If you have been referred 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.
The evaluation is done to determine if a hearing loss is present and, if so, to detail 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 referrals 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 or outer ear problem) or sensorineural (inner ear problem or an issue with the auditory nerve and central auditory pathways).
At a minimum, a diagnostic audiologic evaluation includes pure-tone testing, bone conduction testing and speech testing.
Pure-tone and bone conduction testing
Pure-tone testing determines the quietest tones that a person can hear at different frequencies, both low and high. Bone conduction testing is similar to pure-tone, however, a different type of headset is used to provide the audiologist with different information. A bone conduction test will help the audiologist determine whether the loss is conductive in nature or sensorineural.
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 the patient can clearly identify words or speech.
The Word Recognition Score is a measurement of your speech comprehension abilities. Your audiologist will test your brain’s ability to understand language by having you repeat sentences and words back to them. It’s important to understand that the parts of your brain that process speech and hearing are separate.
The QuickSIN is a speech-in-noise test that quickly and easily measures the ability to hear in noise. Speech understanding in noise cannot be reliably predicted from the pure tone audiogram or other standard audiometric tests. The QuickSIN test should be used on all adult patients as part of the audiometric test battery
Tympanometry is a simple test used to test the condition of the middle ear and mobility of the eardrum and the conduction bones by creating variations of air pressure in the ear canal.
Real-ear measurements are often used to determine whether or not a hearing aid user is receiving the precise level of amplification needed at every frequency in order to achieve the best hearing improvement possible. Depending on the level of hearing loss, 100% improvement is not always possible, but the goal is to maximize the benefit to get as close to that as possible.
Performing this verification during the initial fitting process helps ensure that the user is receiving a “just right” level of amplification- not too much where everything is too loud, and not too little where the user has significant trouble hearing speech even with the hearing aids on.
The audiologist may also perform otoscopy (physical examination of the outer ear and, ear canal and eardrum) and tympanometry (test of the middle ear) to determine the health of the ear canal and the middle ear.
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.
Visual reinforcement and conditioned play audiometry for children
We can do Conditioned Play on children 4+ yrs. 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 take 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. 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.