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Why I now swear by speech in noise tests

Why I think my Otosphere hearing assessment system is wonderful?

Many reasons and I want to explore one of the main ones here: It allows me to routinely perform two tests which greatly enhance my ability to identify a lot more than a pure tone audiogram will tell me thereby allowing me to be more accurate and objective about the level of technology I should be recommending to a hearing impaired patient.

The Quicksin test

The first of these tests is known as Quick Speech in Noise abbreviated toQuicksin. Hearing in noise is all about the difference between the loudness of the speech compared to the noise,known as the signal to noise ratio. For a normally functioning auditory system the signal has only to be slightly louder than the noise for the listener to hear and understand it. With hearing loss this is not always the case and the requirement might be for the speech to be much louder than the background noise for it to be understood.

The Quicksin tests allows me to produce a measurement of this quantity for each patient.

As its name implies It is simple and quick to perform. The Otosphere system presents a series of simple sentences through a loudspeaker which the test subject is asked to repeat. There are six of these. The first is presented in relative silence and with each additional sentence the background noise level is increased, until in the sixth it is so extreme that even those with normal hearing struggle to understand it. The test subject is asked to repeat the sentences and is marked on the number of keywords correctly repeated. The system calculates and interprets the result giving a reliable and objective measure of individual ability to cope in background noise.

The ANL test

The second test is Acceptable Noise Level abbreviated to ANL. Here the subject is asked to listen to a male voice reading a passage of speech. The volume of this is raised and lowered until the most comfortable level is determined. Then an increasing level of background noise is introduced until it reaches a level which interferes with the ease of understanding of the passage or simply becomes unacceptably loud. The comparison of these results is an indicator of how acceptable amplification will be to the test subject and a prediction as a percentage of how likely they will be to accept amplification.

When is a red flag a good thing?

Now comes the truly wonderful bit. The Otosphere system combines these two results and plots the combined result on a matrix, known as the Red flag matrix. There are four quadrants. If the result falls into the top left quadrant the test subject is likely to be annoyed by environmental noise when using a hearing aid. Bottom right is an indication of potential difficulties with speech understanding or intelligibility. It may not be enough just to make the sound louder. Most challenging is the top right quadrant indicating potential annoyance and intelligibility difficulty. Whilst this is not good news for the patient or the audiologist it at least lays down the ground rule that even though help is needed it will require hard work on the part of both to deliver benefit. Certainly features such as advanced directional microphones, remote wireless microphones, noise suppression and speech enhancement will be matters for discussion, as would auditory rehabilitation. The easiest quadrant is the Clear Zone and a subject falling into this category should do well without the need of many of the advanced features available on modern hearing aid systems, and therefore is likely to pay less for an appropriate fitting.

So this is why I swear by speech in noise testing. My counselling has been enhanced and the process has become much more participative for the patient. The appropriateness of my recommendations and therefore the quality of my fittings has improved greatly. The all- important in clinic experience for the patient has been immeasurably enriched and more than ever I feel confident of delivering what they came to see me for in the first place.

Please contact us on 0141 954 6030 to book your hearing assessment including the Red Flag Matrix Assessment

If you have any questions, or you would like to find out about your hearing, please call us on 0141 954 6030 or book an appointment online now!

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