns about a child’s hearing
· There are concerns about speech and language development
· There are concerns about behaviour
Children can be referred to us for hearing assessment by:
· Their GP or Health Visitor
· An NHS Ear, Nose and Throat (ENT) doctor
· An NHS Paediatrician
If you have concerns about your child’s hearing, please discuss these with your GP or Health Visitor first. We are unable to provide specific advice about children that have not yet been referred to us.
If you or your child requires an interpreter to be present at the appointment, please contact us as soon as possible so that we can arrange this.
Your appointment letter will confirm the location of your appointment.
Most of our appointments are held at Royal Surrey County Hospital, in Outpatients 7.
Please check in for your appointment in Outpatients 7.
Older children can be seen for routine hearing tests and hearing aid reviews at the following locations if these are more convenient for you:
At the present time, the specialist equipment needed for testing young children, and children with complex needs, is only available at Royal Surrey County Hospital. Babies referred from the Newborn Hearing Screening Programme can sometimes be seen at home for assessment if families have difficulty travelling to us.
We will introduce ourselves to you, and ask some questions about your child’s hearing and general health. We will ask you to tell us about any concerns you may have.
We will carry out tests to assess your child’s hearing and middle ear function.
We will then explain the results to you, and give you the opportunity to ask questions. Together we will agree a management plan for your child.
During the appointment we will carry out one or more different tests depending on the developmental age of your child. None of these tests should be uncomfortable for your child or cause any side effects. The aim is to find out your child’s hearing levels and identify any hearing difficulties. This may involve more than one visit to the department to build up a full set of results, to confirm results or to monitor hearing over a period of time.
· Auditory Brainstem Response (ABR) testing – ABR testing is usually used for babies who are too young to show reliable physical responses to sound. Sticky pads are placed on your baby’s forehead and behind each ear, and sounds are played into their ear while they sleep. We check your baby’s responses to sounds by looking at wave patterns on a computer screen, and aim to find out the quietest sounds they can hear.
· Otoacoustic Emission (OAE) testing – A soft-tipped earpiece is placed into your child’s ear canal, and a clicking sound is played. This test gives information about how well the inner ear (cochlea) is working.
· Visual Reinforcement Audiometry – Sounds are played either through small speakers, headphones or a bone conductor (which vibrates on the bone behind the ear), and we condition your child to turn to see a visual reward such as a puppet, when they hear a sound. This test can be used for children between about 6 months and 30 months of age. We aim to measure the quietest level of sound at which your child will respond.
· Play Audiometry – This test is suitable for children with a developmental age of approximately 2 to 4 years. We will play a game with your child, and ask them to carry a simple task – such as putting a man in a boat – when they hear a sound. We aim to measure the quietest level of sound at which your child will respond.
· Pure Tone Audiometry (PTA) – PTA is used to assess the hearing of older children and adults. Your child will be asked to press a button in response to hearing a sound, and we will measure the quietest sounds that they are able to hear. This may be carried out using a small speaker, headphones or a bone conductor (which vibrates on the bone behind the ear).
· Speech testing – Your child will be asked to point to different toys or pictures, or to repeat words they have heard, when listening to a recorded voice played at different levels.
· Otoscopy – We will attempt to examine your child’s ear canals and eardrums using a small torch called an otoscope.
· Tympanometry – This tells us how the middle part of the ear is working. A soft-tipped earpiece is placed into the ear canal for a few seconds. This gently puffs air into the ear canal and measures how well your child’s eardrum is moving. This can tell us if there is any fluid or congestion in the middle ear, often called ‘glue ear’.
We will put together the results of the different tests to work out whether your child has any difficulty hearing, and if so which part of the ear and hearing system may be affected. This will help us to work out whether a hearing loss may be temporary (for example, ‘glue ear’, due to congestion behind the eardrums) or more permanent.
We will explain the results to you and then discuss the options for what to do next. Depending on the results we have found, these options may include:
· Discharge from the Audiology service if results are within normal limits.
· Watchful waiting (for example, in the case of ‘glue ear’ which often resolves by itself after a period of time).
· Trying hearing aids to help ensure your child has best possible access to quiet speech and environmental sounds.
· Referral to other specialties for their opinion, for example: Ear, Nose and Throat Department, Audiological Medicine, Speech and Language Therapy or Teachers of the Hearing Impaired.
After the appointment, you and your GP will receive a written report by post which outlines the results and management plan. Please provide us with names and addresses of any other health professionals that you would like to receive a copy of this report.
If you require any written information to be provided in any language other than English, please let us know as soon as possible.
Children who already have hearing aids should bring these to every appointment.
If your child wears glasses, please bring these too.
Paediatric Audiology Department
The Royal Surrey County Hospital
There is an answerphone attached; please do leave a message if we are unable to answer your call.
We endeavour to respond to all messages received within two working days.
We very much value feedback from all of our patients, and our receptionist may ask you to complete a satisfaction questionnaire when you come to your appointment.
In the children’s waiting area you will also find comments cards and a box, where you can tell us about your experience.
Further information about the Newborn Hearing Screening Programme can be found here: https://www.nhs.uk/conditions/pregnancy-and-baby/newborn-hearing-test/
Further information about hearing and hearing loss is available from the National Deaf Children’s Society: www.ndcs.org.uk
Further information about ‘glue ear’ is available from NHS Choices: https://www.nhs.uk/conditions/glue-ear/Pages/Introduction.aspx