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 0.3 m (1 ft) to
0.6 m (2 ft) 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.