What to expect during an appointment

Paediatric Audiological Assessment

Hearing assessment for children with a developmental age of 4-7 years old are conditioned to perform a task in response to sound presentation. The child will be required to wear headphones and will be taught to put a peg in a pegboard or playing a game. Older children will have their hearing tested like an adult (see below). A test will also be performed on each ear to determine the functioning of the middle ear system. This is done by inserting a rubber tip into the ear and altering the pressure in the ear canal, which does not cause discomfort. Further tests, including speech audiometry, may also be performed.

Patient info sheet on hearing test for child

Adult Audiological Assessment

Older children and adults will listen to a range of sounds through headphones and will be asked to press a button to indicate when they hear the sound. Another test may be performed where a small box is placed behind the ear to test another hearing pathway. Speech audiometry may be conducted to determine how well you can hear and understand speech. A test of middle ear function will also be performed, which involves placing a rubber tip into the ear and altering the pressure inside the ear canal. A series of loud beeps will also be presented, but this test does not require any participation. Other objective tests, such as otoacoustic emissions testing and auditory brainstem response testing may also be conducted.

Patient info sheets on 1) hearing test for adult & 2) ABR

Vestibular Assessment

The standard test procedure includes a range of different assessments, including:

Vestibular Evoked Myogenic Potentials (VEMP): These tests use some small surface electrodes positioned around the patient’s neck and face to measure responses from certain parts of the vestibular system.

3D video Head Impulse Test (vHIT): The patient is asked to wear a special set of goggles that have small cameras mounted on them, which are designed to monitor eye movements. The clinician performs small but quick movements of the patient’s head to measure a balance reflex that can be seen in the eyes.

Oculomotor, Gaze, Positional and Caloric tests: The eyes play an important role in our balance system. Therefore, most of the tests are conducted using goggles which have cameras mounted on them to record the patient’s eye movements in different test settings. During these tests the patient is asked to: 1) follow moving visual targets, 2) look in certain directions with the lights on/off, 3) keep their eyes open in the dark in certain head positions and 4) may have warm and/or cool water delivered into the ears.

Dix-Hallpike Test: Wearing the same goggles, patients are quickly moved into a position to have their head hanging on one side, and then the other side, while measuring their eye-movements. This test is to determine if they have a particular type of positional vertigo called BPPV. If this test is positive, repositioning manoeuvres can be performed.

Subjective Visual Vertical (SVV) Test: A test that assesses the patient’s perception of verticality. It involves placing googles over the patient’s eyes and having them rotate a luminous line (in complete darkness) into a vertical position.

Patient info sheet on vestibular function tests