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Hearing tests for babies and children

The newborn hearing screening programme works to pick up infants with hearing loss at birth. But you will need to go to a paediatric audiology centre if we need to test your child's hearing at any stage after birth or during childhood.

A 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

None of the tests cause any pain or discomfort.

Getting your appointment

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

For older children, your GP or another healthcare professional may refer you to the HSE community audiology department. The audiology service will arrange your appointment.

Related topic

Audiology centres across Ireland

Babies referred by the newborn hearing screening programme

The hearing specialist at your local audiology centre will test your baby's hearing when your baby is 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 and you'll be more familiar with their sleeping pattern after 4 weeks

Preparing your baby for the 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. You should 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.

If you need to bring other children with you, you should bring another adult to look after them. There are no creche facilities.

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 car seat or buggy to make sure it is not heavily padded around the baby’s head. If possible, remove this 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

Once you have checked in your baby in reception, you can start to 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 car seat or your arms.

Hearing tests for babies and older children

Your child can have 3 different tests:

  • Auditory brainstem response test
  • Otoacoustic emission test
  • Tympanometry test

Your child may not need all tests.

What happens during hearing 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.

This test can check whether sound is travelling correctly from the ear into the brain, then back down to the muscle that tightens the ossicles.

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 first 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 36 months.

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 in the left or right box.

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.We will discuss the results with you and agree what to do next. We will send a written report to you later.

Depending on the results, the hearing specialist may recommend:

  • discharge - this means satisfactory results were recorded
  • 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 specialist for a medical opinion
  • providing your child with hearing aids
  • other types of treatment, such as a cochlear implant or bone-anchored hearing aid
  • referring your child to a paediatrician (a doctor that specialises in children's medical problems). This may be to see what
  • has caused the hearing loss
  • refer your child to the visiting teacher of the hearing impaired (VTHI)
  • 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

Related topics

Hearing aids

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

Tests for hearing loss in adults

page last reviewed: 29/07/2019
next review due: 29/07/2022