speech discrimination gives a very rough idea of how much benefit you get from amplification, we use this to set realistic expectations. If speech discrimination is low
we need to look for other alternatives (lace), FM. etc
My mom has speech recognition scores in the 60’s. Without aids she can’t converse at all unless you yell at her. If she could get use to her own voice sounding loud and strange with aids, we can probably get speech scores into the high 70’s or low 80’s. I suggest if you have low speech scores you look at aids you can adjust yourself such as America Hears. With speech testing cd’s you can buy online you can optomize your programs in your aids for speech recognition and test the results yourself. It is doubtful that your audi is going to spend the time in making minor adjustments in your aids and testing your speech recognition after each adjustment until you are satisfied.
something like aural rehabilitation would help (LACE)
I still think, a cochlear implant specialist should be consulted. There are now hybrids cochlear implants, part acustical stimulation part electrical. This seem to be targeted at
this kind of hearing loss.
A Speech Discrimination Score tells us how well your ear and hearing nerve are understanding speech when given at a higher level. This score is a “best-case” scenario for a couple of reasons - it is done in complete silence of a sound proof booth, and you are only focusing on the testers voice with no distractions or background noise.
You hearing loss is not always the deciding factor in this score. Patients can have quite a lot of high frequency hearing loss, but when we turn up the volume and give patients the words, they are able to understand 90% to 100%. However, i could have a patient with the exact same hearing loss, and get a score of 70% to 80%. It is due to the damage done to the hearing nerve. The more damage that is done, the less speech one will be able to understand.
There are other pathologies that affect speech understanding, but they are irrelevant for this particular conversation.
We use these scores as predictors for outcomes of hearing aids because that score is usually a best-case scenario. Meaning that we can expect that even with amplification, you will not understand any MORE than that score with hearing aids. If the score is high, you will do reasonably well with hearing aids. If they score is low, you may benefit from amplification, but more realistic expectations need to be discussed. For example, if I have a score of 60%, that means that when the audi turned up the volume of their voice to compensate for my hearing loss, I understood 60% of the speech being said. So with hearing aids, it would be unrealistic to expect that I would understand more than 60% of speech due to the damage to my hearing nerve. The nerve produces distortion when damaged, and this interferes with speech understanding.
Training systems can help, but normally marginally so. They do more to help you adjust to the amplification and understand the new signals coming in from the hearing aids.
It seems reasonable with proper hearing aids and setup I should do well understanding what’s being said. As I’ve mentioned before I’ve stated my case with my audi guy and he uses it as a point of why I’m not getting what people are saying. I’ve also mention it’s the soft women voices that I’m really missing but states again he can only do so much as to raising the power because it could do me more harm than good. With all the feedback I got from him, he’s really telling me I have what I have and that’s all he can do with my hearing aids.
I’m finding myself really concentrating on what a person is saying(turning my head sideways, squinting eyes, etc.) and in doing so I miss what’s being said, does that make sense? I’m so into trying to hear whats being said because I’m afraid I’ll miss a word/phrase because I’m having a hard time with low soft voices and in that in doing so I lose track of what’s being said. hmmmm edit: my thoughts during a conversaiion is focused on not missing a word, instead of comprehending whats being said
Amplification and speech discrimination do not necessarily go hand in hand. For instance my loss is profound so based on that with enough amplification you would think I could hear just fine. But my speech discrimination for each ear is in the mid 40’s. So no matter how much amplification I receive from my aids I still struggle understanding what people are saying to me. And if a person is one of those that speaks and barely moves their lips, or has facial hair that partially covers their mouth, well then forget it.
One of these days I should get a copy of my hearing test and post it. Let’s just say where on your chart your first two numbers are 20 and 20, which is very good, mine start off at 90, and slowly get worse, like a man sinking in quicksand. Your speech comprehension is very good at 92%. It may help you to try to make sure that the person speaking to you is facing you and you might want to make more of an effort to focus on a person’s lips. I find that this helps. I have tried all types of systems, loops FM, etc. Both help but remember my comprehension is just terrible so I can say they help but not great. With just my aids my comprehension on TV without blasting it is all but non existent. With accessories like blue tooth, neck loops and FM systems it’s better but I still miss a lot. You may find this systems a great help because of your already high scores for speech. Hopefully you audi will let you try something. Keep in mind that FM systems can be very expensive. Only you can decide whether the cost is justified, for you.
With all due respect to your audi, a score 92% unaided (without hearing aids) is an excellent score. It really shouldn’t translate to you having such trouble. And if you have to focus that hard on soft voices, you need an adjustment in your amplification. What hearing aids do you have?
This is a great web site. I am a newbe and learning a lot (I hope) from all of your input. I have been a proud owner of my 1st HA set for 9 days now. Verite 9’s.
Here are my numbers:
L R Hz
-40 -85 250
-20 -65 500
-35 -45 1000
-30 -30 2000
-70 -45 3000
-70 -55 4000
-80 -65 6000
-75 -65 8000
Speech recognition 96%
Noisy restaurants are still bad. Before the aids I just sat, in general gave up on trying to understand (table w 6-8 people).
Now with one time test to date: Still can’t hear great in the noise. It is like a crashing wave coming over you. I can now pick out about 50-70% of what is being said. I do have to still really focus. Better then it was but still not great yet. Maybe when I go back to the audi in a week or so she can do some fine tuning??
Church tomorrow, we will see what difference the HA’s make there.
Well, a question about speech discrimination…
Ok, we sorted out that it decreases if cochlea and/or acoustic nerve is damaged, right? Otosclerosys itself does NOT decrease Speech Discrimination in quality.
So, now about me: I’ve always been “fascinated” by chance to have a stapedectomy on my left ear, my worse ear due to slight otosclerosys (difference with right is due to this)
Point is… what should I expect from this? Actually, I feel the difference between right and left to be like day and night, but… if I do stapedectomy, should I expect a better speech discrimination too? Or I “just” will listen sounds as loud as right, but on worse quality? This is definitively THE question that worries me…
For completeness of information, I report that when I actually use bluetooth to listen TV, I can comfortably follow dialogues with my right Audéo alone, but situation turns to difficult when I try to follow dialogues with Audéo in my left ear only.
I agree completely and success is having conversations, focusing on the topic of the conversation, not focusing on each individual word, at times missing the point.
Speech signal to noise ratio seems the key.