Hearing tests are used to assess your ability to hear different sounds and to determine if there are any problems.

Why are hearing tests needed?

Hearing tests are carried out for two main reasons:

• as a routine part of a baby’s or young child’s developmental checks
• to check the hearing of someone who is experiencing hearing problems or has hearing loss

It's important hearing tests are carried out so the right support and treatment can be provided.

Hearing tests are carried out at regular intervals during childhood, starting with the Newborn Hearing Screening Programme (NHSP) within a few weeks of birth.

Your child's hearing may also be checked during a general health review when they are a few years old and before they start school for the first time.

If you're worried about any hearing problems, you can ask your GP for a hearing test.

Read more about when hearing tests are needed.

What happens during a hearing test?

Although your GP or practice nurse can examine your ears, you will usually be referred to a specialist for a hearing test.

A number of different tests are used to check how well the ears are functioning and their ability to detect different levels of sound.

Common hearing tests include:

• automated otoacoustic emissions (AOAE) tests – a computer attached to an earpiece plays clicking noises and measures the response from the ear
• automated auditory brainstem response (AABR) tests – sensors are placed on the head and neck to check the response of the nerves to sound played through headphones
• pure tone audiometry tests – sounds of different volumes and frequencies are played, usually through headphones, and a button is pressed when they are heard
• bone conduction tests – a vibrating noise generator sensor is placed behind the ear and presses on the bone to test how well the hearing nerve is working

Generally, different tests are used for adults and children but they are all completely painless.

The results of some of these tests are recorded on a graph called an audiogram, so that the type of hearing loss can be identified.

Read more about:

• how hearing tests are carried out
• hearing and vision tests for children

Hearing problems

The ear is made up of three main areas:

• the outer ear – sound enters the outer ear and passes down the ear canal to the eardrum (a thin membrane), which vibrates
• the middle ear – this air-filled cavity contains three tiny bones that pick up and carry the vibrations from the eardrum to the inner ear
• the inner ear – this contains the vestibular system (the balance organ) and the cochlea (the hearing organ), which is a coiled fluid-filled tube that turns the vibrations into electrical signals that are fed along the auditory nerve to the brain

A problem in any of these areas will require a hearing test to determine the type of hearing loss you have.

Conductive hearing loss

Your hearing may be affected if sounds don't reach the inner ear efficiently. This is known as conductive hearing loss. Conductive hearing loss can be caused by problems such as:

• a blockage in your ear canal, such as a build-up of earwax
• a blockage in the middle ear – for example, glue ear
• an infection of your outer ear (otitis externa) or middle ear (otitis media)
• a hole or tear in the eardrum (perforated eardrum)
• otosclerosis, which is an abnormal growth of bone in the middle ear
• disruption of your hearing bones caused by injury or disease

Conductive hearing loss caused by these problems is often temporary and reversible.

Sensori-neural hearing loss

If sounds reach the inner ear but are still not heard, the fault lies in the inner ear or (rarely) in the hearing nerve. This is called sensori-neural hearing loss.

Sensori-neural hearing loss may occur for a number of reasons, most commonly as a result of age-related change. This sort of hearing loss is nearly always permanent.

Read more about causes of hearing loss.