Functional and Communication Needs Assessment: Objective Tests

Question 1

What are some objective assessments of body structure and function?

Answer 1

TEN test (cochlear dead regions)
LDL

Question 2

What are some objective assessments of activity limitations?

Answer 2

QuickSIN
Acceptable noise level (quantifies patient’s tolerance of background noise)

Question 3

What is the rationale for LDL?

Answer 3

Individual tolerance levels vary significantly despite similar threshold loss.
LDL measurement is needed to ensure amplified output doesn’t exceed the individual’s loudness tolerance
Data used to program output and verify OSPL90/MPO limits

Question 4

What frequencies should you always measure LDL for?

Answer 4

2000 and 3000 Hz

Question 5

Why should you do LDL at 2-3 kHz?

Answer 5

These frequencies align with the ear canal’s resonant peak and a hearing aids greatest output so it’s important to be aware of that dynamic range

Question 6

When should you do LDL for 500 Hz?

Answer 6

When the low frequency threshold is greater than or equal to 40 dB HL

Question 7

Are technological recommendations based on a patient’s individual SNR loss?

Answer 7

Yes
Makes it so you don’t recommend too much or too little technology

Question 8

What is SNR-50?

Answer 8

The signal-to-noise ratio that allows an individual to understand 50% of the test signal

Question 9

What is a normal SNR value?

Answer 9

+2 dB

Question 10

How do you calculate SNR loss?

Answer 10

Subtract the patients SNR-50 by the normal SNR-50 function (2)

Question 11

What are some tests that measure SNR loss?

Answer 11

HINT
SPIN
QuickSIN ™
BKB-SIN (Bamford-Kowal-Bench)
Connected Speech Test
AZBio

Question 12

What is the category for 0-2 dB SNR loss?

Answer 12

Normal

Question 13

What is the category for 2-7 dB SNR loss?

Answer 13

Mild

Question 14

What is the category for 7-15 dB SNR loss?

Answer 14

Moderate

Question 15

What is the category for >15 dB SNR loss?

Answer 15

Severe

Question 16

What are the technology needs for those with 0-2 dB SNR loss?

Answer 16

Omni or may benefit obtain benefit with directional microphones

Question 17

What are the technology needs for those with 2-7 dB SNR loss?

Answer 17

Recommend standard directional microphones

Question 18

What are the technology needs for those with 7-15 dB SNR loss?

Answer 18

Require beamforming microphones, in addition to standard directional mics

Question 19

What are the technology needs for those with >15 dB SNR loss?

Answer 19

Requires remote microphone, in addition to above recommendations

Question 20

What are some alternative QuickSIN test protocols?

Answer 20

Monaural presentation with headphones (detect asymmetric SNR loss)
Binaural presentation with headphones (function SNR loss by supplying binaural benefit)
Soundfield presentation (determine if aided SIN performance is improved or degraded)

Question 21

What level is the QuickSIN presented at for a soundfield presentation?

Answer 21

55 dB HL
Simulate normal conversational speech in noise

Question 22

What is the BKB-SIN?

Answer 22

QuickSIN for children
Easier, shorter sentences
For those patients who struggle with the QuickSIN

Question 23

Does the binaural QuickSIN quickly allow us to identify those with binaural interference?

Answer 23

Yes
If their scores degrade

Question 24

Why is the acceptable noise level test used?

Answer 24

To quantify a listener’s willingness to listen to speech in the presence of background noise

Question 25

What is the clinical usefulness of the acceptable noise level test?

Answer 25

Predictive of hearing aid satisfaction with 85% accuracy Identifies those who will have more difficulty adapting to amplification

Question 26

What does a low ANL score mean?

Answer 26

Difference < 7 dB Indicates the patient accepts a lot of background noise Likely to wear hearing aids on a regular basis

Question 27

What does a high ANL mean?

Answer 27

Difference > 13 dB Indicates the patient lacks tolerance for background noise Less likely to wear hearing aids regularly

Question 28

What do ANL scores between 8-12 dB mean?

Answer 28

Equivocal May require extra post fitting counseling or adjustment period

Question 29

What is the scoring for ANL?

Answer 29

MCL - BNL = ANL

Question 30

Does acceptance of noise improve when both directional mics and digital noise reduction are enabled?

Answer 30

Yes, due to research Directional microphones alone only supported partial acceptance DNR alone only showed minimal improvement

Question 31

In 2022, was it determined that the level of technology could effect acceptance of noise?

Answer 31

Yes ANL was improved with premium devices

Question 32

Is QuickSIN the only test that can assess binaural interference?

Answer 32

Yes