- An audiogram is the chart from a hearing test that shows the softest sounds you can hear at different pitches.
- Audiogram results can explain hearing levels, ear differences, speech scores, and whether next steps may include monitoring, medical referral, hearing protection, or hearing aids.
- Audiology & Speech Solutions provides audiogram explanations and hearing evaluations in Rye, NY, for patients who want clear answers about their hearing results.
What Is an Audiogram?
An audiogram is a visual record of your hearing test results. It shows how softly you can hear sounds across different pitches, usually in each ear. Your audiologist uses it to understand the type, degree, and pattern of hearing loss.
The audiogram is not just a pass-or-fail score. It helps answer practical questions:
- Which ear hears better?
- Which pitches are affected?
- Is hearing within the normal range, mild, moderate, severe, or profound?
- Is the problem likely in the outer or middle ear, the inner ear, or both?
- Are speech sounds likely to be clear, muffled, or incomplete?
- Should the next step be monitoring, additional testing, hearing aids, or medical referral?
Once you know what the chart is showing, your results become much easier to understand.
How the Audiogram Chart Works
An audiogram has two main parts: pitch and loudness.
Frequency Shows Pitch
Frequency is measured in hertz, written as Hz. Frequencies run across the top of the audiogram from left to right.
- Low frequencies are deeper sounds, such as bass notes, vowels, and low voices.
- Mid frequencies include many everyday speech sounds.
- High frequencies include sharper sounds, such as birds, alarms, and consonants like s, f, th, and sh.
High-frequency hearing loss is common. A person may hear that someone is talking but miss the crisp speech details that make words clear.
Decibels Show Loudness
Loudness on an audiogram is measured in decibels hearing level, written as dB HL. The scale runs from soft sounds near the top to louder sounds farther down.
This can feel backward at first. On an audiogram, marks closer to the top mean better hearing sensitivity. Marks lower on the chart mean the sound had to be louder before you could hear it.
Thresholds Show the Softest Sounds You Hear
Each mark on the audiogram is a hearing threshold. A threshold is the softest level at which you respond to a sound at a certain pitch.
For example, if your right ear threshold at 2000 Hz is 15 dB HL, that means you heard a very soft sound at that pitch. If your left ear threshold at 4000 Hz is 55 dB HL, that means the sound had to be much louder at that pitch before you heard it.
Audiogram Symbols Explained
Audiograms use symbols to show which ear was tested and how the sound was delivered.
Air Conduction Symbols
Air conduction testing checks the full hearing pathway: outer ear, middle ear, inner ear, and hearing nerve. You usually listen through headphones or insert earphones.
Common air conduction symbols include:
- O: right ear air conduction, often shown in red
- X: left ear air conduction, often shown in blue
These are the symbols most people notice first on their audiogram.
Bone Conduction Symbols
Bone conduction testing bypasses the outer and middle ear and sends vibration directly to the inner ear. This helps your audiologist compare how the ear hears through air versus through bone.
Common bone conduction symbols may include:
- Less-than or greater-than style marks for unmasked bone conduction
- Bracket-style marks for masked bone conduction
The exact symbols can vary by clinic or software, so ask your audiologist to point out which marks belong to each ear.
Masking Symbols
Masking is used when the audiologist needs to keep one ear from helping the other ear during testing. A soft noise is played in the non-test ear so the test ear can be measured more accurately.
Masked results may use different symbols than unmasked results. This is normal and does not mean anything is wrong. It simply means the audiologist needed a more precise measurement.
What Hearing Levels Mean
Audiogram results are often grouped by degree of hearing loss. The exact cutoffs can vary slightly, but common categories include:
- Normal hearing: about -10 to 15 dB HL
- Slight hearing loss: about 16 to 25 dB HL
- Mild hearing loss: about 26 to 40 dB HL
- Moderate hearing loss: about 41 to 55 dB HL
- Moderately severe hearing loss: about 56 to 70 dB HL
- Severe hearing loss: about 71 to 90 dB HL
- Profound hearing loss: about 91 dB HL or greater
These categories are useful, but they do not tell the whole story. A mild high-frequency loss can still make speech sound unclear. A moderate loss in both ears can make group conversations exhausting.
Your daily listening experience matters, along with the numbers.
What the Shape of the Audiogram Can Show
The pattern of your audiogram helps explain what you may notice in real life.
High-Frequency Hearing Loss
High-frequency hearing loss affects the right side of the audiogram. It can make speech sound muffled even when the volume seems loud enough.
