Hearing, audiograms and glue ear
Understand what hearing tests can tell you, what they cannot tell you, and what to ask at your next appointment.
Different kinds of hearing needs
Children’s hearing can differ between ears, across pitches and over time. Conductive hearing loss affects how sound travels through the outer or middle ear. Sensorineural hearing loss involves the inner ear or hearing nerve. Mixed hearing loss includes both.
Ask your audiologist to explain your child’s results individually. A label such as “mild” or “profound” is not a measure of how easy a classroom or conversation feels.
What do the tests do?
| Test | What it helps assess |
|---|---|
| OAE: otoacoustic emissions | Responses produced in the cochlea. An OAE result alone does not establish a child’s hearing levels. |
| ABR: auditory brainstem response | Responses to sounds measured using sensors on the skin. It can help estimate hearing thresholds. |
| VRA: visual reinforcement audiometry | A child’s responses to sounds, usually with a visual reward. |
| Play audiometry | A child responds to sounds through a listening game. |
| Tympanometry | How the eardrum and middle ear respond to pressure changes. It helps investigate middle ear problems such as glue ear. |
Making sense of an audiogram
An audiogram plots hearing thresholds: the quietest sounds detected at different pitches during a test.
| Part of the chart | What it means |
|---|---|
| Frequency, usually shown in Hz | Pitch, with lower pitches towards the left and higher pitches towards the right. |
| Hearing level, shown in dB HL | The level needed to detect a sound. Larger numbers are usually shown further down the chart. |
| Symbols and lines | Different test methods or ears. Ask the clinician to explain the key on your child’s chart. |
Ask which results were obtained with devices, which were obtained without them, and what they mean for everyday communication. The chart does not directly measure language understanding, listening effort or access in noise.
Glue ear deserves support too
Glue ear is fluid in the middle ear that can cause temporary hearing loss. It can affect one or both ears. Contact your GP or hearing team if you have concerns about your child’s hearing or development.
Management may include monitoring, hearing support or grommets, depending on the child. The NHS decision aid can help you discuss the choices with the clinical team.
Before your appointment
- Take previous results and appointment letters if you have them.
- Describe everyday examples: quiet rooms, groups, distance, tiredness and changes you have noticed.
- Ask for your child’s results and next steps in writing.
- Request communication support when booking, including BSL or a spoken language interpreter if needed.
- Check the provider and location on your appointment letter. Stockport’s children’s audiology arrangements have been changing.
Download an appointment preparation sheet or read the separate Stepping Hill information page.
Sources and further reading
Links go to the organisation responsible for the information. Practical prompts on this page are suggestions for family conversations.
- Children’s hearing tests: what the tests doManchester University NHS Foundation Trust · Checked 1 October 2026
- Children’s audiology: objective and behavioural testsWest London NHS Trust · Checked 1 October 2026
- Glue earNHS · Checked 1 October 2026
- Making a decision about glue earNHS England, decision aid PDF · Checked 1 October 2026
- Stockport children’s audiology service informationHealthHarmonie, service provider, PDF · Checked 1 October 2026
- Hearing aid services in StockportNHS Greater Manchester · Checked 1 October 2026