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Home Help Hearing loss Tests ... Hearing tests Contributed by Christine De Luca, Au.D. Reg. CASLPO, Contibutor, Hearing Directory This content was last reviewed on: July 27th, 2020 2020-07-27 00:00:00 2020 Tests Find out what to expect at your next hearing test appointment and how annual testing can lead you to better hearing health. Hearing test ear examination Hearing tests are a method of testing and evaluating your hearing and are easy and painless. A hearing test not only can determine if you have hearing loss, but also the degree of hearing loss (mild, moderate, severe, and profound). Hearing tests are straight-forward, painless and easier than most people think. A thorough hearing evaluation performed by a qualified hearing professional can define the type of hearing loss you have and the available treatment options. Hearing loss can affect anyone and often progresses gradually that it can be difficult to notice until you experience symptoms. Hearing loss can have extended effects on your overall health, including an effect on your quality of life. Getting a baseline hearing test is the first step to better hearing health. Your hearing health history During your visit to your hearing healthcare center, a two-step initial process takes place. First, a registration of your information including your name, date of birth, address and consent to treatment will be completed. Second, a case history of your hearing health including questions related to prior noise exposure, history of hearing loss in your family and symptoms of ringing in the ears will be asked before the testing begins. A list of medications and any medical conditions including allergies, head colds, ear infections and impacted earwax can contribute to your case history as well to determine the cause of hearing loss. This will give the hearing healthcare professional some insight into what concerns you may have, the symptoms you are experiencing and how they are affecting your daily life. Once your hearing health registration and case history is completed, your hearing test will begin. Hearing tests for adults The hearing professional will begin with a thorough examination of the outer ear – comprised of the pinna (earlobe), the ear canal and part of the tympanic membrane (eardrum). They will evaluate the condition of the outer ear through the use of an otoscope – a device used to look into the ear, and determine if there is any wax in the ear canal that may restrict testing. If earwax buildup is a restriction for testing, the hearing professional will perform earwax removal in the clinic or refer you to a medical professional who is specialized in cerumen management. Some general physicians perform earwax removal, so be sure to ask your doctor if they do at your next visit. Next, your hearing professional will proceed to evaluate the middle ear. This is where the three smallest bones in our body are located and also where conductive hearing loss may be detected. A tympanometer (timp-o-nom-it-er) – a device that sends a “puff” of air and sound to the eardrum is used to measure how the eardrum “bounces back”. To do this, the hearing professional will insert a soft rubber tip into your ear and in just a few seconds the device will generate a result. This evaluation helps determine if there are any abnormalities in the middle ear space. Hearing tests take place in a specialized booth that is sound treated. Finally, your hearing professional will proceed to perform pure-tone air-conduction and bone-conduction testing as well as speech testing. In pure-tone air-conduction and bone-conduction testing, you will be presented with a series of pure tones and your hearing professional will ask you to press a button (or raise your hand) to indicate the softest tone you can hear (or threshold). These tones may change in pitch (frequency). Some will sound like a low bass note and others will sound like a high treble note. The hearing professional will then record these results on a graph called an audiogram. The audiogram will show if there is a hearing loss or not. Hearing loss is measured in decibels (dB) and in the following categories: Normal hearing (0 to 25 dB HL) Mild hearing loss (26 to 40 dB HL) Moderate hearing loss (41 to 70 dB HL) Severe hearing loss (71 to 90 dB HL) Profound hearing loss (greater than 91 dB HL) In speech testing, they will ask you to repeat a list of words given at different volumes. Speech testing helps the hearing professional gage how well the auditory nerve is responding to word discrimination ability – or how well you can decipher words that sound similar. Together, these results will enable the hearing professional to determine the best treatment plan for you, if one is necessary. The entire process takes approximately 20 minutes to complete. Once the test is complete, your hearing professional will review the results with you immediately and answer any questions you may have. Hearing tests for babies and children Hearing loss in childhood is especially important to identify early on and seek intervention. If left untreated, it can have implications for speech and language development, social development and success in education. There are many causes of hearing loss in children. These could be (but not limited to) congenital factors, head trauma, chronic ear infections, malformations of the ear, illness in childhood and medications. Most hospitals are equipped with tools that appropriately and accurately screen an infant’s hearing at birth. The Infant Hearing Screening Program (IHP) assesses infants in the hospital and will refer to the appropriate facility for further testing if the initial screening has failed. Hearing tests for babies and children are gentle, simple and similar to adult testing. When testing children in a hearing center, testing processes are quite similar to adult testing. The hearing professional will begin the hearing assessment by reviewing the case history. Depending on the age of the child, this may be completed with the parent or caregiver, with the child or both. This will help determine the nature of the visit. Next, the hearing professional will complete a thorough examination of the outer ear and proceed to the tympanometric assessment