The South Eastern Trust Paediatric Audiology department offers a full diagnostic and rehabilitative (hearing) service, providing:
- Newborn diagnostic testing- Automated Brainstem Response (ABR)
- Hearing aid service (including fitting, maintenance, battery supply and upgrade of hearing aids when required)
- Paediatric Direct access hearing assessment clinics.
We work closely with community and local educational services to meet the needs of our paediatric patients.
All our services, including hearing aid repairs, replacements, upgrades and battery supply are free of charge to South Eastern Trust NHS patients.
Referral
If you have concerns about your child’s hearing please speak to your GP or Health Visitor who can arrange referral. They may choose to refer you either to Paediatric ENT to see a consultant or directly to our Paediatric Direct access audiology clinic. Referrals are also accepted by our service from Speech and Language Therapists, Paediatricians and School Nurses. Waiting lists and waiting times may vary. If your GP refers you directly to us, they can advise you of the current waiting list times at point of referral.
How to find us
The majority of Paediatric Audiology services are on the Ulster site. We are based within the ENT porta cabin which is situated between the main building and Maternity Services.
Occasionally you may receive ENT appointments on other sites such as Lagan Valley or the Downe hospital so please check your appointment letters carefully.
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Types of childhood hearing losses
Conductive hearing loss
The hearing tests carried out today show that your child has a conductive hearing loss.
What does this mean?
This means that your child may find some day to day sounds/conversations difficult to hear, because the sounds can’t travel through the ear because of a blockage.
The ear is separated into 3 sections: outer, middle and inner. The outer ear is what we can see when we look in the ear – we can see up to the ear drum; this is where often wax can accumulate. The middle section is where the main causes of conductive hearing loss occur; this is normally an air-filled space. The inner ear is where the hearing organ and nerves are.
The results from today’s appointment suggest that there is fluid in the middle part of your child’s ear, behind the ear drum. This is commonly referred to as glue ear or middle ear congestion. It is very commonly found in young children. This is not an infection, and does not necessarily require antibiotics. However, this mucus/fluid can be a breeding ground for infection. If your child is unwell please speak to your GP.
Will this hearing loss be permanent?
This typically resolves by itself. If your child’s hearing improves to within normal limits, after a period of watchful waiting, it is highly likely that they will be discharged from audiology.
How will this affect my child?
The audiologist may have discussed with you different treatment options based on your child’s hearing loss. It is important that your child has regular hearing checks. Glue ear is a condition which can temporarily mean that your child’s hearing is poorer than normal. Your child will be referred to a specialist if this is the case, or if there are any changes which require their input.
What treatment may be suggested?
As this type of hearing loss typically resolves by itself we will initially carry out a watchful wait. After a short time, usually three months, we will see you again to see whether or not the hearing loss has resolved. It can fluctuate; it may get better, stay the same or deteriorate.
If your child’s condition has not improved or worsened, a referral to the Ear, Nose and Throat (ENT) department may be necessary. The ENT doctors will perform a full assessment. One treatment they may offer is the insertion of grommets or ventilation tubes, which is a short operation to clear the fluid and place a small tube in the ear. Alternatively, if this is a long term issue, hearing aids may be a treatment option.
One device you can buy, to try, is an Otovent. Using this device helps to open and close the tube which links to your ear (from the nose) to get some air into the middle part of the ear.
Is there anything I can do to help my child?
Yes. Ways in which you can help your child include:
- Make sure that your child has a clear view of your face when you are talking to him/her and speak clearly. This is the same for teachers at school.
- Try to keep background noise to a minimum when talking to your child.
- Make sure everyone who spends time with your child is aware that he or she may have difficulty with hearing, particularly in noisy surroundings.
- When at school make sure they sit with their better ear towards the teacher, or near the front of the class.
- Encourage use of hearing aid (if this has been provided for your child).
- Do not expose your child to cigarette smoke.
