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Hearing is one of the most important senses involved in communication, learning and social development. While hearing difficulties in adults may affect conversations and quality of life, undetected hearing impairment in infants and children can interfere with speech, language acquisition and overall development.
Hearing loss is not always obvious. Some children respond to loud sounds but fail to hear softer speech. Others may have hearing impairment in only one ear. Adults may gradually lose their hearing without recognising the change.
Modern audiological tests help identify hearing difficulties, assess their severity and determine whether the problem involves the outer ear, middle ear, inner ear or auditory pathways.
At Paartha – A Medical, Dental, Cosmetology and Diagnostic Centre, Vijay Nagar, Delhi, we believe that appropriate hearing assessment is an important part of preventive healthcare and child development.
Why Are Hearing Tests Important?
Hearing tests are useful for people of all age groups.
They are particularly important in:
- Newborn babies who require routine hearing screening.
- Infants and children with delayed speech or language development.
- Children who do not consistently respond to their names or spoken instructions.
- Children with recurrent ear infections or suspected middle-ear fluid.
- School-going children with learning or listening difficulties.
- Adults experiencing reduced hearing, tinnitus or difficulty understanding conversations.
- Individuals exposed to occupational or recreational noise.
Early detection allows appropriate medical evaluation, hearing rehabilitation and developmental intervention whenever necessary.
Different Types of Hearing Tests
Different hearing tests assess different components of the auditory system. The choice depends on the patient's age, symptoms and clinical requirements.
1. Otoacoustic Emissions (OAE) – Newborn and Infant Hearing Screening
OAE is one of the most useful objective hearing screening tests for newborns and young infants.
The test assesses the function of the outer hair cells of the cochlea, which is the hearing organ situated in the inner ear.
A small probe is gently placed in the baby's ear canal. It delivers soft sounds and records the tiny acoustic responses generated by the cochlea.
Advantages of OAE testing:
- Painless and non-invasive.
- No injections or sedation required.
- Usually completed within a few minutes.
- Can be performed while the baby is sleeping.
- Particularly useful for newborn hearing screening.
A result of 'Pass' indicates that the expected cochlear responses were detected. A 'Refer' result indicates the need for repeat screening or further assessment; it does not automatically establish permanent hearing loss.
An important point is that OAE does not detect every form of hearing impairment. Certain neural hearing disorders, including auditory neuropathy, may be present despite detectable OAE responses. Further testing with ABR may therefore be necessary in selected babies.At Paartha, we provide facility for OAE and BERA at our speech therapy and audiology unit
Why is newborn hearing screening important?
The first few years of life are crucial for speech and language development. Identifying hearing impairment early allows timely intervention and appropriate developmental support.
2. Impedance Audiometry / Tympanometry – Assessment of Middle-Ear Function
Impedance audiometry evaluates the functioning of the middle ear and the mobility of the eardrum.
It is particularly useful in children with recurrent ear infections, blocked ears or suspected fluid behind the eardrum.
The test involves placing a small probe at the entrance of the ear canal. Controlled changes in air pressure and a test sound are used to assess the movement of the eardrum.
It helps identify or support the assessment of:
- Middle-ear fluid (otitis media with effusion).
- Eustachian tube dysfunction.
- Abnormal middle-ear pressure.
- Eardrum mobility abnormalities.
- Certain middle-ear mechanical disorders.
Tympanometry is quick, painless and does not require the patient to respond verbally.
It is particularly useful when investigating hearing difficulties in infants and children.
3. Pure Tone Audiometry (PTA) – Measuring Hearing Levels
Pure Tone Audiometry is a commonly performed hearing test in older children and adults.
It measures the softest sounds a person can hear at different frequencies.
During the test, the patient wears headphones and listens to sounds of varying pitches and intensities. Whenever a sound is heard, the patient indicates the response by pressing a button or raising a hand.
How Is a PTA Hearing Test Performed?
The procedure is straightforward.
