Not all hearing loss tests are the same. At Journey Audiology, we use a real ear measurement (REM), which is a specific kind of hearing test that measures how well a hearing aid is working in a patient’s ear canal.

And since we know that may be an unfamiliar term, we thought some quick facts might help explain why we opt to do this.

Real Ear Measurements vs Regular Hearing Test

During a hearing test and real ear measurement there are a lot of similar things that happen. The key differences between the two though involve what is being measured.

What Does a Hearing Test Measure?

A routine hearing test is measuring a few things including:

Your ability to hear a range of tones in each ear
How well each ear can understand speech at different volumes
Your clarity of hearing and speech discrimination (in other words, how well you can hear and understand in noisy settings)
The movement of your eardrum in response to changes in ear pressure (this helps detect physical issues like fluid in the ear or eardrum perforations)
How your auditory nerve responds to sound (If an auditory brainstem response (ABR) test is performed)

What Does a REM Measure?

A real ear measurement is a focused exam. REM specifically looks at how well your hearing aid is working in relation to your hearing test. A REM measures how accurately customized a hearing aid is to a patient’s individual ear characteristics and hearing loss needs. REM is the preferred method for verifying hearing aid performance and is used by both the American Speech-Language-Hearing Association (ASHA) and the American Academy of Audiology (AAA).

What Happens During a REM test?

During REM, your audiologist will insert a thin probe microphone into the ear canal, usually within 5mm of the eardrum, and then play tones and speech sounds through a loudspeaker (not directly into your ear like in a regular hearing test).

The probe then will measure the output from the hearing aid in your ear and compare this to targets based on your specific hearing loss. From this comparison, the results help indicate if a hearing aid adjustment is needed, and most importantly, what specific adjustment to make.

REMs are really important to do when getting hearing aids, as they help us customize your devices to your hearing loss needs as well as for your personal comfort levels. This is vital as real-ear measurements are the only way to measure and account for the way your individual ear canal anatomy impacts how sound is delivered to your ear canal, if the dome (plastic tip) is appropriate, and how we can program your hearing aids to work their best for you.

Two other reasons audiologists may do a REM include:

Verifying specific hearing aid features such as frequency-lowering technology
Measuring the effect of your devices’ directional microphones

Verify and Validate: Why We Ask Questions After REM

On a closing note, we know that the way your hearing aids may work is very personal. Just because we can see that the targets match up on our side, doesn’t always mean you are feeling good about the experiences you’re having.

One of the important things we do following a real-ear measurement is to ask you to give your own assessment. Hearing aid validations can be done in-person or with written questionnaires, and the goal of this is to capture your personal experience with the hearing aid. This allows us to compare that with the real-ear measurement results and try to find a sweet-spot with your devices so that you do feel happy and comfortable with them.

Have questions about real-ear measurements? Want to talk to us about getting hearing aids for the first time or adjusting your current ones? We’re always happy to answer questions and take time to help you along your hearing journey, so feel free to contact us here.