scholarly journals A Comparison of Presentation Levels to Maximize Word Recognition Scores

2009 ◽  
Vol 20 (06) ◽  
pp. 381-390 ◽  
Author(s):  
Lesli A. Guthrie ◽  
Carol L. Mackersie
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Maximum Level ◽  
Computer Assisted ◽  
Phoneme Recognition ◽  
Presentation Level ◽  
Wide Range ◽  
Severe Group ◽  
The Mean ◽  
Intensity Functions

Background: While testing suprathreshold word recognition at multiple levels is considered best practice, studies on practice patterns do not suggest that this is common practice. Audiologists often test at a presentation level intended to maximize recognition scores, but methods for selecting this level are not well established for a wide range of hearing losses. Purpose: To determine the presentation level methods that resulted in maximum suprathreshold phoneme-recognition scores while avoiding loudness discomfort. Research Design: Performance-intensity functions were obtained for 40 participants with sensorineural hearing loss using the Computer-Assisted Speech Perception Assessment. Participants had either gradually sloping (mild, moderate, moderately severe/severe) or steeply sloping losses. Performance-intensity functions were obtained at presentation levels ranging from 10 dB above the SRT to 5 dB below the UCL (uncomfortable level). In addition, categorical loudness ratings were obtained across a range of intensities using speech stimuli. Scores obtained at UCL – 5 dB (maximum level below loudness discomfort) were compared to four alternative presentation-level methods. The alternative presentation-level methods included sensation level (SL; 2 kHz reference, SRT reference), a fixed-level (95 dB SPL) method, and the most comfortable loudness level (MCL).For the SL methods, scores used in the analysis were selected separately for the SRT and 2 kHz references based on several criteria. The general goal was to choose levels that represented asymptotic performance while avoiding loudness discomfort. The selection of SLs varied across the range of hearing losses. Results: Scores obtained using the different presentation-level methods were compared to scores obtained using UCL – 5 dB. For the mild hearing loss group, the mean phoneme scores were similar for all presentation levels. For the moderately severe/severe group, the highest mean score was obtained using UCL − 5 dB. For the moderate and steeply sloping groups, the mean scores obtained using 2 kHz SL were equivalent to UCL − 5 dB, whereas scores obtained using the SRT SL were significantly lower than those obtained using UCL − 5 dB. The mean scores corresponding to MCL and 95 dB SPL were significantly lower than scores for UCL − 5 dB for the moderate and the moderately severe/severe group. Conclusions: For participants with mild to moderate gradually sloping losses and for those with steeply sloping losses, the UCL – 5 dB and the 2 kHz SL methods resulted in the highest scores without exceeding listeners' UCLs. For participants with moderately severe/severe losses, the UCL − 5 dB method resulted in the highest phoneme recognition scores.

Normative Data for the Maryland CNC Test

2014 ◽  
Vol 25 (08) ◽  
pp. 775-781 ◽  
Author(s):  
Lisa Lucks Mendel ◽  
William D. Mustain ◽  
Jessica Magro
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Pure Tone ◽  
Normative Data ◽  
Medical Center ◽  
Recognition Score ◽  
Veterans Administration ◽  
Administration Medical ◽  
Wide Range ◽  
Intensity Functions

Background: The Maryland consonant-vowel nucleus-consonant (CNC) Test is routinely used in Veterans Administration medical centers, yet there is a paucity of published normative data for this test. Purpose: The purpose of this study was to provide information on the means and distribution of word-recognition scores on the Maryland CNC Test as a function of degree of hearing loss for a veteran population. Research Design: A retrospective, descriptive design was conducted. Study Sample: The sample consisted of records from veterans who had Compensation and Pension (C&P) examinations at a Veterans Administration medical center (N = 1,760 ears). Data Collection and Analysis: Audiometric records of veterans who had C&P examinations during a 10 yr period were reviewed, and the pure-tone averages (PTA4) at four frequencies (1000, 2000, 3000, and 4000 Hz) were documented. The maximum word-recognition score (PBmax) was determined from the performance-intensity functions obtained using the Maryland CNC Test. Correlations were made between PBmax and PTA4. Results: A wide range of word-recognition scores were obtained at all levels of PTA4 for this population. In addition, a strong negative correlation between the PBmax and the PTA4 was observed, indicating that as PTA4 increased, PBmax decreased. Word-recognition scores decreased significantly as hearing loss increased beyond a mild hearing loss. Although threshold was influenced by age, no statistically significant relationship was found between word-recognition score and the age of the participants. Conclusions: Results from this study provide normative data in table and figure format to assist audiologists in interpreting patient results on the Maryland CNC test for a veteran population. These results provide a quantitative method for audiologists to use to interpret word-recognition scores based on pure-tone hearing loss.

