Alliance Audiology hearing test instrumentsAlliance Audiology LobbyAlliance Audiology Staff

FAQ About Hearing Tests

I am having problems with dizziness (vertigo).
Why do I need a hearing test?

Your vestibular system and auditory system are closely related. There are some disorders/diseases of the inner ear that may cause both dizziness and hearing loss (i.e. Meniere’s disease). A hearing test provides your physician with valuable information that may help determine the cause for your dizziness or vertigo. 

What is tinnitus? Is there a cure?

The classic definition of tinnitus is the perception of sound with no external source. There is no known cure for tinnitus but there are treatment options. Here at the Audiology and Hearing Center at Concord Otolaryngology and Alliance Audiology we perform tinnitus evaluations and are accredited providers of the Neuromonics Tinnitus Treatment program.

What happens when I have a tinnitus evaluation?

• Tinnitus History Questionnaire and Tinnitus Reaction Questionnaire: Detailed information about the onset of your tinnitus, health and medical history, and noise exposure history are obtained through the Tinnitus History Questionnaire. The Tinnitus Reaction Questionnaire provides detailed information about how you perceive the noises in your ears and how it impacts your life. Your audiologist will discuss this information from these questionnaires since they provide valuable and crucial information about you and your tinnitus.

• Tinnitus Evaluation: The nature of the noises (tinnitus) in your ears can be evaluated with specialized equipment and tests. A Pure-tone Audiometry test is administered in our soundproof room to measure your ultra-high frequency hearing (above 8000 Hz) through special headphones.

A second test is called Tinnitus Matching. You will be given different sounds to listen and compare to the noises in your ears. The pitch and sound quality of your tinnitus is matched.

Your sensitivity to sounds is evaluated with the Loudness Sensitivity test. You will listen to different narrowband sounds and asked to rate how loud you perceive those sounds as the volume is increased. We will search for the level that is “uncomfortably loud” for you. This information helps the audiologist to determine if you have loudness tolerance problems.

Your ability to hear a broadband noise called “white noise” is evaluated. Just like the Pure-tone Audiometry test you will listen to the “white noise” and indicate the softest level you can hear it. Then you will listen to that noise and indicate when it just barely “covers up” your tinnitus.

Another test is called Residual Inhibition. In this test you will listen to the sound that was previously matched to your tinnitus. All you need to do is sit quietly and listen to that sound for one minute. If your tinnitus disappears that is a good indicator that you will respond to treatment.

• Tinnitus Treatment: There are number of treatment methods that your audiologist will discuss with you. The appropriate method will depend on the outcome of the tinnitus questionnaires and the tinnitus evaluation. See our products and services.

How long does a hearing test take?

Plan on a 30-minute time block for your scheduled hearing test. If you think you may also want to discuss hearing aids at this visit be sure to let us know and we will allot one hour. You may also choose to schedule a return visit to discuss hearing aids.

My two-year old is having trouble hearing. Can his hearing be tested?

Although this can be a very challenging population to test, it can be done quite successfully. Depending on the capabilities of the child, testing in a soundfield environment or under headphones may be performed.

Your child may be asked to point to body parts or pictures. Their behavioral responses to sounds at different intensity levels are recorded.

In some cases, your child may be able to perform play audiometry—throwing blocks in a bucket in response to a sound.

Your child is an individual so the type of testing performed is largely dependent upon their mood and cognitive abilities.

It is very important that there is an adult present that will be able to accompany the child for testing. There should be no other children present as they often distract the child being tested. It is also important that the test time reflects the time of day that your child is most attentive and well rested.

Will my insurance pay for a hearing test?

Medicare always requires a referral from your physician. Many insurance companies will pay for hearing testing with a physician referral. In some cases a physician referral may not be required.

It is important that you refer to your individual insurance company’s plan to determine whether a referral is warranted and whether the cost of the evaluation is covered.

What is the youngest age that babies can be tested?