Sensorineural hearing loss
What is this due to?
This type of hearing loss is either due to a fault in the inner ear, usually when the hair cells in the cochlea are not working properly or due to the auditory nerve. It is not always possible to find the precise cause of some types of hearing loss. In many cases, there is no history of hearing loss in the family. There are conditions which may occur before or at birth, during infancy or in childhood that can be linked to hearing loss.
What does this mean?
A sensorineural hearing loss leads not only to a loss of loudness but clarity as well. There is generally no medical or surgical help available to correct for sensorineural hearing loss, however, today’s digital hearing instruments and cochlear implants can provide significant assistance.
Will this hearing loss be permanent?
Yes. A sensorineural hearing loss is permanent.
However, there is a potential for the severity of the hearing loss to change. We will monitor this will regular hearing tests.
What treatment may be suggested?
The audiologist may have discussed with you different treatment options based on your child’s hearing loss.
Your child will be referred to a specialist team made up of Ear Nose and Throat Consultants, Teachers of the deaf, Speech and Language Therapists and Sensory Support Services who will offer additional support. Your child may also be offered a hearing aid to enable them to access sounds.
Is there anything I can do to help my child?
Yes. Ways in which you can help your child include:
- Make sure that your child has a clear view of your face when you are talking to him/her and speak clearly.
- Try to keep background noise to a minimum when talking to your child.
- Make sure everyone who spends time with your child is aware that he or she may have difficulty with hearing, particularly in noisy surroundings.
- Encourage use of hearing aid (if this has been provided for your child). Please find extra information in the leaflet-Encouraging my child to wear their hearing aid.
What should I do if I have any further questions?
If you have any questions about the results of the assessment or this leaflet then please call the audiology department on (028) 90561307 and ask to speak to one of the Paediatric Audiologists or e-mail us.
You can also write them down and we’ll discuss them at your next appointment.
To see the NDCS (National Deaf Children Society) Website click here.
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The hearing aids we offer
We offer a range of modern digital hearing aids. The models currently available on the NHS are a great improvement to those used in the past. They are smaller, neater and have advanced amplification capabilities.
In your child’s assessment, the audiologist will consider their hearing loss, dexterity, vision, size and shape of their ear and advise you on the recommended hearing aid fitting. All of our hearing aids have the microphone located behind the ear for ease of long term maintenance.
Our paediatric aids and moulds come in a range of colours, so hopefully we have something to suit most tastes.
The majority of hearing aids we now offer also have the capability to connect wirelessly to Bluetooth devices allowing for streaming of calls and music between your devices and hearing aids.
Behind – the –ear (BTE) digital hearing aid with mould
BTE hearing aids are one of the easiest types of hearing aid to use and are suitable for most people with hearing loss. They are made up of a small metallic device that sits behind your ear that houses all the electronics of the hearing. This is attached with a tube to a custom-made ear mould that fits into your ear.
Receiver in the ear (RITE) hearing aids
We are delighted to be one of the few NHS sites in Northern Ireland offering RITEs. The main difference with RITE hearing aids is that instead of all the electronics of the hearing aid being behind the ear as with BTEs, the piece behind the ear in RITEs houses the microphone which connects to a thin wire to a tiny speaker placed inside the opening of the ear. This allows the piece behind the ear to be smaller and more discrete. The positioning of the speaker in the ear canal also allows the smaller hearing aid to provide more amplification required for moderate to severe hearing losses. However, having the speaker located in the ear canal makes it more prone to blockages and is not suitable for those who suffer from recurrent wax build-up or infections. The RITEs are cosmetically appealing but require a high level of independent self-maintenance and good dexterity to do so. Therefore they are generally only suitable for older children and young adults.
CROS/BiCROS Hearing aids
CROS stands for Contralateral Routing of signals. CROS hearing aids may be considered as a management option for patients who have no functional hearing in one ear. The hearing in the other ear may range from normal to significantly impaired. This can affect a person’s ability to pick up sound coming from the affected side, their ability to recognise where sounds are coming from and their ability to separate background noise from target sounds.
