What to Expect from a Hearing Test

Some medical procedures are ubiquitous in pop culture. Everyone knows the eye test with the different-sized letters on the poster, and we’ve all seen the knee reflex test with the little hammer. But if you were given a pencil and paper and asked to draw what a hearing test looks like, could you do it?

In Ehima’s 2018 Eurotrak survey – conducted on over 11,000 people with hearing loss – it was found that 48% had never taken a hearing test. Furthermore, an additional 18% had not had a hearing test in the past five years.

This means that just 34% of hearing impaired people have taken appropriate action towards addressing their hearing loss. This is far less than the rate that people go to the dentist or to an eye doctor, so it’s not surprising that people may not be fully aware of hearing test procedures.

If you’d like to have a firsthand experience, you can always fill out our online form to arrange your own free consultation with a nearby hearing healthcare professional, including a hearing test of your own!

What happens during a hearing test?

For an average patient, the course of events of a hearing test will be pretty similar to any other doctor’s appointment (thankfully without the shots.)

After showing up to your appointment, your hearing healthcare professional will ask you a few questions about any concerns you have or problems you’ve noticed. After all, no one knows what you’re going through but you.

The test will then take place, comprising a few of the various procedures listed and described below. Afterwards, you’ll have a discussion with your specialist about your options, and whether or not you need a hearing aid. If you do, you may discuss your options and be fitted for a hearing aid there and then, or be prompted to book a follow-up appointment.

How long does a hearing test take?

Not long at all! Most individual examinations only take a few minutes, with the longest kind of examination – speech testing – only happening over the course of about 15 minutes. Most hearing tests involve multiple kinds of examinations, however, and this can add up to around half an hour of testing.

Couple this with the conversations you’ll be having with your hearing specialist, and an average appointment shouldn’t run over an hour at most.

How often should I have a hearing test?

You may never have had a hearing test before. If this is the case, you might be surprised to hear that once you’re over the age of 50, your ears should go the way of your eyes and teeth and receive attention at least once every three years.

Clear Living's own data, collected over the course of a year, shows that 60% of hearing tests are attended by a patient over age 65. 56-65 year old patients follow up with 21% of appointments, with 46-55 year old patients occupying 12%. Finally, under-45's take the remaining 7% of appointments.

Even if you’re under 50, however, if you’ve never had a hearing test, then it’s strongly recommended that you have at least one. That way, you can record your baseline hearing ability and use it for comparison as you age.

For example, if you went to a hearing test at age 55 without having had one prior, the specialist giving the test would have no reference point by which to see if your hearing ability has degraded. This is why you need to have at least one hearing test every ten years or so while you’re under 50, and then one every three years or so once you reach your 50th.

Do I need to bring anything to a hearing test?

If you have had a hearing test before, then you’ll be well-equipped for any tests from here on out – as long as you have your results on hand.

Like we mentioned earlier, the results of a previous test are crucial when it comes to having a second test, as your hearing healthcare professional will need to compare results between your present and past conditions.

Other than that, it would be a good idea to bring any relevant medical records, such as any otolaryngic (ear, nose, or throat) procedures you’ve had, and the names of any medication you’re taking.

And when we say any medication, we mean any medication – not just medications that relate to your ears. All kinds of medications and substances can damage your ears – these substances are “ototoxic,” which literally means “toxic to the ear.”

Finally, like in any medical examination, it pays to be honest. Tell the truth regarding your alcohol consumption, whether or not you smoke, and any other lifestyle questions you’re asked.

What kinds of hearing tests are there?

The most basic kind of hearing test would be a hearing screening. It’s a quick pass-fail test where your hearing healthcare professional assesses the state of your hearing. A pass means that you most likely don’t have hearing loss, and you can go home.

A fail means that you will have to undergo a more thorough evaluation, where both you and your hearing specialist can further understand your hearing loss, before discussing treatment options. This screening is used on newborns, and we break it down in the section below.

Now we’ll look at the four most common hearing tests:

1. Otoscopy

   The simplest test – and probably the one you do recognize – is an otoscopy. The doctor uses a focused flashlight to look into the patient’s ear canal, and determines if there are any obstructions or abnormalities in the ear canal or eardrum.

2. Air conduction audiometry

   The patient is placed in a soundproof booth and wears a pair of headphones. Beeps of varying intensity and frequency are played into one ear at a time, and the patient responds when they can hear them. This tests the hearing threshold of the patient at each frequency, to determine the severity and nature of the patient’s hearing loss.

3. Bone conduction audiometry

   Similar to the previous test, the patient is placed in a soundproof room, but this time wearing a headband with a pad on their mastoid bone (the bone behind your ear.) They then respond to any beeps they hear. This tests their hearing threshold, but tests it through bone conduction rather than conventional hearing. This can determine whether the patient’s hearing loss is conductive, mixed, or sensorineural loss.

4. Speech testing

   The final soundproof booth test can be done in three different ways.