Newborn hearing screening is becoming very common place. Newborns are often tested before they leave the hospital. Here at the Audiology and Hearing Center at Concord Otolaryngology we test infants six months of age or older.

What is a newborn hearing screening?

This is testing that is typically done on the newborn in the hospital while the mother is still in the maternity ward. Screening procedures for newborns and infants can detect permanent or fluctuating, bilateral or unilateral, and sensory or conductive hearing loss, averaging 30 to 40 dB or more in the frequency region important for speech recognition (approximately 500-4000 Hz).

The screening of newborns and infants involves use of non-invasive, objective physiologic measures that include otoacoustic emissions (OAEs) and/or auditory brainstem response (ABR). Both procedures can be done painlessly while the infant is resting quietly.

What is a test for central auditory processing?

Our ears do the hearing and our brain does the listening. Our ability to understand speech involves the coordination of the ears and the center for hearing in the brain. It is in the brain and along the auditory pathways to the brain that sound is processed and meaning assigned.

Central auditory processing tests assess your ability to:

  • Remember what you hear – Auditory Memory
  • Remember what you hear in the order it was presented to you - Auditory Sequential Memory. For example, remembering a string of verbal directions - "get your coat, put it on, put your boots on, go out and shovel the walkway and then go get the mail."
  • Determine which sounds are in the background and which are in the foreground - Figure-ground Perception
  • Fuse or integrate different signals presented to the ears simultaneously – Binaural Fusion.
  • Actively block information presented to one ear while listening to information in the other ear – Binaural Separation
  • Listen to information presented to one ear while listening to different information in the other ear and comprehending both – Inter-hemispheric Transfer of Information.
  • “Fill in the blanks” when auditory signals are less clear – Auditory Closure
  • Perceive patterns of sounds over time – Temporal Processing. For example, being able to discriminate subtle cues like intonation, stress, and rhythm.

What is a vestibular evaluation?

A vestibular evaluation is a series of tests usually ordered by a physician when a person suffers from vertigo, dizziness, or imbalance. These tests measure how different parts of the balance mechanism function in the inner ear by measuring eye movements.

When the head is in motion, the inner-ear balance organs send signals to the eye muscles to keep vision in focus. Therefore, eye movements, called nystagmus, can be used to evaluate the balance system. Electrodes are taped near to the eyes, and a computer records results as patients go through various vestibular tests.

Vestibular tests include:
Videonystagmography (VENG), Vestibular Autorotation Test, Computerized Platform Posturography (EquiTest), Vestibular Evoked Myogenic Potentials (VEMP), and Auditory Brainstem Response (ABR).

Can Childhood Ear Infections Impact Speech & Language?

The answer to this question is "yes". When a child has a middle-ear infection, fluid accumulates in the middle ear. The middle ear space behind the eardrum is typically filled with air - not fluid. This fluid can actually remain even after the infection has cleared. The presence of this fluid can cause a temporary hearing loss or reduction in hearing. And of course children with repeated infections or fluid build up have a higher likelihood of speech and language delays.

Many children have at least one middle-ear infection (also known as Otitis Media) before the age of one and 10-20% of children have more frequent ear infections. Fluid can last on average up to one month per infection. Of huge importance is that persistent fluid is more common for children under 2 years of age than for older children.

Why is this of huge importance? This is a critical time for language learning and speech development. During a child's first three years is when the most amount of language learning is taking place - both learning to speak and understanding language. Children do this by interacting with people around them. If hearing is muffled during this time, it only makes sense that speech and language development may be delayed as a result.


How loud is too loud for my ears?

Better Hearing Institute

If you have to raise your voice to shout over the noise to be heard by someone within an arm’s length away, the noise is probably in the dangerous range. o

Some of the warning signs of the presence of or exposure to hazardous noise are as follows:

  • You can’t hear someone three feet away.
  • You have pain in your ears after leaving a noisy area.
  • You hear ringing or buzzing (tinnitus) in your ears immediately after exposure to noise.
  • You suddenly have difficulty understanding speech after exposure to noise.
  • You can hear people talking but you cannot understand them.

