Audiology - Booth Hearing Tests
Updated September 03, 2013.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
The person being tested sits in the booth wearing either headphones, hearing aids/implants, or nothing over their ears at all.
The audiologist asks them to signal when they can hear a sound. This signaling is usually done by raising the hand or pressing a button on a hand-held signaler.
The audiologist plays recorded frequencies or sound tones at different volumes or levels, testing each ear separately or both ears at the same time. The sounds are made louder or softer until a response occurs. (Of course, if there is no response, it means the sound is not heard).
Also as part of the booth testing, the audiologist will often do a test to check the ear drums (tympanogram), or a bone conduction test.
The sounds used are specified by organizations such as the International Organization for Standardization. In addition, audiometric testing is always done at frequencies of 125 Hz to 8000 Hz. The audiometric testing booths themselves may comply with the standards set by the "American National Standards Institute, which specifies the maximum permissible ambient noise levels allowed in an audiometric test room.
The part of the hearing test that people with hearing loss readily identify with is the spondee speech recognition test. In this part of the booth test, the audiologist covers his or her mouth so you can not cheat by lipreading. The audiologist then says words from a selected list. These two-syllable words have been selected for their vowel sounds, which are either two long syllables or two stressed syllables The words are usually "ice cream, baseball, cowboy, hotdog, airplane, playground," etc. The person being tested tells the audiologist what they think the word sounded like.
With children, spondee words may be tested by having the child point to a picture while the audiologist says "Point to the... [spondee word]." This technique is known as select picture audiometry. Select picture audiometry does not seem to be effective below the age of three. One study found that while 97% of three- to six-year-olds cooperated, only 62% of the two-year-olds did.
An alternative method is Play Audiometry. In Play Audiometry, the young child, who is wearing headphones, touches or moves a toy.
The accuracy of test results and the resulting audiogram are really dependent on the cooperativeness of the person being tested, as well as other factors, such as the speech of the audiologist and how well the headphones fit. If a young child does not cooperate, an alternative is a brain-stem evoked response audiometric test, which can be done without a child's cooperation.
Sources:
Combs, Jerome T, Sharon A. Waterman, and Maureen K. Combs. Select picture audiometry in an office setting. Clinical Pediatrics. March 1996 v35 n3 p161(4).
Gravel, Judith S. Audiologic Assessment of Infants and Toddlers. Paper, download from ERIC.ed.gov. ED373492. 1992.
Northern, Jerry L., and Marion P. Downs.Hearing in Children. Lippioncott Williams & Wilkins, 2001. P. 190.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
How Is a Booth Hearing Test Conducted?
In a booth hearing test, the person being tested (baby, child, or adult) is placed in a special, soundproof room. The room is divided into two halves separated by a window. The person being tested is in one half, and the audiologist is in the other half. The audiologist may be visible through the window.The person being tested sits in the booth wearing either headphones, hearing aids/implants, or nothing over their ears at all.
The audiologist asks them to signal when they can hear a sound. This signaling is usually done by raising the hand or pressing a button on a hand-held signaler.
The audiologist plays recorded frequencies or sound tones at different volumes or levels, testing each ear separately or both ears at the same time. The sounds are made louder or softer until a response occurs. (Of course, if there is no response, it means the sound is not heard).
Also as part of the booth testing, the audiologist will often do a test to check the ear drums (tympanogram), or a bone conduction test.
What Sounds Are Used?
In my own experience, the sounds have been high- and low- pitched "squeal-like" sounds. At my last hearing test, one sound was made so loud it made my left ear itch, and I could feel the headphone vibrate.The sounds used are specified by organizations such as the International Organization for Standardization. In addition, audiometric testing is always done at frequencies of 125 Hz to 8000 Hz. The audiometric testing booths themselves may comply with the standards set by the "American National Standards Institute, which specifies the maximum permissible ambient noise levels allowed in an audiometric test room.
The part of the hearing test that people with hearing loss readily identify with is the spondee speech recognition test. In this part of the booth test, the audiologist covers his or her mouth so you can not cheat by lipreading. The audiologist then says words from a selected list. These two-syllable words have been selected for their vowel sounds, which are either two long syllables or two stressed syllables The words are usually "ice cream, baseball, cowboy, hotdog, airplane, playground," etc. The person being tested tells the audiologist what they think the word sounded like.
With children, spondee words may be tested by having the child point to a picture while the audiologist says "Point to the... [spondee word]." This technique is known as select picture audiometry. Select picture audiometry does not seem to be effective below the age of three. One study found that while 97% of three- to six-year-olds cooperated, only 62% of the two-year-olds did.
Testing a Baby or Young Child
Babies, toddlers, and young children obviously cannot be relied on to signal if they hear a sound, so the booth test is done differently with them. A baby is taught to turn to a sound. When the baby turns to the sound, the baby is "rewarded" with the sight of a toy lighting up or moving. The baby also has to be taught the opposite -- that is, not to respond if nothing is heard. This is called Visual Reinforcement Audiometry (VRA). If the VRA false alarm rate is higher than 23%, it means the baby is not responding as expected and the results cannot be construed as accurate. A newer development is the use of video in VRA.An alternative method is Play Audiometry. In Play Audiometry, the young child, who is wearing headphones, touches or moves a toy.
Accuracy of Booth Hearing Tests
I do my best and try to give honest answers on booth hearing tests, but have such a hard time knowing if I am hearing the sounds that I don't know how accurate my results are. At my last hearing test, I was encouraged to state if I "felt" the sound versus "hearing" it.The accuracy of test results and the resulting audiogram are really dependent on the cooperativeness of the person being tested, as well as other factors, such as the speech of the audiologist and how well the headphones fit. If a young child does not cooperate, an alternative is a brain-stem evoked response audiometric test, which can be done without a child's cooperation.
- Also, see a video about how to test hearing with a tuning fork.
Sources:
Combs, Jerome T, Sharon A. Waterman, and Maureen K. Combs. Select picture audiometry in an office setting. Clinical Pediatrics. March 1996 v35 n3 p161(4).
Gravel, Judith S. Audiologic Assessment of Infants and Toddlers. Paper, download from ERIC.ed.gov. ED373492. 1992.
Northern, Jerry L., and Marion P. Downs.Hearing in Children. Lippioncott Williams & Wilkins, 2001. P. 190.