Diagnostic Assessments by Audiologists

Diagnostic assessments form the cornerstone of understanding and addressing hearing health. Audiologists employ a comprehensive range of tests and techniques to evaluate individuals’ auditory function, identify hearing disorders, and develop tailored treatment plans.

By conducting thorough evaluations, audiologists can accurately identify the nature, extent, and possible causes of hearing loss or other hearing disorders. These assessments enable the development of personalised treatment strategies and facilitate the journey toward improved communication, enhanced quality of life, and overall well-being.

1. Pure-Tone Audiometry

Pure-tone audiometry is one of the most common and essential tests performed by audiologists. During this assessment, patients wear headphones and respond to tones presented at different frequencies and intensities. By determining an individual’s hearing thresholds, audiologists can precisely map the range of sounds a person can hear, which aids in diagnosing the type and degree of hearing loss.

1.1 Air Conduction Testing

Air conduction testing involves the presentation of pure tones through headphones or speakers. The audiologist systematically tests each ear at various frequencies to establish a detailed audiogram. This graph visually represents an individual’s hearing thresholds, providing valuable information about the type and severity of hearing loss.

1.2 Bone Conduction Testing

Bone conduction testing is conducted alongside air conduction testing to assess the inner ear’s responsiveness to sound. Vibrations are transmitted to the inner ear via a bone oscillator placed behind the ear or on the forehead. This test helps differentiate between sensorineural hearing loss (damage to the inner ear) and conductive hearing loss (obstruction or dysfunction in the outer or middle ear).

2. Speech Audiometry

Speech audiometry evaluates an individual’s ability to understand and repeat speech. It provides insights into how well a person can comprehend and discriminate words in everyday listening situations. During this assessment, the audiologist presents recorded or live speech stimuli, such as words or sentences, at different intensity levels. The patient then responds by repeating or identifying the presented speech.

2.1 Speech Reception Threshold (SRT) Testing

SRT testing determines the softest level at which an individual can understand speech. The audiologist presents a series of words or sentences at decreasing volume levels, and the patient repeats or responds to them.

2.2 Word Recognition Testing

Word recognition testing assesses an individual’s ability to correctly identify and repeat spoken words. This test provides valuable information about speech discrimination abilities, helping the audiologist understand the patient’s specific communication challenges.

3. Tympanometry and Middle Ear Analysis

Tympanometry evaluates the mobility of the eardrum and the middle ear’s function. This assessment involves the gentle introduction of air pressure changes into the ear canal, while a probe measures the resulting eardrum movement. Tympanometry helps identify conditions such as fluid accumulation, eustachian tube dysfunction, or abnormalities in the middle ear system.

3.1 Middle Ear Pressure and Compliance

Tympanometry provides information on middle ear pressure and compliance. Abnormal findings can indicate issues like eustachian tube dysfunction or middle ear infections, which may require further medical intervention.

3.2 Acoustic Reflex Testing

Acoustic reflex testing assesses the reflexive contraction of the middle ear muscles in response to loud sounds. This evaluation provides valuable information about the integrity of the middle ear system and the presence of any pathologies.

4. Otoacoustic Emissions (OAEs)

Otoacoustic emissions are sounds generated by the inner ear in response to external stimulation. This non-invasive test assesses the integrity of the cochlea, specifically the outer hair cells. During the evaluation, a small probe is placed in the ear canal, and a series of sounds are presented. The microphone in the probe measures the emissions generated by the inner ear. OAE testing aids in the identification of cochlear pathologies and is particularly useful in screening newborns and infants.

5. Electrophysiological Assessments

Electrophysiological assessments provide objective information about the auditory system’s functioning by measuring the electrical responses generated in the auditory pathway. These tests are especially valuable when evaluating patients who cannot actively participate in traditional behavioral assessments, such as young children or individuals with cognitive impairments.

5.1 Auditory Brainstem Response (ABR)

ABR measures the electrical activity of the auditory nerve and brainstem in response to auditory stimuli. Electrodes are placed on the scalp, and a series of clicks or tones are presented. The resulting waveform reflects the transmission of sound from the ear to the brain.

5.2 Middle Latency Response (MLR) and Late Latency Response (LLR)

MLR and LLR assessments measure the brain’s responses to sound stimuli at different processing stages. These tests provide information about higher-level auditory processing and cortical functioning.

Through diagnostic assessments such as pure-tone audiometry, speech audiometry, tympanometry, OAEs, and electrophysiological tests, audiologists gain valuable insights into individuals’ auditory function, leading to accurate diagnoses and personalised treatment plans