Advanced Diagnostics
Midterm Questions And
Answers Updated 2026
Non-organic hearing loss - Answer •appears greater than can be explained by auditory
system lesion and pathophysiology"
•"subjective hearing level is different from objective hearing level"
•AKA: THEY'RE FAKING IT!
•Terms: - Answer •Nonorganic hearing loss
•Functional hearing loss
•Pseudohypacusis
•Psychogenic hearing loss
•Malingering
•Lack of cooperation may be due to patient: - Answer Not understanding the test procedure
•Lack of motivation
•Physical or emotional restrictions
•Wishing to conceal a handicap
•Desiring personal gain or exemption
,•Suffering from psychological disturbance
Nonorganic Hearing Loss Intent - Answer Highly intentional
Nonorganic Hearing Loss External Gain - Answer •Money
•Attention
•In/Exclusion
Non-organic Hearing Loss Gain Examples - Answer •Worker's compensation
•Disability benefit claim
•Failed hearing screen
•Avoiding duty / exclusion
-Military
-Occupational
Non-test indicators - Answer •Source of referral
•Chief complaint / reason for being seen
•Patient demeanor
•No issue communicating in non-test situations
Test Indicators - Answer •Inconsistent test responses
•10dB+ variability
,•Patient error
-False positive
-False negative
•Straining to listen
-Leaning forward
•Issue communicating in test situations only
Source of referral red flag? - Answer If it is from an attorney then we should be concerned
the true motive
Body language - Answer leaning forward, cupping ear. Shows how hard they are working to
understand (should not have to concentrate so hard)
•BEFORE you see the patient
Look into - Answer •Red flags in case history
•Why are they being tested?
•When did the hearing loss occur?
MEETING the patient
look for - Answer •Exaggerated gestures / facial expressions
•Leaning toward the talker, cupping hand over ears, talking excessively loud
•Can they understand at a normal conversational level? (40-60dB HL)
•Do they respond as you are facing away or with headphones / inserts on?
•Avoid yes / no questions - have them elaborate details about hearing loss
•Imagine that you encounter a nonorganic hearing loss
, •What would you do? - Answer Reinstruct patient and try again
•Act as though equipment is malfunctioning
•Suggest that they should be hearing it at a quieter based on other results obtained
•SRT, WRS, immittance, OAEs
•"Yes-No" technique
•Especially useful with children (children reply no exactly with noise)
•Take the button away and watch for hand movement
•Don't instruct which ear is being tested
•Switch between ears during testing
•Imagine that you encounter a nonorganic hearing loss
What would you recommend? - Answer Suggest retesting
•What are some other tests that can be done? - Answer Diagnostic OAE
Immitance
Present Acoustic Reflex
Elevated
Absent - Answer 70-95
100-105
110+
•Objective tests - Answer •Immittance testing
•Middle ear function normal?
•Acoustic reflex thresholds normal?
Midterm Questions And
Answers Updated 2026
Non-organic hearing loss - Answer •appears greater than can be explained by auditory
system lesion and pathophysiology"
•"subjective hearing level is different from objective hearing level"
•AKA: THEY'RE FAKING IT!
•Terms: - Answer •Nonorganic hearing loss
•Functional hearing loss
•Pseudohypacusis
•Psychogenic hearing loss
•Malingering
•Lack of cooperation may be due to patient: - Answer Not understanding the test procedure
•Lack of motivation
•Physical or emotional restrictions
•Wishing to conceal a handicap
•Desiring personal gain or exemption
,•Suffering from psychological disturbance
Nonorganic Hearing Loss Intent - Answer Highly intentional
Nonorganic Hearing Loss External Gain - Answer •Money
•Attention
•In/Exclusion
Non-organic Hearing Loss Gain Examples - Answer •Worker's compensation
•Disability benefit claim
•Failed hearing screen
•Avoiding duty / exclusion
-Military
-Occupational
Non-test indicators - Answer •Source of referral
•Chief complaint / reason for being seen
•Patient demeanor
•No issue communicating in non-test situations
Test Indicators - Answer •Inconsistent test responses
•10dB+ variability
,•Patient error
-False positive
-False negative
•Straining to listen
-Leaning forward
•Issue communicating in test situations only
Source of referral red flag? - Answer If it is from an attorney then we should be concerned
the true motive
Body language - Answer leaning forward, cupping ear. Shows how hard they are working to
understand (should not have to concentrate so hard)
•BEFORE you see the patient
Look into - Answer •Red flags in case history
•Why are they being tested?
•When did the hearing loss occur?
MEETING the patient
look for - Answer •Exaggerated gestures / facial expressions
•Leaning toward the talker, cupping hand over ears, talking excessively loud
•Can they understand at a normal conversational level? (40-60dB HL)
•Do they respond as you are facing away or with headphones / inserts on?
•Avoid yes / no questions - have them elaborate details about hearing loss
•Imagine that you encounter a nonorganic hearing loss
, •What would you do? - Answer Reinstruct patient and try again
•Act as though equipment is malfunctioning
•Suggest that they should be hearing it at a quieter based on other results obtained
•SRT, WRS, immittance, OAEs
•"Yes-No" technique
•Especially useful with children (children reply no exactly with noise)
•Take the button away and watch for hand movement
•Don't instruct which ear is being tested
•Switch between ears during testing
•Imagine that you encounter a nonorganic hearing loss
What would you recommend? - Answer Suggest retesting
•What are some other tests that can be done? - Answer Diagnostic OAE
Immitance
Present Acoustic Reflex
Elevated
Absent - Answer 70-95
100-105
110+
•Objective tests - Answer •Immittance testing
•Middle ear function normal?
•Acoustic reflex thresholds normal?