of the middle ear space – the function of the eardrum. Finally, depending on the age of the child, pure tone audiometry and age-appropriate word testing are completed and recorded on the audiogram. If the child is of age where they can respond reliably to the pure tone “beeps” using a traditional method like a button press, then the hearing professional will test them in this way. If the child is less than 2 years of age or unable to complete the traditional method of testing, Visual Reinforcement Audiometry (VRA) may be completed. In VRA testing, the child typically sits on the parent’s or caregiver’s lap or in a child seat in a sound booth where speech sounds are presented through two speakers at opposite ends. The hearing professional will begin the test by playing a sound and displaying a visual display (i.e. video or lit-up teddy bear) simultaneously to stimulate the child to turn their head towards the direction of the display. This “trains” the child to respond by shifting their head toward the sound source. Once the child has learned what to do when they hear a sound, the hearing professional will continue to play sounds at different frequencies to determine your child’s hearing profile. The results are obtained right away and are reviewed with the parent or caregiver. Testing times can vary depending on the cooperation of the child and the complexity of the hearing concern. Hearing screenings Hearing screenings are a quick and efficient way of assessing how well you hear different sounds. Screenings are not as involved as a hearing test, but are still valuable. Screenings are often performed to determine if someone will “pass” or “fail” at a certain level (i.e. within “normal” hearing limits of the audiogram). An otoscopic examination – a visual inspection of the outer ear, ear canal and eardrum would be completed first. Then, headphones (or insert earplugs) are put in and the hearing professional and/or doctor will test a few frequencies (or tones) at a certain decibel level or loudness (Intensity). If the patient responds, they will mark that tone as a ‘pass’ and if they do not respond, they will mark it as a ‘fail’. The hearing screening generates either pass or fail results. If you fail your hearing screening, we recommend you receive further testing with your hearing professional to evaluate if you have hearing loss. A hearing professional can provide you with a more comprehensive and thorough hearing test. This should be completed as soon as possible after the failed screening. Ask your doctor for a hearing screening if you have concerns about your own hearing, your child’s, or someone you know. Online hearing tests Simplified hearing screenings are available online or via an application on mobile phones. Although they do not replace a thorough examination conducted in a hearing clinic, they are a quick and an easy place to start. If you are hesitant about booking a hearing test or completing a hearing screening at your doctor’s office, start here. There are two types of online or mobile application-based hearing tests: Sound format: a series of tones are presented and a threshold – quietest sound level you can hear is recorded. This type requires a set of headphones or earbuds. Question format: a set of questions to determine if you are experiencing symptoms of hearing loss and if it is affecting your daily activities. These types of tests can give you a rough estimate of your hearing level or concerns, but should not be replaced by a thorough and comprehensive hearing assessment provided by a hearing healthcare professional. You may choose to bring your online hearing test results to your next hearing test appointment so the hearing healthcare center can keep a record of it in your case history. Understanding your hearing test results Once your hearing professional has completed your hearing assessment and has reviewed the results with you, this is the time to ask questions. Hearing professionals typically allow for extra appointment time to consult with their clients in order to help them understand what is happening with their hearing health. It is also at this time that a prescription and/or recommendation(s) may be provided to you. Take the time to understand how your hearing loss is impacting the different areas of your life and review the treatment options. Be sure to book a follow-up appointment with your hearing professional if you have any more questions that come up after your visit. Some hearing professionals will contact you within 48 hours of your hearing test to ensure you understand your results and ask if you have any further questions they can answer. It is also helpful to discuss the results of your hearing test with friends or family, who can help you to see the bigger picture. They may be able to help you better understand your hearing test results, treatment options, and provide you support. Remember, hearing loss can affect anyone and is a common health concern. You are not alone and there is lots of help. Visit our directory to schedule a hearing test near you. We can help you in taking your first step to better hearing health. Christine De Luca, Au.D. Reg. CASLPO, Contibutor, Hearing Directory Christine De Luca earned her doctorate in audiology from Arizona School of Health Sciences. She practices as a full-time clinical audiologist and regional manager at a major private practice hearing clinic. Christine is guided by her extensive experience in hearing research to provide quality hearing care to people with hearing loss. As a research assistant, she studied the effects of audition and psychology in the Human Communication Laboratory Psychoacoustics department at the University of Toronto. Later, as a research audiologist, she worked to collaborate and investigate the effects of audition and cortical function with senior participants at the University of Toronto, Mississauga campus. Christine is registered with the College of Audiologists and Speech-Language Pathologists of Ontario. Share Tweet Share Pin Help menu You are reading about: Hearing loss / Tests Related topics Types Prevention Treatment Tinnitus treatment More information about hearing aids. Find a clinic Enter city or zip/postal code The Healthy Hearing Report Back to Top Want to read more? Treatment

