If you are an adult and you have trouble hearing, what ever does “passing” a hearing test mean? I’ll tell you – It means you have passed or failed a screening test which compares you hearing with that of a set of young people picked as “the norm”.

A hearing screening test, listening to pure tones, might only take 5 minutes, may not be under calibrated conditions and may not test at many frequencies. A proper hearing evaluation which quantifies and explains your difficulties can take more like an hour, and will give you some answers, not a pass/fail. If you have difficulty hearing, then you have difficulty hearing – you and your friends, family and colleagues already know that. Ah, but you want to know why, and how well you compare with other people. That’s different.

There is a test called an audiogram that compares your hearing with that of a large number of “normals”. If the test is accurately carried out you will be given a graph, which shows you how well you can hear (in decibels of loss) compared with this group. Even the most normal ear is more sensitive to sounds of some pitch than others, but the audiogram compares your hearing at different pitches to a straight line. This is because it is comparing you to the average threshold at the different pitches, and this average is drawn as the zero line. It’s measured in decibels Hearing Level (dB HL). Many of my readers will know that, in relation to sound measurements, dB’s record the relationship of the measured sound pressure, compared with a reference sound pressure, expressed as a logarithm, and multiplied by 20 (i.e. 20 log₁₀ P-Pref/P). This measurement has a somewhat limited relationship with hearing and understanding speech, which relies on the ability to interpret the sounds and understand them, which depends on all sorts of other things, that aren’t measured by an audiogram.

I’m not against using audiograms. An audiogram is  a good starting point for finding out why you have hearing loss, and a fail on a screening test should be followed up.  I do caution against using a pass fail approach to a fifteen minute screening test, and of doing nothing more if you find you pass, if you know you have problems. I will write more on this with respect to children, and for people having screening tests as part of their workplace checks.  Screening tests do have their place.