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A hearing (audiometric) test is part of an ear exam that tests how well a person is able to hear. It is done by measuring how well sound can reach the brain.
The sounds we hear start as vibrations in the air around us. The vibrations make sound waves, which vibrate at a certain speed (frequency) and have a certain height (amplitude). The vibration speed of a sound wave determines how high or low a sound is (pitch). The height of the sound wave determines how loud the sound is (volume).
Hearing happens when these sound waves travel through the ear and are turned into nerve impulses. These nerve impulses are sent to the brain, which "hears" them.
Hearing tests help find what kind of hearing loss you have. The tests measure how well you can hear sounds that reach the inner ear through the ear canal. They also measure sounds that are spread through the skull.
Most hearing tests ask you to respond to a series of tones or words. But there are some hearing tests that do not require a response.
Hearing tests may be done:
Tell your doctor if:
Before you start any hearing tests, your ear canals may be checked for earwax. This can affect how well you can hear the tones or words during testing. Hardened wax may be removed.
You may wear headphones for some tests. You will need to remove eyeglasses, earrings, or hair clips that can affect the placement of the headphones. The person giving the test will press on each ear to find out if the pressure from the headphones on your outer ear will cause the ear canal to close. If so, a thin plastic tube may be placed in the ear canal before the testing to keep your ear canal open. The headphones are then placed on your head and adjusted to fit.
If you wear hearing aids, you may be asked to remove them for some of the tests. You may be asked to shampoo your hair before you have auditory brain stem response (ABR) testing.
Talk to your doctor about any concerns you have about the need for a hearing test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form ( What is a PDF document? ).
Hearing tests can be done in an audiometry (hearing) lab by a hearing specialist (audiologist). They can also be done in a doctor's office, a school, or the workplace by a nurse, a health professional, a psychologist, a speech therapist, or an audiometric technician.
In a whispered speech test, the health professional will ask you to cover the opening of one ear with your finger. He or she will stand 1 ft (0.3 m) to 2 ft (0.6 m) behind you and whisper a series of words. You will repeat the words that you hear. If you can't hear the words at a soft whisper, the health professional will say the words more loudly until you can hear them. Each ear is tested separately.
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 person doing the test will control the volume of a tone. He or she will 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 person 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. A special vibrating device will be placed on the bone behind your ear. Again, you will signal each time you hear a tone.
A tuning fork is a metal, two-pronged device that makes a tone when it vibrates. The person giving the test hits the tuning fork to make it vibrate and produce a tone. These tests check 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, the person giving the test can tell if there is a problem with the nerves or with sound getting to the nerves.
Speech reception and word recognition tests measure how well you can hear and understand normal speech. In these tests, you are asked to repeat a series of simple words spoken at different volumes. A test called the spondee threshold test finds the level at which you can repeat at least half of a list of familiar two-syllable words.
Otoacoustic emissions (OAE) testing is often used to check newborns for hearing problems. In this test, a small, soft microphone is placed in the baby's ear canal. Sound is then sent through a small flexible probe that has been put in the baby's ear. The microphone detects the inner ear's response to the sound. This test can't tell the difference between conductive and sensorineural hearing loss.
Auditory brain stem response (ABR) testing checks for 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 track 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.
It is not painful to have a hearing test.
Having a hearing test does not cause problems.
A hearing test is part of an ear exam that tests how well a person can hear.
Sound is described in terms of frequency and intensity. Your hearing threshold is how loud the sound of a certain frequency must be for you to hear it.
The following table relates how loud a sound must be for a person to hear it (hearing thresholds) to the degree of hearing loss for adults:
Hearing threshold in decibels (dB)
Degree of hearing loss
Ability to hear speech
No significant trouble hearing.
Trouble with faint or distant speech.
Trouble with conversational speech.
Moderate to severe
Speech must be loud; trouble with group conversation.
Trouble with loud speech. Understands only shouted or amplified speech.
May not understand amplified speech.
You may not be able to have the test, or the results may not be helpful, if:
U.S. Preventive Services Task Force (2008). Universal screening for hearing loss in newborns: Recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf08/newbornhear/newbhearrs.htm. Committee on Practice and Ambulatory Medicine, Bright Futures Periodicity Schedule Workgroup (2014). 2014 recommendations for pediatric preventive health care. Pediatrics, published online February 24, 2014. DOI: 10.1542/peds.2013–4096. Accessed March 7, 2014.
Other Works Consulted
Committee on Practice and Ambulatory Medicine, Bright Futures Periodicity Schedule Workgroup (2014). 2014 recommendations for pediatric preventive health care. Pediatrics, published online February 24, 2014. DOI: 10.1542/peds.2013–4096. Accessed March 7, 2014.
ByHealthwise Staff Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Charles M. Myer III, MD - Pediatrics, Otolaryngology
Current as ofMarch 28, 2018
Current as of:
March 28, 2018
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Kathleen Romito, MD - Family Medicine & Charles M. Myer III, MD - Pediatrics, Otolaryngology
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