Hearing Test

A hearing test (audiometry) is how audiologists (hearing specialists) check for hearing loss. They may call it a full hearing test (audiologic evaluation). Most people in the U.S. will have a hearing test at some point in their lives:

• Babies may need one if they don’t pass their newborn hearing screening.
• Children might get tested if they show signs of hearing trouble.
• Adults often get tested after noticing signs like struggling to hear conversations or turning up the TV or phone volume.

There are different types of hearing tests. You don’t need to do anything to prepare for them, and the tests don’t hurt.

Types of hearing tests

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 sounds you can hear at different pitches. Children and adults may have this test.
• Bone conduction testing: This test detects issues with the tiny hair cells in your cochlea, which is part of your inner ear. Hair cells in your cochlea send vibrations to your auditory nerve. The nerve forwards the information to the part of your brain that manages hearing.
• Speech testing: Speech testing shows how well you understand speech. It involves listening to and repeating certain words.
• Auditory brainstem response (ABR): This test checks how your inner ear and your brain work together. Audiologists often use this test to check hearing in babies and children. It’s also a way to test hearing in people who can’t do pure tone tests or have a brain injury that affects their hearing.
• Otoacoustic emissions (OAE): This test checks your inner ear to see if it works like it should. Babies and young children may have this test.
• Tympanometry: This test checks your middle ear by finding out how well your eardrum moves. It can show if you have a ruptured eardrum, fluid in your ear or wax in your ear canal.

How do hearing tests work?

You’ll sit in a sound-treated room and listen for tones, sounds or words piped into your ears via headphones or earphones.

Pure tone hearing test

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

1. You’ll sit in a sound-treated room and wear headphones or earphones.
2. Your audiologist will use an audiometer to do the test. This is a machine that plays sounds at different frequencies (pitches) and volumes.
3. You’ll raise a hand, press a button or say “yes” when you hear sounds.
4. Your audiologist will record your responses on an audiogram. Audiograms show you have hearing loss and how much hearing loss you have.

Bone conduction test

This test sends sounds right to your inner ear:

1. Your audiologist will put a small device behind your ear or on your forehead.
2. They’ll send sounds through the device. Those sounds make your skull vibrate.
3. The vibration will skip your outer and middle ear and go to your inner ear.
4. Your audiologist will compare this test result with your pure-tone test to decide the type of hearing loss you have.

Speech test

This test checks how well you understand spoken words. Your audiologist may do this test along with a pure-tone test:

1. You’ll wear headphones or insert earphones and listen while your audiologist says words softly and then loudly.
2. You’ll repeat the words your audiologist says.
3. Your audiologist will record the softest speech you can repeat.
4. They may also ask you to repeat words spoken more loudly 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’ll wear earphones for this test.
2. Your audiologist will place electrodes on your head that 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 checks your inner ear by measuring otoacoustic emissions (OAEs). OAEs are sounds your inner ear produces when it responds to sound that comes from your middle ear. If you have hearing loss, your inner ear won’t produce OAEs:

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

Tympanometry

Tympanometry checks your eardrum. It shows if your eardrum reacts normally to air pushed into your ear. The air acts like sound from your outer ear. Your eardrum should vibrate when air hits it. The vibrations go through your middle and inner ear to trigger signals to your brain. Your brain translates those signals into sound. Here’s how the test works:

1. Your audiologist will put a small probe in your ear. The probe may look like an earphone or earbud.
2. The probe has a small device that pushes air into your ear. The device has a graph called a tympanogram.
3. Tympanograms measure eardrum movement. It will show how your eardrum moves.

When will I get my test results?

Your audiologist will have your results right away. Your results will be on a chart (audiogram) that shows how well you hear pitches (high to low) and sound (from very soft to loud).

What happens if there are issues with my hearing?

Your audiologist will explain the next steps if tests show you have hearing loss. For example, a test may show wax in your middle ear affects your hearing. Your audiologist may send you to an otolaryngologist (ENT) to remove the wax.

No matter your results, your audiologist will help you understand your options and what comes next. If you have hearing loss, your audiologist will tell you:

• If your hearing loss is mild, moderate or severe
• What hearing devices may help, like different kinds of hearing aids or 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 you choose cochlear implants, your audiologist will arrange for more tests

How often should I have a hearing test?

You should have a hearing test each year if you work in a very noisy place like a construction site or factory. 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. But talk to a healthcare provider if you think you have hearing issues. They may send you to an audiologist for a hearing test.

How do I test my hearing at home?

There are many at-home hearing tests, including online tests, for you to consider. At-home tests may show that you have hearing issues. But you should have an audiologist test your hearing.