Objective testing for confident decisions
Our diagnostic laboratory is the clinical heart of The Hearing Matters. Before any hearing aid is recommended, we establish what your ears and auditory system are doing — through calibrated audiometry, middle-ear analysis, objective pediatric tests, and Real Ear Measurement when devices are fitted.
Guessing from symptoms alone leads to wrong devices, wrong settings, and frustrated patients. We invest in BERA, ASSR, OAE, and speech testing so adults and children receive pathways matched to evidence — whether that means amplification, speech therapy, medical referral, or simply reassurance.
Every appointment includes a results conference: we explain what each test showed, what it means for conversations at home and work, and what we recommend next.
Inside our Bahria Phase 8 lab
Sound-treated booths, calibrated equipment, and pediatric-friendly protocols allow accurate testing for infants through elderly patients.
Our laboratory is designed for accurate pediatric and adult testing in a calm, professional environment at Bahria Phase 8.
Tests that guide the right next step
Below is an overview of the main tests available in our laboratory. Each includes a plain-language explanation so you know what to expect before your appointment.
Pure Tone Audiometry (PTA)
Adults & children
Measures the softest sounds you can hear at key frequencies — the foundation for hearing aid selection and medical referrals.
Tympanometry
Middle ear checks
Assesses eardrum movement and middle-ear pressure to detect fluid, infection, or perforation before amplification is recommended.
OAE screening
Newborns & quick checks
Objective cochlear screening widely used for infants and as part of a full diagnostic workup.
BERA / ABR
Infants & complex cases
Records auditory nerve and brainstem responses when behavioral testing is difficult or unreliable.
ASSR
Pediatric planning
Frequency-specific threshold estimation that supports precise pediatric hearing aid planning.
Speech audiometry
Real-world clarity
Evaluates how clearly you understand words in quiet and noise — essential for realistic communication outcomes.
Live vocal analysis
Speech therapy planning
Reviews voice and speech signals to guide therapy goals when communication — not just hearing thresholds — is the concern.
Real Ear Measurement (REM)
Accurate fitting
Verifies that hearing aids deliver the prescribed amplification inside your ear canal — not just on a computer screen.
Understanding each diagnostic test
Read more about what each test measures, why we use it, and when it is recommended.
Pure Tone Audiometry (PTA) — what it measures
Diagnostic testing
Pure Tone Audiometry is the foundation of every hearing assessment. You listen for soft beeps at different pitches while wearing headphones or insert earphones in a quiet booth. The result is an audiogram — a chart showing the quietest sounds you can hear at each frequency.
PTA tells us whether hearing loss is present, which ear is affected, and whether loss is mild, moderate, or severe. It also shows whether loss is conductive (middle ear), sensorineural (inner ear/nerve), or mixed. That distinction guides whether hearing aids, medical treatment, or further testing is appropriate.
At The Hearing Matters in Bahria Phase 8 and Saddar Rawalpindi, PTA is always explained before and after testing. We walk you through your audiogram line by line so you understand what the numbers mean for conversations at home, work, and in noisy places.
When we recommend this test
- Adults noticing muffled speech or asking people to repeat themselves
- Annual checks for noise-exposed workers or musicians
- Baseline testing before hearing aid fitting or fine-tuning
- Follow-up after ear wax removal or middle-ear treatment
Tympanometry — checking middle-ear health
Diagnostic testing
Tympanometry does not test how well you hear — it checks how your eardrum and middle ear move under gentle air pressure. A soft probe sits in the ear canal for a few seconds while pressure changes slightly. The device plots eardrum compliance and middle-ear pressure.
This test helps detect fluid behind the eardrum, eustachian tube dysfunction, perforated eardrums, or stiff ossicles. Many patients with “blocked” or full ears actually have middle-ear issues that must be resolved before accurate PTA or hearing aid fitting.
We routinely pair tympanometry with PTA so recommendations are based on a complete picture — not hearing thresholds alone.
When we recommend this test
- Fullness, popping, or pressure in the ear
- Recent colds, allergies, or suspected ear infections
- Children with recurring ear problems
- Before fitting in-canal hearing aids when canal health is uncertain
OAE screening — objective cochlear check
Diagnostic testing
Otoacoustic Emissions (OAE) measure tiny sounds emitted by healthy outer hair cells in the cochlea. A probe plays soft clicks or tones; if the inner ear responds normally, the device detects an echo. No patient response is required — ideal for infants and toddlers.
OAE is widely used for newborn hearing screening and as part of pediatric diagnostic pathways. A failed OAE does not always mean permanent hearing loss, but it signals that further testing such as BERA may be needed.
Parents appreciate that OAE is quick, painless, and often completed while a baby sleeps. We explain results immediately and outline next steps in plain language.
When we recommend this test
- Newborn and infant hearing screening
- Quick objective check when behavioral testing is unreliable
- Monitoring cochlear function in noise-exposed adults
- Part of a full pediatric workup alongside BERA and ASSR
BERA / ABR — brainstem response testing
Diagnostic testing
Brainstem Evoked Response Audiometry (BERA, also called ABR) records electrical activity from the auditory nerve and brainstem in response to click or tone stimuli. Electrodes on the scalp pick up responses while the patient rests quietly — often during natural sleep in infants.
