My Child Failed a Hearing Test – What Happens Next? A Parent’s Guide to Children’s Hearing Tests
Being told that your child has not passed a hearing test can
be unsettling. You may immediately wonder whether your child has permanent
hearing loss, whether their speech or learning will be affected, or whether
they will need treatment.
The first thing to understand is that not passing a
hearing screening test does not automatically mean that your child has
permanent hearing loss.
A screening test is designed to identify children who need a
more detailed assessment. Some children have a temporary hearing problem.
Others may have difficulty completing the test reliably because they are tired,
distracted, nervous or simply too young to understand what they need to do.
However, hearing is important for communication, speech
development, learning and interaction with others, so a failed screening result
should be followed up appropriately rather than ignored.
Mr Gaurav Kumar, Consultant ENT Surgeon, assesses children
with ear and hearing concerns from London, East London, Brentwood, Romford,
Ilford, Redbridge, Chelmsford and the surrounding areas of Essex.
This guide explains what a failed hearing test may mean,
what usually happens next, and when further paediatric ENT assessment may be
helpful.
Why Might My Child Have Had a Hearing Test?
Children may have their hearing assessed for several
reasons.
A baby may have a hearing screening shortly after birth. Older
children may be referred because a parent, teacher, health visitor, GP or
another professional has concerns.
“NHS information about hearing tests”
Depending on local arrangements, some children may also be
offered hearing screening around the time they start school.
A hearing test may be recommended if a child:
- does
not always respond when called
- frequently
says “what?” or asks for repetition
- turns
the television volume up
- appears
to hear better on one side
- has
delayed or unclear speech
- struggles
to follow instructions
- has
recurrent ear infections
- has
suspected glue ear
- appears
distracted in the classroom
- has
difficulty hearing in noisy places
- has
passed a previous test but has developed new concerns
Hearing can change during childhood, so passing a newborn
hearing screen does not mean that every later hearing problem can be ruled out.
What Does “Failed” or “Did Not Pass” Actually Mean?
The wording can sound more frightening than the result
necessarily is.
A screening test is not always a complete diagnostic
assessment. Its purpose is to identify children who may need more detailed
testing.
Your child may not have passed because:
- there
was temporary fluid behind the eardrum
- they
had recently had a cold or ear infection
- earwax
was blocking the ear canal
- they
were distracted or did not understand the task
- the
testing environment affected the result
- there
is a genuine hearing loss that needs further investigation
The next step is therefore usually to confirm whether
there is a hearing problem and, if so, understand its type, severity and likely
cause.
Could a Cold Cause My Child to Fail a Hearing Test?
Yes, sometimes.
Children frequently develop colds and upper respiratory
infections. These can affect the Eustachian tube, which helps ventilate the
middle ear.
Fluid may then collect behind the eardrum. This is commonly
called otitis media with effusion, or glue ear.
When fluid is present, sound may not travel through the
middle ear as efficiently. The child may experience temporary muffled hearing.
This can sometimes be enough to affect a hearing test.
The important point is that not every child with temporary
middle-ear fluid needs an operation. The pattern of hearing loss, duration of
symptoms and effect on the child all matter.
What Happens at a Paediatric Hearing Assessment?
Children’s hearing tests are adapted to the child’s age and
developmental stage.
The audiologist may first ask about:
- your
concerns
- speech
and language development
- school
or nursery observations
- previous
hearing tests
- ear
infections
- family
history of hearing problems
- other
relevant medical history
The ears may also be examined for wax, infection or changes
to the eardrum.
Different hearing tests can then be used.
Behavioural hearing tests
For younger children, hearing may be assessed through play
or by observing a consistent response to sounds.
An older child may wear headphones and respond when they
hear tones.
The aim is to identify the quietest sounds the child can
hear across different frequencies.
Tympanometry
Tympanometry assesses how the eardrum and middle ear are
functioning.
It can provide useful information when glue ear or another
middle-ear problem is suspected.
Other tests
Some children need more specialised tests depending on their
age, development and initial results.
