Joint Audiologist – Educational Audiologist service

This is a clinic is run in conjunction with the Hearing Support Service. The clinic has both a Paediatric Audiologist from the Hospital and an Educational Audiologist from the local Authority. The role of this clinic is to see children who have an educational significant hearing loss. This could be sensory neural or conductive and are supported in preschool or school by the hearing support team.

Joint service of Ear, Nose and Throat, Audiologist and Educational Audiologist

This is a multidisciplinary clinic based in the audiology department but headed by an Ear, Nose and Throat (ENT) consultant with a Paediatric Audiologist and Educational Audiologist. This clinic is run for children and babies who have been newly identified as having a permanent hearing loss or have a hearing loss and require further medical support.

Tinnitus and sound sensitivity in children

Tinnitus is the sensation of sound when there is no external source. It can present as a range of different sounds and may be heard in the ears or within the head. It is a common occurrence in adults and overtime we are realising it may be just as common in children as it is in adults.

Having tinnitus does not usually mean there is a problem with the hearing system, but the audiology team can complete a hearing assessment to rule out any hearing problems and offer reassurance. If the tinnitus is at all troublesome the team can also provide some child friendly information and advice. We recommend visiting the British Tinnitus Association website for further reading and reassuring children that it is often normal for our ears to make noises.

Sensitivity to sounds is a common occurrence in childhood. Many young children dislike sounds such as hand dryers, hairdryers and lawn mowers. In most cases this improves with time as children get used to noises and gain a better understanding of what the noises are. Some children show an increase in sensitivity to sounds following an improvement in hearing for example when glue ear resolves. This is because things sound louder than usual and this too tends to settle with time. The audiology department can complete hearing tests to rule out hearing loss and provide written information on sound sensitivity in children. For older children who experience sound sensitivity further information and advice can be provided.

Auditory Processing Disorder (APD)

Some children may have normal hearing, but still have listening difficulties and possible APD.  When children have difficulties listening, it is first important for them to have a hearing test to rule out any underlying hearing loss.  Unfortunately, a formal diagnosis of auditory processing disorders in children is a specialized service and not provided by most NHS Audiology Departments including Musgrove Park Hospital.  A small number of NHS centres in the UK offer formal assessments for APD. To our current knowledge these include Great Ormond Street Hospital and the Royal National ENT Hospital in London. If you wish for the child to undergo formal assessments for APD we would recommend that you read the information on the above centre’s websites. Most of these Centres have a strict referral criterion and require that the child have a speech & language – and educational phycology assessment prior to the referral.   GPs, ENT surgeons, educational psychologists, speech & Language therapists, Paediatrician and audiologists can refer to these Centres.  We have collected some general referral guidance and criteria from APD centres which can be seen below. We hope this is helpful in planning further management:

APD centres generally require speech-language evaluation and psycho-educational testing prior to accepting a referral. Referrals without the supporting documents will be rejected.

In children, APD may be associated with conditions such as dyslexia, attention deficit disorder, autism, autism spectrum disorder, specific language impairment, pervasive developmental disorder, or developmental delay.

The criteria for accepting an APD referral usually entails the following:

1. Children must be 7 – 16 years.
2.  The developmental, cognitive, speech and language ability of the child should be a minimum age of 7 years.
3. There should be a suspicion of APD by an educational and healthcare professional.
4. The child should have normal hearing thresholds in both ears with normal middle and inner ear functions. 

Exclusions:  They do not accept children with:

1) Untreated ADD/ADHD

2) Autism except for high functioning autism

3) Severe speech and language disorder

 4) Cognitive delay (e.g. Down syndrome, certain chromosomal abnormalities) (Non-verbal IQ should not be below 85)

 5) Patient should not have any neurological conditions. If there is language, phonological, cognitive, or other developmental problems these must be assessed first, as the above can adversely affect the outcome of the APD tests making interpretation difficult.