BERA estimates hearing sensitivity when PTA is impossible — for example in very young children or patients who cannot cooperate with button-pressing tasks. It is also used when neurological hearing pathway integrity must be confirmed.
Our pediatric specialists schedule unhurried appointments and involve parents throughout. Results are discussed in a dedicated conference so families understand implications for speech, schooling, and early intervention.
When we recommend this test
- Infants who did not pass OAE screening
- Children unable to complete standard audiometry
- Suspected auditory neuropathy or retrocochlear pathology
- Objective threshold estimation when behavioral results are inconsistent
ASSR — frequency-specific pediatric thresholds
Diagnostic testing
Auditory Steady-State Response (ASSR) testing estimates hearing thresholds at specific frequencies using steady-state tones modulated in amplitude and frequency. Like BERA, it uses scalp electrodes and does not require active patient participation.
ASSR is especially valuable for pediatric hearing aid planning because it provides frequency-specific threshold data needed for precise programming. Combined with BERA and OAE, it supports confident amplification decisions in infants and young children.
We coordinate ASSR with family counseling so parents understand how results translate into device selection, speech therapy referrals, and educational support.
When we recommend this test
- Infants and toddlers needing precise threshold data for aids
- Complex pediatric cases after inconclusive BERA
- Planning amplification when behavioral audiometry is incomplete
- Monitoring progressive hearing loss in children
Speech audiometry — real-world clarity
Diagnostic testing
Hearing thresholds alone do not tell the full story. Speech audiometry measures how clearly you understand words at comfortable volume — in quiet and sometimes in background noise. You repeat words or point to pictures while we record accuracy.
This test reveals whether amplification will genuinely improve communication, not just make sounds louder. It is essential before recommending hearing aids and for verifying that programming supports speech understanding in daily life.
Many patients are surprised when PTA looks mild but speech scores are poor — speech testing catches that gap and guides realistic expectations and device selection.
When we recommend this test
- Adults struggling in conversations despite “mild” audiograms
- Pre-fitting assessment for hearing aid candidacy
- Follow-up after programming changes
- Workplace or classroom communication concerns
Live vocal analysis — voice and speech signals
Diagnostic testing
Live vocal analysis examines voice quality, pitch, intensity, and speech patterns using specialized equipment. It supports speech therapy planning when concerns go beyond hearing thresholds — for example hoarseness, vocal strain, or unclear articulation after hearing improvement.
This service bridges audiology and speech therapy at The Hearing Matters. When a patient’s communication goals involve voice or speech production, vocal analysis helps our therapy team set measurable targets.
Results are shared with families in plain language alongside recommendations for therapy sessions, home practice, and follow-up reviews.
When we recommend this test
- Voice strain, hoarseness, or vocal fatigue
- Speech clarity issues after hearing aid fitting
- Children with delayed speech needing objective baseline
- Adults rebuilding communication confidence
Real Ear Measurement (REM) — verified fitting
Diagnostic testing
Real Ear Measurement places a tiny microphone in the ear canal alongside the hearing aid to measure actual sound output in the ear — not just what a computer screen predicts. REM is the gold standard for verifying that prescribed amplification matches your audiogram.
Without REM, devices may be under- or over-amplified, leading to discomfort or poor speech understanding. We use REM routinely when clinically indicated so patients leave with confidence that programming is evidence-based.
REM appointments are included in our fitting pathway at Bahria Phase 8 and Saddar. Fine-tuning sessions adjust programs based on real-ear results and your feedback in real listening environments.
When we recommend this test
- New hearing aid fittings and reprogramming
- Pediatric fittings requiring precise output verification
- Patients reporting “too loud” or “still can’t hear” after fitting
- Quality assurance for premium device programming
What happens during a lab visit
Assess
We review your history, examine your ears, and select tests based on symptoms — not a one-size-fits-all package.
Explain
Results are plotted, interpreted, and explained in a dedicated conference — what we found, why it matters, and how it affects daily listening.
Plan
Clear next steps: hearing aids with REM verification, speech therapy, ENT referral, monitoring, or wax removal before retesting.
Follow up
We schedule reviews after fitting or treatment so improvements are verified — not assumed.
Diagnostic lab FAQ
How long does a full assessment take?
Most adult appointments take 45–90 minutes depending on tests required. Pediatric cases with BERA or ASSR may need longer — we schedule unhurried time so children are not rushed.
Do I need a referral?
No referral is required for a hearing test at our Rawalpindi clinics. We will advise if an ENT referral is clinically appropriate based on results.
Can tests be done at home?
Yes — many tests can be completed during a home visit in Rawalpindi and Islamabad. Message us on WhatsApp to confirm equipment availability for your address.
Which tests will I need?
That depends on your age, symptoms, and prior reports. We never order tests unnecessarily — your audiologist explains each one before it starts.
Will I get a written report?
Yes — audiograms and summary findings are documented. We walk through them verbally and can provide copies for school, workplace, or medical records when requested.