The Different Hearing Tests in an Audiology Clinic

#1

What different hearing tests you likely to undergo in an audiology clinic?

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#2

That is an interesting list. I had the ABR test done many years ago when my hearing tests done through my employer detected a loss in one ear. The diagnosis for me was that my loss was due to excessive loud noise – gunshots without hearing protection.

Your list is missing a couple of tests though. One is the feedback gain test. This test should be done to determine the maximum gain that can be used in setting up the hearing aids. If this test is not done and the results respected the patient can end up with HA’s that are generating excessive feedback events.

The other missing test is the Real Ear Measurement (REM) which measures how much gain the HA’s actually produce in each individual ear. This is compared to the target gain, and the gain adjusted to target (without exceeding the maximum gain determined by the feedback test). What is sad is that I have seen reports that only about 25% of clinics actually do the REM test. And worse than that, some only do the measurement when it is required by law or insurance, but don’t do any adjustment based on it. They just want to tick the box off so they get paid…

I would not go to any clinic that does not have the REM equipment and actually use it.

Edit: The article below suggests 35-55% of clinics use REM. Various sources report different numbers.

Considerations in Real Ear Measurement: Points to Ponder

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#3

Initially my Audi said lots of times they don’t bother with REM when aids seem ok, but I said you don’t know unless you try to see if you can get good to be better. As it was we had to increase at a specific frequency where I was struggling with certain constonants. When these were amped up we had better.
Then I went home and made a diary of exactly which environments had issues and where speaker was sitting. 3 follow up visits The aids were then fine tuned at the individual programs for crispness of speech, volume on one side, level of noise reduction etc.
This isn’t like eyeglasses where you pop them on and see. Unfortunately a lot of places just program to the test, take your money and it’s good bye and good luck out the door.

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#4

Although not specified, I think they were talking about diagnostic tests. The things you mentioned are tools used to assist in the fitting of hearing aids. Yeah, I know an audiogram is also used to fit the hearing aids. For me the difference is depends on whether it is evaluating your hearing (on it’s own, without hearing aid) or if it’s used to fit the hearing aid.
The feedback gain test, or “critical gain” is not necessarily recommended initially by some manufacturers. At least I think I remember reading that in some fitting instructions. I suspect it would depend a lot on one’s loss. Somebody with a big loss near 3khz and going with open fit is likely to have feedback issues unless care is taken. Although I’m a big fan of REM, I’ve been to a very impressive audiologist who did not use it routinely.

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#5

Yes, I made the assumption that the main purpose of the “clinic” was to sell hearing aids, and the initial tests were just a means to an end. Seems to me that many potential purchasers of HA’s need to be better informed on what to expect when getting your hearing tested, and how hearing aids are to be correctly fitted. I thought that article came up a little short.

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