Hearing Test

What are Hearing Tests?

There are various procedures involved in assessing the hearing disorders. These procedures or tests aim at identifying variety of factors involved in the disorder. In relation to the hearing impairment, these diagnostic procedures allow the clinician to identify the type, degree and configuration of hearing loss. The results of these procedures allow a professional to design a rehabilitation process which is unique and customized to the requirements of the client. On the whole the diagnostic procedures are broadly classified into two types namely Subjective evaluation, Objective evaluation. Subjective tests are procedures that require active participation of the client, i.e., the client will have to manually respond to the signal presented.

Some commonly administered subjective evaluations include: 

• Tuning fork tests 
• Pure tone audiometry 
• Speech Audiometry 
• Short Increment sensitivity index 
• Tone decay test

objective tests are procedures that do not require the active participation of the client. Objective hearing tests are done for those who cannot reliably respond on their own during a subjective hearing evaluation. Administered on difficult to test population such as newborns, persons with comprehension issues such as mentally challenged, etc., and to rule out malingering. 

Some commonly administered objective evaluations include: 

• Impedance audiometry 
• Brainstem Evoked response 
• Oto acoustic emission

Screening and diagnostic tests initially differ based on their intended users and whether they're symptomatic or not. Diagnostic tests are intended for those showing symptoms and are in need of a diagnosis.

Who Should Take a Hearing Test?

Every indivudual at some point of time in their life has to get hearing evaluation done. Below mentioned are certain conditions where getting a hearing evaluation would be a necessity. 

• Every new born should be screened for hearing.
• Every individual with age greater than 40 years. 
• When family members keep complaining about individual’s hearing capacities. 
• When exposed to sudden loud sounds like crackers during Diwali, explosion at mines etc. 
• When exposed to a loud music/ noisy environment for longer duration 
• Individuals who work in noisy environment, e.g., construction workers, armed forces, etc. 
• When using certain medicines like mycin group over a period of time. 
• When on medication for kidney, heart or any major ailments for longer period. 
• When exposed to radiation, chemicals etc

Why Should You Take a Hearing Test?

Hearing tests, or audiometry tests, evaluate your ability to hear. If you have hearing loss, the tests detect the type of hearing loss you have and whether your hearing loss is mild, moderate or severe. Based on test results, your audiologist may recommend treatment like hearing aids or cochlear implants. Apart from this taking a hearing test can also help many other aspects.

Better family relationships- Often, family members may notice a hearing loss earlier than the person with the issue. This can lead to arguments over the volume of TV and movies or who said what about something. Sometimes people can misinterpret your actions if it appears you’re ignoring them (rather than just not hearing them). Once you have the results of your hearing test, you can take action to fix any problems, including family fights.

Hearing the little things you missed- A hearing test provides a roadmap of sorts to allow the audiologist to determine where any hearing loss has occurred and how best to program hearing aids to allow you to hear sounds in that range again. That means you’ll hear sounds you’ve been missing such as a ticking clock, rustling leaves, chirping birds or children’s laughter. It’s certainly one way to brighten up any day!

Better professional and social life- Socializing can be awkward when you’re not hearing portions of conversation due to background noise or if people believe you’re standoffish. There may also be that little issue of not hearing all the details of what the boss says at a meeting.

Catching other health issues- Sometimes hearing loss is a symptom. It may be caused by an infection or earwax impaction or potentially serious health issues such as diabetes, cardiovascular disease or kidney disease. Hearing loss also is associated with depression, dementia and falls.

Signs that You Need a Hearing Test

• Sign 1: You're not hearing well in certain environments or situations. Whether you're turning the TV volume up louder and louder or dreading social situations because you don't always hear well enough to keep up with conversations, don't ignore changes you notice in your hearing.
• Sign 2: Someone else has noticed a change in your hearing. Dr. Martin notes that it's not uncommon for hearing changes to first be noticed by a spouse, child, loved one or friend — not the person with hearing loss.
• Sign 3: You have pain, pressure or drainage in your ears. These symptoms aren't just themselves uncomfortable — they reduce hearing. They're also typically a sign of an underlying ear problem that needs to be treated.
• Sign 4: You've noticed a ringing like sound in the years. More formally called tinnitus, this early sign of hearing loss can also sound like static, buzzing, humming or cricket-like sounds.
• Sign 5: You have a family history of hearing loss. Even if you're not having trouble hearing yet, having a family history of hearing loss is a good reason to establish a relationship with an audiologist and get an early baseline.

