Hearing Tests Explained: The Main Types and What Each One Shows

AudiologyOctober 6, 20268 min read

A full hearing assessment is not one single test but a small set of tests, each answering a different question. Pure-tone audiometry finds the softest sounds you can hear at different pitches. Speech testing checks how well you hear and understand words. Middle-ear tests, such as tympanometry, show how well the eardrum and middle ear are working. Together they reveal whether there is hearing loss, what type it is and how much it affects everyday listening.

Hearing tests are painless and non-invasive. For most of them you simply listen and respond, or sit still while a soft probe rests at the entrance of your ear. Your audiologist chooses which tests you need based on your age, symptoms and history.

What is a hearing test?

A hearing test, or audiological assessment, measures how well your ears detect and process sound. It is carried out by a trained professional, usually an audiologist, using calibrated equipment in a quiet room or sound-treated booth. Calibration matters because it means the sounds played are exactly as loud as the equipment says, so the results are accurate and can be compared over time.

At our centre, each hearing test is carried out by our audiologist. Calibration is the main difference between a clinical test and an app or website check. Online Hearing Checks vs a Clinical Hearing Assessment: What Is the Difference? explains when each one is useful.

What happens before the tests?

Most assessments start with:

A conversation (case history). Your audiologist asks about the hearing difficulties you notice, when they started, whether one or both ears are affected, ringing in the ears, dizziness, ear infections, noise exposure, general health and any family history of hearing loss.
Looking in the ears (otoscopy). A small light is used to look at the ear canal and eardrum. This can show wax, signs of infection or other issues that might affect the results.

For a step-by-step description of the visit itself, see What to Expect During a Hearing Assessment.

What are the main types of hearing tests?

Pure-tone audiometry (air conduction)

This is the test most people picture. You wear headphones or small foam earphones and listen to beeps or tones at different pitches (frequencies) and loudness levels. Each time you hear a sound, even a very faint one, you press a button or raise your hand. The audiologist records the softest level you can hear at each pitch, for each ear separately.

What it shows: your hearing thresholds, meaning how loud sounds need to be for you to just detect them. The results are plotted on a chart called an audiogram.

Bone-conduction testing

A small vibrating device is placed behind the ear, usually on the bone behind it. It sends sound vibrations through the bones of the skull directly to the inner ear, bypassing the outer and middle ear.

What it shows: by comparing air-conduction and bone-conduction results, the audiologist can tell whether hearing loss comes from the outer or middle ear (conductive), from the inner ear or hearing nerve (sensorineural), or both (mixed).

Speech audiometry

Hearing beeps is not the same as understanding speech. In speech testing you listen to words, sometimes at different loudness levels and sometimes with background noise, and repeat them back or point to pictures.

What it shows: the softest level at which you can hear and repeat speech, and how clearly you understand words when they are loud enough. This helps explain the common complaint "I can hear, but I can't understand", and it is useful when considering hearing aids.

Tympanometry

A soft probe is placed at the entrance of the ear canal and gently changes the air pressure for a few moments while measuring how the eardrum moves. You may feel slight pressure, similar to being on a plane, but it does not hurt.

What it shows: how well the eardrum and middle ear are working. It can point to fluid behind the eardrum, a blocked Eustachian tube, a perforated eardrum or other middle-ear problems.

Otoacoustic emissions (OAE)

A healthy inner ear produces very faint sounds of its own in response to sound. A small probe in the ear plays sounds and records these responses. You do not need to respond, so this test is often used for babies and young children.

What it shows: whether the outer hair cells of the inner ear are responding as expected.

Auditory brainstem response (ABR)

Small sensors are placed on the head and sounds are played through earphones. The equipment records how the hearing nerve and brainstem respond. The person needs to be still or asleep, so it is often used for newborns and young children who cannot do behavioural tests.

What it shows: how well the hearing pathway from the ear to the brainstem responds to sound.

Do children have different hearing tests?

Children can be tested at any age, but the methods are adapted to their development. Babies may have OAE or ABR tests. Toddlers may be tested with play-based or visual reinforcement methods, where they turn towards a sound and are rewarded with a light or animated toy. Older children can usually do the same kind of listening tests as adults, made into a game.

Our pediatric hearing test service is designed specifically for babies and children.

What do the results show?

Your audiologist combines all the results to answer three questions:

Is there hearing loss? And in one ear or both?
What type is it? Conductive, sensorineural or mixed.
How much? The degree of hearing loss and which pitches are most affected.

The main summary is the audiogram. Learning to read it helps you understand your own hearing; see How to Read Your Audiogram: A Plain-Language Guide. Your audiologist will also discuss what the results mean for daily life, whether you need to see a doctor, and options such as hearing aids if they would help.

How should you prepare?

Note the difficulties you notice, and bring a list of your medicines, any previous results and your hearing aids if you have them. If you are in Muscat, Booking a Hearing Test in Muscat: What to Know Before Your Visit covers the practical side of booking with us.

When to see a specialist

Book a hearing assessment if:

You notice difficulty following conversation, especially in noise
Family members comment on your hearing or the TV volume
You have ongoing ringing in the ears
You have never had a baseline hearing test and are exposed to noise
You have concerns about a child's hearing, speech or response to sound

See a doctor promptly for sudden hearing loss, ear pain with discharge, ringing in one ear only, or dizziness with hearing loss.

Assessments at our centre are carried out by our audiologist. No referral is needed: you can book an adult hearing test or a pediatric test directly through our booking page.

Frequently asked questions

How long does a hearing test take?

It depends on which tests you need, your age and whether a hearing aid discussion follows. A standard adult assessment usually fits comfortably within a single appointment. The clinic can tell you how much time to allow when you book.

Does a hearing test hurt?

No. Hearing tests are painless and non-invasive. Some middle-ear tests create a brief feeling of pressure in the ear, similar to changing altitude, and one test plays a short loud sound, but neither should be painful.

Do children have the same tests as adults?

Older children can often do the same listening tests as adults, presented as a game. Babies and young children are tested with methods suited to their age, such as OAE, ABR or play-based tests, which do not require them to press a button. A pediatric hearing assessment is tailored to the child's development.

Sources

This article is general information and does not replace advice from a qualified professional.

Adult Hearing Tests & Assessment Ashfeera Ashraf