There are two parts to this testing: tympanometry and acoustic reflex threshold measures. 15 minutes

--For tympanometry measures, a soft plastic tip is placed in the opening of the ear canal. The machine gradually changes the pressure in the ear canal, like when you go up and come down from a mountain. The measure taken shows if your eardrum is moving normally.

--For acoustic reflex threshold measures, the same soft plastic tip is in the opening of the ear canal. Several loud sounds are presented. The examiner finds the level that makes the small ear muscle in your middle ear gently tug your eardrum

An audiometer is used to make a full set of hearing evaluation measures.

--Air conduction threshold testing: Earphones are placed on the ears and tones are presented. From ages 5 and up, clients are usually asked to raise a hand or push a button each time they hear a tone. The examiner finds the lowest intensity tones that can be heard across the frequency/pitch range important for hearing speech. These thresholds show whether there is hearing loss or not, and the degree of loss present. 15 minutes

--Bone conduction threshold testing: A small black vibrator box is placed on the bone behind the ear using a headband. From ages 5 and up, clients are usually asked to raise a hand or push a button each time they hear a beep. With this test procedure, the sound vibration bypasses the ear canal, eardrum, and ear bone chain. The examiner looks to see if hearing by bone conduction is better than by air conduction. If so, this suggests a problem in the parts of the ear that have been bypassed (ear canal, eardrum, and/or ear bone chain). 10-15 minutes

--Word recognition performance: A list of words is repeated, one at a time. The words are presented at a volume level that is judged to be loud and clear, and the client is asked to repeat each word. The examiner determines whether the percentage of words correctly identified (e.g., 70% or 92%) is related to the hearing sensitivity of the client. 10-15 minutes

--Visual Reinforcement Audiometry (VRA): This is typically used with infants, age 6 months up to age 2 ½ or 3 years. The infant or toddler is seated on a parent's lap in the sound booth. Sounds and words are presented through a loudspeaker either to the right or left side. When the child looks toward the sound, a light is turned on above the loudspeaker showing a toy and/or the toy animation is turned on. The examiner finds the lowest intensity sounds to which the child responds. ½ hour

--Conditioned Play Audiometry (CPA): This is typically used with children from the ages of 2 ½ or 3 up to 5 years of age. The child is trained to drop a block in a bucket or place a peg in a board each time s/he hears a sound or word. The examiner finds the lowest intensity sounds to which the child responds. ½ hour

Photos used by permission of Grason Stadler, Inc.