Audiology Service

Public Service, Audiology Service

Auckland Te Toka Tumai District Audiology Service

Auckland Te Toka Tumai Audiology holds clinics at Greenlane Clinical Centre, Starship Children's Hospital and Waitakere Hospital. Community hearing screening clinics are also run in Mt Roskill and Glen Innes.
Diagnostic Testing and Hearing Aid services
The Audiology service provides full audiology services to the paediatric population of Auckland Te Toka Tumai and Waitemata including diagnosing hearing loss, fitting of hearing aids and auditory processing assessments. There is a small service for complex needs Auckland Te Toka Tumai adults.
Balance testing
The service runs a vestibular clinic at the Greenlane Clinical Centre that is designed to diagnose balance problems in adults and children over seven years of age. This is a regional clinic and accepts referrals from the Counties, Waitemata and Te Tai Tokerau districts.
Newborn Hearing Screening
All babies who are born in Auckland Te Toka Tumai are offered hearing screening tests within their first month of life with the aim of testing a baby’s hearing before they leave hospital. Outpatient clinics are provided in the community to ensure babies not seen in hospital or born at home are offered the screening.

Babies that have a diagnosed hearing loss will be fitted with hearing aids within a few months of birth.

For more information on Universal Newborn Hearing Screening please visit   https://info.health.nz/pregnancy-maternity/pregnancy-newborn-screening/hearing-screening-newborns or call the Newborn Hearing Screening office at Auckland Te Toka Tumai on (09) 307 4949 ext: 25020.

Services provided Hearing Loss and Treatment

Hearing loss can be divided into two types: conductive hearing loss (caused by some sort of mechanical problem in the external or middle ear) or sensorineural hearing loss (caused by disorders of the inner ear, hearing nerve or associated brain structures).

Conductive hearing loss is often reversible and can be due to:

• blockage of the ear by e.g. wax, inflammation, infections or middle ear fluid
• poor sound conduction because of e.g. holes or scarring in the eardrum or the bones of the middle ear (ossicles) becoming fixed and rigid.

Sensorineural hearing loss is generally not reversible and can be caused by:

• genetic make-up (this could include congenital conditions i.e. those you are born with, or late-onset hearing loss)
• head injury
• tumours
• infections
• certain medications
• exposure to loud noises
• the aging process (a significant hearing loss is experienced by about one third of people aged over 70 years).

Some of the signs you might notice that indicate you have a hearing loss include:

• having to turn up the volume on the TV or radio
• finding it hard to hear someone you are talking with
• finding it hard to hear in a group situation where there is background noise e.g. in a restaurant
• having to ask people to repeat themselves
• you find people's speech is unclear - they are mumbling

Some of the signs that your child may have difficulty hearing include:

• unclear speech or delayed speech development
• lack of responsiveness to sound
• poor receptive language.

Hearing loss can be partial (you can still hear some things) or complete (you hear nothing) and may occur in one or both ears.

Treatment

Treatments for hearing loss range from the removal of wax in the ear canal to complex surgery, depending on the cause of the loss. One of the most common treatments for hearing loss in children and adults is the use of hearing aids. The type of aid you get depends on the cause of your hearing loss and how bad it is, as well as what your preferences are in terms of comfort, appearance, cost and lifestyle.  For information on funding for hearing aids refer to the section on Costs.

Newborn Hearing Screening

Newborn hearing screening is a quick and non-invasive test performed on babies shortly after birth to check for any hearing loss. The goal is to identify infants who may have hearing impairments early on so that they can receive appropriate interventions as soon as possible, which is crucial for language and speech development.

1. Timing of the Screening

• Newborn hearing screenings typically occur within the first few days of life, often before the baby leaves the hospital. In some cases, if the baby was born in a facility that doesn't offer screening, the test can be done shortly after birth or at a follow-up appointment.

2. Method of Screening

• Auditory Brainstem Response (ABR) Test:
  In some cases, the ABR test may be used. This involves placing small electrodes on the baby’s scalp to measure the brain’s response to sound. The ABR test assesses the auditory nerve and brainstem pathways to determine if the baby can hear sounds at normal levels. 

