HIS 230 - Audiometry - Speech Testing
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This document provides information on various speech recognition tests: - Speech Recognition Threshold (SRT) measures the decibel level required for a patient to correctly identify 50% of two-syllable words. It should be 20dB above pure tone average and use the same bracketing method as pure tone testing. - Most Comfortable Listening Level (MCL) establishes a comfortable intensity for speech using "cold running speech" and increases the level 20dB above SRT. - Word Recognition tests speech discrimination as a percentage of correctly identified words from phonetically balanced word lists at the MCL level. It is conducted for each ear separately and both ears together.
HIS 230 - Audiometry - Speech Testing
- 1. 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.
- 2. Speech Recognition Threshold (SRT) *SRT measurements are obtained using two syllable Spondaic Words. *SAT measurements are obtained using “cold running speech”.
- 3. Speech Recognition Threshold (SRT) For SRT testing, the test level should begin twenty decibels above the test ear pure tone average.
- 4. 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.
- 5. 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.
- 6. 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.
- 7. 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).
- 8. 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.
- 9. Speech Recognition Threshold (SRT) *The difference between 0dbHL and the revealed speech recognition threshold (SRT), is the patient/client’s hearing loss for speech.
- 10. 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.
- 11. 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”.
- 12. 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”.
- 13. Most Comfortable Listening Level (MCL) *Measurements should be made for each ear (monaural), as well as, both ears (binaural).
- 14. 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.
- 15. 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.
- 16. 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.
- 17. 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.
- 18. 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.
- 19. 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.
- 20. 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.
- 21. Word Recognition NOTE: Cochlear disorders usually exhibit word recognition scores which deteriorate (become worse), with the increase of sensorineural hearing loss.
- 22. 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.