Hearing and Tinnitus Tests
Diagnostic Audiologic Evaluation
If you have been referred for a diagnostic audiologic evaluation, it means that your hearing needs to be further examined. A diagnostic audiologic evaluation may be indicated for individuals who did not pass an initial hearing screening.
The evaluation is done to determine if a hearing loss is present and, if so, to detail the type and severity of the hearing loss. It also may provide insight into the cause of the hearing loss as well as provide guidance for the audiologist in making appropriate treatment recommendations - or referrals to other professionals.
What tests will be done?
The specific tests done during the evaluation will depend on the patient's age, symptoms and medical history. 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 otoscopy, pure-tone testing, bone conduction testing and speech testing.
Pure-tone and bone conduction testing
Pure-tone testing determines the quietest tones that a person can hear at different frequencies, both low and high. Bone conduction testing is similar to pure-tone, however, a different type of headset is used to provide the audiologist with different information. A bone conduction test will help the audiologist determine whether the loss is conductive in nature or sensorineural.
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.
A word recognition score (WRS) test is used to evaluate how clear sound is traveling from your ear to your brain, and can indicate how successful or satisfied you will be with amplification. It can also indicate when hearing aids will no longer be helpful and a cochlear implant is needed, or situations in which further evaluation is necessary.
If you have particular difficulty hearing in noise, a speech-in-noise (SIN) test may be used to evaluate your ability to focus on a target sentence in increasing levels of background noise.
The audiologist will perform otoscopy (physical examination of the outer ear and, ear canal and eardrum) and may also perform 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 audiologic evaluation?
The evaluation, including time for discussion with the audiologist to review test results and asking questions, will last about 60 minutes in length.
If the results indicate you need hearing aids, allow for sufficient time to discuss your options.
It is recommended that you bring a family member with you to the evaluation appointment. 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.
Before your appointment, a complete medical history will be completed and the audiologist will want to hear about any complaints you have about your hearing. They will pay 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.
The diagnostic audiologic evaluation is a good chance to establish a relationship with your audiologist. It helps to ask around for recommendations to audiologists in your area and find someone who listens carefully to your concerns. 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.
Diagnostic Hearing Evaluations
A diagnostic hearing evaluation is the first step in determining your hearing capability. If you have a hearing loss, it will detail the extent, type, and specifics of your particular hearing loss. An audiologist will perform the diagnostic hearing evaluation in their office.
The diagnostic hearing evaluation consists of a variety of tests to determine the unique aspects of your hearing loss, as well as the level at which you can detect and understand speech. The results of this test will provide the audiologist with the details they need to accurately recommend the proper treatment..
Why is a diagnostic hearing evaluation important?
Diagnostic hearing evaluations identify hearing loss and give your audiologist important information to help determine the best course of action for treatment. Whether you struggle with high or low frequencies, this test will provide the sounds you most struggle to hear.
If it is determined that you could benefit from hearing aids, the diagnostic hearing evaluation helps your audiologist know which devices and features will be most appropriate for your needs.
What can you expect during a diagnostic hearing evaluation?
The evaluation typically lasts up to one hour. You should also allow for time for discussion with the audiologist to review test results and ask questions.
It is recommended that you bring a family member with you to the evaluation appointment. Most professionals 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.
If the determination is made that you need hearing aids, allow for sufficient time to discuss your options. Your audiologist will discuss the different styles with you, such as in-the-canal, in-the-ear or behind-the-ear options. They will also use this time to talk about the various features hearing aids offer, like Bluetooth, directional microphones and masking features for tinnitus.
The diagnostic hearing 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.
Real ear measurement
In the past, hearing evaluations and fittings for hearing aids consisted mostly of a series of beeps and noises. Today, audiologists are equipped with new technologies and methods to make the hearing evaluation process and hearing aid programming process more effective.
One of the more advanced technologies available is real ear measurement, specifically speech mapping, is a method of fitting hearing aids using recorded, standardized speech as a stimulus to help the audiologist adjust hearing aids to the right settings for each wearer. Speech mapping makes fitting appointments more interactive and can reduce the number of office visits required for successful hearing aid programming.
What is real ear measurement?
Real Ear Measurement, specifically speech mapping, is a hearing aid verification method that is used to ensure that your hearing aids are programmed for your individual needs. With this method, small microphones placed in the ear canal are used to measure the response of the hearing aid in your ear taking into account the natural and individual characteristics of both your ear and your hearing loss.
Your hearing care professional will have high-tech equipment that will allow him or her to “see” what you are hearing through your hearing aids on a screen in real-time. The results may also be displayed on a wall-mounted screen so that you can also see the adjustments and participate in the process. This allows both you and your family members to visualize and understand the differences that hearing aids can make in your hearing ability.
Benefits of real ear measurement
Speech mapping is known for its accuracy. Without speech mapping verification, other methods to program your hearing aid may require additional adjustments. Speech mapping increases the chances that your hearing aid programming will be done correctly on the first try.
Speech mapping also creates a much more positive fitting experience by allowing both you and your family to see the immediate results of your hearing aids and their positive impact on your ability to hear. Both you and your family will be engaged in the fitting process, making it a joint effort.
If you have a hearing loss, you may not be able to fully understand what you can and cannot hear, and therefore, you may not understand everything you are missing. With speech mapping, you will have the ability to hear the improvements immediately, and you will be shown exactly what you can and cannot hear in real-time.
Benefits of real ear measurement:
- Focuses on the important and basic function of being able to effectively hear human speech
- Provides immediate and tangible results
- Shown to increase successful outcomes of fittings
- Increases your confidence and comfort in using your new hearing aids
- Provides more accurate programming of hearing aids
- Reduces number of return visits
Contact your hearing health professional to find out how speech mapping can provide you with a more enjoyable hearing aid mapping experience.