Failed Hearing Test in Children: When to See a Paediatric ENT Specialist

A failed hearing test can be a surprise. Some children seem to hear well at home, but then struggle during a school hearing screen, nursery assessment, speech and language review or GP appointment. Other families have suspected a problem for months because their child asks for repetition, turns up the television or seems not to listen in noisy environments.

Hearing loss in children should always be taken seriously. It may be temporary and treatable, but it can affect speech, language development, confidence, behaviour and school progress if it persists.

At Hampshire ENT Clinics, children with hearing concerns can be assessed by Miss Eleanor Sproson, Consultant ENT Surgeon and Lead Paediatric ENT Consultant at Portsmouth Hospitals NHS Trust. She sees children with hearing loss, glue ear, recurrent ear infections, speech-related concerns and complex paediatric ENT problems.

Quick answer: what should parents do after a failed hearing test?

A failed hearing test should usually be followed by repeat or formal audiology testing and, where appropriate, paediatric ENT assessment. Common causes include glue ear, earwax, recurrent ear infections, eardrum problems and less commonly permanent hearing loss. The next step depends on the degree of hearing loss, age of the child, speech development and ear examination.

Common signs of hearing loss in children

Children do not always describe hearing loss clearly. Parents may notice that their child asks “what?” frequently, turns up the television, speaks loudly, seems inattentive, struggles in background noise or watches faces carefully during conversation.

In younger children, clues may include delayed speech, unclear speech, frustration, poor response to name, difficulty following instructions or concerns raised by nursery or school. In older children, hearing loss may show up as tiredness, reduced concentration or falling behind in class.

Why hearing matters for speech and learning

Children learn language by hearing it repeatedly and clearly. Even a mild or fluctuating hearing loss can make speech harder to access, particularly in classrooms or nurseries where there is background noise.

This does not mean every child who fails a hearing test has a serious problem. It does mean that the result should be followed up properly so that children who need help are identified early.

Common causes of a failed hearing test

One of the most common causes is glue ear, also known as otitis media with effusion. This is fluid behind the eardrum that causes a temporary conductive hearing loss. It is particularly common in younger children and often fluctuates.

Other causes include earwax blocking the ear canal, acute or recurrent ear infections, a perforated eardrum, congenital hearing loss, noise-related hearing issues in older children, or less commonly problems affecting the inner ear or hearing nerve.

What is glue ear?

Glue ear occurs when fluid builds up in the middle ear space behind the eardrum. The fluid prevents the eardrum and hearing bones from moving normally, so sound is muffled. Children may hear as if they are underwater.

Many cases improve naturally, but persistent glue ear can affect hearing, speech, behaviour and learning. This is why hearing level, symptom impact and duration of symptoms are important.

What tests may be needed?

Children usually need age-appropriate hearing tests performed by audiology. Tympanometry may also be used to measure how well the eardrum moves, which can support a diagnosis of glue ear.

The ENT assessment includes examination of the ear canals and eardrums. The consultant will also ask about speech, school progress, infections, snoring, nasal blockage and family history.

When are grommets considered?

Grommets are tiny ventilation tubes placed in the eardrum to allow air into the middle ear and help fluid clear. They may be considered when glue ear is persistent and causing significant hearing loss or developmental impact.

Adenoidectomy may also be discussed in selected children, especially if enlarged adenoids, nasal obstruction, recurrent glue ear or recurrent ear infections are part of the picture.

Does every child need surgery?

No. Some children simply need monitoring, repeat hearing tests or treatment of contributing nasal allergy or infections. Others may benefit from temporary hearing support, classroom adjustments or speech and language input.

Surgery is considered when the balance of symptoms, hearing levels, duration and developmental impact suggests that intervention is likely to help.

When to book an appointment

Parents should consider paediatric ENT assessment if a child has failed a hearing test, has suspected hearing loss, has delayed speech, struggles at school, has recurrent ear infections, or has persistent glue ear.

Hampshire ENT Clinics offers consultant-led paediatric ENT assessment for families across Hampshire, Portsmouth, Winchester, Southampton and the South Coast.

Frequently asked questions

Does a failed hearing test always mean permanent hearing loss?

No. Many children fail hearing tests because of temporary problems such as glue ear or earwax. Formal assessment helps identify the cause.

What is the most common cause of hearing loss in young children?

Glue ear is one of the most common causes of temporary hearing loss in children.

Can hearing loss affect speech development?

Yes. Persistent or fluctuating hearing loss can affect speech and language development, especially in younger children.

What is tympanometry?

Tympanometry is a quick test that measures how well the eardrum moves. It can help identify fluid behind the eardrum.

Will my child need grommets?

Not always. Grommets may be considered when glue ear is persistent and causing significant hearing or developmental problems.

Can earwax cause a failed hearing test?

Yes. Earwax can block the ear canal and reduce hearing. Children should be assessed before assuming the cause.

Can school hearing tests miss problems?

Screening tests are useful but not perfect. Ongoing parental or school concerns should be followed up even if a later test seems normal.

Should I tell the school about hearing concerns?

Yes. Classroom positioning, reduced background noise and teacher awareness can help while assessment is ongoing.

Can Hampshire ENT Clinics assess children’s hearing problems privately?

Yes. Parents can contact Hampshire ENT Clinics to arrange consultant-led paediatric ENT assessment.

Which consultant sees children with hearing problems?

Miss Eleanor Sproson assesses children with hearing loss, glue ear, recurrent infections and other paediatric ENT concerns.