Question
Is speech audiometry very beneficial?
Answer
Well, the answer to that question depends upon the type of testing performed. The speech audiometry protocol as conducted in many clinics consists of testing a patient's speech reception threshold (the softest level a patient can recognize two syllable words like "baseball" and "hotdog") and speech recognition (the percentage of words correctly identified among a list of single syllable words like "else" and "by") at a single presentation level in quiet. These tests are useful for the diagnostic purposes of determining the amount and etiology of hearing loss. Still, for the purposes of determining the functional effects of hearing impairment on communication in other than optimum listening environments or how well hearing aids are likely to resolve the patient's communication complaints, the speech reception threshold and speech recognition tests, as commonly administered, are not very beneficial.
This is not to say that speech recognition testing cannot be useful predictors of speech understanding and hearing aid benefit. Arthur Boothroyd (2000), for example, suggests that measuring performance/intensity functions (measuring speech recognition at increasing presentation levels) can provide considerable insight into the communication performance of the patient with impaired hearing as well as provide useful information for selecting hearing aid characteristics.
Furthermore, some recently developed and commercially available tests such as the Quick Speech-in-Noise Test (QuickSIN) (Killion, Niquette , Gudmundsen, Revit & Banerjee, 2004) and the Hearing in Noise Test (HINT) (Nilsson & Soli, 1994) have been shown to better capture the problems patients experience in noisy environments (often, our patients' primary complaint) as well as predicting how well the patient will perform in those environments when wearing hearing instruments.
References
Boothroyd, A. (2000). Thar's gold in them thar hills: mining the P/I function. Carhart Memorial Lecture, Annual Meeting of the American Auditory Society, Scottsdale, AZ, April 2000.
Killion, M.C., Niquette, P.A., Gudmundsen, G.I., Revit, L.J. and Banerjee, S. (2004). Development of a quick speech-in-noise test for measuring signal-to-noise ratio loss in normal hearing and hearing-impaired listeners. Journal of the Acoustical Society of America, 116, 2395-2405.
Nilsson, M., Soli, S.D. and Sullivan, J. (1994). Development of the Hearing in Noise Test for the measurement of speech reception thresholds in quiet and in noise. Journal of the Acoustical Society of America, 95, 1085-1099.
Dr. Harvey Abrams is the Chief of the Audiology & Speech Pathology Service at the VA Medical Center, Bay Pines, FL and adjunct professor in the Department of Communication Sciences & Disorders at the University of South Florida in Tampa. Dr. Abrams' research is funded though the VA Rehabilitation Research and Development Service.
