Types of Hearing Tests
Hearing tests are simple and painless procedures that determine the severity and type of hearing loss you may have. In many cases, patients are given headphones or earphones that emit sounds. Audiologists may also attach devices to your head.
Each test only takes a few minutes. Some may require you to do or say something when you hear a sound in one or both of your ears. In most cases, your doctor interprets your results immediately and recommends any necessary solutions.
9 types of hearing tests for adults
A comprehensive hearing screening involves short tests of your ability to hear tones and words at different volumes and frequencies. No doctor requires every type of hearing test, but most require two or more of these tests.
- Pure tone test
- A pure tone test is the most common test for hearing loss. With this test, a medical professional plays sounds through headphones or external speakers and asks you to raise your hand when you hear something. The tones have varying decibels and frequencies, which lets the audiologist test your full range of hearing.
- Bone conduction test
- A bone conduction procedure tests the structures of the inner ear by sending vibrations through your skull directly to your cochlea. By isolating the inner ear, an audiologist sees if your hearing loss is caused by a problem with your inner ear, known as sensorineural hearing loss, or your middle and outer ear, known as conductive hearing loss.
- Speech test
- Speech testing, or speech audiometry, tests your ability to hear specific letters and syllables. Like other tests, the audiologist places headphones over your ears and plays words and phrases at varying volumes and frequencies. You hear words spoken by men, women and children. You repeat the words and phrases out loud, and a medical professional records your answers. Your answers let the audiologist determine which syllables, volumes and frequencies you have trouble hearing and which hearing loss solution may be best for you.
- Tuning fork test
- A tuning fork test includes both a Rinne test and a Weber test. In these tests, a doctor strikes a 512-Hz tuning fork and rests it on different parts of your head. With the Weber test, the doctor asks you how loud the tone is compared to other spots on your head to determine whether you have equal hearing in both ears. With the Rinne test, the doctor asks when you stop hearing the tuning fork, which indicates what type of hearing loss you may be experiencing, if any.
- Auditory brainstem response test for adults
- The auditory brainstem response (ABR) test analyzes the inner ear, or cochlea, and the pathways to the brain. You wear headphones and electrodes on your head for this test. When a sound enters your ear, the electrodes measure your brain activity in response. Nothing else is needed from you for this test. The auditory brainstem response test is most often used for children and adults who cannot communicate what they are hearing.
- Otoacoustic emissions test for adults
- Otoacoustic emissions (OAE) are sounds created by the ear through the movement of hair cells in the cochlea. These sounds are emitted in response to sound waves that enter the ear from the outside. The otoacoustic emissions test measures these sounds and ensures your ear is responding in a healthy way to outside noise. When you receive this test, an audiologist inserts a device containing a speaker system and microphone into your ear. The device emits certain notes and measures the responding sound coming from the cochlea.
- Tympanometry test
- Tympanometry is a test that determines the presence of middle ear problems, such as a perforated eardrum or an ear infection. This test uses a low-pitched tone to measure the movement of your middle ear as the air pressure changes. A tympanometry test helps an audiologist determine if any middle ear problems are causing hearing loss.
- Acoustic reflex testing
- Another measurement of middle ear functionality, the acoustic reflex measures the stapedial reflex. This reflex occurs when a loud sound enters the ear canal, and a lack of this reflex may be a sign of conductive hearing loss or severe to profound sensorineural hearing loss. The test is used to determine the presence and type of hearing loss.
- Static acoustic measures
- A static acoustic measures test measures the air pressure in your ear canal. A doctor may conduct this test if they suspect you have a perforated eardrum. If you have ear tubes, this test also determines if they’re blocked.
4 types of hearing tests for children
Because children may have trouble sitting still or understanding instructions, audiologists have developed specific hearing tests for kids. Some of these child hearing screenings attempt to make the test fun, which encourages children to participate. Newborn hearing screenings, however, are simple tests of inner ear movement, since newborns are not capable of indicating that they heard a sound.
- Auditory brainstem response screening for newborns
- For newborns, the auditory brainstem response (ABR) screening is a pass/fail test that determines hearing loss. The test only checks one level of loudness and frequency and tests whether the sound is transmitted to the newborn’s brain. Many newborns fail this test the first time because they have fluid in their ears. A follow-up test determines whether the child has hearing loss.
- Otoacoustic emissions test for newborns
- The otoacoustic emissions test (OAE) for newborns and children works the same way as it does for adults. It measures the sounds emitted from the inner ear hair cells that respond to outside sound. It’s a common test for newborns because they cannot cooperate during tests that involve communication. Typically, an otoacoustic emissions test is conducted before the newborn leaves the hospital after birth. As with the auditory brainstem response screening, many babies fail this test because of fluid in their ears.
- Visual reinforcement audiometry
- Visual reinforcement audiometry (VRA) is a test designed for babies between 6 months and 3 years old. VRA uses a baby’s inclination to turn toward a sound and rewards the child with a visual stimulus, like a short video or a lit-up toy. The reward encourages the baby to turn toward the next sound they hear. Sounds come from earphones or speakers in the room and occur at varying tones and frequencies.
- Play audiometry test
- Getting toddlers and young children to raise their hands when they hear a tone can be difficult, so many audiologists conduct play audiometry tests instead. Play audiometry turns the test into a game. Children are asked to do a task, such as placing a toy in a bucket or throwing a ball across the room, when they hear a tone. This test works well if a parent helps explain the game and encourage the child. Like the pure tone test, tones are played at varying frequencies and decibels.
How do you test for tinnitus?
If you mention to your doctor that you hear ringing in your ears and have not yet been tested for hearing loss, your tinnitus testing starts with hearing tests.
After all hearing tests are complete, your doctor conducts a series of tests to measure your tinnitus. Unfortunately, there is no test that evaluates whether you are experiencing tinnitus, but these tests measure the pitch and loudness of your tinnitus and help find a tinnitus masking solution.
Exact testing for tinnitus varies, but doctors typically find a sound, frequency and decibel that matches your tinnitus. Additional tests help you find an external sound that masks your tinnitus, which helps you choose a sound therapy to cope with the symptoms.
Hearing screening FAQ
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Bottom line
There are many different ways doctors can test your hearing ability — if you’re experiencing hearing loss, you want a full picture of the problem to determine the correct solution. Hearing tests determine the type of hearing loss, its cause and the severity of your hearing loss in decibels and frequency. Once you understand the exact profile of your hearing loss, your doctor can recommend solutions, including hearing aids, medication or cochlear implants.
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