Written by Gwen Cantrell, BC-HIS, CDP — Nationally Board Certified Hearing Instrument Specialist, Certified Dementia Practitioner and founder of Hearing Aid Factory Outlet in Lawrenceville, Georgia.
Hi, I’m Gwen. If you’ve ever sat across from me — or another hearing professional — and walked away holding a piece of paper covered in colored circles, X’s, and a line that dips down toward the right, I want you to know something: almost nobody understands that paper the first time they see it. And that’s okay. That’s exactly why I wrote this.
That paper is called an audiogram, and once someone explains it to you in plain language, it stops being confusing and starts being genuinely useful — for you, and often for the people who love you and are trying to understand what you’re going through. So let’s go through it together, the same way I’d walk you through your own results sitting in my office.
First, What Even Is an Audiogram?
Think of an audiogram as a report card for your ears. During your hearing test, you sat in a quiet booth, wore headphones, and raised your hand or pressed a button every time you heard a beep — even a really faint one. We tested a range of pitches, from low rumbly tones to high whistly ones, and found the softest volume you could hear at each one. Every one of those results becomes a single dot on the chart. Connect the dots, and that’s your audiogram.
How to Read the Chart: Two Simple Directions
I know it looks like a lot of lines and numbers, but really there are only two things going on, and once they click, the whole chart makes sense.
Left to right = pitch
Across the top of the chart, you’ll see numbers going from low to high — that’s pitch, just like the keys on a piano moving from the deep bass notes on the left to the high tinkly notes on the right. We test from low, rumbly tones all the way up to high, whistly ones.
Top to bottom = how loud a sound needs to be for you to hear it
This is the part almost everyone gets backward at first, so let me say it clearly: the lower a mark sits on the chart, the worse your hearing is at that pitch — not better. A mark near the top means you could hear a very soft, quiet sound just fine. A mark near the bottom means a sound had to be much louder before you noticed it at all. So when you see your line dropping down toward the bottom of the page, that’s telling you where you’re struggling to hear.
What Do the Circles and X’s Mean?
You’ll usually see two symbols on your chart: a red circle and a blue X. The red circle is always your right ear, and the blue X is always your left ear. It’s a simple color code, but it lets me see at a glance whether one ear is working differently than the other — which happens more often than you’d think, and it’s important information.
What “Normal,” “Mild,” and “Severe” Actually Mean
On your chart, you’ll notice colored bands stacked on top of each other, from “normal” at the top down to “profound” at the bottom. Here’s what those bands mean in plain terms — think of it as how loud I’d have to talk before you could hear me:
- Normal hearing: You hear whispers and soft sounds just fine.
- Mild hearing loss: You do okay one-on-one, but soft sounds and quiet rooms with background noise start to be a struggle.
- Moderate hearing loss: Normal conversation starts to sound muffled, especially without visual cues like watching someone’s face.
- Moderately severe hearing loss: You need people to speak up and probably rely more on lipreading or context than you realize.
- Severe hearing loss: Even raised voices are hard to make out without help.
- Profound hearing loss: Very little sound gets through at all without amplification.
The further your line dips down into these bands, the louder something has to be before you notice it — and that shows up in everyday life as trouble following a conversation at a noisy restaurant, missing the doorbell, or not hearing the smoke alarm at 2am.
Take a Look at a Real Example
Take a look at the chart above. See how both lines start out higher on the left, near “normal,” and then slope downward as they move to the right, ending down in “severe” territory? That’s one of the most common patterns I see in my chair every single day, especially with age-related and noise-related hearing loss. And it explains something I hear from patients constantly: “I know someone’s talking, I just can’t make out what they’re saying.”
Here’s why that happens. The vowel sounds in speech — the “ahh” and “ohh” sounds — are naturally loud and sit in the low pitches on the left side of the chart. The consonants — s, f, t, ch, the sounds that actually give words their crispness and clarity — are quieter and sit in the high pitches on the right. So when your line slopes down like the one above, you’re still catching the loud, low vowel sounds just fine. What’s slipping away are the quiet, high consonants that let your brain tell one word apart from another. That’s not you not paying attention — that’s simply what the chart is showing.
Why Two People with “The Same” Hearing Loss Can Have Very Different Experiences
I get this question a lot: “My friend has hearing aids too, why does he seem to hear better than me?” The answer is almost always in the shape of the line, not just how far down it goes. If your dip is mostly in the high pitches, you’ll usually still know someone is talking, but you’ll mix up similar-sounding words. If your dip is more in the low pitches, you might miss that a conversation is even happening in the first place, but once you catch it and the volume comes up, you understand it clearly. Same overall degree of loss, completely different day-to-day experience.