The first of these problems can be improved by use of a CROS (Contralateral Routing of Sound) hearing aid which uses a transmitter worn on the bad ear to pick up sound coming from this direction and sends it to a receiver worn on the better hearing ear. If amplification is also required on the better hearing ear then the aid is known as BiCROS. As all the sound is still being received and processed by the better hearing ear only, difficulties with localisation and hearing in background noise remain.
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Maintenance and trouble-shooting
When your child is fitted with a hearing aid, if you agree they will also be referred to the education department to be assigned a Teacher of the Deaf (TOD). A TOD is a qualified teacher with the skills and knowledge required to provide quality teaching to mainstream learners and with the additional mandatory qualification and expertise in teaching deaf leaners. More information on the role of the TOD can be found here.
All hearing aids require a level of ongoing maintenance, some of which your TOD may do, you may be able to do yourself or an appointment may be required at audiology. Tubing on moulds needs to be replaced at least every 6 months, corda tubes every 5/6 months and domes on receivers every time they are removed e.g. for replacing wax guard.
If you have any problems with your child’s hearing aids/s you can book a paediatric digital repair appointment by contacting us by:
- Phone: (028) 90561307
- E-mail: audiology.department@setrust.hscni.net.
Please note we do not offer a walk in service at any of our sites.
We are only able to service hearing aids provided by South Eastern Health and Social Care Audiology Department and are unable to see any patient from other trusts or alternative providers.
The following are some useful documents which may help you with maintain your child’s aid/s.
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Lost Hearing aids
Your child’s hearing aid is provided free of charge on loan. It is theirs for as long as they need it, but it remains the property of the NHS. We will repair or replace hearing aid/s if required, free of charge.
We understand how important your child’s hearing aid is so we will endeavour to provide replacements as quickly as possible.
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Batteries
If you are a patient of ours, we will post you batteries free of charge upon request.
You can send your request via text on 07568102636
Please include the patients registered name and date of birth and put PAEDIATRIC in the subject field to ensure we can fulfil the request.
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Transition to adult services
Transition From Paediatric to Adult Audiology Services
You have been given this information pack as you will shortly be transferring from the paediatric audiology service to the adult service. It includes information about your hearing and hearing aids, as well as access to services and useful equipment.
Introduction
Transition is a smooth process that actually commences from a young age, from as far back as when you picked out your first ear-mould colour! Therefore, just the fact that you are reading this and are aware and interested in your own care means that you are almost ready.
What is transition?
Once you have left full time education your audiological care will be transferred from paediatric audiology to our adult audiology service. This process should have begun from the age of 14, as the department wants to ensure you have gained the necessary skills of caring for your hearing aids while also providing advice on the availability of services when entering into adulthood.
What is the difference between the paediatric and adult services?
Adult services are located at several different hospitals so there is a greater choice of where you can be seen. Currently within the South Eastern Trust (SET) adult hearing aid clinics run in the Ulster Hospital, Bangor Hospital, Lagan Valley Hospital and the Downe Hospital.
You may be used to seeing the same audiologists each time you come to the paediatric clinic. You may see a greater range of audiologists in the adult services although some of the paediatric audiologist’s work across both.
What will happen in the final transition appointment(s)
This will happen in the paediatric service at the Ulster Hospital. We will check that you understand how to look after your hearing aids and that you are able to carry out routine maintenance such as re-tubing your ear mould/replacing domes/wax guards and carrying out a listening check. We will discuss your plans for the future and from this we will suggest services or agencies that you may like to contact so that you can make sure you are getting the best advice and information.
We will discuss any questions which may have arisen from reading this information pack as well as any problems or concerns.
What support am I entitled to?
You are entitled to an interpreter for your appointment if you require one. We can arrange this for you if it is requested in good time before your appointment.
