Speech Audiometry Flashcards
What are the levels of Speech Perception?
Why do we conduct speech audiometry? (3)
- See if someone can understand speech sounds
- To cross-check thresholds of a pure-tone test
- Differential diagnosis (might tell you what is going wrong CHL or Tumor)
Explain the cross-check:
Doing speech audiometry let’s you answer questions like:
- Did the person misunderstand the threshold test?
- Is the person trying to fake the threshold test?
Explain the differential diagnosis:
Differential diagnosis (i.e. physiologic diagnosis – related to body impairments)
More complete diagnosis of speech perception ability (diagnosis of function – activity limitations)
are there deficits in speech perception beyond that which would be predicted in the audiogram?
i.e. to distinguish cochlear from retro-cochlear loss
what is the evidence for this?
What is the difference between Absolute and Differential sensitivity?
- Absolute sensitivity
pure tone thresholds - Differential sensitivity
frequency resolution (hearing loss)
temporal resolution (aging, processing disorders, lesions, neuropathy)
What is SRT?
The Speech Reception Threshold
This is the threshold for identifying a speech sound.
What is the purpose of SRT?
- Coss-check pure-tone
- Understanding of test
- To check pseudohypoacusis
- Establish a base line for other tests
SRT should be within ______ of pure-tone average.
10 dB
What could explain an SRT that does not match threshold?
Your SRT is 25 dB and your PTA is 50 dB
Why did we choose the PTA at 500, 1000, and 2000?
Why is the SRT the same as the PTA?
- Speech has many short-term levels
- Speech is calibrated to produce a level 12.5 dB above a pure tone because some speech sounds are below the PTA threshold so we bump it up
0 dB for speech is 12.5 dB higher than 0 dB for tones
e.g, so if you have 52 dB HL, the threshold will be 52+12.5= 65 dB SPL
What is the SLM?
1/8 of a second
What are Familiarized spondees?
Words that have the same stress on the vowels, thus very easy for you to identify especially for kids
What is SRT-monitored live voice?
- Monitored live voice most common until recently
- Provides customizability
- Face always must be covered – remember McGurk
What is the Martin & Dowdy (1986) Procedure?
- One spondee at suprathreshold level (after familiarization)
- Down 10 after the success
- Up 5 after missed word
- Stop when 3 words are repeated correctly
- Should be within 10 dB of PTA (or the best 2 out of 3 Fletcher AVG)
Suggests collapsing canal
Needs to be retested
AC are lower than BC
What is the difference in accuracy from SDT to PTT?
SDT 2 to 6 dB better than the pure tone threshold
Why would you measure the SDT?
What is Suprathreshold Testing?
speech presented above the auditory threshold of the listener.
Which Results are good and why?
1. Left Ear
SRT: 10
WRS: 100%
- Right Ear
SRT: 35
WRS: 4% - Right Ear
SRT: 35
WRS: 75%
Word Recognition Score
1 and 2
3 WRS is not normal at the level, you have to refer to the table
Explain the nature of speech perception:
problems with speech understanding are the primary reason for seeking audiology services
What would be the lowest % of WRS which would be normal?
PTA and % Correct (Monosyllables-NU6 25)
Refer to this
What is in the standard word recognition (WRS) test?
- Open-set monosyllables are used
(CID W-22 or NU-6 or PB50) - the list must NOT be familiarized first
- Carrier phrase is used
e.g. Say the word ‘car’; Say the word ‘talk’, etc. - Presentation level is held constant during the test
- Testing should not be performed with MLV, unless absolutely necessary!
if time precludes the use of taped speech materials, time should be preserved by not administering speech tests at all (Stach, 1998)
What presentation level should you present words?
- Rules
40 dB above threshold (40 dB SL)
MCL
upper limit of MCL
MCL and high level
(MCL = Most Comfortable level) - best is PBmax
maximum score, not best level!
What is PBMax?
Lowest Maximum WRS to be considered normal
How stable are word recognition scores?
If you have a few items on your list like 10 not really compared to 150 items.
Why use Phoneme scoring?
Gives you more stable speech scores
sat s,a,t
mop m,o,t
din d,i,n
with w,i,th
job j,o,b
What is a PI function?
Different Speech Recognition items present at different levels.
a= Normal
b= CHL
cde= SNHL
- for conductive loss
performance is normal once signal level is increased (100%) - for sensory loss
performance declines with increasing hearing loss - for retrocochlear loss,
scores are often lower at higher levels (this is called ‘rollover’)
performance is also often lower than would be predicted by the SII
What is Rollover?
scores are often lower at higher levels (this is called ‘rollover’)
performance is also often lower than would be predicted by the SII
PBmax = best score
PBmin = lowest score at higher level
RI = (PBmax-PBmin)/PBmax
RI = (64-38)/64
RI = 26/64
RI = .41
When would you refer when there is rollover?
RI = (PBmax-PBmin)/PBmax
RI = (64-38)/64
RI = 26/64
RI = .41
Neural problem suspected when
PB50 RI > .45
NU6 RI > .35
Case study: Is this a normal result?
No, should refer
Case study: Is this a normal result?
Yes, matches the result of a SNHL
How would you expect the speech recognition scores to be depending on the sites of lesions?
What are the different speech materials in Speech audiometry?
- Connected Speech (CST)
- Sentences (CID everyday sentences)
Sentences: critical frequency region is 750 Hz. People with HFSNL will generally perform well if sentences are used - Spondees (W-1)
- Monosyllables (PB50, CID W-22, NU6)
Monosyllables: critical frequency is approximately 1900 Hz – people with HFSNHL will have difficulty with PB words especially as degree of loss approaches 40-50 dB HL - Nonsense syllables (NST, Modified Rhyme Test) CCT
What is the speech intelligibility index? (SII)
It is a bridge between the audiogram and speech understanding
What is does the speech intelligibility tell us? (SII)
A single number between 0 and 1 (0–100%): what percentage of the speech information is audible?
THIS can tell us what is “normal”
What is the SII of this loss?
42 dots above the threshold so about 25 % of speech is audible
What is the SII of this loss?
45 dots below the threshold so about 90 % of speech is audible
Is a 5 dB shift significant?
Definitely, because a 5 dB shift causes at least 20 additional dots to not be heard from those two graphs
Is a 5 dB shift significant?
Definitely, because a 5 dB shift causes at least 20 additional dots to not be heard from those two graphs
Is a 5 dB shift significant in SII units?
5 dB shift causes at least 20 additional dots to not be heard from those two graphs