1. The patient usually sits in a quiet or sound-treated room.
2. Headphones or insert earphones are placed over or inside the ears.
3. The audiologist presents tones of different frequencies and intensities.
4. The patient indicates whenever a tone is heard, usually by pressing a button or raising a hand.
5. Additional testing may be performed using a bone-conduction vibrator placed behind the ear.
Bone-conduction testing helps assess how sound is transmitted through the skull to the inner ear.
The test is non-invasive and generally takes around 15–30 minutes, although the duration varies with the individual and the extent of testing required.
What Does an Audiogram Show?
An audiogram records the softest sounds detected at the frequencies tested.
The findings help the audiologist determine:
- Whether hearing thresholds are within the expected range.
- Whether hearing loss is present.
- The degree of hearing loss.
- Whether the pattern suggests conductive, sensorineural or mixed hearing loss.
The results are interpreted alongside the patient's symptoms, examination and other hearing tests.
The results are plotted on a graph called an audiogram.
PTA helps determine:
- Whether hearing loss is present.
- The degree of hearing impairment.
- The frequencies at which hearing is affected.
- Whether the pattern suggests conductive, sensorineural or mixed hearing loss.
Bone-conduction testing may also be performed to help distinguish between conductive and sensorineural hearing impairment.
The test is non-invasive and generally takes approximately 15–30 minutes, depending on the assessment required.
4. BERA / ABR – Brainstem Evoked Response Audiometry
BERA, also known as Auditory Brainstem Response (ABR), is an objective test that evaluates electrical responses generated along the auditory nerve and brainstem following sound stimulation.
Small recording electrodes are placed on the scalp, and sounds are delivered through earphones or suitable sound-delivery equipment.
The resulting electrical activity is recorded and analysed.
BERA/ABR is particularly useful in:
- Infants who cannot undergo conventional hearing tests.
- Babies with abnormal or inconclusive hearing screening.
- Children with suspected hearing impairment.
- Selected babies with risk factors for auditory neuropathy.
- Individuals requiring further assessment of the auditory pathway.
Unlike conventional pure tone audiometry, ABR does not depend on the patient indicating whether a sound has been heard.
Diagnostic ABR can also help estimate hearing thresholds.
The need for natural sleep, sleep assistance or sedation depends on the patient's age and the testing protocol.
Which Hearing Test Is Suitable for Your Child?
There is no single hearing test suitable for every age group.
Age / Clinical situation| Commonly considered tests
Newborn babies| OAE, AABR
Infants| OAE, ABR, tympanometry
Toddlers| OAE, tympanometry, age-appropriate behavioural testing
Preschool children| Play audiometry, tympanometry, OAE
Older children| Pure Tone Audiometry, impedance audiometry
Adults| Pure Tone Audiometry, impedance audiometry, other tests as indicated
The final choice depends on the child's developmental abilities, clinical history and initial findings.
Hearing Tests and Speech Delay: An Important Connection
One of the important reasons for hearing assessment in childhood is delayed speech and language development.
Children learn spoken language by listening to the sounds and words around them. Even partial or unilateral hearing impairment may affect communication in certain situations.
A child with hearing difficulties may:
- Have a limited vocabulary.
- Fail to respond consistently when called.
- Have difficulty understanding instructions.
- Mispronounce certain words.
- Appear inattentive or unresponsive.
- Experience difficulties in classroom learning.
However, speech delay is not always caused by hearing impairment.
Developmental language disorder, autism spectrum disorder and other developmental conditions may also affect communication.
Therefore, children with delayed speech should undergo appropriate hearing assessment along with developmental and speech-language evaluation.
Can Hearing Loss Be Treated?
Management depends on the underlying cause and severity.
Some forms of conductive hearing loss may improve with appropriate medical treatment of the underlying ear condition.
Other patients may benefit from:
- Cochlear implant evaluation in selected cases.
- Speech and language therapy.
- Auditory rehabilitation.
- Regular audiological monitoring.
Early identification is especially important in children because timely intervention can support communication and developmental outcomes.
Frequently Asked Questions
1. Is newborn hearing screening necessary even if the baby appears normal?
Yes. Many babies with congenital hearing impairment have no obvious symptoms at birth. Newborn hearing screening is recommended irrespective of whether the baby has apparent risk factors.
