Word Recognition Score (WRS)

Hearing Loss
#1

My recent tonal test took about 4 minutes and the WRS test took about one minute at my ENT’s office audioloigist. Total exam.

The two previous WRS tests, there, were not recorded input – but done live. My previous two tests showed WRS with problems and were done live by the same person.-- a woman. The third and most recent test showed no problems at all with WRS (100%) but also done live by a different female audiologist. (My hearing loss is in the upper frequencies)…

My personal experience outside that office shows without a doubt I am having problems understanding certain words. Can two different audiologists with different voice frequencies generate different word recognition scores? Should they have used a recorded test input for comparison purposes?.

#2

Recordings are consistent.
Your tests were not.

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#3

My initial audiogram and testing used recorded sounds and generated tones. It took probably 20 minutes or more.

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#4

I had a test on Tuesday, tones through headphones then bone conduction and that took a good 20 minutes and wasn’t particularly drawn out. I can’t see word recognition scores being consistent with different voices even if they were both female, were they done at the same office? Doesn’t seem very reproducible to me but would also be dependant on your audiogram

#5

WRS is variable even when taped, and different audiologists are often testing for different things when doing it and present it at different levels. Live-voice WRS is only going to give a very gross measure, and becomes more and more meaningless as it is done by different speakers. But the ENT probably isn’t looking for how well you are able to hear speech in quiet. She’s looking for whether you have 100% in one ear and 0% in the other which could indicate some sort of retrocochlear lesion.

#6

Was she looking at you when the test was done?

People don’t typically realize how much they read lips, and with high frequency loss, the sound you miss are formed by the teeth, tongue, and lips, and easy to recognize. When I do live voice discrim, I always cover my mouth so that lip reading is not possible.

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#7

@eric.cobb I can remember going for WRS and the grad student turned her back to me. :flushed: With my profound high frequency loss I badly failed that particular WRS. So badly I asked her to do it again but to get a piece of paper and cover her mouth… My scores still weren’t the best but they were a lot better than 2% both ears.

#8

Can someone help me to read parts of my audiogram? I got the “hearing level” thing, but can’t figure out the other numbers… there is a box labeled: "PTA (dBHL) /AI (%), with readings for Right and left … with categories AC, BC and IA … for Right it shows AC 45; AI 14; Left: AC 55, AI 9. is this word recognition? I really don’t see anything in WRS/SRS box, except for 60 db Hl for both ears? Does this mean I didn’t have a word recognition test?

On an older audiogram, Under “speech audiometry” box, it showed the following but again, I don’t really know how to read it…

SRT/SAT Word Recog

R 45 dB 70/72 %

L 50 dB 80/56 %

I’m confused at to the two percentages? Or is that one percentage?

THanks for any help… I know I should go back to audiologist for more thorough explanation but am trying to get as smart as I can before I go…

#9

The SRT is Speech Reception Threshold and is the lowest level at which you get 50% of the spondiac (two syllable words) correct. The 70/72% is a 72% word recognition score when presented at 70dB. The right and left are a little different which is very common. The AC PTA is air conduction (with headphones or insert earphones) pure tone average of 500, 1000 and 2000 hertz. The AI is articulation index and represents the number of data points out of 100 that fall within you range of hearing. The data points are weighted with more of them in the critical high frequency area. By the way, WRS is also commonly called PB Max (phonetically balanced words maximum score} or also word discrimination score. There can be big differences in scores with regards to different voices and male or female presenters. If they have not done it yet, they should do speech mapping and hearing in noise tests as well.

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#10

Yesterday i had my first 2 hour audiology appointment for a hearing test. I was asked to listen to the recorded words and then sentences.

I closed my eyes in the booth so i couldn’t read the audiologist lips. I may as well have taken the headphones off as i could barely grasp even a few words and once the sentences were played i could not understand a word at all. It seemed too fast and was over before i knew it. I was in disbelief at first.

Since coming back home and thinking it over, it is my opinion that word recognition testing is not accurate because it was a tone of voice i could not understand

For those new to hearing loss it is worth pointing out that the recorded word/sentence test was done with headphones on in a sound proof booth and is played at a loud enough volume and perhaps even a little too loud as determined by the audiologist. You can ask the audio to turn the volume down if it is too loud.

I have listened to many different audio recordings on youtube with amplifier hearing devices and some voices i can understand and others i cannot.

Speech understanding depends on the speakers sex, tone, accent and speed of speech.

Even though my word and sentence recognition was zero i am looking forward to seeing if hearing aids being frequency adjusted and compressed would give a much better result.

