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Nicole Eglinton, Principal Audiologist, Little Ears - updated 28/04/16
Audiologists are post-graduate university trained professionals who assess and provide non-medical management of hearing loss. Paediatric audiologists provide a family focused approach in the hearing assessment of children, and where required, assist parents in choosing the most appropriate hearing management for their child. Their key role is to ensure a child has adequate hearing to develop to their full potential (speech and language development, progress at school etc.). Paediatric audiologists work in collaboration with medical specialists, early intervention services and other relevant allied health professionals (speech pathologists, psychologists etc.).
Audiologists assess a child’s hearing using a range of age appropriate tests (i.e. tailored to the child’s developmental level).
Behavioural measures involve conditioning young children to respond to presented sounds using play (e.g., looking for a puppet to appear once a sound is presented, or placing a peg in a board etc.). Children developmentally younger than 9 months of age are assessed using noisemakers. Generally two paediatric audiologists are required to assess children developmentally younger than 2 years of age. Here, experience in the behavioural responses of young children is a necessity in detecting often subtle responses.
For children who are unable to reliably perform behavioural tasks electrophysiological tests may be used. For example, Auditory Brainstem Response (ABR) assessment determines a child’s hearing levels by positioning small sensors on the child’s head and monitoring the child’s brain activity in response to presented sounds. This requires a child to be relaxed and very still, preferably asleep.
In addition to determining a child’s hearing levels, paediatric audiologists will also assess a child’s middle ear status using Tympanometry. Young children (particularly those younger than 7 years of age) are more susceptible to middle ear problems (often referred to as glue ear) as their middle ear systems are still developing.
Since early 2006 neonatal hearing screening has been offered free for all babies born in South Australia. This has seen the age at which children are identified with hearing loss significantly decrease and ensures early management and the implementation of intervention strategies for hearing loss.
For children found to have normal hearing, normal middle ear function, and no indication of auditory processing difficulties, no further follow-up is required. However, it is important to note that hearing can change and should parents/teachers etc. have any concerns regarding a child’s hearing they should be referred for review.
For children who are found to have hearing loss associated with persistent middle ear problems referral is required to an Ear, Nose and Throat (ENT) specialist for medical opinion and management. Many conductive hearing losses are temporary and will resolve with medical management. The audiologist will liaise with the medical specialist and continue to monitor the child’s hearing as required.
For children who are found to have hearing loss associated with the cochlea (inner ear), or auditory nerve, prompt referral to an Ear, Nose and Throat (ENT) specialist is required. An ENT will investigate the cause of the hearing loss, provide medical management and where appropriate give approval for the fitting of an amplification device. Sensorineural hearing loss is permanent and early intervention is crucial for a child’s development. In Australia, high quality amplification devices (hearing aids etc.) are provided to children and young adults up until their 26th birthday from Australian Hearing free of charge. Cochlear Implants are only considered for children with significant hearing loss where hearing aids are limited in their ability to provide good access to speech sounds. Cochlear Implant services for children are managed by the Women’s and Children’s Hospital.
Children who have normal hearing and normal intelligence but are reported to have poor listening skills and/or significant difficulties listening in background noise may be referred for auditory processing assessment. Children must be at least 6 years of age to be assessed.
Auditory processing refers to one’s ability to detect, discriminate and process auditory (verbal) information. Auditory processing difficulties can significantly affect a child’s ability to listen and learn in the classroom and to respond to everyday instructions around the home. Behaviours typical for that of a child with an auditory processing disorder include: frequent misunderstandings, difficulties following instructions, and difficulties listening in the presence of background noise (e.g. the classroom). A child with an auditory processing disorder (APD) is unable to take advantage of incidental learning and often requires information to be repeated. They may confuse similar sounding speech sounds, have difficulties with spelling and reading, and show slow progress at school.
The following organizations specialise in hearing assessments for children and offer hearing assessments free of charge:
Alternatively, the following private providers also specialise in the hearing assessment of children for a fee (prices vary):
There are currently no services in Adelaide offering free Auditory Processing assessments. Auditory Processing Assessments are available from the following providers (prices vary):
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