Hearing and ear health checks for children

When a child is not hearing it can affect speech, language, learning, sleep, and behaviour.  A speech pathologist will ask about your child's ear health and hearing history and may recommend your child has a checkup before a speech pathology appointment. 

Ear health and hearing checks for children are designed to be gentle, child friendly, and matched to your child’s age and development. A hearing appointment often includes both an ear health check (looking at the ear canal and eardrum) and hearing testing (measuring how your child responds to sound, or how the ear is working)

• A GP/Medical practitioner is often the first step for ear pain, discharge, fevers, or suspected middle ear infection. GPs commonly look in the ears with using an otoscope and will determine if medical treatment is required.
• An Audiologist specialises in measuring hearing and testing how well the ear is functioning with tests like tympanometry and otoacoustic emissions, plus age-appropriate listening games.
• Sometimes specialist or surgical treatment is recommended and a GP/Medical practitioner will refer a child to an Ear Nose and Throat (ENT) specialist.  The ENT will assess the concern and discuss options for management.

Most appointments start with a quick ear health check, because temporary issues in the ear can reduce hearing. Middle ear infections and glue ear are common in young children, and fluid can cause a temporary, mild hearing reduction that may still need monitoring or treatment

• Otoscopy (looking in the ear)
  A clinician uses a small light called an otoscope to look at the ear canal and eardrum. They are checking for wax blockage, inflammation, infection, fluid signs, or perforation. 
• Tympanometry (checking eardrum movement)
  This test checks how well the eardrum moves, which helps identify issues like middle ear fluid (glue ear). A small soft tip sits at the ear opening and the machine changes air pressure briefly.

Audiologists choose tests based on your child’s age, attention, and communication level. Many tests feel like games.  An appointment may include some or all of the following:

• Case history and listening check-in
  You will likely be asked about speech and language, medical history, ear infections, newborn screening (if known), family history, school or daycare concerns, and what you are noticing at home.
• Otoacoustic emissions (OAE) test
  OAEs check inner ear (cochlear) function. A small earpiece plays soft sounds and measures the ear’s response. This can be useful for children who cannot reliably do listening games yet, or as part of a broader test battery.
• Behavioural hearing tests (the “listening games”)
  These measure the quietest sounds your child responds to.  Very small babies can have their hearing tested while they sleep.  Children around 7 months to 3 years might play a game where they learn to turn toward a sound and gets a fun “reward” like seeing a puppet dance.  From 3 years a child may do a simple action when they hear a sound (for example, putting a block in a box).  Older children may wear headphones and respond to beeps and speech at different volumes, or may repeat words or point to pictures.

The video below show's an Audiology appointment at Melbourne's Royal Children's hospital:

You may receive:

• A summary of ear health findings (for example, normal eardrum movement vs restricted movement).
• Hearing levels for each ear (sometimes shown on an audiogram).
• Clear next steps, which may include monitoring, a GP review, referral to ENT, referral to Hearing Australia for further assessment, or support strategies at home or school, depending on results and concerns.

• Explain simply, for example: “We’re going to play listening games and check how your ears are working.”
• Bring comfort items, snacks, and a favourite quiet toy.
• If your child is unwell or has ear discharge, call ahead because some tests may need to be postponed.  

If your child has ear pain, fever, discharge, significant hearing changes, or repeated middle ear infections, start with your GP or Medical Practitioner. Middle ear infections are common, especially in early childhood, and can affect hearing while they are present.  A GP/Medical Practitioner will guide next steps

• Middle ear infection: babies, kids & teens | Raising Children Network  
• Audiologist: guide for parents & kids | Raising Children Network 
• Understanding Hearing Loss in Children and Young Adults - Hearing Australia 

A Speech Pathologist is trained to assess a child's speech and determine if intervention is recommended.  Click below to book an initial appointment with a Speech Pathologist in Blackburn at SpeechTx.

For a local speech pathologist see Speech Pathology Australia's Find a Speech Pathologist 

If you have any questions please contact us. We would be happy to assist you.