hearing loss

[griffalo2]

hi,i have made an appt with gp for tomorrow as I suspect ds(6yrs) has some hearing loss.i have suspected it for about 18months but just thought i was worrying over nothing.
could anyone tell me what the Dr will do tomorrow?just look in ears?will they be able to do test at the surgery?what kind of questions will he ask?

I don't think they will test in surgery, but will refer to ENT. Dr'll probably look in his ears, it may just be glue ear, or even he's stuck something down his ear as a baby. In which case the doctor may be able to see, but actual tests round here would be done at the local ENT department.

ok thank you.can they tell its glue ear just by looking?i don't think he's poked anything inside as he's had his ears checked quite a few times for perforations and infections.although he's not had any for a while.thank god.

The GP should be able to see if he has glue ear (ours describe our ds's as dull and flat when they have glue) or if there is a large amount of wax covering the ear drum (we have used Otrex ear drops with ds1 before to clear it)

Hearing tests in our area are done at an audiology clinic and they refer from there if there is a problem.

Its worth getting GP to note what your concerns are ie whether ds is having any issues at School, if he is you should be asking for support from SENCO (sounds extreme but it can have a profound affect in noisy school environment) and how you have noticed his hearing difficulty

As far as I know glue ear is just wax build up, so should be able to tell a certain amount. That's what they use grommets to help with, and if he has glue ear then ENT should be able to do a hearing test to assess whether grommets would be helpful.

Things to tell the doctor: If he's having hearing/behavioural problems at school, even if it's small then mention it.
Is one ear better than the other.
Does he hear better at times than others (glue ear is often worse in winter)
Is there particular times he struggles to hear eg. lots of background noise
Does he have the TV turned up loud
Does he complain he can't hear.
Is he worse when hearing from behind.
How many infections/perforations has he had this winter/last winter. (they should have this down on records but it's worth mentioning if he's had a lot, ds had 8 perforations last winter after his grommets came out, which is why they were put back in.
Do his ears tend to perforate (that can permanently effect hearing) if they have an infection.

There may be other things that you don't realise is him compensating. The cute little gesture where ds patted my cheek to make me face him when he wanted to talk to me turned out to be him turning my face so he could lip read. I thought he was just trying to make sure he, not his sisters, had my full attention. Stopped when he had grommets in, and returned when the grommets came out. They compensate very well.

Great list from DeWe - so right they compensate well and imo hearing is one of the last things people think of that a child might be struggling with

glue ear isn't just ear wax though, its a build up of fluid in the ear - quite common but for some children it doesn't clear
Glue ear

Also the NICE guidelines for management of glue ear might be helpful if it is that

Hope app goes well x

its going to be hard remembering it all a doctors tomorrow.i will write a list.
yes to one ear better than other,
yes to worse with background noise,
yes to having tv turned up loud,
also complains he can't hear it when i turn it down,
teacher has said he's below average at school,
been seeing speech therapist who says he's behind and also seeing senco for this,
I've recently noticed he looks in different direction for a noise?
he also does the tappy face thing or constantly calls me until i turn around and look at him and looks at my lips when i talk to him.

i should of taken him a long time ago shouldn't i.

Worth looking at NDCS website -- their parents' area has some good downloadable publications on hearing tests and on glue ear.

If tests show glue ear they may want to wait three months and retest before doing anything, so be prepared for that (I don't know how easy it is to talk them out of that if the symptoms have been going on for ages).

If tests show a problem it may be worth asking about referral to local Hearing Impaired Service / Teacher of the Deaf, who can help you and your DS directly and also work with his school on making sure his needs are met (at least in theory).

Did he have a newborn hearing screen, by the way?

thank you Tmesis will check those links out .yeah im pretty sure he had the newborn screen.
Three months seems a long time to wait if he continues to not catch up at school

Yes, exactly, that's why I wanted you to be aware. It might be different in your area, of course.

If he passed the newborn screening then glue ear does sound most likely.

definitely mention about how he is at school, I just got ds's ENT appointment brought forward from June to 6 weeks time based on School report, imo HCP's do take school concerns seriously especially if you have SENCO involved.

Get a copy of the hearing test results to give to SALT and school too

just realised the time.... how was appointment?

just got home from appointment.she is referring him to audiologist.need to wait for letter wit appointment.
she said his ears look ok but something could be happening deeper in where she can't see.she asked him if he could hear her rubbing her fingers together outside both ears and he said no on the oneside.

If the problem is chiefly on one side then there are strategies you could put in place now at home and at school while you are waiting for further assessment/treatment

• position of his chair in school so that his good ear is well-placed to hear important sound and he has a good view of the teacher

• particularly difficult to hear in a noisy background environment, so in those situations make sure that he has a clear view of the speaker's mouth (speaker shouldn't turn away, cover mouth or mumble) and check afterwards that he has heard the message given

• will be difficult for him to work out where a sound/voice is coming from and, crucially, until he's worked out where it's coming from he won't really start processing the content. So instead of saying "DS, will you go to the fridge and fetch the butter, please?" you say "DS" [pause and repeat as necessary until you have his attention and visual contact] "will you go to the fridge and fetch the butter, please?"

• watch out for traffic more than normal, because even if he hears a car he won't know where the noise is coming from so won't be as road-aware

thank you for the advice everybody.
its parents evening tomorrow so can let the teacher know.
does anyone know what tests the audiologist is likely to do?

This link details the type of tests. Mostly its sitting in a sound proofed room with a pair of headphones on and then ds will press a button when they hear a click or whistle, the sounds change in range and do each ear seperately. The audiologists plot the results on a graph to show the range of hearing - thats the bit you need and may need some interperating as to what it means for your ds. Your SALT should be familiar with the graphs and you can ask your SENCO to get help from your hearing team.

fwiw if there are no problems the test is really quick about 15 mins, if they spot someting then they do more detailed testing or may repeat it to get an accurate picture.

Good news to have referral

Oh and this factsheet might be good to give to teacher, has the advice on it that Tmesis suggested