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Northern Beaches Speech Pathology & Audiology

My Child’s Hearing Was Tested When They Were Born: Is That Enough?


In Australia, we’re incredibly fortunate to have access to Universal Newborn Hearing Screening, a free and widely implemented program that screens babies for hearing loss shortly after birth. In New South Wales, this program is called SWISH (Statewide Infant Screening- Hearing) and was introduced in 2002. Most babies born since then have had their hearing screened within the first few days of life, usually before leaving hospital.

This program has been a game-changer. Before it was introduced, the average age at which children with hearing loss were diagnosed was around 2½ to 3 years. Now, most children born with a significant hearing loss are identified before 3 months of age and can receive early intervention well before their first birthday, a vital window for language development.

However, many parents are left wondering:
If my child passed their newborn hearing test, do they ever need their hearing checked again?

The short answer? Yes.

Why a Newborn Hearing Test Isn’t Enough on Its Own

While newborn screening is highly effective at identifying permanent, bilateral hearing loss present at birth, it doesn’t catch everything.

While 1–2 in every 1000 babies are found to have significant permanent bilateral hearing loss at birth (Australian Institute of Health and Welfare, 2018), just as many children will develop hearing loss later in infancy or early childhood.

Hearing can change over time due to:

  • Progressive or late-onset sensorineural hearing loss
  • Temporary or fluctuating hearing loss from middle ear infections (otitis media) or fluid
  • Environmental factors such as frequent colds or allergies
  • Physical changes such as enlarged adenoids impacting the Eustachian tubes

Children may pass their newborn screen but develop hearing issues months or years later, often without obvious symptoms.

When Should My Child’s Hearing Be Tested Again?

As speech pathologists and audiologists, we strongly recommend that all children have their hearing rechecked before starting school, especially if they’ve never had a full diagnostic hearing assessment.

Currently, there is no universal hearing screening program for children after birth, unlike vision screening, which is routinely done before school entry in NSW.

In addition to pre-school checks, hearing should also be assessed at any age if your child:

  • Has unclear speech or is late to start talking
  • Often says “What?” or asks for things to be repeated
  • Appears to not hear from across the room
  • Seems to “tune out” or not respond when called
  • Has a history of frequent ear infections or middle ear fluid
  • Turns up the volume on the TV or tablet
  • Struggles to follow instructions, especially in noisy settings
  • Has attention or behavioural challenges that might be linked to poor auditory access

These signs don’t always mean there is a hearing problem, but it’s an important factor to rule out early.

How Old Does a Child Need to Be for a Hearing Test?

A child’s hearing can be tested at any age, even in the newborn period. However, the type of test used will depend on the child’s age and developmental level.

  • 0–9 months: Testing often involves Auditory Brainstem Response (ABR) or Otoacoustic Emissions (OAE) while the baby is asleep. This is usually done in a hospital setting by a paediatric audiologist for babies at high risk or with known concerns.
  • From 9–10 months onward: Most children can complete a hearing test using a play-based method called Visual Reinforcement Orientation Audiometry (VROA), described below.

What Is VROA (Visual Reinforcement Orientation Audiometry)?

VROA is the most common method used for testing hearing in toddlers and young children (typically from 9 months to 2.5–3 years of age).

Here’s how it works:

  • Your child sits on your lap in a soundproof booth or quiet testing room.
  • Sounds are played through speakers or headphones.
  • When your child turns their head toward the sound, they’re rewarded with a fun visual “surprise”, like a flashing toy or video screen.
  • Over time, the child learns that turning their head when they hear a sound causes something fun to happen, making it a fun, reliable, and accurate way to assess hearing across different pitches and volumes.

Older children (3+ years) usually complete more structured hearing tests that involve play-based responses, such as putting a block in a bucket when they hear a sound.

Why This Matters for Speech and Language Development

Hearing is foundational to communication. Even mild or temporary hearing loss can make it harder for a child to pick up on the full range of speech sounds, especially the quieter ones like /s/, /f/, and /th/. This can affect:

  • Clarity of speech
  • Vocabulary growth
  • Understanding instructions
  • Confidence in social and learning environments

Making sure your child can hear clearly gives them the best chance to thrive, whether they’re beginning speech therapy or getting ready for school.

What Next?

If you’ve ever asked:

“My child passed their newborn hearing test, do they really need another?”

The answer is yes! Especially if you have any concerns about their communication, learning, or attention.

Checking your child’s hearing is quick, non-invasive, and can provide peace of mind or point you in the right direction for support. We offer hearing testing from 9 months of age and would be happy to help if you have concerns.


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