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CSD9510 > 4 - Speech Threshold Testing > Flashcards

4 - Speech Threshold Testing Flashcards

1
Q

When did speech audiometry begin to complement PT audiometry?

A

After WWII

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2
Q

Name 2 common complaints from patients regarding hearing and understanding speech

A
  • speakers mumble or talk too fast
  • female or children’s voices unclear
  • cannot follow conversation, especially with background noise
  • difficulty in group situations
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3
Q

Name one criticism of PT audiometry

A
  • not “real world” sounds

- limited measure of hearing ability (detection only)

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4
Q

How are speech detection and perception usually assessed (4 broad categories)?

A

Awareness/Detection

Identification

  • repeat speech stimulus
  • match to label or picture

Discrimination (detect change)

  • same/different
  • change (yes or no)

Comprehension
- attach meaning to stimulus by answering questions

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5
Q

What are the 4 types of speech stimuli?

A

Nonsense syllables

  • CVC “bod” “dod”
  • ID acoustic features

Spondaic words

  • familiar, 2 syllable words (“hotdog”)
  • SPEECH RECOGNITION THRESHOLD (SRT)

Phonetically balanced word lists

  • single syllable words (“hit””, “up”, “shoe”)
  • predictive of sentence level performance in quiet
  • WORD RECOGNITION SCORE (WRS)

Sentences
- use of context

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6
Q

Patients are better able to guess when _____ (single words/sentences) are used, than when ______ (single words/sentences) are used

A

Sentences

Single Words

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7
Q

Speech Audiometry Procedures use what two types of assessment?

A

Threshold

  • Speech Detection (awareness) Threshold (SAT/SDT)
  • Speech Recognition Threshold (SRT)

Suprathreshold

  • Word Recognition Score (WRS)
  • Sentence Recognition Score (SRS)
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8
Q

What is the purpose of speech audiometry (name 2)

A
  • evaluate the audibility of speech
  • determine the threshold for speech stimuli
  • cross-check pure tone audiogram
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9
Q

Which speech stimuli measures are used in conventional speech audiometry?

A

SRT/SDT - Speech Reception/Detection Threshold

WRS - Word Recognition Score

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10
Q

Which basic components on the audiometer are used for speech testing?

A
  • input selector (recorded materials or microphone for live voice)
  • talk back (monitor patient response)
  • input level control (VU meter) (monitor intensity)
  • attenuator (control the level of speech presented from -10-110 dB HL)
  • output selector (TDH headphones, insert earphones, sound field)
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11
Q

What level on the VU meter should both syllables be peaking at for speech audiometry?

A

0

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12
Q

What are 2 benefits of monitored live voice?

A
  • convenient

- flexible

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13
Q

Name 2 positive or negative considerations for using a recorded voice presentation mode

A

Pros:

  • standardization
  • increased reliability

Cons:

  • more equipment needed
  • accent of recorded voice
  • little control over the amount of time between presentations
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14
Q

What are 2 disadvantages of live voice mode?

A
  • between speaker differences
  • within speaker variability
  • consistency within/between test sessions
  • gender differences (female speaker level must be greater to achieve same test outcome)
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15
Q

What are the two different types of assessment in speech audiometry, and name one example of each

A

Threshold

  • Speech Detection (awareness) Threshold (SAT/SDT)
  • Speech Recognition Threshold (SRT)

Suprathreshold

  • Word Recognition Score (WRS)
  • Sentence Recognition Score (SRS)
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16
Q

Name one patient factor that you should consider when choosing your method of presentation and response format

A
  • age
  • general health
  • cognitive status
17
Q

What are the two threshold measures in speech audiometry?

A

Speech Detection Threshold (SDT) - measure of threshold for detection of speech

Speech Recognition Threshold (SRT) - measure of the threshold for identification of speech

Both use 2 syllable, familiar spondaic words

18
Q

True or False: SRT can be affected by whether English is someone’s second language and by neurological disorders

A

True

19
Q

What is another name for “Speech Detection Threshold”?

A

Speech Awareness threshold (SAT)

20
Q

With SDT (SAT), what percent correct is the threshold set at?

A

50%

21
Q

True or False: The SDT Threshold search uses the bracketing method (down 10, up 5)

A

True

22
Q

Which threshold measure assesses the most simple level of speech processing?

A

SDT

23
Q

When measuring SDT in pediatric or special populations, what are some behavioural responses we might watch for?

A

Orienting to the sound (head turn)

Change in behaviour (body movement, sucking, eye widening)

24
Q

What does SRT stand for, and what does it signify?

A

Speech Recognition (or Reception) Threshold

  • signifies the lowest level at which a speech signal is RECOGNIZED and REPEATED 50% of the time
25
Q

Describe the SRT Procedure

A

Familiarize patient with the words

  • select 10 and ask them to repeat them back
  • no carrier phrase

Measure SRT

  • begin threshold procedure by presenting spondees (recorded or live voice)
  • different ascending, descending and bracketing procedures available to use
26
Q

What are the instructions for SRT?

A
  • You are going to hear a list of words
  • Repeat each word. Take a guess if you are not sure
  • (Familiarize at comfortable level)
  • The words will become very soft. Repeat each word. Take a guess if you are not sure
27
Q

The most commonly used SRT Threshold search is Martin & Dowdy’s Bracketing procedure. Describe it

A

Present spondee word at 30 dB HL
- if patient does not respond, increase to 50 dB, then up 10 dB until positive response

Once patient responds, use 10 down, 5 up procedure with 1 spondee presented at each level

Threshold at 50% words correct at lowest intensity level (2/4 or 3/6)

28
Q

The Downs and Minard SRT Threshold search is another ascending method, but is more time consuming. Describe it

A
  • familiarize with spondees
    -present 1 spondee at lowest attenuator setting
    -ascend in 10 dB steps presenting 1 word at each level until client responds correctly
    -descent 15 dB
    -present 2-4 spondees/level and ascend in 5 dB steps
  • If 3 spondees are missed, ascend 5 dB and try again
    If 2 spondees are correct, stop
29
Q

Explain how SRT Procedures can be modified for children

A

Ask them to point to the object (e.g. hotdog) on a chart

30
Q

If an SRT is used to confirm pure tone test results, the SRT should be within +/- 10 dB of ____

A

PTA3
*If it does not match the PTA 3, consider the hearing loss configuration (sharply sloping or rising? PTA 2 using best 2 thresholds of 500, 1000, and 2000 may provide better match)

31
Q

SRTs can be used to confirm pure tone test results and determine the threshold reference for presentation of __________

A

Suprathreshold Speech Recognition Tests

32
Q

If a client shows SRTs better than PTAs, they may have a differential diagnosis of _________ (non-organic HL/CNS Dysfunction)

A

Non-organic HL

33
Q

If a client shows SRTs worse than PTAs, they may have a differential diagnosis of _________ (non-organic HL/CNS Dysfunction)

A

CNS Dysfunction (e.g. brainstem lesion, cortical deafness)

34
Q

True or False: Bone conduction SRT may assist you in determining a conductive component

A

True

35
Q

True or false: SRT is easier than SDT, and results in a better threshold

A

False; SDT is easier (detection vs recognition), and may result in a ~10 dB better threshold

36
Q

When might SDT be used instead of SRT?

A
  • when client unable to recognize speech stimuli (e.g. repeat, write, or point)
  • pediatric and special populations
  • SDT reflects best PT threshold

CSD9510 (17 decks)

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