Different types of hearing tests exist to determine if one has a hearing loss and its severity.

  • Pure-Tone Test: The well-known pure-tone test requires the patient to wear earphones and raise a hand, press a button, or say “yes” each time a beep is heard. The results are a graph or audiogram that show your hearing threshold, the quietest sound the individual can hear at frequencies.

    If fluid or wax is blocking the outer or middle ear, the pure-tone test is substituted with a bone conduction test. A bone conductor or bone oscillator (a box that causes the bones of the skull to vibrate in response to tones) is placed behind the ear instead of headphones. Similarly, the results are produced in the form of an audiogram.

  • Auditory Brainstem Response (ABR) Test: The ABR test tells us how the inner ear, called the cochlea, and the brain pathways for hearing are working. It measures the hearing nerve’s response to sound. Used for children and others who cannot complete a typical hearing test, individuals whose hearing loss symptoms are due to hearing loss in the brain, or newborns, this test is also known as an auditory evoked potential (AEP) test.

    Stickers called electrodes are placed on the individual’s head and in front of his or her ears and connected to a computer. The electrodes measure how the patient’s nerves respond to sounds are made through the earphones.

  • Speech Test: The speech test is similar to the pure-tone test in that the individual lists to sound through headphones. Instead of tones, the patient listens to words, which they must then repeat. The test determines one’s speech reception threshold. This test can be conducted in either quiet or noisy environments.

  • Middle Ear Test: The middle ear test aims to assess the function of the middle ear by examining how well the eardrum reacts to varying pressure in the ear canal. Hearing ability directly correlates to eardrum sensitivity. There are three types of middle ear tests: Tympanometry (tests how well the eardrum moves using a probe); acoustic reflex measures (records strength of middle ear’s reflex to a loud sound); and static acoustic impedance (measures volume of air in the ear canal to check for a perforated or ruptured eardrum and for fluid behind the eardrum)

  • Otoacoustic Emission (OAE) Test: The OAE test measures hair cell function. In a person with typical hearing, a small probe inserted into the causes the inner ear to emit tones or clicking sounds, while someone with hearing loss may not produce these sounds. Results are monitored while the patient takes no action.

Sources: American Speech-Hearing-Language Association; Children’s Hospital of Pittsburgh; Hear It; Johns Hopkins Medicine


Too many people delay getting a hearing test because they don’t realize that treatment can transform their lives. Here are the top reasons to get your hearing tested.

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1) To rule out a serious medical issue. Schedule your first full diagnostic evaluation by an audiologist or ear, nose, and throat doctor (ENT, or otolaryngologist) by age 30, and then a retest by any hearing healthcare professional every 10 years. In the event of sudden changes, the first test can be used as a baseline. Hearing loss can also be an early sign of cardiovascular problems, diabetes, or dementia. Get tested immediately if you notice a change in your hearing or balance or have tinnitus or difficulty understanding speech.

2) To reduce the risk of brain shrinkage and memory problems. Hearing loss is associated with accelerated brain atrophy, especially in the area of the brain used for short-term memory.

3) To decrease the chance of mental decline from dementia. Countless studies, including Dr. Frank Lin’s 2013 Johns Hopkins study, show that untreated hearing loss speeds up age-related cognitive decline.

4) To improve productivity at work--and increase your paycheck. When you have a hearing loss, your brain utilizes resources that would otherwise go toward problem solving. According to the Better Hearing Institute, “Research shows that hearing loss treatment reduces work discrimination toward the person with the hearing loss. Studies also show that when people with hearing loss use hearing aids, they do better financially.”

5) To keep active and prevent the gradual onset of social isolation and depression. Decreased hearing ability can lead to decreased social activity. Decreased activity leads to isolation, which may then lead to depression. Research has found there is a higher level of depression in those with untreated hearing loss than among those who treat their loss.

6) To reduce stress and fatigue. Active listening (concentrating on what’s being said) can be tiring for anyone. For someone with a hearing loss, it can be downright exhausting. Instead of focusing all your energy on what’s going on around you, your brain has to work even harder just to extinguish the words that are being said. And if your brain gets it wrong, stress and anxiety set in.

7) To enhance the lives of your family members, coworkers, and friends. One of the most overlooked factors is how hearing loss affects other people. Communication is a two-way street, and a hearing loss may affect your loved ones as much as it affects you. Research by the National Council on Aging on more than 2,000 people with hearing loss (as well as their significant others) demonstrated that hearing aids are directly associated with improvements in the social, emotional, and interpersonal well-being of people with hearing loss and their loved ones.

A version of this content originally appeared in Hearing Health magazine’s Fall 2014 issue.