   Speech reception threshold (SRT): The patient is asked to repeat words of varying loudness, presented to one ear at a time. This measures their speech threshold level in each ear.

   Word recognition testing/speech discrimination testing: The patient is asked to repeat words presented to one ear at a time, while sometimes hearing white noise in the opposite ear. This test determines the patient's speech-processing ability, or the connection between what their ears hear and what their brain understands.

   Speech-in-noise testing: The patient is asked to repeat sentences with varying degrees of background noise. This is used to determine their ability to process speech in the presence of external distractions.

These four procedures usually make up a basic hearing test, and are what you’ll need to undergo if your screening results indicate hearing loss.

The trio of air, bone, and speech testing is collectively referred to as an audiogram, and is conducted by the hearing specialist if they want to determine the patient’s candidacy for hearing aids.

Some more procedures include:

Tympanometry: A plastic probe is inserted into the ear canal to measure the canal’s volume and the eardrum’s response (i.e. whether or not it moves normally.)

Acoustic reflex testing/acoustic reflex decay testing: The same plastic probe used during tympanometry testing is inserted, and produces a loud beeping noise. This test conveys the status of the acoustic nerve using tracings interpreted by the audiologist. 

Hearing tests for the elderly

Tests for the elderly usually follow the course we’ve discussed, but might differ slightly for patients with significant dementia or cognitive impairment.

In these cases, the audiogram can be a bit trickier to reliably measure, and the patient might need to be re-instructed on the rules of the test and how they should respond. This makes the tests a bit more hands-on than they would be otherwise, but mechanically they remain unchanged.

Hearing tests for children

So far, we’ve discussed what a hearing test looks like for an adult. However, you might be reading this article for your child, toddler, or infant, and wondering if they’ll be going through anything different when they have a hearing test.

There are actually more differences and depth behind a child’s hearing test than you might think. First, we’ll look at hearing test screenings for newborns.

Screenings are so quick and simple that they’re easily performed on newborns – sometimes in their sleep! A full rundown of one such test is detailed here, but we’ll give you a quick look at these tests.

There are two screening tests that can be given – otoacoustic emission (OAE) and automated auditory brainstem response (AABR.) The OAE is given first, and if the results are uncertain, an AABR is administered.

The OAE involves a soft earpiece being placed into the baby’s ear. Mellow clicking sounds are played, and the doctors monitor the baby's inner ear hair cells for a reaction. If an abnormal tracing occurs with the OAE test, then worry not – this is where the AABR comes in.

Sensors and headphones are placed on the baby’s head, and similar clicking noises are played. The autonomic acoustic nerve is monitored using electrodes, and his or her hearing test will pass or fail based on these measurements.

This procedure is elective, but entirely harmless, and therefore strongly recommended. As you can see in the charts below, above 90% of newborns undergo this procedure.

Data source: healthypeople.gov

Data source: healthypeople.gov

As you can see from the data above, there has been a massive increase in aural health appreciation in new parents within the past decade, both in hospitals immediately after the birth, and in clinics a few months down the road.

For more about hearing tests for children, you can look at our article here to see how to prepare your child for an examination. Their hearing tests are generally the same as adult hearing tests, but the prep work may differ.

How much does a hearing test cost?

Maybe this is the real reason you or your loved one haven’t considered a hearing test. You/they might be noticing hearing loss, but you can still hear almost everything, so why spend the money on a hearing test?

Who could fault this line of thinking? Medical bills can be steep, and if a condition isn’t causing you intense physical pain or discomfort, do you need to spend the money?

Well, firstly, yes. Hearing loss can be a precursor or a symptom of a larger issue. Even if it isn’t, if left untreated, hearing loss can lead to some serious physical and mental health concerns.

But secondly, you don’t have to worry about costs, because you’ve found us. We’ve partnered with hundreds of hearing clinics across the country in order to offer our users free, top-quality hearing consultations.

All you have to do is fill out our quick and easy online form, which takes no more than five minutes. You’ll then be directed to a hearing healthcare professional near you, who will be happy to provide you with a free consultation, which includes a hearing test.

If you don’t use our form, a hearing test can cost up to $250 dollars without insurance. If you have insurance, then hearing tests are usually covered, but it’s always worth checking with your provider. Insurance usually stops there, however, and very rarely covers the cost of hearing aids or other forms of treatment.

Can you have an online hearing test?

While there are passable hearing tests available online, professionals recommend a standardized in-person hearing test. When taking part in a test online, there are many factors that mean the results could vary between people with similar hearing conditions.

For example, your computer volume might be too low, your headphone quality may be subpar, or you may be inundated with background noise. While online hearing tests can give you a good idea of what to expect in a professional hearing test, they’re no substitute for the real thing.

How to get a hearing test

If this has all sounded intriguing to you, then don’t miss out! If you fill out our form, you’ll be redirected to a nearby hearing specialist who will offer you a free hearing test, where you’ll be able to experience some – or if you’re lucky, all – of the fun we’ve discussed here today.