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Most ‘free’ hearing tests are what’s called screening tests. These are a basic pass or fail tests designed to find out if you suffer from hearing loss. These kinds of tests are also available as free downloads from app stores or online. It requires little or no skill to administer, which is why they are free.
In these screening tests four different beep tones are presented at a level considered to be within normal limits and if you hear it you pass. These tests can be extremely inaccurate and many people with normal hearing end up failing them. The screening can also be affected by ambient noise, incorrect administration, equipment issues, and finally (and unfortunately) results being skewed by administrators due to commissions being paid for failed screenings.
The next step after a hearing screen is to get a basic hearing assessment to see if there is indeed a hearing loss, how severe it might be and what area of the hearing system the problem may stem from. Because this is a significantly more time-consuming test and relies on the skillset of clinician there is usually a charge. This can be upfront or is commonly built into the price of hearing aids.
This second assessment finds the point where you just start hearing different pitched beeps through a set of headphones. By measuring this we test how sound is being detected through the outer ear, middle ear and inner ear. This is known as air conduction. We then find these points again with a special set of headphones called a bone conductor. The bone conductor directs the beeps to the inner ear without going through the outer and middle ear.
If we get the same results with bone and air conduction we know the middle ear and outer ear are letting all the sound through to the inner ear. So if there is a hearing loss it’s in the inner ear. If there is difference between the bone and the air conduction results then we know the middle or outer ear is the source of the hearing problem.
The information obtained in conjunction with other assessments is then used for either two purposes, to find out where and what the problem is, and to assist with treatment with hearing aids and/or implantable technology.
If the information is for diagnostic reasons it is only the first step to help ascertain if any other areas of the ear or auditory/balance system are affected as on its own it does not tell us what could be causing the problem and does not assist with formulating treatment options. Most importantly this test does not measure the difficulties you are experiencing with communication or the impairment the hearing loss may be giving.
A rehabilitation assessment focuses on assessing not just the hearing but also the impairment and communication difficulties you may be facing. It does use some of the same assessments as a diagnostic assessment, but also includes a lot of tests that measure other things important to communication such as auditory processing and cognition, to name but a few.
It is the combination of these latter tests that ensure you get the right treatment for your hearing problems. Those ‘free’ hearing tests are mostly just to get you through the door.
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