My speech discrimination took a 20% dive

Hi all - 3 months since onset of sudden hearing loss in R ear. Left ear already had existing loss from 30 years ago, of unknown origin. I saw an otologist yesterday for a “final” post onset visit, making sure there’s nothing else that can be done etc. We did another hearing test, and while the tone points were still about the same as my last test a month ago, my speech scores dropped 20% in both ears. (was 100 and 84, now 88 and 64) This was a different audi from the previous two tests and she used the over ear headphones, and used a recording for the speech. They were the usual terrible headphones with hard plastic and awful sound (I am a recording studio owner). I’m not actually sure if the previous two tests had the audiologist speaking the words to me - but I think so. also previous tests were the inside the ear headphones. I might call them to see if this might explain the difference. at any rate, what can be done about speech discrimination scores? I pray this isn’t a trend. I am very anxious about this. I’m mostly ok in conversation (ear buds on the iphone etc) but my wife’s voice seems to distort and I do miss some words. These are also new to me widex hearing aids, and I’m still early ion the trial. Thoughts?

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You’ve basically illustrated why we regard WRS as pretty subjective in the UK.

Handy for a simple A:B comparison but pretty irrelevant if you alter the test parameters in even a basic way.

If your audiogram is unaltered and you’ve not had a TIA , viral or another neural issue, it’s pretty unlikely what you’ve been shown in terms of WRS is accurate in terms of the original test.


I truly appreciate your posts. I learn from every one!
My audiologist is incredible and has worked really hard to improve performance of my Phonak Audeo Paradise P90R’s he provided for me.
I was concerned because he speaks out loud for my word recognition test. I’m not concerned with your response.


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My recent word recognition tests have involved standardized recorded words. My last test used higher sound levels and showed a 30% improvement in word recognition.

Costco uses recorded sounds for word recognition. I ended up getting better results from Duke University. Does University of Toronto have an audiology practice?

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OP here - audiologist just confirmed - her original audiogram used in-canal foam headphones, and it was the audiologist speaking the words herself for the discrimination scores, as opposed to yesterday’s (worse score) audiogram, in which a different audi used on top of/outside the ear headphones, and a recorded male voice, which sounded terrible, at least to me. I should probably worry a little less about it - but I will get the MRI they suggested, not that there’d be anything they could do about it if they found something. I’m finding all of this so stressful, and part of me things I should just hit the brakes on all testing, and have some peace and “normalcy” for a few weeks. sudden hearing loss (as a music producer with deadlines), navigating new hearing aids, new hearing tests, blah blah - it’s so very tiring and has had me in a rough place on some days. Thanks all

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I understand there could be some surgical options.

It is very stressful, even for those of us who have worn hearing aids for many years. Hearing tests in particular are incredibly stressful for me- this is a test I am destined to fail!
My previous Audi was a Professor and had rotating University Audi interns in the private practice. I am very hard to fit. I was always having hearing tests (more to the students’ benefits), and these students all had different (US) accents. Even though I knew many of the words, my WRS scores varied. My Audi told me the same thing Um_bongo stated. It still bothered me a lot. The world is filled with different voices, and environments, but intellectually - I know the WRS scores in theses tests vary, especially if I am stressed or allergy season, yada yada.
Sadly, you can’t rush the acclimation of new hearing aids. It is stressful making the mental decisions harder - and your work deadlines driving the need to find solutions fast. I agree, slow down, take a breath, find some normalcy - unfortunately your hearing loss will wait for you.
It is very hard on family members also.


That is why many practices, including all Costcos, use standardized voices for word recognition scoring. It has been over 10 years since I had a hearing professional test with voice.

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You missed the point. Those conducting the hearing tests were Audiology Students in the Doctoral Program interning in private practice.


And my recent test giver just graduated with her doctorate a couple of years ago. Students more than 10 years ago should have been taught the improved test methods.

Recorded word lists have been around for several decades.


It’s normal to get better scores with live voice word lists than with recorded.

That would be highly variable. I remember one person trying that with no headphones and I told them they were purposely emphasizing some sounds. She said it was to improve results???

It’s very difficult to avoid going out of your way to enunciate to help the other person out.

As ever, live voice WRS is near useless.


Certainly, but at least here in Canada my experience from 2006 to date is that most providers (at least three hospitals and four different private clinics over the years) weren’t using them until quite recently. Lots of different accents, from Slavic to Asian and various others as well, so it always made me wonder about the validity of this metric.

I guess it takes quite a long time for protocols and equipment in clinics to catch up with best practices, and old habits die hard. It doesn’t really give one a great deal of confidence about how cutting-edge other aspects of care will be…

Absolutely; as I’ve explained above, imho the use of WRS (unless you vey strictly control the environment) is pretty meaningless in anything other than immediate A:B comparisons.