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Mitch Adair

Hearing tests for kids!

I first started working with kids about 12 years ago while I was a graduate audiologist. In the meantime I've had the opportunity to develop my skills and knowledge in this area in a number of private practices around Sydney. In 2017, I opened my own practice in the Lindfield Medical Suites on Tryon Road. I would love to have offered the full range of child hearing tests right away, but I didn't have a sound-proof room... until now!

About a month ago, Lindfield Audiology moved to a custom-built facility equipped with a sound-proof audiology room - the perfect setup for paediatric hearing testing.

How do we test hearing in children?

Behavioural tests

The system we use for testing very young children is called Visual Reinforcement Orientation Audiometry (VROA). VROA is a paediatric hearing test that has been used for over 40 years. At the beginning of the test, we spend some time demonstrating to your child that when they hear a test sound, a cute puppet appears in a light box and starts dancing. After this association has been made, we draw your child's attention to something in front of them, and keep them focused here for as long as possible. With your child focused on this distraction, we occasionally present a test sound, being careful not to visually cue them in any way. When your child turns to look for the puppet immediately after a test sound has been presented, we record this on an audiogram. Over the course of the session, we are able to build an informative picture of your child's functional hearing ability.

This is Walter, our VROA bear. He's an avid reader. You might see him again on this blog doing the odd book review.


For children who are too young to perform an adult hearing test, but too old for VROA, we use Conditioned Play Audiometry. For this test, we create a game in which your child performs a task every time they hear a sound (for example, putting a peg in a board, or dropping a marble into a marble race toy).

In addition to tests of hearing sensitivity (i.e. the audiogram), we routinely use speech discrimination tests to assess your child's functional hearing ability. The results of these tests also serve to cross-check the results we see on the audiogram, further adding to the reliability of the assessment.

Objective tests

During paediatric hearing assessments, we routinely perform tests of middle and inner ear function. These tests are objective, meaning they do not require any response from your child:

  • Tympanometry: no hearing test is complete without tympanometry, as this test gives us essential information about your child's middle ear function and is important as a cross-check for the other tests. We can also infer information about Eustachian tube function from tympanometry.

  • Otoacoustic Emissions: while tympanometry gives us important information about the middle ear, otoacoustic emissions (or OAE's) are a test of the inner ear, or cochlea. Specifically, OAEs are a response from the outer hair cells of the cochlea. OAE testing does not require any response from the child, and are extremely helpful in cases where behavioural testing has not been possible or reliable.

  • Auditory Brainstem Response (ABR): the ABR is an electrophysiological test where we measure the auditory system's response to sound via electrodes on the skin. This test can only be done in a restful or asleep state. Unlike tympanometry and OAE testing, the ABR is not a routine part of our paediatric hearing assessment protocol, but we are able to provide this test if needed.

Medicare rebates available

If you have a referral from your GP or ENT specialist, Medicare rebates are available for all of our t

Please feel free to contact us at 02 9188 9280 or reception@lindfieldaudiology.com.au with any questions.


Working With Children Check Number: WWC0059093E





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