Diagnostic Audiologic Evaluation

If you, your child, or someone you care for has been referred for a diagnostic audiologic evaluation, this generally means that any possible hearing loss needs to be further investigated.

This type of evaluation is normally done when someone has not passed an initial hearing test, and can help your audiologist to understand the reasons for this.

The first and most important thing to remember in preparing for the test is this: don’t worry! Your audiologist will guide you through the test, and explain what part of the test is for. If you have any questions before, during, or after the test, do not hesitate to ask them.

The test, after all, is designed to help both you and your audiologist understand your hearing better.

What is the test for?​

There are many reasons why someone could fail an initial hearing test. Children can sometimes be confused during an initial screening, as can elderly people, and so their hearing can appear worse than it really is.

One of the primary reasons for a more in-depth evaluation is therefore to rule out, or confirm, hearing loss.

If your audiologist finds that you, your child, or someone you care for has some level of hearing loss, a diagnostic audiologic evaluation can help them understand why. Hearing loss can be caused by a variety of factors, and it is important to understand if the problem is conductive or sensorineural in nature. Conductive hearing loss relates to the middle or outer ear, while sensorineural loss stems from the inner ear or even brain.

The results of the test will allow you and your audiologist to determine the best treatment for any hearing loss.


Preparing for the test​

Before the test, you should ask a family member (or someone else that you trust) to come with you. Most audiologists agree that hearing loss is a family issue, and it can really help to have the support of a loved one during and after the test. You should also bring a list of all the medications you are taking, because your audiologist will ask about these.

The Test​

When you arrive for the evaluation, your audiologist will ask about your medical history. This will include any medicines you are taking, and your audiologist will also ask you about any complaints you have about your hearing. This could include concerns about exposure to loud noise, or any problems with tinnitus or balance. It is important to explain any concerns you have at this point.

The evaluation itself will last about 30 to 40 minutes, after which you will be able to discuss with your audiologist any recommended treatment.

What tests will be done?

The specific tests that your audiologist will do depend on the age and other circumstances of the person being tested. Special tests exist for very young children, and for people with developmental or cognitive impairment.

A standard diagnostic audiologic evaluation, though, consists of three main tests: a pure-tone air test, a bone conduction test, and a speech test.

Pure-tone Air Test
During this test, you will listen to a variety of tones through headphones. This will allow your audiologist to determine the lowest volume tones you can pick up at various frequencies.

Bone Conduction Test
This test is a lot like the pure-tone test, but you will wear a different set of headphones. This test can help to determine if your difficulty hearing is caused by a problem with the inner, outer, or middle ear.

Speech Testing
With adults and older children, a speech reception threshold (SRT) test helps verify the outcome of the pure-tone diagnostic. During this test, you will listen to speech at various volume levels, in order to determine the quietest speech you can hear.

Other Tests
Sometimes, your audiologist will recommend a number of other tests. Otoscopy, for example, examines the ear canal in more depth. Another common test used to determine middle ear health is called a tympanometry.

If you are taking your child to the evaluation, or someone with developmental or cognitive impairment, these extra tests can sometimes cause distress. It is therefore important to reassure the patient that these tests will not hurt, and to explain (as far as possible) what they are for.

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