Hearing Test (Audiometry)

What is a hearing test (audiometry)?

A hearing test is how audiologists (hearing specialists) determine if you have hearing loss. Audiologists may call this a full hearing evaluation or audiologic evaluation. Most people in the U.S. will have a hearing screening or hearing test (audiometry) during their lifetime:

• Babies born in the U.S. have hearing screenings right after they’re born to confirm they can hear.
• Children may have hearing screenings as part of their well-child appointments or at school. They may have hearing tests (audiometry) if they appear to have trouble hearing.
• Most adults have hearing tests because they have issues hearing people talk or need to turn up the volume on television, laptop or mobile phone.

There are different types of hearing tests. The tests don’t require special preparation and don’t hurt.

Types of hearing tests

If you have a hearing screening, you’re having a test to see if you have normal hearing. If your screening test results show potential issues, you may have a full hearing test.

Audiometry tests show the type of hearing loss you have and if that loss is mild, moderate or severe. There are several types of hearing tests, including tests for babies, children and adults:

• Pure-tone testing: This common hearing test finds the quietest volume you can hear at each pitch. Children and adults have pure-tone testing.
• Bone conduction testing: This test shows if there are issues with the tiny hair cells in your cochlea. Your cochlea is the part of your inner ear that sends vibrations to your auditory nerve and on to the part of your brain that manages hearing.
• Speech testing: Adults and some children may have this kind of hearing test. Speech testing involves listening to and repeating certain words. The test shows how you understand speech.
• Auditory brainstem response (ABR): This test checks the connections or pathways between your inner ear and your brain. Audiologists may use this test to check hearing in children and people who can’t complete pure-tone tests. They may also use this test for people who have a brain injury that affects their hearing.
• Otoacoustic emissions (OAE): Audiologists use this test to check your inner ear function. They typically use this test for babies and young children.
• Tympanometry: This test checks how well your eardrum moves. Audiologists may do tympanometry tests to see if you have a ruptured eardrum, fluid in your middle ear or wax in your ear canal.

How do hearing tests work?

Specifics vary, but for most tests, you’ll sit in a sound-treated room and listen for sounds, tones or words piped into your ears via headphones or earphones. You don’t need to do anything to prepare for a hearing screening or hearing test.

Pure-tone hearing test

This is the most common hearing test. Here’s how it works:

1. You sit in a sound-treated room.
2. You wear headphones or insert earphones.
3. Your audiologist uses a machine called an audiometer, which delivers sounds at different frequencies (pitches) and loudness.
4. You raise a hand, press a button or say “yes” when you hear sounds.
5. Your audiologist records your responses on an audiogram. Audiograms chart your hearing loss patterns. If you have hearing loss, the audiogram shows the degree of hearing loss you have.

Bone conduction test

This test sends sounds directly to your inner ear:

1. Your audiologist puts a small device behind your ear or on your forehead.
2. They send sounds through the device. Those sounds make your skull vibrate.
3. The vibration skips your outer and middle ear and goes to your inner ear.
4. Your audiologist compares this test result with your pure-tone test result to determine the type of hearing loss that you have.

Speech test

Your audiologist may do a speech test along with a pure-tone test:

1. Like the pure-tone test, you wear headphones or insert earphones.
2. Your audiologist will say words in softer and louder sound levels.
3. You’ll repeat the words your audiologist says.
4. Your audiologist will record the softest speech you can repeat.
5. They may also ask you to repeat words spoken at a louder level to test your word recognition.

Auditory brainstem response (ABR)

Unlike a pure-tone test, you don’t need to respond to sounds during an ABR. You do need to stay still during the test:

1. You wear earphones for this test.
2. Your audiologist puts electrodes on your head. The electrodes stick to your skin and connect to a computer.
3. The electrodes record your brainwave activity as your brain responds to certain sounds played through the earphones.
4. The computer displays your brainwave activity. Your audiologist reviews computer printouts to see your test results.

Otoacoustic emissions test (OAE)

This test measures otoacoustic emissions (OAEs). OAEs are sounds your inner ear produces when it responds to sound coming from your middle ear. If you have hearing loss, your inner ear won’t produce OAEs:

1. Your audiologist places a small earphone or probe in your ear.
2. The probe puts sound into your ear and measures the sounds that come back.
3. Your test results show up on a monitor.

Tympanometry

Your eardrum is a flexible barrier that separates your outer ear from your middle ear. When sound from your outer ear hits your eardrum, your eardrum vibrates. Those vibrations travel through your middle and inner ear, triggering signals that go to your brain. Your brain translates those signals into sound. Tympanometry shows if your eardrum responds to air pushed into your ear:

1. Your audiologist puts a small probe in your ear. The probe may look like an earphone or earbud.
2. A small device attached to the probe pushes air into your ear.
3. The device has a graph called a tympanogram that registers eardrum movement.
4. The graph shows your audiologist how your eardrum moves.

When will I get my test results?

In general, your audiologist will share your test results with you right away. Your results will appear on a chart (audiogram) that measures your hearing against normal ranges. The audiogram will show how well you hear pitches (high to low) and sound (from very soft to loud).

What happens if there are issues with my hearing?

If tests show issues with your hearing, your audiologist will explain the specific issue and recommend next steps. For example, if a hearing test (audiometry) or tympanometry result shows there’s wax or fluid blocking your middle ear, your audiologist may refer you to an otolaryngologist (ENT) to remove the wax or fluid. Or, if your pure-tone hearing test shows you have hearing loss, your audiologist will tell you:

• If you have mild, moderate or severe hearing loss.
• What hearing devices may help you hear. For example, they may tell you about different kinds of hearing aids. They may talk about hearing assistance like cochlear implants.
• They’ll tell you what you can expect when you use specific hearing devices.
• If you choose hearing aids, your audiologist will select and fit them.
• If your audiologist recommends you consider cochlear implants, they’ll schedule you for further testing and evaluation.

How often should I have a hearing test?

Everyone’s situation is a bit different. If your job involves working in very noisy environments like a construction site or factory, you may need your hearing checked once a year. If you don’t, you may not need a hearing evaluation until you’re in your 50s or 60s. That’s when many people start having age-related hearing loss.

If you have concerns about your hearing, ask a healthcare provider about hearing evaluations. They may refer you to an audiologist for a formal hearing evaluation.

How do I test my hearing at home?

There are many at-home hearing tests for you to consider. At-home tests may show that you have hearing issues. But to find out what’s wrong — and to get help — you should have a hearing evaluation done by an audiologist.