Reasonable Adjustments

Eye tests can be adapted to support children and young people with learning disabilities or other additional needs.

Many adjustments can be planned before the appointment.

It helps to tell the optician or eye clinic about the child’s needs before the day of the test.

Examples of reasonable adjustments include:

• visiting the practice or hospital before the test so the child can get used to the rooms

• booking the appointment at a quiet time or at a time of day that suits the child best

• doing the tests while the child stays in their wheelchair (you may need to check access and room size before the visit)

• using different types of vision tests, such as Kay Pictures, Cardiff Cards, Keeler Cards or the Bradford Visual Function Box

• spreading the tests over more than one visit if the child gets tired or finds it hard to concentrate

• explaining each step of the test to the child, or showing the test on a parent or carer first

Some children find glasses uncomfortable because of sensory differences.

These ideas may help:

• try ultralight, flexible glasses — these are soft, light and bend without breaking

• use an elastic strap to help keep the glasses in place — the gentle pressure can feel calming for some children

• check the frames often, as some children pull glasses off when the frames become bent

• bring hearing aids to the appointment if the child wears them, so the glasses can be fitted comfortably around them

Books to Help Children Wear Their Glasses

Some children find it hard to wear their glasses.

The Glasses Fairy book can help.

It tells a fun story to encourage children to wear their glasses.

There is also a guide at the back of the book based on psychological research.
Families can use the guide and story together to help build a routine and make wearing glasses more positive.

An experienced children’s audiologist (a specialist in hearing tests) can assess the hearing of children from birth.

Every child is different. One of the hardest parts of the test can be helping the child feel calm and safe. Building trust takes time.

Some children need many short visits to get used to:

• the audiologist

• the clinic

• the equipment

They may need time to get used to having their ears touched.

They may also need a few different types of tests over several visits to get a full and accurate picture of their hearing.

Before your child’s first appointment, it helps to talk to the audiologist. They can tell you what will happen so you can prepare your child.

You can play simple “wait and listen” games with your child before the hearing test.

These games teach your child to listen for a sound and then do an action.

Choose a toy your child enjoys, such as:

• a ball and bucket

• building blocks

• a toy drum

How to play:

1. Put the toys in front of your child.

2. Ask your child to “wait” and “listen.”

3. Make a clear sound, like a clap, tapping a drum, or saying “go.”

4. Show your child what to do when they hear the sound (e.g., drop the ball in the bucket).

5. Repeat the sound and action until your child copies it.

6. Keep practising until your child waits, listens and responds each time.

You can make the game harder by:

• sitting or standing behind the child so they cannot see you make the sound

• making the sounds louder or quieter

More information

When a child starts wearing hearing aids, it is important that they wear them often.

This helps them get used to the sounds and helps the audiologist understand how well the hearing aids work.

Parents have shared these tips:

• Make sure the hearing aids fit well and feel comfortable.

• Build up wearing time slowly — start with a few minutes several times a day.

• If your child takes the hearing aids out, take a break and try again later. Keep it positive.

• Make hearing aids part of a daily routine.

• Make the hearing aids fun with colours or decorations.

• Use distractions (favourite toy, TV) when putting them in.

• Show your child other people who wear hearing aids.

• Use rewards, such as stickers or small treats.

More information

There are several types of hearing tests for babies, children and young people.

The type of test depends on the child’s age and needs.

Hearing Test for Newborn Babies

This test checks a baby’s hearing soon after birth.
It is quick and painless.

Hearing Tests for Young Children

These tests are designed to match a child’s stage of development.

Hearing Test Using Sounds and Lights (Visual Reinforcement Audiometry – VRA)

Used from around 6 months.
The child hears a sound and is rewarded with a picture or light.

Hearing Test Using Play and Games (Play Audiometry)

Often used from age 2.
The child hears a sound and then does an action, like putting a block in a box.

Hearing Test Using Beeps (Pure Tone Audiometry)

The child wears headphones and listens for beeps.
They press a button or raise their hand when they hear a sound.

Hearing Test Using Gentle Vibrations (Bone Conduction Test)

A small device is placed behind the ear.
It sends gentle vibrations to the inner ear to check where the hearing problem is.

Test That Checks the Middle Ear (Tympanometry)

This checks how well the eardrum moves.
It can help detect fluid behind the eardrum, such as glue ear.

More information

Babies, children and young people may have several types of eye tests.

These tests check how well they can see and whether there are any eye‑health problems.

Eye Health Check Using a Light (Red Reflex Test)

A light is shone into the eyes.
The reflection helps show if the eyes are healthy.

Eye Test That Checks How the Pupil Reacts (Pupil Reflex Test)

Checks how the pupil gets smaller or larger when light is shone into it.

Checking How a Baby Looks at Things (Attention to Visual Objects)

This checks whether a baby or young child looks at and follows moving objects.

Reading Letters from a Chart (Snellen and LogMAR Charts)

These charts have letters or symbols that get smaller on each line.
Children read the letters to show how clearly they can see.

Tests That Check Eye Movements (Range of Movement Tests)

These tests check whether the eyes move smoothly in all directions.

Test to See If Your Child Needs Glasses (Refraction Test)

The optician checks how the eyes focus light.
This helps determine the correct lens strength.

Tests for Colour Blindness (Colour Vision Deficiency Tests)

These tests check whether your child can tell different colours apart.

More information