Subjective Hearing Tests

Usually, noises, sounds or words are played and a specific reaction sought. The results of various tests determine if the hearing loss is conductivesensorineural, or mixed.

Pure-tone audiometry.

This test takes place in a sound-attenuated room and requires your active participation. A doctor or hearing care professional plays varying tones in varying loudness through headphones. As soon as you hear a sound you make a sign, generally by pressing a button or raising a hand as soon as the sound is heard. The volume at which you have heard the tone for the first time, in conjunction with the corresponding frequencies (pitches), is recorded in the audiogram.

From approximately eight years old onwards, children can respond to a pure-tone audiometry test as adults do. The hearing threshold for air conduction is determined at different frequencies. In a second step, bone conduction is measured. A headset with a bone transducer is placed behind the respective ear while sounds are played. As before, the child is asked to respond when a sound is heard.

Speech testing.

Your hearing care professional may also test your ability to hear and understand speech in quiet and in noise. The results of speech testing and pure-tone audiometry testing are used in together to determine your candidacy for hearing aids or other hearing solutions.

For children, this method is useful as a supporting method for verifying the hearing loss and for comparing the child’s performance with different hearing aids or fittings. The test materials consist of single word or sentence lists. Different test materials are available depending on the age and language skills of the child.

Reflex and play audiometry.

Reflex audiometry uses a baby’s neonatal reflexes to test hearing. The normal hearing perception threshold of newborns is about 80 dB HL. During the test, short loud narrow-band sounds are presented, usually via speakers or insert headphones. The examiner watches carefully to determine if the baby shows any kind of reflexive behavior in response to the sound, and at what loudness levels. Babies lose most of the neonatal reflex behavior between 8 to 16 weeks after birth.

Play audiometry turns the hearing test into a game and is appropriate for children from a developmental age of two to three years onwards. The child might be told to throw a marble in a bucket for each sound heard or to complete a puzzle piece by piece. Depending on the age, size, and reaction of the child toward headphones, the test sounds may be displayed via speakers, air-conduction headphones, and/or a transducer for bone conduction. When loudspeakers are used, the test procedure is shorter because both ears are tested at the same time. However, it is also less exact because the result does not allow a differentiation of the hearing threshold for the right and left ears.

Tuning fork test.

Physicians may also determine the nature of your hearing loss by using a tuning fork.