Useful tools for working practice


Speech-discrimination testing is an essential part of hearing-aid evaluation for confirming which speech sounds are heard and recognised through modern signal processing hearing aids.

Traditionally in the UK there have been few speech tests available, and these may be too easy or too difficult, depending on a child’s word-recognition ability. New speech tests with more refined speech acoustics and vocabulary are needed to meet a wider range of performance in speech recognition.

The Consonant Confusion Task (CCT) and the Revised Auditory Performance Task (RAPT) are two monosyllable, closed-set speech tests. The CCT is more appropriate for younger children (from about 3 years of age) whereas the RAPT can be used from about 5 years.

Currently these tests are supplied as books of the stimulus pictures with a response sheet. The test material comes on a CD with a calibration tone and six different orderings of the test words. Testing is also possible using speech-shaped noise that has been recorded onto a second channel for speech-in-noise testing.

If you would like to order the CCT or the RAPT tests, please email or download the order form below.

Speech Test Order Form
Speech Test Information


The Auditory Skills Checklist, developed by the Cincinnati Children's Hospital in collaboration with the Center for Hearing and Deafness Research and the University of Cincinnati, is a useful evaluation tool for young children. It is designed for use by an audiologist or therapist using observational input from the family, and can be used to assess the listening skills we might expect a child to have by the time they start school. 


Josephine Marriage runs courses on different aspects of audiological management, at the London centre, in NHS hospitals or in clinics around the UK. These can be arranged around specific learning needs and services and in collaboration with other agencies.

Chear has contracts with three South London NHS trusts for prompt individualised intervention for cases of diagnosed sensorineural hearing loss. Josephine is doing monthly clinics for Barts Hospital NHS trust at Chapel End Audiology Department.

School Screening

Chear now provides hearing screening at schools, using portable audiological equipment. We know that temporary deafness caused by persistent glue ear can cause delayed speech development in young children and affect children’s behaviour and educational progress.  There is also known to be a link between recurrent glue ear and Auditory Spatial Processing Disorder.  Furthermore, certain types of sensorineural deafness will not necessarily be picked up during a newborn hearing screen – including cases of progressive hearing loss; or acquired hearing losses as a result of illness or injury.  Despite this, there is no currently specific national standardisation of the School Entry Hearing Screen.

Screening is advisable for children in school years between reception and year 2 whilst children are most susceptible to middle ear infections.

For more information about school screenings, please contact Emma Whiting at


Research studies are an integral part of the Listen & Talk As One initiative, a collaboration between Chear, AVUK and Phonak.

Current research:

Social pragmatics in teenagers: the response of adolescents to hearing aids and hearing-aid technology

If you are aged between 8 and 23 years and wear one or two hearing aids, we would be delighted if you could share your experiences by filling in our Listening to Young People With Hearing Loss survey at The survey is anonymous and takes about 15 minutes to complete.

Listening to music through hearing aids: how can it be improved?

We are always very grateful for the help and commitment of families and children to our research. Without them we would be unable to develop strategies of hearing-aid amplification. This can also lead to the development of new materials for use by clinicians in audiology. If you are interested in volunteering for one of our studies, please contact Emma Whiting at

Previous research:

Josephine’s previous research includes: new hearing-aid fitting strategies for children and adults, in collaboration with Professor Brian Moore at the Department of Auditory Perception, Cambridge University; new methods for the diagnosis of dead regions in the cochlea; hearing-aid fitting strategies in adults; and the development of new speech-test materials for children and adults.

Josephine’s PhD was on the management of hyperacusis in children with Williams Syndrome and we continue to develop our programme for hearing oversensitivity in children with Autistic Spectrum Condition.

Useful websites

AVUK – a British charity offering hearing-impaired children and babies a unique rehabilitation programme called auditory verbal therapy.

Listen And Talk As One– an initiative of Chear, AVUK and Phonak which brings together the skills of paediatric audiology, listening and spoken language specialists under one roof in the London area.

Elizabeth Foundation – a British charity supporting infants and preschool children with hearing loss and their families.

Christopher Place – a speech and language centre for babies and children under five who have hearing impairment, delay in speech, language and communication or more complex needs.

National Deaf Children’s Society – a national charity dedicated to creating a world without barriers for deaf children and young people

The Ear Foundation – an organisation that bridges the gap between the clinical services where modern hearing technologies are fitted, and home, school and work, where they are used.

Steps2Speech - an independent speech and language therapy practice run by Maria Cameron, a speech and language therapist and teacher of the deaf who is training as an auditory verbal therapist.

01763 263 333
01763 243 546


Josephine is a highly professional audiologist with many years experience in working with children, families and adult clients. Chear represents an extremely valuable resource where clients will find high levels of expertise, professionalism and a friendly and supportive approach
John Bamford, Honorary Professor of Audiology, University of Manchester
Many thanks for a successful appointment in trying to obtain some hearing level thresholds for Louie. You did it! You were both so fantastic, so patient and so informative. Thank you. You are so skilled at what you do.
James and Rebecca, parents of Louie, 5 months