3A_Speech In Noise

Question 1

Why do we test speech in noise?

Answer 1

• To quantify reported difficulty listening in noise (cannot be reliably predicted from audiogram)
• As a counselling tool (demonstrate speech understanding ability, predict amplification benefit, establish realistic goals and expectations, “ownership” of their hearing in noise problem)
• HA fitting tool (e.g. special features, demonstrate benefit)

Question 2

What is SNR-50?

Answer 2

The signal to noise ratio at the point where someone gets 50% correct on a performance intensity function for a given speech signal

Question 3

What is SNR loss?

Answer 3

The amount that the hearing impaired person needs the signal boosted (compared to normal listeners)
- the difference (in dB) between a normal person’s SNR-50 and a hearing impaired person’s SNR-50 (e.g. +6 dB)

Question 4

What types of things may influence SNR-50 results?

Answer 4

• speech material used
• type of background noise
• test setup (e.g. inserts, sound field)
• audibility
• reverberation
• knowledge of the language
• age

Question 5

What are 3 examples of speech in noise assessments?

Answer 5

QuickSIN
HINT
WIN

Question 6

Give a brief overview of the QuickSIN

Answer 6

• word recognition in noise test for adults
• score number of correctly repeated words to determine SNR loss
• 6 sentences/list
• hearing loss < 45 dB HL = 70 dB HL, otherwise “loud but okay”
• SNR loss = 25.5 - total correct words
• 2 repetitions averaged
• compare to normative scores

Question 7

Give a brief overview of the BKB-SIN

Answer 7

• can be used on children and adults (for which QuickSIN too hard), as well as CI users
• uses adaptive noise with SNR loss scoring
• 1st grade level language
• 23.5 - TL correct

Question 8

Give a brief overview of the WIN

Answer 8

• patients repeat words to evaluate speech understanding in noise (babble)
• results reported as S/B for 50% correct identification
• 70 monosyllabic words (2 lists of 35)
• 7 diff S/B ratios (+24 to 0)
• PTA 40 or less = 80 dB HL
  PTA 40 - 60 = 90 dB HL
  PTA > 60 = do not test
• use chart to compare # correct to S/B ratio

Question 9

What are some reasons the HINT is used more in research than clinic?

Answer 9

• no longer commercially available
• more complicated set-up, test administration, and scoring
• clinics must obtain their own sound field norms

Question 10

Give a brief overview of the HINT

Answer 10

• used to measure threshold for sentences in quiet and noise
• fixed speech level (65 dB SPL)
• presentation varies based on response
• test 3 conditions (front, L, and R)
• 1st grade reading level; phonemically balanced and equivalent
• 25 groups of 10 sentences, or 12 groups of 20
• scored for SNR-50
• bracketing (4 and 2 dB steps) used until whole sentence correct
• # incorrect x 0.8 dB = reduction in word level in noise