What to Expect From a Hearing Test

Wondering what a hearing test involves or when you might need one? Whether you're noticing changes in your hearing or just curious about routine checks, understanding how hearing is tested can help you take the right next steps. Here's a quick guide to what hearing tests are, how they work, and why they matter.

What Is A Hearing Test?  

A hearing test, also called audiometry or an audiologic evaluation, is used to check your hearing. 

There are different types of hearing tests. They are performed by a hearing care professional called an audiologist or an ear, nose, and throat doctor (ENT) called an otolaryngologist. 

If a hearing test detects hearing loss, the results can tell whether it is mild, moderate, or severe and which part of the hearing isn’t working properly.

Hearing Screening vs Hearing Evaluation 

A hearing screening is a basic pass or fail test that determines whether or not hearing loss is present. During a hearing screening, the patient is asked to detect a series of beeps and tones at different pitches across the normal range. The screening can tell whether or not hearing loss is present, but not the type or severity. A hearing screening can be done at a primary care provider’s office, at community health centers and health fairs, and even online. 

A hearing evaluation (hearing exam or auditory test) is a comprehensive exam performed by a licensed audiologist (hearing specialist). It may include several types of hearing tests as well as a detailed interpretation of the results. The results of a hearing exam can determine the type of hearing loss, the severity, and the appropriate treatment.

If a hearing screening shows potential issues, a health care provider may refer the patient for a full hearing exam (audiometry).

What Are The Types of Hearing Tests?  

As mentioned, a full hearing exam (audiometry) consists of various tests that can detect hearing loss and assess the severity (mild, moderate, or severe). Some of the hearing tests done in infants, children, and adults include:

Pure Tone Testing

This hearing test is commonly performed on children and adults using an instrument called an audiometer. It helps to identify the lowest volume in decibels that you can hear at each frequency. The result is plotted on a graph called an audiogram and compared to the average for the general population.

Bone Conduction Testing

This hearing exam identifies problems with hair cells in a part of the inner ear called the cochlea. These hair cells are the sensory cells of the auditory system. They detect sound vibrations and transmit them to the brain via the auditory nerve. Examples include the Rinne and Weber tests, which use vibrating tuning forks placed against the skull.

Speech Testing

During this auditory test, the patient is asked to listen to and repeat certain words to assess how well they understand speech. Speech testing can be done in adults and some children, depending on their age and ability to cooperate. 

Auditory Brainstem Response (ABR)

Also called brainstem auditory evoked potentials (BAEP), audiologists use this hearing test to check connections between the inner ear and brain. It can detect hearing problems in young children, people with brain injuries, and those with a limited ability to communicate during pure-tone hearing tests. 

Otoacoustic Emissions (OAE)

An OAE hearing exam is performed to check the inner ear (cochlea) function in babies, young children, and adults who cannot complete traditional hearing tests. This test does not require a subjective response to sound. It is done using an aural probe that contains built-in speakers and microphones to deliver an acoustic stimulus and detect emissions.

Tympanometry

This is a hearing test to check your eardrum movement. It is done using an instrument called a tympanometer that has a soft tip like earplugs. The probe emits air and a low tone and records how your eardrum moves in response. The test can feel like a pressure sensation in your ear, similar to your ears popping during air travel. Audiologists use tympanometry to diagnose conditions such as fluid in the middle ear, wax in the ear canal, and a ruptured eardrum.

Online Hearing Tests

Online hearing tests typically assess your ability to hear sounds and understand speech. They are often done using headphones and ask you to identify specific tones or words while sitting in a quiet place. For example, Costco offers a free hearing test online. 

Are Home Hearing Tests Accurate?

A free online hearing test can be used to screen for potential hearing problems, but it is not a substitute for a professional hearing test by an audiologist. 

Hearing Tests for Adults and Children

Some people are born with hearing problems, while others develop them as they grow older. Hearing tests check how well a baby or child can hear and detect hearing issues in adults. 

All infants born in the US have a hearing screening immediately after birth to confirm they can hear. Older children may have hearing screenings during well-child exams or school health fairs. Children may be referred for hearing tests (audiometry) if the screening reveals difficulty hearing.

In adults, the need for a hearing test depends on the situation. Those who work in noisy environments may need a hearing evaluation every year. Others may not need to have their hearing checked until they are in their 50s or 60s, when age-related hearing loss (this is called presbycusis) typically starts. 