2. Is OAE testing painful?
No. It is a painless and non-invasive procedure. A small probe is gently placed in the ear canal.
3. If my baby passes OAE, does it mean hearing is completely normal?
Not necessarily. OAE is a screening test and cannot detect every type of hearing impairment. Further assessment may be needed if there are risk factors or developmental concerns.
4. Can hearing tests be performed in very young babies?
Yes. OAE and ABR are specifically useful in infants who cannot communicate their responses verbally.
5. Should every child with speech delay undergo a hearing test?
Hearing assessment is an important part of evaluating speech and language delay. It helps identify or exclude hearing impairment as a contributing factor.
6. Can middle-ear fluid affect hearing?
Yes. Fluid behind the eardrum can interfere with sound transmission and cause temporary conductive hearing loss. Tympanometry can help identify this problem.
Protecting Hearing, Speech and Communication
Hearing difficulties should not be ignored, particularly during infancy and early childhood.
A simple screening test can identify babies who need further evaluation, while appropriate audiological investigations can help adults and children understand the nature of their hearing difficulties.
At Paartha, Vijay Nagar, Delhi, we encourage parents to take hearing concerns seriously, particularly when a child has delayed speech, inconsistent responses to sounds or a history of recurrent ear problems.
Early screening. Accurate assessment. Timely intervention. Better opportunities for communication and development.
For hearing assessment and appointment enquiries, contact Paartha Diagnostic Centre, E21, Vijay Nagar, Delhi – 110009.
Hearing difficulties can develop gradually, making them easy to overlook. A hearing test can help identify hearing loss, assess its severity and guide decisions about further evaluation or management.
Pure Tone Audiometry (PTA) is one of the most commonly used tests for measuring hearing sensitivity in older children and adults.
What Is Pure Tone Audiometry?
Pure Tone Audiometry is a behavioural hearing test that determines the softest tones a person can detect at different frequencies.
Sound frequency, measured in hertz (Hz), relates to pitch. Lower frequencies correspond to deeper sounds, while higher frequencies correspond to sharper sounds.
The intensity of sound is measured in decibels hearing level (dB HL).
The results are plotted on a graph called an audiogram, which shows hearing thresholds across the frequencies tested.
What Are the Types of Hearing Loss?
1. Conductive hearing loss
This occurs when sound transmission through the outer or middle ear is impaired. Possible causes include earwax obstruction, middle-ear fluid, eardrum abnormalities and certain middle-ear disorders.
2. Sensorineural hearing loss
This usually results from problems involving the cochlea or auditory nerve. Causes may include age-related changes, noise exposure, genetic conditions and certain infections or medications.
3. Mixed hearing loss
This involves both conductive and sensorineural components.
Identifying the likely type of hearing loss helps determine whether medical treatment, further investigation, hearing technology or other interventions may be appropriate.
Who Should Undergo Pure Tone Audiometry?
PTA may be recommended for people who:
- Notice reduced hearing.
- Frequently ask others to repeat themselves.
- Experience persistent tinnitus, or ringing in the ears.
- Have difficulty understanding conversations in groups.
- Have failed a hearing screening.
- Have relevant occupational noise exposure.
- Require hearing assessment following an ear condition.
Children with speech or language delay also need hearing evaluation, although conventional PTA may not be suitable for every young child.
Depending on the child's age and developmental abilities, an audiologist may recommend visual reinforcement audiometry, conditioned play audiometry, OAE or ABR.
Can PTA Be Used for Young Children?
Yes, when a child is developmentally able to participate reliably.
Some preschool children can complete play-based hearing assessments, while older children may perform conventional PTA.
For infants and children who cannot provide reliable behavioural responses, objective tests such as OAE and ABR may be required.
The appropriate method depends on the child's age, development and clinical circumstances.
PTA vs OAE vs Impedance Audiometry
Each test evaluates a different aspect of hearing.
- PTA: Measures behavioural hearing thresholds.
- OAE: Assesses cochlear outer hair cell responses.
- Impedance audiometry: Assesses middle-ear function and, when performed, acoustic reflexes.
A comprehensive assessment may combine these tests to provide a more complete picture of auditory health.
