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Children’s hearing assessment & management

Children’s hearing assessment & management

What causes hearing loss?

We have extensive experience and expertise in finding the finest solutions to suit a wide range of children’s hearing loss.


As a parent or carer your involvement is vital and together, we make sure that your child can enjoy the world of sound in a relaxed and friendly environment.


What causes hearing loss?

There are many causes of hearing loss.


Some are due to mechanical dysfunction known as a conductive loss whilst others are the result of a nerve or Cochlea dysfunction known as a sensorineural loss. A smaller number of hearing losses can be due to a mixture of both.

Other rarer hearing conditions, associated with the neural pathways at higher levels, or cognitively, can also result in hearing disorders.

The origins and causes of hearing loss are many, the most common being fluid in the middle ear, genetic, viral and anoxia. A a virus called Cytomegalovirus (CMV) from the herpes family is responsible for 40% of infections during pregnancy that result in hearing loss in children. Sometimes the cause is never definitively established, which can lead to lack of acceptance in the hope that there is a cure. However, this should never delay early intervention.

How do you test your child for hearing loss

How do you test children for loss?

Test methods vary depending on the age of the child. However, it is possible to test hearing in all ages and abilities, from newborn onwards. We work closely with The Portland Hospital Audiology Department to offer the latest equipment and test methods, and all testing is carried out by specialist paediatric audiologists.


The optimal environment, equipment and Audiologist skills are essential to the process of making children feel at ease whilst accommodating the different abilities within paediatric development.

What are the effects of hearing loss?

The earlier hearing loss occurs in a child's life the more serious the effects can be on a child's development. Therefore, the earlier the problem is identified, and intervention is made with hearing aids, the less serious the impact will be. There are six major ways in which hearing loss affects children. These are:

  1. A delayed and more limited vocabulary.

  2. Poor development of sentence structure and misunderstanding.

  3. Certain speech sounds are not heard and therefore not reproduced, such as "s", "sh", "f", "t", and "k". Thus, speech may be difficult to understand.

  4. All areas of education are affected especially in reading and mathematical concepts resulting in reduced academic achievement.

  5. Impaired and underdeveloped social functioning which causes frustration, unhappiness, poor self-confidence and social isolation.

  6. The loss of spatial awareness, localization and environmental sounds.


These may all have an impact on a child's vocational choices later in life.

Optimal period for speech and language development

Optimal period for speech and language development

It is widely accepted that there is an optimal time period for language acquisition, typically during the first few years of life, during which children develop their speech and language more easily. According to some researchers, language acquired after about five years is more difficult, and may never be acquired as completely as that in the first few years of life.

Not all language development is auditory. Visual cues are also extremely important, for example the speakers’ expressions and facial cues are important in understanding speech, particularly in noisy conditions. It is also likely that there is an optimal period for developing the integration of auditory and visual speech signals necessary to optimise this method of language acquisition.


To understand speech, what we hear is supported by extensive auditory processing and cognitive function. For example, if only part of the sentence is heard, the rest will be filled in based on the topic and context of the conversation and using key words in the conversation to guess or fill in the gaps. This requires good auditory memory and receptive language skills. Auditory processing is supported by lip reading, facial expression, tone of voice, body language and other non-auditory cues. However, sound is of course vital, and the more sound that is audible, the easier it is to understand speech, and the better developed other auditory processing skills will be.


Children with additional sensory impairments are particularly reliant on auditory input.

Impact on behaviour

Human interaction with others relies heavily on sound. Children need to learn how to react in response to sound, for example listening to someone speaking, waiting for them to finish speaking before initiating communication, and the link between sound and meaning. If good quality sound is only intermittently present during early years then a child may have greater difficulty learning these reactions later in life.


This can lead to difficulties with socializing, engagement with activities, concentration, and either withdrawal or inappropriate interactions with others.

Impact on behaviour
Effect on your child's learning

Effect on educational, emotional and social development and quality of life

Just as there is an optimum time for developing speech and language, early interaction with others has an enormous impact on emotional, social and educational achievement, which in turn impact quality of life.


Children who are hearing impaired, even if only intermittently, can be expected to have significant difficulties hearing in many everyday environments, especially if noise is present. These would include interactions at home, school, sports and social environments.

Without proper support it would be very easy for a child to be effectively excluded from normal educational and peer to peer interaction, and this could affect their social and emotional development and quality of life significantly.

Is there a choice of treatments?

Is there a choice of treatments?

At the consultation with your physician or surgeon, the options for treatment will be discussed. Surgery is generally the choice for conductive hearing impairment, but not exclusively. Hearing aids are the only option for sensorineural loss. It is important to fully understand and have confidence in the recommended treatment.

Mother and baby with hearing aids

What styles and types of hearing aid are there?

The style and type of hearing aid depends upon a number of factors such as: degree of hearing loss, type of hearing loss, educational needs, age of child, size of the child’s ear, and other special need requirements. These are identified by the Audiologist.

In general, Canal or in the ear instruments are not normally recommended unless there are exceptional medical circumstances. Our Paediatric Audiologist will evaluate your child and suggest the most appropriate audiological intervention system to assist your child. These generally comprise of behind the ear instruments from miniature to standard size, sometimes in conjunction with additional wireless personal communication aids. The latter are especially beneficial in classroom or similar use.

How can we verify the effectiveness of hearing aid?

The Audiologist, in conjunction with other professionals, will provide a treatment plan. This will include regular reviews to monitor your child’s progress, and make any adjustments to ensure hearing aids are aligned to the degree of hearing loss, types of speech sounds required and to the educational requirements of the child.

Testing with the hearing aids in place is routinely carried out, so we can be sure that your child is getting just the right amount of sound.

Child with cochlear implant

What if hearing aids are insufficient? 

Hearing aids can restore the communication link but do not restore hearing to normal. For the more profound hearing loss a child may benefit from a Cochlear implant. We work closely with Cochlear implant programmes, but it is a part of conventional medical practice to assess a child using hearing aids prior to consideration for assessment of Cochlear implantation.

A multi-disciplinary approach

In order to receive the maximum benefit from Audiological intervention it is paramount to have good communication set up between parents / caregivers and schools as they will be involved in completing assessments, questionnaires and providing essential reporting and feedback. Where other professionals are involved, such as Visiting Teachers of the Hearing Impaired and Speech and Language Therapists, we aim to have a close relationship with them.

Can I refer my child myself?
Wallpaper in M&M Practice

Can I combine private and NHS management?

We offer a system of shared or top up management for children whose hearing loss is diagnosed and medically managed by the NHS but want to obtain hearing aid management privately. This is not a problem. We have long standing experience of providing shared management and working closely with the NHS and NHS Professionals.


For more information please contact us and speak to Catherene McKinney.

Can I refer my child myself?

In the UK you are not required to be referred to us by a specialist. We are required, however, to ensure you have been fully assessed by a doctor or physician, who has provided a diagnosis and supports hearing aids as a part of any rehabilitative approach. We will always request that you consult with a nominated medical professional regarding your child.

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