Audiological Evaluations

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, seniors, and those with special needs.

Hearing loss can occur at any age. Reduced hearing leads to communication struggles and can impact relationships at work and 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 more social and active life.

What should I expect during an audiological evaluation?

Air & Bone Conduction Testing – Speech Discrimination

A complete diagnostic audiological evaluation includes speech discrimination testing 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. 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 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 for “bone-conduction” responses. This testing will help determine the type of hearing loss you may have. You will also be asked to repeat back words at differering volume levels for speech threshold and discrimination testing. 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 earbud attached to a machine that manipulates air pressure will be placed into your 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 and this test takes less than a minute to complete.

Otoacoustic Emissions (OAE)

A soft earbud will be placed into your ear canal and a series of sounds are 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 remain still and 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.

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 evaluated?

First, the audiologist will talk with you and your child to determine what goals, concerns and questions you have about your child’s hearing. Then, impedance and OAEs are assessed as described above. Depending on your 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 evaluating children 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 and volume will be played and when your child turns to look towards the direction of the sound, a light-up toy will be activated as a reward to encourage this response. The sound will change in frequency and get quieter as we continue to look for your child’s response and reinforce with the light up toy. Speech tests will also be performed as appropriate for your child’s age. 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. You will be asked not to respond to the sounds yourself or repeat any words you may hear, as to not give them any “hints” when the sounds are very quiet. Sometimes, an assistant will also be with you to aid in obtaining the necessary responses from your child.

Conditioned Play Audiometry (CPA)

For children over two-and-a-half or three years of age, play audiometry provides a positive and fun experience while a specially trained audiologist evaluates hearing ability. CPA is performed by having the child listen to sounds through headphones and asking them to perform a given action, like putting a block in a bucket or a peg on a pegboard, when they hear the sound. Speech testing will also be conducted by having your child repeat words or point to pictures as asked. During this test you may be asked to assist your child in learning the “listening game” or an assistant will be with you to aid in obtaining the responses.

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