Audiometry

Hearing loss can happen to anyone, at any age. That’s why audiometry is useful for children, adults, and older people.

You might benefit from a test if you:

• Often ask people to repeat themselves
• Struggle to hear conversations in restaurants or crowded rooms
• Turn up the TV or radio louder than others prefer
• Hear ringing or buzzing in your ears (tinnitus)
• Miss sounds like the phone, doorbell, or alarms
• Have frequent ear infections
• Work in noisy places, such as factories, construction sites, or music venues

Even without clear symptoms, adults over 50 are advised to take this test to check their hearing. Hearing loss often develops slowly, and catching it early makes treatment easier.

Hearing loss isn’t the same for everyone. A basic hearing screening is used to check whether your hearing is normal. If the results suggest a problem, your audiologist may recommend a comprehensive audiometry test. There are different types of tests available, which include: 

• Speech audiometry – In this test, you listen to words or sentences and repeat what you hear. It shows how clearly you understand speech at different volumes.
• Pure-tone audiometry – This is the most common test. It checks the softest sounds you can hear at different pitches and is used for both children and adults.
• Auditory brainstem response (ABR) – This test measures how sound signals travel from your inner ear to the brain. It is often used for children or for people who cannot participate in pure-tone testing. It may also be used for patients with brain injuries that affect hearing.
• Otoacoustic emissions (OAE) – This test checks how well the inner ear is working. It is commonly used for newborns and young children.
• Tympanometry – This test looks at how your eardrum moves. It helps detect problems such as fluid in the middle ear, earwax blockage, or a perforated eardrum.
• Bone conduction test – This test checks whether sound reaches your inner ear correctly. A small device sends vibrations through the bone behind your ear to see if the hair cells in the cochlea are functioning properly.

Hearing loss often develops slowly, and many people adjust without realising how much they’re missing. Symptoms of hearing loss may include:

• Speech and other sounds may seem muffled
• Difficulty following conversations, especially in noisy environments or crowded rooms
• Trouble distinguishing certain consonants (non-vowel sounds)
• Frequently asking others to slow down, repeat, or speak more clearly
• Increasing the volume on the TV or radio higher than others prefer
• Avoiding social gatherings or situations where hearing is challenging
• Finding background noise particularly distracting or irritating
• Hearing a persistent ringing or buzzing in the ears (tinnitus)

The process can vary, but most audiometry tests follow a similar pattern. You usually sit in a quiet, sound-treated room and wear headphones or earphones. Different tones, sounds, and words are played through the audiometer. You don’t need to prepare, and the test is safe and painless.

Pure-tone test

• This is the most common hearing test. 
• You sit in a quiet room and wear headphones or earphones. 
• An audiometer produces sounds at different pitches and volumes. 
• Each time you hear a sound, you raise your hand, press a button, or say “yes”. 
• Your responses are noted on a chart called an audiogram, which shows your hearing ability and whether you have hearing loss.

Bone conduction test

• This test checks how well your inner ear works. 
• A small device is placed behind your ear or on your forehead. 
• The device sends vibrations that travel through the bone to reach your inner ear, bypassing the outer and middle ear. 
• Results are compared with the pure-tone test to determine the type of hearing loss

Tympanometry

• This test checks how well your eardrum moves. 
• A soft probe is gently placed in your ear. 
• A device sends a small puff of air into your ear canal. 
• The movement of your eardrum is recorded on a graph called a tympanogram. 
• This shows whether your eardrum is working normally or if problems such as fluid, wax, or a perforation are present.

Auditory brainstem response (ABR)

• In this test, you don’t need to respond to sounds. 
• You wear earphones, and small electrodes are placed on your head. 
• Sounds are played through the earphones. 
• The electrodes record your brain’s response to these sounds. 
• The results are displayed on a computer for the audiologist to interpret.

Speech audiometry

• This test is often done along with pure-tone testing. 
• You wear headphones or earphones. 
• The audiologist says words at different sound levels, and you repeat them back. 
• This helps measure the quietest speech you can hear and how clearly you understand speech at louder volumes.

Otoacoustic emissions test (OAE)

• This test measures the tiny sounds your inner ear produces when it responds to noise. 
• A small probe is placed in your ear. 
• The probe sends sound into your ear and records the echo that comes back. 
• If your inner ear does not produce these responses, it may indicate hearing loss.

Not sure if you need a test? See an audiologist if:

• You notice sudden hearing loss in one or both ears.
• You have ongoing hearing difficulties.
• Hearing problems affect your job, studies, or relationships.
• You experience ear pain, discharge, or dizziness.
• You are over 50 and haven’t had a test recently.
• You work in a noisy setting and want to check or protect your hearing.

A hearing test provides peace of mind, whether the results show normal hearing or reveal an issue that requires treatment.

Your test results are shown on an audiogram. This chart records the softest sounds you can hear, measured in decibels (dB).

• 0–20 dB – Normal hearing
• 21–40 dB – Mild hearing loss
• 41–70 dB – Moderate hearing loss
• 71 dB or higher – Severe to profound hearing loss

Your audiologist will explain what the results mean in daily life. For example, mild hearing loss may make it difficult to hear whispers, while moderate loss can affect everyday conversations. 

Based on your results, you may be advised to use hearing aids, cochlear implants, medical treatment, or lifestyle changes to protect your hearing.