If you have recently had a hearing test, you may have received a chart filled with lines, circles, X’s, numbers, and unfamiliar terms. This chart is called an audiogram.
An audiogram provides a visual picture of your hearing ability. It shows how softly you can hear different sounds and helps a hearing care professional understand whether you have hearing loss, which frequencies may be affected, and how each ear is performing.
Understanding your audiogram results can make your hearing evaluation much easier to understand and help you have a more informed conversation with your audiologist.
What Is an Audiogram?
An audiogram is a graph that displays the results of a hearing test, usually a pure-tone hearing test or pure-tone audiometry. It measures the softest sounds you can hear at different frequencies.
The two main measurements shown on an audiogram are:
- Frequency, measured in Hertz (Hz), which represents pitch
- Hearing level, measured in decibels hearing level (dB HL), which represents how loud a sound needs to be for you to hear it
During a hearing test, different tones are presented to each ear. You respond when you hear a sound, even if it is very soft. Your responses are then plotted on the audiogram chart.
In simple terms, an audiogram answers an important question:
“How quiet can a sound be before you can hear it?”
Why Is an Audiogram Important?
An audiogram is more than just a hearing test chart. It helps a hearing professional identify patterns in your hearing and understand how well you detect different pitches.
Your hearing may be stronger at some frequencies than others. For example, you might hear lower-pitched sounds relatively well but have difficulty hearing higher-pitched sounds.
This can affect everyday communication. High-frequency hearing loss, for example, may make certain speech sounds such as S, F, SH, and H harder to hear clearly.
An audiogram can help your hearing care professional determine whether you may have:
- Normal hearing
- Mild hearing loss
- Moderate hearing loss
- Moderately severe hearing loss
- Severe hearing loss
- Profound hearing loss
The audiogram can also provide information that helps distinguish different types of hearing loss.
How to Read an Audiogram
At first glance, an audiogram chart can look confusing. However, once you understand the two axes, it becomes much easier to follow.
1. The Horizontal Axis: Frequency
The horizontal axis represents frequency, which is measured in Hertz (Hz).
Frequency describes the pitch of a sound:
- Lower frequencies = lower-pitched sounds
- Higher frequencies = higher-pitched sounds
A typical clinical audiogram may test frequencies from around 250 Hz to 8,000 Hz.
Think of the frequency scale like a piano. Lower-pitched sounds appear toward the left side of the audiogram, while higher-pitched sounds appear toward the right.
2. The Vertical Axis: Decibels
The vertical axis shows decibels hearing level (dB HL).
This is one of the most confusing parts of an audiogram because the scale works in the opposite direction from what many people expect.
The quieter levels are near the top of the chart, while louder levels appear farther down.
If your hearing threshold is plotted closer to the top, you were able to hear a softer sound. If it is plotted farther down, the sound needed to be louder before you could detect it.
What Do the O’s and X’s on an Audiogram Mean?
You may notice circles and X’s on your hearing test results.
These symbols are commonly used to show hearing thresholds for each ear.
- O commonly represents the right ear
- X commonly represents the left ear
Other symbols may be used for bone-conduction testing or other parts of the hearing evaluation.
Your audiologist uses these symbols to compare your right and left ears and identify differences between air-conduction and bone-conduction results.
What Are Hearing Thresholds?
A hearing threshold is the softest level at which you can detect a particular sound frequency during the hearing test.
For example, the audiologist may test several frequencies and gradually change the volume of the tone. Your response is recorded when you can reliably hear the sound.
Each threshold is then plotted on your audiogram.
Looking at these thresholds across different frequencies gives your hearing professional a clearer picture of your hearing sensitivity.
What Do Different Hearing Loss Levels Mean?
Hearing loss can be described according to the level at which sounds become audible.
While classification ranges can vary slightly depending on the clinical guideline being used, hearing professionals commonly describe hearing loss using categories such as normal, mild, moderate, moderately severe, severe, and profound.
Normal Hearing
Thresholds within the expected normal range generally indicate that you can detect soft sounds across the frequencies tested.
However, a person’s hearing experience should not be judged by a single number alone. The overall audiogram pattern and other hearing test results are also important.
Mild Hearing Loss
With mild hearing loss, some softer sounds may be difficult to hear.
You may notice that you:
- Ask people to repeat themselves
- Have difficulty following conversations in background noise
- Miss quiet speech
- Increase the volume on your television
Moderate Hearing Loss
Moderate hearing loss can make everyday conversations more difficult, especially when the speaker is far away or there is background noise.
You may notice that speech sounds less clear or that you frequently need people to repeat themselves.
Moderately Severe Hearing Loss
At this level, understanding normal conversation can become significantly more difficult without appropriate hearing support.
Severe Hearing Loss
Severe hearing loss means that many conversational sounds may not be loud enough to hear without significant amplification or other hearing support.
Profound Hearing Loss
Profound hearing loss involves very limited access to many sounds, even when they are loud.
The appropriate next steps depend on the individual’s hearing test results, communication needs, medical history, and recommendations from a qualified hearing professional.
What Is Pure Tone Audiometry?
Pure tone audiometry is one of the most common types of hearing testing used to measure hearing sensitivity.
During the test, an audiologist presents tones at different frequencies and loudness levels through headphones or other equipment. You indicate when you hear each tone.
The softest level you can reliably hear at each frequency is recorded as your hearing threshold and plotted on your audiogram.
This test helps create a frequency-by-frequency picture of your hearing.
What Is the Difference Between Air and Bone Conduction?
