HEARING TESTS

 

Hearing Tests For KIDS

 

Hearing Tests for Kids

 At Harmony Hearing we provide a comprehensive hearing test for kids from the age of 5. By school age children can usually sit still and respond to tones and speech stimuli. By wearing head-phones we can attain ear specific measurements. They can also sit still for tympanometry. It is a similar hearing test battery as that used for adults. Children under 5 may require specialised test facilities and we can refer you for those professional services.

 Hearing well is essential for children to develop their speech and language skills. Hearing loss can lead to delays in this development. If you or a teacher are concerned your child may have hearing loss it is best to book your child for hearing test with an Audiologist as soon as possible. You don’t need a referral.

If your child is found to have hearing loss it is important to have it treated appropriately.

 How common is hearing loss in children?

Hearing loss is very common in children. One national survey (https://jamanetwork.com/journals/jama/fullarticle/187415) in the United States of America estimated that 15% of kids have hearing loss although in most cases it was mild and in one ear.

 Causes of hearing loss in children

Hearing loss in children can be temporary or permanent. It can be caused by a variety of factors including; middle ear infections, medications, head trauma, childhood illnesses, deformities of the ear canals or malfunctioning ear drums. There can be congenital hearing loss where it is present from birth.

 How is Hearing Loss in Children Treated?

How hearing loss is treated in children depends on the underlying cause. Ideally hearing loss should be identified before the age of 6 months. Earlier intervention has been shown to greatly improve speech and language outcomes for children.

 Hearing Loss in Toddlers & School Aged Children

Even a mild hearing loss can cause a child to miss hearing some important speech sounds. A more severe hearing loss can make it difficult for a child to hear any speech. Hearing difficulties can be exacerbated by competing noise such as in a busy classroom. It is important to try and detect and treat hearing loss early and appropriately to reduce the impact it has on their development and education.

 As described by Joy Vicary managing Editor of Healthy Hearing in her excellent article on “Hearing Loss in Children” see https://www.healthyhearing.com/help/hearing-loss/children (Link) these are some of the

Signs of hearing loss in toddlers and school-age children to look out for:

  • They ignore sudden or loud sounds.
  • Don’t respond when called by name.
  • You have to repeat yourself often.
  • They say “Huh” or “What” quite often.
  • Have difficulty locating where sounds are coming from (localisation).
  • Turns the television volume up very high or sits very close to the T.V.
  • Misunderstand questions and respond inappropriately
  • Have difficulty understanding what people are saying.
  • Complains of itchy ears or ear pain.
  • Say they hear noises such as ringing or buzzing (Tinnitus)
  • Speak differently from other children the same age or have speech delays and difficulties pronouncing speech sounds.
  • There’s a drop in their school grades – which results from not hearing the teacher well.
  • Watch people’s faces and lips very intently when they speak.

Please note. “Hearing loss in children can escape detection because the child is very good at compensating through lip reading.”

If your child exhibits some of these signs then it’s a good idea to book in with Harmony Hearing & Audiology for a comprehensive child hearing test as soon as possible.

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 Our Hearing Test for Kids Procedure

  1. Case History. Initially we’ll take a case history querying your child’s ear health history speech and language development and general health.
  1. Outer Ear Examination: We look at the outer ear and use an otoscope to look into the ear canals and examine the ear drums (tympanic membranes).

 

  1. Test Middle Ear Function. We perform Tympanometry which is a type of middle ear pressure and mobility test. A soft rubber probe tip is inserted into the ear and the pressure in the ear canal varied whilst a low frequency tone is presented. It shows just how efficiently the middle ear system is moving to convey sound through to the inner ear. It also indicates middle ear pressure. It contributes to identification of any middle ear pathologies.

 

  1. Pure Tone Audiometry. We then perform air conduction pure tone Audiometry. Headphones are placed over your child’s ears and they are asked to respond to different frequency tones. They are coached to respond with either the press of a button or a posting activity such as putting a block in a bucket each time they hear the tones. We record their thresholds which is the softest tones they can respond to on the Audiogram.

 

  1. Bone conduction Audiometry. A bone conductor (vibratory device) is placed just behind your child’s ear on the mastoid bone. Your child’s responses to the softest tones presented at different frequencies are recorded on the audiogram. This helps us differentiate between outer and middle ear problems.

 

  1. Speech Audiometry. This is perhaps the most important part of a diagnostic hearing test as it determines how well your child hears speech. Under headphones your child will hear a series of words being read out and is asked to repeat each word as they hear them. We are recording the number of speech sounds or phonemes heard correctly for each ear. We may include a speech in noise sentence test (SPIN) to gauge how well your child follows speech in different levels of competing noise. There are a variety of speech tests we can choose from depending on the circumstances.

 

  1. Reporting to Your Doctor

One we’ve completed the testing we’ll discuss the results with you and talk about an appropriate treatment plan if required. We’ll also let you know if further medical investigation is warranted. We usually forward a full Audiological report to your doctor. This consists of the hearing test results as well as a report letter outlining the history and concerns, test methods used and results of those tests as well as a description of any follow up investigation that may be warranted.

 Please note: Medicare rebates are only available from a GP through a Chronic Disease Management Plan (CDM) or referral from an ENT Speciaslist or Neurologist. Please speak with your GP for more details. 

 Treatments for children with hearing loss

A diagnostic child hearing test together with any additional medical tests required will help guide best treatment options. Ultimately the treatment will depend on the severity and cause of the hearing loss.

 Obstructions & Ear Wax Removal

If there is debris or minor obstructions in your 5+ year old child’s ear canals then we can remove it. We usually do this under the microscope using a micro-suctioning or irrigation technique. We can also remove foreign objects from the ear canals using small forceps.

