You know what to expect at an eye exam, a physical and a handful of other medical tests. But are you familiar with what happens at a hearing test? How does it differ in children and adults? A hearing test involves several distinct examinations of your ears and hearing.

Hearing testing in adults

If your last hearing test was decades ago, it’s a good idea to get a baseline test. This exam sets a baseline that helps your audiologist monitor any gradual hearing loss as you age. The same tests are performed in a few years, perhaps after you have noticed some gradual hearing loss, and results are compared to the baseline.

Your audiologist will usually start with a physical examination of your ear. After that, the hearing evaluations begin, usually with a pure-tone test. You sit in a soundproof room and wear headphones or earplugs. Tones are played and you raise your hand or press a button when you hear the sound. The tones vary in volume (decibels) and pitch (frequency).

A speech test generally comes next. Sometimes the test uses recorded words; sometimes a tester speaks the words to you, usually very softly or in a whisper. You repeat the words you hear.

A tuning-fork test also may be performed to determine if you have any conductive or nerve problems. The tuning fork is placed on your head or near your ear. When it is tapped and makes a tone, you note when the tone fades. You also evaluate how loud the tone sounds in each ear.

Hearing testing in children

Pure-tone testing also is done with young children, but instead of pressing a button or raising a hand, the child is instructed to look toward the sound source or complete an activity when a sound is heard.

If a child has a history of middle ear infections, several tests may be performed to determine the problem. A tympanogram pushes air into the ear canal to check movement of the eardrum and can determine if there is fluid in the ear, a wax blockage or a perforated eardrum. An acoustic-reflex test helps determine the location of any hearing problem.

Several tests are done on infants, usually before they leave the hospital. These tests examine the nerves and function of the ear itself. An auditory-brainstem-response test (ABR) uses small sensors on the forehead and behind the ears and a small microphone in the ear canal to measure the inner ear’s electrical response to sound. An otoacoustic emissions test (OAE) uses a similar small device in the ear canal to record the inner ear’s response to sound.

Your hearing should not be taken for granted. It is imperative that children be tested early on so there are no problems with developing speech and language. As we age, it’s important to have a baseline hearing test before any noticeable hearing loss and then again once gradual hearing loss is detected.