scholarly journals Perceptual Implications of Level- and Frequency-Specific Deviations from Hearing Aid Prescription in Children

2017 ◽  
Vol 28 (09) ◽  
pp. 861-875 ◽  
Author(s):  
Ryan W. McCreery ◽  
Marc Brennan ◽  
Elizabeth A. Walker ◽  
Meredith Spratford
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Word Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Computer Assisted ◽  
Phoneme Recognition ◽  
Absolute Deviation ◽  
Children With Hearing Loss ◽  
Dependent Error

AbstractThe purpose of providing amplification for children with hearing loss is to make speech audible across a range of frequencies and intensities. Children with hearing aids (HAs) that closely approximate prescriptive targets have better audibility than peers with HA output below prescriptive targets. Poor aided audibility puts children with hearing loss at risk for delays in communication, social, and academic development.The goals of this study were to determine how well HAs match prescriptive targets across ranges of frequency and intensity of speech and to determine how level- and frequency-dependent deviations from prescriptive target affect speech recognition in quiet and in background noise.One-hundred sixty-six children with permanent mild to severe hearing loss who were between 6 months and 8 years of age and who wore HAs participated in the study.Hearing aid verification and speech recognition data were collected as part of a longitudinal study of communication development in children with HAs. Hearing aid output at levels of soft and average speech and maximum power output were compared with each child’s prescriptive targets. The deviations from prescriptive target were quantified based on the root-mean-square (RMS) error and absolute deviation from target for octave frequencies. Children were classified into groups based on the number of level-dependent deviations from prescriptive target. Frequency-specific deviations from prescriptive target and sensation levels (SLs) were used to estimate the proximity of fittings across the frequency range. Lexical Neighborhood Test (LNT) word recognition in quiet and Computer-Assisted Speech Perception Assessment (CASPA) phoneme recognition in noise were compared across level-dependent error groups and as a function of SL at 4 kHz.Children who had deviations from prescriptive target at all three input levels had poorer LNT word recognition in quiet than children who had fittings that matched prescriptive target within 5 dB RMS at all three input levels. Children with lower 4 kHz SLs through their HAs had poorer LNT recognition in quiet and CASPA phoneme recognition in noise than children with higher aided SLs.Children with HAs fitted to provide audibility for speech across a range of inputs and frequencies had better speech recognition outcomes than peers with HAs that were not optimally fitted to prescriptive targets.

Piezoelectric bone conduction hearing implant Osia® - audiological and quality of life benefits

2021 ◽  
Vol 75 (4) ◽  
pp. 1-5
Author(s):  
Joanna Marszał ◽  
Renata Gibasiewicz ◽  
Magdalena Błaszczyk ◽  
Maria Gawlowska ◽  
Wojciech Gawęcki
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Speech Understanding ◽  
Mixed Hearing Loss ◽  
Wide Range ◽  
The Mean ◽  
Bone Conduction Hearing

