HIS 230 - Audiometry - Speech Testing
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Transcript of HIS 230 - Audiometry - Speech Testing
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Speech Recognition Testing (SRT)
*Speech recognition testing should not be confused with Speech Awareness Testing (SAT).
*SRT is the measurement defined when speech is recognized.
*SAT is the value recorded when the patient/client has an awareness that a speech signal is present.
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Speech Recognition Threshold (SRT)
*SRT measurements are obtained using two syllable Spondaic Words.
*SAT measurements are obtained using “cold running speech”.
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Speech Recognition Threshold (SRT)
For SRT testing, the test level should begin twenty decibels above the test ear pure tone average.
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Speech Recognition Threshold (SRT)
*The speech signal should be monitored by the tester using the audiometer volume unit (VU) meter.
*The syllables should peak at zero on the VU meter.
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Speech Recognition Threshold (SRT)
*For each list the common number of two syllable spondaic words is thirty-six. *However, rarely are all of the words used to determine the fifty percent response/score required to establish the speech threshold.
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Speech Recognition Threshold (SRT)
*Its threshold is defined as the decibel level required for fifty percent of the words to be correctly identified.
*The same bracketing method used to obtain pure tone thresholds should also be used to obtain speech thresholds.
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Speech Recognition Threshold (SRT)
NOTE: The SRT decibel level results should be in agreement with the pure tone average threshold level obtained during pure tone air conduction testing (plus or minus 10dbHL).
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Speech Recognition Threshold (SRT)
NOTE: Speech testing using a bone conduction oscillator is normally not a calibrated test method.
*Results from bone conduction speech tests are not accurate.
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Speech Recognition Threshold (SRT)
*The difference between 0dbHL and the revealed speech recognition threshold (SRT), is the patient/client’s hearing loss for speech.
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Most Comfortable Listening Level (MCL)
*This test uses “cold running speech” as its stimulus.
*The purpose of MCL testing is to establish a comfortable intensity level for listening to speech.
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Most Comfortable Listening Level (MCL)
*The intensity level should be set twenty decibels above the SRT.
*It should be gradually increased to find the most comfortable listening level (MCL) for “cold running speech”.
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Most Comfortable Listening Level (MCL)
*The patient/client should be instructed to indicate whether the “cold running speech” is too soft, too loud, or comfortable i.e. “like their TV or radio”.
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Most Comfortable Listening Level (MCL)
*Measurements should be made for each ear (monaural), as well as, both ears (binaural).
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Most Comfortable Listening Level (MCL)
*Since speech testing measures the higher levels of sound recognition, the affect that occurs from speech stimulation of each temporal lobe is generally summated in the midbrain.
*This summation normally results in a decrease/reduction of five decibels of intensity.
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Uncomfortable Loudness Level (UCL)
*This is another speech test using “cold running speech”.
*It is often used to determine the level at which speech sound is no longer tolerated.
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Uncomfortable Loudness Level (UCL)
Please note: Uncomfortable Loudness, measured by frequency instead of speech, generates more useful information when creating an aural rehabilitation program or when programming digital hearing instruments.
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Word Recognition (WR)
*This test is often referred to as speech discrimination testing. *We will use Word Recognition testing.*It is expressed as a percentage of words correctly identified during the presentation of phonetically balanced (PB) words at the MCL intensity level.
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Word Recognition
*The intensity level used, should be the decibel level identified during Most Comfortable Listening (MCL) testing.
*Testing of each ear (monaural), as well as both ears (binaural) should be conducted.
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Word Recognition
*The word lists used are single syllable phonetically balanced (PB) words.*The most commonly used are fifty word lists either W-22 or NU-6.
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Word Recognition
Please note:
*Research has found that reliable results may be obtained using twenty-five of the fifty words.
*Some clinicians will choose to use the short list to expedite the test battery.
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Word Recognition
NOTE: Cochlear disorders usually exhibit word recognition scores which deteriorate (become worse), with the increase of sensorineural hearing loss.
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Word Recognition
NOTE: Retro-cochlear (higher level) disorders usually exhibit word recognition scores which are significantly worse than the pure tone hearing loss might indicate.