What to expect at a hearing test

A hearing test is a painless, non-invasive assessment that measures how well you hear sounds across different frequencies and volumes. Knowing what to expect can help you feel comfortable and get the most out of your appointment.

Hearing tests are performed by audiologists at hearing clinics. You do not need a referral to see an audiologist in Canada, and many hearing clinics offer free hearing tests for adults.

What happens at a hearing test?

A full hearing assessment typically includes several components. Your audiologist will guide you through each step.

Health history

Your audiologist will begin by asking about your medical history and any hearing concerns. They may ask about:

• How long you have noticed changes in your hearing

• Whether hearing loss runs in your family

• Any noise exposure at work or during recreational activities

• Medications you currently take

• Whether you experience ringing in your ears (tinnitus) or dizziness

Outer and middle ear exam

Your audiologist will examine your ears using an otoscope — a small handheld device with a light. This allows them to look inside your ear canal and check for:

• Earwax blockages

• Inflammation or infection

• Damage to the eardrum

• Foreign objects

They may also perform tympanometry, which measures how well your eardrum moves. A small probe is placed at the entrance of the ear canal and creates a gentle change in air pressure. This test is painless and takes only a few seconds. It helps detect fluid behind the eardrum, a perforated eardrum, or problems with the middle ear bones.

Pure-tone test

The pure-tone test is the most common part of a hearing assessment. You will wear headphones or small earphones and listen for a series of beeping tones. Each tone plays at a different pitch (frequency) and volume (decibel level).

When you hear a tone — even if it is very faint — you press a button or raise your hand. Your audiologist uses your responses to determine the softest sound you can hear at each frequency. This is called your hearing threshold.

Each ear is tested separately. The results are plotted on a graph called an audiogram.

Speech test

A speech test measures how well you can hear and understand spoken words. You may be asked to:

• Repeat back words spoken at different volumes

• Identify words in the presence of background noise

This helps your audiologist understand how your hearing loss affects your ability to communicate in everyday situations.

Understanding your audiogram

Your audiogram is a chart that maps the results of your pure-tone test. It shows the softest sounds you can hear at different frequencies, ranging from low-pitched to high-pitched sounds.

Hearing care professionals use the following terms to describe the degree of hearing loss:

• Normal hearing (0–20 dB) – You can hear most speech sounds clearly in quiet and noisy environments.

• Mild hearing loss (21–40 dB) – You may miss soft speech sounds or struggle to follow conversations in noisy environments.

• Moderate hearing loss (41–70 dB) – You will miss many speech sounds and may frequently ask others to repeat themselves.

• Severe hearing loss (71–90 dB) – You will miss most conversational speech. Using a standard telephone will be very difficult.

• Profound hearing loss (91 dB or more) – You cannot hear speech sounds even at very loud levels.

Hearing tests for babies and young children

Young children and infants cannot respond to a standard hearing test the way adults can. Audiologists use specialized tests suited to each age and developmental stage.

Otoacoustic emissions (OAE)

OAE testing checks whether the inner ear (cochlea) is responding to sound. A small probe is placed in the ear canal and emits sounds. A healthy cochlea will produce faint sounds in response — these are the otoacoustic emissions. The test is quick and does not require a response from the child.

OAE testing is commonly used in newborn hearing screenings.

Auditory brainstem response (ABR)

ABR testing measures how the hearing nerve and brainstem respond to sounds. Small electrodes are placed on the baby's head and behind the ears. Clicking sounds are played through small earphones while the baby sleeps or rests quietly.

ABR testing can identify hearing loss even in newborns and does not require any participation from the child.

Visual reinforcement audiometry (VRA)

VRA is used for children between six months and two and a half years of age. The child is conditioned to turn their head toward a sound source. When they respond correctly, a visual reward — such as a flashing light or animated toy — is activated. This reinforces the behaviour and encourages the child to respond consistently.

Tympanometry

As with adults, tympanometry can be performed on children to assess middle ear function. It is particularly useful for detecting fluid in the middle ear, which is common in young children with recurrent ear infections.

School hearing screenings

Many schools conduct routine hearing screenings to identify children who may have hearing difficulties that could affect learning. School screenings are basic pass or fail tests, not full hearing assessments.

If your child does not pass a school hearing screening, follow up with a full hearing assessment at a hearing clinic. A failed screening does not necessarily mean your child has permanent hearing loss — it may be due to a cold, fluid in the ear, or excess earwax.

Online hearing tests

Online hearing tests can give you a general idea of your hearing ability from the comfort of your home. However, they cannot replace a professional hearing assessment. Factors like speaker quality, background noise and listening environment can affect the results.

If you are concerned about your hearing, use an online test as a first step — then book a full hearing test with a hearing care professional.

When should you get a hearing test?

It is a good idea to get a hearing test if you:

• Have difficulty hearing in noisy environments

• Frequently ask others to repeat themselves

• Turn up the television or radio volume higher than others prefer

• Have ringing, buzzing or hissing in your ears (tinnitus)

• Have been exposed to loud noise over many years

• Are over the age of 50

For adults with no known hearing concerns, a baseline hearing test is recommended at age 50, or sooner if you have risk factors like occupational noise exposure or a family history of hearing loss.

How to find a hearing test near you

Hearing Directory lists trusted hearing clinics across Canada. Find a hearing clinic near you to book your hearing assessment today.