Following a visual examination of your ear, ear canal and ear drum, the hearing sensitivity test is performed - Pure Tone Audiometry. In addition to this, functional brain hearing tests such as speech tests in noise, and speech sensitivity will be performed alongside cognitive function tests.
The hearing sensitivity test
The Pure Tone hearing test is a key to providing a measurement of your hearing sensitivity. It helps us determine the type and degree of hearing loss. You will be required to use a headset through which a series of tones are presented at various pitches (frequencies) and volumes (intensities) to one ear at a time. You are required to press a button or raise your hand each time a tone is heard, no matter how soft. The softest volume (intensity) required to hear each tone is recorded on an audiogram.
Functional brain hearing tests
Hearing loss is generally identified by conducting a routine Pure Tone hearing test as described above. This gives you insight into your hearing sensitivity which is a great starting point. Although essential for determining type and degree of hearing loss, Pure Tone tests do not provide a clear depiction of your ability to listen to and understand speech.
Speech is complex and many factors impact on our ability to understand it, particularly in challenging or noisy environments. Fortunately, Clearly Hearing routinely test these abilities rather than just relying on a pure tone stimulus to detect hearing as many other providers in the NHS and on the High Street. Speech tests are performed in quiet and in noise to provide a better perspective of a person’s functional hearing. Speech tests include:
Rather than relying on a tonal stimulus, speech audiometry assesses your ability to discriminate speech. This gives a much better ‘real world’ perspective of your hearing. Furthermore, it carries additional diagnostic information as it is a good indicator of where in the auditory system the hearing loss lies. This is important as the location of the hearing loss can relate to the functional benefit you may experience if you are a candidate for a personalised hearing solution.
Speech-in-noise tests quickly and easily measure your ability to hear speech in noise. We run these tests in simulated real-life situations such as social gatherings, dinners and noisy environments. It better reflects ‘real-world’ hearing and listening ability.
Cognitive function tests
In addition to exploring your hearing sensitivity and your ability to understand speech, here at Clearly Hearing, we also assess the key cognitive skill sets that are relevant to successful hearing and communication.
The role of cognition in hearing ability is one that we cannot ignore. Your ears are one part of an auditory system that collects and delivers a wide variety of sound signals; it is in the brain that listening happens – the act of applying meaning and making sense of sound. Two people could have the same hearing sensitivity, but how their brain processes information and the mental effort required to do so will be completely different.
Although it may appear that the communication problems experienced is due to hearing loss alone, often this is not the primary issue. In many instances, it may be related to the ability to filter out distraction, focus attention, process information and remember information. The fact is, successful and effortless hearing is reliant on these key cognitive skills and for a person with hearing loss, they are even more reliant on these skills.
During our comprehensive and holistic assessment of hearing, we explore the skill sets that are vital for good communication and daily living in general. This approach, which is unique to Clearly Hearing, allows us to provide you with a real awareness of your current state of living and enables us to provide the best possible support that is genuinely individualised.
We try to find the quietest sounds the patient can hear at each frequency, in each ear. We present the tones in a random but methodological way that the Audiologist can track and record the hearing thresholds.
When testing the sensitivity of hearing, if the quietest sound the ear can hear is above 20dB at 4 frequencies between 500Hz to 4000Hz (in the UK), this would constitute a hearing loss. However, some people who don't meet these criteria may notice a deterioration in their hearing and can still benefit from a kind of hearing solution or management that could improve their quality of life.
We test the entire hearing pathway through a headset which goes over the ears, and then we do the same again through a headset that sits behind the ear and vibrates the cochlear through the skull. If there is a discrepancy of more than 5db between the hearing threshold results of the two tests, this would show that there could be a conductive hearing loss.
We start off by taking the medical history and examining the ear with an otoscope. If we find no contraindications, we carry out the gold standard procedure to test hearing sensitivity - Pure Tone Audiometry..
A heart problem can sometimes manifest as a hearing loss because the restricted blood flow can damage the hearing organ permanently. Sometimes hearing loss is the first sign of possible cardiovascular issues.
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We are open, with normal clinic hours operating. We will remain open during the lockdown unless we receive any updated guidance from the government, as hearing clearly is essential. Boris Johnson has emphasised the need for medical services to continue, and we remain committed to ensuring that we support our patients with their paths to better hearing during this difficult time.