Will I have to pay for anything?
Hearing aids, ear-moulds and batteries all continue to be free within the adult audiology service.
What are my responsibilities?
You will need to make your own re-assessment appointments. Within the paediatric audiology service you would have been sent for automatically every year for a review. Within adult services a re-assessment is normally carried out approximately every three years and the onus on you is to contact the audiology admin team to arrange. The team can be contacted by:
- Phone: (028) 90561307 or;
- E-mail audiology.department@setrust.hscni.net
If you notice any sudden change in your hearing this may indicate an emergency and you should seek an appointment as soon as possible.
How will my information be shared?
We use one database at the SET for all patients, both adult and paediatric. Your information will remain on this database so that the adult team can access it. If you move away from home, your new audiology department can request we send your information to them with your permission.
How do I access audiology services when I’m away from home?
If you are away from home, for example at university, you may need to register with a GP close to where you live. Your GP will then be able to refer you to an audiology department nearby. Again with your permission we can send any information about your hearing and hearing aids to other departments.
Equipment
There is a wide range of equipment available that may be useful to you. Some equipment supports independence in the home and other equipment works with hearing aids to help with study or in the workplace. There are also devices that can give you access to entertainment and educational materials as well as equipment designed to help with communication.
Note: Some of the assistive listening devices that are available are only compatible with a specific type of hearing aid, talk to your transition audiologist about your wider needs and they will be able to advise you.
- Listening devices are designed to help you make the best use of your hearing. They generally work with hearing aids or cochlear implants to reduce the problems caused by background noise. Examples are loop systems, personal listening aids, connections to smart phones and tablets/computers.
- Radio aids can be useful at college or work. They help to reduce background noise to allow you to concentrate on one voice.
- Alerting devices use light, vibration, sound or mixture of all three to alert you to events happening around the home. Examples are doorbells, smoke alarms and alarm clocks.
Detailed information on equipment can be found at:
If you are interested in any of the products and would like further information or advice if you let us know we can make a referral to the Sensory Support Team and they can arrange to assess you to see which equipment they may be able to provide for you.
Education
If you are already studying in a higher education setting or want to apply to do a course in higher education, you could get communication services and equipment to help you. Disabled students in higher education- which includes students who are deaf- can apply for Disabled Students’ Allowances (DSA) to pay for communication services or equipment. If you live in Northern Ireland you will need to apply through Student Finance Northern Ireland (SFNI). Application forms are available on their website.
If you are studying in a further education setting, you usually don’t qualify for DSA. Instead, the college where you are studying should provide what you need. Different colleges provide different amounts of support.
Employment
Access to Work is a government funded scheme set up to ensure deaf people have equal access at work. The scheme can help with the cost of any equipment, communication support and changes to your working environment. Access to Work covers the full cost of any kind of communication service, such as BSL/English Interpreters, lip-speakers, speech-to-text reporters or note takers.
Equipment that might help include telephone amplifiers, text-phones or loop systems to help you carry out your job and communicate with work colleagues more easily. You can find out more information about Access to Work here or you can speak to the Disability Employment Advisor at your local Jobcentre for more information.
Benefits
If you are deaf and not working (or working fewer than 16 hours a week), then you may accepted as having limited capacity for work and/or work-related activity, so you could claim Employment and Support Allowance (ESA). You may get ESA if your ability to work is limited by ill health or disability. You can find out more information here.
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Interpreting Services
If you require an interpreter please contact our department and include the following details:
- Language (specify region if applicable)
- Sign language (specify BSL/ISL)
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Other useful agencies
- National Deaf Children Society (www.ncds.org.uk)
- Royal National Institute for Deaf People (rnid.org.uk)
- Sensory Support Services:
- Lisburn (028) 9260 7746
- Downpatrick (028) 4461 6915
- Ards (028) 9151 0136
- Belfast (028) 9504 0200
(028) 9056 1307
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