Introduction: Nowadays, there are many options to treat hearing-impaired patients: tympanoplastic surgery, hearing aids and a wide range of implantable devices. Objective: The aim of this study is to present the mid-term audiological and quality of life benefits after the implantation of the Osia®, a new active piezoelectric bone conduction hearing implant. Material and methods: The state of the tissues in implanted area, as well as audiological and quality of life results were analyzed six, nine and twelve months after implantation in a group of four adult patients with bilateral mixed hearing loss. Results: In all the cases, no postoperative complications were found. One year after surgery the mean audiological gain in FF PTA4 (pure tone average for 0.5, 1, 2, and 4 kHz) was 52.2±3.5 dB in comparison to the unaided situation, the mean speech understanding with Osia® in quiet was 90±8.2% for 50dB SPL, 98.8±2.5% for 65dB SPL and 100±0% for 80dB SPL, and mean speech understanding with Osia® in noise was 37.5%±23.6 for 50dB SPL, 93.8±4.8% for 65dB SPL and 98.8±2.5% for 80dB SPL. There was also an evident improvement in the quality of hearing as well as in the quality of life, measured by the APHAB (Abbreviated Profile of Hearing Aid Benefit) and the SSQ (Speech, Spatial and Qualities of Hearing Scale). Conclusions: The Osia® is an effective treatment option for patients with bilateral mixed hearing loss. The mid-term audiological and quality of life results are excellent, but further observations including bigger groups of patients and a longer follow-up are required.

Use of Contralateral Masking in the Measurement of the Auditory Brainstem Response

1982 ◽  
Vol 25 (4) ◽  
pp. 528-535 ◽  
Author(s):  
Larry E. Humes ◽  
Marleen G. Ochs
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Auditory Brainstem Response ◽  
Mean Amplitude ◽  
Auditory Brainstem ◽  
Normal Hearing ◽  
Brainstem Response ◽  
The Mean ◽  
Intensity Functions ◽  
Contralateral Masking

In the first portion this study, the effects of two levels of contralateral masking on the auditory brainstem response (ABR) were investigated in 10 normal-hearing subjects. No significant changes were observed in the mean latency-intensity functions or the mean amplitude-intensity functions of this group of subjects when noise of various levels was added to the nontest ear. In the second portion of this study, ABRs were also recorded from the poorer ear of four subjects with a profound unilateral sensorineural hearing loss. Results from the latter group revealed a crossed-over wave V in all cases when the stimulus was delivered to the poorer ear and the nontest (better) ear was not masked. Contralateral masking obliterated this "crossed ABB" in all four unilaterally impaired subjects. These results provide support for the use of contralateral masking when recording from the poorer ear of subjects having asymmetrical hearing loss.

Confidence Limits for Maximum Word-Recognition Scores

1995 ◽  
Vol 38 (2) ◽  
pp. 490-502 ◽  
Author(s):  
Judy R. Dubno ◽  
Fu-Shing Lee ◽  
Alan J. Klein ◽  
Lois J. Matthews ◽  
Chan F. Lam
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Confidence Limit ◽  
Lower Boundary ◽  
Clinical Judgments ◽  
Wide Range ◽  
Northwestern University ◽  
Cochlear Hearing Loss ◽  
Aged Subjects ◽  
Measure Word

Clinical judgments are often made regarding whether maximum word-recognition scores (PB max ) are appropriate in relation to degree of sensorineural hearing loss. In order to determine if word recognition is significantly poorer than expected, it is necessary to consider the lower boundary of PB max associated with a particular degree of hearing loss for speech materials commonly used to measure word recognition. The purpose of this experiment was to define a confidence limit for PB max from Northwestern University Test #6 (NU-6) word-recognition scores obtained from a large group of young and aged subjects with confirmed cochlear hearing loss. Word-recognition scores at several speech levels were obtained from 407 ears with a wide range of pure-tone averages. Because the characteristics of the distribution of maximum scores are not known, a procedure was developed using computer simulations to approximate the distribution of word-recognition scores corresponding to PB max and determine the 95% confidence limit (CL). Results of the simulation were confirmed by comparing means and standard deviations of PB max derived from experimental and simulation data. Percentages of young and aged subjects with scores outside the 95% CL are equal to their proportions in the entire subject sample. If PB max determined from a score-level psychometric function is poorer than the 95% CL, PB max may be considered “disproportionately” poor in relation to the degree of hearing loss. One score measured at a single arbitrary suprathreshold level that is poorer than the 95% CL suggests that the score may underestimate PB max and that word recognition should be measured at additional levels to obtain a more reasonable estimate of the listener’s maximum word-recognition score.

