A Guide to Hearing Tests

Audiologists can use a variety of different tests in order to gain an overall picture of a person’s hearing health. These tests vary by measuring how different parts of your ear function separately and as part of your auditory testing. Depending on your specific symptoms and medical history, your audiologist may perform the following tests:

Pure-tone testing

• The most common type of hearing test that establishes a person’s ability to hear sounds at various frequencies. 
• Can be used to diagnose hearing loss in one or both ears.
• The person undergoing the test sits in a soundproof room and is asked to wear headphones, through which a series of sounds are played. When a sound is heard, they can raise their hand or otherwise indicate this to the audiologist. 
• The test takes between 30-45 minutes in total. 
• The results of the test are recorded on an audiogram.

Speech testing

• This type of test seeks to measure how well a person can fully separate speech from background noise and recognize individual words.
• During the test, recorded speech will be played, and the test subject will be asked to repeat the words that they hear clearly. 
• This type of test is used to determine a person’s “speech recognition threshold” (or SRT); the faintest sound of speech that can be heard 50% of the time.

Bone conduction testing

• This type of test is usually used to in addition to pure tone testing to differentiate between sensorineural hearing loss (hearing loss relating to the hair cells or the cochlea or the hearing nerve) and conductive hearing loss (hearing loss that occurs when sound cannot reach the inner ear, often due to an obstruction such as fluid buildup or tumors)
• A conductor is placed on the bone behind the ear (the mastoid bone) and then vibrations are sent to the inner ear. As with pure tone audiometry, the person undergoing the test will then raise their hand or press a button when they hear sounds. The results of the test are plotted on an audiogram. 
• If the results indicate that the bone conduction test has not detected an obstruction, but the pure-tone test has indicated hearing loss, sensorineural hearing loss will usually be diagnosed. 
• If bone conduction testing does indicate an obstruction, then conductive hearing loss is suspected.

Tympanometry

• Measures the eardrum’s response to air pressure. 
• Can help to ascertain if tumors or other obstructions are present in the ear or if the eardrum is perforated. 
• The test involves a probe being inserted into the ear canal. This probe will then adjust the pressure in the ear canal, play sounds and take a series of measurements.

Other hearing tests

• Acoustic reflex testing can measure the muscle contractions of the inner ear to help further understand the location and type of hearing loss a person may be experiencing. 
• Auditory brainstem response (ABR) testing is most commonly used on newborns and children and seeks to measure the response of brainwaves to sound stimuli. 
• Otoacoustic emissions testing is also most frequently used on children and checks for blockages in the ear canal, damage to hair cells in the ear, or fluid buildup.

All of the tests above can help to thoroughly assess a person’s ear health and hearing ability and, if hearing loss is identified, help to guide the future treatment process.