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May 16, 2022As an audiologist, hearing tests are one of the most common questions I get asked about. Many people wonder if it’s painful, what the audiologist does to test your hearing, and what it means if you pass or fail the test. Let’s look at some of the basics to be prepared when you book your next appointment with your audiologist to see how well you can hear!
AUDIOMETRY TEST
When we think of audiology tests to assess our hearing, we think of pure tone audiometry to do it best.
Audiologists use various tools during comprehensive hearing test, including pinna vibrators, air-conduction testing equipment, immittance measures such as tympanometry and acoustic reflexes checks, behavioral assessments such as word recognition testing, tympanogram evaluation, speech discrimination evaluations, and middle ear measurements.
Audiometry is performed using a computerized machine called an audiometer. During these tests, which usually occur in a doctor’s office or hospital setting, patients listen through headphones as tones of various frequencies are played through one ear.
Each test provides valuable information about our ability to hear certain sounds and gives us insight into where problems exist in the auditory system.
Several important factors to consider when selecting an audiologist include experience with specific issues such as tinnitus management or balance disorders; knowledge about specific treatments like cochlear implants; insurance coverage; distance from home/work; appointment availability; cost of treatment/insurance/testing etc.
REAL-EAR MEASUREMENT

Practice acceptance
Audiologists ensure the safety of hearing devices and headsets using Real-Ear measurement and verification methods. Real-ear measurement helps audiologists to verify how hearing devices and headsets used for hearing sounds are able to used according to a person’s hearing levels without further damaging their remaining hearing.
Sound is presented to the ear (recorded or live) via a speaker system and a calibrated microphone. The output from the ear is measured via the microphone to see if hearing targets for ease of speech understanding are maintained without extending noise exposure.
AURAL BRAINSTEM RESPONSE
If you’re planning to see an audiologist to get tested for hearing loss, here’s what you can expect:
- A hearing assessment will begin with your ear canal cleaned and soft earplugs inserted.
- Electrodes will be attached to your scalp so that you can hear tones in each ear independently. The audiologist will also plug your ears with cotton swabs to completely block outside sound.
- He or she will play different sounds at varying frequencies into both of your ears.
Your brainstem response is measured as it processes these tones and transmits signals to your auditory cortex. This process is repeated several times until all of your hearing has been tested thoroughly.
Your audiologist may then conduct additional tests using other instruments or even ask you to complete some exercises based on hearing-related tasks (such as reading aloud).
After completing all of these steps, an audiogram will be generated that shows how well you hear at different frequencies—audiologists use this to determine whether or not hearing loss is present.
PURE TONE AUDIOMETRY

Audiologists need to measure how well you can hear accurately to conduct a hearing test. In pure tone audiometry (or PT), also known as air conduction testing, small sounds are played from different directions, and your ability to hear those noises is assessed.
With each sound, you’ll provide either a yes or no answer based on whether or not you can listen to it. Your results are usually reported using what’s called an audiogram.
Your audiologist will create an audiogram that plots your results against ear function on either side of your head. It should look like a hill with valleys representing areas where you might have issues hearing specific frequencies.
The steeper and higher these peaks and valleys are, the more significant your hearing loss may be. Some audiograms show expected results, while others offer a mild upset in one area with better-than-normal results in another place.
If your audiogram shows any issues, your audiologist may recommend further testing to determine if there’s an underlying cause for concern. But don’t worry—your doctor has ways of figuring out if there’s anything wrong with your ears!
SPEECH AUDIOMETRY

An audiologist will conduct a hearing test called speech audiometry. An audiologist plays several different tones during speech audiometry and records how loud each style needs to be for a patient to hear it.
An average hearing loss is present if someone can listen to sounds at louder levels than other sounds. If someone has no hearing, they wouldn’t hear any of them.
The audiologist then compares these results with normal hearing ranges to determine whether or not someone has hearing loss.
To get more specific information about your hearing health, you should visit a hearing specialist like an audiologist.
Audiologists often use hearing tests to help diagnose hearing problems. They may also use hearing tests to monitor patients who have already been diagnosed with hearing difficulties. There are two main hearing tests: pure tone testing and speech Audiometry.
Pure tone testing involves listening to pure tones through headphones while watching a visual display on an oscilloscope screen.
Speech audiometry consists in listening to words through headphones while wearing earphones that play white noise (to cancel out external noises).
In both cases, patients press a button when they hear certain tones so that their responses can be recorded as data points on graphs showing their reactions over time.

To perform tympanometry, audiologists first use a probe-tube microphone to measure air pressure in each ear canal. This air pressure is then used to determine how well the eardrum vibrates when stimulated with sound waves.
The hearing test also tests for frequency discrimination between high and low frequencies. One common way to test for frequency discrimination is through an automated auditory brainstem response (ABR) test.
This test measures electrical activity along your auditory nerve after different tones are played in each ear individually.
An audiologist will be able to tell you if you have any hearing loss or other abnormalities during or after your hearing test. If so, they can recommend hearing aids that could help restore your hearing and improve your quality of life.
Hearing aids can cost anywhere from $2,000 to $6,000 per pair—but fortunately, there are plenty of ways to offset those costs by applying for government programs like Ontario Health Insurance Plan (OHIP) or insurance discounts such as Veterans Affairs benefits.
You should always talk with an audiologist about what kind of hearing aid is best suited for you—and discuss whether other options might better suit your needs and budget. A good hearing specialist will work closely with you throughout the process, including ensuring that your new hearing aids fit properly!
OTHER TESTS
In addition to audiology tests, some clinics may conduct an air conduction test, which measures how well you can hear by placing a microphone in your ear canal.
This test is usually performed before and after inserting earplugs or earmolds, as it will show whether or not they are fitting correctly and functioning appropriately.
An auditory brainstem response (ABR) test is another hearing test you may be asked to undergo; it measures your reactions to certain sounds.
The audiologist will use electrodes on your scalp to send low-level sounds into your ears and monitor your responses via computer.
A word of caution: You should avoid eating, drinking caffeinated beverages, chewing gum, or smoking cigarettes for at least two hours before the hearing test.
If you have any wax buildup in your ears, tell your doctor so they can remove it before testing begins.
The doctor might also ask you to temporarily stop taking certain medications that could interfere with results—particularly blood thinners like aspirin—and suggest taking vitamin B12 supplements if necessary.
Other tests: In addition to audiology tests, some clinics may conduct an air conduction test, which measures how well you can hear by placing a microphone in your ear canal.