Questions about the Test Results
What kind of results do I get?
You will be told the individual results for your right ear and your left ear in the following terms: within the “Normal Range” or “Slightly Below” or “Substantially Below Normal.”
Why aren’t the results given in comparison with people in my age group rather than compared to the sensitivity of young adults with normal hearing?
As the question implies, the hearing of average adults becomes less sensitive as they age. In a recent review of studies of presbycusis, the technical name for age-related hearing loss (http://www.uptodate.com/contents/presbycusis), it is reported that:
The prevalence of hearing loss increases with age, with up to 80 percent of functionally significant hearing loss occurring in older adults. In one population cohort in the United States, the prevalence of hearing loss (defined by audiometry) increased steadily with age:
- 11 percent ages 44 to 54
- 25 percent ages 55 to 64
- 43 percent ages 65 to 84
The results of the screening test are intended to measure how much difficulty a person will have in hearing speech and other sounds that they want to hear, not how they compare to others their age. Whether you are 40, 60 or 80 you will have similar hearing problems if you have, for example, a 40-decibel hearing loss in the range of speech. Of course how you hear compared to others your age might help an audiologist or physician specializing in hearing understand the cause of your loss.
Why were my NHT results different from those obtained by my audiologist?
It is our goal to maximize the accuracy of the National Hearing Test. However, all screening tests are imperfect and will be wrong some of the time. That is why we tell everyone who takes the test that, regardless of the results, they should see a hearing professional if they are concerned about their hearing. We have worked hard to make this test as good as a telephone hearing screening can be, but the test results can vary for a variety of reasons. Some people will not always be correctly categorized as either within the normal range or below the normal range.
Hearing loss varies continuously from 0 to more than 100dB, and we try to provide a meaningful score by telling the caller where his or her performance lies relative to two boundaries, roughly 25 and 35 dB. If your hearing loss is quite close to one of those boundaries, successive measures can easily put you on one side one time and the other side the next.
This article, in which the NHT was used on over 1000 veterans’ ears, and its results compared to the traditional pure-tone tests used in hearing clinics, may be of interest to you. The study shows that the NHT is quite good and explains how we evaluate the accuracy of the test.
When do I get the results of my hearing screening?
You will receive your results immediately after the hearing screening. As soon as both ears have been tested, the results will be reported to you over the telephone. You will be told the individual results for the right ear and the left ear. Please have pen and paper handy to write down the results.
What sorts of hearing problems does the National Hearing Test detect?
The National Hearing Test is designed to measure functional hearing ability, specifically the ability to understand speech in the presence of interfering noise. This ability is impaired in persons with the most common form of hearing problem, often referred to as sensorineural hearing loss or presbycusis. It is the hearing problem that is most common in persons above middle age, especially in males, but also in females.
What sorts of hearing problems does the National Hearing Test NOT detect?
Screening tests of the type used in the National Hearing Test might not detect conductive deafness. In this disorder, nerves of the inner ear are healthy, but sound energy cannot reach them due to a problem in the ear canal or in the middle ear. There are also rare but serious conditions, such as acoustic neuromas (tumors on the eighth cranial nerve), that might not be detected by a functional screening test. If you have conditions such as dizziness, tingling sensations in your face, headaches, or ringing in your ears that seem to be associated with a hearing problem, you should definitely see a doctor. The incidence of acoustic neuromas has been estimated to be under one in ten thousand adults, perhaps as rare as one in one hundred thousand, but persistent symptoms including those listed should not be ignored. Therefore, if you suspect you have a problem with your hearing even though you passed a screening test such as the National Hearing Test, you are strongly encouraged to visit a certified audiologist or other hearing specialist for a more complete hearing assessment. If you believe you have a hearing problem, the odds are that you are right.
What is the difference between a hearing screening and a full-scale hearing evaluation?