How come I can hear but I can’t understand?

A common type of hearing loss is a high frequency loss where the low frequencies can be heard but the high frequencies cannot. With this kind of hearing loss, you can hear the voice but you don’t clearly hear consonant sounds, such as [s], [t], [ch], [sh], and [f]. So you may hear the word “sheep” instead of “cheap” or “fifty” instead of “fifteen”.

If you have trouble hearing clearly in quiet it only gets worse in noisy places or when someone is across the room. That could spell trouble for many people who work in restaurants and customer service jobs.

Can listening to music with my iPod and headphones damage my ears?

Yes, absolutely! The general rule of thumb is that if someone can hear your music at an arm’s length away then you’re are playing your music too loud. However, your hearing can be damaged if you listen for long periods of time with the volume at a comfortable level.

Earphones or earbuds often don’t fit snugly enough to isolate background noise. So when your child listens to his favorite song in the backseat of the car he will feel the need to crank up the volume just to hear over the noise.

When you exercise on the treadmill you may raise the volume to damaging levels without realizing it. Any sound at 85 decibels puts you at risk for hearing loss after eight hours of exposure. Just three decibels louder (88 decibels) will cause hearing loss in four hours. At 97 decibels your hearing will be damaged in 30 minutes!

Don’t run the volume any higher then 60% of maximum range and limit your listening to one hour. If you use earbuds run it lower and shorter.

What are the signs of hearing loss?

From Better Hearing Institute. Patricia E. Connelly, PhD, CCC-A, FAAA

The signs of hearing loss can be subtle and emerge slowly, or they can be significant and come on suddenly. Either way, there are common indications. You should suspect hearing loss if you experience any of the signs below.

You might have hearing loss if you . . .


  • require frequent repetition
  • have difficulty following conversations involving more than 2 people
  • think that other people sound muffled or like they're mumbling
  • have difficulty hearing in noisy situations, like conferences, restaurants, malls, or crowded meeting rooms
  • have trouble hearing children and women
  • have your TV or radio turned up to a high volume
  • answer or respond inappropriately in conversations
  • have ringing in your ears
  • read lips or more intently watch people's faces when they speak with you


  • feel stressed out from straining to hear what others are saying
  • feel annoyed at other people because you can't hear or understand them
  • feel embarrassed to meet new people or from misunderstanding what others are saying
  • feel nervous about trying to hear and understand
  • withdraw from social situations that you once enjoyed because of difficulty hearing


  • have a family history of hearing loss
  • take medications that can harm the hearing system (ototoxic drugs)
  • have diabetes, heart, and circulation or thyroid problems
  • have been exposed to very loud sounds over a long period or single exposure to explosive noise

How can I tell if I have a hearing loss?

Take this Hearing Loss Checklist test to get a general idea of your hearing capabilities. We will be happy to see you for a comprehensive evaluation if the 5-minute test indicates that you need to see an audiologist.

(link to interactive file, “How’s your hearing?”)

What Can I Do About Hearing Loss?

While hearing loss isn’t reversible, most age or noise related loss can be managed and often compensated for. Sometimes that means medication or surgery. But just as eyeglasses are used to correct most vision problems, hearing instruments are used to treat most kinds of hearing loss.

Any treatment starts with a comprehensive evaluation of your hearing by an audiologist. Once you know the nature and extent of the hearing loss, you’ll be able to make your own decisions about treatment.

*Adapted from by Starkey Hearing Foundation

I suddenly lost my hearing. What should I do?

The first thing is to see your physician right away. It could be earwax that can be removed and restore your hearing.

If your physician does not find earwax or suspects an infection you should have your hearing tested as soon as possible. The audiologist can determine the type of hearing loss which will help your physician provide the best course of treatment. For some types of problems time is of the essence to receive appropriate treatment to recover your hearing.


Back to Top