Hearing Tests & Other Assessments
Our audiologists assess the auditory system to diagnose hearing loss to determine what intervention is needed. Discover what diagnostic audiological assessment includes.
Pure Tone Audiometry
Pure Tone Audiometry is a fundamental auditory evaluation that assesses an individual’s ability to detect sounds across a spectrum of frequencies, from low to high pitches. This assessment is conducted in an acoustically controlled environment – a soundproof booth – to eliminate any external auditory interference. Participants are equipped with headphones through which a series of beeps or tones are transmitted, each at varying pitches and volumes, into one ear at a time.
The participant signals the audiologist each time a tone is perceived by either pressing a button or raising a hand. This process allows the audiologist to determine the softest level of sound the participant can hear at different frequencies, effectively mapping the individual’s hearing sensitivity.
The outcomes of this essential test are instrumental in understanding an individual’s auditory capacity. It facilitates the determination of whether there is a need for hearing aids or other hearing assistive devices. The procedure is non-invasive, offering valuable insights into the patient’s hearing health with the aim of enhancing auditory perception of their environment.
Tympanometry
Tympanometry is an evaluative procedure that assesses the functionality of your eardrum and middle ear. It is important to note that this is not a test of hearing acuity but rather an examination to understand how your eardrum reacts to variations in air pressure.
During the tympanometry test, a small, soft plug is gently inserted into the ear canal. This device modifies the air pressure within the ear canal and emits a steady tone. The movement of your eardrum in response to these alterations in pressure is meticulously measured and documented.
This procedure is instrumental in identifying various conditions, such as the presence of fluid behind the eardrum, perforations in the eardrum, or complications with the ossicles, the tiny bones within the middle ear. The test is brief, entirely painless, and requires no active participation from you beyond remaining still for a short period.
Eustachian Tube Dysfunction (ETD) Testing
Eustachian Tube Dysfunction testing focuses on assessing the function of the Eustachian tube, a small passageway that connects the middle ear to the back of the throat. The Eustachian tube helps maintain pressure balance in the middle ear and drains fluid. When it does not work properly, it can lead to discomfort, pressure changes, and hearing problems.
Two common techniques used in ETD assessment are:
This involves trying to exhale gently with the mouth closed and nostrils pinched shut. It increases pressure in the nasopharynx and can help open the Eustachian tube, potentially relieving symptoms of ETD. This manoeuvre is often used to check if the Eustachian tube can properly equalize pressure in the middle ear.
For this test, you swallow while keeping the nostrils pinched closed. Swallowing helps open the Eustachian tube, and the closed nostrils increase nasal pressure, which can assist in diagnosing how well the Eustachian tube is functioning. It is a simple technique that helps assess the ability of the Eustachian tube to equalize ear pressure during normal activities.
Both manoeuvres are non-invasive, simple to perform, and can provide valuable information about the Eustachian tube’s functionality, aiding in the diagnosis and management of ETD.
ETD testing is crucial for diagnosing and managing conditions related to the Eustachian tube, such as frequent ear infections, persistent ear fullness, or difficulties with pressure equalization during flights. Understanding the function of the Eustachian tube helps audiologists and ENT specialists recommend the best treatment options, ranging from exercises to improve tube function to medical or surgical interventions.
Acoustic Reflex Testing
Acoustic Reflex Testing measures your ear’s reflex response to loud sounds. This reflex is a natural muscle reaction in the middle ear that happens when we hear loud noises, and it helps protect our inner ear from damage.
During the test, you’ll wear headphones, and similar to tympanometry, a small plug is placed in your ear. This plug delivers sounds at different volumes into your ear through the headphones. The test checks to see if the muscles in your middle ear contract in response to these sounds. It is a way to check the health of the pathway from your ear to your brainstem.
This test also does not require any effort from you and is pain-free. It can help diagnose problems with your hearing system that might not be apparent in other types of hearing tests.
Speech Audiometry Testing
Speech Audiometry Testing is a key part of assessing your hearing health, focusing on how well you can hear and understand speech. Unlike tests that use beeps or tones, this test uses spoken words to see how hearing affects your ability to understand conversations. It involves:
This test finds the quietest level at which you can just begin to hear speech. You will not need to repeat the words; simply indicate when you can hear that someone is speaking – it is like listening for a whisper and acknowledging when you hear it.
Similar to the SDT, the SRT measures the softest level at which you can understand and repeat back half of the spoken words.
