Question
I have some patients with low hearing instrument satisfaction after 1 year of use. When I looked at their audiometry I found that they have a very low Articulation Index and their Word recognition was very bad. So could the AI help me to know if I have to be more careful in the fitting process of these patients? Could it be a prediction index?
Answer
Word recognition (sometimes referred to as speech discrimination) testing can help determine how much someone will benefit from hearing instruments as it relates to speech understanding. AI (Articulation Index) helps emphasize the importance of a particular frequency relative to the contribution of incoming speech. Simply put, some frequencies contribute more to speech understanding than others. For example, 2 KHz is the highest weighted frequency, accounting for approximately 1/3 of the overall speech intelligibility. This information then becomes a useful counseling tool more so than a consideration in the actual fitting process. The following scenario will help demonstrate:
A person achieves a word recognition score of less than 50% during audiometric testing. This indicates that even with amplification, he or she should not expect to understand more than 50% of speech in the real world. Word recognition testing is conducted in a sound-treated booth to create an optimal listening condition with no background noise or other interference. Under headphones or using insert earphones, speech is presented in quiet at a comfortable level for the test person. It should be clear to see that if a person understands less than 50% of speech in this condition, they should not expect to do better in the outside world (even with hearing instruments) which is much noisier and adverse in most situations.
In conclusion, word recognition testing and articulation index factors play an important role in the beginning of the rehabilitation process. They help the Hearing Care Professional set realistic expectations for their patient.
August Roy Hernandez, M.A.-FAAA has been an Educational Specialist and trainer for Siemens Hearing Instruments for the past six years. Prior to Siemens, August worked in multiple private practice and hospital settings providing diagnostic services and audiologic rehabilitation for hearing impaired individuals.
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