What to Expect from a Complete Hearing Test
If you are experiencing hearing loss, before you have a hearing
test administered, it is important that you first visit your physician
or an ENT to find out if there is a medical cause. The doctor will
be able to assess your situation and may be able to treat your underlying
issues, such as an ear infection, a blockage, or even a hole in
your eardrum. Once all of your medical issues have been resolved
and your doctor determines that you could potentially benefit from
a hearing aid, he or she will then likely recommend that you have
a complete round of hearing tests administered.
Hearing tests can be performed by an audiologist or a licensed
hearing aid fitter, as well as by a physician. Your doctor may be
able to give you a referral, and your insurance will likely cover
the cost of your hearing test, although you should speak with your
carrier to get confirmation. In addition, certain hearing aid vendors
may also make the hearing test available free of charge. However,
free hearing tests may come along with high sales pressure to buy
your hearing aid from that particular vendor, so enter into that
situation with caution. If you ever feel any sales pressure, you
have the right to leave.
The Beginning of Your Visit
When you go to the audiologist or fitter’s office for your
hearing test, you will first have a discussion with the test administrator
about your medical history as well as your history of hearing loss
in general. You may be asked questions about noise exposure, medications
you are taking, any ear surgeries you may have had, any diseases
of the ear that you have or had, and hereditary factors. It may
be helpful to bring notes with you to make sure that you cover everything
comprehensively before the hearing test begins.
Upon completion of this discussion, you will be put through a series
of seven different hearing tests to gauge different aspects of hearing
loss. Different audiologists and fitters may do the following hearing
tests in a slightly different order, but the sequence below outlines
what is most common. It is extremely important that you have all
of these tests done to create the most complete picture of your
hearing – and all of these hearing tests can be performed
in a single office visit.
The First Step - Tympanometry
The first step in your hearing test is tympanometry. Tympanometry
tests the movement of the eardrum. During this painless test, you
need to do nothing but relax and let the readings be taken. The
hearing test administrator will begin by placing the tip of a handheld
tool into your ear. This tool will change the air pressure inside
your ear and will also produce a clear tone. It will then measure
how your eardrum responds to the pressure change and to the sound.
This test will help to set a baseline for the rest of the hearing
tests by letting the administrator know if any specific medical
issues, such as an ear infection or a blockage of your Eustachian
tube, should to be taken into consideration.
The Next Step – Hearing Tests that Require Headphones
Next, you will be placed in a soundproof room and given headphones
through which the administrator will speak to you or play sounds.
You will then be given a series of hearing tests through these headphones,
including a pure-tone test, a speech reception threshold test (SRT),
a most comfortable listening level test (MCL), an uncomfortable
loudness level test (UCL), and a word recognition test, also commonly
known as a speech discrimination test.
First, you will be given a pure-tone hearing test, which can help
to determine the type, degree, and configuration of your hearing
loss. Pure-tone thresholds (PTTs) determine the softest level at
which you can hear the tone at least 50 percent of the time. For
this hearing test, you will be asked to indicate each time you hear
a tone in the headphones by either raising your hand or pressing
a button.
The SRT test will be administered next. During this hearing test,
you will be asked to repeat several two-syllable words while the
intensity is decreased in order to find the lowest level at which
you are able to repeat half of the words. Then, the MCL test will
be performed to determine the loudness at which you prefer to hear
by having you identify the level at which it is easy and comfortable
to hear sounds. The UCL test (also called the upper level of comfortable
loudness) will then do the opposite and will find the loudest level
that you would ever wish to listen to – with anything louder
being painful. During this portion of the hearing test, the volume
in the headphones will slowly be raised, and you will be asked to
indicate when the voice you hear has reached this upper level. These
three hearing tests can give great insight into your level of hearing
loss.
You will then be given the word recognition/speech discrimination
test, in which you will listen to a set of single syllable, phonetically
balanced words at a comfortable hearing level. You will then be
asked to repeat these words back to the administrator one at a time.
The results of this portion of the hearing test are critical to
helping you establish a realistic expectation of what a hearing
aid can do for you.
The Last Step – Bone Conduction
Finally, you will remove the headphones for the last of the hearing
tests – the bone conduction test. A small oscillator (which
looks like a small disc) will be placed on the bone behind your
ear, and it will painlessly stimulate the bones of your skull, which,
in turn, stimulate your inner ear. You will again be asked to indicate
when you hear a tone as the sound level is raised and lowered to
find a level at which you can hear the sound at least half the time.
This hearing test is used to find out whether or not your hearing
loss is affected by issues relating to your inner ear.
The Results of Your Hearing Test
Once your hearing tests are complete, the results should be available
immediately, and the administrator should discuss them with you
and put them into the context of your every day life. The hearing
tests will be able to determine if your hearing loss is conductive
(relating to the outer and/or middle ear), sensory neural (relating
to the inner ear hair cells and nerves), or a combination of the
two. The hearing test results will also tell you whether your hearing
loss is mild, moderate, severe or profound. And your speech discrimination
results will give you a practical look at what level of speech understanding
you will be able to achieve with a hearing aid, because even with
the best hearing aid you cannot achieve a level of understanding
that is better than your discrimination score.
If the administrator is also a hearing aid dispenser, he or she
may then make recommendations as to what type of hearing aid would
work best for you, and may even suggest two or three different models.
Remember – you are under no obligation to purchase your hearing
aid from the administrator of your hearing test. Because of HIPAA
regulations, you are entitled to a copy of the results of your hearing
tests without making a purchase. Remind the administrator of this
if any issues arise, and make sure that your copy of your results
also includes the date of the exam and the administrator’s
name.
Armed with the results of your hearing tests, you can then move
forward toward making the purchase of a quality hearing aid that
meets your needs. Take your time, ask a lot of questions, and shop
around for the best product at the best price. The hearing test
administrator may be the person you return to when making your purchase,
and he or she may not. The most important thing is to make sure
that when you finally buy your hearing aid, the dispenser is taking
the results of your hearing tests into consideration and is helping
you to make a purchase that will help improve your hearing for years
to come.
About the Author
Henry Smith is the founder of America Hears,
a leading manufacturer and distributor of hearing aids online for
over 26 years. The company recently rolled out its new FreedomAD
product line, which utilizes the latest generation of ADRO hearing
aid technology. Henry started the company in 1979, following a 15-year
career at the Pennsylvania School of the Deaf, including his work
as an Acoustic Technician. Henry is a pioneer in the use of computers
and the Internet to allow customers to have a hands-on approach
to the tuning and adjusting of their digital
hearing aids. He strives to be customer-centric in all aspects
of his work.
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