Speech Audiometry/Speech Testing Flashcards
What is speech testing used for?
- measuring communication skills
- site of lesion diagnosis
- reliability check
- compromised patients
Ways to measure communication skills:
- quiet vs noise
- S/N ratios
How this applies to site of lesion diagnosis:
-speech recognition score
How do you know if something is reliable?
-it is consistent and accurate
Who would be classified as a compromised patient?
- young children
- developmental disabilities
- dementia
Audibility is not equal to ______________
intelligibility
SDT
-Speech detection threshold
SAT
Speech awareness threshold
SRT
-Speech recognition threshold
-speech reception threshold
-50% accurate word recognition using spondee words
SRT should = PTA +/- 10 dBHL
-can be influenced by configuration of hearing loss
-used to determine dBSL for discrimination testing
Speech Awareness Threshold …
- Any speech material (ba ba ba, name, counting, reading)
- use only in patients that cannot give SRT
- SAT tends to be 10 dB below SRT
- ascending/descending technique
- spondee words
- transducer/signal/routing
Common transducers:
- inserts
- earphones
- speaker
- bone conductor
Types of signals:
- Live voice
- Recorded materials
Types of routing:
- left ear
- right ear
- both
Live voice presentation …
- VU meter
- 0 on meter= exactly correct dB presentation
- stay within +/- 3 dBHL for presentation
Pros of live voice presentation:
- can control the rate of presentation
- local/native speech patterns
- can use non-standard materials
- can repeat items even though its not standardized procedure
Cons of live voice presentation:
- hard to keep voice at a steady +/- 3 dBHL
- tendency to over articulate
- accent/articulation issues
Recorded materials presentation:
- use calibration tone to set VU meter
- dial set to 0
Pros of recorded materials:
- presentation level is steady
- more standard
- no over articulation
- smooth rate
Cons of recorded materials:
- Presentation pace often too fast/slow
- some materials may not be available
- cannot repeat usually
Intelligibility Testing…
- WRS/WDS
- Presented SL
- Monosyllabic words with a carrier phrase
- open and closed sets
WRS
word recognition score
WDS
Word discrimination score
SRT _______ dBHL
+35
Open set:
- phonetically balanced word lists
- phonemes proportionate to typical English language
- Normed on kindergarten children
Closed set:
-Used for patients who cannot read words
Open set lists are mostly consisted of _____and_______. The CID W-22 is ____________________
nouns and verbs
phonetically balanced
-for adults and older children
NU6 is made up of …
a consonant, nucleus, consonant
harder vocab
Performance Intensity level:
- useful in diagnosing retrocochlear dysfunction (VIII nerve)
- Time consuming but faster than a ABR/MRI
- identify point of roll over
For performance intensity level, % correct will ______ and _________ normal listeners and sensorineural (cochlear) hearing loss.
peak and maintain
Or, % correct will ____ and ______ with higher intensities for retrocochlear disease.
peak and then decrease
What is the point of “roll over”?
- PB max -(PB min / PB max)
0. 25-0.45=-0.2 significant difference
Categories of performance:
- pg 137
- often used in reports
- relevance depends on testing materials
- Booth effect
What is the Booth effect?
-when you place a patient in a sound treated room with no distractions they will be focused on testing
Presentation Levels:
Sensation Level
- typical 35-40 dB above SRT
- provides discrimination accuracy at sufficient volume above threshold
- may be inadequate depending on hearing loss configuration
Presentation levels:
Conversational Level
- helpful in looking at real world communication skills
- May help person see need for hearing aids
Masking noise choices:
- speech babble
- multi-talker babble
- speech weighted noise (spectrum)
- running discourse
- white noise
Masking formulas
- SRT te - IA greater than or equal to nte
- If no BC data, assume 0 dBHL
- If no SL is greater or equal to 40 dBHL, mask
Dynamic Range
MCL
- most comfortable listening level
- patients subjective opinion
- can be done with pure tones
- primarily used for speech testing
Dynamic Range
LDL (UCL)
- Patients subjective opinion of uncomfortable level
- pure tones, but primarily speech
Dynamic Range
SRT LDL
- Dynamic range of hearing (threshold to discomfort)
- Reduced dynamic range in problematic
Recruitment
-Unusual growth in loudness perception
-Perception changes quickly with limited increase in dB
MCL may be only slightly above the SRT
Low % scores due to insufficient gain
-Creates a small dynamic range
Tend to do poorly with hearing aids
May not tolerate increased input levels
Testing in Noise Routing and signal
- ipsilateral or contralateral
- speech weighted noise, multi-talker babble
Quantitative info:
-% correct at varying levels
Qualitative info:
- slower response rate
- hesitation
- guessing
- request repetition
Additional Speech Tests (open sets):
- HINT hearing in noise test
- CID everyday sentences
- Utley Test of lip reading
- SPIN speech perception in noise
HINT test
- Hearing in noise test
- presented in quiet and in noise
- ascending and descending technique
- evaluates aided and unaided
CID
- everyday sentences
- 10 sentences presented
- 50 key words within sentences
- % correct of key words=%correct score
Utley Lip reading test:
can use auditory only for speech recognition
SPIN
- speech perception in noise
- assesses key word (last word in the sentence)
- High predictability vs low predictability lists
Additional speech tests (closed set):
- Synthetic sentence identification
- WIPI Word identification by picture identification
- Nu chips
- CCT California consonant test
Synthetic sentence identification:
- 10 nonsense sentences
- Present competing noise using connected discourse
- pick correct sentence form list
- must be able to read
WIPI
- word identification by picture identification
- 6 color pictures on a page
- words sound similar
- normed on 4-5 year olds
Nu Chips
- normed on 3-4 year olds
- 4 pictures per page
- black and white
CCT
- California consonant test
- 100 test items
- pick from four choices
- highly sensitive to high frequency losses
- ID’s consonant confusions
Additional Speech Testing (not normed):
- Ling Six sound test
- Body parts
- Same/different
- SERT sound effects recognition test
Ling Six sound test:
- each sound is representative of a frequency range
- help determine threshold levels
- check aided function
- reception/perception
Body Parts test:
- labeling/pointing to body parts
- can give estimates of speech perception
- Ear/hair nose/toes teeth/knee
Same/Different Test
- different levels
- monosyllabic vs bisyllabic
- spondee words
- monosyllabic with diverse vowels
- monosyllabic with diverse consonants
SERT
- sound effects recognition test
- technically not a speech test
- can give info about frequency perception and pattern perception
- taped sounds, pick from pictures
Downside to non-standardized materials…
can be misleading to parents, patients and therapists
Fewer test items =
more variability in results
Single word tests are designed for 50 words however most audiologists use____ because _____________.
25
It increases the variability between tests
