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Caring for Your Child’s Hearing

Children’s Services

Children under the age of 4 in need of a hearing test are required to book an appointment at either our Clayton or Brighton clinic only.

Children over 4 years old are able to book for a hearing test at all Victorian Hearing clinics.

  • Visual Reinforcement Audiometry or VRA, is a hearing assessment technique specifically tailored for children from around the ages of 8 months until the child’s development allows for them to be able to move onto Play Audiometry (generally around 2 ½ – 3 ½ years). By assessing how the child reacts to various sounds, the audiologist can determine their hearing levels and identify any possible hearing issue. Children are tested at the frequencies most important for speech development.
  • VRA involves the child sitting on an accompanying adult’s lap and presented with sounds in a soundproof environment. A sound is presented at an audible level and they are encouraged to turn towards that sound. When this occurs, they will be rewarded with a visual stimulus (eg a puppet, animated image on a screen). This test provides an indication of hearing levels in at least one ear. Without the use of headphones, it is not possible to determine which ear is being tested. On occasion it may be possible to obtain individual ear information.
  • Play audiometry is a hearing assessment method used to determine a child’s hearing levels in a playful and interactive manner, using games and activities to engage them. These activities can include stacking blocks, putting objects in a container or clapping hands. A variety of sounds are played through headphones (or speakers) at different frequencies and volumes. The child is encouraged to respond when they hear the sound
  • Pure tone audiometry is the commonly used test of hearing ability in both adult and older paediatric populations. The test involves listening for a range of tones at different pitches and volumes. The older child will be asked to respond when they hear the sounds. The response can be as simple as raising a hand or pressing a button. The volume of the tones will continue to drop until just heard, which indicates to the audiologist the child’s hearing thresholds (ie. the softest sounds they can hear repeatably).

For all the paediatric testing methods, the audiologist will record the child’s responses to create an audiogram – a graphical representation of hearing thresholds at various pitches. This and an accompanying report will be provided to a referring Doctor, other Specialist involved in the child’s care and/or parent/guardian, on request.


Tympanometry is an objective measure of middle ear function, and of how mobile the eardrum is.

A small rubber tip is placed into the ear canal, and a small amount of air is pumped into the ear to measure the mobility of the eardrum, the amount of pressure behind the ear drum, and the volume of the middle ear space. This test can detect whether there is fluid behind the eardrum; a perforation of the eardrum; Eustachian tube dysfunction; a grommet insitu or blocked, causing or exacerbating hearing loss.

All paediatric services at Victorian Hearing are administered by experienced audiologists who have extensive training in assessing the hearing of children of all ages.

Speech Discrimination Testing: Speech discrimination testing is used as an additional tool to support the audiogram results. For this test, the child is asked to either repeat single words which are presented through headphones or identify familiar objects without headphones (known as the Kendall Toy Test). The Kendall Toy Test (KTT) is a test which assesses a child’s ability to correctly identify specific items which are spoken at a minimal voice level, usually 35-40dB(A), with all visual cues removed.

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