Hearing care

This advice applies across the UK.

Hearing care is not only important in speech development and learning. Children also use their hearing to take in information and to make sense of their world. Listening to music may be exciting or soothing. Hearing footsteps coming towards them means they know they are not alone.

Learn how to spot the signs of hearing problems and what you can do to look after your child’s hearing.

In this article

Ears and hearing problems

For some children, hearing difficulties may be having a hearing loss in one or both ears. The level of hearing could range from mild to profound hearing loss. Some children are born with a hearing loss, but for others it develops during childhood.

Other children have normal levels of hearing, but difficulties listening and processing sounds, leading to problems understanding speech and environmental sounds. This is known as auditory processing disorder (APD).

Other factors also affect the way we process sound, such as our language ability, memory and attention. This is because even a simple task, like following the instructions of a teacher, requires that all these different abilities work together. As a result, APD often occurs with other childhood developmental delays such as language, attention and memory difficulties, as well as dyslexia and autism.

8/10 children will experience glue ear before the age of 10

Hearing difficulties can be temporary. Most children will experience glue ear at some point during their childhood. Glue ear is one of the most common childhood illnesses. It happens when the middle ear (behind the eardrum) becomes filled with sticky fluid. Glue ear usually lasts less than three months and is often linked with ear infections. But long-term glue ear can affect children’s hearing and their development.

Why is ear and hearing care important?

Hearing problems are common among children with a learning disability, autism or both, but often they have not had a recent hearing check.

Hearing loss in children with autism is 10 times higher than in the general population

Without support, hearing difficulties can make a child’s learning difficulties more challenging, and impact on their educational progress and social development. Hearing difficulties can cause or contribute to speech or language delays, difficulties learning and reading, and cause difficulties communicating with others.

But if we know about a child’s hearing difficulties, there are lots of things we can do to help. When we understand a child’s hearing difficulties, everyone can work together to help them achieve their potential.

4/10 young adults who have a learning disability also have permanent hearing loss

Signs of hearing difficulties to look out for

The behaviours below can indicate a problem with the ears or hearing. It is also possible that they could be explained by a child’s learning difficulties. But it is worth having a hearing check to rule out any problems, particularly if it is noticed for the first time or it is a change from their normal behaviour:

• Does not respond when called by name.
• Watches faces intently.
• Appears to hear some voices better than others (e.g. low- or high-pitched).
• Sits close to the TV or turns the volume up.
• Loud noises upset them.
• Is startled by people approaching from behind who they haven’t seen/heard.
• Speaks or vocalises very quietly or loudly.
• Breathes through their mouth and has a ‘blocked nose’ most of the time.
• Has discharging ears and/or ears have an unpleasant smell.
• Frequently rubs their ears.

Getting a hearing test

How will the hearing test go?

There are lots of different hearing tests, and the ones used will depend on your child’s age and stage of development. It’s likely that several different tests will be done to get a clear picture of your child’s hearing.

Some tests measure how well the ear, and hearing nerve between the ear and brain, are working. They don’t require your child to show that they have heard the sound. Other tests involve the audiologist recording your child’s response to sound. This might be a startle, look or head turn, or they could move a toy or clap when they hear a sound.

It’s possible to test the hearing of all children from birth, and you may remember having a newborn hearing screen done shortly after your child was born. Even if your child has had this check done, a hearing loss can develop at any time. It is worth having a further assessment later.

Hearing tests may be carried out in your child’s school, but if they aren’t, then your school or GP can refer you to your local audiology service.

Ask your audiologist to share with you a plain English, written report of your child’s hearing, with any hearing difficulties explained in language you and your child’s teachers can understand.

How can I support my child to have a hearing test?

It’s often assumed that children with a learning disability, autism or both are unable to perform routine hearing tests because they don’t understand what’s expected of them or won’t cooperate. In practice, an experienced paediatric audiologist should be able to assess the hearing of all children from birth.

Every child is different, but often the most challenging and time-consuming activity is to introduce the hearing tests in a way that reduces anxiety and establishes trust. Some children may need to get used to the audiologist, clinic and procedures very gradually, including getting used to having their ears touched, and so on. Sometimes this can mean a series of different types of tests over a period of time, in order to build up an accurate picture of their hearing.

Questions to ask before your child’s appointment

Before your child’s first appointment, talk to the audiologist about what you can expect so that you can prepare your child. Prepare a list of questions that you would like to ask beforehand. For example:

• Do they have any leaflets or videos of children having hearing tests that you can show your child?
• Can I take a favourite toy that could be used as part of the hearing test?
• How long will the appointment take? (Should I bring a drink and snacks?)
• My child won’t wear headphones – will you be able to test their hearing?

How to help your child prepare for a hearing test

You can practice playing simple games with your child to help them prepare for a hearing test. Playing these games teaches your child to wait and listen for a sound and then perform an action. If your child does well with a particular toy at home, you could take it with you to the clinic.

Choose a toy that your child enjoys and that they can perform an action with. This could be dropping balls into a bucket, building a tower of blocks, or hitting a drum.

• Put the toys in front of your child.
• Instruct your child to ‘wait’ and ‘listen’ until you make a sound such as a clap, bang a drum, or say “go”.
• Show them the action you want them to do when they hear the sound (such as moving their hand with the ball to drop it in the bucket) and keep repeating the sound and action together until they do the action on their own.
• Repeat until your child waits, listens and performs the action in response to each sound you make.
• If they do this well, you can try this game sitting or standing behind them so they cannot see you make the noise. You can also try making the sounds louder or quieter.

Help for your child’s hearing

If your child does have hearing difficulties, there is support available and lots of things that can be done to help. Your audiologist may recommend hearing aids. They will continue to monitor your child and refer to other services if needed.

Hearing care could include:

• Training in good deaf awareness for school staff.
• Support from a specialist Teacher of the Deaf.
• Changes to teaching, learning and support strategies.
• Assistive listening equipment.
• Improving acoustics to create good listening environments.

Where can I find out more?

Talk to your child’s school, GP, Health Visitor, or paediatrician about any concerns you have about your child’s hearing.

National Deaf Children’s Society have information on hearing tests, types and causes of deafness, and support on their website.

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