I am due for fitting in the next few weeks as it will be custom fitted ITC earmoulds. A backup pair will be provided on the day of fitting.

I am excited as it will be the first time in my life since i have worn a pair of hearing aids since i was born with progressive deafness from birth.

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#11

Updating your audiogram for us to see would nice.
Word recognition of zero is bad. Do you just read lips or did you just give up doing the tests?
I am surprised your fitter is putting ITE aids on you with such bad hearing. We’re cochlear implants mentioned?
Sorry to be so negative, just trying to understand your hearing loss.
Let us know.

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#12

@Raudrive Yes, i will be updating my audiogram in the coming weeks. I did see 60db loss in the low frequency and 90db in the higher frequency. It is the left ear that is worse. I am sure i need to pay first for the hearing aids before the audiologist will allow me the audiogram results. I can only understand the receptionist and audiologist voice with hearing amplifiers and lip reading but no word/sentence understanding with the recorded voices. I did complete the test including bone conduction. I probably did most of the talking but there was no mention of cochlear implants. Like i mentioned in my post i do feel that the word recognition test is not accurate as sex, tone, accent and speed of speech makes results vastly different if there were to be other recorded voices presented. I showed the audiologist my ENT audiogram that was taken 30 yrs ago. I am surprised that she told me the left ear is still 90db when it seems much higher.

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#13

My take. I’m more inclined to doubt the audiologist/hearing aid fitter than the Word Recognition Test. Those tend to be pretty standardized. Sounds like they’re largely interested in selling a pair of hearing aids. Feel free to ignore.

#14

@MDB I appreciate your comments. As there was no suggestion of cochlear implants i insisted i would like to try the Starkey livio ai 2400 custom moulds. I was asked to sign the paperwork for a trial period. Once fitted a backup pair will be provided. Maybe my word recognition will be much improved when retested with new hearing aids as i was tested unaided since it was my first time. Even if i was a candidate for cochlear implants it wouldn’t be approved since they need to know first if hearing aids work for a period of time. With the backup hearing aids i am going to listen to youtube podcasts and see if i can understand any words with my iphone at full volume. That is the only way i can find out if hearing aids will work for me. But yes, i don’t ignore anyones post as i feel it is valuable feedback and is a concern whether H/Aids will help my word recognition without lip reading.

#15

Can somebody please help me understand this situation? Although i had zero word/sentence recognition in the sound booth i did a self experiment. I turned up my iphone volume to full and placed the speaker at the bottom of the phone deep in each ear seperately and then listened to a Dr Cliff youtube podcast. To my surprise could understand every word! What does this mean people? Would be grateful to hear if anyone has tried doing the same. Please remember that this is without hearing aid or cochlear implant if you give it a try :slightly_smiling_face:

#16

I have no idea. I don’t really even understand what you did. “speaker at the bottom of the phone deep in each ear separately”?? Phone held at ear and listened twice? Earphones? Perhaps the WRS test wasn’t done correctly although I think you said the volume was pretty loud. Again, I really have no idea.

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#17

Hey, sorry for any confusion. I turned up the iphone and at the bottom of the phone is where i can hear most of the sound coming out. When i placed the bottom part of the phone (speaker - near where you plug in the charger) i pressed the phone as tight as possible against my ear. I could understand words perfectly. Then i repeated for the next ear. Yes, the headphone test was loud but no clarity. Maybe if the volume was turned down and piped directly into my ear canal i would have understood every word! Something tells me that sound is bending very quickly even at a short distance. And i discussed with the audiologist that by having a ITC it would help put sound deeper into the canal for better word understanding. I dont think i would get the same results with a BTE custom mould or RIC.

#18

Thanks for clarification. I wonder if you have some bone conduction going on? I still have no explanation.

#19

No worries and sorry again for any confusion. Yes the bone conduction test was completed and the audiogram results showed it looked almost identical to the first hearing test audiogram results. Weeks prior to getting tested i bought a pair of bone conduction headphones and found no benefit so the middle ear seems to be working fine. I am wondering if i have profound deafness in one ear and severe in the other that caused the lack of word understanding?

#20

The ITC aids are no deeper in your ear canal than any other hearing aids. All are placed and built to put sound at the eardrum. The style hearing aid you need is decided by your hearing loss.

Not so bad hearing losses can use most styles of hearing aids. But…as a persons hearing loss gets worse the choices are limited. Telling your fitter exactly what style hearing aids you want may be setting yourself up for failure and not hearing the best you can. It all depends on your hearing loss. It’s important.

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