What Happens After the Hearing Test?
Management depends on the results.
Depending on the findings, the next step may include:
- Medical assessment for a treatable ear condition.
- Additional audiological testing.
- Hearing aids or other hearing technology.
- Evaluation for cochlear implantation in selected cases.
- Further investigation of persistent hearing difficulties.
A hearing test identifies a pattern of hearing sensitivity; it does not always establish the underlying cause by itself.
Frequently Asked Questions
Is PTA painful?
No. It is a non-invasive test that involves listening to tones and indicating when they are heard.
Does PTA require injections or sedation?
No. Conventional PTA does not require either.
Can a normal PTA rule out every hearing problem?
No. Some people experience difficulty understanding speech despite relatively normal pure-tone thresholds. Further assessment may be appropriate if symptoms persist.
How often should hearing be tested?
There is no single interval suitable for everyone. Testing frequency depends on symptoms, medical history, occupational exposure and previous results.
Book a Hearing Assessment
If you are concerned about reduced hearing, tinnitus or difficulty following conversations, seek advice about an appropriate hearing assessment.
At Paartha Diagnostic Centre, Vijay Nagar, Delhi, you can enquire about available hearing assessment services and further evaluation where indicated.
Recognising hearing loss early is an important step towards protecting communication, learning and quality of life.
Frequently asked questions
Q1. What is audiometry?
Audiometry is a hearing assessment used to determine how well a person can hear sounds at different frequencies and volumes. It helps identify hearing loss, estimate its severity, and guide further evaluation or treatment.
Q2. Who needs an audiometry test?
An audiometry test may be recommended for:
Children with speech or language delay.
People who have difficulty understanding conversations.
Individuals who frequently ask others to repeat themselves.
People exposed to loud noise.
Individuals experiencing tinnitus or ringing in the ears.
Patients with suspected hearing loss or certain ear conditions.
Children who require hearing evaluation as part of a developmental assessment.
Q3. Is an audiometry test painful?
No. Routine pure-tone audiometry is non-invasive and painless. The person usually wears headphones and responds when they hear sounds.
Q4. How long does an audiometry test take?
A routine pure-tone audiometry test generally takes around 15–30 minutes, although the duration varies according to the type of assessment and the person's ability to participate.
Q5. Can audiometry be performed in children?
Yes. Hearing tests can be adapted for children of different ages. Depending on the child's developmental level, testing may involve play audiometry, visual reinforcement audiometry, or other age-appropriate methods.
Very young children or children unable to participate reliably may need objective tests such as OAE or BERA/ABR.
Q6. What is the difference between pure-tone audiometry and speech audiometry?
Pure-tone audiometry measures the softest sounds a person can hear at different frequencies.
Speech audiometry evaluates aspects of hearing for speech, such as the ability to recognise or understand spoken words.
Both tests can provide complementary information about hearing ability.
Q7. What is the difference between audiometry and an OAE test?
Audiometry generally measures behavioural hearing responses to sounds, while otoacoustic emissions (OAE) testing measures sound responses generated by the inner ear's outer hair cells.
OAE testing is useful for newborn hearing screening and for assessing cochlear function, but a normal OAE result does not rule out every type of hearing loss.
Q8. Can audiometry detect hearing loss in one ear?
Yes. Audiometry can assess each ear separately and help identify whether hearing loss affects one ear or both.
Q9. Can hearing loss cause speech delay?
Yes. Hearing loss can interfere with a child's ability to hear speech sounds and learn spoken language. Early hearing assessment is particularly important when speech development is delayed.
Q10. Is fasting required before an audiometry test?
No. Fasting is not required for a routine audiometry test.
Q11. What should I do before an audiometry test?
Follow the testing centre's instructions. Inform the audiologist or clinician about ear pain, ear discharge, recent ear infections, existing hearing aids, or previous hearing test results.
Q12. Where can I get a hearing test in Vijay Nagar, Delhi?
You can contact Paartha Diagnostic Centre, E21, Vijay Nagar, Delhi 110009, to enquire about audiometry and other hearing assessment services. Confirm the availability of the specific test before visiting.
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