Hearing Tests: How It Is Done

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How It Is Done

Hearing tests can be done in an audiometry laboratory by a hearing specialist (audiologist) or in a health professional's office, a school, or the workplace by a nurse, health professional, psychologist, speech therapist, or audiometric technician.

Whispered speech test

In a whispered speech test, the health professional will ask you to cover the opening of one ear with your finger. The health professional will stand to behind you and whisper a series of words. You will repeat the words that you hear. If you cannot hear the words at a soft whisper, the health professional will keep saying the words more loudly until you can hear them. Each ear is tested separately.

Pure tone audiometry

Pure tone audiometry uses a machine called an audiometer to play a series of tones through headphones. The tones vary in pitch (frequency, measured in hertz) and loudness (intensity, measured in decibels). The health professional will control the volume of a tone and reduce its loudness until you can no longer hear it. Then the tone will get louder until you can hear it again. You signal by raising your hand or pressing a button every time you hear a tone, even if the tone you hear is very faint. The health professional will then repeat the test several times, using a higher-pitched tone each time. Each ear is tested separately. The headphones will then be removed, and a special vibrating device will be placed on the bone behind your ear. Again, you will signal each time you hear a tone.

Tuning fork tests

A tuning fork is a metal, two-pronged device that produces a tone when it vibrates. The health professional strikes the tuning fork to make it vibrate and produce a tone. These tests assess how well sound moves through your ear. Sometimes the tuning fork will be placed on your head or behind your ear. Depending on how you hear the sound, your health professional can tell if there is a problem with the nerves themselves or with sound getting to nerves.

Speech reception and word recognition tests

Speech reception and word recognition tests measure your ability to hear and understand normal conversation. In these tests, you are asked to repeat a series of simple words spoken with different degrees of loudness. A test called the spondee threshold test determines the level at which you can repeat at least half of a list of familiar two-syllable words (spondees). These tests distinguish conductive from sensorineural hearing loss.

Otoacoustic emissions (OAE) testing

Otoacoustic emissions (OAE) testing is often used to screen newborns for hearing problems. OAE testing is done by placing a small, soft microphone in the baby's ear canal. Sound is then introduced through a small flexible probe inserted in the baby's ear. The microphone detects the inner's ear's response to the sound. This test cannot distinguish between conductive and sensorineural hearing loss.

Auditory brain stem response (ABR) testing

Auditory brain stem response (ABR) testing detects sensorineural hearing loss. In this test, electrodes are placed on your scalp and on each earlobe. Clicking noises are then sent through earphones. The electrodes monitor your brain's response to the clicking noises and record the response on a graph. This test is also called brain stem auditory evoked response (BAER) testing or auditory brain stem evoked potential (ABEP) testing.

Last updated:	April 30, 2007
Author:	Monica Rhodes
Reviewed By:	Kathleen Romito, MD - Family Medicine, Charles M. Myer, III, MD - Otolaryngology
Editors:	Kathleen M. Ariss, MS, Tracy Landauer