How to Read Your Audiogram Results: Hearing Test Results Explained

Seeing your hearing test chart for the first time can be confusing. Learning how to read your audiogram results helps you understand what your audiologist is seeing and what it means for your everyday hearing. This guide walks through the basics of an audiogram, how to interpret the lines and symbols, and how those results connect to speech understanding and treatment options.

What Is an Audiogram?

An audiogram is a graph that shows the softest sounds you can hear at different pitches, or frequencies. It is the standard way hearing care professionals record and explain your hearing test results. Each ear is tested separately so your audiologist can see whether one ear hears differently from the other.

During the test, you listen to beeps or tones through headphones or ear inserts. You press a button or raise your hand each time you hear a sound, even if it is very faint. Your responses are plotted on the graph to create a picture of your hearing sensitivity.

Understanding Audiogram Frequencies and Decibels

The Horizontal Axis: Frequency (Pitch)

The horizontal line across the top of the audiogram shows frequencies, measured in Hertz (Hz). These are the pitches being tested, from low to high. Common test frequencies include:

250 Hz – very low-pitched sounds, like a deep drum
500 Hz – low-pitched vowels and some background sounds
1000–2000 Hz – many speech sounds
4000–8000 Hz – higher-pitched consonants, birdsong, and alarms

Everyday speech covers a range of audiogram frequencies and decibels, which is why these pitches are so important for communication.

The Vertical Axis: Decibel Hearing Levels (Loudness)

The vertical line on the side of the graph shows decibel hearing levels, or how loud a sound must be before you can hear it. Decibels (dB HL) on an audiogram usually range from -10 or 0 dB (very soft sounds) down to 120 dB (very loud sounds).

On the graph:

Numbers near the top (around 0–20 dB) show softer sounds
Numbers in the middle (40–60 dB) show moderate loudness
Numbers near the bottom (70–120 dB) show loud to extremely loud sounds

The lower the mark appears on the page, the louder the sound had to be for you to hear it.

Symbols and Lines: What Each Ear’s Results Mean

Right Ear vs. Left Ear Symbols

Your audiogram usually uses different symbols to separate the ears:

Right ear air conduction: often shown as a red “O”
Left ear air conduction: often shown as a blue “X”

These symbols show how sound travels through the entire ear system, including the outer ear, middle ear, and inner ear.

Bone Conduction Symbols (If Shown)

Sometimes you’ll see additional symbols, often brackets, from testing done with a small vibrator behind the ear. This is called bone conduction testing and it helps your provider understand whether changes in hearing are coming from the outer/middle ear, the inner ear, or both. Your audiologist will explain those symbols in the context of your individual results.

Audiogram Interpretation: Degrees of Hearing Loss

Audiogram interpretation often starts by looking at the average of your hearing levels at key speech frequencies, typically 500, 1000, and 2000 Hz. This helps determine the overall degree of hearing loss. While exact cutoffs can vary, audiologists commonly use ranges like these:

Normal hearing: 0 to 20 dB HL
Mild hearing loss: 21 to 40 dB HL
Moderate hearing loss: 41 to 55 dB HL
Moderately severe hearing loss: 56 to 70 dB HL
Severe hearing loss: 71 to 90 dB HL
Profound hearing loss: 91 dB HL and above

Keep in mind that your hearing may not be the same at every frequency. Some people hear well in the low pitches but have trouble in the high pitches, while others have a flatter pattern across all frequencies. Your audiologist will look at the shape of your audiogram, not just one number.

Common Audiogram Patterns and What They Mean for Everyday Hearing

High-Frequency Hearing Loss Signs on the Audiogram

One of the most common patterns is high-frequency hearing loss, where the symbols slope downward on the right side of the graph. This means you need louder sounds to hear the higher pitches than you do for low pitches.

Possible high-frequency hearing loss signs in daily life include:

Speech sounds muffled or unclear, especially women’s and children’s voices
Difficulty understanding speech in noisy places, even when you hear that someone is talking
Frequently asking others to repeat themselves, especially consonants like “s,” “f,” or “th”
Trouble hearing beeps, birdsong, or high-pitched alarms

Because many speech sounds live in the high frequencies, this kind of hearing loss can strongly affect communication.

Flat or Low-Frequency Hearing Loss

Some audiograms show a flatter line, where hearing is reduced by about the same amount across most pitches. Others show more loss in the low frequencies (the left side of the graph). These patterns can be linked to different causes and may affect how you hear background noise, music, or deep voices.

Your provider will review your specific pattern with you and explain how it connects to your symptoms.

Speech Understanding and the Audiogram

Why You May “Hear” but Not Understand

Many people say, “I can hear, I just can’t understand.” This often makes sense when you look at your speech understanding and audiogram together. The audiogram shows the softest levels you can detect sounds, but separate speech tests measure how clearly you understand words at a comfortable loudness.

If your audiogram shows more loss in the high frequencies, you may still hear that someone is speaking but miss key consonants that carry clarity. This leads to speech sounding mumbled or unclear, especially in noise or at a distance.

Speech Testing Results

Your hearing care provider may also share other test scores, such as:

Speech reception threshold (SRT): the softest level at which you can repeat simple words
Word recognition score (WRS): the percentage of single-syllable words you can repeat correctly at a set volume

Together with your audiogram, these results help your audiologist understand how well your ears and brain are working with speech and what type of treatment may help.

From Audiogram to Treatment: How Results Guide Next Steps

Hearing Aid Fitting from Your Audiogram

Your hearing chart is a key tool in planning hearing aid fitting from audiogram results. The pattern and degree of hearing loss at each frequency help your audiologist:

Select appropriate hearing aid styles and technology levels
Program amplification to target the pitches where you need the most help
Adjust settings for comfort in quiet and noisy environments
Estimate how much benefit you may get in different listening situations

Follow-up adjustments and real-world listening feedback are also important for fine-tuning your devices.

Other Recommendations Based on Your Results

Depending on your audiogram and symptoms, your provider may also discuss:

Medical referrals if there are signs that need further evaluation
Hearing protection for loud sound exposure
Communication strategies for you and your family
Assistive listening devices for TV, phone calls, or meetings

Putting It All Together: How to Read Your Audiogram Results

When you know how to read your audiogram results, the chart becomes more than just lines and symbols. It is a visual summary of how you hear different pitches and volumes and a starting point for improving your communication. Focus on:

Where your symbols fall on the decibel (loudness) scale
Which frequencies are most affected
How that pattern lines up with the challenges you notice in daily life
What your audiologist recommends based on the full test battery

If anything on your audiogram is unclear, ask your hearing care professional to walk through it with you. Understanding your results is an important step toward better hearing and more confident communication.