Diagnostic Hearing Evaluation

The hearing evaluation is carried out to determine for each person whether a hearing loss exists and to outline the type and severity of loss. It provides insight into the cause of the hearing loss as well as guidance to the audiologist in making appropriate treatment recommendations.

What Tests Will Be Done?

A diagnostic audiologic evaluation includes pure tone air and bone conduction testing, speech testing and tympanometry, at a minimum.

Additional testing, such as speech-in-noise testing, acoustic reflex testing and otoacoustic emissions, may also be carried out depending on the person’s age and what is known already about their hearing. These various tests will help to outline the degree and type of hearing loss and the condition of the ear canal and middle ear. The tests will allow the audiologist to determine if the loss is conductive (middle ear disorder) or sensorineural (inner ear or auditory nerve disorder).

Otoscopy and Tympanometry

The audiologist begins with otoscopy, a visual inspeciton of the ear canal, to make sure the canal is free from excessive cerumen, or earwax, which could interfere with the ability of sound to reach the eardrum and lead to erroneous test results. The general condition of the ear canal is also examined.

Following the otoscopy, tympanometry (test of the middle ear) is carried out to determine if the tympanic membrane, or eardrum, is vibrating freely and to give an assessment of the status of the middle ear.

Pure Tone Air and Bone Conduction Testing

With pure tone air conduction testing, the quietest tone a person can hear at different frequencies is measured. Low, mid and high frequencies, or pitches, are presented. Bone conduction testing is carried out also, and is similar to pure-tone air conduction testing, With this testing, a small dense object, is placed gently behind the the ear or on the forehead. This bone vibrator carries tiny vibrations of sound that directly stimulate the inner ear and nerve and allows a person to hear. The bone conduction results help the audiologist to determine if the hearing loss is originating from the middle ear or inner ear.

Speech Testing

A speech reception threshold (SRT) test is carried out to determine the lowest level at which the patient can recognize and repeat simple words. The SRT is used to cross check or confirm the results of the pure tone test.

A Word Recognition Test is to determine the degree to which a person can hear and repeat words clearly. This test measures the percent accuracy in repeating words presented at a comfortable or loud level. The Word Recognition Score (WRS) can further help to assess the type of hearing loss and direct treatment options.

Discussing Test Results and Treatment Options

After the hearing evaluation, the audiolgist will interpret the tests, review the results with you and answer any questions you may have. If you need a referral to another specialist, you will be given the necessary information for this.

To determine the best path toward better hearing, the audiologist will do a complete Communication Needs Assessment and begin discussing treatment options.

Audiologists are specialists in hearing assessment and hearing rehabilitation. Never hesitate to ask your audiologist for clarification or further information on anything you do not understand.

Additional Tests

Specialized tests exist for infant and children. Other tests are used with adults with developmental and cognitive impairments. These more-specialized tests allow the audiologist to test the auditory system when the patient is not able to particiate actively in the testing process.

Why the Hearing Evaluation is Important

Diagnostic hearing evaluations identify hearing loss and give your audiologist important information to help determine the best course of action for treatment. Some types of hearing loss can be treated medically or surgically, so it's important that these types of hearing losses be ruled out before hearing aids or other treatments are considered.

If it is determined that you could benefit from hearing devces, the diagnostic hearing evaluation helps your audiologist know which hearing system will be most appropriate for you.

What Can I Expect During the Hearing Evaluation?

The evaluation will take about 30 to 40 minutes in length. It is recommended that you bring a family member or close friend with you to the appointment. Hearing loss also affects those around us. It helps to have another supportive person at the appointment to help you understand the information and recommendations.

Before your test, a complete medical history will be completed and the audiologist will want to hear about the difficulty you are experiencing with hearing clearly. He or she will pay special attention to any concerns you have about your history of noise exposure, tinnitus, and balance problems. Make sure that you take a full list of any medications and supplements you are taking with you to your appointment.

The diagnostic hearing evaluation is a good chance to establish a relationship with your audiologist. It helps to ask around for recommendations for audiologists in your area and find someone who listens carefully to your concerns. Above all, don't be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding hearing solutions that work best for you and your lifestyle.

    Other tests may include:

  • Visual reinforcement and conditioned play audiometry, for children
  • Otoacoustic emissions (OAE) testing
  • Auditory brainstem response (ABR) and auditory steady-state response (ASSR) testing