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The profession of audiology is committed to providing auditory and vestibular care through ethical and evidence-based clinical practices that lead to optimal patient outcomes. Standard of practice documents outline basic services that audiologists are expected to include in the provision of quality healthcare. They reflect the values and priorities of the profession, providing direction for professional practice and a framework for the evaluation of practice. Standards of practice are prepared by subject matter experts, based on available evidence, peer-reviewed and subject to periodic updating.

1. A comprehensive diagnostic hearing evaluation is comprised of valid and reliable assessments of auditory function necessary for differential diagnosis.
2. Communication with patients is conducted in a clear, empathetic manner consistent with the patient's communication mode, comprehension, and their health literacy level. Audiologists encourage involvement of communication partners (e.g., family members, significant others, companions) whenever possible and appropriate.
3. A thorough patient history is obtained as part of the evaluation.
4. Visual inspection of the outer ear, ear canal, and eardrum are performed.
5. Pure tone air conduction thresholds are obtained at a minimum of octave frequencies, 250 Hz – 8000 Hz. Thresholds are obtained at interoctave frequencies when there is a 20 dB or greater difference between octave thresholds or as otherwise deemed necessary by the audiologist.
6. Pure tone bone conduction thresholds are obtained at octave frequencies 500 Hz – 4000 Hz to identify conductive, sensorineural, or mixed hearing loss. Thresholds are obtained at other octave and interoctave frequencies as deemed necessary by the audiologist.
7. Speech recognition thresholds or speech awareness thresholds are obtained using recorded stimuli to assess agreement with pure tone findings.
8. A measure of speech recognition ability is obtained using recorded stimuli at a presentation level that is expected to approximate the patient’s maximum performance. Audiologists perform speech recognition in noise to assess functional capacity.
9. Acoustic immittance of the external/middle ear is measured to support differential diagnosis. A tympanogram is obtained for each ear. When indicated by the patient’s history and audiometric findings, acoustic reflex thresholds are measured ipsilaterally and/or contralaterally.
10. Results and recommendations are communicated to the patient.
11. Written documentation of the diagnostic hearing evaluation is maintained as part of the patient record.

DISCLAIMER
Adherence to this standard will not ensure successful treatment in every situation. Furthermore, this standard should not be deemed inclusive of all appropriate methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the audiologist and the patient, in light of all the circumstances presented by the individual patient. This standard reflects the best available data at the time the standard was prepared. The results of future studies may require revisions to this standard to reflect new data.