Several aetiological categories are associated with changing sensorineural thresholds (SNHL) in children. However, details about the nature of the changing pattern and the audiological management of such cases are rarely reported in the literature. The aims of the present study were, therefore, to analyse and describe the audiological patterns of children with changing SNHL, to investigate the relationship between changing audiological patterns and aetiology of SNHL, and to describe the test procedures and audiological management used for these children. Twenty-one children with changing SNHL, 12 parents of the children and five audiologists were the participants in this study. The study used a retrospective case study design with data being collected on the children from a file audit. The degree of change in hearing thresholds over time was examined for each child in terms of the frequencies that showed change and the decibel range of threshold change. In addition, details of all test procedures were recorded. Parents and audiologists were surveyed to investigate the audiological management strategies used for the children who experienced changing SNHL. Deterioration in hearing was the most common changing SNHL pattern, followed by improvement in sensorineural thresholds. For four children, the improvement was such that they no longer required their hearing aid amplification. Only the children within three aetiological groups maternal rubella, meningitis and large vestibular aqueduct syndrome displayed common changing SNHL patterns. That is, the children within each group showed similar SNHL changing patterns. However, these SNHL patterns were different between each of the aetiology groups. The results showed that regular hearing assessment together with parental interview were the best indicators of the pattern of the changing SNHL. Overall, the parents were able to predict their childs hearing changes prior to these being confirmed on behavioural or electrophysiological audiological assessment. Regardless of the aetiological category, the audiologists managed the change in hearing similarly for the children. The findings of this study have a number of clinical implications for children with changing SNHL. It is recommended that the children receive regular behavioural hearing assessments, referral for electrophysiological assessment as needed, and regular functional assessments, together with a parental interview. Information should be shared across all professionals working with the child and a written management plan should be developed for each child.