Development of a Speech-in-Multitalker-Babble Paradigm to Assess Word-Recognition Performance

2003 ◽  
Vol 14 (09) ◽  
pp. 453-470 ◽  
Author(s):  
Richard H. Wilson
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Recognition Performance ◽  
Recognition Task ◽  
Normal Hearing ◽  
Presentation Level ◽  
The Individual ◽  
Binaural Listening

A simple word-recognition task in multitalker babble for clinic use was developed in the course of four experiments involving listeners with normal hearing and listeners with hearing loss. In Experiments 1 and 2, psychometric functions for the individual NU No. 6 words from Lists 2, 3, and 4 were obtained with each word in a unique segment of multitalker babble. The test paradigm that emerged involved ten words at each of seven signal-to-babble ratios (S/B) from 0 to 24 dB. Experiment 3 examined the effect that babble presentation level (70, 80, and 90 dB SPL) had on recognition performance in babble, whereas Experiment 4 studied the effect that monaural and binaural listening had on recognition performance. For listeners with normal hearing, the 90th percentile was 6 dB S/B. In comparison to the listeners with normal hearing, the 50% correct points on the functions for listeners with hearing loss were at 5 to 15 dB higher signal-to-babble ratios.

Cochlear Implant Performance in Adult Patients with Absent Intraoperative Electrically Evoked Compound Action Potentials

2020 ◽  
Vol 162 (5) ◽  
pp. 725-730
Author(s):  
Timothy Cooper ◽  
Katie L. Melder ◽  
Rick Hyre ◽  
Candace E. Hobson ◽  
Andrew A. McCall ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Performance Outcomes ◽  
Adult Patients ◽  
Electrode Placement ◽  
Retrospective Case ◽  
Wide Range ◽  
Tertiary Center ◽  
The Mean ◽  
Compound Action

Objective To describe cochlear implant performance outcomes in adult patients in whom no intraoperative electrically evoked compound action potential (ECAP) responses were able to be obtained despite intracochlear electrode placement. Study Design Retrospective case review. Setting Academic tertiary center. Subjects and Methods Patients 18 years of age and older undergoing cochlear implantation between May 2010 and September 2018 with absent ECAP measurements intraoperatively with intracochlear electrode positioning were identified. Patient performance on sentence recognition testing using the Hearing in Noise Test (HINT) and AzBio at 6 to 12 months postoperatively was compared to preimplantation scores. Additional collected data included patient demographics, etiology of hearing loss, and preoperative pure-tone average (PTA) and word recognition scores (WRSs). Results Intraoperative ECAP measurements were unable to be obtained in 15 cochlear implants performed on 14 patients out of 383 cochlear implant cases. Of the patients with absent ECAP measures, the mean ± SD age was 61.7 ± 15.7 years. Causes of hearing loss included congenital hearing loss, meningitis, autoimmune inner ear disease, otosclerosis, presbycusis, and Ménière’s disease. The average preoperative PTA was 103.5 ± 17.0 dB. Twelve implanted ears had a WRS of 0% and 9 had a HINT score of 0% prior to surgery. The mean HINT score at 6 to 12 months postimplantation was 57.8% ± 37.8% and had improved by 42.6% ± 35.6% compared to the mean preimplantation HINT score (95% confidence interval, 22.0%-63.1%, P = .001, paired Student t test). Conclusion There is a wide range of cochlear implant performance in patients with absent intraoperative ECAP measures ranging from sound awareness to HINT scores of 100%.

Three Experiments on the California Consonant Test

1979 ◽  
Vol 44 (1) ◽  
pp. 61-72 ◽  
Author(s):  
Daniel M. Schwartz ◽  
Rauna K. Surr
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Sensorineural Hearing Loss ◽  
Normal Distribution ◽  
High Frequency ◽  
Correlation Coefficients ◽  
Sigmoidal Function ◽  
High Frequency Hearing Loss ◽  
Wide Variability ◽  
Intensity Functions

Three experiments were conducted using the California Consonant Test (CCT). Initially, performance-intensity functions were obtained for both normal hearers, and those with high frequency sensorineural hearing loss. Results demonstrated almost a linear function for both subject groups (approaching asymptote at 50 dB SL) as compared to the typical sigmoidal function obtained with conventional word recognition tests. Experiment II compared results of the CCT to those of the N.U. No. 6 lists in 60 subjects with high frequency hearing loss. Consistent with previous findings, relatively high word recognition scores were obtained for the NU-6 materials whereas the range of scores on the CCT approximated a normal distribution. Experiment III examined the internal consistency and split-half reliability of the CCT. Despite significant (p ≤ 0.05) correlation coefficients, the wide variability between half-list scores among individual listeners does not support the use of half-list testing.

