Hearing tests are designed to reveal hearing loss and its progression: what you can hear and what you can’t. However, it’s becoming increasingly common that people get their hearing tested and have the results come back in normal hearing range, despite knowing that they have some difficulty hearing. What does this mean?

The Blind Spot of Pure Tone Hearing Tests
A traditional hearing test, known as a pure tone test, is conducted in a soundproof room with the patient wearing headphones. A series of beeps will play through the headphones, and the patient indicates, either by raising their hand or pushing a button, when they hear a beep. These beeps are played at varying volumes and pitches, testing the full range of pitches that the patient is capable of hearing.
What this test is good for is discovering what your ears can pick up, process and relay to the brain’s auditory processing center. What it misses, however, is the auditory complex’s ability to synthesize and perceive the sounds sent to it by the ears.
What Is Hidden Hearing Loss?
Hidden hearing loss, or HHL, is a relatively new term. It describes a form of hearing loss that is not detectable on a traditional hearing test, because the ears themselves function well and can pick up and send the sound information. It is the auditory processing center that then struggles to process the sound correctly.
Symptoms of HHL include:
- Hearing the words spoken in a conversation, but feeling confused or foggy about what is being said.
- Getting easily distracted by background noise.
- Feeling overwhelmed when having a conversation in a noisy setting.
- Misunderstanding speech often.
- Frustration or fatigue after a conversation or a long period of listening.
Perhaps these symptoms lead you to get a hearing test, but the results come back in the normal range. In that case, you could have HHL.
Hearing Tests for Hidden Hearing Loss
Pure tone hearing tests are the most used hearing tests, but they’re not the only type of hearing test out there. A different kind of hearing test is perfect for detecting HHL, and that test is called the speech-in-noise test. This test also makes use of a soundproof room and a pair of headphones, but these tests simulate real-life listening scenarios, instead of beeps.
A speech-in-noise test will play audio of speech, and the patient will repeat back what was said in the audio. This speech will be played over various types of background noise at varying volumes, testing the patient’s ability to parse auditory information in complex listening situations.
If you’re interested in learning more about HHL or hearing tests, contact Gary D. Schwartzberg, Au.D., Doctor of Audiology. We would be happy to give you more information and schedule an appointment for a hearing test.