If you have trouble hearing or understanding those around you, you might have a hearing loss. Hearing loss can happen slowly over time, which can cause a delay in treatment as you might not notice it right away.
The best way to check your hearing health is to take a hearing test. This is a test that allows a hearing care specialist or licensed practitioner to evaluate your hearing. Your hearing test results will determine any next steps that are needed. Regular hearing tests are essential for your hearing health.
What is a hearing test?
A hearing test is an evaluation of your hearing sensitivity across a wide range of frequencies (measured in hertz (Hz) or kilohertz (kHz)). Frequency tells us the pitch of a sound so that a high pitch sound corresponds to a high frequency.
The most common test frequencies on a hearing test are those critical for hearing speech. A standard hearing test can include up to approximately ten frequencies within the speech range.
The purpose of the hearing test is to determine the softest level you can hear at each frequency. The level of the sound (soft to loud) is measured in decibels (dB). The results of the test are recorded in an audiogram, which is the graphical representation of your hearing level.
Why are hearing tests important for daily life?
Untreated hearing loss can lead to social consequences. You might feel left out of activities or no longer enjoy them because you have difficulty understanding others. It can cause you to rarely take part in social events and therefore it can increase social isolation.
Hearing plays an integral part in your day-to-day life. You talk to your family, your co-workers, your friends. You may talk on the phone or watch TV. Regardless of whether it is active listening (conversing with someone) or passive listening (not paying attention to a sound such as those in nature or background music), you use your ears every day.
A hearing test is a simple way to monitor your hearing health and help keep you active in life.
Comprehensive hearing test or hearing screening?
There are two specific categories of hearing tests: a comprehensive hearing test and a hearing screening.
What is a comprehensive hearing test?
A comprehensive hearing test can include:
- a hearing history
- a middle ear test
- a pure tone test (frequency test of up to approximately 10 frequencies)
- speech testing.
The test is completed in a sound-treated booth or room to ensure that outside noise does not interfere with your hearing test. You will wear headphones or inserts (small foam tips resembling earplugs), where the test sounds will come from.
What is a hearing screening?
A hearing screening is a simplified hearing test normally including four frequencies instead of 10. This test is done as an online hearing test, or you might see hearing screenings at a health fair or pharmacy.
This type of hearing test is not comprehensive and only provides a general idea about your hearing and whether a more thorough examination is recommended.
You can try our online hearing test here.
Should I get a hearing test?
Hearing loss can affect people of all ages. It can be caused by medical-related issues, accidents, noise exposure, age-related hearing loss, or unknown causes. Regardless of the cause of the hearing loss, if you start to notice symptoms, you should get your hearing tested.
What is the most common cause of hearing loss?
A common type of hearing loss is age-related, meaning that it happens slowly over time, with the effects being seen first later in life. Everybody loses sensitivity to high-frequency sounds as they age. Some barely notice a change, while others might need hearing aids.
For an older adult who has not had any previous hearing issues, hearing loss is most commonly attributed to age-related hearing loss. Those who work in occupations with high noise levels are also at risk of hearing loss due to noise exposure.
If you would like to learn more about hearing loss, you can read this article about hearing loss.
What are the signs I may need a hearing test?
There are many possible signs that you can look out for, which may suggest a hearing test is required. These can include:
- difficulty hearing in crowded rooms or restaurants
- thinking that people mumble a lot
- friends or family commenting on you not hearing well or asking ‘what?’ frequently
- having to ask others to repeat what they said
- others noticing the TV volume is too high.
These are general signs for people experiencing age-related hearing loss or hearing losses that can occur over time. There are also other circumstances where it might be good to get your hearing checked regularly, for example:
- you work in noise
- you have loud hobbies such as shooting or using loud equipment (leaf blower, mower, power tools, etc.)
- you often listen to music or other sounds at a loud level (live or recorded)
- you have a family history of hearing loss.
There are also other medical reasons for hearing loss, including infections, ear wax buildup, medication, head injuries, etc. If you have any medical-related issues or already have confirmed hearing loss, you should speak to your licensed medical practitioner about the best plan to monitor your hearing health.
Hearing tests are done as often as needed to monitor your hearing. You can also take online hearing tests on some websites to keep track of when it might be time to schedule an appointment at a hearing clinic.
What can I expect during a comprehensive hearing test?
So, you have scheduled your first comprehensive hearing test and are not sure what to expect. A comprehensive hearing test can include several tests, to test the whole hearing process from the outer ear to the brain. Despite the various tests, they are not challenging to complete.
Your hearing care specialist will determine which hearing tests are required during your appointment. Depending on the set of tests, the appointment might take around 30 – 60 minutes.
Before the hearing test
Before the hearing test, a few things will happen:
- First, you will have a conversation about your hearing history, which helps the hearing care specialist learn more about you and your hearing.
- Next, a visual inspection of the ear canal using an otoscope ensures nothing is blocking the channel, such as ear wax, which could affect the hearing test.
