If you or your child has been referred for a diagnostic audiologic evaluation, it means that hearing loss needs to be ruled out or further examined. The 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 in to the cause of the hearing loss as well as provide guidance for the audiologist in making appropriate treatment recommendations.
The specific tests done during the evaluation will depend on the patient’s age, and what is known already about their hearing status. These various tests will the degree of hearing loss, the type of hearing loss, and the conditions of the ear canal and middle ear. The audiologist will also determine if the hearing loss is conductive (middle or outer ear problem) or sensorineural (inner ear problem or central processing difficulty of the brain).
A diagnostic audiologic evaluations includes pure-tone testing, bone-conduction testing, and speech testing.
Pure-tone air conduction 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 air conduction testing. A different type of headphone is used during bone conduction testing, and the results help the specialist determine if the hearing loss is originating from the outer/middle ear or from the inner ear.
A speech reception threshold (SRT) test is often used with older children and adults to confirm the results of a pure-tone test. This test determines the lowest level at which the patient can recognize words or speech stimuli.
The audiologist may also perform otoscopy (examining the ear canal) 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.
- Auditory brainstem response (ABR) and auditory steady-state response (ASSR) testing
- Otoacoustic emissions (OAE) screening
- Visual reinforcement and conditioned play audiometry for children
For children, it is important to have a diagnostic audiologic evaluation whenever a hearing loss is suspected. It is the first step in identifying hearing loss and dealing with it to improve quality of life.
Along with the evaluation, you should generally expect to have time to review the results with the audiologist. He or she 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.
Dr. Jon Ashby is a University professor & who frequently presents clinical instruction and research at numerous professional conferences and conventions.