Clinical Assessment: Whisper Test
Whisper three random letters and numbers from 2 feet behind the patient with the untested ear occluded. Test each ear separately. A fail on either ear warrants formal audiometric evaluation.
Whisper Test
A simple, no-equipment bedside hearing screen. The clinician whispers a combination of numbers and letters 2 feet (60 cm) behind the patient and asks the patient to repeat them. Validated as a first-line hearing screen in community and primary care settings.
Administration protocol:
- Occlude (press the tragus into the canal) or have the patient cover the untested ear.
- Stand approximately 2 feet (60 cm) behind the patient to prevent lip-reading.
- Exhale fully before whispering to minimise voice volume.
- Whisper a combination of three random letters and numbers (e.g. "4-A-7"). Ask the patient to repeat what they heard.
- Repeat with a different combination if the patient fails the first attempt. A pass requires correctly repeating at least 3 of 6 items across two attempts.
- Test each ear separately.
Interpretation reference
Pass (Hears whisper bilaterally at 2 feet)
Patient correctly repeats whispered words from approximately 2 feet (60 cm) behind them on the tested side.
Hearing within normal functional range for conversational frequencies. Gross screen negative.
Document as pass. Routine follow-up per patient age and risk factors. Formal audiometry recommended for patients ≥ 65 or with risk factors.
Fail (Cannot hear whisper at 2 feet)
Patient cannot correctly repeat the whispered words on one or both sides.
Possible hearing loss. Sensitivity ~80%, specificity ~80% for hearing loss ≥ 30 dB.
Notify provider. Refer for formal pure-tone audiometry. Assess safety implications (inability to hear alarms or emergency instructions). Consider hearing-loss communication adaptations.