Children’s Community Audiology

The service offers assessment for any child where there are hearing concerns. We provide hearing assessments for children, using techniques that are age and developmentally appropriate.

Many of the children that we see have a temporary hearing loss caused by congestion behind the eardrum (‘glue ear’). We can monitor the hearing of these children and refer on for intervention if necessary. We also provide specialist care for children with permanent hearing loss. These children are seen regularly for monitoring and hearing aid support. Our specialist paediatric audiologists work with hearing support teachers from the Sensory Support Services, and paediatric hearing aid audiologists from the Royal United Hospital, Bath.

Many of our children are first seen as babies, following identification of a hearing loss by the Newborn Hearing Screening Programme. For other children, a hearing difficulty becomes apparent when seen in clinic as an older child.

We review and monitor children with known hearing loss, with or without hearing aids. We are also pleased to support children with permanent hearing loss who have moved in to the area from another audiology service.

We can see any child whose family doctor is in: Bath & North East Somerset, Frome and Shepton Mallet, in East Mendip, North West Wiltshire (Malmesbury to Warminster and Bradford-on-Avon across to Devizes).

Referrals must be made using our audiology referral form and are accepted in the post or by email.  If you have any concerns about a referral, please do contact us directly.  Before a referral is made, please:

• Check ears for occluding wax (refer to ENT for removal)
• Ensure ear infections are documented and appropriately treated (refer to ENT if >6 infections per year)
• Ensure no sudden hearing loss (see guidance for urgent cases in referral criteria below)

• GP
• Health Visitor, School Nurse
• Speech and Language Therapist
• Paediatrician (community or hospital based)
• Other health or education professional

A parent/carer wishing to discuss a self-referral to our service, can get in touch with us directly

When to refer

• Sudden hearing loss (over a period of 72 hours or less) in one or both ears in child younger than 5 years. Refer within 24 hours of onset
• Parental concern about persistent reduction in hearing (ongoing for at least 1 month) in one or both ears
• Nursery/ pre-school/school concerns about hearing
• Known hearing loss or history of medical condition associated with hearing loss
• Significant and sustained speech and language delay
• Concerns with listening: easily distracted by other auditory or visual cues, difficulty listening in background noise, slow or delayed responses when spoken to, misunderstanding or mishearing what is said, frequently requesting repetition

When not to refer:

• Recurrent ear infections- instead refer to ENT
• Sudden hearing loss if the child is 5 years or older (refer to ENT)
• Occluding wax- instead follow local guidelines or refer to ENT
• Mild or recent speech concerns with no other symptoms- instead refer to Health Visitor or Speech & Language Therapy
• Speech delay in a child under 18 months of age- instead advise family to contact Speech Language & Therapy for advice

All referrals are reviewed by a clinician and triaged into an appropriate clinic, usually within 3 days.

Parent/carer will receive a call to arrange an appointment.   If we are unable to contact you, we will advise you to contact our team to arrange an appointment.

An appointment letter is sent out in the post and a text message reminder will also be sent.

Your child will be seen by a Specialist Paediatric Audiologist and in some appointments, an Associate Audiologist will support.

Pictures of the faces your child might see can be found in the coming to the audiology clinic story.

Explain to your child that they are going to have their hearing checked and will be playing some listening games

Encourage your child to become familiar with headphones if you have them at home. It is helpful to practice putting them on with your child if they are happy to do so

Arrange to attend without siblings where possible

Avoid bringing your child if they are poorly (e.g. with a very heavy cold, contagious illness such as chicken pox, a sickness bug or symptoms of coronavirus). Please get in touch to cancel and rearrange their hearing test. Food and drink should not be brought into the test rooms. Also, if possible your child should take their dummy or soother out during the hearing test.

Allow plenty of time for travelling to the hospital and parking (if you are driving). If you are late for your appointment we may have to rearrange it and see you on another date.

Advise us before your appointment date if you are unable to attend or if you need an interpreter or any special assistance for your child’s appointment.

Going to the audiology clinic – a story for children

Please click HERE to download a story, aimed at children, which explains what happens at the audiology clinic. It can be useful for children and their family to find out in advance about what they will see and do during an audiology appointment, especially if they are feeling anxious. The story aims to prepare your child for their visit, including pictures of where to go, who you might meet, and what to expect.

• Arrange to attend without siblings where possible
• Avoid bringing your child if they are poorly (e.g. with a very heavy cold, contagious illness such as chicken pox, a sickness bug or symptoms of coronavirus).  Please get in touch to cancel and rearrange their hearing test
• Food and drink should not be brought into the test rooms
• If possible your child should take out their dummy or soother out during the hearing test
• Allow plenty of time for travelling to the hospital and parking (if you are driving).  If you are late for your appointment we may have to rearrange it and see you on another date
• Advise us before your appointment date if you are unable to attend, require an interpreter or any assistance for your child’s appointment

Before we assess your child’s hearing we will ask you some questions about your child, including:

• Your observations of your child’s hearing
• Your child’s perception of their hearing, if appropriate
• Observations of your child’s hearing from anyone else involved in their care
• Concerns you may have about their hearing or speech
• Your child’s understanding of speech
• Your child’s general development and health
• Your child’s medical history
• Family history of hearing loss

We use a range of hearing tests to measure children’s hearing and will decide which ones to use depending on your child’s age, development, and the type of concerns raised about their hearing.

