What happens at a hearing test

Any new experience can be daunting so therefore we thought it would be helpful and reassuring to briefly explain the basics of what happens when you go for a hearing test ...

Firstly, the audiologist or audiometrist will ask you for a brief history regarding your hearing as this may provide insight into your hearing loss. For example, is there a history of deafness in your family? Have you had any operations on your ears? Significantly, have you exposed your ears to excessive noise? Clues to your present circumstances might be hidden within the answers to these questions.

A quick examination of your ear canals using an otoscope comes next. We are looking for any abnormalities in the ear canal and ear drum, or a build up of wax which is much more common. This is followed by the insertion of a small probe into your ear canals to check out the pressure in your middle ear. This tells us if your eardrum is working correctly and whether your middle ear is clear of fluid. None of these tests are painful but they do give us a fuller picture of what is going on.

Next we perform the audiogram which involves placing a set of headphones on and testing each ear separately. We are looking to establish the threshold of your hearing at a number of different pitches ranging from low to high. Your job is to indicate when you hear the noise being presented. The threshold is the point at which you can just hear a sound. With this information we can plot your hearing onto a graph, called an audiogram.

Below we show a typical audiogram of an elderly person with hearing loss, (although this can be very similar to a younger person with a noise induced hearing loss). For simplicity, on this example we are only showing one ear.

Along the bottom are the frequencies: low frequencies/pitch to the left and high frequencies/pitch to the right. Decibels are on the left going from very quiet at the top to very loud at the bottom. So the further down the chart you are, the worse your hearing is at that frequency. Normal hearing is defined as a threshold above 20 decibels across the board as shaded on the audiogram. So it is possible to have normal low frequency hearing progressing to a severe loss at high frequencies.

The next test is a speech discrimination test to establish how well your brain is processing the sounds of speech. We test each ear separately and at different noise levels. We use word lists and you are asked to repeat what you have heard after each word, and if you’re not sure – just guess. This is quite familiar to people with a significant hearing loss!! The point of the exercise is to see if an increase in volume positively affects your score. We then explain the results and their implications.