Exam Questions Flashcards
What two sites of lesion can be potentially differentiated by word recognition scores? Select the best answer.
cochlear vs. retrocochlear
Why is it important to have a high level of confidence that the word recognition score we obtain represents the patient’s best performance (PB max)? Select the best answer.
The score is used in multiple comparisons so it’s important that we are comparing the best score.
According to the SPRINT chart for 25-item word list, using NU-6 materials, two PB max scores of 48% and 68% ARE significantly different.
false
According to the SPRINT chart for 25-item word list, using NU-6 materials, two PB max scores of 44% and 72% ARE significantly different.
true
According to the SPRINT chart for 25-item word list, using NU-6 materials, a word recognition score of 68% with a pure tone average of 40 dB would likely be PB max (NOT disproportionately low).
true
According to the SPRINT chart for 25-item word list, using NU-6 materials, a word recognition score of 16% with a pure tone average of 76 dB would likely be PB max (NOT disproportionately low).
true
How is a screen for rollover administered?
How is the rollover index calculated?
What rollover index suggests retrocochlear pathology (assuming NU-6 word list)? Include the cutoff and if values greater than or less than that would be considered significant for rollover.
Rollover is administered at two levels and can only be completed if the patient doesn’t have too much of a hearing loss. We do SRT score and add 40 to it, if this is too large we cannot complete rollover. If we are able to complete two levels, the first level of rollover is found using our protocol for WRS. We determine the presentation level by taking SRT + 40. We check to make sure this is audible at all frequencies (at least 10dB above). We then determine if masking is needed. After this, we present the full 50 word list and keep track of their % correct. We note this % on the audiogram form. To find the second level, we complete the full 50 word list at the patient’s UCL - 5 level. We then compare the scores and calculate the rollover index.
calculated by taking second level - first level score divided by second level score
if >.25 suggestive of retrocochlear
What does UCL stand for and why would we measure UCL for speech testing?
uncomfortable loudness level. This is the level that a patient experiences speech uncomfortably. We want to measure UCL for speech testing in order to complete rollover to find the second level. We also want to measure UCL if the patient has a significant hearing loss so that we can make sure we do not exceed this uncomfortable level for the PT when testing.
Research shows that scores obtained using word recognition using recorded materials vs. monitored live voice are equally valid.
false
clinical uses of word recognition scores to differentiate cochlear from retrocochlear site of lesion?
Use the SPRINT chart to compare PB max scores obtained at each ear for significant asymmetry
Consider word recognition (PB max) below 80% with a PTA of 30 dB or better as a red flag for retrocochlear pathology.
Screen for rollover by presenting word recognition at two different presentation levels, including UCL-5 as one of the levels.
Describe the process (protocol for this course) for determining word recognition presentation level.
First we want to calibrate the material we will be using for WRS. Then, to determine presentation level, we take our SRT score and add 40dB to it. We make sure this level we found will be audible and at least 10dB above the thresholds. If the level is not audible at the low frequencies, we add 10dB to the poorest low threshold. If the level when we took SRT + 40 was not audible in the high frequencies, we take the threshold at 2000 Hz and add 15dB to it. If the individual has a severe to profound hearing loss or we cannot get audibility, we present WRS at their UCL-5.
consider loudness to the PT
Briefly explain how a word recognition score overestimates a patient’s speech understanding ability outside of the booth. Briefly explain how this score may underestimate a patient’s speech understanding ability. Answer in bullet points or short phrases.
A WRS can overestimate a patient’s speech understanding ability because it is done at high presentation levels compared to conversation speech levels. It is done in a quiet sound treated booth with no competing noise when conversation happens in varying levels of noisy environments with other competing noises.
A WRS can underestimate a patient’s speech understanding ability because there are no cues or context or redundancy when testing compared to conversational speech. For example, “say the word pig” is harder to understand than if someone were to say “My dad’s favorite farm animal is a pig.” Another way it can underestimate their ability is because there are no visual cues like lip reading, as well as WRS is established monaurally and conversational speech occurs binaurally.
nonsense syllables
open set
single-syllable digits in English
closed set
picture-pointing task with 4 choices
closed set