The National Hearing Test is a hearing screening test, designed to provide a quick, preliminary check of your hearing to see if you should seek a more complete evaluation. A full-scale hearing evaluation is much more involved and is administered by a certified or licensed hearing professional. A complete hearing evaluation might start with taking your case history and doing a visual examination of your ear canal by means of an otoscope. After that, a selection of tests is used to determine the specific nature of your hearing problem. The procedure used depends in part on your age and other factors. The evaluation might entail a series of tests, such as pure-tone testing, speech-recognition testing, middle-ear testing, auditory brainstem testing, and/or otoacoustic emissions testing, as determined by your audiologist. Treatment options, if needed, will also be discussed with you by your audiologist, including but not limited to hearing aids.
Does the test take into account wax in my ears?
No, it does not. If you are concerned about ear wax, you should consult your physician or an audiologist. Hearing loss caused by excessive ear wax is a form of conductive deafness. Note that the National Hearing Test is not designed to detect conductive deafness; it is primarily designed to detect hearing loss that occurs with age or as a result of exposure to intense noises.
Questions about How to Pay for and Take the Test
How do I pay for the screening?
To pay for the test, go to the Directions page. Online purchases of the test require a credit or debit card.
How do I get my unique Access Code to take the screening?
Once you have paid for the test, you will immediately receive your Access Code. To pay for the test, click here. Right after you have paid, your Access Code will appear.
How do I enter my responses to the test?
After you hear a three-digit sequence, please use the keypad on your telephone to enter the digits.
How long does the hearing screening take?
It should take about four minutes for each ear.
The test said my Access Code was invalid when I tried to use it a second time. Why?
An Access Code is good for only one test. If you want to take the test a second time, you must pay for it again. To pay for another test, go to the Directions page. If you believe that your test was improperly terminated or for some reason you were not given your test results, please send us an email at firstname.lastname@example.org. Include the Access Code you used so we can check your test results. You will be sent your results by email or, if there was an error in the administration of the test, you will be sent another Access Code without charge.
Why is there an $8.00 charge for the National Hearing Test?
The National Hearing Test is provided on a nonprofit basis. It has no financial connections with any hearing products or services. (Free tests are typically offered by organizations selling hearing aids or providing services for a fee.) The $8.00 fee helps defray the costs of making it widely available to the public and processing test data; any remaining money goes to support further research on hearing loss.
Is it okay to use a cell phone?
For the most reliable results, we recommend that you do not. Cell phones often have poor or unreliable connections that introduce unpredictable amounts of distortion. Failing the test on a cell phone would not be a clear indication of a hearing problem.
What kind of phone should I use to take the hearing screening?
It is best to use a telephone that plugs into a wall-mounted jack and has a corded handset, as this offers a better and more consistent sound quality than cell phones. Having the keypad on the telephone base avoids the awkwardness of using the receiver for both hearing and entering the numbers you hear. If you do not have access to a telephone with a corded receiver, be sure your telephone is providing clearly audible sound that is free of noise or distortion. Note that the National Hearing Test was standardized for use with wired landline telephones. The sound quality of other types of phones may not be good enough for proper testing and may adversely affect test scores.
Why should I take the test in a quiet location?
Even though a room may seem quiet enough for a phone conversation, background noises can interfere with your ability to hear the sounds and concentrate on the test. Even an occasional noise can be distracting enough to affect the results. So please find a very quiet room where noise and other distractions are minimized. This will reduce the chances of getting invalid test results.
Why do you want to know my age and sex?
This is solely for research purposes by the hearing scientists who have been involved in the research and development of the National Hearing Test. The information will not be shared.
Questions about Who Should Take the Test
I already wear hearing aids. Can I take the test?
If you have a question about the effectiveness of your hearing aids, we recommend that you consult a certified hearing professional. Of course, you could take the test if you remove your aids; however, it is unlikely that you will learn anything from a screening test that you do not already know.
Can children take the National Hearing Test?
The National Hearing Test has not been validated for use by children. If you have concerns about your child’s hearing, we strongly recommend that you consult a certified hearing professional as soon as possible. It is very important to deal with a child’s hearing problems as early as possible because hearing difficulties can profoundly affect a child’s development in many different ways. Language and cognitive development might be significantly delayed by hearing impairment.
