What is a Békésy test?
A Békésy test is an automatic test method used to measure hearing thresholds. It can be used for audiometric screening and is often used to screen for noise-induced hearing loss (NIHL). The Békésy test uses pulsed tones that automatically change in frequency, intensity, and ear, according to a pre-set programme. Pulsed tones can be easier to hear for someone with tinnitus, so it is a more effective test to perform in this instance.
A Békésy test requires a high level of concentration from the patient. During the test the patient controls the intensity of the stimulus by pressing a response button whenever they hear the tone, and releasing the response button when they can no longer hear the tone.
When the response button is pressed, the intensity level is automatically reduced, and when the response button is released the intensity level is automatically increased. The patient’s response will be recorded as a trace on the test screen. The mid-point of that trace is used to calculate the threshold.
How is the Békésy method carried out?
- Start by providing the patient with clear instructions i.e., You will hear a series of tones. Press the response button for as long as you hear a tone and then release when the tone is no longer heard, no matter how loud or how quiet or which ear you hear the tones in
- Select ‘auto Békésy’ test on the audiometer
- Familiarise the patient with the auto Békésy test and the type of sound they will hear
- The test will automatically begin once the familiarisation process is complete
- The patient controls the intensity by pressing the response button
- The intensity is automatically reduced in steps until the patient no longer presses because the signal has become inaudible
- The audiometer automatically reverses the procedure and increases the level until the patient presses the button again
- This produces a zigzag trace of troughs and valleys (otherwise known as excursions)
- The mid-point of this is what gives the threshold
- The lowest frequencies are presented first, moving through to the higher frequencies
A common sequence is to include 500 Hz, 1KHz, 2KHz, 3KHz, 4KHz, 6KHz, 8KHz
- The threshold/s will be stored automatically.
The benefits of using a Békésy test
The Békésy test has both advantages and disadvantages when compared to a Hughson Westlake test. A case study (Ventry, 1971) found that the major advantage of the Békésy test is that it can highlight functional hearing loss. Pulsed tones can also be easier to hear for someone with tinnitus, and can therefore be a more effective test to perform in this instance. However, the Bekesy test is a more demanding test than the Hughson and Westlake test and requires a high level of concentration, and therefore may have a higher level of inconsistency in some people.
Equipment and training
Amplivox provides an extensive range of intuitive and accurate audiometry equipment as well as accredited training for professionals to learn all about the Békésy test, along with other types of testing. For more information on any of our audiometry products please visit our audiometers webpage, contact our customer support team on +44 (0)1865 880 846, or email us.
National Library of Medicine (2017). Audiometric Testing With Pulsed, Steady, and Warble Tones in Listeners With Tinnitus and Hearing Loss. Accessible at:
Acoustical Society of America (2005). Comparison of the Auditory Threshold as Measured by Individual Pure Tone and by Békésy Audiometry. The Journal of the Acoustical Society of America: Vol 29, No 12. Accessible at:
Erlandsson. B, Håkanson. H, Ivarsson. A & Nilsson. P (2009). Comparison of the Hearing Threshold Measured by Manual Pure-Tone and by Self-Recording (Békésy) Audiometry. Taylor & Francis Online. Audiology: Vol 18, No 5. Accessible at:
I. Ventry. Bekesy Audiometry in Functional Hearing Loss: A Case Study. Journal of Speech and Hearing Disorders. Accessible at:
A. Taymour (2018). Békésy Audiometry – Reliability Tested. Curtis Law. Accessible at:
National Library of Medicine (2018). Automated Audiometry: A Review of the Implementation and Evaluation Methods. Accessible at: