OUR HEARING ASSESSMENT PROCEDURE
Each component of our assessment procedure is vital in order that the audiologist can determine the nature and extent of your hearing loss, if medical / surgical intervention is required or whether we can go on to prescribe a suitable hearing system.
The assessment procedure will typically cover the following individual stages;
- Case history
- Lifestyle appraisal and needs analysis
- Pure tone audiometry
- Speech tests
- Speech in noise tests
We will be asking you a series of questions to help the audiologist understand your medical, health and hearing history. Our intention is to establish a subjective account of the symptoms a patient is experiencing or has experienced in the past so that we may use this information in conjunction with otoscopy and our audiological tests to make a diagnosis.
These questions will relate to the presence of pain, irritation, discharge or tinnitus. We will look at family history, work environment, general health, prescribed medication, operations or procedures to your ears and how long it has been since you first noticed the symptoms. Finally, we shall examine the factors which caused you to seek our help now.
LIFESTYLE APPRAISAL AND NEEDS ANALYSIS
Here, we are going to discuss how you live your life, who you may talk to during the day or the week, what sort of environment the conversations take place, whether you work, attend church or meetings. Do you spend a lot of time with friends or family, might you look after grandchildren, do you enjoy television or music and how do you cope on the telephone or with a conversation in the car or on a bus? These are all factors we need to consider.
We will attempt to establish key situations where you accept that your hearing lets you down and document them. Please bear with the audiologist as some of the questions may seem repetitive and probing but we need to be quite specific in order we can return to them if and when hearing aids are prescribed and determine benefit of your chosen hearing aids.
We use modern, state-of-the-art video equipment to examine the inside of your ear. We need to establish the physical condition of the outer ear, the ear canal and the ear drum to determine if we can proceed with the rest of the test procedures. There will be certain conditions we may find that warrant a medical opinion, in which case we will refer you to your GP or if you prefer we can recommend an ENT consultant for you to see privately. These conditions would include an ear infection or un diagnosed damage to the ear drum. It would be quite normal to find wax in the ear canal. However, if it is causing a blockage or interrupting our view of your ear drum it may warrant removal prior to the rest of the test procedures. Of course, we can perform this service for you but we will always discuss your options with you.
PURE TONE AUDIOMETRY
Simple sounds such as beeps or buzzes will be played through headphones at a variety of volumes in order that we can determine the absolute quietist sounds you can hear at specific tones. This part of the test is called air conduction. All you have to do is simply respond to the signal when you hear it, either verbally or by pressing a button.
The second part of pure tone audiometry is bone conduction. A pad will be placed behind the ear, this will enable you to hear the tones directly in the inner ear without any potential interruption from the ear drum or bones of the middle ear. Typically we will test fewer tones using this method as opposed to air conduction. The bone conduction test is vital to ensure the correct prescription is calculated.
Depending on your results so far, this would complete this part of the procedure. In some cases the above may need to be carried out again, only this time we might "mask" the ear not being tested with some form of rushing noise to ensure we do not get any erroneous results from the ear being tested.
The results are plotted on a graph to produce the Audiogram. Again, there may be certain conditions we find that warrant a medical opinion, in which case we will refer you on.
This test is the minimum requirement for an audiologist to be able to prescribe a hearing aid. Steer clear of companies who will perform a hearing test just using hearing aids to deliver the test tones.
Whilst Pure tone audiometry will show us the quietist sounds we can hear, it does little to show us how this impacts on our ability to make sense of speech. In this test, we will present random words delivered through a speaker at predetermined volume levels. You just need to repeat back what you hear and you will be scored on the number of words or part of the words you get correct. Testing in this way ensures that we can repeat the test under the same conditions when conducting routine ongoing assessments in the future. The results can be used as a benchmark for measuring the improvement in benefit of any particular hearing aid fitting. This test may also be used to ascertain the effectiveness of your current hearing aids by carrying out the test whilst you are wearing them.
Beware of companies who try to perform this test by mumbling from behind paper. This is not scientific, not accurate, not repeatable and open to abuse.
SPEECH IN NOISE TESTS
Most people with some form of hearing loss will complain that they struggle to hear in background noise, whether the noise is in a car, restaurant or simply a small family group.
We have a number of speech in noise tests at our disposal to simulate these environments. Typically, they will use pre-recorded speech, this time in sentences with variable but measureable levels of background noise present. The test can be performed through a speaker, through headphones or a combination of the two. We are recording the number of words you score correct to establish what we call the signal to noise ratio loss or SNR.
Whilst there are other tests available to us, depending on an individuals specific circumstances this would complete our usual protocol. However depending on a clients abilities some of these tests may be omitted.