Diagnostic Audiologic Evaluation
If you have been referred by your primary care provider for a diagnostic audiologic evaluation, it means that your hearing needs to be further examined. A diagnostic audiologic evaluation may be indicated for individuals who did not pass an initial hearing screening or for those that have expressed concerns about their hearing to their healthcare provider.
A hearing evaluation is done to determine if a hearing loss is present and, if so, to identify the type and severity of the hearing loss. It also may provide insight into the cause of the hearing loss as well as provide guidance for the audiologist in making appropriate treatment recommendations, or referring to other professionals.
What tests will be done?
The specific tests done during the evaluation will depend on the patient's age, symptoms and medical history. These various tests will determine the degree of hearing loss, the type of hearing loss and the conditions of the ear canal and middle ear. The audiologist will also establish if the hearing loss is conductive (middle ear or ear canal problem) or sensorineural (inner ear problem or a problem with the auditory nerve and central auditory pathways).
At a minimum, a diagnostic audiologic evaluation includes pure-tone testing, bone conduction testing and speech discrimination testing.
Pure-tone and bone conduction testing
Pure-tone testing is completed using headphones and tests the entire pathway of sound, from our ear canal to our brain. It determines the quietest tones that a person can hear at different frequencies, from low pitch to high pitch. Bone conduction testing is similar to pure-tone testing, however, a different type of headset is used and placed behind the ear. This provides the audiologist with information about the hearing sensitivity of the inner ear. A bone conduction test will help the audiologist determine whether the loss is conductive or sensorineural.
Speech discrimination testing
A speech reception threshold (SRT) test is used to confirm the results of a pure-tone test. This test determines the lowest level of sound at which the patient can clearly identify words. Word recognition testing is a test that is most often used when there is a hearing loss present. This test reveals the patient's ability to understand words at an amplified volume. Often this test helps an audiologist understand what kind of outcomes a patient might have with hearing aids or other assistive devices.
The audiologist will also perform otoscopy (physical examination of the outer ear, ear canal and eardrum) and may also perform tympanometry (a test of the middle ear) to determine the health of the ear canal, eardrum and the middle ear space.
Specialized tests exist for infants and young children, as well as children and adults with developmental and cognitive impairments. These more-specialized tests allow the audiologist to test the auditory system when the patient is not able to actively participate in the tests or evaluation.
Diagnostic audiometry for children
For children, it is important to have a diagnostic hearing evaluation whenever a hearing loss is suspected. It is the first step in identifying hearing loss and developing a treatment plan to improve academic and social success.
Along with the evaluation, you should generally expect to have time to review the results with the audiologist. They can interpret the tests for you, answer your questions, provide you with information and referrals as needed, as well as begin planning for treatment, if indicated.
Audiologists are specialists in hearing and hearing rehabilitation. Never hesitate to ask your audiologist for clarification or further information on anything you do not understand.
What can I expect during a diagnostic hearing evaluation?
The evaluation will last about 30-40 minutes in length. You should also allow time for discussion with the audiologist to review test results and ask questions.
If the results indicate you need hearing aids, allow for sufficient time to discuss your options.
It is recommended that you bring a family member with you to the evaluation appointment. Most audiologists agree that hearing loss is a family issue. It helps to have another supportive person at the appointment to help you understand the information and recommendations.
Before your appointment, a complete medical history will be completed and the audiologist will want to hear about any complaints you have about your hearing. They will pay special attention to any concerns you have about exposure to noise, tinnitus and balance problems. Make sure that you bring a full list of any medications and supplements you are taking with you to your appointment.
The diagnostic audiologic evaluation is a good chance to establish a relationship with your audiologist. It helps to ask around for recommendations to audiologists in your area and find someone who listens carefully to your concerns. Above all, don't be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding hearing solutions that work best for you and your lifestyle.