Diagnostic Audiologic Evaluation
If you have been referred for a diagnostic audiologic evaluation, it means that your hearing needs to be further examined. A diagnostic audiologic evaluation may be indicated for individuals who did not pass an initial hearing screening.
The evaluation is done to determine if a hearing loss is present and, if so, to detail the type and severity of the hearing loss. It also may provide insight into the cause of the hearing loss as well as provide guidance for the audiologist in making appropriate treatment recommendations or referrals to other professionals.
What tests will be done?
The specific tests done during the evaluation will depend on the patient's age, symptoms and medical history. These various tests will determine the degree of hearing loss, the type of hearing loss and the conditions of the ear canal and middle ear. The audiologist will also establish if the hearing loss is conductive (middle or outer ear problem) or sensorineural (inner ear problem or an issue with the auditory nerve and central auditory pathways).
At a minimum, a diagnostic audiologic evaluation includes pure-tone testing, bone conduction testing and speech testing.
Pure-tone and bone conduction testing
Pure-tone testing determines the quietest tones that a person can hear at different frequencies, both low and high. Bone conduction testing is similar to pure-tone, however, a different type of headset is used to provide the audiologist with different information. A bone conduction test will help the audiologist determine whether the loss is conductive in nature or sensorineural.
A speech reception threshold (SRT) test is used to confirm the results of a pure-tone test. This test determines the lowest level of sound the patient can clearly identify words or speech.
The audiologist may also perform otoscopy (physical examination of the outer ear, ear canal and eardrum) and tympanometry (test of the middle ear) to determine the health of the ear canal and the middle ear.
Specialized tests exist for infants and young children, as well as children and adults with developmental and cognitive impairments. These specialized tests allow the audiologist to test the auditory system when the patient is not able to actively participate in the tests or evaluation.
Visual reinforcement and conditioned play audiometry for children
For children, it is important to have a diagnostic hearing evaluation whenever a hearing loss is suspected. It is the first step in identifying hearing loss and developing a treatment plan to improve academic and social success.
Along with the evaluation, you should generally expect to have time to review the results with the audiologist. They can interpret the tests for you, answer your questions, provide you with information and referrals as needed, as well as begin planning for treatment, if indicated.
Audiologists are specialists in hearing and hearing rehabilitation. Never hesitate to ask your audiologist for clarification or further information on anything you do not understand.
What can I expect during a diagnostic hearing evaluation?
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The easiest test you’ll ever take
A hearing evaluation is quick, simple and painless. In most cases, the results are instantaneous—you will learn immediately if you have a hearing loss and what steps you should take to improve your hearing. There are different testing methods, but most start with brief questions about the health of your ear, your general health and your lifestyle. These questions assist in determining the cause and nature of your possible hearing loss.
Remember that you are in the hands of a Doctor of Audiology who has been extensively trained in the advance diagnostic audiological testing and wants to help you improve your quality of life. Do not hesitate to bring up your concerns or ask any questions.
A quick look into the ear
First, your audiologist will look into your ears with an otoscope. The purpose of looking into yours ears is to examine the ear canal—the tunnel that leads from the outer ear to the eardrum. Inspection of the ear can provide a lot of information about your eardrum and the middle ear. Looking into the ear does not hurt, and you may even get to see a picture of your ear drum.
The actual hearing evaluation
A hearing test evaluates your hearing sensitivity and is performed using an audiometer, which determines sensitivity at different frequencies. This will typically last about 30-40 minutes.
- You will sit inside a sound-proof room with a set of foam earphones placed in your ear canals or headphones placed snuggly on the ears.
- Your earphones are connected to the audiometer. The audiometer is calibrated to measure your hearing with precision.
- The audiometer sends tones at various frequencies to one ear at a time, while the Doctor of Audiology plots the loudness (in decibels) on an audiogram.
- While you are being exposed to the different tones, you’ll signal to the doctor of audiology by pressing a button (or raising your hand) when you hear the tone, no matter how quiet it is. The Doctor of Audiology is looking for the softest levels at which you can hear the tones important for understanding speech. You may hear the same tone many times. Don’t worry: this is part of the test and ensures accurate results.
- Over the course of the test, the Doctor of Audiology plots points on a graph that will explain your hearing in comparison to the normal range.
- The test will produce results in the form of a graph that shows your hearing loss in pitch and loudness. The result is referred to as your “threshold.” Normal hearing for adults is defined as the ability to hear sounds that are 25 decibels or quieter.
- Your evaluation will include speech audiometry. Your Doctor of Audiology will read lists of words to you through the earphones, and you will do your best to try and repeat the words. This will allow the Doctor of Audiology to understand how you are hearing in real-world situations.
- Noise is the most difficult situation for communication and many people struggle to hear in noisy environments so we will evaluation how you understand sentences with additional background noise.
- Your Doctor of Audiology will discuss the results of your hearing evaluation in full detail with you and discuss recommendations for your unique situation.
- If hearing technology is recommended by your audiologist, you will test different types of hearing devices.