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Why is it necessary? of Hearing and vision tests for children

The standard hearing and vision tests are carried out so that any problems can be detected as early as possible. Doctors can then monitor and if necessary treat the condition, or provide equipment to improve the child’s hearing or vision, such as glasses or a hearing aid. It will also enable the child and his or her parents to access special learning support services.

Hearing tests

Routine hearing tests, given as part of the normal tests carried out by the health visitor and later the school nurse, detect whether a child’s hearing is within the normal range of volume (loudness) and pitch (high and low sounds).

In between these regular checks, a parent, health visitor, or carer might notice that a child’s hearing is not developing properly. Babies should jump or start at loud noises from birth, and children should turn to find out where a sound is coming from. By the age of 12 months children are often starting to copy whole words. If normal child development doesn’t happen, the cause should be investigated. It could be a hearing impairment that has always been there, one that is currently growing, or a temporary hearing problem, such as reduced hearing caused by a cold.

Possible causes of hearing impairment include:

  • glue ear (build up of fluid in the middle ear). This is common in small children and they normally grow out of it;
  • damage to the cochlear or auditory nerves (that take hearing signals to the brain). This can be caused by a serious head injury, exposure to loud noise, or other factors such as head surgery; 
  • genetic (inherited) conditions such as otosclerosis, which stop the ears or nerves working properly;  
  • infections that affect the child while it is in the womb, or that are caught at birth, for example rubella or cytomegalovirus;
  • being starved of oxygen at birth (birth asphyxia);
  • illnesses such as meningitis or encephalitis (which involve swelling in the brain), or head injury, after birth.

Vision tests

Routine eye tests, during school nurse and child development checks, detect whether there is any visible defect or deformity in the eyes themselves, such as a cataract, squint or crossed eyes. They also check that a child can follow movement in the normal field of vision (looking up, down, and side to side), and is not short-sighted or long-sighted. Secondary school age children mayalso be tested for colour-blindness.

Parents and other people who interact with a child may be able to spot problems before they are picked up in tests. A baby should be able to see from birth, and by six weeks from birth he or she should be able to follow a colourful or interesting object, such as a face, with his or her eyes. Some babies are born with a squint or their eyes roll away from each other occasionally. If this happens all the time you should mention it to your health visitor and GP. Other signs that a child may have vision problems include purposeless roving eye movements, not turning towards the source of sounds (also a sign of hearing impairment), mannerisms such as eye poking and rubbing, and not making eye contact. Another sign of some rare eye problems such as growths in the eye, is that one eye looks white and the other red when a colour photograph is taken using a flash. If this happens you should take your child for urgent eye tests.

Possible causes of visual impairment include:

  • long- or short-sightedness (which tended to be inherited); 
  • other genetic (inherited) conditions such as astigmatism, where the eye has not formed in quite the right shape, or choroidoretinal degeneration, where part of the eye gradually stops working properly;
  • damage to the optic nerve, which takes sight messages to the brain. This is also called optic atrophy, and may be present at birth (inherited) or may appear because of a condition such as diabetes;
  • a tumour or growth pressing on the sight-centre of the brain;
  • cataracts that a child is born with (congenital), which may be caused by conditions such as Down’s syndrome, or the effects of an infection caught during pregnancy, such as rubella; 
  • problems related to premature birth, because the eyes have not had time to finish forming fully.

When sight problems are detected, treatment and educational support can be given. The earlier this happens, the better, because untreated sight problems can often get worse. Children themselves don’t always realise they have a sight impairment (their vision is normal, to them) so it is important to take advantage of all the free eye checks you are offered, up to the age of 16.