A Free Hearing Test is not a Hearing Evaluation
Until recently, there were only a couple of places that offered hearing instruments to the public in Greeley. Today there are many outlets that offer hearing instruments and it is difficult for the average consumer to discern the differences between the “deal of the weekend” in the paper, “free hearing tests” and other offers that seem to be available on every corner.
While it used to be that audiologists were the professionals that were providing aural rehabilitative treatment concerned with the benefit offered by the products that were provided as part of the rehabilitative process, currently there are many that work for hearing aid sales operations and their concern is how many products that the sell each day. These facilities offer a “free hearing test”. A free hearing test is not an evaluation of your hearing.
A Hearing Evaluation should include the following battery of hearing tests:
- A Hearing Health History: A discussion of the hearing difficulty and other health issues that could affect your hearing.
- An examination of the ear with a microscope to insure that there is nothing blocking the ear canal and/or other disorders that require referral to your physician for medical treatment.
- First of the evaluations is Pure Tone Air conduction. For this portion of the evaluation you should be evaluated using insert headphones in a sound treated environment (sound booth). At this point you are asked to listen for tones that are presented and push a button whenever you think that you hear a tone. This first evaluation tests the whole auditory system is a cursory test that lets the examiner know if there is a hearing loss present.
- Also part of the evaluation is Speech testing. The speech test is used to correlate the tonal test with speech to see if they are roughly the same. For this portion of the evaluation you will be asked to repeat 2 syllable words and get softer each time until you cannot hear them. The words will be presented again until a level is found where you just barely hearing the words and can tell what was said. This speech level should be compared to the tones for reliability and validity. A second speech test should be conducted so as to evaluate the patient’s understanding ability on scale from 1-100%. These are one syllable words and are assess so as to determine how clear speech is to the person when it is at a comfortable level.
- Once the overall hearing loss and test reliability is determined, it is necessary to find out where in the auditory system does the hearing impairment reside. This is first done by a bone conduction assessment. In the bone conduction assessment a vibrator is placed on the mastoid process (just behind the ear). The bone conduction evaluation tests just the cochlea and the auditory pathways and by passes the eardrum and bones of the middle ear. From this portion of the evaluation the audiologist will look at if the hearing is the same as the air conduction assessment or if the hearing is better by bone conduction. If the hearing is better, then physician referral may be indicated, if not the impairment is probably in the inner ear and, generally, cannot be treated by medication or surgery.
- Some clinics will also include Otoacoustic Emissions. In this test a foam plug is inserted into the ear and measurements are conducted. We know that if we send a certain type of tone to the cochlea, it will send a tone back to us if hearing is normal. If not we do not get a tone sent back to the ear probe. Often this portion of the evaluation validates the overall hearing evaluation.
- Immittance Audiometry. In this test, the middle ear is evaluated to determine how the eardrum moves and if the bones of the middle ear are functioning normally. Muscle contractions are also taken to determine if they are present or absent. From these tests the audiologist can assess the middle ear function.
PROBLEMS WITH THE “FREE HEARING TEST”
The true hearing evaluation consists of the review of all of the above specific tests. When considered in total there is a complete picture of how the patient actually hears sound. We know the type, degree, and configuration of the impairment and if there is special circuitry required to facilitate the hearing loss due to abnormal loudness sensitivity or other issues.
From the review of a full hearing evaluation, it can be determined if a physician referral is necessary and/or the characteristics of a specific hearing impairment that may need special attention in a hearing aid fitting.
Just a “Free Hearing Test” will usually just be the tones presented #3. Additionally, the “hearing test” is conducted outside of a sound treated room, it may not be very accurate. Here are some considerations that go along with a “Free Hearing Test”
- Non-Audiologists that are hearing aid salespeople are NOT licensed in Colorado and the person testing your hearing could be someone that was selling shoes yesterday.
- They are interested in selling product, NOT necessarily your best hearing.
- Franchise operations (i.e. Miracle Ear, Beltone, Audibel, etc) are usually more expensive than your private audiologist and often are simply hearing aid sales people, not audiologists.
- Many audiologists work for hearing aid sales operations and their goal is to sell as many products as possible, not necessarily the best ones for your and your lifestyle.
- Most sales operations handle only one manufacturer of hearing aids.
- Big Box stores (COSTCO, Sams Club, etc.) that offer hearing aids are typically hearing aid salespeople and may have been stocking shelves a few months before you see them. Again, they are NOT Licensed in Colorado.
- Online hearing tests are totally unreliable and invalid.
- Upon referral from your physician hearing evaluations are paid by health insurance and Medicare.
Hearing aids are quite beneficial if obtained through an audiologist that genuinely cares about you, your lifestyle, and your increased hearing capabilities. These products are expensive and require careful thought before their purchase. If you respond to your mailbox, the internet, some hearing aid salesperson, or a big box store, the risk that you will not get what you pay for significantly increases. Basically, its buyer beware and the best method of insuring that you are treated to a true hearing rehabilitation experience is to find a good audiologist that has been in business for a number of years in your city. Check out our credentials and, most of all reputation! You owe it to yourself to find the best possible person to assist you with your hearing.