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Speech Audiometry
Audiology Exam 2
| Question | Answer |
|---|---|
| ____________ are presented through Audiometer | Speech stimuli |
| Speech stimuli may include? | • Integrated Speech Lists • External CD/MP3 player |
| For speech audiometry, what transducers (always air conduction) are used? | • Sound Field Speakers • Earphones • Inserts |
| In the test environment, don't let the patients read your ______ | Lips |
| What should be done in a test environment? | • Dim the lights on the audiologist side of booth • Use Acoustic Hoop • Spin patient 90 or 180 degrees away from window • Use Recorded Speech |
| What can you do to consider each patient? | • Bigger problem for speech testing than pure tones • Patients ability to Respond • Testers ability to understand the response for scoring purposes • Level of patients vocabulary |
| Sound hoop | Acoustically transparent, but hides the audiologists mouth. |
| The patient is repeating words _______ for most tests | Verbally |
| More basic speech tests may simply require the patient to detect the presence of speech by what two things? | • Hand raise • Button press |
| Some patients may not be able to respond vocally, what can be done during the speech test instead? | • Point to picture • Write response |
| Monaural | Stimuli presented to only one ear |
| Binaural | Stimuli presented to both ears |
| Most Audiologists will test each ear _________ | Individually (monaurally) |
| Some audiologists will also test both ears _______ | Simultaneously (binaurally) |
| Testing both ears simultaneously does what two things? | • Gives an indication of how the patient hears in real life (with 2 ears) • More frequently done with hearing aid candidates (Especially when the ears are different in their performance) |
| Monitored Live Voice | The tester speaks the words through a microphone and monitors the volume of their voice through the audiometer (Ex: "Any problems with this?") |
| Recorded Speech | Either CD or MP3 recorded speech lists that are calibrated through the audiometer and presented (Standardized) |
| Open response | An infinite number of possible responses: • Patient most generate answer independently • Example- Fill in the blank |
| Closed responses | Limited number of possible responses • Patient provided answers to choose from • Example – Multiple Choice |
| Pure tones represent a ________, whereas speech is a complex signal that crosses ___________ (250-8000 Hz) | Single frequency, Many frequencies |
| When speech testing, what is being tested? | A range of frequencies |
| Patients with different audiogram shapes will perform differently on speech tests based on which __________ they have poorer hearing in | Frequencies |
| What are the two different speech threshold tests? | 1- Speech Awareness Threshold (SAT) 2- Speech Recognition Threshold (SRT) |
| Speech Awareness Threshold (SAT) | Softest point at which patient indicates they can detect speech is present |
| Speech awareness threshold _______ require patient to understand and repeat words- just has to know that speech is present | Doesn't |
| Speech awareness threshold responses involves? | Hand raising or button pressing |
| Speech awareness threshold stimuli involves? | Ongoing speech or continuous discourse |
| Speech recognition threshold (SRT) | Softest point at which 50% of speech is understood |
| Speech recognition threshold stimuli involves? | Spondee words - Two syllable word pronounced with equal stress and effort |
| Give an example of a spondee word | Hotdog, Airplane, Baseball, Toothbrush, playground |
| Speech recognition response involves? | Repeat word, point to picture, write word |
| How do you find the speech recognition threshold? | Essentially the same as for pure tones (down 10, up 5), but using spondee words |
| Speech recognition threshold should be close to the average pure-tone threshold of ______, _______, _____ Hz (Pure-tone average PTA) | 500, 1000, 2000 |
| Most Comfortable Level (MCL) | Level at which speech is comfortably loud for that individual patient |
| How does most comfortable level work? | Continuous discourse presented at various intensity levels – patient indicates when speech is most comfortably loud |
| Most comfortable level is commonly measured among which patients? | Hearing aid patients (NYS law requires this test) |
| Average conversational speech is approximately? | 50 dB SL |
| Uncomfortable loudness level (UCL) | Level that speech (or tones) become uncomfortably loud to an individual patient |
| Normal uncomfortable loudness level is? | 100 dB HL |
| How does uncomfortable loudness level done presented? | Presented at increasingly louder levels until patient identifies it becomes uncomfortably loud |
| Uncomfortable loudness level is ________ discourse or _______ | Continuous, pure tone |
| Uncomfortable loudness level is measured for which patients? | Hearing aid patients |
| Uncomfortable loudness level is also known as? | Loudness discomfort levels (LDL) |
