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 into the cause of the hearing loss as well as provide guidance for the audiologist in making appropriate treatment recommendations.
What Tests Will Be Done?
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 reveal the degree of hearing loss, the type of hearing loss, and the condition of the ear canal as well as the 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 evaluation includes history taking, otoscopy, pure-tone testing, bone-conduction testing, and speech testing.
Pure-tone Air and Bone Conduction 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 audiologist 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. These other tests may include:
- Auditory brainstem response (ABR) testing
- Otoacoustic emissions (OAE) evaluation
Visual reinforcement and conditioned play audiometry for children
The diagnostic audiologic evaluation is often covered by most health insurance policies, though you may need a referral from your primary care physician to quality for coverage.
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.
For more information on this topic, please refer to the section on Diagnostic Hearing Evaluations.