What Does a Hearing Test Measure?
An audiologist uses a hearing test to measure your type, degree and configuration of hearing loss. An audiology evaluation consists of a series of one or more of these tests. Your audiologist will use your test results to create a treatment plan for your unique hearing loss.
Who Should Have Their Hearing Tested?
An audiology (or hearing) evaluation can benefit patients of all ages, even those who do not show signs of hearing loss. Experts recommend having your hearing tested every 10 years until age 50. For those 50 and older, you should visit your audiologist for a hearing exam every three years.
Why Should You Have a Regular Hearing Test?
Hearing loss is a progressive condition that often develops slowly. Many people are not aware of a change in their hearing because they adjust to the loss over a long period of time. Studies indicate that it takes seven years, on average, for a hearing impaired individual to seek treatment.
Take the First Step Toward Treating Your Hearing Loss
An audiology evaluation should be the first step for anybody who suspects a loss of hearing; the sooner it is diagnosed, the more successful treatment will be. Early detection means more options for you, your partner or a loved one with hearing loss.
The Consequences of Untreated Hearing Loss
When left untreated, hearing loss can damage your physical health, emotional well-being and professional success. This includes:
- Increasing your risk of cognitive decline
- Increasing your feelings of depression, anger and anxiety
- Reducing job performance and monetary compensation
- Leading to difficulty concentrating and storing new information
- Increasing your likelihood of suffering physical injuries, specifically falls
Many physicians believe you should make audiology evaluations a routine part of your overall health care, just like regular vision exams and dental checkups. Hearing tests are quick, painless and provide immediate results.
What Are the Different Types of Hearing Tests?
An audiology evaluation includes a physical examination, a review of your medical history and diagnostic tests that measure different aspects of your hearing. You will be given any or all of the following tests:
Pure Tone Testing
Pure-tone testing (also known as pure tone audiometry) uses air conduction to measure your ability to hear sounds of different pitches and volumes.
How Is a Pure Tone Audiometry Test Done?
While wearing a pair of medical-grade headphones you will be asked to identify a series of tones by raising a hand, pressing a button or responding verbally.
Pure Tone Testing Results
The results are charted on an audiogram, a graph that shows the type, degree and configuration of your hearing loss by comparing pitch (frequency) with loudness (intensity). The recorded pattern will help your audiologist determine your hearing threshold (the level at which you can no longer detect sound).
Bone Conduction Testing
Bone conduction testing is another type of pure-tone test that measures the inner ear’s response to sound. Bone conduction audiometry testing is often used when there is damage or a blockage (like earwax) in the outer or middle ear.
How Is a Bone Conduction Testing Done?
Instead of sending the tones through the ear, this test is able to bypass the outer and middle ear and send the tone directly to the inner ear. Bone conduction testing uses a small vibrator placed behind the ear. The device sends out a vibration that passes through the skull bone to reach the inner ear.
Bone Conduction Testing Results
If the results of this test are different than the air conduction test, your audiologist can use this information to determine whether you have a conductive or sensorineural hearing loss.
Bone conduction testing is often used in place of air conduction testing when an obstruction in the outer or middle ears is present.
Speech (or word recognition) testing is used to measure your speech reception threshold (SRT), or the faintest speech you can understand 50 percent of the time. These results are compared with your pure-tone test results to confirm a diagnosis. Your ability to separate speech from background noise will also be recorded.
Speech testing may be administered in either a quiet or noisy environment; results are recorded on an audiogram for easy visual reference.
Tympanometry is a test of the middle ear used to detect fluid, wax buildup, eardrum perforations and tumors. It measures movement of the eardrum in response to air pressure; the results are recorded on a chart called a tympanogram.
Acoustic Reflex Testing
The acoustic reflex test measures involuntary muscle contractions of the middle ear, and is used to determine the location of your hearing problem (the ossicles, cochlea, auditory nerve, etc.) as well as the type of hearing loss.
Otoacoustic Emissions (OAEs)
Otoacoustic emissions (OAEs) are sounds generated by vibrations of the hair cells in the cochlea of the inner ear. OAE testing uses a tiny probe fitted with a microphone and speaker to stimulate the cochlea and measure its response. Individuals with normal hearing will produce emissions; when a hearing loss exceeds 25-30 decibels, no sound will be produced.
This test helps determine whether there is a blockage in the ear canal, excess fluid in the middle ear or damage to the hair cells of the cochlea.
Auditory Processing Disorder
An APD is a disorder of how the brain receives, encodes and interprets the information it receives. These disorders occur at the level of the brain versus the ear. It is important to remember, we detect sound with our ears, but we hear with our brains.
Causes for APD:
Head trauma, strokes, diseases and medications may also contribute to auditory processing disorders. In these cases, APDs can occur suddenly and are obvious; other times, they can be more subtle. It is possible that an APD can indicate that there is an underlying medical condition that may warrant further attention.
Untreated hearing loss, or inappropriately treated hearing loss, is another cause for APD. The lack of auditory input, or distorted input, will reduce or distort the input the brain receives, which may result in neural atrophy or neural reorganization (the neurons necessary for hearing disappear or do not respond appropriately to input). This ultimately leads to reduced ability to hear sounds or process language, especially in complex situations.
Signs or Symptoms of APD:
Symptoms of APD may range from mild to severe. Common difficulties include, but are not limited to, difficulty hearing in the following situations:
- Hearing in noisy environments
- Following conversations
- Understanding speech when spoken quickly
- Following complex or multi-step directions
- Remembering spoken information
- Maintaining focus and attention
- Processing nonverbal information
- Issues organizing at home or work
Diagnosing an Auditory Processing Disorder
APDs can create subtle difficulties with hearing and communication. This can lead to frustration, social withdrawal, isolation, safety concerns, anxiety, and depression. However, these same conditions can also be seen with untreated hearing loss. For this reason, a thorough assessment is important to determine if an APD may be contributing to hearing and communication difficulties.
An audiologist who specializes in auditory processing disorders can determine the exact nature of your hearing issues. A typical test battery should consist of: 1) a basic hearing evaluation, 2) a speech in noise test, and 3) tests of auditory processing performance. APD tests typically assess areas of binaural separation, binaural integration, and temporal processing. Binaural separation is important because it helps with selective attention, sound localization and lateralization skills. Binaural integration is also important for sound localization ability and the brain’s ability to process multiple and/or competing auditory signals. Temporal processing is the auditory system’s ability to use timing aspects of a sound, including duration and sequencing/ordering cues.
Treatment options for APD often include hearing aids, but treatment might also involve auditory training activities to help improve brain function and day-to-day listening activities. Occasionally, referral to another specialist is recommended.
Call Audiology Center of Maine at (207) 664-2123 for more information or to schedule an appointment.