Read the page in the right order
First confirm which symbols represent the right and left ear and whether they are air- or bone-conduction thresholds. Next look for asymmetry, the overall configuration and any air–bone gaps. Only then consider labels such as mild or moderate. Symbol conventions can change when masking is used, so use the legend on the actual report.
Frequency and hearing level
Frequency is measured in hertz. Lower frequencies contribute much of the energy and rhythm of speech; many consonant cues extend into higher frequencies. Hearing level is plotted in dB HL, a clinical reference scale. A point lower on the page means a louder signal was needed for a response at that frequency.
Air, bone and type of loss
Air-conduction testing includes the outer, middle and inner ear. Bone conduction largely bypasses the outer and middle ear. A meaningful gap between air and bone results can support a conductive component. When air and bone results are similarly reduced, the pattern can support a sensorineural component. A mixed pattern can include both. The clinician must decide whether differences are significant and reliable.
Why an average is not the whole result
A pure-tone average usually combines selected speech-range frequencies. It is useful for consistency checks and summary, but two people with the same average can have different high-frequency access, speech scores and real-world needs. A steeply sloping result may produce more difficulty with clarity than the average suggests.
Worked example
Suppose the right and left ears are similar through 1,000 Hz, then both slope downward at higher frequencies. The person reports that voices are audible but words blur in a busy room. That complaint is consistent with missing high-frequency detail, but the audiogram still cannot predict every listening situation. Speech testing, history, technology fit and communication strategies complete the picture.
What to ask next
- Are the results reliable and similar between ears?
- Is there an air–bone gap or another reason for medical referral?
- What do speech scores add?
- Which frequencies explain my most important communication problem?
- How will we measure benefit after an intervention?
Speech results, reliability and change over time
An audiogram should be read alongside the test conditions and the clinician’s judgment about reliability. Responses can be affected by attention, instructions, earphone placement, background noise and whether masking was needed. Small differences between tests do not always represent a real change. Ask which shifts are clinically meaningful and whether the same test method was used.
Speech measures answer different questions from pure tones. A speech threshold can help check agreement with the audiogram, while word-recognition results describe performance for a particular material and presentation level. They are not a universal percentage of how much speech someone understands in daily life. When monitoring change, keep copies of the complete reports rather than only the summary label.
Sources and review notes
Sources were checked for this editorial update on September 26, 2026. External guidance can change; follow the linked source for the current version.
This page provides education, not an individual diagnosis, treatment plan, legal opinion or billing decision. Historical expert contribution is credited only where supported by the original project record; it does not imply review of this update.
