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The Importance of Speech Testing in Audiology

Learn the role of speech testing during a hearing evaluation and whether or not it can affect your treatment.


Hi, I’m Jim Cuddy. And this is Ask The Hearing Doctors and I’m joined today by Dr. Ashly Wilcox, Dr. Adriana Martineau, doctors of audiology with Hearing Doctors. The Washington DC area’s highest-rated audiology practice with over 1,500, five-star reviews. Adriana, Ashly. Great to see you both. Thank you.

 So we’re always talking about testing for hearing. Today we’re talking about speech testing. What is the purpose of speech testing?

 Yeah. So, um, when somebody initially comes in for, um, a hearing test, we test two things. So you’re testing the ability for you to detect tones. And then the second part that, um, most people don’t think of is your ability to under understand speech. So we also evaluate speech. That’s important because in your everyday life, you communicate with speech. So it’s crucial that we test that in the office.

 All right. So now let’s talk about some of the tests that you do in speech testing. Now there’s SRT, Speech Recognition Threshold. What is that?

 So after you’re listening to those beeps or the pure tones, we’re going to move on and we’re going to start with the speech testing. So we’re going to ask you to repeat words that you hear, and the words are called spondees. They’re two syllable words. So baseball, hot dog, playground. And all we want you to do is repeat back the word that that you hear. And the goal is to repeat back 50% of the words, correct. At the softest level. And that’s per ear. So we’ll eventually we’ll play it louder and we’ll get softer and softer until you don’t know what they’re saying. And then we’ll bring it back up and whatever that, uh, that less, that decibel is, that is your SRT. And the reason why we do that is it further helps us with the next part of the speech testing. It gives us, um, a starting level.

 Yeah. Um, and the next part of the speech testing is word recognition. So your ability to discriminate and understand the words at a level that’s presented, that’s appropriate for your hearing. So typically what people, um, audiologists will do is it’s about 30 to 40, um, decibels sensation level above your SRT. So if, um, for an example, if you’ve got an SRT at 20 decibels, you’re going to present at 60 decibels or 50 decibels, and what we’re actually presenting is another word list. So, um, in this word list, it’s a little bit different from the spondees that you would hear. It’s a word list that’s specific, um, that’s recorded. And, um, this word list is usually 25 words to 50 words that you’ll hear. It starts with a phrase, “say the word” dog. As a patient they would just repeat that last word, which would be dog. After we get that tallied up of the 25 words or the 50 words that you’ve repeated back to us, we’d score that out of a hundred percent. So if you’ve got, let’s say you got two words, you misunderstood two words, okay. Then your score for that ear would be 92%. And then we would do the same thing on the other ear.

 Okay. Now another one, MCL, Most Comfortable Listening Level. What are we looking for there?

 So that we’re looking for the most comfortable level if you had to listen to sound or speech at that level all day. When I do it, um, I like to tell the person, if I were a radio and you had to listen to me all day is this a comfortable listening level, or do you want me louder or softer? It just helps further determine the appropriate gain for the hearing aid. So you’re listening at a comfortable level. We don’t want anything uncomfortable or, you know, not audible enough.

 All right. Now the next one, UCL, Uncomfortable Listening Level. I’m assuming this is the opposite of the comfortable?

 Yes. So this is very important. Um, what we’re looking for is the most uncomfortable listening level, and we’re playing a different beeps for this. It’s not words typically. So we want to find the point where if it were to be any louder, it’s almost painful. And the reason why this is important is it allows us to ensure that your hearing aid will never go over that level. We never want your hearing aid to exceed your UCL because that would be painful and it’s not good.

 Right. Right. So that you’re actually controlling that, that upper end or whatever, whatever the correct terminology would be for that. All right. Now, something else, speech in noise testing. What is that?

 Yeah. So, um, that’s a test called QuickSin. Also, there’s another test that’s called HINT that you can do, um, in our practice, we do QuickSin. Um, but what it is is it’s a speech in noise testing. So it puts somebody in a real world as real world, as we can get in the office, a real world experience. Um, people who have hearing loss or hearing deficit, um, the most challenging environments, is when you are in background noise. So with the speech in noise testing, we actually present noise in the background while you read off, or repeat back a sentence to us. So we’re testing to see if you’re able to decipher what’s speech and what’s noise. And then that allows us to better fit you with a hearing aid. And recommend what’s best for you technology level wise.

 Right. Right. That’s covering a lot of bases. I just, you just don’t think of these things when it comes to the hearing problems, but it’s nice that you cover all of these kind of real world, um, real life experiences. Can, can you complete speech testing with patients who have say strong dialects, different languages and that kind of thing?

 Yeah. Um, I think it’s really dependent on the person, but as long as they know what task they’re given and they feel comfortable, then yeah. Um, I’ve done it and I’m sure you’ve done it as well. Definitely.

 So, it’s something that is available in many languages?

 Yes. Um, I know we also, uh, do speech testing in Spanish, um, Dr. Anzola here at Hearing Doctors speak Spanish. So that is very nice, um, for those who don’t speak English. Um, so cause we, we just need speech testing is very important for your goals and your, your capabilities. So we just, it’s very important for us to know.

 Yeah. So what is the end goal with speech testing?

 So the end goal is to just really know your ability to hear and process speech. Speech is part of our communication every day. So if you’re unable to hear those words clearly and process those sounds, it’s going to take an effect and help us take into consideration some counseling techniques we can give you, what best hearing aid is suited for you. Um, we just, it’s so important for our testing and it’s, it’s very necessary. So it just allows us to know how are you able to communicate? And how are you able to hear speech? Because everyone is different and not everybody can hear speech clearly. Not everybody for their word recognition score will have a high, hundred percent. So we need to know where you stand, because that helps us, you know, give you advice and give you techniques.

 I yet, again, I just never realized how much goes into, uh, testing for, for, for people’s hearing loss and things like that. Obviously speech is a huge part of it. Thank you for bringing that to us today, to our attention and teaching us a little bit more about it. Of course. Thank you.

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Dr. Ana Anzola, CCC-A, FAAA, ABA Principal

Dr. Anzola received her Doctorate degree in Audiology (AuD) from the Arizona School of Health Sciences, and her Master’s Degree in Audiology and her Bachelor's Degree in Speech Language Pathology and Audiology from Towson University. She has been a fellow of the American Academy of Audiology (AAA) since 1995, board-certified by the American Board of Audiology (ABA), and certified by the American Speech-Language-Hearing Association (ASHA).


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