This is where we separate a real diagnostic evaluation from a screening. You go through a comprehensive selection of evaluations, not just a single “beep” test.

Step 7: Tympanometry & Acoustic Reflex Testing

Here, we measure the mobility of your eardrum and the pressure in the middle ear. This takes about 90 seconds and tells us whether there's fluid, a perforation or a dysfunction with your Eustachian tubes.

We also assess your stapedius muscle reflex, which is a tiny muscle in the middle ear that contracts in response to loud sounds. Abnormal results can signal issues anywhere from the middle ear to the auditory brainstem. This helps rule out retrocochlear pathology.

Step 8: Pure Tone Audiometry: Air Conduction

You'll sit in our sound-treated booth and respond to tones presented through headphones at different pitches (frequencies) and volumes. This maps out the softest sounds you can hear at each frequency, producing the classic "audiogram." Your hearing is evaluated from 250 Hz (low pitch) to 8000 Hz (high pitch), which encompasses the full range of speech and beyond.

Step 9: Pure Tone Audiometry: Bone Conduction

Instead of headphones, a small vibrator is placed behind your ear that sends sound directly through the skull to the inner ear, bypassing the outer and middle ear entirely.

Comparing air and bone conduction results tells us where in your auditory system the problem lies: the outer/middle ear (conductive loss), the inner ear/nerve (sensorineural loss) or both (mixed loss).

This distinction is clinically essential to understanding your unique hearing loss challenges.

Step 10: Speech Recognition Threshold (SRT)

You are presented with two-syllable words at decreasing volumes and asked to repeat them; this confirms the accuracy of your pure tone results and gives us a real-world reference point for your hearing health.

Step 11: Word Recognition Score (WRS)

You are presented with a list of single-syllable words at a comfortable listening level and score how many you can correctly identify.

This is one of the most important assessments we run, as two people can have identical audiograms but wildly different word recognition scores. Someone with a 70% score will experience hearing aids very differently than someone with a 95% score.

This shapes our entire recommendation for your hearing health.

Step 12: Speech-in-Noise Testing (When Indicated)

Hearing in a quiet booth is only part of the story. Most people with hearing loss struggle most in environments with background noise, like restaurants, family gatherings, meetings or busy stores.

In this assessment, speech is presented while background noise is played at the same time, and you repeat the words or sentences you hear. This allows us to measure how well your brain can separate speech from noise.

The results help us understand real-world listening difficulty and are extremely useful when determining whether hearing technology (and which features) may provide meaningful improvement to you.

Step 13: Uncomfortable Loudness Levels (UCL)

This assessment helps determine the level at which sounds become uncomfortably loud for your ears, which is critical for hearing aid programming, as it reveals the full dynamic range of your hearing, not just the bottom of it.