- A middle ear test is done to help check for ear infections or other issues that can occur in your middle ear. This test uses a device called a tympanometer that creates a slight pressure in your ear canal to check your eardrum movement. During this test, you might get a few tones played into your ear. The sounds evaluate the reflex of your middle ear muscles in addition to the mobility of your eardrum.
The hearing test
There are two possible parts of a comprehensive hearing test where test sounds will be played for you to react to: pure tone audiometry and speech audiometry.
What is pure tone audiometry?
This is the test used to determine your hearing sensitivity level by testing various frequencies or pitches to find the softest level that you can hear each frequency. Although the test is not difficult, it does require you to concentrate, as you need to respond to very soft sounds.
Each time you hear a small beep or tone, you need to press a button to let the specialist know you heard it. These sounds test each level of frequency for both the left and right ears. The responses are plotted on an audiogram to show the graphical representation of your hearing.
There are two parts to this test: air conduction and bone conduction. The air conduction test uses headphones/inserts, whereas the bone conduction uses a small device called a bone oscillator that sits on the bone behind the ear. Combined, the hearing care specialist can learn about how well the outer, middle, and inner ear are working.
What is speech audiometry?
Speech audiometry is another part of a comprehensive hearing test. For this test, you need to repeat words or sentences while wearing headphones/inserts or listening via a loudspeaker.
This test is completed at lower volumes to find the softest level of speech you can hear and understand. The test can also be done at louder levels to test for understanding at conversational loudness or at upper limits to determine loudness comfort.
Some speech tests are conducted in noise instead of a quiet room. A noise test provides a more realistic assessment of how you might hear in daily life, such as in a restaurant or crowded space.
How to read hearing test results
When your hearing test is finished you will receive your audiogram, which is the graphical representation of your hearing.
The graph's points represent the softest level you heard at each frequency or pitch for the right ear (red line) and left ear (blue line). The frequency level sits on the horizontal axis (low on the left to high on the right), and the intensity or level of the sound in dB HL is on the vertical axis (soft on the top to loud on the bottom).
In a hearing test, there are no pass or fail scores. A hearing test evaluates your hearing ability which can fall into one or more hearing loss categories.
What are the hearing loss categories?
The are 5 specific hearing loss categories:
- mild hearing loss: 26 to 40 dB HL
- moderate hearing loss: 41 to 55 dB HL
- moderate-to-severe hearing loss: 56 to 70 dB HL
- severe hearing loss: 71 to 90 dB HL
- profound hearing loss: 91 to 100 dB HL.
Any level measured at 25 dB HL or below is considered normal hearing. The farther down your results are on the list, the greater the hearing loss and greater the impact on your hearing ability.
What do the categories mean in daily life?
- Mild hearing loss: Many of the soft daily sounds fall into this level and could be missed by someone with a mild hearing loss. Soft daily sounds include people breathing, leaves rustling, people whispering, refrigerator humming, cat purring and dripping of water. Although people with mild hearing loss can communicate well in quiet surroundings, in situations with background noise there could be word confusion for words starting with certain consonants (“s”, “f” or “th”).
- Moderate hearing loss: People with moderate hearing loss will have more difficulty hearing and understanding speech at normal conversations levels. Following a conversation will require more effort and many of the words could be missed or misunderstood even in quiet. It may not be possible to follow a conversation at normal levels in background noise. Other sounds that could be missed include laughter, rain falling and coffee brewing.
- Moderate-to-severe hearing loss: People with moderate-to-severe hearing loss will have difficulty understanding speech in most situations and have even more difficulty in noise. The TV or radio are not understandable at normal levels and require louder volume levels to be understood. Other daily sounds that could be missed include water running, an alarm clock, children playing, a busy street, an electric toothbrush and a washing machine.
- Severe hearing loss: People with this hearing loss will have difficulty with most conversations at normal and moderately loud levels. Speech at loud levels might be understood as long as there is no competing background noise. Other daily sounds that could be missed include a doorbell or telephone, traffic noise, a vacuum cleaner, a toilet flushing, and people working or various office sounds.
- Profound hearing loss: People with this hearing loss can only hear very loud sounds such as a lawn mower, a motorcycle, an ambulance siren or a blender. Speech at normal levels would not be heard and even when shouting, the speech might not be audible or understood. Those with profound hearing loss are generally candidates for cochlear implants or may rely on sign language or lip-reading to help them understand speech.
I have my hearing test results, what next?
If a hearing loss was measured in the comprehensive hearing test, your hearing care specialist or licensed practitioner will recommend a possible treatment.
There is no cure for permanent hearing loss, but many hearing aids and devices help compensate for hearing loss. If hearing aids are required, your hearing care specialist can help find the best hearing aid to fit your needs. Discover Philips HearLink hearing aids here.
You should continue to monitor your hearing regularly or as often as specified by your hearing care professional. Regular hearing tests will detect any changes in your hearing ability. Hearing issues can then be addressed to help support the best hearing possible every day.