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Hearing tests for babies and children

Newborn babies and children are offered routine hearing tests to identify any problems early on in their development.

Serious hearing problems during childhood are rare. But early testing ensures that any problems can be managed as early as possible.

A children's hearing specialist called a paediatric audiologist carries out the hearing tests.

There are 2 types of hearing tests for children:

  • physiological – these test what happens inside your child's ear and brain when sounds are played to them
  • behavioural – these test how children behave when sounds are played to them

These tests do not cause any pain or discomfort.

When your child's hearing will be checked

Your child's hearing may be checked:

  • within a few weeks of birth – this is known as newborn hearing screening
  • from 9 months to 2.5 years of age – you may be asked whether you have any concerns about your child's hearing during your baby's health and development checks - hearing tests can be arranged if necessary
  • at around 4 or 5 years old – some children will have a hearing test when they start school - this may be done at school or an audiology centre depending where you live

Your child's hearing can also be checked at any other time if you have any concerns. Speak to your GP if you're worried about your child's hearing.

Getting your appointment

Your baby may be referred to the paediatric audiologist after newborn hearing screening. The screener will arrange your appointment. They will do diagnostic hearing tests on your baby.

For older children, your GP may refer you to an audiology centre. The audiology service will arrange your appointment. All tests are free for children under 18.

Find an audiology centre

Babies referred by the newborn hearing screening programme

The hearing specialist (audiologist) at your local audiology centre will test your baby's hearing when they are around 4 weeks old.

This is because:

  • the tests are more accurate when your baby is 4 weeks old
  • your baby might have had fluid or debris in their ears after birth, which can take a few weeks to clear
  • the test works best when your baby is sleeping - you'll be more familiar with their sleeping pattern after 4 weeks

Preparing your baby for the hearing tests

Do the following things to prepare for your baby's hearing tests:

Try to make sure your baby is tired

The hearing test cannot be done unless your baby is asleep. Make sure your baby is tired coming to the appointment so they will sleep during the test. Try not to feed your baby for at least 90 minutes before the test.

Bring enough supplies

Hearing tests take between 1 to 3 hours to do. Bring enough food and nappy changes to cover this time.

Try to bring a friend or relative with you

If you have a long car journey, try to bring a friend or relative who can play with your baby and keep them awake. Often babies sleep during the car journey, which means they arrive at the clinic wide awake.

There are no childcare facilities at audiology centres. If you need to bring other children with you, bring another adult to look after them.

Make sure your baby's head and ears are easy to access

The audiologist needs to be able to access the baby’s head and ears easily. Dress your baby in clothes that are not bulky around their neck and remove any hats.

Check your buggy to make sure it is not heavily padded around the baby’s head. If possible, remove any padding for the test. A seat that reclines completely flat is the best sleeping and testing position.

Arrive on time

If you arrive late for your appointment, there may not be enough time to do the hearing assessments. In this case, you will be offered another appointment.

After you arrive

When you have checked in your baby at reception, you can feed and change your baby in the waiting area. This may be an opportunity to settle your baby and get comfortable before the hearing test.

The audiologist will call you into the test room. They will take a history, outline the tests and answer any questions that you may have.

Your baby will need to be in a relaxed sleep for 30 to 45 minutes or more to complete testing. It's a good idea to keep your baby in the buggy or your arms.

What happens during hearing tests

The tests your child needs will depend on their age, but may include the following:

  • Acoustical reflex test
  • Auditory brainstem response test
  • Otoacoustic emission test
  • Play audiometry test
  • Pure tone audiometry test
  • Tympanometry test
  • Visual reinforced audiometry test

Your child may not need all the tests.

Acoustical reflex test

When we hear loud sounds, our ears trigger a protective reflex. The reflex tightens the small bones (ossicles) that connect the eardrum to the inner ear.

During this test, the hearing specialist checks that a muscle tightens the ossicles in response to a sound.

Auditory brainstem response test

This test is used on young babies and some older children.

To do the test, your baby or child needs to be completely asleep.

Older children may have to be sedated if:

  • it is not possible to perform routine hearing tests accurately
  • there is concern over the hearing levels

The hearing specialist will place an ear tip in your child's ear canal and sensors on your child's head. The specialist will play different tones or clicks to your child. The sensors record the activity in your child's auditory nerve and brain.

Otoacoustic emission test

This test measures how well your baby or child's inner ear (cochlea) works.

It measures the echo produced by the inner ear and outer hair cells when they respond to a sound.

It's similar to the test that babies have during newborn hearing screening.

Play audiometry

This test is for young children aged between 30 months and about 4 years.

Your child will wear earphones and be told to do a fun task whenever they hear a sound. For example, putting a man in a boat in response to a sound.

The hearing specialist will reduce the volume to work out the lowest sound level your child can hear at different pitches.

Pure tone audiometry

This test is for school-age children upwards.

Your child will wear earphones and be told to press a button for as long as they can hear a sound.

The hearing specialist will reduce the volume to work out the lowest sound level your child can hear at different pitches.

Tympanometry test

This test shows how well your baby or child's eardrum moves when a soft sound and air pressure are played into the ear.

It can help to identify middle ear problems, such as fluid collecting behind the eardrum.

Visual reinforced audiometry test

This test is for babies and toddlers aged 6 months to 3 years.

The hearing specialist will sit your child between 2 boxes that show animations. Each of the boxes is next to a loud speaker.

The hearing specialist will play a sound from the left or right speaker at the same time as showing an animation.

Once your child learns to link the sound with the animation, the specialist will play different sounds. This is to work out what your child can and cannot hear.

Getting the results

You'll get the results of the tests right after the assessment. The audiologist will discuss the results with you and agree what to do next. Later, they will send you a written report.

Depending on the results, the hearing specialist may recommend:

  • discharge - this means there is no problem with your child's hearing
  • continuing to monitor your child's hearing as they grow - particularly if there are risk factors
  • referring your child to an ear, nose and throat (ENT) specialist for a second opinion
  • giving your child hearing aids
  • other types of treatment, such as a cochlear implant or bone-anchored hearing aid
  • referring your child to a paediatrician (children's doctor), to see what has caused the hearing loss
  • referring your child to Chime (formerly DeafHear) a national charity for deafness and hearing loss
  • referring your child to a speech and language therapist

The hearing specialist can also give you advice about:

  • coping with the diagnosis
  • understanding childhood deafness
  • technology and other useful equipment that can help with hearing
  • other services and professionals who can support you

Tests for hearing loss in adults

Understanding Childhood Hearing Loss - Chime (PDF, 1.34MB, 36 pages)

page last reviewed: 19/09/2022
next review due: 19/09/2025