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According to the Royal National Institute for Deaf People (RNID) 12 million adults in the UK experience hearing loss greater than 25dBHL. That means distinguishing speech sounds has become impaired, so conversations at a normal level are difficult and require quite a lot of effort.
Thankfully, most hearing loss can be treated, often with hearing aids, for example, but first it needs to be diagnosed by an audiologist. And that means getting a hearing test.
In this article, we’ve unpacked what’s involved in having your hearing tested, the different types of tests you could have, where to go to get a hearing test, and what’s available on the NHS versus if you pay to go private.
With advice on the process as a whole, we aim to make the experience of having a hearing test as stress-free and straightforward as possible.
The clearest sign that you’d benefit from having a hearing test is changes to your hearing. That may seem obvious, but you might not realise for a long while that your hearing has changed.
Usually, hearing loss occurs gradually over time, especially as you get older. Age-related hearing loss, called presbycusis, is the most common type of hearing loss. In fact, around 40 per cent of people over 50 have some degree of hearing loss. That figure rises to 70 per cent for those over 70.
Whatever your age, if your hearing loss is gradual, it’s often a friend or family member who notices before you do, especially if you live together. You might think nothing of turning the volume up on the TV but, when you need it so loud that it becomes uncomfortable for other people, it’s a sure sign there’s a problem with your hearing.
Struggling with conversations is often the first indication that you need a hearing test. That’s because high-frequency sounds are the most difficult to process if your hearing is impaired, so you might find it hard to distinguish between ‘s’, ‘f’ and ‘th’ sounds.
Context helps your brain to fill in the gaps to start with, but as hearing loss progresses and the range of sounds you can’t hear properly grows, it gets more difficult to understand speech.
If you can relate to the following statements, it’s probably a good idea to get your hearing tested:
Another sign that you should get your hearing checked is if you start getting tinnitus. Sometimes referred to as ringing in the ears, tinnitus is when you hear sounds that don’t come from an external source.
You might experience tinnitus as ringing, whooshing, buzzing, humming or other sounds, and it can affect one or both ears. Importantly, tinnitus can be a symptom of hearing loss, so it should prompt you to go for a hearing test.
If you experience sudden hearing loss in one or both ears, you should call NHS 111 or go to A&E as soon as possible. The chances are it might not be anything to worry about, but losing your hearing suddenly could signal a potentially serious medical condition that needs to be assessed as an emergency.
There are a range of different hearing tests that can detect whether you have any hearing loss, how severe it is, what’s causing it, and what treatments might be possible. The best treatment for hearing loss is usually a hearing aid.
Everyone can get a hearing assessment through the NHS by visiting their GP, who can refer you to a hearing specialist, called an audiologist, for more detailed hearing tests if necessary.
Some branches of large pharmacies and opticians, such as Boots and Specsavers, also provide hearing tests, often for free. You’ll also find hearing aid manufacturers, for instance Amplifon, operating in high street shops where you can get your hearing tested.
Alternatively, you can pay to see an audiologist privately and have a thorough series of hearing tests.
When people go for a hearing test it’s common practice for a case history to be taken, looking at the kind of difficulties you may be having, and an overview of your hearing health. Your audiologist will look inside your ears to check for any wax or foreign bodies, and arrange for them to be cleaned before any further testing.
Audiometry is what people commonly refer to as hearing testing and is a vital part of taking care of our hearing. Equipment should be calibrated annually, and ideally, testing would occur in a soundproof booth or room. The testing is done with headphones, which either go over your ears or push inside, and a tight band that goes behind one ear.
Audiologists have to create an audiogram to see your hearing thresholds (the quietest sounds that you can hear) across the speech frequency range (250Hz-8kHz). That’s what they’re doing when they ask you to press the button every time you hear a sound, even if it’s very faint. This chart or graph gives the audiologist information about the level of your hearing, the health of your ears and possible causes of your hearing loss.
You may also have tympanometry (middle ear measurements) and a range of speech testing performed. This will give your audiologist extra information and help them advise you. Hearing testing allows your audiologist to establish whether your hearing is healthy, or whether it needs further investigation by an ear nose and throat (ENT) consultant. ENT consultants can be seen through the NHS or privately.
You might have different hearing tests depending on where you have them done. If your first port of call is your GP, it’s likely they’ll perform one or two very simple checks, rather than a full hearing test.
This basic hearing assessment can be carried out by your GP, and may also form part of an audiologist’s initial assessment should you bypass the NHS and choose to go private.