Some hearing evaluations include both air-conduction and bone-conduction testing.
Air-Conduction Testing
During air-conduction testing, sounds are delivered through headphones or earphones and travel through the outer and middle ear before reaching the inner ear.
Bone-Conduction Testing
During bone-conduction testing, a small device is placed against the bone behind the ear. Vibrations travel through the skull toward the inner ear.
Comparing these results can help a hearing professional understand the type and location of a hearing problem.
What Is a Speech Hearing Test?
A complete hearing evaluation may include more than pure-tone testing.
Speech testing can evaluate how well you detect or understand spoken words. One commonly reported measurement is word recognition, which indicates how accurately words are recognized under the conditions of the test.
This is important because hearing is not only about detecting sounds. Being able to understand speech is also an important part of communication.
Can an Audiogram Show the Type of Hearing Loss?
Yes. An audiogram can provide valuable information about the type of hearing loss.
The major categories include:
Conductive Hearing Loss
Conductive hearing loss involves problems affecting the outer or middle ear that interfere with the transmission of sound.
Possible causes can include conditions such as earwax blockage, fluid in the middle ear, or problems involving the eardrum or middle-ear bones.
Sensorineural Hearing Loss
Sensorineural hearing loss involves the inner ear or auditory nerve pathways.
Age-related hearing changes and long-term exposure to loud noise are among the factors that can contribute to this type of hearing loss.
Mixed Hearing Loss
Mixed hearing loss includes both conductive and sensorineural components.
Your audiogram, medical history, and other examination findings help your hearing professional determine what may be contributing to your hearing difficulty.
What Does an Audiogram Say About Everyday Hearing?
An audiogram provides important information, but your real-world hearing experience matters too.
Two people can have similar hearing thresholds but experience communication difficulties differently.
For example, you may have difficulty:
- Understanding speech in restaurants
- Following conversations in groups
- Hearing someone from another room
- Understanding soft voices
- Hearing children’s voices
- Following conversations when there is background noise
- Hearing certain high-frequency speech sounds
- Hearing alarms, notifications, or other everyday sounds
This is why a hearing evaluation should consider both your test results and the situations in which you experience hearing difficulty.
When Should You Get a Hearing Test?
Consider scheduling a hearing test if you notice changes in your hearing or communication.
Common signs include:
- Frequently asking people to repeat themselves
- Turning the television volume higher
- Difficulty understanding conversations in noisy places
- Feeling that people are mumbling
- Difficulty hearing on the phone
- Trouble following conversations with several people
- Feeling that one ear hears differently from the other
- Ringing or other sounds in your ears
- Family members noticing your hearing difficulty
Regular hearing evaluations can also help monitor changes in hearing over time.
What Happens After an Audiogram?
After your hearing test, a hearing professional can explain your audiogram results and discuss what they mean for your everyday hearing.
Depending on your results and individual needs, the next step may include:
- Monitoring your hearing
- Additional hearing tests
- Medical evaluation
- Hearing protection recommendations
- Hearing aids or other hearing technology
- Hearing aid programming and follow-up care
- Communication strategies
There is no single solution that works for everyone. Hearing care should be based on your hearing profile, lifestyle, communication needs, and personal goals.
At Hearing Care OC, hearing evaluations are designed to provide a clear understanding of your hearing and help guide personalized next steps. The practice provides hearing testing and ongoing care, with recommendations based on individual hearing needs and lifestyle.
Frequently Asked Questions About Audiograms
What is an audiogram?
An audiogram is a graph that shows the results of a hearing test. It displays hearing thresholds across different sound frequencies and helps identify patterns of hearing sensitivity.
What does an audiogram measure?
An audiogram primarily measures how softly you can hear different frequencies. Frequency is measured in Hertz (Hz), while hearing level is measured in decibels hearing level (dB HL).
What does 0 dB mean on an audiogram?
Zero dB HL does not mean complete silence. It is a reference level based on standardized hearing thresholds. Some people with normal hearing may have thresholds below 0 dB HL at certain frequencies.
Is a lower number better on an audiogram?
Yes, generally a threshold closer to the top of the audiogram means that a softer sound was detectable. However, audiogram interpretation should consider the complete pattern rather than one number alone.
Can an audiogram show hearing loss in one ear?
Yes. The right and left ears are tested and plotted separately, allowing a hearing professional to identify differences between the ears.
How often should I get a hearing test?
The appropriate frequency depends on your age, hearing history, symptoms, noise exposure, and individual risk factors. If you notice a change in hearing, difficulty understanding speech, or other hearing concerns, a hearing evaluation can help determine what is happening.
Conclusion
An audiogram is an important part of understanding your hearing health. Although the chart may initially look complicated, it provides useful information about how well you hear different pitches and how much sound is needed for you to detect them.
By understanding the frequency scale, decibel levels, hearing thresholds, audiogram symbols, and hearing loss ranges, you can better understand your hearing test results and discuss them with your hearing care professional.
Remember that an audiogram is only one part of a complete hearing evaluation. Your symptoms, communication difficulties, lifestyle, medical history, and individual goals are also important when determining the right approach to hearing care.
If you are experiencing difficulty hearing conversations, frequently asking others to repeat themselves, or simply want to understand your current hearing health, a professional hearing test can provide helpful answers.
Hearing Care OC provides personalized hearing testing and hearing care in Tustin, Orange County, with clear explanations of results and ongoing support designed around each patient’s needs.
Ready to understand your hearing better? Schedule a hearing consultation with Hearing Care OC and take the next step toward clearer communication.