Understanding Hearing Loss

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Hearing Tests

Newborn Hearing Screen

A baby’s hearing is tested shortly after birth as part of the Newborn Hearing Screening Programme.  

The two tests that may be used in the Newborn Hearing Screen are oto-acoustic emission and automated auditory brainstem response.  Both of these tests are objective tests and do not require the baby to respond in anyway.  The auditory brainstem response test needs the baby to be asleep (either under natural sleep or sedated).

NHS choices provides further information about the Newborn Hearing Screen and includes a video of a child having the oto-acoustic emission hearing test and an automated auditory brainstem response.

This video explains about the hearing screen for newborn babies. 


Visual Reinforcement Audiometry (VRA)

A child will not be ready to do the next type of hearing test until they are about 6 months old.  Distraction testing and visual reinforcement audiometry (VRA) require a child to be able to sit on an adults lap and have developed head control to be able to turn when they hear a sound.  VRA is a test which encourages the child to look for a visual reward of a moving toy in response to hearing a sound.  VRA is the test of choice for children from about 6 months to 2 years plus.  Distraction testing may be used if the child isn’t developmentally ready for VRA.


Play Audiometry

Between the ages of 2 to 3 years, a child can be taught (conditioned) to carry out an action in response to hearing a sound.  In Play Audiometry, sounds can be presented through speakers, headphones and insert earphones. The child is encouraged to hold a toy until they hear a sound, when they will place a person in the boat, a ball/ring on a stacking toy etc. The child’s developmental ability and attention levels will impact on the success of this test.


Bone Conduction Test

A bone conduction test sends sound directly to the inner ear.  It is carried out by placing a small vibrating device on the bone behind the ear.  This test can help to determine if the hearing loss is due to a problem in the middle ear.

This NHS document describes different types of hearing tests.

'Understanding your child's hearing tests' is a booklet that has been produced by the NDCS and explains the different hearing tests in more detail.

Families will be offered tests to find out the cause of the hearing loss, although in many cases the reason may not be known. The process involved in investigating a hearing loss is explained in this British Association of the Deaf (BATOD) article.



British Society of Audiology (2018) Recommended Procedure Pure-tone air-conduction threshold audiometry with and without masking. [Online] Available at: https://www.thebsa.org.uk/resources/pure-tone-air-bone-conduction-threshold-audiometry-without-masking/   [Accessed: 13 February 2021]

NDCS (2016) ‘Understanding  your child’s hearing tests’ [Online] Available at: https:www.ndcs.org.uk/information-and-support/childhood-deafness/hearing-tests/   [Accessed: 13 February 2021] 

Rangan, S., Kennedy, V. (2020) Why do we need to investigate a hearing loss? BATOD Magazine, Sept 2020. [Online] Available at: www.batod.org.uk  [Accessed: 20 February 2021].