Conventional Speech Audiometry includes...
Speech Recognition Threshold
Suprathreshold speech recognition
part of the audiological evaluation that describes the impact of hearing loss on daily function?
questionnaire completed by adult patients that assesses their perception of their level of communication difficulty related to hearing
Hearing Handicap Inventory (HHI)
intervals of pure tones that stimulate specific places in the cochlea
-250, 500, 1000, 2000, 4000, 8000
ANT (average normal threshold) is the reference point because...
it is in dB SPL, and is set to 0 dB HL
Threshold that reflects the integrity of the total peripheral auditory mechanism
Air conduction threshold
Air Conduction measurement
different pure-tone stimuli transmitted through earphones one ear at a time
can also be conducted in the sound field
Pure Tone Threshold Measurement Procedure
Instruct the patient
test right ear OR better ear first
begin at 1000 Hz
present each tone for 1 second and vary timing between tones
what is the very first step of Threshold Measurement Familiarization
present the pure tone at 30 dB HL
if there is no response at 30 dB HL during Threshold Measurement Familiarization, you...
increase the level by 20 dB (to 50 dB HL)
if there is still no response at 50 dB HL, you...
increase the level by 10 dB until there is a response
if there is a response after first presenting the pure tone at 30 dB HL...
move on to threshold determination (down 10 up 5)
decrease level by 10 when there is a response; increase level by 5 when there is no response ;
until there are 2 responses in the ascending direction only.
after threshold determination...
you repeat the familiarization and threshold determination processes at different frequencies
Pure Tone Frequency Sequence:
1000, 2000, 3000, 4000, 6000, 8000, retest 1000 (first ear only), 500, and 250 Hz
Test interoctaves If the Test-retest reliability for Pure Tone Frequency Sequence is over...
is over 20 dB or greater difference between thresholds at adjacent octave intervals (ex: 750, 1500)
threshold that is not ear-specific unless masking is used
(b/c vibration of the skull reaches both cochleas)
Threshold determination procedures for Bone conduction the same as for air conduction except for a few differences
Frequencies tested for bone conduction
1000, 2000, 4000, 500, 250 Hz
(different from air conduction)
If a person's Air conduction thresholds are normal in both ears, bone conduction is usually...
If standing waves are present because of earphone placement...
there's an increase in high-frequency thresholds
**Pure Tone Average
Calculation of the average (mean) loss of hearing for the pure tone thresholds at 500, 1000, and 2000 Hz.
TWO QUESTIONS FOR DETERMINING TYPE OF LOSS
1) Is bone conduction abnormal (>15)?
----if yes, sensorineural
2) Are there air-bone gaps present (gaps >10)?
----if yes, conductive
Bone conduction normal (under 20 dB HL)
Air-bone gaps present (greater than 10 dB HL)
BC abnormal; greater than 15 dB HL
no air bone-gaps; AC and BC thresholds approximately the same at all test frequencies.
Hearing Loss Configuration
Speech Audiometry definition
a technique designed to assess a person's ability to hear and understand speech
minimum hearing level (dB HL) at which an individual can just detect the presence of speech material.
Speech Detection Threshold (SDT)
The SDT is used when..
when you have a client who can't perform the SRT.
-clients whose word recognition is so poor that speech is heard but not understood
-young client's who can't respond by pointing to pictures or writing a response
Procedure for SDT
usually presented via monitored live voice.
Use procedure similar to pure tones.
Ascending procedure may also be used.
Speech Recognition Threshold
minimum hearing level for speech at which an individual can identify simple speech materials approximately 50% of the time
two-sylable words with equal emphasis on each syllable. common vocab, sound be able to understand and respond to each spondee.
Response Required for Speech Recognition Threshold
Identification of the word
pointing to picture or object,
signing or writing the response
what is the mode of presentation for SRT?
usually MLV (monitored live voice)
--b/c of it's flexibility
can be recorded
--standardized speaker, material and presentation level
--recorded speech is inflexible; can't vary the rate of presentation or the test words.
testing that the vocab used is familiar to the client.
determine that client's responses are recognizable to the clinician.
SRT Familiarization Procedure
-present words at 50 dB HL (or clearly audible level)
-have client respond to every word
-eliminate problem words
SRT Threshold Determination Procedure
similar to pure-tone threshold method; down 10 up 5.
Need THREE correct responses at the same level; count both descending and ascending responses (b/c recognition required)
(for pure-tone, only need two responses in the ascending direction only)
Modifications for SRT Threshold Determination
should be noed; children's spondees, selected spondees
The SRT can be used as...
a reference point to determine optimal presentation level for suprathreshold word recognition testing
for an adult with hearing loss with relatively flat configuration, what is the optimal presentation level?
-will result in optimal word recognition performance
suprathreshold performance/Word recognition measures...
ability to identify speech material at intensity levels above the threshold.
Word Recognition testing Material
list of monosyllabic words that are phonetically balanced.
Typically open set material
What mode of presentatin is preferred for Word Recognition Testing?
-greater reliablilty, standardization, comparison btwn listenrs
Response required for Word Recognition Testing?
Oral- repitition of word
can be written or point to pictures
Presentation level for Word Recognition Testing for listeners with normal or flat hearing losses?
at least 40 dB SL above the PTA or SRT
Presentation level for Word Recognition Testing for liesteners withs sloping hearing loss
Greater SL needed
youcan present the Word Recognition Testing Level at a high intensity for...
screening for retrocochlear pathology
Normal PI (performance-intensity function)
increasing performance (% correct) with increasng intensity of speech until plateau