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Hearing tests

Contributed by Christine De Luca, Au.D. Reg. CASLPO, Contibutor, Hearing Directory
This content was last reviewed on: July 27th, 2020 2020-07-27 00:00:00 2020 Tests

Find out what to expect at your next hearing test appointment and how annual testing can lead you to better hearing health.

Hearing tests are a method of testing and evaluating your hearing and are easy and painless. A hearing test not only can determine if you have hearing loss, but also the degree of hearing loss (mild, moderate, severe, and profound).

Hearing test ear examination — Hearing tests are straight-forward, painless
and easier than most people think.

A thorough hearing evaluation performed by a qualified hearing professional can define the type of hearing loss you have and the available treatment options.

Hearing loss can affect anyone and often progresses gradually that it can be difficult to notice until you experience symptoms. Hearing loss can have extended effects on your overall health, including an effect on your quality of life.

Getting a baseline hearing test is the first step to better hearing health.

Your hearing health history

During your visit to your hearing healthcare center, a two-step initial process takes place. First, a registration of your information including your name, date of birth, address and consent to treatment will be completed. Second, a case history of your hearing health including questions related to prior noise exposure, history of hearing loss in your family and symptoms of ringing in the ears will be asked before the testing begins. A list of medications and any medical conditions including allergies, head colds, ear infections and impacted earwax can contribute to your case history as well to determine the cause of hearing loss. This will give the hearing healthcare professional some insight into what concerns you may have, the symptoms you are experiencing and how they are affecting your daily life. Once your hearing health registration and case history is completed, your hearing test will begin.

Hearing tests for adults

The hearing professional will begin with a thorough examination of the outer ear – comprised of the pinna (earlobe), the ear canal and part of the tympanic membrane (eardrum). They will evaluate the condition of the outer ear through the use of an otoscope – a device used to look into the ear, and determine if there is any wax in the ear canal that may restrict testing.

If earwax buildup is a restriction for testing, the hearing professional will perform earwax removal in the clinic or refer you to a medical professional who is specialized in cerumen management. Some general physicians perform earwax removal, so be sure to ask your doctor if they do at your next visit.

Next, your hearing professional will proceed to evaluate the middle ear. This is where the three smallest bones in our body are located and also where conductive hearing loss may be detected. A tympanometer (timp-o-nom-it-er) – a device that sends a “puff” of air and sound to the eardrum is used to measure how the eardrum “bounces back”. To do this, the hearing professional will insert a soft rubber tip into your ear and in just a few seconds the device will generate a result. This evaluation helps determine if there are any abnormalities in the middle ear space.

Hearing test booth — Hearing tests take place in a specialized booth
that is sound treated.

Finally, your hearing professional will proceed to perform pure-tone air-conduction and bone-conduction testing as well as speech testing.

In pure-tone air-conduction and bone-conduction testing, you will be presented with a series of pure tones and your hearing professional will ask you to press a button (or raise your hand) to indicate the softest tone you can hear (or threshold). These tones may change in pitch (frequency). Some will sound like a low bass note and others will sound like a high treble note.

The hearing professional will then record these results on a graph called an audiogram. The audiogram will show if there is a hearing loss or not.

Hearing Test Audiogram

Hearing loss is measured in decibels (dB) and in the following categories:

Normal hearing (0 to 25 dB HL)
Mild hearing loss (26 to 40 dB HL)
Moderate hearing loss (41 to 70 dB HL)
Severe hearing loss (71 to 90 dB HL)
Profound hearing loss (greater than 91 dB HL)

In speech testing, they will ask you to repeat a list of words given at different volumes. Speech testing helps the hearing professional gage how well the auditory nerve is responding to word discrimination ability – or how well you can decipher words that sound similar. Together, these results will enable the hearing professional to determine the best treatment plan for you, if one is necessary.

The entire process takes approximately 20 minutes to complete. Once the test is complete, your hearing professional will review the results with you immediately and answer any questions you may have.

Hearing tests for babies and children

Hearing loss in childhood is especially important to identify early on and seek intervention. If left untreated, it can have implications for speech and language development, social development and success in education. There are many causes of hearing loss in children. These could be (but not limited to) congenital factors, head trauma, chronic ear infections, malformations of the ear, illness in childhood and medications.

Most hospitals are equipped with tools that appropriately and accurately screen an infant’s hearing at birth. The Infant Hearing Screening Program (IHP) assesses infants in the hospital and will refer to the appropriate facility for further testing if the initial screening has failed.

Hearing test children — Hearing tests for babies and children are
gentle, simple and similar to adult testing.

When testing children in a hearing center, testing processes are quite similar to adult testing. The hearing professional will begin the hearing assessment by reviewing the case history. Depending on the age of the child, this may be completed with the parent or caregiver, with the child or both. This will help determine the nature of the visit.

