Audiometric Evaluation
How will my hearing be tested?
You will be seated in a sound-treated room (booth) and will wear headphones or small insert earphones. You will be instructed to indicate, by raising your hand or pushing a button, when you hear a sound/beep/tone in your ear. The sounds will vary by pitch (frequency) and by loudness (intensity). Using this method the audiologist is able to establish the softest level of sound you are able to hear (threshold). The threshold at each frequency is recorded on a graph called an audiogram.
You will be asked to complete other tasks as part of the evaluation, including repeating words at soft and comfortable listening levels to determine your speech understanding. Bone conduction testing will be performed using a special headphone that is placed behind the ear. Thresholds for tones/beeps will be determined using the same methods as with standard headphones. This test assesses the function of the inner ear bypassing the effects of outer or middle ear problems, such as fluid. These results are used to determine the type of hearing loss (conductive vs. sensorineural vs. mixed)
A test of middle ear function (tympanometry) will likely be conducted. This test requires a small, soft probe tip to be inserted into the outer portion of the ear canal. You will feel a slight pressure change in your ear while this is being performed. You are not required to do anything during this test other than to sit very quietly. This test measures how well the eardrum (tympanic membrane) moves in response to slight pressure change, and the results are printed on a graph called a tympanogram. This test is very sensitive in detecting anything that may inhibit normal movement of the eardrum, such as fluid, infection, Eustachian tube dysfunction, or perforation. In addition to the pressure test, additional tests may be performed to assess the function of the muscles and nerves within the ear. These tests use the same probe tip inserted into the outer portion of the ear canal, but this time will produce some loud tones. With this test as well, you are asked to sit very quietly and do not need to respond to the tones.
A test called Otoacoustic Emissions (OAE) may be performed during your visit. This test is used to assess the health and function on the inner ear (nerve fibers called hair cells). This is a fast, simple, and painless procedure. The test entails placing a small foam earplug into the outer portion of the ear canal. This foam plug contains a probe tip that will produce a series of sounds and record the ear’s response to these sounds. You do not need to respond in any way to these sounds, but it is necessary that you be very quiet for this test.
Following your hearing evaluation, the audiologist and/or physician will explain the results. He/She will identify the type and degree of hearing loss, if any, and will make recommendations based on those results.
Testing Children
Children of any age can have their hearing evaluated. Older children (5 years and older) can be tested in the same manner as adults. Children between the ages of 2 and 5 will be asked to place a block or ball into a basket when they hear a sound (conditioned play), rather than raise their hand. Children under the age of 2 will likely be testing using a method referred to as Visual Reinforced Audiometry (VRA) or Conditioned Oriented Response (COR) testing. This involves the child sitting on the parent’s lap in the middle of the sound booth. Sounds will be presented through speakers placed on either side of the room. The child will be conditioned to look towards the sound when it is heard and this action will be reinforced by a toy lighting up as a reward. This method will be used to assess hearing at several frequencies (pitches) and for speech awareness.
The specific testing method used will vary based upon the child’s age, cognitive ability, and cooperation level (i.e. if a 3 year old child will not wear headphones, s/he may be tested using a “younger” level test).
In most cases tympanometry will be performed as well. This test requires a small, soft probe tip be inserted into the outer portion of the ear canal. A slight pressure change will be felt in the ear while this is being performed. This test is not painful and the child is not required to do anything during this test other than to sit very quietly. This test measures how well the eardrum (tympanic membrane) moves in response to slight pressure change, and the results are printed on a graph called a tympanogram. This test is very sensitive in detecting anything that may inhibit normal movement of the eardrum, such as fluid, infection, Eustachian tube dysfunction, or perforation.
A test called Otoacoustic Emissions (OAE) may be performed during your visit. This test is used to assess the health and function on the inner ear (nerve fibers called hair cells). This is a fast, simple, and painless procedure. The test entails placing a small foam earplug into the outer portion of the ear canal. This foam plug contains a probe tip that will produce a series of sounds and record the ear’s response to these sounds. This is a quick and painless test that is often used to verify behavioral results, or used when behavioral tests could not be achieved due to age or cooperation. The child does not need to respond in any way to these sounds, but it is necessary that he/she (and everyone in the room) be very quiet for this test.
An additional test may be requested by your physician, particularly if results are questionable or if the child is not able to cooperate for traditional testing. This test is referred to by several names including ABR (Auditory Brainstem Response), BSER (Brainstem Evoked Response), and BAER (Brainstem Auditory Evoked Response). This is a non-invasive test, but in some children may require sedation.