Speech Audiometry Complete Study Notes

Flashcards reviewing speech audiometry concepts, threshold testing (SDT/SAT vs. SRT), spondaic words, suprathreshold testing (MCL, UCL, dynamic range), speech recognition scores (WRS), and test equipment reliability.

Why is speech audiometry performed in addition to pure-tone audiometry?

Patients often report difficulty hearing or understanding speech in everyday communication rather than merely detecting sounds, and pure-tone testing alone cannot determine speech communication difficulties in real situations.

What is the acoustic definition of a pure tone?

A sound containing one sinusoidal frequency (for example, a $1000\text{ Hz}$ audiometer tone or an idealized tuning-fork tone).

How is speech defined acoustically compared to a pure tone?

Speech is a time-varying complex acoustic signal containing energy at many frequencies.

What parameter is adjusted during speech threshold testing rather than selecting a single frequency dial?

The speech presentation level in $\text{dB}$.

What are the three main categories of speech audiometric testing?

Speech threshold testing (SDT/SAT, SRT), speech recognition testing (Word-recognition score/WRS), and suprathreshold measures (MCL, UCL/LDL, dynamic range).

What is the definition of Speech Detection Threshold (SDT) or Speech Awareness Threshold (SAT)?

The lowest level in $\text{dB}$ at which the listener can just detect the presence of speech and identify it as speech, without needing to understand or repeat words.

What is "cold running speech" and why is it used in SDT/SAT testing?

Ongoing connected speech delivered rapidly and monotonously without emotionally engaging content, intended to reduce predictable or attention-grabbing cues.

What are the typical patient response actions for Speech Detection Threshold (SDT/SAT)?

Raising a hand, signaling with a finger, or pressing a response button.

What is the Speech Recognition Threshold (SRT)?

The lowest presentation level at which a listener correctly recognizes and repeats $50\%$ of a standard set of speech test words.

Why is the SRT typically measured at a higher decibel level than the SDT?

Recognizing a word requires more acoustic information than merely detecting the presence of a voice.

What is the expected decibel agreement between the SRT and the Pure-Tone Average (PTA)?

They should usually agree within $5\text{--}10\text{ dB}$ as a cross-check for reliability.

What is a spondee (spondaic word)?

A two-syllable word produced with approximately equal stress or emphasis on each syllable.

What are five examples of spondees listed in the study notes?

"Hotdog," "baseball," "toothbrush," "snowman," and "airplane."

What preliminary steps must be completed before starting the SRT threshold search?

Introduce the spondee word list, verify that the patient recognizes the vocabulary and the clinician can understand their responses, and exclude unfamiliar or difficult words.

In the classroom SRT threshold search sequence, what are the step sizes used when a word is heard versus when it is not heard?

Decrease presentation level by $10\text{ dB}$ after correct recognition and increase by $5\text{ dB}$ when not heard.

What is the formula for calculating Word-Recognition Score (WRS)?

$$\text{WRS} = \left(\frac{\text{number correct}}{\text{number presented}}\right) \times 100\%$$

If a patient correctly repeats $42$ out of $50$ presented words, what is their Word-Recognition Score (WRS)?

$$84\%$$

What is Most Comfortable Level (MCL)?

The presentation level at which speech is judged most comfortable to listen to.

What is Uncomfortable Loudness Level (UCL or LDL)?

The sound level judged uncomfortably loud (distinct from a painful threshold).

What is dynamic range in speech audiometry?

The range between hearing threshold and an upper uncomfortable level, under the specific measurement convention.

What four major factors influence the reliability of speech audiometry?

Calibration and equipment, test environment (controlling ambient noise), patient responses (understanding instructions and vocabulary), and clinician/examiner skill (examiner sophistication).

What is the function of the Volume Unit (VU) meter during speech audiometry?

It visually monitors the speech input level to help the clinician maintain consistent vocal presentation levels during live-voice testing.

What are the primary strengths and limitations of monitored live voice (MLV) testing?

It is flexible and often quick, but performance can vary with examiner pronunciation, cadence, presentation level, and stress.

What is the main advantage of using prerecorded speech materials over monitored live voice?

It provides consistent presentation and standardization independent of examiner speaking style.

What is the difference between monaural and binaural testing?

Monaural tests each ear individually, whereas binaural presents the signal to both ears simultaneously.

What are three valid response modes for a patient during speech recognition testing?

Oral response (repeating aloud), written response, and picture/object identification (pointing to the correct item).