Patient Information

Your child’s hearing clinic visit


This gives you information on how to prepare for your child’s hearing clinic visit and what to expect during the visit.

Preparing for your child’s appointment

Some children feel anxious when they come to their appointment because the hospital is an unfamiliar environment. It is not unusual for children to be uncomfortable with someone touching or looking into their ears.

Using an otoscope

We try to make your child feel as comfortable and settled as possible. You can also help by trying to get your child used to having their ears touched.

In the days leading up to the appointment you can help by doing the following.

  • Use your child’s favourite toy animal or doll. Let your child watch you touching the ears of the animal or doll. You can encourage your child to touch the ears on the animal or doll themselves. Then you can see if your child will let you touch their own ears.
  • If you have a toy ear light you can use this to practice with. Or you can look at pictures of an ear light together.

If there is anything you feel we should know about your child before we meet them, contact us to let us know (see Contacts section below).

During the appointment

We use different tests to assess how much hearing your child has, depending on their age and stage of development.

We may need to perform several different tests over more than one appointment. This will help us to build up a clear picture of your child’s hearing ability.

Diagram of inner ear

Different types of hearing test

Visual response audiometry (VRA): suitable for approximately 6 months old to approximately 2.5 years old

  • We play sounds of different frequencies and loudness, either through speakers or headphones.
  • When the child hears the sound, they turn their head and a visual or tactile ‘reward’ is activated”, such as a fun interactive toy or digital image. We play the loud sound at the same time as the toy or image at first, so that your child learns to associate the reward with the sound.
  • Once your child has got used to associating the reward with the sound, we only activate the reward when your child turns their head for the sound.
  • It is possible to perform this test on a 6 month old, but every child’s ability to perform this test is different. Some children are not ready for this kind of test until they are at least 9 months old. 

Play audiometry: suitable for [xxx]

  • During this listening game, we play sounds of different loudness and frequencies (pitch). We play them through a speaker for younger children and through headphones for older children.
  • We ask the child to do a simple fun task every time they hear the sound. For example we might ask them to put a hoop on a post, or add a block to build a tower, or add ‘spikes’ to Spike the Hedgehog.
  • You can prepare your child for this test by practicing listening or waiting games with them at home. For example you can use the ‘Ready, Steady, Go’ game. To play this, you say ‘ready, steady, go’ and when you say ‘go’ you encourage them to complete a fun task like throwing a block into a box. If you praise your child for getting it right it will encourage them to respond and make the situation fun.

Tympanometry: suitable for all ages

  • Tympanometry testing is used to check how well the moving parts of the middle ear are working (see diagram of a human ear above).
  • We hold a soft earpiece gently in the ear canal. A pump causes the pressure of the air in the ear canal to gently change. If the ear is working, the eardrum will move freely with the change in pressure.
  • This test is quick to perform and is suitable for most children.  It is not suitable for some conditions such as excessive ear wax.

Otoacoustic emission (OAE): suitable for newborns to approximately 4 months old

  • The otoacoustic emission test (OAE) is commonly used for newborn screening. It works on the principle that a healthy cochlea (see diagram of a human ear above) will produce a faint response when stimulated with sound.
  • We place a small earpiece in the child’s ear and play a clicking sound. If the cochlea is working, the earpiece picks up the response and we record it with a computer.
  • An OAE can be recorded quickly, but it is affected by background noise, excessive ear wax and middle ear fluid. This means it is unsuitable for a child older than 4 months, because they are unable to stay still or quiet for a long enough period of time to enable us to carry out the test.
  • When a child is struggling to settle, it can help if they are allowed to watch an episode of their favorite TV programme or a video downloaded on your mobile (with the sound turned off). Note that the wifi signal can drop in the hearing test rooms, so you might want to download a video before your visit.

Auditory brainstem response (ABR): suitable for newborns to approximately 4 months old

  • This test is used for babies who have not registered a clear response on their newborn hearing screen. It measures sounds being sent from the cochlea, through the auditory nerve to the brain (see diagram of a human ear above) .
  • The audiologist lightly scrubs the skin on the child’s forehead and behind both ears. Three sensors are placed on the skin. We deliver sound through an insert or headphone and the response is recorded on a computer. The audiologist interprets the results to find the quietest level of sound being picked up by the child’s hearing nerves.
  • The test can take up to 2 hours. For an accurate result the child must be sleeping throughout, as other brain or muscle activity will interfere with the ability to record the response from the auditory nerve.

Some children are too old for the VRA test, but not yet ready for the PTA test. In this situation, the audiologist will discuss with you some games you can play at home to train your child for their next hearing appointment.

More information

Diagram of human ear uses image by Macrovector on Freepik


Kingston Hospital Audiology department 020 8934 6406

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Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
For detailed information on accessibility at Kingston Hospital visit Kingston Hospital AccessAble (https://www.accessable.co.uk/kingston-hospital-nhs-foundation-trust).

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