Speech Recognition Testing (SRT)

*Speech recognition testing should not be confused with Speech Awareness Testing (SAT).

*SRT is the measurement defined when speech is recognized.

*SAT is the value recorded when the patient/client has an awareness that a speech signal is present.

Speech Recognition Threshold (SRT)

*SRT measurements are obtained using two syllable Spondaic Words.

*SAT measurements are obtained using “cold running speech”.

Speech Recognition Threshold (SRT)

For SRT testing, the test level should begin twenty decibels above the test ear pure tone average.

Speech Recognition Threshold (SRT)

*The speech signal should be monitored by the tester using the audiometer volume unit (VU) meter.

*The syllables should peak at zero on the VU meter.

Speech Recognition Threshold (SRT)

*For each list the common number of two syllable spondaic words is thirty-six. *However, rarely are all of the words used to determine the fifty percent response/score required to establish the speech threshold.

Speech Recognition Threshold (SRT)

*Its threshold is defined as the decibel level required for fifty percent of the words to be correctly identified.

*The same bracketing method used to obtain pure tone thresholds should also be used to obtain speech thresholds.

Speech Recognition Threshold (SRT)

NOTE: The SRT decibel level results should be in agreement with the pure tone average threshold level obtained during pure tone air conduction testing (plus or minus 10dbHL).

Speech Recognition Threshold (SRT)

NOTE: Speech testing using a bone conduction oscillator is normally not a calibrated test method.

*Results from bone conduction speech tests are not accurate.

Speech Recognition Threshold (SRT)

*The difference between 0dbHL and the revealed speech recognition threshold (SRT), is the patient/client’s hearing loss for speech.

Most Comfortable Listening Level (MCL)

*This test uses “cold running speech” as its stimulus.

*The purpose of MCL testing is to establish a comfortable intensity level for listening to speech.

Most Comfortable Listening Level (MCL)

*The intensity level should be set twenty decibels above the SRT.

*It should be gradually increased to find the most comfortable listening level (MCL) for “cold running speech”.

Most Comfortable Listening Level (MCL)

*The patient/client should be instructed to indicate whether the “cold running speech” is too soft, too loud, or comfortable i.e. “like their TV or radio”.

Most Comfortable Listening Level (MCL)

*Measurements should be made for each ear (monaural), as well as, both ears (binaural).

Most Comfortable Listening Level (MCL)

*Since speech testing measures the higher levels of sound recognition, the affect that occurs from speech stimulation of each temporal lobe is generally summated in the midbrain.

*This summation normally results in a decrease/reduction of five decibels of intensity.

Uncomfortable Loudness Level (UCL)

*This is another speech test using “cold running speech”.

*It is often used to determine the level at which speech sound is no longer tolerated.

Uncomfortable Loudness Level (UCL)

Please note: Uncomfortable Loudness, measured by frequency instead of speech, generates more useful information when creating an aural rehabilitation program or when programming digital hearing instruments.

Word Recognition (WR)

*This test is often referred to as speech discrimination testing. *We will use Word Recognition testing.*It is expressed as a percentage of words correctly identified during the presentation of phonetically balanced (PB) words at the MCL intensity level.

Word Recognition

*The intensity level used, should be the decibel level identified during Most Comfortable Listening (MCL) testing.

*Testing of each ear (monaural), as well as both ears (binaural) should be conducted.

Word Recognition

*The word lists used are single syllable phonetically balanced (PB) words.*The most commonly used are fifty word lists either W-22 or NU-6.

Word Recognition

Please note:

*Research has found that reliable results may be obtained using twenty-five of the fifty words.

*Some clinicians will choose to use the short list to expedite the test battery.

Word Recognition

NOTE: Cochlear disorders usually exhibit word recognition scores which deteriorate (become worse), with the increase of sensorineural hearing loss.

Word Recognition

NOTE: Retro-cochlear (higher level) disorders usually exhibit word recognition scores which are significantly worse than the pure tone hearing loss might indicate.