Speech Audiometry

Question 1

What are the levels of Speech Perception?

Answer 1

Question 2

Why do we conduct speech audiometry? (3)

Answer 2

• See if someone can understand speech sounds
• To cross-check thresholds of a pure-tone test
• Differential diagnosis (might tell you what is going wrong CHL or Tumor)

Question 3

Explain the cross-check:

Answer 3

Doing speech audiometry let’s you answer questions like:

• Did the person misunderstand the threshold test?
• Is the person trying to fake the threshold test?

Question 4

Explain the differential diagnosis:

Answer 4

Differential diagnosis (i.e. physiologic diagnosis – related to body impairments)

More complete diagnosis of speech perception ability (diagnosis of function – activity limitations)
are there deficits in speech perception beyond that which would be predicted in the audiogram?

i.e. to distinguish cochlear from retro-cochlear loss
what is the evidence for this?

Question 5

What is the difference between Absolute and Differential sensitivity?

Answer 5

• Absolute sensitivity
  pure tone thresholds
• Differential sensitivity
  frequency resolution (hearing loss)
  temporal resolution (aging, processing disorders, lesions, neuropathy)

Question 6

What is SRT?

Answer 6

The Speech Reception Threshold
This is the threshold for identifying a speech sound.

Question 7

What is the purpose of SRT?

Answer 7

• Coss-check pure-tone
• Understanding of test
• To check pseudohypoacusis
• Establish a base line for other tests

Question 8

SRT should be within ______ of pure-tone average.

Answer 8

10 dB

Question 9

What could explain an SRT that does not match threshold?

Answer 9

Your SRT is 25 dB and your PTA is 50 dB

Question 10

Why did we choose the PTA at 500, 1000, and 2000?

Question 11

Why is the SRT the same as the PTA?

Answer 11

• Speech has many short-term levels
• Speech is calibrated to produce a level 12.5 dB above a pure tone because some speech sounds are below the PTA threshold so we bump it up
  0 dB for speech is 12.5 dB higher than 0 dB for tones

e.g, so if you have 52 dB HL, the threshold will be 52+12.5= 65 dB SPL

Question 12

What is the SLM?

Answer 12

1/8 of a second

Question 13

What are Familiarized spondees?

Answer 13

Words that have the same stress on the vowels, thus very easy for you to identify especially for kids

Question 14

What is SRT-monitored live voice?

Answer 14

• Monitored live voice most common until recently
• Provides customizability
• Face always must be covered – remember McGurk

Question 15

What is the Martin & Dowdy (1986) Procedure?

Answer 15

• One spondee at suprathreshold level (after familiarization)
• Down 10 after the success
• Up 5 after missed word
• Stop when 3 words are repeated correctly
• Should be within 10 dB of PTA (or the best 2 out of 3 Fletcher AVG)

Question 16

Question 17

Question 18

Answer 18

Suggests collapsing canal
Needs to be retested
AC are lower than BC

Question 19

What is the difference in accuracy from SDT to PTT?

Answer 19

SDT 2 to 6 dB better than the pure tone threshold

Question 20

Why would you measure the SDT?

Question 21

What is Suprathreshold Testing?

Answer 21

speech presented above the auditory threshold of the listener.

Question 22

Which Results are good and why?
1. Left Ear
SRT: 10
WRS: 100%

2. Right Ear
   SRT: 35
   WRS: 4%
3. Right Ear
   SRT: 35
   WRS: 75%

Word Recognition Score

Answer 22

1 and 2

3 WRS is not normal at the level, you have to refer to the table

Question 23

Explain the nature of speech perception:

Answer 23

problems with speech understanding are the primary reason for seeking audiology services

Question 24

What would be the lowest % of WRS which would be normal?

Answer 24

PTA and % Correct (Monosyllables-NU6 25)
Refer to this

Question 25

What is in the standard word recognition (WRS) test?

Answer 25

- Open-set monosyllables are used (CID W-22 or NU-6 or PB50) - the list must NOT be familiarized first - Carrier phrase is used e.g. Say the word ‘car’; Say the word ‘talk’, etc. - Presentation level is held constant during the test - Testing should not be performed with MLV, unless absolutely necessary! if time precludes the use of taped speech materials, time should be preserved by not administering speech tests at all (Stach, 1998)

Question 26

What presentation level should you present words?

Answer 26

* Rules 40 dB above threshold (40 dB SL) MCL upper limit of MCL MCL and high level (MCL = Most Comfortable level) - best is PBmax maximum score, not best level!

Question 27

What is PBMax?

Answer 27

Lowest Maximum WRS to be considered normal

Question 28

How stable are word recognition scores?

Answer 28

If you have a few items on your list like 10 not really compared to 150 items.

Question 29

Why use Phoneme scoring?

Answer 29

Gives you more stable speech scores sat s,a,t mop m,o,t din d,i,n with w,i,th job j,o,b

Question 30

What is a PI function?

Answer 30

Different Speech Recognition items present at different levels. a= Normal b= CHL cde= SNHL - for conductive loss performance is normal once signal level is increased (100%) - for sensory loss performance declines with increasing hearing loss - for retrocochlear loss, scores are often lower at higher levels (this is called ‘rollover’) performance is also often lower than would be predicted by the SII

Question 31

What is Rollover?

Answer 31

scores are often lower at higher levels (this is called ‘rollover’) performance is also often lower than would be predicted by the SII PBmax = best score PBmin = lowest score at higher level RI = (PBmax-PBmin)/PBmax RI = (64-38)/64 RI = 26/64 RI = .41

Question 32

When would you refer when there is rollover?

Answer 32

RI = (PBmax-PBmin)/PBmax RI = (64-38)/64 RI = 26/64 RI = .41 Neural problem suspected when PB50 RI > .45 NU6 RI > .35

Question 33

Case study: Is this a normal result?

Answer 33

No, should refer

Question 34

Case study: Is this a normal result?

Answer 34

Yes, matches the result of a SNHL

Question 35

How would you expect the speech recognition scores to be depending on the sites of lesions?

Answer 35

Question 36

What are the different speech materials in Speech audiometry?

Answer 36

* Connected Speech (CST) * Sentences (CID everyday sentences) Sentences: critical frequency region is 750 Hz. People with HFSNL will generally perform well if sentences are used * Spondees (W-1) * Monosyllables (PB50, CID W-22, NU6) Monosyllables: critical frequency is approximately 1900 Hz – people with HFSNHL will have difficulty with PB words especially as degree of loss approaches 40-50 dB HL * Nonsense syllables (NST, Modified Rhyme Test) CCT

Question 37

What is the speech intelligibility index? (SII)

Answer 37

It is a bridge between the audiogram and speech understanding

Question 38

What is does the speech intelligibility tell us? (SII)

Answer 38

A single number between 0 and 1 (0–100%): what percentage of the speech information is audible? THIS can tell us what is “normal”

Question 39

What is the SII of this loss?

Answer 39

42 dots above the threshold so about 25 % of speech is audible

Question 39

What is the SII of this loss?

Answer 39

45 dots below the threshold so about 90 % of speech is audible

Question 40

Is a 5 dB shift significant?

Answer 40

Definitely, because a 5 dB shift causes at least 20 additional dots to not be heard from those two graphs

Question 40

Is a 5 dB shift significant?

Answer 40

Definitely, because a 5 dB shift causes at least 20 additional dots to not be heard from those two graphs

Question 41

Is a 5 dB shift significant in SII units?

Answer 41

5 dB shift causes at least 20 additional dots to not be heard from those two graphs