Hearing management

Updated 11 December 2017

How hearing is tested

When testing someone’s hearing, age is an important consideration, as is the type of hearing loss that one is testing for.


For someone of any age to hear, the ear has to change sound waves into electrical signals which the brain can interpret. This is a complex process, and any malfunction of any part of the ear/hearing apparatus can have hearing loss as a result.

Hearing tests for babies and young children

In newborn babies, when their hearing is tested, clicking sounds are played through an earpiece of headphones and the response from the inner ear and brain is measured. This test can also be used on older children who may have difficulty responding to instructions.

Read: What can be done to help kids hear?

From the age of seven months to about two-and-a-half years, visual reinforcement audiometry (a test in which a child’s ability to link a sound to a visual reward is evaluated), is used. Reducing the sound slowly will give an indication of the level at which a baby/toddler stops hearing a particular sound.

From the age of two to five, a play audiometry test is used, in which a child is given instructions through a headphone or speakers to perform certain tasks. The volume and pitch is then reduced, and it can be seen at which volume the child stops responding to instructions. A graph called an audiogram is used to show the results of this test.

Tests of the middle ear can determine whether there are blockages in the ear canal, and if so, where they are, and whether the eardrum might be perforated.

Hearing tests for older children and adults

For older children, and for adults, a pure tone audiometry test is used in which sounds are played at different tones and frequencies, and the person is asked to indicate when they are able to hear them.

Read: Hearing loss can make elderly feel more isolated

Speech tests are also used in which it is determined what the faintest speech is the person can hear – both with and without background noise. The person being tested is asked to repeat certain words or phrases.

The Otoacoustic Emissions test measures the vibration produced when the cochlea (a part of the inner ear which produces nerve impulses in response to sound vibrations) is stimulated. People who have substantial hearing loss do not produce these sounds/vibrations.

Hearing loss or difficulties can have a profound effect on anyone’s life: it can hamper development in children, and cause serious social problems or problems in the workplace for older people. It is essential to get treatment as soon as possible.

Read more:

What is hearing loss?

Symptoms of hearing loss

Types of hearing loss


National Health Service:; American Speech-Language-Hearing Association:


Ask the Expert

Hearing Expert

Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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