We Conduct Hearing Tests on Children From The Age Of 5 Years Old

Young girl holding her ear

Paediatric audiologists at Liverpool Hearing Centres are specially trained clinicians who work with children and specialise in the detection of hearing loss. A paediatric audiologist will be able to determine which tests are necessary and perform them with accuracy and efficiency. If a hearing loss is discovered, the paediatric audiologist will educate you on hearing loss, communication options, and resources.


The Four Main Hearing Tests For Children

Tympanometry in Children

Audiologists can normally view inside the ear up to the eardrum. If wax is in the way, this can usually be removed using microsuction or a gentle water technique.


Audiologists use tympanometry and the acoustic reflex threshold (ART) to check if a child's middle ear is functioning correctly. An audiologist will put a probe into your child's ear that will measure air pressure. The test results are sent to a tympanometer, which records the data on a tympanogram.


The pressurised probe goes only slightly into your child's ear during a tympanometry test. It measures how the tympanic membrane changes when the pressure changes. The audiologist looks at the data with a handheld tool called a tympanometer and its output, a tympanogram.


Tympanometry is often used to find out if otitis media with effusion (OME) is present. When fluid stays in the inner ear after an infection is gone, this is called OME. A normal result means there is no fluid in your child's middle ear, and the eardrum and middle ear bones that help you hear are moving as they should.


If the tympanometry is not normal, more tests should be done, as it may indicate that there is fluid in the middle ear or a tear in the tissue that separates the middle ear from the outer ear. It can also reveal if the middle ear bones are not moving as they should or if there are scars from frequent illness. The tympanogram can also find other problems, like a hole in the eardrum, too much earwax, or even tumours in the middle ear.

Pure tone Audiometry

Children as young as 5 years old may undergo pure-tone audiometry testing. This is the test frequently used to evaluate a child's hearing before they begin school; it is also known as the "sweep test." This is comparable to an adult's regular hearing test.


Beeps are played through headphones, and your child is instructed to press a button or perform an action when they hear them. The audiologist can determine the quietest sounds your child can hear in each ear by adjusting the sound level.


In addition to speakers or headphones, a bone conductor, a small vibrating device, is put behind the ear. This apparatus transmits sound directly to the inner ear via the skull bones, which can help determine which part of the ear is causing your child's hearing issues.

Speech Testing In Children

Speech perception tests are used to evaluate your child's word recognition ability. Depending on your child's age and ability, this can be done in a variety of ways. Some may be performed vocally, while others may involve listening to speech through headphones or a speaker. The child may need to identify words he or she hears by pointing to a toy or a picture or by repeating what they hear.


The AB Isophonemic Monosyllabic Word Test (Arthur Boothroyd, 1968) is a test of speech perception consisting of fifteen 10-word lists. The lists are phonetically balanced, containing the same 10 vowels and 20 consonants, and are typically scored phonetically, which boosts the reliability of the test. They are used to test both children and adults using residual hearing or when aided with a hearing aid or cochlear implant.


The Bench-Kowal-Bamford (BKB) Sentence Test (Bench et al., 1987) is a well-known open-set speech perception exam designed for use with hearing-impaired children (typically >8 years old). It can be utilised with adults as well. The examination can be given in either a quiet or noisy environment. Each BKB list consists of 16 short phrases and is graded based on the number of 50 key words that are repeated correctly.


QuickSiN involves the delivery of a list of six sentences with five important words in each sentence, accompanied with "babble noise." The sentences are given in signal-to-noise ratios that decrease in 5-dB increments from 25 (very easy) to 0 (very hard)


Simply explained, QuickSiN conveys real-world scenarios, like being in a noisy classroom, to the test-taker with greater precision than other test options.

Play Audiometry For Children

We do not currently test children under 5 at Liverpool Hearing Centre. 


Children between the ages of 2 and 5 are best suited for play audiometry. During play audiometry, your child will listen to sounds through headphones or speakers. When your child hears a sound, they will be asked to complete a simple task (such as placing a toy in a bucket). The volume and pitch of the sound will be adjusted to find the quietest sounds they can hear.

Why children often lose their hearing

There are many things that can cause kids to lose their hearing. Some of them are short-term and get better on their own, like when you have a cold. Some hearing problems may have been going on for a longer period and need medical evaluation and treatment. Most of the common reasons why children lose their hearing can be fixed with medicine or small changes. If your audiologist thinks you have permanent hearing loss, they can help you figure out what to do next.

Too Much Earwax In A Child's Narrow Ear Canal


Ears generally clean themselves, and any wax that gets to the outside of the ear can be easily wiped away. Please resist the urge to stick Q-tips, baby buds, or anything else into your ear. Doing so will only make things worse and cause wax to build up and harden over time. Your doctor may give you ear drops to soften the wax, and we should be able to use microsuction with a tiny vacuum to remove any extra wax. Microsuction does require the child to stay still for a short time, so it can't be done on kids under 5 or on those who are very anxious.


Glue Ear (Otitis Media with effusion)

Most children get otitis media at some point, and in most cases, it goes away on its own over time. If it doesn't clear up on its own, the fluid can get very thick (like glue) and may need to be treated. You can help your child get rid of it by teaching them how to blow their nose and pop their ears. As a treatment for glue ear, you can also buy Otovent, which has a child use a nasal tip to blow up a small balloon. If time and these simple treatments don't help, your ENT doctor may suggest that you get "grommets," or tubes that let air into the middle ear and stop fluid from building up. Most grommets fall out on their own between 6 and 18 months.

Infected ears (Acute Otitis Media)

Acute otitis media, unlike glue ear, is caused by an infection. This means that your child may not only have trouble hearing but also feel sick, have a fever, and complain of ear pain. Acute otitis media is best treated by your doctor, who may give you antibiotics and painkillers. If the eardrum bursts, there may be a foul-smelling discharge from the ear or on the pillow. Most of the time, the pain and temperature will go away, and almost always, the eardrum will heal quickly.

Hearing Loss in Children Symptoms

  • Signs of a possible hearing issue in older children include: – 
  • Inattention or poor concentration
  • Unresponsive to their name being called
  • Talking loudly and watching television at a high volume level.
  • Difficulty determining the source of a sound
  • Mispronunciation of words
  • Speech delay/difficulty
  • A shift in academic performance or in conduct

For babies, the personal child health record (Red Book) contains a checklist that can be used to monitor your child's hearing as he or she grows.

Childrens' Hearing & Why it Should be Checked

Hearing is essential at all times, but particularly in childhood when we are learning to interact and communicate. Hearing loss in children can be caused by a number of things, most of which can be treated with good results for your child.


Hearing loss that isn't treated can make it hard for a child to learn how to speak and understand language. It can also cause them to miss out on conversations and make it tricky for them to hear clearly at school.


A child's overall development and health depend on his or her ability to hear. Without good hearing, speech and language development, as well as social skills and school performance, could be slowed down. In addition to behavioural concerns, undiagnosed and untreated hearing loss can also lead to emotional issues.


If you have worries about your child's hearing, scheduling an evaluation might put your mind at ease. Call today or fill out the form to schedule a hearing test for your child with one of our highly skilled paediatric clinical audiologists.