Young babies are often tested whilst they are sleeping – if we would like your child to be asleep for their hearing test we will explain this in your appointment letter. Once a child is 8 months old, we usually like them to be awake and alert for their appointment. Our assessment usually involves looking at their reactions to sounds or playing a game with sounds.

The hearing tests measure how the different parts of the ear (outer, middle and inner ear) respond to sound. The response to sound is measured at different frequencies (pitches). We may use different methods such as loudspeakers, headphones and a bone vibrating headphone to measure your child’s hearing. For more information about hearing tests for babies and children please ask a member of our team for details.

Your audiologist may recommend that you read some leaflets as part of your child’s care plan. Please download and read the leaflets relevant to your child and show them to other people who look after your child. Please let us know if you would like us to send you a leaflet in the post or you require a different format or language.

At the end of the appointment we will discuss the results with you and agree a care plan for your child. We will give you time to ask questions. Please let us know if you would like a copy of your child’s hearing test results or care plan.

Discharge– if your child’s hearing is satisfactory, they will be discharged from the audiology service.

Recall– if enough information has not been obtained in one session, a further appointment may be arranged to get more information.

Review– if your child has a temporary hearing loss likely to be caused by congestion (glue ear or otitis media with effusion) we will discuss this with you and arrange to review their hearing and discuss management options.

Monitor – if your child has a permanent hearing loss, we will discuss this with you and arrange to regularly check their hearing and communication development. We will discuss different management options with you including hearing aids.

Onward referral– with your agreement, we may refer your child to other health and education professionals such as:

Ear, Nose and Throat (ENT) at the hospital for consultations and surgical management Local hearing aid Audiology Team for hearing aid management Paediatrician to investigate possible causes of hearing loss Hearing Support Team to provide educational support for your child.

Sensory Support Teams

All babies. children and young people identified as having a permanent bilateral hearing loss will be offered support from the Hearing Support Team based within the Sensory Support Service which covers the area where you live. This is part of the Education Service and the Hearing Support Teachers (HST) within it are qualified Teacher’s of the Deaf (ToD).

Your local team can provide information and help on many issues concerning hearing loss in children, including language and communication support, hearing aids, parenting a deaf child and educational support.

• B&NES, Bristol, South Glos and N. Somerset: Elmfield House, Greystoke Avenue, Avon, Bristol BS10 6AY t: 0117 903 8441 w: sensorysupportservice.org
• Wiltshire: 2nd Floor, SEND, Wiltshire Council, County Hall, Trowbridge BA14 8JN t: 01225 718095 w: www.wiltshirelocaloffer.org.uk/hearing-impairment
• Somerset: 01823 334475 e: SSE.SEN@somerset.gov.uk w: supportservicesforeducation.co.uk/Services/3325

Speech and Language Therapy

• B&NES
  • t: 01225 831 708 Telephone Advice line: 01225 831 752 (speak to a therapist: Wednesdays, 1.00pm – 4.00pm, during term time)
  • e: BATHNES.SLTadviceline@virgincare.co.uk
  • w: https://bathneshealthandcare.nhs.uk/childrens/speech-and-language-therapy/
• Wiltshire
  • t: 0300 237 0090
  • e: vcl.wiltshirespa@nhs.net
  • w: https://wiltshirechildrensservices.co.uk/our-services/speech-language-therapy/

The National Deaf Children’s Society

The leading charity dedicated to creating a world without barriers for deaf children and young people. NDCS also runs local support groups (including groups in Chippenham and Bristol) where parents find it helpful to meet other families with children who have a diagnosis of hearing loss.

t: 0808 800 8880

w: www.ndcs.org.uk

Hearing Heroes Deaf Children’s Society

Hearing Heroes is a parent led charity supporting deaf children and their families in Chippenham and West Wiltshire. They are a group of parents who aim to provide a support network for other parents of children with all types of hearing loss / deafness.

To find them, you can search for ‘Hearing Heroes Children’s Society’ on Facebook or click on this link https://www.facebook.com/groups/122953415825823/

Bristol Deaf Children’s Society

Bristol Deaf Children’s Society aims to provide a support network for parents of children with all types and levels of hearing loss. You may wish to use the group to ask other parents for advice, organise informal meet ups, celebrate your child’s successes or share tips that you have found useful. The group is run by a committee of parent volunteers.

To find it, you can search for ‘Bristol Deaf Children’s Society’ on Facebook or click on this link https://www.facebook.com/groups/1083505435078936/

Rainbow Resource

You can access information on what services children, young people and their families can expect from a range of local agencies – including education, health and social care providers and voluntary organisations using the Bath and North East Somerset Local Offer website – the Rainbow Resource.