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Paediatric Audiological Services

Visual Reinforcement Audiometry (VRA)

Sounds of different intensities and frequencies will be presented through speakers or ear phones. The child will be trained to turn towards the direction of the sound and will be rewarded by visual reinforcements such as toys and/or videos. VRA is usually used for young children between the ages of six months and three years old.

Play Audiometry

The hearing levels of children aged between three and five years old can be tested using play audiometry. Whenever the child hears a sound, he/she will carry out a simple task using toys to show his/her response.


Tympanometry (or Impedance/Immittance Test) assesses the child’s middle ear function by measuring the movement of the eardrum in response to changes in pressure. The results can tell us if the child has any middle ear issues such as otitis media or a perforated eardrum.


Auditory Brainstem Response (ABR) and Steady State Evoked Potential (SSEP) test records hearing levels objectively without needing the child to respond. These tests are administered when behavioural hearing results cannot be obtained or when newborns do not pass their hearing screening. In these tests, sounds are presented via ear phones and responses are measured through recording pads attached to the child’s head. The entire test battery may take up to 3 hours. As the tests are sensitive to noise, the child is required to sleep.

OAE Test

Otoacoustic Emission (OAE) test measures hair cell function in the cochlea. The cochlea’s responses to sounds are recorded using an ear tip inserted into the child’s ear. This test requires the child to stay still and keep quiet for at least a minute as movement and noise can affect the accuracy of the test.

Bone Conduction Test

This test involves placing a vibrating conductor behind the child’s ear, which transmits the sound directly into the inner ear. It can assess how well the inner ear and hearing nerve are working and determines the type of hearing loss that the child has.

Speech Perception Test

Speech will be presented either though speakers, ear phones or live voice. The child is required to repeat the word or point to an item or picture that corresponds to the word. This test gives us information on how well the child can understand speech without any visual cues (e.g. lip reading). 


Central Auditory Processing Disorder (CAPD) refers to difficulties experienced with the processing of sound despite the ear being able to detect sounds at normal levels. Specifically, it refers to difficulties experienced with attending to, discriminating, recognizing or understanding audible signals that cannot be attributed to either impaired hearing sensitivity or intellectual impairment. At the Centre, a detailed diagnostic assessment can be done to ascertain if the child has any central auditory processing disorder.