All of our new patients receive a full diagnostic hearing evaluation during their first visit to our practice. The evaluation is completed to determine if a hearing loss is present and, if so, to detail the type and severity of the hearing loss. Diagnostic evaluations are more thorough than screenings that are available through retail outlets. These more detailed tests provide insight into the origin of the hearing loss which provides guidance for the audiologist in making appropriate treatment recommendations and/or referrals to other professionals for care.
What tests will be done?
The specific tests done during the evaluation will depend on the patient’s age, symptoms, and medical history. As stated above 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 air and bone conduction testing
Pure-tone air conduction testing determines the quietest tones that a person can hear at different frequencies, both low and high, through use of over-the-ear headphones or insert earphones. Pure tone bone conduction testing assesses the patient’s ability to hear the same tones using a headband that stimulates the inner ear directly by using vibration of the bone behind the ear. Comparison of air conduction and bone conduction scores will help the audiologist determine whether the loss is conductive in nature or sensorineural.
Speech testing
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.
Additional tests:
The audiologist may also perform otoscopy (physical examination of the outer ear and, 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 more-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?
Prior your appointment, we will give you a “hearing health history” form to be completed. Take your time filling out this form and try to provide as much detail as possible, paying special attention to any concerns you have about exposure to noise, tinnitus and balance problems. Make sure that you take a full list of any medications and supplements you are taking with you to your appointment.
New patients are typically booked for a 75 minute appointment. This allows time for the audiologist to review your hearing health history with you, perform a comprehensive diagnostic evaluation, and review results and make recommendations for treatment. When amplification is recommended, an in-office demonstration is completed that day as well.
If possible, we recommend that you have a family member or close friend accompany you to your first visit. They are often able to provide insight into times/places where you have difficulty hearing well. Most audiologists agree that hearing loss is a family issue. It helps to have another supportive person at the appointment to help you understand the information and recommendations as well. In the event of an in-office hearing aid demonstration it is also helpful to hear the difference in a voice that is familiar to you.
The diagnostic audiologic evaluation is a good chance to establish a relationship with your audiologist. Above all, don’t be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding hearing solutions that work best for you and your lifestyle.