Hearing aid evaluation test

Overview

A hearing aid evaluation test is a series of checks done by an audiologist (a hearing specialist) to find out if you have hearing loss and whether a hearing aid could help you. The test measures how well you hear different sounds and helps pick the right hearing aid for your needs.

Yes, hearing loss is very common, especially as people get older. Many adults have a hearing evaluation at some point to see if a hearing aid can improve their quality of life.

Hearing aid evaluations are for people of any age who suspect they have hearing loss. This includes children, adults, and older adults. It is most often done for older adults, but can be needed at any age due to noise exposure, infections, or other causes.

Symptoms

Common symptoms

• Struggling to hear conversations, especially in noisy places
• Often asking people to repeat themselves
• Turning up the TV or radio louder than others prefer
• Feeling like people are mumbling
• Difficulty hearing on the phone

Symptoms in children

• Not responding when called
• Delayed speech or language development
• Trouble following instructions in school
• Complaints of ear pain or ringing

Symptoms in older adults

• Withdrawing from social events because it's hard to follow conversations
• Feeling tired from straining to hear
• Missing doorbells, alarms, or phone rings

Causes

Main causes

• Natural aging (presbycusis) – the most common cause of hearing loss in older adults
• Long-term exposure to loud noise (from work, concerts, or headphones)
• Ear infections or a buildup of earwax
• Certain medicines that can harm hearing (ototoxic drugs)
• Genetics – some people inherit hearing loss

Risk factors

• Age over 60
• Working in noisy environments without hearing protection
• Family history of hearing loss
• Chronic conditions like diabetes or high blood pressure
• Smoking

When to see a doctor

See a doctor urgently if:

• Sudden hearing loss, especially if it happens overnight or within a few hours
• Hearing loss with severe dizziness (vertigo) or ringing in the ears
• Hearing loss after a head injury

Book a routine appointment if:

• You notice hearing loss that has been getting worse over months or years
• You often feel left out of conversations because you can't hear well
• You have trouble hearing on the phone or in groups

Diagnosis

An audiologist will perform a hearing aid evaluation. This includes a full hearing test (audiogram) to measure your hearing at different pitches and volumes. They will also ask about your medical history, lifestyle, and specific hearing difficulties.

Tests that may be done

• Pure-tone audiometry – you wear headphones and press a button when you hear beeps
• Speech audiometry – you repeat words at different volumes
• Tympanometry – a test that checks how your eardrum moves (to rule out middle ear problems)
• Real-ear measurement – a tiny microphone in the ear canal to check how a hearing aid performs in your ear

What to expect at your appointment

The test is painless and takes about 45 minutes to an hour. You will sit in a quiet room or booth. The audiologist will give you clear instructions. After the test, they will discuss the results and whether a hearing aid might help. If you decide to go ahead, they will help you choose and fit a hearing aid.

Treatment

If the evaluation shows you have hearing loss that can be helped by a hearing aid, the audiologist will recommend a suitable device. Hearing aids amplify sounds and are customised to your hearing profile. They come in different styles (behind-the-ear, in-the-ear) and levels of technology. Treatment may also include training on how to use and care for the hearing aid.

Self-care at home

• Protect your ears from loud noises with earplugs or earmuffs
• Keep the volume low on headphones and earbuds
• Clean your ears gently – do not use cotton swabs inside the ear canal
• Have your hearing checked regularly as you age

Medical treatments

In some cases, hearing loss is caused by earwax blockage, which can be removed by a healthcare professional. If the hearing loss is due to an infection or other medical condition, your doctor may prescribe treatment (like antibiotics for an ear infection). For hearing loss that cannot be reversed, hearing aids are the main treatment. Your audiologist will help you choose the right type and settings.

When is surgery considered?

Surgery is rarely needed for typical age-related or noise-related hearing loss. However, if you have severe hearing loss that hearing aids cannot help, your doctor may discuss special implantable devices like cochlear implants. That is a different procedure and not part of a routine hearing aid evaluation.

Living with this condition

Living with hearing loss can be challenging, but hearing aids can make a big difference. You may need time to adjust to wearing hearing aids – your brain needs to get used to sounds you haven't heard clearly in a while. Start by wearing them for a few hours each day and gradually increase the time. Practice in quiet settings before noisy ones.

Lifestyle tips

• Tell family and friends about your hearing loss so they can speak clearly and face you
• Use captions on TV and videos
• Ask for quiet seating in restaurants or meetings
• Consider assistive devices like amplified phones or TV listening systems

Diet and exercise

A healthy diet and regular exercise support good blood flow, which can help protect your hearing. Avoiding smoking and managing conditions like diabetes and high blood pressure may also reduce the risk of further hearing loss.

Mental health and emotional wellbeing

Untreated hearing loss can lead to feelings of isolation, frustration, and even depression. It is important to address hearing concerns early. If you feel sad, anxious, or lonely because of hearing problems, talk to your doctor or a counsellor. You are not alone – support is available. In a crisis, call your local emergency number or a mental health helpline.

Prevention

Some types of hearing loss cannot be prevented, especially age-related hearing loss. But you can lower your risk by protecting your ears from loud noise, avoiding smoking, and managing health conditions like diabetes.

Vaccines

Vaccines can prevent some infections that cause hearing loss, such as meningitis and measles. Make sure you and your children are up to date on recommended vaccines. Talk to your doctor for more information.

Screening programmes

Routine hearing screening is recommended for newborns (usually done before leaving hospital) and for adults over 50. If you have any concerns about your hearing, ask your doctor about a hearing check.

Complications

If left untreated

• Difficulty communicating with loved ones, leading to social withdrawal
• Higher risk of falls and accidents (because you may not hear alarms or warnings)
• Increased risk of cognitive decline and dementia in older adults
• Feelings of frustration, anxiety, or depression

Long-term outlook

With proper evaluation and treatment, most people with hearing loss can lead full and active lives. Hearing aids have improved enormously and can significantly improve your ability to hear and connect with the world. The key is to get help early and to give yourself time to adjust. You can still enjoy conversations, music, and everything that sounds matter to you.

Find support

Local organisations

• Your local audiology clinic or NHS audiology department · United Kingdom

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