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Paediactric Process


Paediatric Process

Typically children need to be assessed with a so called battery of tests. As your child grows and is able to participate more in the testing procedures regular re-testing will be required. It is of critical importance to assess your childs hearing and intervene with appropriate measures as early as possible.

Your childs hearing assessment can start as early as one week after birth, just when we can be sure, that they middle ear is free of fluids.

Generally we are assessing two different things, your childs hearing and general central automation and central auditory processing (age appropriately).

Typically first tests would be a tympanometry to assess the function of the middle ear and if there is no problems follow up with an OAE (OtoAcoustic Emission) test.

OAE tests your childs cochlear functions by sending a signal into the cochlear and measuring, with a very sensitive microphone, the sound the cochlear makes processing this signal. The absence of such a noise indicates that there might be a problem in your childs cochlear functions associated with outer hair cell loss.

In such a case the next step would be to an ABR (auditory brainstem response) or ASSR (auditory steady state response) tests.

These tests assess the complete pathway of sound and are the most conclusive and definite at early childhood. Small electrodes are places on your childs scull and neck (this is not painful) your child than will hear some signals presented via small loudspeakers inside the ear and the electrodes will pick up any brain activities, which may be associate with your child having heard these signals.

To avoid artefacts and increase the accuracy of such a test your child may need to be mildly sedates so she/he can sleep through the whole process.

Typically the results will then be backed-up by your observation on how your childs react to sounds and play or visual reinforced audiometry in a clinical setting. All of these tests are performed in sequence and might be repeated several times to insure the accuracy of the results.

As your child matures these tests need to be regularly repeated to ensure the accuracy and monitor any changes in results as well as include subjective tests one your child can provide reliable feedback on her/his hearing experience. These new and additional information is very important to update and fine tune your childs hearing devices.


There are 3 equally important parts of after care for your child with Hearing Aids or Cochlear Implants; General Central Auditory Development, Acquisition of Language and Vocabulary.

Normal auditory development starts in the mother’s womb at around week 26 of pregnancy. Until your child got his/her hearing aids or CI’s he/she didn’t hear enough and thus didn’t follow a normal auditory development. Even once your child got the best devices the input to the central auditory system still will not be 100 % normal.

Your child needs special help in compensating for the delay and reduced input.

To provide additional necessary input to your childs central auditory centres special Auditory training, training devices and software applications are available.

These trainings will help your child to automate the whole hearing process reducing the strain on concentration. Additionally special part of these training will concentrate to help with the difficult tasks of hearing in noise, directional hearing ability and the ability to discriminate speech prosody and let you train your childs ability to understand plosives.

Accurate and automated hearing is a prerequisite of clear speech production and also of academic success. Additionally your child will need the family to help with the acquisition of normal speech and vocabulary with the help of professionals in this field. For further information follow this link.