1. Speech Audiometry
Lecture 8

2. Why do speech testing?
Most people with HL complain about inability to understand speech
Reflects how clear speech is
Tells how loud it needs to be for optimal understanding
Speech testing provides additional information about the nature of the HL
Role in decisions about and performance with amplification
Cross check principle

3. How is speech testing performed?
Examiner provides words/sentences through audiometer to headphones or speaker
Client responds by repeating or writing words or pointing to pictures
Cross hearing can occur in all tests under certain conditions
Considered a “subjective” measure

4. Common Speech Assessments
Threshold tests
Speech Detection/Awareness (decibel)
Speech Reception Threshold (decibel)
Scored tests
Word Recognition Test/Score (%)
Speech Perception Test/Score (%)
Sentences
phrases
Audibility Index – Aritculation Index
Calculated from Pure tone test
AI = % of speech audible

5. Speech Detection Threshold (SDT)
Record level (dB HL)at which an awareness or localization to sound was observed.
Sometimes called SAT
Determines ___________ only, not comprehension of words
Not considered a true threshold
Application:

6. Speech Recognition Threshold (SRT)
First test administered in audiometric evaluation
Lowest level at which speech can be understood 50% of the time
Usually a very soft level (db HL)
Use spondaic word lists (cowboy, baseball) and ask client to repeat word
Ear – specific test
Threshold obtained used as reference for the presentation level used during word recognition testing
Application:

7. Spondee Words
A spondee is a word with two syllables that are both pronounced with equal stress
Use the VU to obtain equal syllabic stress
Both syllables should peak at 0 VU if presented live voice
Also presented using recorded speech

8. Procedure
Present 1st spondee words at initial presentation level (50 dB HL)
If correct, go down in 10 dB, present another word
Continue to go down in 10 dB steps until client stops responding
When they respond incorrectly, go up in 5 dB steps
“Bracket” the response in this pattern until you determine threshold

9. Integration Concept: Relationship between SRT and PTA
High correlation between the SRT and PTA +/- 5 to7 dB HL
If difference between SRT and PTA is > 10 dB HL…
Exceptions:

10. Word Recognition Testing
Word or Speech Recognition (Discrimination) score
Word lists used are single syllable phonetically balanced (PB) words
% correct of PB monosyllabic words

11. Word Recognition Try to __________word recognition ability
Determine the best word recognition ability in ideal listening situation
Words are presented at a comfortable – listening level above threshold for speech (aka________)
If SRT = 30 dB
If SRT = 50 dB
Recorded on audiogram in percent correct

14. Materials Use monosyllabic word lists
Adults word lists generated from research efforts have unusual names, recorded on audiograms
NU – 6
W-22
Child word lists
WIPI – allows for picture pointing response
PBK

17. Scoring
Calculate a percentage of words (2 pts each) correctly repeated by the patient
%- Excellent
88-95% Very Good
80-87% - Good
Fair
50-69 – Poor
< 50% Very poor

18. Procedural vs Individual factors affecting variability
Number of words
50, 25 or 10
Monitored Live voice vs recorded ***
Use of carrier phrase
Visibility of speaker’s mouth
Multicultural Issues
Familiarity with material
Cognitive/Attention

19. Cross Over Hearing in Speech Assessments
Greater risk of cross-over in speech recognition testing due to higher presentation levels
As the level of the test signal increases, the more likely the opposite ear will be involved.
Masking in WRS
Level of words in TE – 40dB >/= best BC nte

20. Integration concept: Word Recognition Score & how it relates to type of HL
CHL – typically “excellent” word recognition scores
SNHL – “reduced” word recognition scores
Mild HL
Moderate HL
Severe HL
Profound HL
Neural – “poor” compared to SNHL
Good predictor of potential
benefit from amplification

21. Integration concept:
Relationship of speech perception to speech production

22. What’s a significant shift?
Thorton and Raffin (1978) see table Pg 154
Mathematical model to determine variability in testing speech recognition
At extreme ends little variability
96% and 4%
In middle, more variability
50%

25. Many other recorded and live voice speech tests
Two common tests used by SLPs
Phonemes
Sentences

26. LING Test
Concept behind test was to select familiar speech sounds that would broadly represent the speech spectrum from low to high frequencies of spoken English.
Determine ability to detect and discriminate all sounds.

28. CID Sentences

29. 1 minute evaluation What can you apply when you leave this room?
What was the most important thing you remember learning today? What one question would you like reviewed related to what was discussed ?
What can you apply when you leave this room?