What to Expect at Your First Visit
Here are a few things to consider when you are first seen at our office for a hearing assessment. When you arrive for your exam, you will be greeted by the front office staff and asked to fill out several forms, including those that record your personal information, medical history including medication list and verify your insurance. You will also be given a copy of a Notice of Privacy. To save yourself time you may download the forms and complete them prior to your visit.
For infants and children expect the evaluation process to take approximately one hour. In adult cases the evaluation process usually takes approximately one hour unless there are significant questions regarding hearing aids (amplification) and treatment options. In those cases expect the appointment to last one and a half hours. Please do not try and schedule an appointment when you are pressed for time since these evaluation times cannot be shortened.
As your exam begins, your audiologist will review your personal information with you and will ask you some questions pertaining to the nature of your visit as well as questions related to any difficulty you may be having with your hearing, your ears or your balance.
Next, the audiologist will look into your ears by using an otoscope. This instrument is used to see the ear canal and the eardrum and whether or not there is ear wax obstructing the canal. In certain cases if ear wax (cerumen) is occluding or blocking your ear the audiologist may remove the wax so that it does not interfere with the testing.
One test that is conducted is impedance testing or tympanometry testing. A small probe is placed in the ear and gently pushes and pulls on the eardrum to measure the pressure behind the eardrum in the middle ear space. It takes seconds to record the data. The data gives your audiologist information about the integrity of your eardrum, the pressure behind the eardrum in the middle ear space as well as if there is fluid behind the eardrum and the function of the Eustachian tubes which connect the middle ear space to the back of the throat.
Another test that is conducted is the pure tone hearing test. This is conducted in a quiet environment, such as a sound attenuating booth. The audiologist will place headphones that are connected to an audiometer in or over your ears. The audiometer transmits a series of tones at a variety of volumes into your ears to determine the “threshold” at which you can hear various frequencies of sounds. When you hear a sound, you will respond by pressing a button.
Next is speech testing. You will listen to a series of one and two syllable words at different volumes and be asked to repeat the words. This will determine the level at which you can not only detect, but understand speech. Another test that may be conducted is a speech in noise test. This test will determine how well you hear sentences in a noisy environment.
The results of your tests will be recorded on a form called an audiogram, which the audiologist will review with you. The audiogram reflects your hearing loss in frequencies and decibels. You will be shown the type, pattern and degree of hearing loss. Your audiologist will then relate these results to your concerns about your hearing. The audiologist will then discuss treatment recommendations with you and your family member and make the appropriate referrals regarding treatment.
A NOTE ON TESTING INFANTS AND CHILDREN UNDER 5 YEARS OLD
Unlike adults and children over the age of 2, infants and very young children (birth to age 2) do not have to be awake during assessment. It is very common for parents to wake their child up when bringing them into the office however we ask that you try and keep your infant asleep when bringing them into the office. Allow them to sleep in their carrier if possible and do not try and wake them prior to seeing the audiologist. They do not actively participate in testing and should be sleeping during assessment. The quieter the infant the quicker the testing can be done. Testing of an infant involves placing small probes into the ear canals (completely painless and harmless) and measuring responses from the auditory system.
Children age two to five are asked to be awake since their participation in testing is important. If they are willing to wear headphones or insert earphones then testing is similar to adults. At times when they are unable to wear headphones they are tested similar to infants. They will also be placed in the booth and listen to sounds through speakers. The most common problem we face in testing young children stems from the parents trying to comfort their child by saying “It’s not going to hurt.” We ask that all parents refrain from saying this phrase or implying any type of physical pain could occur when visiting our office. Everything we do is painless. When children hear the phrase “It’s not going to hurt” it usually means the exact opposite (such as when it is time for shots at the pediatrician’s office). If you want to instruct your child prior to their visit, say things like “You’re going to play a listening game” and “They’re going to take pictures of your ears with a camera.”
You can play out the actions of what we are going to do by gently pulling on the earlobe and pretending to look down in their ear. You can make sounds such as beeps and clicks and ask them to repeat words back to you or point to body parts. The more fun you imply it is the less chance that your child will have significant anxiety when he or she is seen. Also you are desensitizing your child to someone touching their ears which helps when we are trying to complete assessment of their hearing.