 Performing micro-suctioning. The head is supported and ear held for stability.

 Often hearing loss due to middle ear conditions can be treated by an ear nose and throat Specialist (ENT or Otolaryngologist). For example, if the child has recurrent middle ear infections that reoccur despite antibiotic treatment then an ENT Specialist may surgical insert grommets or ventilation tubes into the child’s ear drums (tympanic membranes).

Other treatments can depend on the nature of the hearing loss and whether it is short term, long term or permanent. It may involve the use of hearing aids, assistive listening devices, cochlear implant and can include speech therapy as required.

 Hearing aids for Kids

Hearing aids can help kids hear clearly. There are high powered hearing aids that can help kids with severe to profound hearing loss. Hearing aid solutions need to be adapted for use by kids. For example, they require tamper proof battery doors to avoid the risk of swallowing toxic batteries. This is why new rechargeable hearing aid for kids are a good idea. Special water resistant socks or coverings are also important and they can be interconnected by a lanyard to reduce the chances of getting lost. Kids hearing aids be in both the behind the ear style (BTE) and custom in the canal (ITC). They can choose fun colours and decorative patterns.

Hearing well in the Classroom

Busy classrooms with active student centred learning approaches can make for quite a bit of competing noise. This can make it very challenging for children with hearing loss to follow their teacher’s speech and directions. If not addressed can lead to academic and behavioural problems. There’s variety of assistive devices and methods that can make it much easier to follow the teachers voice.

Assistive Listening Devices (ALD’s)

Assistive Listening Devices are usually additional accessories or functional aspects of hearing aids or cochlear implant that allow sound such as the teachers voice to stream directly into hearing aids or cochlear implants. For example the teacher can wear a microphone that allows her voice to stream directly into the child’s ears via her hearing aids. This overcomes any issues of distance or competing noise to enable the child to clearly hear the teachers voice. This audio can be streamed by FM systems (radio signal) or by an inductive loop system using a tele-coil if it is a feature in the child’s hearing aids. For a great resource please see “All About FM” on Aussie Deaf Kids website: https://www.aussiedeafkids.org.au/all-about-fm-1.html (Embed Link)

Classroom Sound Field Amplification Systems

This is where the teacher wears a microphone and their voice is amplified and played from strategically placed speakers around the classroom. It is especially useful to get their voice heard toward the back of the classroom where their speech would normally be diminished substantially by the room acoustics and masking effect by competing sounds. A company by the name of Go Font Row offer these sound field communication systems. Please see https://youtu.be/TOVTb1N4Ato (Embed Video on Page)

Cochlear Implants for Kids

For infants and children where hearing aids may provide limited benefit they may be a candidate for a cochlear implant. Cochlear implants work by electrically stimulating the auditory nerves of the inner ear. There are candidacy checks performed by an Implant Specialist and there is a surgical component to the rehabilitation process.

A new type of transducer for Cochear implants has been developed by the company Cochlear ™ called the Kanso.  It consists of an all in one sound processor and transducer that is relatively small and light. It represents a very good solution for kids and adults that can’t benefit from high powered hearing aids. Please see PDF https://cicadaqld.com.au/wp-content/uploads/2017/02/FAQ_Kanso.pdf

 I have a young musician client a gentleman in his 20’s that I originally fitted binaurally with hearing aids. Due to a rare health condition his left ear hearing thresholds declined markedly over a couple of years to the point that the hearing aid for his left ear was providing limited speech intelligibility. He was referred for cochlear implant candidacy assessment. As a result, he has been fitted with the modern Kanzo to his left ear and is very pleased with the outcome and cosmetic appearance of the device. He finds the bimodal fitting of the cochlear implant to his left ear (Kanzo) and the hearing aid to his right ear a good combination. Now that he has adapted to the use of both he receives a good balanced perception of volume and speech understanding. Here’s a photo of a boy with the Kanzo cochlear implant. They come in different colours that blend well with hair colours.

 Bone Conduction & Bone Anchored Hearing Aids

In some cases, a bone conduction hearing aid can be more suitable and beneficial then a conventional air conduction hearing aid. Various conditions of the outer or middle ear may contra indicate an air-conduction aid. For example, if the child is https://harmonyhearing.com.au/hearing-test-for-kids/prone to recurrent middle ear infections with discharging ears then a bone conduction aid may be more suitable to convey sound directly to the inner ear through bone conduction. Or there may be atresia’s where there are anatomical malformations that prevent sound being passed down the ear canal and through the middle ear system. A bone vibrator can be held against the head by and elastic head band as in the following photograph.

A bone anchored hearing aid is a surgically implanted device. A titanium abutment oseo-integrates with the skull and forms the interface into which the bone conduction aid is connected.

Speech Therapy

Hearing loss can affect a child’s speech and language development. The services of a Speech Pathologist or Speech Therapist can be employed to help their skills along. It can help strengthen the way they use and understand language. For a great resource on Speech Therapy please see the Speech Therapy Australia https://www.speechpathologyaustralia.org.au (Add Link)

School Support

There’s are a variety of support systems and staff that enable children with hearing loss to be mainstreamed in standard classrooms. For example the Senses Australia formerly WAIDE provide and range of support programs for kids in Western Australia. Please see their website https://www.senses.org.au

Book your kids hearing test today!

If you are concerned about your kids hearing ability or simply want confirmation that their hearing ability it ok then book in with Harmony Hearing & Audiology. Our team are friendly and professional and will help your child feel comfortable. We charge $120 for a Kids Hearing Test for which we schedule an hour appointment. We take the time to discuss the hearing test results with you. You receive a take home copy of the results and we forward a report to your family doctor as required.

 Simply call 1800 020 406 to make a time that suits or send us an email if you would like more information (Button link to booking form)