Hearing Assessments

Hearing Assessments:

If you have never visited a hearing care professional, you probably don’t know what to expect. You are in for a pleasant experience that is interesting, informative and a great start on your path to better hearing. You will have the opportunity to better understand your hearing needs and explore possible solutions.

Curt Culford, M.Cl.Sc. Aud, Registered Audiologist, is the sole clinician at Culford Family Hearing. Curt performs all hearing assessments and will go over the results with you afterward. Below is an outline of what to expect at your hearing assessment.


What’s involved: Once you arrive for your visit, I will sit down with you to discuss your hearing history to better understand what issues you may be having. This case history will investigate what may have influenced or contributed to your current hearing status. It is helpful to speak of certain instances where you may have hearing difficulty, for example not hearing certain family members clearly, or trouble hearing in certain settings or places (church, restaurants, gatherings, etc.). By knowing where your difficulties lie, we can establish goals on how to best to tackle them.

In addition to the case history, I will conduct a hearing assessment. The first step includes looking in to the ear canal with an otoscope to determine the physical condition of the ear canal, such as if there is a wax blockage. I also have a video otoscope which can be used with my laptop to provide a real-time image on the screen for you to see. You will be able to see what I am seeing!

After the visual inspection, I will then do an automated test, typically called a “tymp test”, “middle-ear test”, or “pressure test”. I insert a soft tip into the ear that emits a low humming sound and very briefly inserts air pressure into the ear canal. This allows me to see how well the eardrum is moving and can give insight on the physical movement of the middle ear bones. I may also present some beeps to take an automatic reflex measurement.

The main part of the hearing assessment takes place in a large, comfortable sound booth. It is here where we find out how well you are hearing by measuring the softest sounds you can hear. I put earphones into both ears and instruct you on how to respond. Many different frequencies, or pitches, will be presented but the object will be same each time: to click a button when anytime you hear a “beep”. We also do word testing, where you repeat words at different sound levels.

Once we have completed all the tests, I will go over the results with you. I will explain what they mean and tell you if there is a hearing loss. We can then explore options to help remedy the situation. For many hearing losses, this can include hearing aids.
The whole test process and discussion of the results usually takes about an hour. Most people find it helpful to bring a family member, spouse, or friend with them to the appointment. You will typically get more out of the visit if someone close to you can share in the experience. It also gives me added insight to learn about your hearing abilities from someone close to you.


The procedure for children’s hearing assessments is similar to that of an adult assessment. I gather information from the parent or guardian, and the child themselves depending on their age, to investigate any issues the child may be having. Depending on the issue, the test procedure may be modified, such as the order in which I complete various tests. For example, I may do a pressure test after looking in the ear, or I may start with testing the hearing in the sound booth. Often, how the child is feeling can direct how the test will unfold.

Depending on the age of the child, there are different methods of testing available. For infants and very young children (6 – 24 months) I can test their hearing using specialized equipment, called VRA – Visual Reinforcement Audiometry.

For older children, from 2 or 3 years to 4 years, I can test by a method called CPA – Conditioned Play Audiometry. I condition the child to throw an object in a bucket when they hear a sound. As children of this age usually do not tell you reliably when they hear a sound, the conditioned response is a more reliable way of obtaining responses. It can be a fun activity for the child as it is less of a ‘test’ and more like a game.

School-aged children can typically follow the instructions of an adult test and can respond reliably during the test.

Each test method can be modified based on the abilities or needs of the child. Some children may be shy or scared so there are times when we are unable to complete a test or get accurate results. In these situations, it is recommended to try again another day. At home, the parent can practice the test procedure with the child to help warm them up to the task.

Ear infections are a common cause for a hearing test in children. Due to the physical structure of their ears and eustachian tube, many children are at greater risk of developing ear infections compared to adults. Even with an ear infection or fluid behind the eardrum, we can perform a hearing test to find out if it is impacting the child’s hearing. We will then have a baseline that can be used to measure improvement. After treatment of the ear infection by the family doctor, we can do a no-charge follow-up test within a month to see if things are improving. We can then make appropriate recommendations based on the results.

It is important to note, OHIP does not cover hearing tests for any age; there is a fee for children’s assessments. Some private insurances may have coverage but it is best to contact the insurance company directly to inquire as plans vary.