A hearing test, formally known as an audiometric evaluation, measures an individual’s ability to hear sounds across various pitches and volumes. The results are plotted on an audiogram, which visually represents the quietest sound level a person can detect at different frequencies. This examination is a proactive health measure, establishing a baseline of hearing function and identifying potential impairments before they significantly affect daily life. Because hearing loss can be gradual and often goes unnoticed, understanding the optimal times for testing is important for maintaining auditory health.
Routine Screening by Age
Hearing loss, particularly age-related loss, is a subtle process that begins long before a person recognizes communication difficulty. For adults with no noticeable symptoms and no history of noise exposure or medical risk factors, a periodic screening schedule helps monitor the slow changes in auditory function. Establishing a baseline measurement is recommended for all adults, even those in their younger years, to provide a reference point for future testing.
Individuals between the ages of 18 and 40 should consider a screening every three to five years. This interval helps to document a person’s normal hearing thresholds before age-related changes become common. For adults aged 40 to 60, the frequency should increase to every one to three years, as this is the period when subtle deterioration often begins and accelerates.
After age 60, a more frequent, often annual, hearing test is recommended, regardless of perceived symptoms. By this age, nearly 25% of people experience some degree of hearing impairment, which is linked to a decline in cognitive health and an increased risk of falls. Regular annual testing allows for the earliest possible detection and intervention, which can mitigate the broader health consequences associated with untreated hearing loss.
Warning Signs Indicating an Immediate Need
Beyond routine scheduling, certain symptoms should prompt an immediate hearing test, as they indicate a change in auditory health that requires attention. One of the most common signs is struggling to follow conversations, particularly in environments with competing background noise, such as restaurants or crowded gatherings. This difficulty often suggests a high-frequency hearing loss, making it hard to distinguish consonant sounds like “s,” “f,” and “th,” which are crucial for speech clarity.
A frequent need to ask others to repeat themselves, or the persistent feeling that people are mumbling, indicates that speech is not being processed correctly. This can lead to significant communication strain and social withdrawal. Another prominent sign is tinnitus, the perception of ringing, buzzing, or humming sounds in the ears, which often serves as an early marker of auditory nerve damage.
A behavioral indicator is the need to excessively increase the volume on the television, radio, or phone to a level that is uncomfortable for others. A sudden loss of hearing in one or both ears is a medical emergency that requires immediate evaluation by a specialist, as timely intervention can sometimes restore function. Other physical symptoms, such as ear pain, a feeling of fullness, or discharge, also warrant an immediate assessment to rule out conditions like middle ear infection or obstruction.
Special Considerations for Children
Pediatric hearing screening follows a distinct timeline closely tied to developmental milestones, with early detection being paramount for language acquisition. Universal newborn hearing screening is standard practice, typically performed before the infant leaves the hospital using objective tests like otoacoustic emissions or automated auditory brainstem response. If a newborn fails this initial screening, a comprehensive diagnostic evaluation should be completed promptly, ideally before three months of age.
Following infancy, hearing is often screened during routine well-child visits, with formal audiometry recommended at specific ages. The American Academy of Pediatrics suggests screenings at ages four, five, six, eight, and ten, as well as several times during adolescence. These periodic checks are important because hearing loss can be acquired due to illness, injury, or noise exposure, even if the initial newborn screening was passed.
Parents and caregivers should also watch for developmental red flags that necessitate immediate testing outside of the standard schedule. These signs include a child not startling at loud noises, not turning toward a sound source by six months of age, or experiencing delayed or unclear speech development. Poor academic performance, especially difficulty following instructions in a classroom, can sometimes be incorrectly attributed to inattention when the underlying cause is actually a subtle hearing problem.
Occupational and Environmental Exposure Triggers
Exposure to excessive noise in the workplace or environment creates a risk factor that requires frequent hearing tests. Workers in high-risk occupations are often required by regulatory bodies like the Occupational Safety and Health Administration (OSHA) to undergo annual audiograms. This testing is triggered when noise exposure reaches or exceeds an action level of 85 decibels averaged over eight hours. High-risk occupations include:
- Construction
- Manufacturing
- Military service
- Music performance
The annual test establishes a baseline and monitors for a Standard Threshold Shift, which indicates a measurable change in hearing due to occupational noise exposure. Beyond loud noise, some chemicals, known as ototoxicants, can also damage the auditory system; these include certain solvents and asphyxiants. Workers exposed to these substances are often advised to have annual audiograms because the combination of noise and ototoxicants has a synergistic effect, increasing the risk of hearing loss.
Medical conditions or treatments can also trigger the need for hearing monitoring. Patients receiving certain medications known to be ototoxic, such as high-dose intravenous antibiotics or specific chemotherapy drugs, require regular audiological monitoring. These tests track changes in hearing sensitivity while the medication is being administered, allowing physicians to adjust dosages or switch treatments to prevent permanent hearing damage.