What to expect at your child's hearing test

When we test your child's hearing, we use a combination of methods based on their age, ability and interests. Some of our tests require your child to be alert, awake and happy to play with the audiologist. These are known as behavioural tests. Other tests require your child to be quiet and still, or even asleep. These are known as objective tests.

Before we do any tests, we ask you a few questions about your child's hearing and development. We also look inside your child's ears using an otoscope (or auriscope).

Visual Reinforcement Audiometry (VRA)

VRA is a hearing test designed to be used for children of a developmental age of 8 months to 3 years.

Your child will sit with you, opposite an audiologist playing with some toys. A tone will be presented from either a left or a right sided speaker. When your child turns to the sound they will be rewarded by a toy puppet  dancing in a lit box, or a short cartoon on a television screen. Your child's attention is then drawn back to the audiologist so that additional sounds can be presented.

When a sound is presented into the room through a speaker, we are testing your child’s overall hearing (both ears working together). Once this part of the assessment is completed we will aim to test each ear specifically using  earphones, and bone conduction headband if necessary.

We aim to establish the quietest sound that your child will turn for, for a variety of different frequencies of sound necessary for access to speech and language.

Play Audiometory

Play Audiometry is designed to test children’s hearing between 2 - 5 years old. Your child will be shown how to perform a repetitive play task such as putting a toy man in a toy boat each time they hear a sound - either through a speaker or through earphoes/headphones, and a bone condition headband if necessary.

We aim to establish the quietist sound that your child can hear for a range of frequencies necessary to access speech and language.

You can help your child practice for the test with our guide: Play Audiometory.pdf

Puretone Audiometry

Pure-tone audiometry is ideal for children from around 5 years of age and is used for adults too. Your child will press a button to indicate when they hear a range of tones. Either headphones or earphones that sit at the entrance of the ear canal will be used. If needed, we will use a bone conducter like the one in the above photo for more comprehensive tests. The results will be plotted on a graph called an audiogram which will show you what your child's hearing is for a range of tones.


Tympanometry is an examination used to test the middle ear function. A probe tip will be placed at the entrance of your child's ear canal which will introduce variations of ear pressure into the ear. The audiologist can use the readings to indicate whether your child has congestion behind the eardrum and whether the ear is ventilated through the Eustachian Tube. This measurement is not a hearing test and should be used in conduction with a hearing test plotted on an audiogram. 

Oto-Acoustic Emissions

Otoacoustic emissions (OAEs) are sound echos given off by the inner ear when it is stimulated with a sound. A small probe will be inserted into your child's ear canal to both play a sound into the ear and measure the echo coming out. People with normal or near normal hearing produce emissions. Your baby/child will need to be quiet during the test which usually takes no longer than 2 minutes. 

Auditory Brainstem Response (ABR) Audiometry

The ABR test measures the brain's activity in response to sound. Three small electrode pads (like a small sticker) will be placed on the child/baby: one on the forehead and one behind each ear. Headphones or insert earphones are placed on or in the baby/child's ears. A series of clicking sounds are then played and a computer records the brain's response. 

The baby/child needs to be sleep during this test. If the patient is a baby, we will do this test under natural sleep. If the child is slightly older, we may request that the child be sedated. In the latter case, we will arrange for your child to attend a hospital ward as a day case where a doctor will administer the sedation and your child will be monitored closely throughout the test. Your child should be discharged home on the same day.

Speech Tests

There are different types of speech tests but they generally aim to determine how softly your child is able to hear words. Your child may be asked to 'point' to a toy or repeat a word that has been said to them at different volumes. There are certain speech tests where we can test how well your child hears speech in the presence of background noise.