Speech Recognition Tests

I’ve had this test from several different people at my audiology clinic, both male and female. Since their voices are different, their loudness different, and their enunciation different, I’m left wondering how much value such tests have?
As an aside–I find them even more frustrating than eye exams (is it an ‘e’ or an ‘f’) (was it ‘tree’ or ‘flee’)
Thanks for help.
Dave

The lack of control lessens the value but I think it’s a rough indicator of how likely hearing aids are to help. If the test was done at adequate volume and one is scoring in the teens and twenties consistently, I’d wonder if hearing aids are going to help much. If it’s in the eighties and nineties, one should do pretty well. Somewhere in between? They should help, but don’t expect miracles. I don’t know that there’s really much more fine tuning than that. If scores are going down significantly, it might warrant more investigation. If your scores are already low, I don’t know that there’s much benefit in doing them every time.

The loudness level is set by how well you did on the hearing test. It also tells what the softest speech or words you can hear at least 50% of the time and will help tell what level your hearing loss is at and what hearing aids will help you hear the best.

Seb,
How is the information used to help determine what hearing aids will help the best?

Regarding the sound level the test is done at, I’ve seen a lot of variety in my very limited experience. I think the classic, “textbook” way is to use MCL (most comfortable level), although I’ve seen audiologists just pick a level that he/she are confident will work.

I’ve wondered about this. It seems to me that using a pre-recorded and normalized voice would eliminate the variability in the test. I know that there are two audiologists in my office and, while they both do their best to use a neutral “audiologist’s voice,” there is no doubt that the other audiologist speaks more loudly and enunciates more precisely than mine does when doing the test.

haha thats why i found problem and wondering that why everthing worsen after comming out from office of audi. they know how to speak than you will be able to hear. from your audiogram. they show to even without ha one inaudible and another audible then fitted ha when out of office evething chaned. due to noise

LOL. Totally agree. I go through the speech recognition test about every 3-4 years, have been doing this for 30+ years now. What have I learned? That most audis use a “canned” voice recording - so for the past 10 years, I’ve listened to a MAN’s voice, even tho I think I may distinguish better with a female voice? Also, that the volume is typically set at a comfortable level as the audi-guy asks me, but then the recording begins and most times THAT is at a lower volume! Should I say “Excuse me! This ain’t at 80 dB!”

In some respects, a speech recognition test is almost goofy. Who goes around trying to distinguish or hear: DUCK POND. ICE CREAM. FREE FALL. TREE SAP. I dunno who makes up these word pairings, but what I think would be MORE meaningful is to listen to a sentence with several words or even hear a paragraph read and paraphrase that or even be quizzed on things heard. What that test would measure is actual comprehension - and that is a very important point of the whole ear/brain connection, in addition to being more “real world”.

So what if a person can repeat back ROAD MAP. THIN THING. SIDE WALK. What really matters is comprehension of the idea - and that’s something that some folks do NOT get even if they hear words in isolation. Ah, maybe I’m overworking this whole thing, but I take the word recognition score with a grain of salt. It’s just so basic, and I wish hearing tests would be more comprehensive, more physical examination and even follow-up with the SAME tests repeated after a new pair of aids is in the ear right at the audi’s office.

I have to clear up some misunderstandings about speech testing: First of all, speech testing, in no way, should be used to determine candidacy for hearing aids, and in no way does it provide us with an indication of how well a patient is likely to do with amplification. There are two types of routine speech tests that are typically done: 1) speech recognition threshold (SRT); 2) word recognition scores (WRS). SRT is generally done “live voice,” i.e., you hear the provider’s voice. The only purpose of the SRT is to check that threshold against pure tone thresholds so that we can be sure that your behavioral responses to tonal stimuli are consistent with responses to speech. WRS should be done (note: SHOULD BE), recorded. Patients often believe this measure tells us how well we expect them to do with hearing aids. Not true. This is a measure we use to test the integrity of the auditory nerve. We can compare scores between ears and compare scores over time. Note also: speech testing is not a test of auditory processing or “comprehension.”

1 Like

I trialed a pair of hearing aids almost exactly a year ago now where the whole initial testing and ‘fitting’ was done on word recognition. Online hearing test | Blamey Saunders hears. You’re meant to fine-tune them with their fitting software once you get them.

That is very interesting! I appreciate that explanation, cuz my own aud-guy had never gotten into WHY it is done, and so for decades, I’ve always assumed it had to do with how poorly my own ears hear word pairs in a vacuum of any other conversation or sentence. Tat made me wonder why the same test isn’t done with new HAs in the ear. Hm. Makes sense to test the basic auditory processing over time.

That is correct. And, the best test is from a known source. However, a good audiologist is trained to give it well. But voices do vary. I have had it from men and women and it is relatively close.

I started with the normal, aging loss. I had solid WRS. Then I got Meniere’s Disease. That is a bit of a misnomer. It is more symptom than disease and can embrace a number of causes. You can take a look a my chart to see the change.

I lobbied for WRS to also be shown. It is an important bit of knowledge about one’s hearing.

My Costco audiologist recommend I’d probably do as well with a single aid. I tried to and am glad I did. I don’t have much better understanding but it add a richness that makes things more fulfilling.

Semantics perhaps. This is just from a little research and please correct if I’ve got any of this wrong. Syndrome is typically the name given to a disorder that is a collection of symptoms that we really don’t understand what is going on. Autism, Fibromyalgia are examples. It seems like we understand Meniere’s beyond just a collection of symptoms to be related to the flow of fluid in the inner ear. I couldn’t find anywhere that called Meniere’s a syndrome, although it seems like it’s an intermediate stage. We seem to know that the fluid is the issue, but we really don’t know what causes the fluid to build up.

Regarding use of WRS. Sorry if I was mistaken, but what I shared is what I was led to believe. I still suspect if somebody has consistently very low WRS that hearing aids may be of questionable use.

Yes, my hearing now sucks with aids. In the past they were a tremendous help. I was even quite successful with PSAP type devices then.

My well thought of ENT says he knows only one doctor in the Chicago area who can successfully determine if the cause is classic Meniere’s Disease. His Audiologist told me that it is a rupture in the area between two fluids in the ear. When they co-mingle, a caustic mixture results.

I’ve detailed what it was like in other threads.

The literature would appear to back this statement:

The preponderance of studies reviewed here suggest that speech intelligibility tests, conducted either unaided or aided, are not good predictors of hearing aid benefit for everyday listening situations as measured on self-report scales of hearing aid outcome. - Source

However, I do wonder whether those with poorer WRS expect less from a hearing aid fitting, and thus report higher than average satisfaction / benefit on self-report scales of hearing aid outcome, given their actual outcome in terms of speech comprehension etc.

2 Likes

Anything less is amatuer hour. Find another provider.

1 Like

Indeed. I suppose another good use of the measure is to determine whether monaural or binaural amplification is warranted.