Hearing Testing: What to Expect & How to Read Your Results

A hearing test (audiometric assessment) is a comprehensive, non-invasive evaluation of your hearing ability. It tells you not only whether you have hearing loss, but what type it is, how severe it is, and which specific frequencies are affected. Here's exactly what to expect and how to understand the results.

Why Get a Hearing Test?

You should consider a hearing test if:

• You've noticed changes in your hearing
• You're over 60 and haven't had one in the past year
• You work or have worked in a loud environment
• You have tinnitus (even occasional)
• A family member or friend has expressed concern about your hearing
• You're experiencing balance issues (hearing and balance are connected via the inner ear)
• You're considering hearing aids and want a baseline assessment

What Happens During the Appointment

Before the Tests (Case History)

Your audiologist will ask about your hearing concerns, medical history (ear infections, surgeries, medications), noise exposure history, and family history of hearing loss. This context helps interpret the results.

Physical Examination

The audiologist will use an otoscope to look into your ear canals and at your eardrums. They'll check for earwax blockages, infections, perforations, or any visible abnormalities. This is quick and painless.

Hearing Tests (The Actual Assessment)

Several tests are typically conducted. The full assessment takes 30–60 minutes and is completely painless.

Types of Hearing Tests

Pure Tone Audiometry

The core hearing test. You wear headphones in a soundproof or sound-isolated room and are played a series of tones at different frequencies (pitches) and volumes. You press a button or raise your hand each time you hear a sound. The test maps the quietest sound you can detect at each frequency — this becomes your audiogram.

Bone Conduction Testing

Often done at the same time as pure tone testing. A small vibrating device is placed behind your ear (on the mastoid bone). This sends sound directly to your cochlea, bypassing the outer and middle ear. By comparing air conduction results (headphones) to bone conduction results, the audiologist can determine whether your hearing loss is conductive or sensorineural.

Speech Testing (Speech Audiometry)

Instead of tones, words are played at varying volumes. You're asked to repeat them. Two key measurements:

• Speech Reception Threshold (SRT) — the quietest volume at which you can correctly repeat 50% of two-syllable words
• Word Recognition Score (WRS) — the percentage of words you correctly repeat at a comfortable listening level

Tympanometry

A probe is placed in the ear canal and briefly emits a tone while the pressure is changed. This tests the mobility and function of the eardrum and middle ear system. It helps identify eardrum perforations, middle ear fluid, and Eustachian tube dysfunction. It doesn't test hearing per se — it's a middle ear function test.

Otoacoustic Emissions (OAEs)

A probe in the ear canal plays sounds and measures the faint echoes produced by the outer hair cells of the cochlea. This test can detect damage to the cochlea even before the person notices hearing loss — useful for newborn hearing screening and monitoring ototoxic medication effects.

Understanding Your Audiogram

An audiogram is a chart showing your hearing thresholds. The horizontal axis shows frequency (pitch, measured in Hertz/Hz) — low frequencies on the left, high frequencies on the right. The vertical axis shows loudness (measured in decibels hearing level, or dB HL) — quiet at the top, loud at the bottom.

Your audiologist will explain your results in plain language. A good audiologist will walk you through the audiogram, explain what sounds you're missing, and what that means in practical terms (e.g., "you'd struggle to hear most women's voices clearly" or "consonants in quiet conversation would be difficult").

Next Steps After Testing

Based on the results, your audiologist will recommend a personalised management plan:

• Normal hearing or mild loss with no functional impact — monitoring, lifestyle advice, annual review
• Mild-to-moderate hearing loss — OTC hearing aids may be recommended; no GP referral required in most countries
• Moderate-to-severe or complex hearing loss — referral to an ENT specialist, prescription hearing aids, or cochlear implant evaluation
• Conductive or mixed hearing loss — ENT referral to investigate medical causes (earwax, infection, structural issues)
• Sudden hearing loss — immediate medical referral; urgent steroid treatment may be indicated

Cost and Accessibility

In Australia: comprehensive diagnostic audiometry ranges from AUD $80–$200. Pensioners and health care card holders may be eligible for subsidised testing through the Australian Government Hearing Services Program.

In the UK: NHS audiology services offer free hearing tests. Private audiologists typically charge £40–$150 for a full assessment.

In the US: audiologist hearing tests range from $60–$250 without insurance. Medicare Part B covers diagnostic hearing tests when ordered by a doctor.