Hearing Evaluation: What to Expect

Many people have never had a hearing test before,

and some have had only minor screenings done.


At Accurate Hearing Centers, our full Aural Examinations are 100% complimentary.  This is our way to help educate the public of what proper care for your hearing is all about.  And this begins with proper assessment.  The following is a synopsis of what you (or your loved one) should expect when visiting a hearing care professional.


On your first visit to a hearing care specialist, he or she will start by asking you questions about your medical and hearing history, which is called the Case History. Some sample questions are listed below:

  • What have you noticed difficulty with your hearing?
  • For how long? When do you think the hearing loss began?
  • Does your hearing problem affect both ?
  • Has your difficulty with hearing been gradual or sudden?
  • Do you have ringing (tinnitus) in your ears?
  • Do you have a history of ear infections/ surgeries?
  • Have you noticed any pain in your ears or any discharge from your ears?
  • Do you experience dizziness?
  • Is there a family history of hearing loss?
  • What medications are you on, or other health conditions being treated for?



Next, the your hearing care professional perform an otoscopy (scary word for looking into your ears).  He or she will look into your ears using a light, called an otoscope, and check for anything in the ear canal that might affect the test results or require referral back to your primary care physician.


Hearing Evaluations

Finally, they will conduct a test or series of tests to assess:

  • Whether there is a hearing loss
  • The cause of the hearing loss
  • The degree and configuration (one or both ears?) of hearing loss


Types of Tests Used: A complete hearing evaluation consists of a variety of assessments, the most common being:

  • Pure-Tone Testing
  • Speech Testing
  • QuickSYN
  • Soundfield
  • Middle Ear Testing


Pure-Tone Testing: This hearing test determines the faintest tones a person can hear at selected pitches (frequencies), from low to high. During this test, earphones are worn so that information can be obtained for each ear. The person taking the test may be asked to respond to the sounds in a variety of ways, such as by:

  • Raising a finger or hand
  • Pressing a button, pointing to the ear where the sound was received
  • Saying “yes” to indicate that the sound was heard
  • The results are recorded in an audiogram

Sometimes, children are given a more play-like activity to indicate response. The most common techniques involve visual reinforcement audiometry (VRA) and conditioned play audiometry (CPA).


Speech Testing: These may be the most important assessment done by your hearing care provider.  Various speech assessments may be done – some in a quiet room like Soundfield, and others within noisy environments QuickSYN. Difficulty understanding speech in background noise is a common complaint of people with hearing loss, and QuickSYN information is necessary to assess one’s abilities in these challenging environments. Soundfield assessment further assists understanding how one’s objective hearing abilities translate into real-life speech recognition.  These results are also recorded on the in the test subject’s profile chart.


Speech Testing Results: Unlike pure-tone testing that is very objective in its findings, speech testing gives us the subjective information’s about how one’s hearing loss actually manifests itself in real-life conversation and recognition.  For this reason, is very advisable for the test subject be accompanied by spouse, significant other whenever possible.  By using this most-familiar voice to administer speech testing – we gain the most accurate results possible.


Middle Ear Testing: Tympanometry assists in the detection of fluid in the middle ear, perforation of the eardrum, or wax blocking the ear canal. Tympanometry pushes air pressure into the ear canal, making the eardrum move back and forth. The test measures the mobility of the eardrum. Graphs are created, called tympanograms. These can reveal a stiff eardrum, a hole in the eardrum, or an eardrum that moves too much.


The Audiogram: The audiogram is a graph showing the results of the Pure-tone testing It illustrates the objective type, degree, and configuration of hearing ability.


Pitch or Frequency

The frequency or pitch of the sound is referred to in Hertz (Hz). The intensity or loudness of the sound is measured in decibels (dB). The responses are recorded on a chart called an audiogram that shows intensity levels for each frequency tested. Each vertical line from left to right represent a pitch, or frequency, in Hertz (Hz). The graph starts with the lowest pitches on the left side and moves to the very highest pitches (frequencies) tested on the right side. The range of frequencies tested are 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 3000Hz, 4000 Hz, and 8000 Hz.


Loudness or Intensity

Each horizontal line on the audiogram from top to bottom represents loudness or intensity in units of decibels (dB). Lines at the top of the chart (-10 dB and 0 dB) represent soft sounds. Lines at the bottom of the chart represent very loud sounds. The culmination of any/all of these necessary tests to evaluate one’s hearing may take up to an hour, and by the end, we will know:

  • If there is hearing loss
  • What the cause may be
  • Treatment options and restoration strategy