Audiology services for children

The Paediatric Audiology service provides assessments, intervention and support for hearing impairments for children from newborn to adulthood.
We offer a full range of assessments using the latest technology and can provide hearing aids if required from just a few weeks of age.

Our team of experienced audiologists and hearing therapists work closely with the sensory support team (teachers of the deaf), the Ear, Nose and Throat department, Social Services and Paediatrics to make sure we offer a comprehensive service for your child.

If you are concerned about your child’s hearing, you can request a referral yourself from any health professional, such as your GP or midwife. Alternatively you can call our team on 01872 254905.

We hold a joint clinic for children with permanent childhood hearing impairment (PCHI) with other health professionals and specialists. Call 01872 254905 for more information.

Newborn Hearing Screening

All newborn babies in Cornwall and the Isles of Scilly are offered a hearing screen as part of the Newborn Hearing Screening Programme.

Why Screen?

About 1 in every 900 babies is born with a hearing loss in one or both ears. The screening test helps identify babies with a hearing loss early. Finding a hearing impairment early gives children a better chance of developing speech and language skills, and of making the most of social and emotional interaction from an early age.

Even if there is no family history, it is still important to screen all babies because most babies with hearing loss are born into families with no previous history of the condition.

What does the test involve?

Health Visitors screen babies when they are between 10 and 14 days old, at home, as part of the primary visit.

The test is called the AOAE (automated otoacoustic emission) and takes a few minutes. A small, soft-tipped earpiece is placed in your baby’s ear and soft clicking sounds are played. When the ear receives sound, the inner part (called the cochlea) responds and this can be picked up by the screening equipment.

It is not always possible to get clear responses from the first test. This does not necessarily mean your baby has a hearing loss. It can mean your baby was unsettled when the test was done, there was background noise, you baby has fluid or a temporary blockage in their ear (this is common and passes with time) OR your baby has a hearing loss.

If this happens, we will offer your baby another test. This may be the same as the first test or another type called an AABR (automated auditory brainstem response) test. During an AABR, three small sensors are placed on your baby’s head and neck, and soft headphones are placed on your baby’s ears whilst soft clicking sounds are played. This test takes up to 30 minutes and is done by specially trained staff.

Possible Results

If your baby has clear response in both ears then they are unlikely to have a permanent hearing loss. However, newborn hearing screening does not pick up all types of hearing loss and children can develop hearing loss later on. It is important to check your child’s hearing as they grow up.

The checklist in your baby’s personal child health record (red book) tells you how to do this. If you have any concerns about your child’s hearing tell your health visitor or family doctor.

If the screening results do not show a clear response from one or both of your baby’s ears, we’ll make an appointment with audiology to see a hearing specialist. About 2-3 babies in every 100 do not show a clear response on the screening tests. Being sent for further tests does not necessarily mean your baby has a hearing loss.

You and your baby will see a hearing specialist, usually within four weeks of having your baby’s hearing screen. It is very important that you attend the appointment in case your baby has a hearing loss.

Getting Results

You will be given your baby’s results as soon as the hearing test is done

If your baby has been on the Neonatal Unit

Around one in every 100 babies who spend more than 48 hours on the Neonatal Unit has a hearing loss in one or both ears. We offer these babies both AOAE and AABR tests when they are at least 34 weeks gestation and up to 3 months of age.

Specially trained staff will undertake these tests and is usually when the baby is near to discharge, when treatment and intervention is complete.

For further information, please contact the Newborn Hearing Screening Manager, Sandy Dyer, on 01872 25 3998 or rch-tr.hearingscreening@nhs.net. You can also find out more about the Newborn Hearing Screening Programme on gov.uk.

What can I expect when my child has been referred?

We will arrange an appointment at one of the 18 locations we cover depending on the age, needs of your child and the type of testing or interventions needed for the appointment. We can also offer a hearing screening test in school. This initial appointment will usually take place within 6 weeks.

We use different testing methods depending on the age of your child, click on the headings below to find out more about what will happen and how we carry out the tests.

What happens during the hearing assessment?

We will ask some questions about your concerns, the health and development of your child and if they attend any nursery or preschool. We will examine your child’s ears, and the based on your answer, we’ll assess their hearing using a range of tests. These tests may include:

Tympanometry

The test usually takes a few seconds for each ear. A small rubber tip is placed gently in the ear canal to measure the movement of the eardrum. This helps us look for possible congestion behind the eardrum.

Visual reinforced audiometry (VRA)

We use this test for children approximately six months and older who are able to turn their heads and have been demonstrating curiosity with sounds around them. The child sits on an adult’s lap and sounds are played from each side, either through speakers or small headphones.When the child turns to locate the sound, they are given a visual reward.

Distraction testing

Again, we use this for children from around six months old up to around three. Your child will sit on your lap facing a table. There will be a second tester available who will gently keep your child’s interest. Sounds will be made from behind your child. If the child is interested in the sound they may turn and we record the level of the sound required to obtain this result.

Otoacoustic emissions

A small soft earpiece is placed into the ear canal and a soft clicking sound will be played. Children need to be relaxed and free of congestion to allow the test to be accurate. This is very similar to the test which would have been performed when your child was first tested as a newborn.

Performance or play audiometry

From toddler age onwards, your child may be able to listen to sounds, either from speakers or headphones, and be able to react to the sound by performing a task such as putting a brick into a box, building a tower, putting balls onto sticks etc.

Audiometry

From around school age we also use a test similar to adult testing, where your child may be able to press a button when different sounds are heard.

Hearing aids for children

We provide digital hearing aids for children for both permanent and temporary hearing losses. In both cases, these are small devices that sit behind the ear. Your child will also need to have a custom ear mould which is made of soft silicone material. We will need to replace the ear mould as your child grows, but this is a quick process and new moulds are usually ready in around 10­-14 days.

The hearing aids we supply are some of the most sophisticated available today. They use the latest technology to give excellent sound quality, and can be programmed to specific needs and work with the other devices. They are free on the NHS, as is aftercare and battery replacement.

Hearing aids for permanent hearing loss

Most often this kind of hearing loss is detected via the Newborn Hearing Screening Program, which aims to detect permanent hearing loss within the first few months of life. We currently provide Phonak hearing aids which are extremely reliable and have easy access to FM systems (for radio aid to help in school and hearing in noise). The hearing aids provide excellent high frequency response which helps your child detect the consonants of speech and aids their speech production.

Hearing aids for temporary hearing loss

Temporary hearing loss is most often due to Glue Ear (also known as OME, or Otitis Media with Effusion), and can affect children of all ages. Hearing aids can be used whilst your child’s hearing is reduced and removed when it improves. We currently offer Oticon hearing aids for temporary hearing loss. They have excellent sound quality for low and mid frequency sound which are often most affected by glue ear. They also have simple and efficient volume control, making them ideal for fluctuating hearing loss.

Transition to adulthood

We aim to start this process when you are in Year 9, and will support you as you take control of your own health.

We can provide information on the support available to you as you progress through higher education or as you enter the workplace. As a joint adult and children’s service, you will generally have appointments with the same audiologist you have been working with, but you will also be introduced to the wider team.

Further information and support

For specific information about children’s hearing difficulties, here are some useful resources:

Children Hearing Services Working Group (CHSWG)

A local group of professionals and families who help with services for deaf children. Contact Helen Coad 01872 254905 or Melissa McDermott 01872 253754 for more information.

National Deaf Children’s Society

Visit their website

Family Information Service

Details of care and support available in Cornwall. Visit their website.