Hearing Tests

Hearing tests provide valuable information for your hearing healthcare professional

If you think you have a hearing loss, your first step should be to set up an appointment to get your hearing tested. While at your appointment, your hearing healthcare professional will complete a series of tests to help identify the type and degree of hearing loss you are experiencing. It is important to know that you cannot “fail” a hearing test. These tests are given to provide your hearing healthcare professional with the information they need to recommend a treatment option for you. Keep in mind that a hearing test is an important first step in improving your hearing and your life.

Find a Hearing Specialist in your area to determine the type of hearing loss you may be experiencing and what treatment options are available.

Hearing and understanding are two different things

Most people experiencing hearing loss report difficulty understanding speech or have been told by family members that they have difficulty understanding speech. In other words, they can hear people talking, but can’t quite understand all of what is being said. That is why an important part of your hearing evaluation will be a speech recognition test. A speech recognition test will give your hearing healthcare professional important information about your ability to understand words and sentences spoken at an everyday listening level.

Even with the help of hearing aids, some people may have difficulty understanding speech. If this is the case and you have a severe to profound hearing loss, cochlear implants may be the solution. Cochlear implants are indicated only for those individuals who get minimal/limited benefit from hearing aids, so testing your speech understanding with hearing aids is a necessary step to help your hearing healthcare professional determine if you’re a candidate for cochlear implants. If you don’t have hearing aids, your hearing healthcare professional may be able to loan you hearing aids for these tests or require a hearing aid trial.

An audiogram is an important tool in understanding your personal hearing loss

The results of your hearing tests will be recorded onto a chart called an audiogram, which shows the lowest level (in decibels) that you can detect a variety of sounds, ranging from low to high frequencies (commonly referred to as pitch). On average, normal conversation takes place within the 20 to 60 decibel range, commonly referred to as the "speech banana." As you can see from the audiogram below, the speech banana got its name because of the shape it makes on an audiogram. Hearing loss that falls within or above the speech banana (within 60 decibels) is particularly important because this degree of hearing loss affects your speech understanding. The audiogram contains some examples of everyday sounds plotted on it, and you can see where these everyday sounds fall in relation to the speech banana. For example, the sound of a bird chirping is softer and higher-pitched than most normal conversations, while the sound of a dog barking is louder and lower-pitched.

The results of your hearing tests will be plotted as two lines (right ear and left ear) on the audiogram. The sounds that occur above the lines are what you have difficulty hearing, whereas the sounds that occur below the lines are what you can hear. Some people may have trouble hearing high pitched tones in the higher frequencies (2,000 – 8,000 Hz) whereas other people may have trouble hearing low pitched tones in the lower frequencies (125 – 1,000 Hz). The audiogram will also be able to tell you the severity of your hearing loss―mild, moderate, moderately severe, severe, or profound. Your hearing healthcare professional will help you understand your personal audiogram.

Defining Hearing Loss

The degree of hearing loss a person is experiencing is measured by the softest sound the person can hear (measured in decibels, dB) and described by one of the following categories: mild, moderate, moderately severe, severe, or profound. The chart below defines each degree of hearing loss.1

Degree of hearing loss Softest sound able to be heard (in decibels) Frame of reference
Mild 26 to 40 dB Able to hear the loud or more intense vowel sounds, but may miss some of the softer consonant sounds.People with a mild hearing loss may have difficulty hearing soft spoken people and young children. Also, they may have to ask people to speak up or repeat themselves on occasion.  
Moderate 41 to 55 dB In addition to missing consonant sounds, vowel sounds then become more difficult to hear. People with a moderate hearing loss often comment that without hearing aids they hear, but can't always understand.  
Moderately Severe 56 to 70 dB Without hearing aids, speech becomes inaudible, whereas with hearing aids, speech may still be difficult to understand.  
Severe 71 to 90 dB Without hearing aids, speech is inaudible, but loud sounds like a baby crying or a dog barking are audible. Hearing aids may no longer be enough for people with severe hearing loss.    
Profound 91+ dB Without hearing aids, speech is inaudible, but very loud sounds like a lawn mower or jet airplane are audible. Hearing aids may no longer be enough for people with profound hearing loss.    

Reference: 1. American Speech-Language Hearing Association. Degree of Hearing Loss. Available from http://www.asha.org/public/hearing/Degree-of-Hearing-Loss/. Accessed February 2012.