This test checks how well you understand speech at a comfortable loudness level. You will listen to a series of words spoken at a level that is easy for you to hear and then repeat them back. This helps gauge how clearly you can understand speech in ideal conditions.
This test evaluates how well you can understand speech in a noisy environment. You will try to focus on and repeat back words or sentences while background noise is played. It mimics real-life situations where you have to listen to someone talking in a place with lots of background sounds (e.g. in a restaurant)
These tests give a comprehensive picture of your hearing health, specifically focusing on the practical aspects of hearing in daily life. They help not only to identify if you have hearing loss, but also how it might be affecting your ability to communicate with others. Understanding your speech audiometry results can guide the audiologist in recommending the best treatment or hearing aids to improve your hearing and quality of life.
Visual Reinforcement Audiometry (VRA) Testing
Visual Reinforcement Audiometry Testing is child-friendly approach to hearing assessment, primarily used for infants and toddlers aged 6 months to 3 years. It combines sound with visual cues to gauge a child’s hearing capabilities in a way that is engaging and non-threatening.
Testing Method
During the test, the child sits on a parent’s lap or in a chair in a sound-treated room. Sounds are played through speakers or headphones, and when the child turns toward the sound, they are rewarded with a visual stimulus, such as a moving toy, video clip or a flashing light.
Purpose
VRA testing is designed to determine the softest levels of sound a child can hear across different frequencies. It effectively assesses hearing sensitivity without requiring the verbal or complex motor responses needed for traditional audiometry.
Visual Reinforcement
The visual rewards are used to condition the child to respond to sounds. Over time, the child learns to associate hearing a sound with turning their head to receive the visual reward. This makes the test both effective and enjoyable for young participants.
Procedure
The test typically involves presenting a series of tones at varying pitches and intensities. The audiologist carefully observes the child’s reactions to each sound, noting the responses to determine the hearing thresholds.
Benefits
VRA is a crucial tool for early detection of hearing loss in young children. Early identification allows for timely intervention, which is vital for the child’s speech and language development, as well as for social and cognitive skills.
Visual Reinforcement Audiometry provides a non-invasive, reliable method of assessing hearing in young children. It ensures that any hearing impairments are identified early on, enabling parents and healthcare providers to take the necessary steps toward management or treatment, setting the foundation for better developmental outcomes.
Conditioned Play Audiometry Testing
Conditioned Play Audiometry Testing is a special hearing test designed for young children, typically between the ages of 2 and 5 years old. It makes the process of checking hearing levels fun and engaging by turning it into a game.
Instead of asking the child to simply indicate when they hear a sound, this test uses play activities as responses. For example, the child might be asked to drop a block into a bucket, place a peg in a pegboard, or put a ring on a cone every time they hear a sound. It is a way to keep their attention and make the test enjoyable.
This test is conducted in a friendly, child-centric environment to make the child comfortable and ensure they are engaged with the task.
The main goal is to assess the child’s hearing sensitivity across different pitches and volumes in a way that is easy for them to understand and participate in. It helps identify hearing loss or difficulties in children who are too young for traditional hearing tests.
Conditioned Play Audiometry is a crucial tool for early detection of hearing difficulties in children. By identifying hearing loss early, parents and specialists can take steps to manage or treat it, ensuring that it doesn’t interfere with the child’s language development, learning, and social interactions.
The audiologist plays various sounds through speakers or headphones at different pitches and volumes. Each time the child hears a sound, they perform a specific play task. Success in the game means the child is hearing the sounds, which provides a clear indication of their hearing abilities.
Conditioned Play Audiometry is an innovative approach to paediatric hearing assessment, turning a potentially challenging experience into a fun activity. This ensures accurate hearing evaluations are possible even with very young children, facilitating early intervention and support when necessary.
Otoacoustic Emissions (OAE) Testing
Otoacoustic Emissions (OAE) testing is a quick, simple, and non-invasive method used to check the function of the inner ear, specifically the cochlea (the hearing part of the inner ear). It is particularly useful for screening hearing in newborns, children, and others who might have difficulty taking traditional hearing tests.
During an OAE test, a small, soft probe is placed in the ear canal. This probe emits sounds into the ear and then measures the very faint sounds that are naturally produced back by the cochlea in response. These faint sounds are the “otoacoustic emissions,” and their presence indicates that the outer hair cells of the inner ear are likely functioning normally.
There are two main types of OAE tests—Transient Evoked OAEs (TEOAEs) and Distortion Product OAEs (DPOAEs). TEOAEs measure the response to a brief clicking sound, while DPOAEs measure the response to two simultaneous tones. Both provide valuable information about the inner ear’s health.