Types of Hearing Tests (Adults & Babies and Children)

Audiometry tests show the type of hearing loss you have and if that loss is mild, moderate or severe. There are several types of hearing tests, including tests for babies, children and adults:

• Pure-tone testing: This common hearing test finds the quietest volume you can hear at each pitch. Children and adults have pure-tone testing.
• Bone conduction testing: This test shows if there are issues with the tiny hair cells in your cochlea. Your cochlea is the part of your inner ear that sends vibrations to your auditory nerve and on to the part of your brain that manages hearing.
• Speech testing: Adults and some children may have this kind of hearing test. Speech testing involves listening to and repeating certain words. The test shows how you understand speech.
• Auditory brainstem response (ABR): This test checks the connections or pathways between your inner ear and your brain. Audiologists may use this test to check hearing in children and people who can’t complete pure-tone tests. They may also use this test for people who have a brain injury that affects their hearing.
• Otoacoustic emissions (OAE): Audiologists use this test to check your inner ear function. They typically use this test for babies and young children.
• Tympanometry: This test checks how well your eardrum moves. Audiologists may do tympanometry tests to see if you have a ruptured eardrum, fluid in your middle ear or wax in your ear canal.

Preparation for a Hearing Test

Avoid getting sick with a cold or flu before your test

Here are few practical tips to prepare for a hearing test:

• Find an audiologist convenient for your daily life with good proximity to your home or work place
• Avoid exposure to loud sounds before the test
• Get your ears cleaned
• Take a family member or friend along for the test

What to expect

The whole process should take about 30 minutes, and it’s painless.

Most adults who get hearing tests are asked to wear earphones and listen to short tones that are played at different volumes and pitches into one ear at a time. Whether or not you can hear each sound shows whether or not you can hear high-pitched or low-pitched sounds, quiet or loud sounds, and whether your left or right ear has hearing loss.

During some hearing tests, you may also be asked to listen to speech at different volumes, which will be played into one ear at a time. The voices will be played quietly through your earphones, and you’ll be asked to repeat what words were just said. This test is done in a soundproof room, since some people have trouble hearing voices when there’s background noise.

After Completing a Hearing Test: What's Next?

Review Your Results: 

A hearing test isn’t a pass-fail exam. But the results can show whether you have hearing loss in one or both ears and how much hearing is gone.

The intensity of sound is measured in units called decibels. Adults with hearing loss up to 16-25 decibels have normal hearing. Hearing loss breaks down this way:

• Mild hearing loss: 26 to 40 decibels
• Moderate hearing loss: 41 to 55 decibels
• Moderate-to-severe hearing loss: 56 to 70 decibels
• Severe hearing loss: 71 to 90 decibels
• Profound hearing loss: 91 to 100 decibels

Explore Treatment Options

If you find out that you need to wear hearing aids, there are many different styles to choose from, including those sold over the counter. And they’re much smaller than hearing aids that your grandpa wore years ago. Some models sit behind the ear, others go in it. Still others are hidden all the way in the ear canal.

Consider Lifestyle Adjustments:

Tips to be conveyed to hearing aid user post fitting for better speech comprehension: 

• Confidence, positive approach and continuous practice is the only way to success. 
• All ways try to face the speaker. 
• Sit near the speaker 
• Keep the environment well illuminated, so they can see the speaker clearly. 
• Always use two hearing aids. 
• Try to move away from noisy environment, if not possible at-least move to less noisy environment. 
• If attending lectures or prayers always try to sit in front rows and at centre of the rows facing the speaker where maximum speech information is available. 
• Move away from source of sound, such as speakers, in order to avoid excess sound. 
• If in a group conversation try to focus on one speaker at a time. 
• Request to speak one at a time, so you can listen to all. 
• Ask the speaker to speak at a low pace, so you get time to understand the speech entirely. 
• Keep your self-prepared for the topic, and gain as much knowledge as possible before the conversation starts. 
• Keep your self-attentive all throughout the conversation. 
• Do not hesitate to ask for a repetition.

Follow-Up Care: 

This stage is even more crucial than the actual fitting itself, wherein the client and the attendant needs to be educated about the usage and handling of device, care and maintenance and do’s and don’ts with hearing aids. • Importance of follow up visits and information related to what to expect during a follow up session need to be discussed with client.

Educate Yourself: 

Encourage readers to learn more about hearing health, care, and protection after diagnosis. Hearing aid care and maintenance (to be explained to client post fitting): 

• Know about the cleaning tools present in the hearing aid kit. 
• Develop a maintenance routine and stick to it. 
• Clean the device at the end of the day. 
• Avoid extreme heat or cold 
• Always switch off the hearing aid when not in use. 
• Hearing aid should not be dampened. 
• Hearing aid should not be worn while sleeping. 
• No solvents to be used to clean hearing aid. Concentrate on the wax guard.
• Hearing aid should be placed in dry aid kit without a battery overnight to control moisture build up.
• Hearing aid should be worn as long as possible and comfortable

Role of Audiologists or Hearing Specialists

An Audiologist is a health care professional who is trained to identify, assess, manage and rehabilitate disorders of balance, hearing and other associated systems.

By virtue of education, training, licensure, and certification, audiologists engage in professional practice in the areas of hearing and balance assessment, nonmedical treatment, and (re)habilitation. 

Audiologists provide client-centred care in the prevention, identification, diagnosis, and evidence-based intervention and treatment of hearing, balance, and other related disorders for people of all ages. Audiologists provide professional and personalized services to minimize the negative impact of these disorders, leading to improved outcomes and quality of life.