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What To Expect During a Hearing Test  

To complete a hearing test, you will sit in a sound-treated room and be asked to identify sounds or tones through a pair of headphones or earphones. The audiologist may also ask you to repeat certain words to evaluate your speech recognition.

For some hearing tests, the audiologist may insert a small device into your ear, which may make your skull vibrate or create a pressure sensation in your ear.

Some of the questions to ask a hearing care professional include:

• Do I have hearing loss?

• What type of hearing loss do I have?

• Is my hearing loss mild, moderate, or severe?

• Is the hearing loss the same in both ears?

• Which hearing aid is best for my type of hearing loss?

• How often do I need to come in for adjustments to my hearing aids?

• How long will my hearing aids last?

• Will insurance cover the cost of my hearing aids?

Interpreting Hearing Test Results  

The goal of audiometry is to check hearing ability and detect potential hearing loss. A hearing test checks your hearing across a range of frequencies and volumes in each ear. The test results are delivered in the form of a chart or graph called an audiogram. 

What Is A Normal Hearing Test Result?

The audiogram has a range of frequencies or pitches (expressed in hertz) on the X-axis and a range of volumes (expressed in decibels) on the Y-axis. Lower frequencies are on the left, with progressively higher frequencies to the right. Louder sounds are at the bottom, with progressively quieter sounds towards the top.

A person with normal hearing will be able to hear the softest sounds across all frequencies. For example, a person humming, a faucet dripping, leaves rustling, or birds chirping in the distance. 

The gap between the normal hearing range and your results represents the sounds you cannot hear. The bigger the gap, the more sounds you’re not hearing, and the more severe your hearing loss.

Addressing Hearing Loss  

What Is The Most Common Cause of Hearing Loss?

The most common cause of hearing loss is exposure to loud noises. Other significant factors include aging and too much earwax.

About 1 in 3 older adults above the age of 65 has some degree of hearing loss. Hearing loss develops slowly, and you may not notice it at first. If you suspect you or someone you know may be experiencing some level of hearing loss, see the common symptoms below.

Find out which medications can cause hearing loss.

Symptoms

Warning signs of hearing loss can vary from person to person. Common signs and symptoms include:

• Straining to hear conversations.

• Asking people to repeat themselves.

• Difficulty understanding others.

• Feeling like people mumble when they talk.

• Hearing better in one ear than the other.

• Difficulty hearing high-pitched sounds like doorbells and alarms.

• Needing to turn up the volume on your mobile phone or TV.

• Sudden hearing loss in one or both ears.

Treatment Options  

If a hearing loss test demonstrates trouble hearing, your audiologist may refer you to an ear, nose, and throat (ENT) doctor. They will discuss the type, cause, and severity of your hearing loss and what types of hearing aids may help. If your doctor recommends devices called cochlear implants, you may need further testing. 

Can Hearing Loss Be Reversed Naturally?  

No home remedies or natural solutions have been found to reverse hearing loss. Medical treatments may reverse some types of hearing loss. Sensorineural hearing loss, which is the most common type, is permanent and cannot be reversed. Conductive hearing loss may be reversible, depending on the cause. For example, if conductive hearing loss is due to cerumen impaction (earwax blockage), it can be reversed.

What Are The Stages of Hearing Loss?

The stages of hearing loss are as follows:

What Is The 60-60 Rule For Hearing Loss? 

The 60/60 rule for hearing health recommends listening to sound at no more than 60% of your device's maximum volume for a maximum of 60 minutes at a time. Limiting exposure to loud noises can help maintain better hearing over the years.

When Should You See A Hearing Professional?  

See a hearing professional to get examined for potential hearing loss if you have trouble hearing or other symptoms such as tinnitus (ringing or buzzing in the ears), ear pain, dizziness, or balance problems.

Find out what medications can cause tinnitus.

Hearing Test Costs

How Much Does A Hearing Test Cost?  

A hearing test can cost between $20 and $200, depending on the number and complexity of the tests done and your location.

Does Insurance Cover Hearing Tests?

Most insurance, including Medicare, will pay for a comprehensive hearing exam if it is ordered by your healthcare provider. Part of the cost may need to be covered out of pocket.