If you are experiencing hearing loss, before you have a hearing test administered, it is important that you first visit your physician or an ENT to find out if there is a medical cause. The doctor will be able to assess your situation and may be able to treat your underlying issues, such as an ear infection, a blockage, or even a hole in your eardrum. Once all of your medical issues have been resolved and your doctor determines that you could potentially benefit from a hearing aid, he or she will then likely recommend that you have a complete round of hearing tests administered.
Hearing tests can be performed by an audiologist or a licensed hearing aid fitter, as well as by a physician. Your doctor may be able to give you a referral, and your insurance will likely cover the cost of your hearing test, although you should speak with your carrier to get confirmation. In addition, certain hearing aid vendors may also make the hearing test available free of charge. However, free hearing tests may come along with high sales pressure to buy your hearing aid from that particular vendor, so enter into that situation with caution. If you ever feel any sales pressure, you have the right to leave.
The Beginning of Your Visit
When you go to the audiologist or fitter’s office for your hearing test, you will first have a discussion with the test administrator about your medical history as well as your history of hearing loss in general. You may be asked questions about noise exposure, medications you are taking, any ear surgeries you may have had, any diseases of the ear that you have or had, and hereditary factors. It may be helpful to bring notes with you to make sure that you cover everything comprehensively before the hearing test begins.
Upon completion of this discussion, you will be put through a series of seven different hearing tests to gauge different aspects of hearing loss. Different audiologists and fitters may do the following hearing tests in a slightly different order, but the sequence below outlines what is most common. It is extremely important that you have all of these tests done to create the most complete picture of your hearing – and all of these hearing tests can be performed in a single office visit.
The First Step - Tympanometry
The first step in your hearing test is tympanometry. Tympanometry tests the movement of the eardrum. During this painless test, you need to do nothing but relax and let the readings be taken. The hearing test administrator will begin by placing the tip of a handheld tool into your ear. This tool will change the air pressure inside your ear and will also produce a clear tone. It will then measure how your eardrum responds to the pressure change and to the sound. This test will help to set a baseline for the rest of the hearing tests by letting the administrator know if any specific medical issues, such as an ear infection or a blockage of your Eustachian tube, should to be taken into consideration.
The Next Step – Hearing Tests that Require Headphones
Next, you will be placed in a soundproof room and given headphones through which the administrator will speak to you or play sounds. You will then be given a series of hearing tests through these headphones, including a pure-tone test, a speech reception threshold test (SRT), a most comfortable listening level test (MCL), an uncomfortable loudness level test (UCL), and a word recognition test, also commonly known as a speech discrimination test.
First, you will be given a pure-tone hearing test, which can help to determine the type, degree, and configuration of your hearing loss. Pure-tone thresholds (PTTs) determine the softest level at which you can hear the tone at least 50 percent of the time. For this hearing test, you will be asked to indicate each time you hear a tone in the headphones by either raising your hand or pressing a button.
The SRT test will be administered next. During this hearing test, you will be asked to repeat several two-syllable words while the intensity is decreased in order to find the lowest level at which you are able to repeat half of the words. Then, the MCL test will be performed to determine the loudness at which you prefer to hear by having you identify the level at which it is easy and comfortable to hear sounds. The UCL test (also called the upper level of comfortable loudness) will then do the opposite and will find the loudest level that you would ever wish to listen to – with anything louder being painful. During this portion of the hearing test, the volume in the headphones will slowly be raised, and you will be asked to indicate when the voice you hear has reached this upper level. These three hearing tests can give great insight into your level of hearing loss.
You will then be given the word recognition/speech discrimination test, in which you will listen to a set of single syllable, phonetically balanced words at a comfortable hearing level. You will then be asked to repeat these words back to the administrator one at a time. The results of this portion of the hearing test are critical to helping you establish a realistic expectation of what a hearing aid can do for you.
The Last Step – Bone Conduction
Finally, you will remove the headphones for the last of the hearing tests – the bone conduction test. A small oscillator (which looks like a small disc) will be placed on the bone behind your ear, and it will painlessly stimulate the bones of your skull, which, in turn, stimulate your inner ear. You will again be asked to indicate when you hear a tone as the sound level is raised and lowered to find a level at which you can hear the sound at least half the time. This hearing test is used to find out whether or not your hearing loss is affected by issues relating to your inner ear.
The Results of Your Hearing Test
Once your hearing tests are complete, the results should be available immediately, and the administrator should discuss them with you and put them into the context of your every day life. The hearing tests will be able to determine if your hearing loss is conductive (relating to the outer and/or middle ear), sensory neural (relating to the inner ear hair cells and nerves), or a combination of the two. The hearing test results will also tell you whether your hearing loss is mild, moderate, severe or profound. And your speech discrimination results will give you a practical look at what level of speech understanding you will be able to achieve with a hearing aid, because even with the best hearing aid you cannot achieve a level of understanding that is better than your discrimination score.
If the administrator is also a hearing aid dispenser, he or she may then make recommendations as to what type of hearing aid would work best for you, and may even suggest two or three different models. Remember – you are under no obligation to purchase your hearing aid from the administrator of your hearing test. Because of HIPAA regulations, you are entitled to a copy of the results of your hearing tests without making a purchase. Remind the administrator of this if any issues arise, and make sure that your copy of your results also includes the date of the exam and the administrator’s name.
Armed with the results of your hearing tests, you can then move forward toward making the purchase of a quality hearing aid that meets your needs. Take your time, ask a lot of questions, and shop around for the best product at the best price. The hearing test administrator may be the person you return to when making your purchase, and he or she may not. The most important thing is to make sure that when you finally buy your hearing aid, the dispenser is taking the results of your hearing tests into consideration and is helping you to make a purchase that will help improve your hearing for years to come.