Speech Audiometry Flashcards
What is the purpose of Speech Audiometry?
It determines the degree of disability in speech communication caused by hearing loss
For speech audiometry, what test equipment is used?
- Audiometer
- 125-12000 Hz
- -10- 120 db HL - Transducers (mostly air conduction equip)
- Speakers
- Earphones
- Bone oscillator
Which equipment is not typically used for Speech Audiometry?
Bone oscillator
Why is a bone oscillator not used for Speech Audiometry?
- It’s not typically calibrated for speech
- Is unreliable for assessment purposes
- It’s not comfortable since a patient can get a vibrotactile response
What background information regarding Speech Audiometry is like Pure Tone?
- Testing environment
- Testing Chambers
- Criterions to keep in mind for patients
- Positioning
- Response (first 6)
For Speech Audiometry, regarding the patient’s speech-language, what should an Audiologist know?
- The patient’s speech-language difficulties
- Patient’s receptibility to understand
- Tester’s ability to understand response for scoring purposes
Between Speech Testing and Pure-tone Testing which one is a bigger problem for the patient?
Speech testing
For Speech Audiometry, what are the types of responses?
It depends on the test
- Hand raising
- Finger raising
- Signal button
- Vocal response
- Conditional Play Audiometry
- Visual Reinforcement Audiometry
- Pointing to pictures
- Writing
For Speech Audiometry, can false response occur?
Yes
How can a false positive response occur for Speech Audiometry?
- For awareness task - it can happen if they happen to press the button at the right time
- Word identification - if pictures are used, pt can potentially guess the right answer?
What does monaural mean?
An audiologist testing each ear individually
What does binaural?
An audiologist testing both ears simultaneously
What are the benefits of using binaural testing?
- Two ears are better than one demonstrates binaural benefit
- Important for hearing aid candidates
For binaural, why is 2 ears better than one?
There’s a boost when they’re both working together vs working in isolation
With binaural testing, why is this test done for hearing aid candidates?
- To convince people to get 2 hearing aids when they have a HL in both ears
- Occasionally, the test can prove that the pt does not need 2 hearing aids
From a binaural test, why might a hearing aid candidate be turned away from receiving 2 hearing aids?
The poorer ear may bring the better ear down. The poorer ear hears noise and junk, and this will affect the better ear from processing sound
What are the 2 options of how a pt can hear the speech sounds?
- Monitored Live Voice
2. Recorded Speech
What is Monitored Live Voice (MLV)?
An actual tester’s voice that uses a microphone and monitoring system through audiometer
What is Recorded Speech?
Is a CD or tape recording of voice and a calibration tone on recording to monitor
What are the two Speech Threshold Testing?
- Speech Detection/Awareness Threshold (SDT/SAT)
2. Speech Recognition Threshold (SRT)
What is SDT/SAT?
It’s the lowest level at which one can barely detect the presence of speech and identify it as speech
For SDT/SAT what are the patient’s thoughts?
” I am aware that there is speech but can’t recognize the words”
For SDT/SAT testing, what are the stimulus?
- Words
2. Cold Running Speech
For SDT/SAT testing, while giving the stimulus, what are we still doing?
- 2/3 - words recognized
2. Down 10 up 5
For SDT/SAT, what are the type of responses?
Hand raise, finger raise, push button etc
What is SRT?
The lowest level at which 50% of speech is correctly understood
For SRT what are the patient’s thoughts?
” I can hear the speech but i’m still not sure what’s being said but once you increase the volume, I can hear it now”
What are the stimuli for SRT?
- Spondees
2. Carrier Phrase
What are spondees?
Is a two-syllable word with each syllable being produced with equal stress and effort (airplane)
What is a carrier phrase?
A phrase you hear before the spondee is given to the pt for them to respond to
For SRT, what is the threshold search?
It’s the same procedure as for pure tones (down 10, up 5)
For SRT, what are the responses?
Oral, pointing, and writing
For Speech Threshold Testing, what are the other types of responses?
- Closed
2. Open
For Speech Threshold Testing, what is an open response?
Where pt must produce the answer an infinite # of responses without receiving a response
For Speech Threshold Testing, what is a closed response?
Pt has a set of answers and pt chooses the correct answer
Another definition for SDT/SAT is…
A speech awareness or detection where pt can detect speech but can’t understand what was said
SDT/SAT shows
The presence of speech NOT content
Another definition for SRT is….
Speech recognition where the pt can understand what was said
SRT shows
Presence AND Content
Between SRT & SDT/SAT which one requires a higher intensity level?
SRT
Why is SRT louder?
The voice must be louder so that the pt can understand speech than just detecting the presence of it
When is Speech Awareness used?
When pt cannot respond to SRT
What is MCL?
