Hearing Evaluations

What a hearing evaluation is

A hearing evaluation goes well beyond a quick screening. Instead of a simple pass or fail, it maps how each ear hears across the full range of pitches, how clearly you understand speech, and how your ear canal, eardrum, and middle ear are working.

That complete picture matters because hearing loss comes in different forms. Some hearing loss is conductive, meaning sound is being blocked on its way in, for example by earwax or fluid behind the eardrum. Some is sensorineural, meaning the inner ear or hearing nerve has changed. That’s the most common type with age and noise exposure. Some people have a mix of both. Each type points to a different next step, so we test carefully before recommending anything.

Signs it’s time for a hearing test

Most people come in because something has changed, even if it’s subtle. Common reasons include:

• Asking people to repeat themselves, or feeling like others mumble
• Struggling to follow conversation in restaurants or groups
• Turning the TV up louder than others want it
• Ringing, buzzing, or hissing in your ears
• A plugged or muffled feeling that doesn’t go away
• Family or friends mentioning that you seem to miss things

We walk through these in more detail in 7 signs it’s time for a hearing test. You don’t need a specific complaint to book, though. A baseline test is useful even when things seem fine, because it gives you something to compare against later.

If your hearing drops suddenly, especially in one ear, don’t wait for a routine appointment. Contact a doctor or audiologist the same day.

What to expect at your visit

A full evaluation takes about 60 to 90 minutes. Here’s how it usually goes.

1. A conversation about your hearing

We start by talking. We’ll ask what you’ve noticed, which situations are hardest, and about your health history, medications, and any noise exposure from work, music, or hobbies.

2. A look in your ears

Using an otoscope, we check your ear canals and eardrums. Earwax blocking the canal can affect your results, so it may need to be cleared first. Our Earigator earwax removal service is a gentle way to do that.

3. Tone testing

Wearing headphones or soft earphones, you’ll listen for a series of beeps at different pitches and volumes and signal each time you hear one. This pure-tone air conduction testing finds the softest sound you can hear at each pitch.

We also do bone conduction testing, using a small headband that sends gentle vibrations directly to the inner ear. Comparing the two results tells us whether a hearing loss is coming from the outer or middle ear, the inner ear, or both.

4. Speech testing

Real life is about understanding words, not beeps. You’ll repeat words presented at different volumes so we can measure how clearly you understand speech. For many people, that’s the result that matters most in daily life.

5. Additional tests when helpful

Depending on what we find, we may add tympanometry, which uses gentle air pressure changes to check how your eardrum moves, and otoacoustic emissions, which measure tiny sounds your inner ear makes in response to sound. Neither requires you to do anything but sit still.

6. Going over your results

Your results are plotted on an audiogram, a chart of your hearing across pitches. We’ll explain it in plain language, answer your questions, and talk through what comes next.

How to prepare

• Bring your medication list and any past hearing test results you have.
• Bring a partner or family member if you can. Their view of where listening gets hardest is valuable.
• Avoid loud noise the day before if possible, such as concerts or power tools, since it can temporarily affect your hearing.
• Let us know if you have a cold or ear infection, since it can change your results.

Our approach at Alexander Audiology

Our practice is led by Dr. Melissa Alexander, Au.D., CCC-A, who has cared for hearing-impaired patients across Southern California since 2010 and is certified by the American Board of Audiology. She earned her doctorate at Rush Medical Center in Chicago and completed her residency at West Coast Hearing and Balance in Thousand Oaks.

Our goal is understanding, not selling. Once we have your full diagnostic profile, we discuss your options openly, with no pressure and no upsell. For some people the answer is simply keeping an eye on things. For others it’s hearing aids, tinnitus treatment, earwax removal, or custom hearing protection to preserve the hearing you have.

After your hearing test

Hearing changes over time, so your first evaluation becomes your baseline. We’ll recommend when to come back based on your results. If you decide to move forward with hearing aids, your evaluation guides every part of choosing and programming them.

Book a hearing evaluation

Whether you’re on the Westside of Los Angeles or in the Santa Ynez Valley, book a hearing evaluation at our Santa Monica or Solvang clinic. It’s one appointment, and you’ll leave with a clear picture of where your hearing stands.