The aim is to find out if there’s something simple causing your hearing loss that can be easily resolved. For example, the examiner will look into your ear with a device called an otoscope, which can show if there’s a build-up of wax or something else blocking your ear canal, or any sign of an ear infection.
Other basic checks include a whispered voice test, where the examiner stands at arm’s length behind you and whispers letters and numbers – usually a sequence of three at a time – to see whether you can hear them.
You might also have a tuning fork test, where a tuning fork is placed against the top of your head or behind your ear, then struck to check whether you can hear the noise it produces. It can be useful in detecting some types of hearing loss and identifying if you’re hearing impaired in one or both ears.
Based on what the hearing assessment shows, your GP might suggest a more detailed look at what’s happening and refer you to an audiologist for a full hearing test, which you can get for free with the NHS.
Pure tone audiometry, often referred to simply as audiometry, is what probably comes to mind when you think of a hearing test. It measures your hearing range and sensitivity; in other words, if and how you hear sounds at different pitches, tones and frequencies.
It involves listening out for beep sounds through headphones and indicating each time you hear a sound.
This hearing test is performed by an audiologist who’s trained to carry out audiometry and interpret the results. They’ll also be able to advise you which treatments might help you, and give you advice for the best hearing aids for your needs, if necessary.
Very similar to pure tone audiometry, this hearing test plays spoken words rather than beep noises through the headphones at different volumes.
Also called speech recognition threshold testing, the advantage of this assessment is that it specifically examines how well you can hear other people speaking and whether there are certain elements of speech that you find more difficult than others.
Using natural speech sounds, it gives more of an overview of your hearing in normal, everyday life. Sometimes speech audiometry is performed against background noise, which can help the audiologist to suggest the best hearing aids for you, should you need them.
Hearing loss is sometimes caused by a malfunction in your middle ear, and a tympanometry hearing test can be useful in detecting such problems.
In tympanometry, the audiologist introduces a probe into your ear canal and air is gently pushed through to see how your eardrum moves in response. The vibrations are recorded on a graph.
If your eardrum is damaged, or you have fluid in your middle ear, for example, your ear drum won’t vibrate as it should and no movement will be recorded on the graph.
Used to assess how severe your hearing loss is, an acoustic reflex test measures your ears’ response to loud noise. It examines the automatic reflexes of a tiny muscle in your middle ear in reaction to sounds of varying loudness.
The audiologist plays sound at increasing volume through a probe in your ear. What they’re looking out for is the minimum sound intensity required to activate your acoustic reflex.
More commonly associated with hearing screening in newborn babies, an otoacoustic emissions (OAE) test can also be used for adults to diagnose hearing problems that originate from the cochlea in your inner ear.
Like with other hearing tests, sounds are played through a small probe in your ear. The audiologist checks for acoustic feedback – called otoacoustic emissions – that your inner ear sends back to your middle ear in response to the sound.
The results can help identify the severity of hearing loss and guide the audiologist as to whether a hearing aid or other treatment might benefit you.
There are two routes to taking a hearing test: NHS and private. You’ll probably have the same hearing tests either way, but it will almost certainly take longer to get an NHS referral than it will if you choose to go private.
While you won’t necessarily have to pay for private hearing tests – some retailers offer free hearing tests – you will have to pay for any treatment, including hearing aids. By using the NHS, treatments and hearing aids, as well as hearing tests, are free. Any doctors who practise privately to assess, fit and provide aftercare for hearing aids must be registered with the Health and Care Professions Council.
The following high street retailers offer hearing tests for free:
You can book a free hearing test with your preferred retailer online, or by calling or visiting your local branch.
It’s really easy to take an online hearing test and there is no shortage of hearing test providers and hearing aid manufacturers that have online hearing test platforms.
They take five minutes or less and can give you an idea if you should seek further advice about your hearing. Online hearing tests are no substitute for having a hearing test with an audiologist or getting advice from your GP.
To undergo an online hearing test, you should find a quiet spot with no background noise and you will need headphones or earphones.
Below is a list of online hearing tests that you can access. You could also search online for others – there are many to choose from:
Whether you are experiencing some changes to your hearing or you’d like reassurance that your ears and hearing are healthy and functioning well, getting a hearing test is straightforward and, very often, free.
With so many routes to healthy hearing – high street retailers, private audiology clinics and NHS providers – there is no reason to delay getting your hearing tested.
And if you do need hearing aids, read our experts’ recommendations for the best hearing aids on the market or read our full list of hearing articles.
