The prospect of having one’s hearing tested for the first time can be a daunting one. Sometimes people feel a pressure from friends or family to have it checked, and people are often very worried about what the results will be- even if they already know that there is a problem. All this stress is compounded by not knowing what to expect. A diagnostic hearing assessment should include similar tests regardless of where you have it done, so keep reading to prepare yourself for your first appointment.
It is important to note that a ‘Diagnostic Hearing Test’ is not the same as a ‘Hearing Screening Test’. Hearing screening tests are typically more basic, and often done for free- they are helpful to indicate whether a diagnostic test is necessary, but a screening test is not sufficient to diagnose hearing loss or to treat it. If you are looking for a comprehensive analysis of your hearing ability, that will allow for ethical management of your hearing, you need to ensure that the test you are having is a full diagnostic hearing assessment performed by a registered hearing healthcare professional.
A full diagnostic hearing assessment should always follow a similar format, with similar tests- although sometimes not in the same order! Your hearing test should always begin with a comprehensive case history, so be ready to answer questions about your hearing experience, your medical history, and some strange-sounding associated symptoms. Don’t worry- all information you give will be treated with the utmost confidentiality. This information helps to identify any factors that might contribute to your hearing ability.
Your audiologist will then look in your ears using an otoscope. We look for a build up of wax, infection in the ear canal, perforations of the ear drum, and fluid behind it- as well as many other pathologies that might influence the results of the test. If there is active infection or a build up of wax, we may stop the test at this point, as the results will not be reliable.
Your audiologist will prepare you for the actual assessment of your hearing, by seating you in a sound-treated booth while wearing earphones, or placing noise-cancelling headphones on your ears in the consulting room. We always begin with Pure Tone Audiometry. You will hear a series of ‘beep’ sounds in your ears, one ear at a time. You will need to press a button, or indicate in another specified way, every time you hear the sound. Some of the sounds will be very soft, and they will be at different pitches. Using these results we will draw a picture called an Audiogram, which gives us a representation of your hearing ability from low to high pitch. Unless your hearing is completely normal, we will repeat the test using a different headphone, called a bone conductor, which sits behind your ear. This transmits the sound through the bone of the skull directly to the inner ear, which helps us to see where the hearing problem originates.
Another essential part of the hearing assessment is Speech Audiometry. During this test you will be asked to repeat words presented either by your audiologist, or by a recording. These words will be at different volumes, and you will not be able to hear and distinguish all of the words- finding your threshold is part of the test! This test shows us a more functional indicating of your hearing ability, and is also used to check the reliability of the overall hearing test. Your audiologist may also do a speech-based hearing test at a loud volume, to check for any sound distortion when the volume is high. Don’t worry- if it feels too loud for you, your audiologist will be able to turn it down.
Based on otoscopy results and the results of the pure tone and speech testing, your audiologist may need to check the status of the middle ear. The audiologist will hold a probe up to the ear canal, and push some air into the ear- this is called tympanometry. You will feel a slight pressure in the ear, and you may hear some beeps and buzzes. This test measures the movement of the ear drum and the pressure in the middle ear, and can help identify middle ear problems like infection, fluid or bone dislocation. It is usually immediately followed by an acoustic reflex test, which checks the reflex of the stapedial muscle in the middle ear, which contributes to the findings of the overall hearing assessment.
Sometimes your audiologist may feel that it is necessary to do further testing. These may include a speech-in-noise test, an uncomfortable loudness measurement, or a Eustachian tube function test. If this is the case, your audiologist should explain these tests to you in detail before beginning.
After all the tests have been completed, a diagnostic hearing assessment should always end with a discussion of your results. Your audiologist should explain the findings and their implications to you. Some audiologists might show you the Audiogram while explaining to make sure that you fully understand the results. After explaining the findings, you and your audiologist will discuss and decide upon a management plan for your hearing- this may include regular testing, referral to another medical professional, or the fitting of hearing aids or assistive devices. You should feel comfortable to ask your audiologist any questions that you may have, so you leave feeling satisfied that you understand your hearing status and the steps that are required to maintain or treat it.
As mentioned above, there are variables in the hearing assessment, but they should all contain the same basic elements. Always make sure that the minimum tests are performed fully before taking steps to manage your hearing loss, as an incomplete hearing test could lead to mismanagement and possibly even further damage to your hearing. Please post any comments or questions below, or get hold of us via email or telephone for more information.