Speech and Hearing Test Types: A Comprehensive Guide
Audiologists and other healthcare providers use various types of hearing tests to confirm adequate hearing function or identify and measure hearing loss. Healthcare providers can perform hearing tests on people of all ages. Typically, babies get hearing assessments soon after they’re born.
If you're considering scheduling an appointment with an audiologist to examine your ears and hearing and discuss your hearing health, you may be wondering: What's going to happen during the test? How long does a hearing test take?
Hearing tests are absolutely painless and safe. Most of these tests are performed in a soundproof studio with specially adapted headphones.
Types of Hearing Tests
There are many different tests that can be used during a hearing screening. At Alabama Hearing Associates, we offer a full range of hearing tests to understand your hearing health. These tests help us find out if you have hearing loss, what kind it is, and how we can best help you. Here’s an overview of common hearing test types:
1. Pure Tone Testing (Pure Tone Audiometry)
Also called pure tone audiometry, this hearing test uses air conduction to assess your ability to detect sounds at various volumes and pitches. Also known as pure tone testing, this type of hearing test measures your ability to hear sounds at different pitches and loudness using air conduction. Pure-tone testing is the most common type of hearing test. It is used in a doctor's office, as well as for hearing screening programs in schools.
During the pure-tone test, the healthcare practitioner plays several tones at different frequencies to see if you can hear within the normal range. The right and left ears are tested separately using headphones, allowing the doctor to determine whether hearing loss is present in only one or both ears. During the test, you’ll wear headphones and sit in a quiet room. When you hear a sound through the headphones, you’ll either raise your hand or press a button to show that you heard it.
2. Bone Conduction Testing
This is another pure-tone test that assesses your inner ear’s reaction to sound. This differs from the classic version, which sends audible noises via air. Bone Conduction Testing is similar to Pure Tone Testing but works a little differently. Instead of sounds traveling through the air, this test uses tiny vibrations that go straight to your inner ear.
The audiologist places a conducting device behind your ear, sending subtle vibrations through the bone to your inner ear. Your audiologist will put a small device behind your ear or on your forehead. They’ll send sounds through the device. Those sounds make your skull vibrate. The vibration will skip your outer and middle ear and go to your inner ear. Your audiologist will compare this test result with your pure-tone test to decide the type of hearing loss you have.
3. Speech and Word Recognition Test
Just like it sounds, the speech and word recognition test is used if you are having trouble following along in a conversation or can’t understand what someone is saying to you. This hearing test measures your speech reception threshold (SRT). That’s the faintest speech you can understand 50% of the time. What is SRT? This refers to the faintest level of speech you can understand 50% of the time. The test can be given in a quiet room or a noisy environment.
During the test, you will wear headphones and the healthcare or speech specialist will say words to you at different sound levels and have you repeat the words back. Your audiologist may also ask you to repeat words spoken more loudly to test your word recognition. The goal is to find the softest words you can understand.
4. Tympanometry
Tympanometry checks your eardrum. It shows if your eardrum reacts normally to air pushed into your ear. This test focuses on the movement of your eardrum in response to air pressure. The tympanometry test measures how well your eardrum is working. The tympanometry test uses probes that are placed in your ear, one at a time. The probe introduces air into the ear, which is displayed in graph form (tympanogram).
Your eardrum must be able to move freely to transmit sounds to your inner ear. Your audiologist will put a small probe in your ear. The probe may look like an earphone or earbud. The probe has a small device that pushes air into your ear. The device has a graph called a tympanogram. Tympanograms measure eardrum movement. Audiologists use the assessment to detect buildups of wax or fluid, eardrum perforations, and tumors.
5. Acoustic Reflex Testing (Middle Ear Reflex Measurement)
Also known as the middle ear reflex measurement, this tests the reflex of the muscle in the middle ear in response to noises. Your middle ear has muscles that contract involuntarily (meaning without any effort on your part). When you hear a loud noise, your ear muscles automatically tighten to protect your hearing. Acoustic Reflex Testing checks how well your middle ear muscles react to loud sounds. This test uses a small probe inserted in your ear to evaluate whether those contractions are occurring as they should.