The exact assessment is individualised. A single test result
should be interpreted alongside the child’s history and the rest of the
assessment.
What Are the Common Causes of Hearing Difficulty in
Children?
There are several possibilities.
1. Temporary middle-ear fluid
Glue ear is a common cause of fluctuating or temporary
hearing difficulty in children.
Some children improve with time, while persistent hearing
loss may need further assessment and discussion of management options.
2. Earwax
A significant wax blockage can interfere with hearing or
prevent a clear examination of the eardrum.
Parents should not insert cotton buds, hair grips or other
objects into a child’s ear to remove wax, as this can push it deeper or injure
the ear canal.
3. Ear infection
Hearing may temporarily feel muffled during or after an ear
infection.
4. Eardrum problems
A perforation or other eardrum abnormality can affect
hearing.
5. Permanent hearing loss
Some children have sensorineural hearing loss involving the
inner ear or hearing pathway.
Permanent hearing loss can be present from birth, but some
forms may become apparent or develop later in childhood.
This is one reason why concerns from new parents or teachers should be taken seriously, even if a child previously passed a newborn hearing screening.
What Signs of Hearing Difficulty Should Parents Watch
For?
Hearing difficulty is not always obvious.
Children are often very good at adapting. They may watch
faces, follow other children or use contextual clues.
Possible signs include:
- Repeatedly asking “What?”
- needing
instructions repeated
- turning
one ear towards the speaker
- increasing
the television or tablet volume
- appearing
not to listen
- struggling
more in noisy rooms
- speaking
unusually loudly or quietly
- unclear
speech
- delayed
language development
- falling
behind at school
- becoming
tired after listening for long periods
- withdrawing
from conversations
- frustration
or behavioural changes
These signs do not prove that a child has hearing loss.
Attention, language development and other factors can produce similar
behaviours.
A proper hearing assessment helps distinguish between these
possibilities.
Can Hearing Problems Affect School and Speech?
Hearing plays an important role in how children access
spoken language and classroom teaching.
A child with fluctuating hearing may hear well on some days
but struggle on others. Noisy classrooms can be particularly challenging.
Depending on the severity and duration of the problem,
parents or teachers may notice difficulties with:
- following
verbal instructions
- hearing
the teacher from a distance
- distinguishing
similar speech sounds
- learning
new vocabulary
- pronunciation
- concentration
- classroom
confidence
This does not mean that every child who fails a hearing test
will develop speech or learning difficulties.
It does mean that persistent hearing concerns deserve
appropriate assessment and support.
While waiting for further assessment, simple measures can
help. Teachers and family members can gain the child’s attention before
speaking, reduce unnecessary background noise, speak face-to-face and check
that important instructions have been understood.
When Might My Child Need to See an ENT Specialist?
Not every child who fails a hearing screen needs an ENT
operation or even an ENT appointment.
Audiology is often the first step because it establishes
whether hearing loss is present.
Paediatric ENT assessment may be considered when there is:
- persistent
hearing loss
- recurrent
or persistent glue ear
- recurrent
ear infections
- concern
about the eardrum
- significant
earwax that cannot be managed easily
- ear
discharge
- a
suspected structural problem
- asymmetrical
hearing
- concern
that medical or surgical treatment may be needed
The decision depends on the individual child and the
findings of the hearing assessment.
Will My Child Need Grommets?
Not necessarily.
Grommets are small ventilation tubes inserted into the
eardrum and may be considered for some children with glue-ear-related hearing
loss.
However, a failed hearing test by itself is not an
indication for grommet surgery.
Management may include:
- monitoring
- repeat
hearing assessment
- practical
support at home and school
- treatment
of an identified ear problem
- hearing
support in selected children
- grommets
in appropriately selected cases
The most suitable approach depends on the persistence and
severity of the hearing loss, its effect on the child, examination findings and
family preferences.
Parents should have an opportunity to discuss the expected
benefits, alternatives and potential risks of any proposed intervention.
My Child Passed the Newborn Hearing Test – Can They Still
Develop Hearing Loss?
Yes.
