What Your Audiologist Checks During a Comprehensive Hearing Evaluation

When you schedule a hearing evaluation, understanding what happens during your appointment can help ease any concerns and prepare you for the experience. At Family Audiology and Hearing Centers, our audiologists conduct thorough assessments designed to give us a complete picture of your hearing health. Each step of the evaluation serves a specific purpose in identifying potential issues and determining the best path forward for your care.

The Initial Conversation

Your evaluation begins before any testing equipment is used. We start by discussing your hearing concerns, medical history, and lifestyle. This conversation helps us understand when you first noticed changes in your hearing, what situations cause the most difficulty, and whether you've experienced other symptoms like tinniness or dizziness. Your occupation, hobbies, and daily routines all factor into our assessment, as different environments present unique hearing challenges.

We also review your medical history, including any medications you're taking. Certain health conditions and medications can affect hearing, so this information helps us identify potential contributing factors to your hearing difficulties.

Physical Examination of Your Ears

Before testing your hearing ability, we need to examine the physical structures of your ears. Using an otoscope, we look into your ear canal to check for several conditions:

Earwax buildup can block sound from reaching your eardrum, creating temporary hearing difficulties that resolve once the wax is removed. We check for excessive accumulation that might interfere with testing or hearing aid use.

Ear infections or inflammation can affect both your comfort and hearing ability. We look for signs of redness, swelling, or fluid that might indicate an infection requiring medical treatment.

Eardrum condition is assessed to ensure it's intact and healthy. Perforations or scarring on the eardrum can impact hearing and may need addressing before other treatments.

Structural abnormalities in the ear canal might affect hearing aid fitting later, so we note these during the examination.

This examination takes only a few minutes but provides valuable information about the health of your outer and middle ear structures.

Pure-Tone Audiometry

The core of your hearing evaluation involves pure-tone audiometry, which measures your ability to hear sounds at different frequencies and volumes. You'll sit in a soundproof booth wearing headphones, and we'll present tones at various pitches and volumes. Your job is simple: indicate when you hear each tone, typically by pressing a button or raising your hand.

We test frequencies ranging from low-pitched sounds (like a foghorn) to high-pitched sounds (like a bird chirping). For each frequency, we determine the softest volume you can hear. This creates your hearing threshold—the quietest sound you can detect at each pitch.

The results appear on an audiogram, a graph showing your hearing ability across different frequencies. Normal hearing thresholds fall between 0 and 25 decibels. Results beyond this range indicate varying degrees of hearing loss. The pattern of your results helps us identify whether you have difficulty with high-frequency sounds (common in age-related hearing loss), low-frequency sounds, or a more complex pattern.

Speech Recognition Testing

Hearing pure tones in a quiet booth differs significantly from understanding conversation in real life. Speech recognition testing evaluates how well you understand words, not just whether you hear sounds.

Speech Reception Threshold (SRT) testing determines the softest level at which you can understand speech. We present two-syllable words at decreasing volumes until you can barely make out what's being said. This measurement should align with your pure-tone results and helps verify the accuracy of your testing.

Word Recognition Score (WRS) testing measures how clearly you understand speech at comfortable listening levels. We present single-syllable words at a volume you can hear easily, then calculate the percentage you repeat correctly. Someone with normal hearing typically scores 90-100% on this test. Lower scores suggest that even when sounds are loud enough, clarity remains a challenge—an important distinction when planning treatment.

Speech-in-Noise Testing

Understanding speech in quiet is one thing; understanding conversation in noisy restaurants, busy offices, or family gatherings is another. Speech-in-noise testing simulates these challenging environments by presenting speech alongside competing background noise.

This testing reveals how well you separate important sounds (like conversation) from unimportant noise. Many people with hearing loss struggle particularly in noisy environments, even when their hearing in quiet seems adequate. The results from this testing help us understand your real-world hearing challenges and guide treatment recommendations.

Bone Conduction Testing

While air conduction testing (using headphones) measures how sound travels through your outer and middle ear, bone conduction testing bypasses these structures. We place a small device behind your ear that vibrates, sending sound directly to your inner ear through the bones of your skull.

Comparing air conduction and bone conduction results reveals whether hearing loss stems from problems in the outer or middle ear (conductive hearing loss) or from issues in the inner ear or auditory nerve (sensorineural hearing loss). This distinction affects treatment options significantly.

If bone conduction thresholds are better than air conduction thresholds, we know something in the outer or middle ear is blocking sound—perhaps earwax, fluid, or a structural issue. If both show similar hearing loss, the problem lies in the inner ear or beyond.

Tympanometry

Tympanometry assesses how well your eardrum moves in response to air pressure changes. A small probe placed in your ear canal creates slight pressure changes while measuring eardrum movement. The test takes only seconds and feels like mild pressure in your ear.

Normal eardrum movement suggests healthy middle ear function. Reduced movement might indicate fluid behind the eardrum, a stiffened eardrum, or issues with the small bones that conduct sound through the middle ear. This information helps us distinguish between different types of hearing loss and identify conditions that might require medical treatment.

Understanding Your Results

After completing these tests, we review your results together. Your audiogram shows the type and degree of any hearing loss present. We explain what your results mean for your daily life and discuss whether medical treatment, hearing aids, or other interventions would benefit you.

If hearing loss is present, we discuss its likely causes based on your test pattern, medical history, and symptoms. Age-related hearing loss typically affects high frequencies first. Noise exposure often creates a characteristic pattern. Sudden hearing loss or hearing loss in only one ear may require prompt medical evaluation.

At Family Audiology and Hearing Centers, we use advanced equipment and Real Ear Measurement when fitting hearing aids, ensuring any devices we recommend are precisely programmed for your specific hearing loss. This verification step confirms that hearing aids are providing appropriate amplification across all frequencies.

Schedule Your Comprehensive Evaluation

Understanding your hearing health starts with a thorough evaluation. Our audiologists at Family Audiology and Hearing Centers conduct detailed assessments at our 17 locations across Ohio and Wisconsin. If you've noticed changes in your hearing or simply want to establish a baseline for future comparison, contact us to schedule your appointment. We'll guide you through each step of the process and help you understand your results, ensuring you have the information needed to make informed decisions about your hearing health.