If you have noticed changes in your hearing or if a family member or friend has noticed that you aren’t hearing well, take the time to have an evaluation.
- Before making your first audiological appointment, it is advisable to get a thorough ear, nose and throat examination by an otolaryngologist so that you know whether or not any medical procedures are indicated. The doctor may recommend an audiologist for testing.
- Make an appointment with your audiologist and have a comprehensive hearing test, including pure-tone, bone, and speech testing. The audiologist may suggest a type of hearing aid best for you. Some audiologists dispense hearing aids.
What to expect at your hearing evaluation:
- An assessment of your hearing usually begins with an examination of your ear. The audiologist will first look into your ears using a lighted instrument called an otoscope. The audiologist is looking for anything that might be blocking your ears, such as earwax or other physical objects, and is also checking the physical appearance of your eardrum. Along with the otoscopic inspection, you will also be asked for some background information about your hearing. This is called a case history, and it is very important that you provide the audiologist with as much information about your hearing as you can.
- After these pre-assessment procedures, you will be asked to sit in a very quiet room and a pair of earphones will be placed on you. You will be asked to listen for a sound that seems like a whistle or beep and signal the audiologist each time you hear the sound. By changing the tone of the sound and its loudness, the audiologist can determine the softest level that each tone can be and still have you hear it. This procedure is done for both ears, one at a time. You will also be asked to listen for the tones after the audiologist has placed a vibrating object on the bone behind your ear. This measures your hearing by bone conduction. The results obtained via the earphones will be compared to the results of your bone conduction test to determine the general type of hearing loss you might have.
- Another important part of your hearing evaluation is to determine how well you can hear and understand speech. You will be asked to repeat a series of words presented to you at various loudness levels. This can be done both through earphones and also through loudspeakers, both with and without competing background noise.
- The final part of your audiological evaluation is a physical assessment of the function of your middle ear. A machine called a typanometer is used to find out how well your eardrums move back and forth in response to changes in air pressure. This machine also determines if your middle ear is clear of fluid or other occlusion. It also checks the air pressure in your ears to make sure the passage between your middle ear and you throat is open.
- Your audiologist should give you a copy of your audiogram to keep. Take your audiogram with you any time you visit the hearing aid dispenser or anyone in hearing health care.
- If the evaluation shows you have a hearing loss, your audiologist can tell you if hearing aids will be helpful to you. An audiologist may also refer you to an otolaryngologist if you may be a candidate for a cochlear implant.
Degree of Hearing Loss
Your evaluation will allow an audiologist to tell you the nature of your hearing loss, if any. Audiologists use general terms (normal, mild, moderate, severe, and profound) to characterize the degree of hearing loss. Hearing loss is measured in decibels (dBs) and the general categories refer to an average of the decibel level of hearing loss present.
In general, people with normal hearing (up to 25 dB hearing loss for adults, up to 15 dB for children) can hear most speech sounds in quiet and comfortable listening situations. For information regarding children with hearing loss, please see “Children and Pediatric Hearing Loss.”
Adults with mild hearing loss (between 26 and 40 dB) may hear reasonably well in one-on-one conversation, but will miss words and speech sounds when speech is quiet or when there is background noise present.
Adults with moderate hearing loss (between 41 and 70 dB) miss a lot of speech sounds and telephone conversation. They often ask for repeats and often say, “What did she say?”
Adults with severe hearing loss (between 71 and 90 dB) need hearing aids to perceive speech sounds almost all of the time. People with severe hearing loss will miss the vast majority of conversational speech and using telephones will be very difficult.
Adults with profound hearing loss (91 dB or more) cannot hear speech sounds even if they are very loud. People with profound hearing loss need hearing aids or cochlear implants to perceive speech sounds.