An audiologic evaluation is sometimes thought of as “just a hearing test,” but more than “just” the ability to hear sounds is involved. The audiologic evaluation consists of a battery of tests, each providing specific standalone information. Yet, the tests complement one another. The audiologic evaluation consists of several different components.
Case History
The audiologist will ask several questions during the case history. For example:
- What brought you here today?
- Have you noticed difficulty with your hearing?
- What have you noticed?
- For how long?
- When do you think the hearing loss began?
- Does your hearing problem affect both ears or just one ear?
- Has your difficulty with hearing been gradual or sudden?
- Do you have ringing (tinnitus) in your ears?
- Do you have a history of ear infection?
- Have you noticed any pain in your ears or any discharge from your ears?
- Do you experience dizziness?
- Is there a family history of hearing loss?
- Do you have greater difficulty hearing women’s, men’s, or children’s voices?
- Do people comment on the volume setting of your television?
- Has someone said that you speak too loudly in conversation?
- Do you frequently have to ask people to repeat?
- Do you hear people speaking, but can’t understand what is being said?
- Do you have any history of exposure to noise in recreational activities, at work, or in the military?
- Are there situations where it is particularly difficult for you to follow conversation? Noisy restaurant? Theater? Car? Large groups?
For children, questions will also be asked regarding:
- speech and language development
- health history
- recognition of and response to familiar sounds
- the startle response to loud, unexpected sounds
- the presence of other disabilities
- any previous hearing screening or testing results
Physical Examination
The audiologist will look at the outer ear (the pinna) checking for any malformation. The audiologist will use an otoscope, an instrument that contains a light and a magnifying lens, to examine the ear canal and eardrum. The ear canal is examined for the presence of excessive wax (cerumen), or foreign objects (food, toys, pieces of cotton swabs, etc.). The eardrum (tympanic membrane) is examined for any perforation and signs of fluid or infection. The audiologist will look for any indicators suggesting the need for referral for a medical evaluation and/or treatment.
Tests of Hearing and Listening
The audiologist will conduct tests of hearing tones. This is called pure-tone audiometry. The results are recorded on a graph called an audiogram. The audiologist will also determine speech reception threshold or the faintest speech that can be heard half the time. Then the audiologist will determine word recognition or ability to recognize words at a comfortable loudness level.
Tests of Middle Ear Function
The audiologist may also take measurements that will provide information about the status of the outer and middle ear. These are called acoustic immittance measures. Tympanometry, one aspect of immittance testing, can assist in the detection of fluid in the middle ear, perforation of the eardrum, or wax blocking the ear canal. Acoustic reflex measurement, another aspect of immittance testing, can add diagnostic information about middle ear function and hearing loss.
After the test battery is completed, the audiologist will review each component of the audiologic evaluation to obtain a profile of hearing abilities and needs. Additional specialized testing may be indicated and recommended on the initial test results. Audiologic evaluation may result in recommendations for further follow-up such as medical referral, educational referral, hearing aid/sensory aid assessment, assessment for assistive listening devices, audiologic rehabilitation assessment, speech and language assessment, and/or counseling.
As you can see, an audiologic evaluation is much more than “just a hearing test!”