Next, the hearing professional will complete a thorough examination of the outer ear and proceed to the tympanometric assessment of the middle ear space – the function of the eardrum.

Finally, depending on the age of the child, pure tone audiometry and age-appropriate word testing are completed and recorded on the audiogram. If the child is of age where they can respond reliably to the pure tone “beeps” using a traditional method like a button press, then the hearing professional will test them in this way. If the child is less than 2 years of age or unable to complete the traditional method of testing, Visual Reinforcement Audiometry (VRA) may be completed.

In VRA testing, the child typically sits on the parent’s or caregiver’s lap or in a child seat in a sound booth where speech sounds are presented through two speakers at opposite ends. The hearing professional will begin the test by playing a sound and displaying a visual display (i.e. video or lit-up teddy bear) simultaneously to stimulate the child to turn their head towards the direction of the display. This “trains” the child to respond by shifting their head toward the sound source. Once the child has learned what to do when they hear a sound, the hearing professional will continue to play sounds at different frequencies to determine your child’s hearing profile. The results are obtained right away and are reviewed with the parent or caregiver.

Testing times can vary depending on the cooperation of the child and the complexity of the hearing concern.

Hearing screenings

Hearing screenings are a quick and efficient way of assessing how well you hear different sounds. Screenings are not as involved as a hearing test, but are still valuable. Screenings are often performed to determine if someone will “pass” or “fail” at a certain level (i.e. within “normal” hearing limits of the audiogram).

An otoscopic examination – a visual inspection of the outer ear, ear canal and eardrum would be completed first. Then, headphones (or insert earplugs) are put in and the hearing professional and/or doctor will test a few frequencies (or tones) at a certain decibel level or loudness (Intensity). If the patient responds, they will mark that tone as a ‘pass’ and if they do not respond, they will mark it as a ‘fail’. The hearing screening generates either pass or fail results. If you fail your hearing screening, we recommend you receive further testing with your hearing professional to evaluate if you have hearing loss. A hearing professional can provide you with a more comprehensive and thorough hearing test. This should be completed as soon as possible after the failed screening.

Ask your doctor for a hearing screening if you have concerns about your own hearing, your child’s, or someone you know.

Online hearing tests

Simplified hearing screenings are available online or via an application on mobile phones. Although they do not replace a thorough examination conducted in a hearing clinic, they are a quick and an easy place to start. If you are hesitant about booking a hearing test or completing a hearing screening at your doctor’s office, start here.

There are two types of online or mobile application-based hearing tests:

Sound format: a series of tones are presented and a threshold – quietest sound level you can hear is recorded. This type requires a set of headphones or earbuds.
Question format: a set of questions to determine if you are experiencing symptoms of hearing loss and if it is affecting your daily activities.

These types of tests can give you a rough estimate of your hearing level or concerns, but should not be replaced by a thorough and comprehensive hearing assessment provided by a hearing healthcare professional. You may choose to bring your online hearing test results to your next hearing test appointment so the hearing healthcare center can keep a record of it in your case history.

Understanding your hearing test results

Once your hearing professional has completed your hearing assessment and has reviewed the results with you, this is the time to ask questions. Hearing professionals typically allow for extra appointment time to consult with their clients in order to help them understand what is happening with their hearing health. It is also at this time that a prescription and/or recommendation(s) may be provided to you. Take the time to understand how your hearing loss is impacting the different areas of your life and review the treatment options. Be sure to book a follow-up appointment with your hearing professional if you have any more questions that come up after your visit.

Call a professional for hearing help Some hearing professionals will contact you within 48 hours of your hearing test to ensure you understand your results and ask if you have any further questions they can answer.

It is also helpful to discuss the results of your hearing test with friends or family, who can help you to see the bigger picture. They may be able to help you better understand your hearing test results, treatment options, and provide you support.

Remember, hearing loss can affect anyone and is a common health concern. You are not alone and there is lots of help. Visit our directory to schedule a hearing test near you. We can help you in taking your first step to better hearing health.

Christine De Luca, Au.D. Reg. CASLPO, Contibutor, Hearing Directory

Christine De Luca earned her doctorate in audiology from Arizona School of Health Sciences. She practices as a full-time clinical audiologist and regional manager at a major private practice hearing clinic. Christine is guided by her extensive experience in hearing research to provide quality hearing care to people with hearing loss. As a research assistant, she studied the effects of audition and psychology in the Human Communication Laboratory Psychoacoustics department at the University of Toronto. Later, as a research audiologist, she worked to collaborate and investigate the effects of audition and cortical function with senior participants at the University of Toronto, Mississauga campus. Christine is registered with the College of Audiologists and Speech-Language Pathologists of Ontario.

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