Man taking a hearing test in a booth.

Most people aren’t proactive about the health of their hearing and probably haven’t had a hearing screening since grade school because it’s usually not part of a routine adult physical. The good news: Hearing tests are easy, painless, and provide a wealth of insight to professional hearing specialists, both for identifying hearing issues and determining whether treatments like hearing aids are working.

A full audiometry test is more involved than what you might remember from childhood, and you won’t get a lollipop or a sticker when it’s completed, but you’ll gain a much clearer understanding of your hearing. Here are three of the most prevalent kinds of hearing tests and what they’ll reveal.

Pure tone testing

We usually think of sound as measured in decibels, but decibels only indicate the intensity of a sound. Tone, what we conversationally refer to as pitch, is another key factor. It’s measured in Hertz (no relation to the car rental company), with a low bass sound measuring about 50-60 Hz, and normal speech ranging from 500 to 3,000 Hz. 20 to 20,000 Hz is the range of frequencies that a healthy human ear can hear.

For pure tone testing, you’ll wear headphones or earphones attached to an audiometer. Another device that your hearing specialist might use is called a bone oscillator which simply measures how well sound is conducted by your bones. Pure tones are directed to one ear at a time, and you signal (by pressing a button or raising a hand) when you hear a sound.

The minimum volume that you can hear the tones will then be monitored. In other words, this test assesses how well your ears are working: What range of sound you have problems hearing (which can be an integral indicator of whether you’d benefit from hearing aids), and whether you are suffering from hearing loss in both ears equally or if one ear is worse than the other.

Speech audiometry

This test also makes use of headphones, but instead tracks your ability to hear speech. In some circumstances, you’ll be asked to repeat recorded words that are spoken while there is background noise. In other situations, the individual doing the test will say words to you, but there’s a catch, you can’t see the person’s mouth.

Because you are unable to see the speaker’s mouth, you won’t have any visual cues to assist you, and because they are only speaking single words, you won’t have any context to help you. Words that rhyme, let’s say crime, time, dime, and climb, can be hard for people dealing with high-frequency hearing loss to distinguish.

Rather than just focusing on the volume or threshold needed for hearing, as tone testing does, speech audiometry evaluates your ability to make sense of the sounds you hear. Whether hearing aids will be helpful is another thing that word recognition testing can help identify.

Immittance audiometry

This type of testing normally won’t cause pain, but it might be a bit uncomfortable. In tympanometry, a small probe is inserted in your ear, and air flows through it to artificially alter your ear’s pressure. Your hearing specialist will get a graph readout that displays how well your eardrum functions, which can indicate whether there’s a possible issue such as impacted earwax or a perforation.

Your ears have reflexes that are checked by a similar probe. When you hear a loud noise, muscles in your middle ear automatically contract. Identifying the noise level required for this reflex can help a hearing specialist determine the extent of hearing loss. Individuals with extreme hearing loss don’t exhibit any reflex.

Though immittance tests are most useful in diagnosing conductive hearing loss, problems with the eardrum and/or little bones inside the ear, because these can occur at the same time as age- or noise-related hearing loss, it’s important to include to know everything that’s going on with your ears.

Are you having difficulty hearing? Get it tested! If you have hearing loss or tinnitus, we can help inform you on how to maintain healthy hearing, and what your potential treatment options might be.

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