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Patient Instructions for Establishing ANL

Melinda C. Freyaldenhoven, MA, CCC-A, Patrick N. Plyler, PhD, CCC-A

December 11, 2006

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Question

I have been measuring Acceptable Noise Levels (ANLs) with my patients and wanted to know what the best verbal directions were to increase the reliability of repeated measures.

Answer

Our research has indicted that ANL measurements are very reliable. Our official instructions are as follows:

Instructions for establishing most comfortable level for speech:

You will listen to a story through a loudspeaker. After a few moments, select the loudness of the story that is most comfortable for you, as if listening to a radio. Hand-held buttons will allow you to make adjustments. First, turn the loudness up until it is too loud and then down until it is too soft. Finally, select the loudness level that is most comfortable for you.

Instructions for establishing noise level:

You will listen to the same story with background noise of several people talking at the same time. After you have listened to this for a few moments select the level of background noise that is the MOST you would be willing to accept of "put-up-with" without becoming tense and tired while following the story. First, turn the noise up until it is too loud and then down until the story becomes very clear. Finally, adjust the noise (up and down) to the MAXIMUM noise level that you would be willing to "put-up-with" for a long time while following the story.

There are additional details on how to instruct patients, including how to break the ANL instructions into sections and an overview of the ANL procedure on our web site at web.utk.edu/~aspweb/faculty/nabelek/anl.shtml

Melinda C. Freyaldenhoven, Ph.D., CCC-A (Assistant Professor): Mindy earned the Ph.D. degree in Speech and Hearing Science from The University of Tennessee (Knoxville) in 2006. She is currently an Assistant Professor at Louisiana Tech University (Ruston).

Patrick N. Plyler, Ph.D., CCC-A (Assistant Professor): Patrick earned the Ph.D. degree in Speech and Hearing Science from The University of Tennessee (Knoxville) in 1998. He then moved to Louisiana State University (Baton Rouge), where he was an Assistant Professor for 5 years. In 2004, Patrick returned to The University of Tennessee (Knoxville) as an Assistant Professor.


Melinda C. Freyaldenhoven, MA, CCC-A

Melinda Freyaldenhoven received the Master of Arts degree in Audiology in May 2003 and will receive the Doctor of Philosophy degree in Speech and Hearing Science in August 2006.  Ms. Freyaldenhoven’s research has concentrated on the Acceptable Noise Level (ANL) procedure.  She has 6 research manuscripts “in print” or “in press,” presented research at 12 national or international conferences, and received 5 grants/scholarships.  Ms. Freyaldenhoven also served as an instructor for an Amplification Technology at The University of Tennessee.


patrick n plyler

Patrick N. Plyler, PhD, CCC-A

Assistant Professor.

Patrick Plyler graduated from The University of Tennessee with his Doctor of Philosophy in 1998.  He then moved to Louisiana State University, where he was an Assistant Professor for 5 years.  In 2004, Dr. Plyler returned to The University of Tennessee as an Assistant Professor.  Dr. Plyler’s research interests are in the areas of diagnostic audiology, efficacy of advanced features in modern hearing instruments, and speech perception in quiet and in noise.  Dr. Plyler has received external support for several research projects, most of which have investigated various features in digital hearing instruments.  Dr. Plyler has published articles in the following journals: Journal of the American Academy of Audiology, Journal of Educational Audiology, Clinical Neurophysiology, Journal of the Acoustical Society of America, and Journal of Speech-Language Hearing Research.  In addition, Dr. Plyler serves as an editorial consultant for the American Journal of Audiology, the Journal of Educational Audiology, Trends in Amplification, and the Journal of Speech-Language Hearing Research. Melinda Freyaldenhoven and Patrick Plyler have nothing to disclose.


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