You may notice:
- Trouble hearing speech in background noise
- Difficulty hearing children or soft voices
- Missing consonants
- Asking people to repeat themselves
- Feeling like people mumble
Low-Frequency Hearing Loss
Low-frequency hearing loss affects the left side of the audiogram. It is less common than high-frequency loss but can affect deeper voices, bass sounds, and listening comfort in certain environments.
Flat Hearing Loss
A flat audiogram means thresholds are similar across many frequencies. Sounds may need to be louder overall. This pattern can affect both volume and clarity.
Asymmetrical Hearing Loss
Asymmetrical hearing loss means one ear is noticeably different from the other. Depending on the size and pattern of the difference, your audiologist may recommend monitoring, additional testing, or medical evaluation.
Air-Bone Gaps and Type of Hearing Loss
Comparing air conduction and bone conduction results helps identify the type of hearing loss.
Conductive Hearing Loss
Conductive hearing loss happens when sound has trouble moving through the outer or middle ear. This may be related to earwax, fluid, eardrum problems, or middle ear conditions.
On an audiogram, conductive loss often shows an air-bone gap. Bone conduction may be better than air conduction.
Sensorineural Hearing Loss
Sensorineural hearing loss involves the inner ear or hearing nerve. It is often permanent and may be related to aging, noise exposure, genetics, illness, or other factors.
On an audiogram, air and bone conduction results are usually similar.
Mixed Hearing Loss
Mixed hearing loss includes both conductive and sensorineural components. Air conduction and bone conduction may both be outside the normal range, with an air-bone gap between them.
Speech Scores Explained
An audiogram often comes with speech test results. These scores help explain how well you understand words, not just tones.
Speech Reception Threshold
Speech reception threshold, often written as SRT, is the softest level at which you can repeat familiar words about half the time. It should generally line up with the tone results on the audiogram.
Word Recognition Score
Word recognition score shows how clearly you understand words when they are loud enough. It is usually shown as a percentage.
For example:
- A high score may mean speech is clear when volume is appropriate.
- A lower score may mean clarity is reduced even when the sound is loud enough.
- A large difference between ears may need closer review.
This is important because two people can have similar hearing thresholds but very different speech understanding.
Speech-in-Noise Testing
Some evaluations include speech-in-noise testing. This measures how well you understand speech with background noise present. It can be helpful when your main complaint is hearing in restaurants, meetings, or groups.
What Your Audiogram Means for Next Steps
Your next step depends on the pattern of your results, your symptoms, and your communication goals.
Possible recommendations may include:
- No treatment, with routine monitoring
- Hearing protection for noise exposure
- Earwax removal or medical referral if a conductive issue is suspected
- Additional testing for asymmetrical or sudden changes
- Tinnitus evaluation if ringing or buzzing is present
- Hearing aid consultation if hearing loss affects communication
- Hearing aid fitting and programming if devices are recommended
- Aural rehabilitation or communication strategies
The audiogram helps guide the plan, but your real-world listening needs guide the final decision.
Common Questions About Audiograms
Is an audiogram the same as a hearing test?
Not exactly. A hearing test is the full evaluation. The audiogram is the chart that shows part of the results, usually the tone thresholds for each ear. A complete evaluation may also include speech testing, middle ear testing, and a discussion of symptoms.
What does a normal audiogram look like?
A normal audiogram usually has hearing thresholds near the top of the chart across the tested frequencies. Normal results do not always mean listening is easy in every situation, especially if tinnitus, sound sensitivity, or background noise problems are present.
What do O and X mean on an audiogram?
O usually marks the right ear, and X usually marks the left ear for air conduction testing. Colors are often used too, with red for the right ear and blue for the left ear.
What is a good word recognition score?
Higher word recognition scores usually mean better speech clarity when the sound is loud enough. Your audiologist will interpret the score based on your hearing thresholds, test level, symptoms, and ear-to-ear differences.
Can an audiogram show why I have hearing loss?
An audiogram can show the type and pattern of hearing loss, but it does not always identify the exact cause. Your history, ear exam, symptoms, and additional tests may be needed.
Connect With A Trusted Audiologist in Rye, NY
If you have a copy of your audiogram and are not sure what it means, bring it to your audiologist. The chart can explain a lot, but it should be interpreted with your symptoms, speech scores, listening goals, and ear health history.
Audiology & Speech Solutions provides hearing tests, diagnostic hearing evaluations, audiogram review, hearing aid consultations, and hearing aid services in Rye, NY.
A clear explanation of your results can help you understand what is happening and what to do next.
Contact us today to schedule an appointment!