Many people with sound sensitivity have great apprehension about any testing that involves presenting noise or tones or other sounds to the ears.  They have been tested before, using methods that may have caused discomfort or even pain, and these experiences have created a fear of future testing.

Hyperacusic patients require special care and considerations.  Many times, testing that may be perfectly acceptable to the vast majority of people, will cause discomfort to this group.  Many people with sound sensitivity find that presentations louder than quiet normal conversational levels are difficult to tolerate.  This means that many standard tests completed by audiologists and often physicians may create problems for this population.

Undestandably, we must assess the physiology of the person to discover any conditions that may be underlying the condition of hyperacusis.  Sometimes, we simply must cause some discomfort to find out what the situation really is, and to also see what can be done in the way of treatment or therapies.

However, there are many audiologic tests that can be avoided or changed a bit to lessen the impact of the sound upon the person's fragile physique.  All presentations of tone or noise should begin at sub threshold levels and increase from there, for example.  Sudden sound tests should begin at the lowest possible levels to avoid excessive noise levels.

Patients should be warned in advance of sound tests and carefully informed about what is to come in the procedure, and why it is happening.  Armed with information, i.e., this sound will last about 3 seconds, most patients can complete the test sequence.

All people who suspected of hyperacusis should consult an otologist and an audiologist.  The audiologist whould find the baseline thresholds for air and bone conduction, and measure the discomfort levels using 1 tone at a time, gradually walking up the loudness levels of the tone presentations.  Patients who fall below the average tolerance level of 90 dB for tones, and 90-95 dB for monitored live voice, should be regarded as having sensitivity to sound. 

People who have significant hearing loss may also have a type of sensitivity known as recruitment.  People can have a combination of hyperacusis and recruitment, or one of these conditions all by itself.  People with recruitment often find that they can improve their sound tolerance by using the hearing aid for a period of time (3-6 months). 

Evaluations for the severe-profound hyperacusis require special training and professionalism by the audiologists.  There is a fine list of approved clinicians at Dr. Pawel Jastreboff's website.

To learn more about evaluations and testing for hyperacusis, visit the Hyperacusis Network or the Oregon Tinnitus & Hyperacusis Treatment Clinic.