Is there a Difference Between Hearing Tests and Hearing Screening?

There comes a point in many people’s lives where they believe they may be hard of hearing. In fact, nearly one-third of all adults over the age of 65 develop hearing loss [1]. Even when you look at the US population that is over 12 years old, nearly 1 in 5 has some degree of hearing loss [2]. With numbers such as those, healthcare professionals and all people alike should be precautious in protecting their hearing. At some point, everyone will likely take some sort of hearing exam or screening, and it’s important to know what you’re getting.

Hearing screenings and hearing exams are not the same. You should know the goals of a hearing screening vs hearing tests that way you can be confident you’re appropriately approaching potential hearing loss.

What is a Hearing Screening?

 Hearing Screening

When someone is given a hearing screening, the healthcare professional is looking to see whether or not the test subject has any sort of hearing impairment.

The screening only has two results—pass or fail. If you pass, that means your hearing is just fine. If you fail, that means you may have some degree of hearing impairment, but it is also not certain. When you fail a hearing screening, you’ll likely have to undergo more thorough hearing tests to determine if you have a condition.

A hearing screening typically entails the patient being played a series of sounds—they may be beeps, tones, or ringing sounds. The whole process is painless and easy for all age groups. The screening looks to see how well a patient can hear the sounds played.

Typically, they’re played at different decibel levels to test your hearing capacity, and at different frequencies to see if you can hear the standard frequency range of sounds. A standard hearing screening usually only takes a few minutes.

Who Should Get a Hearing Screening

People of all ages should get a hearing screening if they believe they may have issues with hearing. Beyond that, most babies will receive a hearing screening before are even 1 month old. From there, children will likely receive hearing screenings at school. Typically, a child should receive a hearing screening every 2 years.

If a baby or child does not pass a hearing screening, they should undergo further testing as soon as possible. Hearing impairments can worsen with time, so getting them checked early is key to improving their condition.

For adults, the American Speech-Language-Hearing Association recommends getting a hearing screening every 10 years, until you are 50 years old. Once you reach 50, the organization recommends getting tested every 3 years, as hearing loss can come quickly and is more likely to present itself later in life. To get a hearing screening, you can ask your doctor or find a local health center that performs them.

What is a Hearing Test?

audio test

A hearing test is an examination that looks to uncover further information about your hearing and history. Hearing tests are conducted by licensed audiologists or hearing instrument specialists.

These experts will review your history, background information, and more before giving you any actual tests. As a patient who has undergone a hearing screening, and been told you need further testing, you may receive various types of hearing tests such as the following.

Speech Testing

When someone takes a speech test, they will be listening to spoken words, likely through a pair of headphones, and asked to repeat them. Throughout the test, these spoken words will become quieter.

The audiologist given the test will record what sound levels of speech you can hear and still repeat correctly. These tests may be given in either loud or quiet environments to represent different environments where one normally listens to speech.

Auditory Brainstem Response

Much different than a speech test, the auditory brainstem response (ABR) tests how well the components of your inner ear can communicate with your brain. The test is performed by the patient having electrodes on their head. As various sounds are played to the patient, the audiologist will monitor the resultant brain activity.

This sort of test requires zero involvement by the patient, as their inner ear and brain do all the work. The results of the test may indicate whether a patient has a hearing disorder that stems from the auditory neural pathways.

Otoacoustic Emissions


Another test that requires zero involvement from the patient is an otoacoustic emissions test or an OAE. When someone receives an OAE, they will have an earphone placed inside their inner ear. This will play sounds in the inner ear and measure the resultant sounds that come back.

The goal is to determine whether the inner ear responds correctly to the sounds by giving off otoacoustic emissions. If a subject has hearing loss, they will not produce the OAEs that an audiologist expects from someone with normal hearing.

Middle Ear Test

To hear and process sounds, all parts of your ear must work in conjunction with each other. That includes the middle ear. An audiologist may perform a variety of middle ear tests, including tympanometry, acoustic reflex measures, and static acoustic measures. Tympanometry will test how well your eardrum moves in response to air pushed into your ear.

The acoustic reflex test checks the reflex of a muscle within your inner ear in response to the loudness of sounds. A static acoustic test will measure how much air is inside the ear which may correlate to a hole in the eardrum or fluid stuck behind the eardrum.

Who Should Get a Hearing Test

Anyone who has not passed a hearing screening should receive a hearing test. However, which test one takes is determined by an audiologist. Before someone can be properly diagnosed, they may even take multiple hearing tests as each test finds different information about one’s condition.

The Bottom Line

Hearing screenings and hearing tests are both vital in determining if someone has a hearing impairment. Most people who believe they may have trouble with hearing will likely receive a screening before they get a hearing test. From there, an audiologist will help direct each patient on the best course of action to take. That way, each patient will be set up for success.

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