3. How the Test Works

• Quiet Environment: The test is done in a quiet, calm environment to avoid any interference.

• Non-invasive and Painless: The baby doesn't experience any pain during the test. The OAE test involves a tiny ear probe, and the ABR test uses electrodes on the scalp, but neither procedure causes discomfort.

• Duration: The screening takes only a few minutes, and the baby is typically awake and calm during the test.

4. Results

• Pass: If the baby passes the hearing screening, it generally means their hearing is normal. However, no test is 100% accurate, so some babies who pass the screening may still have hearing loss. If there are concerns, a follow-up test may be scheduled.

• Refer: If the baby does not pass the screening, it doesn’t necessarily mean they have hearing loss. It could be due to factors such as fluid in the ear or the baby being too fussy during the test. A “refer” result means that further evaluation is needed, often through more detailed testing (like ABR) to determine if there is hearing loss.

5. Follow-up

• Confirmatory Testing: If the baby doesn't pass the initial screening, follow-up testing is crucial. Additional hearing tests, typically performed by an audiologist, may include more sophisticated ABR testing or visual reinforcement audiometry (VRA) as the child gets older.

• Early Intervention: If hearing loss is confirmed, early intervention is important for the baby’s development. This may involve hearing aids, cochlear implants, speech therapy, or other specialized support, all of which can significantly improve the child’s speech, language, and social development.

6. Importance of Early Detection

• Language and Speech Development: Early identification of hearing loss allows parents and caregivers to start interventions at a critical time, often before six months of age. Early support greatly improves the child’s chances for developing language skills and social abilities.

• Screening Programme: In NZ, newborn hearing screening is part of standard newborn care.  This programme aims to catch hearing issues as early as possible to provide children with the best chance for language development and learning.

Auditory Brainstem Response Testing An Auditory Brainstem Response test (ABR) evaluates how well the sounds travel along the hearing nerve pathways to the brainstem. An ABR may be recommended for a variety of reasons. It can be used to determine the integrity of the auditory pathway, or to estimate hearing thresholds in newborns, older children and adults who cannot perform reliably on a behavioural hearing test.

Recording electrodes are placed onto the head and soft foam tips are inserted into the ear canals. While the patient is sleeping, quiet clicking sounds are delivered through the foam tips. Nerve responses elicited by the sound are picked up by the electrodes and then passed on to a computer to be recorded. The recordings are analysed to determine if they fall within normal limits. The results are then reported to the patient's GP or to the Ear, Nose and Throat (ENT) specialist if further medical evaluation is required.

Depending on the age and compliance of the patient, an ABR may be performed either during natural sleep or, in rare cases, under general anaesthetic. Visual Reinforcement Audiometry Visual Reinforcement Audiometry (VRA) is a behavioural audiometric test obtained in a sound-proof room.

This test is used for children between the age of 6 months through to 2 1/2 years old. Your child is seated on your lap or at a small table in front of a calibrated loudspeaker, or wearing headphones. When a sound is presented, the infant's head-turn response toward the sound source is rewarded by activation of a puppet mounted near the loudspeaker. Your child's attention  is then distracted back to the midline so that additional sounds can be presented.

Any test performed through loudspeakers rather than headphones is called "sound field" audiometry and does not test each ear separately; rather, sound field audiometry yields an audiogram for the better-hearing ear if there happens to be an ear difference in hearing. However, if your child tolerates wearing earphones, then each ear can be assessed separately. Play Audiometry Appropriate for testing children from 30 months through to five years of age.

