Audiological Assessment

The HEAR Center is equipped to serve clients at all stages of life. While we are well-known for our Pediatric Audiology, we are proud to offer services to adults and seniors. 

Hearing loss can occur at any age. Reduced hearing leads to communication struggles and can impact relationships at work and at home. The isolation that develops can be devastating.

At the HEAR Center, we believe that early identification through diagnostic evaluations and appropriate amplification can help maintain communication skills and a normal life. 


What should I expect during an audiological evaluation?

  • Air - Bone - Speech - Discrimination

A complete diagnostic audiological evaluation including speech discrimination and threshold testing across a range of frequencies. This test is conducted in a sound-treated room, typically under headphones or insert earphones for the “air-conduction” responses and speech testing. Sounds of different frequencies (pitches) and at varying volume levels will be presented to each ear, one ear at a time. You will be asked to either push a button or raise your hand each time you hear it, regardless of how soft the sound is. The purpose of the test is to determine the softest level you are able to hear a sound at each frequency. This same process will be repeated with a different headset that rests behind your ear instead of over it, for “bone-conduction” responses, to help determine the type of hearing loss you may have. You will also be asked to repeat back words for speech testing, at differing volume levels. Other tests may be added, determined by the audiologist, and you will be instructed as needed.

  • Impedance (Tympanometry & Acoustic Reflexes)

During this test, a soft probe tip attached to a machine that manipulates air pressure is placed into the ear canal. Changes in air pressure and reflexive reactions to loud sounds introduced by the machine cause the eardrum to move or stiffen. The measurements are recorded and evaluated by the audiologist. You will not be asked to respond to the sounds you hear during this test.

  • Otoacoustic Emissions (OAE)

A soft probe tip is placed into the ear canal and a series of sound is introduced to the ear. When sound is received by a healthy ear, a low level echo is generated. It gives an estimate of hearing acuity without requiring a response from the listener: if no measurable echo is recorded, a moderate or worse hearing loss may be indicated. You will not be asked to respond to the sounds heard during this test, and in fact should remain silent, as any noise or movement may interfere with the measurements. This test is painless, and with a quiet and still person, may be completed in a matter of seconds.

  • Auditory Brainstem Response (ABR)

This test measures the brain's response to sound. During the test, headphones and non-invasive electrodes are placed on the patient's head and the response is recorded. Not currently provided.


Pediatric Audiology

The cornerstone of our auditory services is the evaluation of a child's hearing. At the HEAR Center we perform age-appropriate diagnostic testing to obtain the most accurate audiological results possible.

What should I expect when my child is tested?

Impedance and OAEs are assessed for each child as described above. In addition to these tests, and depending on the child’s calendar or cognitive age, and level of participation, your child’s responses to air, bone, and speech sounds will be evaluated in a sound-treated room to determine hearing levels.

Special methods for testing children behaviorally include:

  • Visual Reinforcement Audiometry (VRA)

Used typically for babies up to three years of age, VRA uses auditory stimulation through headphones or speakers, partnered with a visual reinforcer, e.g. a light-up toy, to elicit a conditioned response. In other words, sounds in different frequencies will be presented on the left side and the right side, and the child will be trained to look towards the direction of the sound. When they turn to look, a light-up toy will be activated as a reward to encourage this response. During this test you will be in the room with your child or have them in your lap, giving them encouragement and support, as well as helping them stay on task. Speech tests will also be performed as appropriate for your child’s age. You will be asked not to respond to the sounds yourself or repeat any words you may hear the audiologist say to your child during the course of the test (with the possible exception of the training/conditioning phase), as the volume of her voice is controlled. Most often, an assistant will also be with you to aid in obtaining the necessary responses from your child.

  • Conditioned Play Audiometry (CPA)

For children typically over two-and-a-half or three years of age, play audiometry provides a positive and fun experience while a specially trained audiologist measures hearing ability. CPA is performed by having the child listen to sounds typically through headphones, and respond to them by moving a toy piece in a practiced way to determine hearing acuity. Speech testing will also be conducted by having your child repeat words or point to pictures as asked. During this test you and your child may choose to have you in the room with them or wait on the other side of the window with the audiologist controlling the machines, as an assistant helps him or her learn the “listening game”.

*Around age 5 years and above, children can typically use a hand-raise or button response, the same way an adult would be tested.