Acute Assessment Unit
About us
We aim to improve outcomes for every child identified with hearing impairment through effective rehabilitation.
We specialise in children’s hearing and are open to children of all ages from newborns up to the age of 25 (depending on whether they are on an EHCP plan).
We provide a range of hearing assessments as well as hearing aid fittings and patient focused rehabilitation programmes.
The team work closely with other healthcare professionals and offer onward referrals to other services if required. Aetiological investigations are also offered if needed, to establish the cause of the hearing loss.
Our team is based at Teddington Memorial Hospital to serve patients in the Richmond and Ealing borough. We are also accessible at several local outreach clinics.
Our service is proud to hold the Improving Quality in Physiological Services (IQIPS) accreditation, which ensures that our patients are consistently receiving high quality care. We follow local and national protocols closely, as well as actively participating in regional peer review groups to help maintain the quality of our service.
What we do
- Hearing screening for newborn babies and school entry level children.
- Age appropriate, comprehensive diagnostic electro-physiological and behavioural assessments.
- Patient focused rehabilitation including hearing aid fittings and specialist intervention referrals to other services, including cochlear implants and for bone anchored hearing aids.
- Aetiological investigation for children with permanent hearing loss, offered by our Associate Specialist Paediatrician who has a special interest in Audiology.
- Provide family friendly support to children with hearing loss and their families in their educational environment, by liaising with specialist teachers of the hearing impaired and special educational needs co-coordinators (SENCOs) in their school.
- Wax removal service for children when necessary.
We co-ordinate prompt specialist intervention, multi professional and educational support for every child in our care.
Audiology clinic appointments
When your child attends their first appointment, an audiologist will discuss your concerns and take a detailed history of their development.
Please bring along your child’s Red Book (Personal Child Health Record) to the appointment. It is also useful to bring along your child’s Neonatal Discharge Summary and any other hospital reports.
We will carry out a hearing assessment that is appropriate for your child’s age and needs.
Children under 3 years are usually seen by two clinicians and it may not always be possible to get all the information in one session. It is important to remember that hearing is tested in very quiet conditions. Towards the end of the session the clinician will explain the assessment results.
With your consent the Audiologist will send a copy of the report to your home address and to healthcare professionals involved in your child’s care within 10 working days. Please make sure we have the correct contact details.
Hearing tests
We use objective and behavioural hearing tests. Each test uses different ways to build up a total picture of your child’s hearing.
The tests used depend on your child’s stage of development and it is not always possible to get all the information in one session. Hearing must be tested in very quiet conditions.
Objective hearing tests
For these tests, your child’s participation is not essential. They are mainly used to assess hearing levels in babies and are similar to the hearing tests carried out when a baby is first born.
Oto-acoustic emissions (OAE)
A small earphone is placed into the baby’s ear and sounds are played to the cochlea (hearing organ). The response from the cochlea is then picked up by the earphone and recorded on to a computer screen.
This test alone does not give an indication of hearing levels but is used in combination with other hearing tests.
Auditory brainstem response (ABR)
This test is carried out when children are sleeping and in a relaxed and settled state. An audiologist cleans areas behind the ear and places sticky pads behind each ear and one on the upper forehead.
Small earphones are placed into the ears so that different pitches of sounds can be played at different levels. This test allows us to see how well the ear is responding to sound.
Tympanometry
This test tells us how well the eardrum is moving. A small tip is placed into the ear to check for any build-up of congestion behind the eardrum.
Behavioural hearing tests
Behavioural hearing tests involves the use of toys, rewards and listening games to gain more information about children’s hearing levels as they get older.
Visual reinforcement audiometry (VRA)
This test is usually suitable for children aged from six months. They are seated in the centre of the sound treated room either on their own chair or, if they’re younger, on a parent or guardian’s lap. Different sounds are then played either through loudspeakers or small earphones or headphones. The child is taught to turn their head every time they hear a sound and to look for a flashing light or moving toy as a reward.
Pure tone audiometry
Children aged 2 ½ to 5 years will be asked to listen to different sounds through headphones and play a game.
For example, they may be asked to move toy people into a boat or put different coloured blocks on to a stand every time they hear a sound through the headphones.
Older children from school age onwards may be asked to press a button every time they hear a sound through the headphones.
An audiogram is a chart used to record hearing tests results.
Speech tests
The audiologist will ask your child to identify or repeat toys, pictures or objects to determine the quietest listening levels and child’s ability to discriminate different sounds
Hearing aid fitting
Following a hearing assessment, the audiologist may suggest a hearing aid trial if they feel your child would benefit from amplification.
There are two parts to a hearing aid: the hearing aid which sits at the back of the ear, and a custom-made ear mould.
We will need to take an impression of the ear for the ear mould.