scholarly journals Verification of Hearing Aids by Comparing Real Ear Measurements and Word Recognition Scores

2021 ◽  
Vol 64 (9) ◽  
pp. 619-625
Author(s):  
Taeuk Cheon ◽  
Yehree Kim ◽  
Marn Joon Park ◽  
Min Young Kwak ◽  
Chan Joo Yang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Discrimination Score ◽  
Success Rates ◽  
Speech Mapping ◽  
The Mean ◽  
Functional Gain

Background and Objectives In this study, we introduce our method of hearing aid (HA) verification using real ear measurement (REM). We verified HAs that have gone through the fitting program using speech mapping REM; we then compared the outcome with word recognition scores (WRS) to evaluate functional gain. Subjects and Method Fifty-six patients of sensorineural hearing loss (81 ears) were enrolled in the study. In REM, if the gap between the target gain of HA and real ear aided response (REAR) was less than 10 dB SPL, fitting was considered successful. In speech audiometry, unaided maximum discrimination score (PB max), unaided WRS at 65 dB HL and aided WRS at 65 dB HL were measured. By comparing PB max and aided WRS at 65 dB HL, patients were sorted into best (n=15), good (n=57), and poorly (n=9) aided groups and analyzed for the successes of fitting. Fitting was deemed unsuccessful if REAR was ≥10 dB SPL lower than the target value of HA.Results The mean aided WRS at 65 dB HL of best, good and poorly aided groups were 85.6%, 77.3%, and 54.2%, respectively. There were statistically significant differences between all groups (p=0.019, 0.001, 0.002). The success rates of HA fitting showed significant differences at 0.5, 0.75, 1, 4 kHz of 55 dB SPL (p=0.023, 0.005, 0.003, 0.014), and at 4 kHz of 65 and 75 dB SPL (p=0.004, 0.001). The high WRS group showed sufficient gain at many frequencies. Conclusion Well fitted HAs can provide sufficient increase in speech intelligibility. Using the speech mapping REM is a great method to verify fitting of HA.

Impact of Masks on Speech Recognition in Adult Patients with and without Hearing Loss

ORL ◽  
2021 ◽  
pp. 1-7
Author(s):  
Elizabeth Ritter ◽  
Craig Miller ◽  
Justin Morse ◽  
Princess Onuorah ◽  
Abdullah Zeaton ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Word Recognition ◽  
Effective Communication ◽  
Recognition Score ◽  
Adult Patients ◽  
Digital Recording ◽  
Clinical Exam ◽  
Exam Room ◽  
The Mean

<b><i>Introduction:</i></b> The coronavirus 2019 pandemic has altered how modern healthcare is delivered to patients. Concerns have been raised that masks may hinder effective communication, particularly in patients with hearing loss. The purpose of this study is to determine the effect of masks on speech recognition in adult patients with and without self-reported hearing loss in a clinical setting. <b><i>Methods:</i></b> Adult patients presenting to an otolaryngology clinic were recruited. A digital recording of 36 spondaic words was presented to each participant in a standard clinical exam room. Each word was recorded in 1 of 3 conditions: no mask, surgical mask, or N95 mask. Participants were instructed to repeat back the word. The word recognition score was determined by the percent correctly repeated. <b><i>Results:</i></b> A total of 45 participants were included in this study. Overall, the mean word recognition score was 87% without a mask, 78% with a surgical mask, and 61% with an N95 mask. Among the 23 subjects (51.1%) with self-reported hearing loss, the average word recognition score was 46% with an N95 mask compared to 79% in patients who reported normal hearing (<i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> Our results suggest that masks significantly decrease word recognition, and this effect is exacerbated with N95 masks, particularly in patients with hearing loss. As masks are essential to allow for safe patient-physician interactions, it is imperative that clinicians are aware they may create a barrier to effective communication.

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