Hearing tests are used to assess your ability to hear different sounds and to determine if there are any problems.
Why are hearing tests needed?
Hearing tests are carried out for two main reasons:
as a routine part of a baby’s or young child’s developmental checks
to check the hearing of someone who is experiencing hearing problems or has hearing loss
It's important hearing tests are carried out so the right support and treatment can be provided.
Hearing tests are carried out at regular intervals during childhood, starting with the Newborn Hearing Screening Programme (NHSP) within a few weeks of birth.
Your child's hearing may also be checked during a general health review when they are a few years old and before they start school for the first time.
If you're worried about any hearing problems, you can ask your GP for a hearing test.
What happens during a hearing test?
Although your GP or practice nurse can examine your ears, you will usually be referred to a specialist for a hearing test.
A number of different tests are used to check how well the ears are functioning and their ability to detect different levels of sound.
Common hearing tests include:
automated otoacoustic emissions (AOAE) tests – a computer attached to an earpiece plays clicking noises and measures the response from the ear
automated auditory brainstem response (AABR) tests – sensors are placed on the head and neck to check the response of the nerves to sound played through headphones
pure tone audiometry tests – sounds of different volumes and frequencies are played, usually through headphones, and a button is pressed when they are heard
bone conduction tests – a vibrating noise generator sensor is placed behind the ear and presses on the bone to test how well the hearing nerve is working
Generally, different tests are used for adults and children but they are all completely painless.
The results of some of these tests are recorded on a graph called an audiogram, so that the type of hearing loss can be identified.
how hearing tests are carried out
hearing and vision tests for children
The ear is made up of three main areas:
the outer ear – sound enters the outer ear and passes down the ear canal to the eardrum (a thin membrane), which vibrates
the middle ear – this air-filled cavity contains three tiny bones that pick up and carry the vibrations from the eardrum to the inner ear
the inner ear – this contains the vestibular system (the balance organ) and the cochlea (the hearing organ), which is a coiled fluid-filled tube that turns the vibrations into electrical signals that are fed along the auditory nerve to the brain
A problem in any of these areas will require a hearing test to determine the type of hearing loss you have.
Conductive hearing loss
Your hearing may be affected if sounds don't reach the inner ear efficiently. This is known as conductive hearing loss. Conductive hearing loss can be caused by problems such as:
a blockage in your ear canal, such as a build-up of earwax
a blockage in the middle ear – for example, glue ear
an infection of your outer ear (otitis externa) or middle ear (otitis media)
a hole or tear in the eardrum (perforated eardrum)
otosclerosis, which is an abnormal growth of bone in the middle ear
disruption of your hearing bones caused by injury or disease
Conductive hearing loss caused by these problems is often temporary and reversible.
Sensori-neural hearing loss
If sounds reach the inner ear but are still not heard, the fault lies in the inner ear or (rarely) in the hearing nerve. This is called sensori-neural hearing loss.
Sensori-neural hearing loss may occur for a number of reasons, most commonly as a result of age-related change. This sort of hearing loss is nearly always permanent.
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Page last reviewed: 29/10/2014
Next review due: 29/10/2016
When a hearing test is needed
Hearing tests are carried out regularly during childhood to identify any problems as soon as possible. Adults can also ask their GP for a hearing test.
In the past, many children born with hearing loss were not diagnosed until they were 18 months or older. But identifying hearing loss late can have a negative impact on a child's language development, social skills and self-confidence.
If hearing problems are diagnosed early, appropriate support can be provided for the child and their family.
It's also important to identify hearing loss in adults early, as treatment is more likely to be effective the earlier problems are diagnosed.
Newborn Hearing Screening Programme (NHSP)
Around one in every 900 babies is born with some form of hearing loss and many of these can be identified with testing.
Newborn babies are now given a routine hearing test as part of the Newborn Hearing Screening Programme (NHSP).
It's not easy to identify hearing loss in babies who are too young to have a conventional hearing test, so screening uses an Automated Otoacoustic Emissions (AOAE) test. This test is carried out in the first few weeks following birth. This enables some problems to be identified at an early stage.
The test will either take place in the hospital maternity unit or in your home by a health visitor during a routine visit. If you are not offered a screening test for your baby, you should ask your midwife, health visitor or GP to arrange one.
Sometimes, premature babies pass this test but are still felt to be in a high-risk group for hearing loss. In these cases another hearing test is recommended for when they are between six and eight months old.
Later childhood tests
There will also be further opportunities to check your child’s hearing as they get older. For example:
a child may have their hearing checked as part of their general review when they are about two-and-a-half years old
all children have a hearing test when they are between four and five years old before they start school
your GP can arrange for your child to have a hearing test at any age if you feel that their hearing is not right (see below)
The age at which routine tests or assessments are carried out may vary between different areas. Your GP or health visitor should be able to advise you.
Reporting problems to your GP
If you think your child may have a hearing problem, take them to see your GP as soon as possible. Hearing tests can be used at any time to help diagnose or rule out other health conditions. In some cases, hearing loss may be the cause of delayed speech and language development.
Many children who experience hearing problems turn out to have a common and temporary condition called glue ear, in which mucus blocks the ear.
Less commonly, other explanations for a child apparently having hearing difficulties include behavioural problems such asattention deficit hyperactivity disorder (ADHD).
Adult hearing tests
Adults can also request a hearing test from their GP if they are concerned about their hearing.
Hearing loss in old age is a common and usually gradual process. It often begins with difficulty hearing other people clearly, particularly when there is a lot of background noise. At first you may not realise you have a hearing impairment and other members of your family may be the first ones to notice.
However, there are other reasons why adults might lose their hearing, such as ear infections, ear disease or prolonged exposure to excessive noise.
You should visit your GP if you experience hearing loss in one or both ears, or if you have:
tinnitus – ringing or buzzing in your ears
vertigo – dizziness or loss of balance
severe ear pain that lasts for more than 24 hours
discharge – fluid or blood coming out of the ear
You may also need to have a hearing test if you have a head injury, because it could damage your inner ear or your hearing bones.
Older people with permanent hearing loss may benefit from having a hearing aid. If you have a hearing aid fitted, you will receive advice and support from your local audiology department, including advice about changing the battery, repairs and upgrades.
You are more likely to benefit from a hearing aid if your hearing loss is diagnosed early. Ask your GP to arrange a test if you are at all concerned about your hearing.