Questions after Taking the Test
What should I do with the results?
If your hearing screening indicates that your hearing is not normal, you should have a complete hearing evaluation by a certified hearing professional. If your results are in the “Normal” range but you still have concerns about your hearing, we encourage you to seek a complete hearing evaluation. To find a hearing professional near you, please see the directories of professionals below.
Will my health insurance pay for the test?
It is unlikely that your health insurance will pay for the test.
I can’t afford to see an audiologist or buy hearing aids. What options are there for me?
Some sources of financial assistance are discussed on a website made available by the National Institute for Deafness and other Communication Disorders. (NIDCD is a branch of the U.S. National Institutes of Health.)
How can I find a certified hearing professional in my area?
You can ask your physician or use the following directories on the websites of professional organizations that certify or license audiologists: American Academy of Audiology: Professional organization for audiologists, American Speech-Language-Hearing Association: Professional association for audiologists and speech-language pathologists, American Academy of Otolaryngology – Head and Neck Surgery: Professional organization representing medical specialists who treat disorders of the ear, nose, throat, and related structures of the head and neck.
Questions about the National Hearing Test Development and Validity
What is the National Hearing Test?
The National Hearing Test is a quick and easy-to-take screening test provided by telephone. The test presents spoken digits in a background of noise, after which the test taker enters the digits on the telephone keypad. It is an inexpensive, scientifically validated method to determine whether your hearing is within normal limits. If you fail the test, you should seek a more complete hearing evaluation. For a more complete explanation, see About the Test.
Is it safe to enter my information to your website?
Yes, the website has been made secure for credit card transactions with Authorize.net, which is a respected leader in managing online transactions. Your personal information will not be shared. Click here for our privacy and security policies.
Does the National Hearing Test have any financial connections with hearing products or services?
Unlike many free screenings, the NHT has no financial association with organizations that manufacture devices or provide clinical services for persons with hearing loss. All information is private and any revenue is used to support research on communication disorders.
Are all telephone tests of hearing reliable? How can a telephone test be any good?
All telephone tests for hearing screening are NOT the same. When telephone hearing screenings use pure tones (such as those used in hearing tests at a clinic), the loudness of the tones cannot be reliably controlled; consequently, your hearing ability cannot be properly assessed. In contrast, the National Hearing Test uses a Digits-In-Noise test (that is, spoken digits in a background of noise), which is largely unaffected by the loudness (within the typical loudness range of telephones).
What is “National” about the National Hearing Test?
It is nationally available in the U.S. in the same way that national hearing tests are provided in many other countries. The United Kingdom, Denmark, France, Germany, Poland, Switzerland, Spain, and Australia have developed and introduced their own versions of a telephone hearing screening, all using digit sequences presented in noise. These countries developed versions based on their own languages; the U.S. version uses English with a General American dialect. As in other countries, the NHT has no ties to providers of commercial hearing services or manufacturers of devices for hearing, including hearing aids. As in other countries, the NHT is provided on a nonprofit basis.
How was the National Hearing Test developed?
In 2004, hearing scientists in the Netherlands introduced the Dutch National Hearing Test, a telephone test using spoken digits in a background of white noise. Extensive research on this type of screening test has shown it to be a very good predictor of performance on a more complete battery of tests given in a hearing clinic. Because these screening tests are quick, easy, inexpensive, and valid, several other countries, including the U.S., have developed their own version. In the U.S., the National Hearing Test was developed and validated with the support of the National Institute for Deafness and other Communication Disorders of the National Institutes of Health, under Grant No. 3R43DC009719 in a collaborative effort by Communication Disorders Technology, Inc., Indiana University, and VU University Medical Center of Amsterdam.
Why is the National Hearing Test copyright held by Communications Disorders Technology, Inc.?
Communication Disorders Technology, Inc., (CDT) is the research and development company to which the National Institutes of Health awarded grants to support the creation of the National Hearing Test. The company began in 1989 and has developed products and services for persons with a range of speech and hearing disorders. CDT provides the test on a nonprofit basis, as stipulated by its award from NIH.