The doctor will place a small probe in your ear to determine how loud the sound needs to be for the muscle in your middle ear to tighten in response.
6. Otoacoustic Emissions (OAE) Test
Otoacoustic emissions are vibrations of hair cells in the cochlea in the inner ear. This test determines whether a specific type of hearing loss (called sensorineural) is present. Audiologists commonly perform it on newborns. This test uses a tiny probe that has a microphone and speaker to stimulate the cochlea and assess its response. OAEs are noises produced by the vibration of the hair cells in your inner ear’s cochlea.
Your audiologist will put a small earphone in your ear. The earphone sends sound into your ear and measures the sounds that come back. Your test results show up on a monitor. This test can determine whether there is an ear canal blockage, damage to the cochlea’s hair cells, or excess fluid in the middle ear. If your cochlea is working well, it will produce small sounds, known as emissions, in response.
7. Auditory Brainstem Response (ABR)
Unlike a pure-tone test, you don’t need to respond to sounds during an ABR. You do need to stay still during the test: You’ll wear earphones for this test. Your audiologist will place electrodes on your head that stick to your skin and connect to a computer. The electrodes record your brainwave activity as your brain responds to certain sounds played through the earphones. The computer displays your brainwave activity. Your audiologist reviews computer printouts to see your test results.
8. Tuning Fork Test
The tuning fork test is a simple tool used during a routine physical exam to check for hearing loss in one or both ears. A Weber test uses a tuning fork to detect hearing loss. During a tuning fork test, your healthcare practitioner taps the tuning fork on their forearm and then places it on your forehead. The tester strikes the device to make it vibrate and then places it in various spots on the head and face - forehead, top of the head, above the upper lip, etc.
9. Physical Examination of the Ear
This is a routine physical examination of the ear. Using an instrument called an otoscope, the doctor will look at your eardrum and ear canal to check for signs of infection or ear obstructions, such as ear wax.
Types of Hearing Loss
Multiple factors can contribute to hearing loss.
- Conductive: This occurs when sound waves are blocked from moving through the outer and middle ear to the inner ear due to ear wax, a foreign object, fluid, infection, a bone abnormality or if the eardrum is injured.
- Sensorineural: This occurs when the inner ear or hearing nerve becomes damaged as a result of aging, exposure to loud noise, injury, disease, genetics or certain drugs.
- Mixed: Hearing loss becomes more common as we age. Hearing loss is often gradual, but there are things to look out for.
Online Hearing Tests
Even though you can find hearing tests online, they aren’t always accurate. There are also ways to do a hearing test online. One form of an online hearing test is a simple questionnaire. Another form is a phone app that offers hearing tests that use your headphones to listen to a series of sounds and pitches. The best way to know how well you hear is by having a professional hearing test. An audiologist, who is a hearing specialist, uses special tools and equipment to give you the most accurate results.
What to Expect After a Hearing Test
Typically, a standard hearing test takes around 30 minutes to an hour and includes a physical exam, the speed and word recognition test and the pure-tone test. Many hearing clinics and health facilities offer free screenings year-round or at certain times of the year.
You may have a hearing loss of up to 25 decibels and still be within the normal hearing range. Once the level of hearing loss is determined, the audiologist will review your hearing loss treatment options. Hearing aids are the most common treatment for hearing loss and are available in different styles and technologies. Your audiologist will also discuss the next steps in your hearing care. This may include a follow-up appointment, a referral to another type of hearing care specialist - such as an ear, nose and throat (ENT) doctor - or a fitting with a hearing aid specialist.
The Importance of Hearing Care
Hearing tests help us understand how well a person can hear. They are important because hearing loss often happens slowly, so many people don’t notice it until it becomes a big problem. Protecting your hearing and compensating for hearing loss are essential to a good quality of life.
If you have concerns about your hearing, talk with your primary care physician.