Finding Care
LSTN Editorial Team · Editorially overseen by Dan McCoy
If you haven't been to an audiologist before, not knowing what happens makes it easier to put off. A first appointment takes 60-90 minutes and follows a predictable structure. Here's exactly what happens, so you can walk in prepared rather than anxious, and leave knowing what your results actually mean.
Bring a list of current medications, particularly any you know are on the ototoxic medication list. Document your hearing history: when you first noticed changes, which environments are most difficult, whether tinnitus is present, how long it's been present, and whether it's in one ear or both.
Note your noise exposure history, both occupational and recreational. Decades of noisy work environments, military service, regular concert attendance, or years of high-volume earbud use are all relevant clinical history.
Consider bringing a family member or close partner if one is available. They often have observations you don't: specific situations where they notice your difficulty, how frequently they're asked to repeat themselves, or changes they've observed over time. This information changes the clinical picture.
The appointment typically begins with a detailed case history. The audiologist will ask about onset and progression of hearing changes, which environments are most challenging, tinnitus characteristics, history of ear infections or surgeries, family history of hearing loss, occupational noise exposure, and current medications.
Be specific about the situations that are difficult. 'I have trouble hearing' is much less useful than 'I can follow one-on-one conversations in quiet rooms, but I lose conversations completely when there's background noise, more than two people talking, or when I can't see the speaker's face.' That specificity helps the audiologist design the evaluation and interpret results in context.
You'll likely complete a brief self-report questionnaire about your communication difficulties. Common ones include the HHIA (Hearing Handicap Inventory for Adults) or a communication needs assessment. These aren't tests. They capture functional impact, which the audiogram alone doesn't measure. My front office team would coach patients on this before they went in: be specific. 'I struggle at restaurants' is less useful than 'I lose conversations when there are two or more people talking and any background noise at all.'
Before any hearing testing, the audiologist will examine each ear canal with an otoscope. They're looking for: cerumen (earwax) buildup that could occlude the ear canal and affect test accuracy, signs of infection or inflammation, eardrum integrity and mobility, and anything that would indicate a medical referral before proceeding.
If significant wax is present, the appointment may be rescheduled pending clearance, or the clinic may have a process for removing it before proceeding. Don't use cotton swabs to 'prepare' your ears. This typically pushes wax deeper.
Tympanometry is often performed as part of the battery. This places a small probe in the ear canal and measures eardrum movement in response to pressure change. It assesses middle ear function: whether fluid is present, whether the eardrum is moving normally, and whether the ossicular chain (the three small bones of the middle ear) is functioning. It takes about 30 seconds per ear.
You'll be seated in a sound-treated booth wearing headphones. The audiologist will present tones at different frequencies and volumes. Your job is to respond every time you hear a tone, even if it's very faint, either by pressing a button or raising your hand. This generates your audiogram.
After pure-tone testing, speech discrimination testing measures how clearly your auditory system decodes speech. The audiologist presents recorded words at a comfortable volume and asks you to repeat each one. Your score (the percentage repeated correctly) reflects how well your auditory system processes speech, not just how loud sound needs to be.
Together, these tests answer two different questions: what can you detect (audiogram) and how well do you understand what you detect (discrimination score). Both are needed for a complete clinical picture.
After testing, the audiologist will walk you through your audiogram, explain what the results mean in practical terms, and make clinical recommendations. These might range from monitoring only (for mild or borderline findings), to medical referral (for asymmetry, sudden change, or other red flags), to hearing aid evaluation.
If hearing aids are recommended, this is typically a separate appointment for fitting, not the same day. Take the evaluation results away and give yourself time to process them before making a device decision.
Ask questions. Good ones include: What type of hearing loss is this? Is it likely to progress? What can I expect in terms of daily impact? What are my options, and what are the tradeoffs between them?
Common Questions