Paediatric Audiology - Manchester Royal Infirmary

What is the Children’s Hearing Service?

The Children’s Hearing Service (or Paediatric Audiology) is available for babies, children and young people in Manchester where there is a concern about their hearing or a known hearing problem. It offers a comprehensive and specialist clinical service to diagnose and help babies, children and young people with hearing loss.

A hearing problem is not always obvious, particularly in young children. There are different degrees and types of hearing impairment. Although a child may respond to some sounds around the home, they may not be able to hear all the sounds that they should be hearing.

A child may not respond to some sounds around the house e.g. a key turning in a lock, creaking floors, or a door opening.
A child may have difficulty hearing you when you are out of sight.
A child may not respond to quiet sounds but respond to loud sounds.
A child may have more difficulty hearing in noisy places.
A child’s behaviour may alter, becoming more disruptive or naughty.

The level at which a child can hear plays a major role in their development and their ability to develop good speech and language skills.

All babies born in England are offered a hearing screen shortly after birth. A clear response on the hearing screen means that there is unlikely to be a hearing loss that will significantly affect the development of speech and language. This hearing screening test will allow those babies who do have a hearing loss to be identified early. Early identification is known to be important for the development of the child. It also means that support and information can be provided to parents at an early stage.

Who is the service for?

The Children’s Hearing Service is a service for babies, children and young people who:

need a hearing test because of concerns about their hearing or development
have a known hearing loss and need help and support

The service receives referrals from any professionals in contact with children and young people where there are concerns about the hearing. We are also happy to see children at the request of parents if your child has previously been seen in the department and discharged but you have concerns.

Who’s on the team?

The service is part of a local team of a range of different professionals working with children. The team includes:

Clinical scientists
Audiologists
Consultant community paediatricians
Audiological physicians
Specialist speech and language therapists
Teachers of the Hearing Impaired
Ear, Nose and Throat (ENT) doctors

What services are provided?

Services offered include:

Specialist hearing assessment from newborn babies to adolescents
Fitting of hearing aids
Evaluation of progress with hearing aids
Assessment for cochlear implantation and other specialist hearing aids as appropriate

Our aim

To provide you with an excellent service to meet your individual needs
To give you individual attention
To offer you access to any service within the department
To offer you a suitable appointment date
To make every effort to see you for an appointment on time
To be available to you should you or your child need advice or reassurance
To provide support when you are coming to terms with a hearing loss
To offer you help if a hearing loss causes problems when yours or your child’s lifestyle changes
To ensure you and your child feel confident and happy using a hearing aid

The Paediatric Audiology Service follows national guidelines and recognised best practice whilst also meeting the individual needs of children and their families. We involve parents in the decision making for their child and in the development and improvement of our services.

We are also actively involved in the Children’s Hearing Services Working Group (CHSWG) for Central Manchester that works to promote the development of all services to support children and their families.

What parents say about our service

“Clinical staff were very warm and welcoming and information was communicated at every step which made me feel inclusive. Thank you.”

“I was pleased with the service given.”

“We were given lots of information and our concerns were dealt with.”

Glossary of Terms

Auditory Brainstem Response (ABR)

A small earphone plays clicks into the baby’s ear. If the baby can hear the click we can measure the response of the auditory (hearing) nerve from sensors placed on the baby’s skin. Different sounds may be used to test the different pitches separately. The sounds can be made quieter or louder to estimate the quietest sound your child can hear.

Otoacoustic Emissions (OAE’s)

A small soft earphone plays clicks into the baby’s ear. These travel through the middle ear to the cochlea (the hearing organ). If the sound reaches the hair cells in the cochlea and the hair cells are working well they respond by sending a sound back to the ear-canal. This is detected by a microphone.

Play Audiometry

This is where your child is asked to put a man in a boat or a ring on a stick when they hear the sound. We can play sounds through small speakers in to the room which tests both ears working together (soundfield testing), through earphones to test each ear separately, or through a box that vibrates on the bone behind the ear sending sound straight through to the hearing organ.

Speech Testing

Where your child is asked to point to different toys (or pictures) by a recorded voice at different loudness levels.

Tympanometry

This test tells us how well the middle part of the ear is working. A soft tip is placed in the ear for a few seconds. This test can help find out if there is any fluid or congestion in the middle ear. Congestion such as this is often known as “glue ear”.

Visual Reinforcement Audiometry

Where your child turns to see a moving puppet as a reward when they hear the sound. We can play sounds through small speakers into the room which tests both ears working together (soundfield testing), through earphones to test each ear separately, or through a box that vibrates on the bone behind the ear sending sound straight through to the hearing organ.

Frequently Asked Questions

How can I get an appointment?

If your baby has been referred from the newborn hearing screen, you will automatically receive an appointment.

If you have concerns about your child’s hearing you can go to your family doctor or health visitor and ask them to refer your child for a hearing test.

If you are new to the area and your child has a known hearing loss and wears hearing aids, you should ask for your family doctor to refer to us so that we can continue to monitor your child’s hearing and progress with hearing aids.

How long will I have to wait for an appointment?

You will be offered an appointment for your child within six weeks of us receiving the referral. We aim to find out what your child can hear as quickly as possible. Often we can do this in just one appointment but sometimes it takes a number of appointments before we can get all the information we need.

What will happen when I have my appointment?

At the first appointment we will test your child’s hearing. We will explain the results with you and talk about what they mean for your child and their development.

If your child has a hearing loss we will talk about the options that are available and how they can help. We will then agree the next step with you and set a care plan. This will include your child’s specific needs and what we have agreed to do to address them. Sometimes we can decide to monitor your child’s hearing and progress. Sometimes we need to do something to help your child hear better and this can include having a small operation (grommets) or wearing a hearing aid. We may also talk about using sign language to help your child communicate. The options available will depend on your child and the cause of the hearing loss.

You will always receive a letter after your appointment with us. This summarises what you told us at the appointment, the test results and what they mean and the plan that we agreed for you and your child. We copy this letter to your family doctor, your health visitor or your child’s school nurse and to any other people your child sees.

We offer appointments at both Manchester Royal Infirmary and Royal Manchester Children’s Hospital. If you receive an appointment from us, it is important to check the appointment letter for details of where the appointment is.

Can I bring my child's siblings to the appointment?

It is always best to try and make alternative arrangements for your child’s siblings. To test the hearing we need the test room to be very quiet and to have as few distractions as possible. If you cannot arrange for anyone to look after your other children we will try our best to ensure everything runs smoothly.

What do I do if my child is ill on the day of the appointment?

If your child is unwell, please phone the department and let us know as early as possible. We can then change the date of the appointment for you.

What if my child has a hearing loss?

If your child has a hearing loss we will discuss the best ways to help your child with their hearing. We will also carry out further testing as needed to get as much information as possible about your child’s hearing.