Understanding your Audiogram

An audiogram is a graph that shows the results of a hearing test. It can help your healthcare provider figure out the cause of your hearing loss and the best way to treat it. The audiogram shows how well you hear sounds in different pitches or frequencies.

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An audiogram is a graph that shows the results of a hearing test. It can help your healthcare provider figure out the cause of your hearing loss and the best way to treat it. The audiogram shows how well you hear sounds in different pitches or frequencies. 

In this article, I'll talk about the main parts of an audiogram:

  • The audiogram itself
  • Speech reception thresholds (SRTs)
  • Word recognition scores
  • Speech in noise scores

The audiogram

You’ll see a series of X’s and O’s. The X's show how well you can hear in your left ear, and the O’s show how your hearing works in your right ear.

You can see how sensitive you are to hearing when sound is bone-conducted through your skull through the blue and red angle and square brackets. These are your conduction scores. The lower your graph markings, the louder we must play the beeps before you can hear them, and the poorer your hearing sensitivity is.

Low frequencies or pitches are on the left side, and they go up to high pitches or frequencies on the right side, just like on a piano keyboard. If the square and angle brackets are close to the X's and the O's, the damage to your hearing is inside your cochlea.

If the brackets are higher, some or all of your hearing loss is caused by sound not being able to get through your outer and middle ears.

A person can have different levels of hearing loss in each ear and even different levels of hearing loss in the same ear. As a general rule, we look at how well your air conduction and bone conduction scores measure your health. The lower the markings on this graph, the worse your hearing loss is.

You may also see a note on the audiogram that says "U." This shows the point at which sound is too loud for you to be comfortable. The lower these letters are on the graph, the more you can deal with loud sounds.

Speech reception thresholds (SRTs)

This number is found in the speech audiometry part of your hearing test. It is written in decibels, and the SRTs show the level at which you can understand speech 50% of the time.

Your hearing care professional will look at these numbers against what we call your pure tone averages. These are the 500, 1000, and 2000 Hertz average air conduction thresholds in each ear. We would expect your pure tone averages and your SRTs to be close together because it helps us ensure we get an accurate hearing test. In addition, the higher the SRT, the more likely it is that you will have a hard time understanding soft-spoken people.

Besides pure tone beeps, you may also see the terms most comfortable levels (MCLs) and uncomfortable levels (UCLs), which are meant for speech instead of pure tone beeps. These are also shown in decibels. They can help you determine which decibel levels should be used to test your word recognition scores.

Word Recognition Scores

This score tells us how well your brain can understand speech.

Look at the speech presentation level in decibels to see how well you did. You may also see a number in the "Masking" section that shows how much static sound was played into the other ear to keep that ear from helping your other ear.

It's easier to understand speech when the words used in the test are amplified to a level that overcomes your hearing loss, which is shown on your audiogram by the X's and O's on it.

You should pay a lot of attention to your word recognition score percentages because these percentages show how much benefit you can expect from hearing treatment.

Speech-in-noise score

Next, let's talk about how well your speech sounds in noise. You may see the term 'SNR Loss' displayed in your results. The more SNR Loss you have, the more trouble you should expect with background noise. It would be better if the SNR Loss were as low as possible.

A score of zero dB SNR Loss means that the level of the speech you can hear is just as loud as the background noise. You will be able to understand 50% of what is being said. If you get a higher score, such as a 10 dB SNR Loss, you'll need speech to be twice as loud as the background noise before understanding 50% of what's being said.

It's essential to know your dB SNR Loss number to determine if you need help beyond hearing aids if you want to hear well in background noise.

Understanding your audiogram will help you make the best choices for your hearing health. I hope this helps you better understand your hearing test. Take this information and use it alongside a more thorough explanation from your hearing provider.An audiogram is a graph that shows the results of a hearing test. It can help your healthcare provider figure out the cause of your hearing loss and the best way to treat it. The audiogram shows how well you hear sounds in different pitches or frequencies.

Written by
Reviewed by
Dr. Cliff Olson
Founder & Audiologist
Read full bio

Dr. Cliff Olson is an Audiologist and founder of Applied Hearing Solutions in Phoenix, Arizona. A former Marine Corps Scout Sniper, he left the military to earn his Audiology doctoral degree from the University of Illinois at Urbana-Champaign.

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