Results and treatment

Understanding your child’s test results

After the test the audiologist will discuss the results with you and how they may impact on your child.

Hearing levels are established by assessing the quietest sound one can hear and respond to at a variety of sound frequencies (sound types).  These response levels are generally plotted on an audiogram for each of the frequencies tested. For younger children, where we may have measured the minimum responses levels rather than the absolute threshold of hearing, we may present the results in a table instead. 

With children’s hearing tests we often aim to test, at minimum, between 500Hz and 4000Hz as these are the sounds most commonly represented in speech.

We test hearing by air conduction, where the sound passes through the full ear system from the outer ear to the inner ear and up to the brain, using over ear headphones, a standalone speaker or insert ear phones.  We also test hearing using bone conduction where a transducer is placed on the mastoid bone on the head behind the ear and transmits sound through the bone to the inner part of the ear, bypassing the outer and middle part of the ear.

Hearing Loss

Satisfactory hearing is when a person is able to hear the test sounds at minimum quiet levels which would enable them to hear speech sounds and other environmental sounds well.  For younger children we would want them to respond at a level of 25dBHL or above when testing overall hearing using speakers. If they were tested using headphones or insert earphones we would want them to respond at 20dBHL or better.

Hearing loss, or impairment, is when your ability to hear sound is reduced.  We can establish the degree of hearing loss based on where on the audiogram the points are plotted. We use the average decibel level of the central frequencies (500Hz- 4000Hz) to determine the level of hearing loss.

Hearing loss is categorized as being satisfactory, mild, moderate, severe or profound and we do not tend to describe the impairment in percentage lost.

If still have any questions about your child’s hearing test results please contact us and ask to speak to an audiologist.

Types of hearing loss

Hearing loss or impairment is described in 3 main categories; sensorineural hearing loss, conductive hearing loss and mixed hearing loss.

Sensorineural hearing loss occurs when the sound is conducted through the outer and middle ear without problem, but the sound is not received in the inner ear or sent to the brain normally.  This type of hearing loss is not helped by surgery or other treatments.  The intervention option for improving most types of sensorineural hearing loss is hearing aids.

Conductive hearing loss occurs when the underlying function of hearing is satisfactory but the sound is not conducted through the outer or middle ear system.  Often, conductive hearing loss is temporary and resolves without intervention.  Most conductive hearing loss in children is caused by a condition called glue ear and can be treated easily with grommets in most cases (they will be referred to an Ear, Nose and Throat consultant for this).  Conductive hearing loss can also be caused by infections, perforated ear drums, impacted wax and middle ear problems including issues with the ossicles (middle ear bones).

Mixed hearing loss is when there may be an underlying sensorineural hearing loss, but also a conductive element which causes the hearing levels to be worsened.

Management of hearing

Permanent hearing loss identified

Sometimes hearing loss is identified which appears to be permanent (sensorineural) in nature.  In some of these cases, if clinically appropriate, hearing aids can be offered to treat the hearing loss.  In other cases we will monitor hearing loss on a regular basis to check for any changes, particularly while children are accessing education. 

Monitoring

If your child has a mild or temporary hearing loss we may decide to use a ”watch and wait’ method to monitor their hearing without immediate intervention. This method is commonly used for children with glue ear, as their hearing is likely to fluctuate over time.  With glue ear, if hearing loss does not improve after a watch and wait period, your child may be referred to the Ear, Nose and throat (ENT) team for further management.  The ENT consultants are based at James Cook and travel to our sites for clinics.

Glue Ear

This is a very common condition in childhood caused by a build-up of middle ear fluid which is often temporary.  Sometimes this middle ear fluid persists, affecting hearing to a mild or more level, and requires intervention.  More information can be found here:

Satisfactory hearing

If results of the hearing test indicate your child’s hearing is satisfactory, they will be discharged from audiology.  It is possible for you, or a health professional involved in their care, to arrange a further hearing assessment for your child should you feel their hearing changes.