What to Expect from Hearing Tests for Children

Children’s Disclaimer: Concerns about children’s hearing development should always be assessed by a qualified paediatric audiologist or GP.

If you have never been to a hearing assessment with a child before, the unknown can feel a little daunting — for parents and children alike. What will they ask your child to do? What if your child does not cooperate? What happens if a problem is found?

The good news is that paediatric audiologists are experienced at working with children of all ages, including very young children and those who are anxious. The assessments are designed to be engaging, non-invasive, and as comfortable as possible.

This article walks through exactly what happens, so you can feel prepared before you arrive.

What to bring before the appointment? 

Before attending, it is helpful to bring:

• Any previous hearing assessment results or letters from your GP or paediatrician
• Your Medicare card and any relevant Health Care Card or concession details
• A list of any concerns you have noticed — specific observations from home or from school are very useful for the audiologist
• For young children, a favourite toy, snack, or comfort item can help settle nerves

It is also worth letting your child know what to expect in age-appropriate terms. For a toddler, “we are going to play some listening games” is often enough. For an older child, a brief explanation — “the audiologist is going to check how well your ears work, and it is not going to hurt” — can help reduce anxiety.

Types of Hearing Tests for Children

Newborn Hearing Screening

Queensland conducts universal newborn hearing screening in hospitals, typically using Automated Auditory Brainstem Response (AABR) testing, which involves small sensors placed on the baby’s head. This is done while the baby is settled or asleep and takes only a few minutes. A clear screen result is noted in the child’s health record.

If the initial screen does not pass, a follow-up assessment is arranged — this does not necessarily mean hearing loss is present. It means a more detailed assessment is needed.

Visual Reinforcement Audiometry (VRA) — Babies and Toddlers (6 months – ~2.5 years)

For very young children, standard audiometry is not appropriate. Visual Reinforcement Audiometry is a technique that uses a baby’s natural response to sound and their interest in visual rewards.

The child sits on a parent’s lap. Sounds are played through speakers or small earphones. When the child turns their head toward a sound, an animated toy or light is activated as a reward. This reinforces the listening response and allows the audiologist to test responses across a range of frequencies.

VRA is a well-validated technique and can provide useful diagnostic information even in very young children. The audiologist may need more than one session to obtain a complete picture, particularly with very young or unsettled children.

Play Audiometry — Young Children (~2.5–5 years)

Play audiometry turns the hearing test into a simple game. The child is taught to perform an action — dropping a block into a bucket, placing a ring on a peg, pressing a button — each time they hear a sound. This makes the test engaging and cooperative rather than passive.

Sounds are presented through headphones or insert earphones at different frequencies and volumes, building a picture of the child’s hearing across both ears.

Many children find play audiometry enjoyable. The audiologist will use a variety of sounds and tasks to keep the child engaged, and the pace is adapted to the individual child.

Pure-Tone Audiometry — Older Children (5 years and up)

From around five years of age, most children can manage a conventional pure-tone audiometry test — the same type used for adults. The child wears headphones and presses a button or raises their hand each time they hear a tone.

Testing covers a range of frequencies from low to high, in each ear separately, to produce an audiogram — a graph of the child’s hearing thresholds across the frequency range. This is the most detailed type of hearing test and provides a clear picture of the type and degree of any hearing difference.

Tympanometry (Middle Ear Testing)

In addition to pure-tone testing, the audiologist will often perform tympanometry — a test of how well the eardrum and middle ear are working. This involves placing a small probe gently in the entrance of the ear canal. The child does not need to do anything, and it takes only seconds.

Tympanometry is particularly useful for identifying glue ear (fluid in the middle ear), which is very common in children and can affect hearing even when the inner ear is healthy.

What Happens After the Test

After the assessment, the audiologist will explain the results to you in plain language. You do not need to understand audiograms or technical terminology — the audiologist’s job is to translate the results into something useful for your family.

Possible outcomes include:

Hearing is within the typical range. The audiologist will note this, explain the results, and advise on any follow-up that might be appropriate based on your concerns.

A middle ear issue is identified (e.g., glue ear). The audiologist will explain what this means, how it typically progresses, and whether referral to a GP or ENT (ear, nose and throat specialist) is recommended. Mild, temporary cases often resolve on their own.

A hearing loss is identified. The audiologist will explain the type and degree of hearing loss, what it means for your child’s day-to-day life, and what options are available. This may include a referral to Hearing Australia for assessment for hearing technology, a referral to an ENT specialist, or recommendations for classroom support. You will not be rushed into any decisions.

What if My Child Won’t Cooperate?

This is one of the most common concerns parents raise, and it is worth addressing directly.

Paediatric audiologists are trained to work with uncooperative, anxious, or very young children. If a child does not engage on a given day, the appointment is not wasted — the audiologist will adapt the approach, try a different technique, or arrange a follow-up session.

Even a partial assessment can be informative. And in many cases, children who are nervous in the waiting room settle quickly once they are in the testing room and realise the activity involves play rather than anything uncomfortable.

Bring any comfort items, let the audiologist know about your child’s temperament, and trust that this is a very common situation that clinics are experienced in managing.

Frequently Asked Questions

Q: At what age can a child have a proper hearing test? Hearing can be assessed at any age, including at birth, using age-appropriate techniques. Newborn screening happens in hospital. For babies from around 6 months, Visual Reinforcement Audiometry is used. Play audiometry is typically appropriate from around 2.5–3 years. Conventional pure-tone audiometry is usually possible from around 5 years of age.

Q: Does a hearing test hurt? No. All standard hearing assessments are non-invasive and painless. Testing involves listening to sounds through headphones or speakers and responding in some way — there are no injections, instruments inserted into the ear, or discomfort involved.

Q: How long does a children’s hearing assessment take? A full paediatric hearing assessment typically takes 45–60 minutes, though this varies depending on the child’s age, cooperation, and what tests are needed. It is worth allowing a little extra time so the process does not feel rushed.

Q: Do I need a referral to book a children’s hearing test at CQ Audiology? A referral is not always required, but a GP or paediatrician referral can be helpful for coordination of care and may be relevant for certain funding pathways. Contact us directly if you are unsure and we will walk you through what you need.