What Causes Hearing Loss? A Quick Word on “Where” the Problem Is
Part of a full hearing evaluation is figuring out not just how much you’re missing, but where the breakdown is happening. I test this two ways:
- Through your headphones — this checks your whole hearing pathway, from your outer ear all the way to your brain.
- Through a small device behind your ear that sends sound directly to your inner ear, skipping the outer and middle ear entirely.
When both of those tests come back matching each other, that usually means the hearing loss is coming from the inner ear itself — we call this sensorineural hearing loss, and it’s by far the most common type I see. It’s typically permanent, but the good news is it responds beautifully to today’s hearing aids. When the two tests don’t match, and the behind-the-ear test comes back better than the headphone test, that often points to something in the outer or middle ear — like earwax buildup or fluid — some of which can actually be treated and improved, sometimes without hearing aids at all. If there’s a bit of both going on, we call that a mixed hearing loss. This is exactly why I never want anyone reading their own audiogram cold, without someone trained walking them through it — the shape tells a story that a single number never will.
Why I Take This Chart So Seriously
Here’s what I want you to understand: your audiogram isn’t just a piece of paper we file away. It’s the foundation of every recommendation I make.
- It tells me exactly how to program your hearing aids. The Starkey, Signia, and Phonak devices I fit are adjusted frequency by frequency to match your unique chart — amplifying precisely where you need help and leaving alone the pitches where you’re already hearing well.
- It flags things worth a closer look. A sudden drop in one ear, an odd dip at a single pitch, or a big gap between your two ears can point toward causes I want to investigate further, sometimes with a referral to a physician.
- It gives us a starting point. Hearing usually changes slowly over years, and having your results on file means we can compare future tests against today’s, so we catch changes early instead of after they’ve already made life harder.
- It replaces guessing with facts. Instead of “I think I hear fine,” we now have real numbers — which matters whether we’re deciding on treatment, or you’re just trying to settle that ongoing debate at home about how loud the TV really needs to be.
If Your Chart Shows Hearing Loss, Here’s What I’d Tell You
Seeing hearing loss on paper for the first time can feel like a lot to take in — I’ve watched it happen across the table more times than I can count, and that reaction is completely normal. But I also want you to see it for what it really is: the first concrete, useful step toward doing something about it.
Depending on where your results fall and the shape of your particular loss, your options might range from simple monitoring and hearing protection all the way up to today’s most advanced hearing aids — devices like the Starkey Omega AI, the Phonak Audéo Infinio Ultra Sphere, or the Signia Integrated Xperience (IX), each one built to target the specific pitches your own chart shows you need help with. There’s no one-size-fits-all answer here, and that’s exactly the point — your audiogram is what lets us build a plan around your ears specifically, not a generic average.
I’ve spent my career reading these charts and translating them into plain language, and it’s a responsibility I don’t take lightly — it’s part of why I hold a Governor-appointed seat on Georgia’s State Board of Examiners for Speech-Language Pathology, Audiology, and Hearing Aid Dispensing. I want every patient who sits across from me to leave understanding their own results, not just holding a piece of paper.
Questions I Hear All the Time
Is a lower line on the chart worse?
Yes. Since the vertical axis shows how loud a sound has to be before you can hear it, a lower mark means more hearing loss at that pitch.
Can I figure out my own results without a professional?
You can absolutely get the basics from a guide like this one. But I’d still want to sit down with you and go through it together, because there are patterns — a notch here, a gap there — that matter and are easy to miss without training.
Why is one of my ears different from the other?
A small difference between ears is normal. A bigger gap is worth talking about — it can point to one-sided noise exposure, a past ear infection, or something else I’d want to look into with you.
How often should I come back for another test?
I generally recommend a baseline test once you’re in your 50s, and then once a year after that — or sooner anytime you notice a change.
Come See Me and Let’s Go Through Yours Together
The best way to really understand your hearing is to see your own numbers on the page with someone sitting next to you explaining what they mean. Schedule a comprehensive hearing evaluation with me at our Lawrenceville office inside Sugarloaf Mills, and I’ll walk you through your results the exact same way I just walked you through this one — clearly, honestly, and with a plan built around what your chart actually shows, not a generic script. Learn more about my background or call us at 404-786-6416 to book your appointment.
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