The level at which speech is most comfortable loud to an individual
What is used to determine MCL?
Cold running speech at louder and softer levels
Who typically receives a MCL & UCL testing?
Hearing aid patients
What is UCL?
The level of speech that is uncomfortably loud to an individual
What is not UCL?
It isn’t the loudest sound you can hear. You can hear louder than your MCL but you don’t want to since it’s gets uncomfortable
What’s used for UCL?
Cold running speech
For UCL, how is cold running speech presented?
At increasingly louder levels and the pt states the point at which it’s uncomfortable
What the normal hearing UCL?
~ 100 db HL
What is Dynamic Range of Speech?
Decibel range of comfortable speech
What does Dynamic Range of Speech give?
A functional range for hearing
What gives us the DR?
UCL (loudest they can tolerate) - SRT (what they can understand)
For DR, who typically has a smaller range?
Individuals with hearing loss
For DR, why are those with HL have a smaller DR range?
- Poorer SRT - more sound is need
2. Recruitment - has an increased growth of loudness in pts w/SNHL
What is recruitment?
Sensitivity to loudness
For SNHL pts, why would they have a higher recruitment sensitivity?
Since our cochlea is tonotopically organized and acts as filter for frequencies, those with SNHL has a damaged cochlea where it broadens which causes the area being stimulated to be greater. The area that’s greater causes more neurons to fire because it makes our brain think there’s more loudness when there isn’t and causes an increased sense of loudness
What is Speech Recognition Testing?
It tests a pts ability with speech above their threshold to see what level of loudness they need
For Speech Recognition Testing, what does a CHL pt benefits from?
Simply making the speech louder helps since they need volume not clarity
For Speech Recognition Testing, what does a SNHL pt benefits from?
They need clarity and volume
What does Speech Recognition Testing determine?
- A pts ability to understand speech presented at supra threshold levels
- Brain tumors
What are the criteria for Speech Recognition Testing?
- When sound is turned up to a comfortable level, is it still distorted?
What is Speech Recognition Testing important for?
- Prognosis with hearing aid fitting
2. Identifies site of lesion
What does the Speech Recognition Testing consist of?
- Word Recognition Score (WRS)
- List of words (25 or 50) presented at ONE supra threshold level in quiet
- Score is percentage correct
- Variety of lists to choose from (W-22 & NU-6)
One difference between SRT and Speech Recognition Testing is
For SRT you’re getting a threshold but for Speech Threshold Testing, the score is the percentage correct
When is Speech Recognition with sentences used?
For pts with cochlea implants
What’s the pro & con of using a Speech Recognition with Sentences?
CON - connects with validity, what are we testing since the sentence’s factors in an individual’s hearing, memory, and contextual cues
PRO - presents more real-world example of speech
When is WRS not a “real world” scenario?
When it’s in quiet
What are the competing stimuli for Speech Recognition in Competition?
Noise, Competing Speech, & Multitasker Babble
Is Single-to-Noise ratio a ratio?
No
What’s the formula to find SNR?
Intensity of the Signal - The intensity of the interfering noise = SNR
What’s an example of intensity of the signal?
dB HL of someone’s voice
IF the intensity of a signal is louder or softer what does that mean?
If louder = the answer should be positive
If softer = the answer should be negative
For SNR, what does larger positive numbers mean?
Better/easier listening conditions
Patients with hearing loss would have what type of experience for SNR?
They would have difficulty hearing in noise
Since patients with HL have a challenging time hearing in noises, what does this mean?
A larger SNR is needed for them to perform at the same success rate in listening task
What seven things are criterions for Administering Speech Recognition Tests?
- Method of delivery
- Test to be used
- Method of response
- Intensity of presentation (dB)
- If testing at more than one level provides useful information
- Presence of competing signal
- Masking
Does the levels for WRS test presentation varies?
Yes
For WRS, what presentation level is commonly used?
40 dB SL & 50 dB HL
For WRS, what does 40 dB SL mean?
How far above the patients SRT is from 40
When using 40 dB SL for WRS, what’s the method?
You add 40 to whatever the SRT is
For WRS, why is 40 dB SL used?
It determines how well a patient does when loudness is increased to a comfortable level
For WRS, why is 50 dB HL chosen?
It’s the average conversational speech
For WRS, does 50dB HL pertain to sensation level?
No
For WRS, what is the reasons for using 50 dB HL?
For counseling purposes, it can inform the client on what they’re missing and compare it to the 40 dB SL letting them know what they could be hearing
For Pediatric Speech Testing, how can an Audiologist make it fun?
- Copycat
- Pictures
- “Put it in”
For Pediatric Speech Testing, what’s the problem with using pictures?
It pertains to a close set of responses which will yield more false responses
