FAQs

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1. Hearing tests for children are available from the National Health Service (NHS). Why have an independent centre?

Fast Access

Often parents are the first people to become concerned about their child's hearing, but it can take time to be seen by the appropriate services within the NHS. You do not need a medical referral to be seen at Chear, parents can request an appointment directly. Appointments can be made within two weeks usually.

Convenience of Appointments

NHS appointments may be restricted to within working hours which may not be convenient for all families. At Chear we are able to offer flexibility in appointment times. There is easy transport access to Chear.

Variability in Paediatric Audiology Services

The precise assessment of hearing in very young children, below the age of 7 months, is challenging. However it is important to give stimulation to the hearing pathways from early life so that the hearing structures become effective in carrying information. The assessment of hearing is built up through a number of different tests to define the type and level of hearing loss. Audiology teams are made up from a number of different professionals, each bringing their own experience and approach to the assessment process. This means that there is great variability between services in the UK.

Chear is the only independent specialised paediatric audiology facility for hearing assessment from birth to adulthood in the UK. We have experience of a large number of young children with hearing loss, ranging from mild to profound.

Follow up from Neonatal Hearing Screening

The process of assessment and hearing aid provision is complex and takes time. Parents may choose to have an independent overview of their child's hearing loss and progress to date. The option of an independent opinion is available for all NHS users. Having a second opinion does not compromise the level and quality of care given by NHS teams. Chear works in close liaison with many children’s audiology services, to the mutual benefit of all partners.

For children who have been diagnosed as having a hearing impairment or the possibility of a hearing loss:

Lack of Cohesion in Management

A child with a recognised hearing loss is typically under the care of several services within health, education, voluntary groups or social services. There may be various approaches to management by different professionals, which can be confusing for parents and other carers. Parents may want an independent opinion about their child's hearing ability and to discuss the options for management.

Independent Opinion on the Child's Hearing Aid Fitting

With the rapid improvement in hearing aids, there are many alternatives to hearing aids that are routinely prescribed for children. Many parents ask whether the hearing aids that their child has give the best access to sound for his/her hearing loss. The digital hearing aids that the NHS supplies for children include a number of high-quality, flexible devices which are fully appropriate for most types of hearing loss. NHS hearing aids can be therefore be set to optimise the hearing aid amplification for an individual child's hearing needs.

Chear has been set up to allow families fast access to specialist children's hearing assessment and review of management choices with appointments as required.

2. My child passed the hearing screen carried out shortly after birth, but I am not sure that he/she is hearing well now. Does the hearing need to be retested?

The hearing screen is an efficient method of picking up many children with hearing loss. However there are some types of hearing problems that it does not pick up. Also, hearing may change over the early months of life, with either temporary or longer term effects.

If parents are actively concerned about their child's hearing, the child should be referred to an appropriate service without delay. Paediatric hearing tests should allow full evaluation of the type and extent of the hearing impairment. This needs to be followed up with appropriate management to improve the child's access to sound and to reduce the impact of the impairment on the child's development. This can be provided through your local audiology service, once the hearing loss has been identified, if appropriate.

3. Is Chear an alternative to our local NHS Paediatric Audiology service?

The aim of Chear is to give parents independent information about their child's hearing loss and options for using the hearing most effectively. This advice allows parents to be informed about and involved in management decisions taken by the child's own audiology service in the NHS.

Additional features of an assessment at Chear include:

A Full Report for Parents, (and other Professionals as Requested by Parents)

In order for families to be part of the decision-making for their child, it is fundamental that a full exchange of information is built into the appointment. Time is given to understanding the family’s perspective and hopes for their child. Also time is taken to explain the test results and the implications of these for speech understanding.

A full report is written, describing the child’s current hearing and development profile, the tests and results obtained in the Chear assessment, including the current hearing aid fitting. These results lead on to recommendations and options for management for the individual child. Parents can ask for the report to be circulated to other agencies involved in their child’s care. If any adjustments have been made to the hearing aid fitting, we are required to send this information, with a copy of the report, to the child’s local audiology service.

Earmould Provision

Well-fitting earmoulds are considered to be fundamental to appropriate hearing aid amplification for children. At Chear we have an on-site earmould laboratory with an expert earmould technician. The typical cost for a pair of soft silicon earmoulds is £45, with a turn around time of less than one week.

Speech Discrimination Testing

There is no alternative to using speech-based testing to monitor a child’s access to speech cues. As part of our research and development programme, in collaboration with Cambridge University, new speech materials are being developed and validated for use to verify hearing aid fittings with different age-groups of children.

Hearing Aid Accessories, Batteries and Loan Hearing Aid Stock

Chear has a range of accessories to help maintain hearing aid use, including puffers, stethoclips, de-humidifiers and earmould tubings. We have a small range of loan hearing aid stock for urgent situations, though usually these would be provided by NHS audiology departments. We also have a number of waterproof hearing aids for loan and/or trial at a cost of £90 for six week period.

Chear does not aim to take primary responsibility for a child’s audiology care from their local NHS provision. We aim to develop a coherent liaison and joint-working with NHS audiology services, based around the individual needs of the child. Many children are seen only once at Chear, while others may choose to have further review appointments, in addition to their local service care.

Children come to Chear from all over the UK and Ireland.

4. Once a child has been seen at Chear will they need to be seen regularly by this team?

It is not always possible to fully define a child's functional hearing status at one appointment, especially when a child is very young, but the aim is to maintain primary audiological management within the NHS system.

Why?

It is better for children to continue under the care of their local audiology and education service provision to maintain a multi-disciplinary team approach at a local level and to give easier access to services. However parents can request further review appointments with Chear and alternative hearing aid management if they wish.

5. How are appointments paid for? How much does an appointment cost?

Typically parents will pay for an appointment with a standard price being agreed prior to the appointment. It is our aim to keep costs at a reasonable level to keep the service accessible. Sometimes funding for an appointment has been arranged through local health or education services.

The typical cost of an appointment in 2006, including the report, is:

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