What Happens During a Hearing Test?

A hearing "test" actually includes several tests that measure how well you hear a variety of sounds such as tones and speech. Hearing tests are conducted by state-licensed practitioners in special sound booths or extremely quiet rooms. Generally, hearing tests result in one of two outcomes: normal hearing or some degree of hearing loss.

A baseline hearing screening is recommended at around age 50, unless you're experiencing symptoms of hearing loss sooner. Recent studies indicate that the earlier hearing loss is detected and treated, the slower it progresses. And conversely, if hearing loss goes undiagnosed, it can worsen more quickly than necessary. Because hearing loss often appears gradually, you may be unaware of its onset-so don't put off your initial hearing screening!

Hearing History

A hearing test usually begins with questions pertaining to your overall health and your hearing history. Typical questions about your hearing may include:

• Have you noticed difficulty hearing?
• Did the problem come on suddenly or gradually?
• Is there hearing loss in your family?
• Are one or two ears affected?
• Were you subjected to chronic loud noise during your life?
• Do your ears ring?
• Do you have dizziness or vertigo?
• Did you have ear infections as a child?
• Do you have ear pain?
• Is it harder to hear the voices of men, women, or children?
• Do you notice environments where it's challenging to follow the conversation?

At this time, you should also be asked about medications you take. This is important because many prescription and over-the-counter drugs are ototoxic, or harmful to your hearing. This is also the stage to mention anything else you feel relates to your hearing.

Visual Examination of the Ears

Next, your ear canal and ear drum are inspected by a lighted device called an otoscope that magnifies the structures in the ear. Most hearing care specialists use video otoscopes which show you the inside of your ear on a video screen. Among other conditions, otoscopes spot ear wax blockages, ear drum perforations and signs of infection in the ear canal or middle ear. These problems can contribute to hearing loss, and are generally corrected by medical doctors. If none of these conditions is found however, the hearing screening continues with the pure-tone air-conduction test.

Air Conduction Testing

The pure-tone air-conduction test notes the very softest tones you can hear at least 50% of the time they are played for you. During this test, you will sit in a completely quiet room or sound booth, wearing earphones. Starting with one ear, the practitioner plays tones of different frequencies, (high-to-low pitches), one at a time. When you hear the sound, you raise a finger or press a button. Each tone is played at softer and softer levels until you no longer respond consistently. The softest level you can hear is your threshold for that particular frequency. The various frequencies played represent the range of sounds you commonly hear in the world. Your responses are charted on an audiogram, and the resulting graph indicates how well your outer and middle ear structures are processing sound.

Bone Conduction Testing

Bone conduction testing uses the same process as air conduction testing, but tones are sent to a device placed behind your ear instead of into earphones. This allows sounds to bypass your outer and middle ear and pass through your skull to your inner ear. In this manner, bone conduction testing accurately assesses your inner ear's hearing ability, without influence from your outer or middle ear.

Once the results of both air conduction and bone conduction testing are plotted on your audiogram, a fuller picture of your hearing health emerges. The picture may show normal hearing or may indicate hearing loss. If the latter, the audiogram identifies the degree (mild, moderate, severe, profound), and the type (conductive, sensori-neural, mixed) of your hearing loss.

Speech Testing

The next step in the process is testing that utilizes speech. The first test requires you to repeat a series of two-syllable words that are played at successively lower levels. This test helps to determine the level at which you can detect speech. You will then be asked to repeat one syllable words set at a comfortable listening level, to see how well you understand speech. Identifying these levels helps to further determine your hearing aid candidacy. Other valuable speech tests may include:

• Speech-in-Noise testdetermines how well you hear sentences in noisy environments
• Most Comfortable Listening Level (MCL)systematically increases volume until it feels "just right"
• Threshold of Discomfort (TD)/Recruitment testsystematically increases volume until it's uncomfortable /li>

If your hearing tests show you require hearing aids for hearing loss, these speech tests help customize your hearing devices so it's easy to comprehend conversation in multiple listening environmentseven noisy ones.

Take Charge of Your Hearing Care

While a hearing screening can range from a short procedure to a battery of tests, a good hearing care professional will always take the time to explain every step, and help you understand your results. Remember, good hearing is in your control, so never hesitate to ask questions or seek answers!