Your child is conditioned to perform a play activity (e.g. dropping a block in a bucket) whenever they hear a sound. Once the child is conditioned, threshold of hearing can be determined by decreasing signal intensity. This test is usually performed under headphones to obtain ear- and frequency-specific information. Pure Tone Audiometry Pure-tone Audiometry is a behavioural test used to determine hearing sensitivity and is conducted in a soundproof room. The test is performed using headphones and the patient is asked to respond each time they hear a sound. Pure-tone thresholds indicate the softest sound audible to an individual at least 50% of the time. Hearing sensitivity is plotted on an audiogram, which is a graph displaying intensity as a function of frequency. Otoacoustic Emission Testing Otoacoustic Emission (OAE) testing measures the status of the inner ear (cochlea), specifically hair cell function. It is an objective test that can be used on patients of any age. The test can even be performed on sleeping babies because it does not rely on behavioural responses. Tympanometry and Acoustic Reflex Testing
Tympanometry measures the function of the middle ear. A small soft probe is placed in the ear canal then the response of the ear drum to pressure changes is measured.

Acoustic Reflex testing measures a reflex arc that goes between the middle ear and brainstem in the auditory system which is elicited by an intense stimulus. These tests do not directly assess hearing ability, but are interpreted in conjunction with other test results. Speech Testing Word recognition/speech discrimination tests the ability to hear correctly a set of words or sentences. You will be asked to repeat back what you heard at the different intensities. Auditory Processing Testing Children with an auditory processing disorder (APD) can typically hear information at normal levels but have difficulty attending to, storing, locating, retrieving and clarifying that information to make it useful for academic and social purposes. We offer diagnostic testing for APD to those children older than seven who have passed a screening test of attention and cognition. Management and diagnosis of children with APD is performed in the private sector at a cost.  See the NZAS website, https://www.audiology.org.nz. Adult Hearing Aid Assessments Auckland Te Toka Tumai provides adult hearing aid fitting services only to those who meet the Enable criteria for the Hearing Aid Funding Scheme with a bilateral hearing loss from childhood (moderate-severe or worse) or has a "dual disability" or if they have suffered a sudden or severe hearing loss  average of 65dB in the worst 3 frequencies of .5 kHz to 4 kHz (in the better ear).

Evidence of this hearing loss needs to be provided for the referral to be considered.  Free hearing checks for adults are widely available through private audiology clinics with little to no waiting times. Also some private clinics are now offering hearing aids at greatly reduced prices or offer a "pay as you go" service.

We will see the patient while the hearing aid is still under warranty and for 6 years if they still meet the eligibility criteria for to Auckland Te Toka Tumai.

If your patient does not meet the above criteria they will have to be seen in the private sector. A list of private clinics can be found on the NZ Audiological Society website https://www.audiology.org.nz/. Balance Testing A vestibular clinic focuses on diagnosing and treating balance and dizziness problems. 

Videonystagmography VNG - uses cameras in goggles to record rapid eye movements.

Caloric testing - warm and cold air is put into the ear canal to see if this causes temporary dizziness and cameras in goggles record your eye movements.

Vestibular Evoked Myogenic Potential VEMP - electrodes are placed on the head and loud clicking sounds are presented through headphones. The patient may lift their head or raise their eyes when hearing the sounds and the electrodes measure the responses of the muscles to the sounds.

Video Head Impulse test vHIT - cameras in goggles record the eye movements when the patient's head is moved quickly, testing the vestibulo-ocular reflex.

We accept referrals for children 7 years and older and adults.

Contact

Greenlane Clinical Centre

Street address

Greenlane Clinical Centre
Greenlane West
Auckland

Postal address

GREENLANE CLINICAL CENTRE Audiology Department Level 4, Building 4 Greenlane West Road Auckland

Email: audiology@adhb.govt.nz

Starship Child Health, Central Auckland

Street address

Starship Audiology
2 Park Road
Grafton

Postal address

GREENLANE CLINICAL CENTRE Audiology Department Level 4, Building 4 Greenlane West Road Auckland

Email: audiology@adhb.govt.nz

Waitakere Hospital

Street address

Greenlane Clinical Centre
Greenlane West
Auckland

Starship Audiology
2 Park Road
Grafton

Postal address

GREENLANE CLINICAL CENTRE Audiology Department Level 4, Building 4 Greenlane West Road Auckland

Email: audiology@adhb.govt.nz

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