Types of Hearing Tests

  • August 24, 2020
Types of Hearing Tests

As hearing health care professionals, we are familiar with the common questions you have regarding hearing tests. Do I need a hearing test? What does a hearing test involve? Can I take a hearing test online? Is it painful? Are hearing test only for the elderly?  While there are many considerations for when, where, and how to have a hearing test, let’s review the basics. 

Pure Tone Audiometry 

Pure tone audiometry, AKA “raise your hand when you hear the beep,” is the basis of any hearing evaluation. An audiogram is a plot of the softest sounds you can hear in each ear across a frequency range and is how your hearing evaluation is illustrated. While humans have a hearing range between 20-20,000 Hz, most hearing tests include 250-8,000 Hz because it is the range for speech understanding. The pure tone audiometry test involves two segments: air conduction and bone conduction. Air conduction evaluates the entire pathway from the outer ear, through the middle ear, to the inner ear nerve, and up to the level of the brain. For this portion, you will wear headphones over your ears or earphones inserted into your ear canals. Bone conduction testing evaluates only the sensitivity of the inner ear, nerve, and brain. A headband with a bone oscillator is placed behind the ears, which vibrates the bones of the skull and directly stimulates the inner ear bypassing the outer and middle ear. Both of these evaluations together give information about the status of the outer and middle ear for differential diagnostic purposes, as it can indicate whether an obstruction or pathology is present before sound reaches the inner ear. Pure tone audiometry is an essential test that provides the basis for diagnosing and treating hearing loss.  

Speech Audiometry 

Speech audiometry, AKA “repeat what you hear,” is another important portion of the hearing evaluation. Just as a pure tone audiometry examination diagnoses hearing loss through listening to tones and beeps, speech testing is about the day-to-day challenges we experience communicating with others. Speech audiometry gives information about the processing and clarity of speech. While understanding speech in quiet environments can be challenging for some, many of us have significant difficulties in situations with background noise, such as restaurants, parties, and family dinners. For that reason, a speech audiometry examination should be conducted in both a quiet as well as noise. Speech audiometry is critical for understanding how hearing loss is affecting a person’s overall communication ability. 

The results found from a pure tone and speech audiometry exam will indicate if hearing loss is present, and if so, to what degree, type and configuration. As we age, our hearing tends to decline and our sensitivity to higher pitch sounds decreases. High pitch sounds give us the clarity of speech, so when we lose that, we struggle to understand conversations. 


Yet another aspect of a hearing evaluation is tympanometry, AKA “middle ear pressure test”, which assesses the function of the middle ear. A probe is gently placed in the ear canal and generates pressure to move the eardrum. The amount of movement and pressure level at which maximum movement is obtained is measured. It indicates the functional mobility of the eardrum, which in turn relates to the status of the middle ear space, middle ear bones and the presence of fluid.  

When and How to Get Your Hearing Tested 

Now that we have reviewed hearing test basics, we can dive into where and how you can have your hearing tested. Best practices for hearing tests are those performed in the presence of a hearing care professional. Testing takes place in a sound treated room or booth with special equipment offering the highest level of accuracy possible.  

Online hearing tests have become more popular and increasingly more accurate. Many hearing test options are available, with some being better than others. Most online assessments are a hearing screening, rather than a diagnostic evaluation, but these are evolving. Soon, the best online hearing tests will be driven by a hearing care professional, with calibrated headphones and improved accuracy. However, an in-person office visit to verify the online assessment results and complete a visual inspection of your ear canal remains the best practice.  With the current threat of COVID-19, online hearing assessments are a safe alternative to an in-office visit and a great place to begin your hearing care journey.  

Lastly, let’s talk about when a hearing test is necessary. If you think you need a hearing test, you probably do! A thorough hearing assessment, either online or in the office, can diagnosis of your current hearing ability and form a baseline for future testing. A good starting point would be the three-minute hearing assessment on our website or a consultation with one of our local hearing care experts. For answers to frequently asked questions and what to expect during your first visit, please visit the resource section of our website.