Occasionally, if appropriate, older children may be fitted with a hearing aid that uses a smaller ear dome and thin tube that fits into the ear, but the selection of hearing aids will depend on your child’s age and individual hearing needs.
If necessary, we may need to take an impression of the child’s ear shape. This is to ensure the hearing aid can be fitted without discomfort.
Once the ear mould is back, you will be asked to bring your child back for the hearing aid fitting.
Hearing aid 'how to' videos
How to re-tube your earmould (youtube.com)
How to change your hearing aid battery (youtube.com)
How to change your hearing aid battery - Tamperproof version (youtube.com)
School screening
The school screening programme offers a routine hearing screen to all school entry level children in Richmond. The aim of the school hearing screen is to detect temporary, permanent or progressive hearing loss.
Hearing loss can impact speech and language development and can also be a contributory factor to problems such as social, behavioural or learning difficulties, and once detected can be managed appropriately.
Occasionally, some children do not routinely pass the screen and are therefore, referred into clinic. Few of the common reasons for children being referred into clinic are glue ear, concentration difficulties during screening and lack of cooperation during screening.
Ear plugs and moulds
One in seven people in the UK are hard of hearing or deaf, but hearing loss caused by noise exposure or frequent ear infections is preventable.
We offer a range of custom-made ear plugs to patients and the public as a preventative measure against hearing damage.
We take an impression of the ear and send it to the specialised laboratory to create a bespoke tailor-made mould for your ear, which ensures the highest possible quality and performance levels from your ear plugs.
Our custom-made swim plugs can help prevent ear infections, protect against swimmer’s ear, and are beneficial for individuals who have been advised to keep the inside of their ears dry.
The Trust’s range of swim plugs are long lasting and reusable. They are also floatable and come in a range of colours.
Fitting and advice is provided by our team of professionals.
All our ear plugs/moulds are tailor made to fit your ear. We do this first by taking an impression of your ear, before creating the product just for you.
Pricing:
- Paediatrics swim plugs: £45
- Adult swim plugs: £50
Payment can be made by cash or cheque and must be made before your ear impression is made.
Loud music is a major cause of hearing damage and can lead to premature hearing loss, tinnitus and hyperacusis (reduced tolerance to sounds).
Hearing damage cannot always be reversed, however many people are not aware of this risk and do not take preventative measures.
We provide a range of noise reduction ear plugs - which are custom made to fit the shape of your ears and suit the type of noise levels you are exposed to. They are also reusable and washable.
These include:
Musicians' ear plugs
With or without filters - designed specifically for people who need to reduce volume whilst maximising the frequency range and quality of audio they hear.
- Musician plugs without filters: £65
- Musician plugs with filters: £125-£150
Ear defenders
With or without filters – noise plugs aimed at people who need to reduce audible volume at gigs, night clubs, concerts, loud sporting events or working in loud environments.
- Ear Defenders/noise plugs with filters: From £60-70
- Ear Defenders/noise plugs without filters: £45-£55
Ear plugs are perfect for noise reduction when out and about in loud or noisy environments as they limit harmful levels of noise to safe levels.
Payment can be made by cash or cheque and should be made prior to your ear impression being taken.
Find out more
To find out more about the products on offer, or to book an appointment and make a purchase, please get in touch.
Telephone: 020 8714 4108 or 020 3771 6030
Email: hrch.
Support groups
These groups are comprised of all the services which support hearing impaired children in the area. CHSWGs meet four times a year to discuss ways to improve provision and integrate their services effectively.
In Richmond, the CHSWG meetings are attended by representatives from many services, including newborn hearing screening, Paediatric Audiology, Speech and Language Therapy, Education Services, Social care, Healthcare Commissioners and both local and national voluntary organisations.
In addition to these professionals, CHSWGs have active involvement from local parents of hearing-impaired children. One of the most important functions of the CHSWG is to ensure that the services provided locally, meet the needs of the families who use them.
The leading charity dedicated to creating a world without barriers for every deaf child. They provide free impartial and unbiased information to families, empowering them to make informed choices for their child.
Twickenham and Richmond Area Parents of Hearing-Impaired Children (TRAPHIC) is a group of local parents of hearing impaired children.
TRAPHIC takes members’ ideas for helping children cope with their challenges forward to the local service providers.
If you would like to join the group, please contact:
Ellen Purton: ellenpurton
Hearing aid battery request form
Hearing aid accessories request form
Referrals
Referrals can be made by healthcare professional, such as health visitors, school nurses, speech and language therapists, GPs and paediatricians.
Please use the paediatric audiology Richmond referral form. Self-referrals can also be made by using this form.
Parents who have concerns about their child’s hearing can contact us for advice and information regarding our referral pathway.