Newborn hearing screening is extremely valuable for
identifying many babies with permanent hearing loss early in life, but it
cannot predict every hearing problem that may develop later.
A child who passed newborn screening may later develop
hearing difficulty because of:
- middle-ear
fluid
- recurrent
infection
- earwax
- eardrum
problems
- certain
inner-ear conditions
- other
less common causes
Parents should therefore seek advice if they develop new
concerns about their child’s hearing, regardless of an earlier normal screening
result.
When Is Hearing Loss Urgent?
Most childhood hearing concerns can be assessed through
routine audiology, GP or ENT pathways.
However, sudden hearing loss is different.
Seek urgent medical advice if your child develops:
- sudden
hearing loss in one or both ears
- hearing
that becomes noticeably worse over a few days or weeks
- hearing
loss with significant ear pain or discharge
- hearing
loss after a significant head injury
- hearing
loss with severe dizziness or neurological symptoms
A child who is very unwell, has severe symptoms or has had a
significant injury may need emergency assessment.
Sudden sensorineural hearing loss is uncommon in children,
but prompt assessment matters because it should not simply be assumed to be wax
or glue ear.
What Can Parents Do While Waiting for an Appointment?
If you are waiting for a repeat hearing test or specialist
assessment:
- face
your child before speaking
- gain
their attention first
- reduce
background noise where possible
- avoid
calling instructions from another room
- tell
the nursery or school about the hearing concern
- consider
preferential seating nearer the teacher
- check
that important information has been understood
- do
not use cotton buds or objects to clean inside the ears
- attend
planned audiology follow-up even if your child seems to be hearing better
Hearing problems can fluctuate, so an apparently good day
does not always mean the issue has completely resolved.
Paediatric ENT Assessment in London and Essex
For families in London and Essex, the most important first
step is understanding whether a hearing problem is present and what may be
causing it.
Mr Gaurav Kumar, Consultant ENT Surgeon, assesses children
with ear and hearing concerns, including persistent hearing difficulty,
recurrent ear problems, glue ear and conditions that may require specialist ENT
management.
Families may attend from London, East London, Brentwood,
Romford, Ilford, Redbridge, Chelmsford and surrounding areas of Essex.
An individual assessment may include review of the child’s
symptoms, ear examination and consideration of appropriate audiology results
before discussing management options.
Frequently Asked Questions
1. Does failing a hearing test mean my child is deaf?
No. A screening result means that further assessment may be
needed. Temporary problems such as middle-ear fluid, a recent cold or earwax
can affect hearing-test results. A diagnostic hearing assessment helps clarify
the cause.
2. Can my child fail a hearing test because they were
distracted?
Yes. Age, concentration, tiredness and understanding of the
task can sometimes affect behavioural hearing tests. Audiologists use
age-appropriate methods and may repeat or adapt testing when necessary.
3. My child passed the newborn hearing test. Why do they
need another test?
Children can develop hearing problems later. Common causes
include glue ear, ear infections and earwax, while some permanent hearing
conditions may also become apparent after the newborn period.
4. Should I clean my child’s ears before a hearing test?
Do not insert cotton buds or other objects into the ear
canal. If significant wax is suspected, seek appropriate clinical or pharmacy
advice rather than trying to remove it mechanically at home.
5. Does my child need an ENT specialist after failing one
hearing test?
Not always. Many children are first assessed by paediatric
audiology. ENT review may be appropriate if hearing loss persists or there is
an underlying ear condition requiring specialist assessment.
6. Will my child need grommets?
A failed hearing test does not automatically mean grommets
are needed. Grommets are one possible management option for selected children
with persistent glue-ear-related hearing loss.
7. Can hearing loss affect my child’s speech or learning?
Persistent or significant hearing difficulty can affect
access to speech and classroom communication. The effect varies considerably
between children, which is why appropriate assessment and support are
important.
8. When should I seek urgent help?
Seek urgent medical advice for sudden hearing loss, hearing
that rapidly worsens over days or weeks, or hearing loss associated with
significant pain, discharge, severe dizziness, neurological symptoms or major
injury.