The primary goal of OAE testing is to determine whether the inner ear (cochlea) is working effectively. It is a way to quickly screen for hearing loss without needing any active response from the person being tested, making it ideal for infants or individuals who cannot communicate or follow instructions well.
OAE testing is a crucial tool for early detection of hearing loss, especially in newborn hearing screening programs. Early identification allows for prompt intervention, which is vital for normal speech and language development in children with hearing loss. It is also used to monitor the inner ear health in adults exposed to factors that can damage hearing (such as noise exposure or ototoxic medication).
The test is fast, typically taking just a few minutes per ear. It can be performed while the patient is asleep or lying still. The presence or absence of these emissions helps to identify potential hearing loss, prompting further assessment if necessary.
OAE testing is a foundational element in hearing health, offering a straightforward, reliable method for assessing cochlear function. Its non-invasive nature and ease of administration make it an essential tool in the audiological assessment process, ensuring that hearing loss can be detected and addressed as early as possible.
Auditory Steady State Response (ASSR) Testing
Auditory Steady State Response (ASSR) testing is an advanced and highly technical method used to evaluate hearing, especially in young children, infants, or individuals who might have difficulty with more traditional hearing tests. It uses computerized equipment to measure the brain’s response to sound.
During the test, the person being tested wears headphones or earphones, and sounds at various frequencies and volumes are played into the ears. At the same time, electrodes placed on the head measure the brain’s electrical responses to these sounds. The test does not require any active response from the person; they can even be asleep during the procedure.
ASSR testing utilizes sophisticated technology to precisely measure hearing sensitivity. It is capable of providing a comprehensive overview of an individual’s hearing abilities by detecting the brain’s consistent responses to auditory stimuli.
ASSR testing helps determine the softest levels of sound someone can hear across different pitches, similar to traditional hearing tests but in a way that does not rely on their active participation. This is particularly useful for testing the hearing of very young children or those with conditions that make traditional hearing tests challenging.
One of the main advantages of ASSR testing is its ability to accurately assess hearing in patients who are difficult to test using conventional methods. This includes very young children, individuals with developmental delays, or those who cannot respond reliably in a traditional hearing test setting. It is also useful for confirming the results of other hearing tests.
The test is conducted in a quiet room. The patient is usually asked to relax or even sleep, as movement can interfere with the measurements. The audiologist plays a series of sounds through the headphones and monitors the brain’s activity to these sounds.
ASSR testing is a non-invasive, objective method that plays a crucial role in diagnosing hearing loss early, particularly in patient populations that are difficult to test. By enabling early detection, it allows for timely intervention, which can be critical for the development of speech and language skills in children with hearing loss.
Auditory Brainstem Response (ABR) Testing
Auditory Brainstem Response (ABR) testing is a sophisticated and detailed way to evaluate the auditory (hearing) nerve pathway from the ears to the brainstem. This test is essential for checking hearing in newborns, young children, and others who might not be able to take part in traditional hearing tests.
During an ABR test, the patient wears headphones, and small electrodes are placed on their head and ears. Sounds are played through the headphones, and the electrodes measure the brain’s activity in response to these sounds. The test examines how the brain processes these sounds, providing information about the auditory pathway’s health and function.
The ABR test provides detailed data about the timing of electrical waves from the auditory nerve to the brainstem in response to sound. By analysing these waves, audiologists can assess hearing levels and detect abnormalities in the auditory pathway.
ABR testing is used to determine a person’s hearing sensitivity and to identify any issues within the hearing nerve pathways that could be causing hearing loss. It is particularly useful for assessing hearing in individuals who cannot communicate about what they hear.
The ABR test is a critical component of early hearing detection and intervention programs. Identifying hearing loss early can lead to timely treatment and support, which is crucial for the development of speech and language skills in children. For adults, it can pinpoint the location of hearing issues within the auditory pathway, guiding treatment plans.
The procedure is non-invasive and usually requires the patient to be very still or asleep, as movement can affect the results. It can take from 30 minutes to a couple of hours, depending on the depth of the assessment needed. Many times, for infants, the test is done while they are naturally asleep or after feeding when they are likely to sleep.
ABR testing offers a comprehensive assessment of the auditory system’s functionality, making it an invaluable tool in diagnosing and managing hearing loss. Its ability to provide objective, detailed information about a person’s hearing capabilities ensures that individuals of all ages can receive the appropriate care and interventions needed for optimal auditory health.
