Hearing Assessment & Services for Children
Paediatric Hearing Assessments
Paediatric Hearing assessment differ greatly from adult hearing assessment as objective test are needed to assess a child’s hearing properly, either exclusively or to verify subjective tests results.
Depending on the age of your child and the ability to actively partake in the individual tests more or less emphasis will be given to objective clinical assessments.
In general the clinical assessment will start with otoscopy to ensure there is no obstruction or other contraindication to proceed with the tests. This will be followed by tympanometry. Tympanometry gives a status of the ear functions. A normally functioning middle is the prerequisite for all other hearing tests.
Next we will do Optoacoustic (OAE) test. This test measures the functions of the outer haircells in the cochlear. It can be done very frequency specific. In the absence of otoacustic emissions, a hearing loss greater than 40 – 50 dB may be assumed. Both, Tympanometry and OAE are quick and easy to administer, typically just take a few minutes and can be done without your child’s cooperation.
Depending on age and cooperation we will now proceed with an ABR/ASSR or Pure Tone Audiogram. ABR or ASSR we will select in cases if your child is too young to give a reliable response to heard sounds. If your child is a bit older, or to substantiate the ABR/ASSR test, we might do Pure Tone Visual reinforced or Play Audiometry, in FreeField or with headphones.
In case your child is a is undergoing cochlear implant candidacy assessment we are able to do promontory stimulation/eABR test. This test can electrically verify the conductive pathway from the cochlear to the brain, before Cochlear Implantation.
Children have very different hearing needs from adults. Their whole auditory system is still developing and every intervention must always keep this in mind. Time is a very important factor in your child’s treatment, where everything needs to be done correctly, and there are some developmental stages which we don’t want to miss - missing some developmental stages are opportunities lost which can never be brought back. Also, whereas adult hearing services are often centred around bring back something which has been lost, with children it's about helping abilities to develop. With today’s technology it is possible to help almost all children to a degree of hearing which enables them to lead a normal life.
Like with adults we offer a holistic approach to your child’s hearing problems, providing all services, from diagnostic testing, over device selection, to habilitation and therapy. We typically start with a consultation to let you, the parents know what tests we are planning to do and the purpose of each of these tests. For children it is important to work with a complete battery of tests, each confirming the finding of the previous one. To get reliable stable results we might have to do some or all of the tests more than one time. Once the test results are final and stable we will discuss our findings with you and discuss with you’re the best cause of treatment and device selection.
With adult ongoing treatment is important to regain what has been lost. For children closely monitored ongoing treatment is important to keep up with your childs auditory and overall development. In case of hearing aids regular reprograming and change of earmolds will be essential. In the case of cochlear implant, regular mapping is required. Regardless of the device used ongoing treatment needs to be supported by regular objective and subjective verification methods. Methods we most commonly use are Real ear measurements, ABR or ASSR and stapedius reflex testing.Read More+