| Dynamic Range | The decibel range from the softest level patient can understand speech (SRT) to the level at which speech becomes uncomfortably loud (UCL) • i.e. UCL-SRT-DR |
| Patients with hearing loss have _______ dynamic range | Smaller |
| Speech recognition threshold gets _______ but uncomfortable loudness level stays at the ______ level with sensorineural hearing loss | Higher, same |
| Recruitment | Increased loudness growth |
| Speech recognition testing | Tests how well patients can recognize speech at supra-threshold level (NOT a threshold) |
| Supra-threshold | speech presented ABOVE the patient's threshold for speech (i.e. SRT) |
| In speech recognition testing, making speech ________ helps patients. These patients need _______, not clarity | Louder, volume |
| In speech recognition testing, making speech louder that helps some patients may indicate what type of hearing loss? | Conductive hearing loss |
| In speech recognition testing, sometimes making speech louder does not help. The patient needs _______ and ________ | Clarity, volume |
| In speech recognition testing, when making speech louder doesn't help patients, what type of hearing loss do they most likely have? | Sensorineural hearing loss |
| Word Recognition Score (WRS) is done with what type of testing? | Speech recognition testing |
| Word Recognition Score (WRS) | Patients presented a list of 25-50 monosyllabic words at 40 dB SL above SRT (supra threshold) |
| Word Recognition Score is scored as _____ correct | % (Ex: 25 word list- each word is worth 4%) |
| Word Recognition Score is commonly performed with a? | Carrier phrase |
| Monosyllabic Words | Words with one syllable (Ex: An, Yard, Carve, Your) |
| Carrier phrase | “Say the Word___”, allows patient to know when word is being presented |
| What happens when the carrier phrase is absent from the word recognition testing? | The patient performs poorer on the word recognition score |
| Rollover testing | When word recognition score testing is repeated at two or more different intensities |
| In rollover testing, typically _______ increases with an increase in presentation level | Word recognition score |
| If a patient's word recognition score decreases when words are presented at louder levels, this could be a sign of? | Retrocochlear damage |
| Retrocochlear damage | Damage beyond the cochlea in the central pathway |
| Speech recognition testing with sentences is not commonly used for? | Basic evaluation |
| Speech recognition testing with sentences, define "the good" | Present a more “real world” listening scenario |
| Speech recognition testing with sentences, define "the bad" | Test results confounded by patients memory and ability to “fill in the blanks” using contextual cues |
| In speech recognition testing with sentences, the bad could alternatively use ____________ | Sentential approximations |
| Sentential approximations | Nonsense sentences |
| Speech recognition testing with sentences are more often used in? what type of evaluations? | Complex audiologic evaluations |
| Speech recognition testing with sentences are more often used in these two complex audiological evaluations | • Auditory Processing Disorder • Cochlear Implant Evaluations |
| The most common complaint among patients with hearing loss is? | Difficulty hearing in background noise |
| Word recognition score does not replicate a _________ scenario | Real world |
| Some patients with hearing loss may perform _______ on words presented in the quiet | Normal |
| Some patients could _______ much more in the presence of background noise | Struggle |
| Speech Testing simultaneously presents a _______ and __________sounds | Signal, competing background |
| Signal | Words, sentences |
| Competing background sounds | Multi-talker babble, speech noise |
| Signal to Noise Ratio (SNR) | The difference between the intensity of the signal and the intensity of interfering noise |
| Positive signal to noise ratio (SNR) | Signal is louder than background noise |
| Negative signal to noise ratio (SNR) | Competing noise is louder than Signal |
| For speech in background noise, patients with _________ need a higher signal to noise ratio than patients with normal hearing to perform at the same success rate on listening task | Hearing loss |
| (Speech Testing in Pediatric Population) Kids can't/won't repeat words, they require an alternative approach depending on ___________ | Stage of development |
| (Speech Testing in Pediatric Population) Pointing to pictures of word or body parts, requires recognition of ________ or ________ | Word Recognition Score (WRS) or Speech recognition threshold (SRT) |
| (Speech Testing in Pediatric Population) What game can be used for recognition? | Simon Says Game |
| (Speech Testing in Pediatric Population) Conditioned play | Perform a task when they hear a sound |
| What is an example of conditioned play | Block in the bucket |
Created by:
RachelJClark
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