4 - Speech Threshold Testing Flashcards by Trina D

When did speech audiometry begin to complement PT audiometry?

After WWII

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Name 2 common complaints from patients regarding hearing and understanding speech

speakers mumble or talk too fast
female or children’s voices unclear
cannot follow conversation, especially with background noise
difficulty in group situations

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Name one criticism of PT audiometry

not “real world” sounds

- limited measure of hearing ability (detection only)

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How are speech detection and perception usually assessed (4 broad categories)?

Awareness/Detection

Identification

repeat speech stimulus
match to label or picture

Discrimination (detect change)

same/different
change (yes or no)

Comprehension
- attach meaning to stimulus by answering questions

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What are the 4 types of speech stimuli?

Nonsense syllables

CVC “bod” “dod”
ID acoustic features

Spondaic words

familiar, 2 syllable words (“hotdog”)
SPEECH RECOGNITION THRESHOLD (SRT)

Phonetically balanced word lists

single syllable words (“hit””, “up”, “shoe”)
predictive of sentence level performance in quiet
WORD RECOGNITION SCORE (WRS)

Sentences
- use of context

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Patients are better able to guess when _____ (single words/sentences) are used, than when ______ (single words/sentences) are used

Sentences

Single Words

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Speech Audiometry Procedures use what two types of assessment?

Threshold

Speech Detection (awareness) Threshold (SAT/SDT)
Speech Recognition Threshold (SRT)

Suprathreshold

Word Recognition Score (WRS)
Sentence Recognition Score (SRS)

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What is the purpose of speech audiometry (name 2)

evaluate the audibility of speech
determine the threshold for speech stimuli
cross-check pure tone audiogram

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Which speech stimuli measures are used in conventional speech audiometry?

SRT/SDT - Speech Reception/Detection Threshold

WRS - Word Recognition Score

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Which basic components on the audiometer are used for speech testing?

input selector (recorded materials or microphone for live voice)
talk back (monitor patient response)
input level control (VU meter) (monitor intensity)
attenuator (control the level of speech presented from -10-110 dB HL)
output selector (TDH headphones, insert earphones, sound field)

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What level on the VU meter should both syllables be peaking at for speech audiometry?

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What are 2 benefits of monitored live voice?

convenient

- flexible

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Name 2 positive or negative considerations for using a recorded voice presentation mode

Pros:

standardization
increased reliability

Cons:

more equipment needed
accent of recorded voice
little control over the amount of time between presentations

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What are 2 disadvantages of live voice mode?

between speaker differences
within speaker variability
consistency within/between test sessions
gender differences (female speaker level must be greater to achieve same test outcome)

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What are the two different types of assessment in speech audiometry, and name one example of each

Threshold

Speech Detection (awareness) Threshold (SAT/SDT)
Speech Recognition Threshold (SRT)

Suprathreshold

Word Recognition Score (WRS)
Sentence Recognition Score (SRS)

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Name one patient factor that you should consider when choosing your method of presentation and response format

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age
general health
cognitive status

What are the two threshold measures in speech audiometry?

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Speech Detection Threshold (SDT) - measure of threshold for detection of speech

Speech Recognition Threshold (SRT) - measure of the threshold for identification of speech

Both use 2 syllable, familiar spondaic words

True or False: SRT can be affected by whether English is someone’s second language and by neurological disorders

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True

What is another name for “Speech Detection Threshold”?

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Speech Awareness threshold (SAT)

With SDT (SAT), what percent correct is the threshold set at?

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50%

True or False: The SDT Threshold search uses the bracketing method (down 10, up 5)

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True

Which threshold measure assesses the most simple level of speech processing?

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SDT

When measuring SDT in pediatric or special populations, what are some behavioural responses we might watch for?

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Orienting to the sound (head turn)

Change in behaviour (body movement, sucking, eye widening)

What does SRT stand for, and what does it signify?

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Speech Recognition (or Reception) Threshold

signifies the lowest level at which a speech signal is RECOGNIZED and REPEATED 50% of the time

Describe the SRT Procedure

Familiarize patient with the words - select 10 and ask them to repeat them back - no carrier phrase Measure SRT - begin threshold procedure by presenting spondees (recorded or live voice) * different ascending, descending and bracketing procedures available to use

What are the instructions for SRT?

- You are going to hear a list of words - Repeat each word. Take a guess if you are not sure - (Familiarize at comfortable level) - The words will become very soft. Repeat each word. Take a guess if you are not sure

The most commonly used SRT Threshold search is Martin & Dowdy's Bracketing procedure. Describe it

Present spondee word at 30 dB HL - if patient does not respond, increase to 50 dB, then up 10 dB until positive response Once patient responds, use 10 down, 5 up procedure with 1 spondee presented at each level Threshold at 50% words correct at lowest intensity level (2/4 or 3/6)

The Downs and Minard SRT Threshold search is another ascending method, but is more time consuming. Describe it

- familiarize with spondees -present 1 spondee at lowest attenuator setting -ascend in 10 dB steps presenting 1 word at each level until client responds correctly -descent 15 dB -present 2-4 spondees/level and ascend in 5 dB steps * If 3 spondees are missed, ascend 5 dB and try again If 2 spondees are correct, stop

Explain how SRT Procedures can be modified for children

Ask them to point to the object (e.g. hotdog) on a chart

If an SRT is used to confirm pure tone test results, the SRT should be within +/- 10 dB of ____

PTA3 *If it does not match the PTA 3, consider the hearing loss configuration (sharply sloping or rising? PTA 2 using best 2 thresholds of 500, 1000, and 2000 may provide better match)

SRTs can be used to confirm pure tone test results and determine the threshold reference for presentation of __________

Suprathreshold Speech Recognition Tests

If a client shows SRTs better than PTAs, they may have a differential diagnosis of _________ (non-organic HL/CNS Dysfunction)

Non-organic HL

If a client shows SRTs worse than PTAs, they may have a differential diagnosis of _________ (non-organic HL/CNS Dysfunction)

CNS Dysfunction (e.g. brainstem lesion, cortical deafness)

True or False: Bone conduction SRT may assist you in determining a conductive component

True

True or false: SRT is easier than SDT, and results in a better threshold

False; SDT is easier (detection vs recognition), and may result in a ~10 dB better threshold

When might SDT be used instead of SRT?

- when client unable to recognize speech stimuli (e.g. repeat, write, or point) - pediatric and special populations * SDT reflects best PT threshold

4 - Speech Threshold Testing Flashcards

(36 cards)