Diagnostic Audiologic Evaluation

What should you expect during a diagnostic audiologic evaluation?

A diagnostic audiologic evaluation (or hearing test) is an essential part of your hearing healthcare. Much like routine vision and dental care, adults should have hearing evaluations once every 3 - 5 years.  For those with hearing loss, yearly hearing evaluations are crucial.

A diagnostic evaluation is an in-depth hearing evaluation that is performed to determine the type and severity of hearing loss. A diagnostic audiologic evaluation is different than a hearing screening, which only provides a brief look at a person's hearing ability. A hearing screening does not provide enough information to appropriately diagnose a hearing loss or allow for treatment recommendations. Therefore, having a diagnostic audiologic evaluation is necessary for those considering amplification/hearing aids or other treatment options.

During the diagnostic evaluation, various tests will be done to determine the degree of your hearing loss (how severe it is) as well as the type of hearing loss you have (whether it is a conductive loss effecting the middle or outer ear or a sensorineural loss that impacts the inner ear, auditory nerve and central auditory pathways.

A diagnostic audiologic evaluation includes (but is not limited to) air conduction and bone conduction testing and speech testing.


To begin, we will use an otoscope to look inside your ears to make sure there are no blockages from wax or other debris and to ensure that the eardrums look healthy and are intact.  If there is a wax blockage in your ears, we can often remove that wax while you are in the office.

Air Conduction Testing

Air conduction testing allows us to look at your hearing ability across different frequencies.  During this test you will wear either a set of earphones (that sit right inside the ear canal) or headphones (that sit over your ears).  You will be asked to indicate when you hear a series of tones or beeps. This test allows us to look at all parts of the ear at one time. 

Bone conduction testing

Bone conduction testing is similar to air conduction testing; however, a different type of headset is used for this test.  This test only checks the inner part of the ear (it bypasses the outer and middle ear); therefore, it allows us to determine which part(s) of your ear are causing your hearing loss.

Speech Testing

Two speech tests are performed during a diagnostic evaluation.  These tests help us to determine how well you can hear and understand spoken words.  These are vital tests as difficulty with communication is one of the most challenging aspects of hearing loss.

During Speech Reception Threshold testing, you will be asked to repeat words that will get quieter and quieter until you are no longer able to repeat them. This test determines the lowest level (volume) of sound where you can hear words or speech.

During Word Recognition testing, you will be asked to repeat a series of words that are played to you at a set volume. This test will tell us how clearly you are hearing speech or how well you understand what is being said to you.

These two tests give us important information regarding treatment options and how well hearing aids will help you in your daily life.


Tympanometry is a test used to determine the mobility of the ear drum. This test


Visual reinforcement and conditioned play audiometry for children

For children, it is important to have a diagnostic hearing evaluation whenever a hearing loss is suspected. It is the first step in identifying hearing loss and developing a treatment plan to improve academic and social success.

Along with the evaluation, you should generally expect to have time to review the results with the audiologist. They can interpret the tests for you, answer your questions, provide you with information and referrals as needed, as well as begin planning for treatment, if indicated.

Audiologists are specialists in hearing and hearing rehabilitation. Never hesitate to ask your audiologist for clarification or further information on anything you do not understand.

What can I expect during a diagnostic hearing evaluation?

The evaluation will last about 30-40 minutes in length. You should also allow time for discussion with the audiologist to review test results and ask questions.

If the results indicate you need hearing aids, allow for sufficient time to discuss your options.

It is recommended that you bring a family member with you to the evaluation appointment. Most audiologists agree that hearing loss is a family issue. It helps to have another supportive person at the appointment to help you understand the information and recommendations.

Before your appointment, a complete medical history will be completed and the audiologist will want to hear about any complaints you have about your hearing. They will pay special attention to any concerns you have about exposure to noise, tinnitus and balance problems. Make sure that you take a full list of any medications and supplements you are taking with you to your appointment.

The diagnostic audiologic evaluation is a good chance to establish a relationship with your audiologist. Above all, don't be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding hearing solutions that work best for you and your lifestyle.