MCL
Most Comfortable Level
purpose of MCL test
to determine best level for patient to hear and understand speech
what is MCL in normal hearing
40-55 dB HL
stimulus for finding MCL
cold running speech
bracketing
raising and lowering intensity while you are talking to find MCL. Increase in 5 dB steps and decrease in 10dB steps
how high is your tv?
a good indication of their MCL
what happens above 110dB
hearing can be damaged
UCL
Uncomfortable Loudness Level
purpose of UCL test
to determine point at which patient won't accept any further loudness
stimulus for UCL
cold running speech
other names for UCL
TD: threshold of discomfort
Tolerance Level
LDL: Loudness discomfort Level
what is UCL for nomal hearing
100-110 dB HL, those with sensioneural loss often have a lower UCL
what is DR or RCL
Dynamic Range of Range of Comfortable Loudness:
this is the range of usable hearing
equation for finding DR or RCL
UCL-SRT = DR
for ex: normal hearing 120 dB (UCL)- 20dB (SRT) = 90 dB DR
what can the range be for DR
normal hearing can have a DR of 100 dB or more
hearing loss DR may be 35 dB or less or anywhere in between
CD compared to live orchestra
CD recorded at 35dB so if have DR of 50 can listen but not to live orchestra which is at 70dB bc/ either too soft or too loud depending on where you sit
names for speech recognition testing
speech recognition testing
word recognition testing
word discrimination testing
speech discrimination testing
discrim
term audiologist may use when referring to the word discrimination testing
measurement of speech discrimination
speech recognition score (SRS)
word recognition score (WRS)
speech discrimination score
purpose of speech recognition testing
-to determine ability to discrimate speech
-to aid in diagnose site of disorder
-proper selection of hearing aids
-help make a prognosis for the outcome of treatment
PB word lists
phonetically balanced word list
% of times sound is on list is = to % of time sound occurs in english language
1 syllable words
familiar to average person
CID-W-22
Central Institute for the Deaf (CID) Auditory Test W-22
NU-6
Northwestern University Test No. 6
6 lists of 50 words
CID-W-22
4 lists of 50 words
NU-6
carrier phrase
say the word" speak with natural inflection so when say the test word after carrier phrase your pitch and loudness will be slightly lower
can you repeat the list
not in the same day, use a different list bc/ the patient is not to be familiarized to the list
what is the presentation level for the speech recognition test
40dB SL above the SRT of the patient or if too loud then at their MCL
will the SL or HL be the same for each patient on the speech recognition test
the SL will be the same bc/ it will be 40dB SL above their SRT so since that varies the HL will be different for each patient
how is speech recognition testing recorded
in %'s. Each word on a 50 word list is worth 2%; on a 25 word they are worth 4%.
Important to record the list used and the intensity level as well as the % on the audiogram
Speech Recognition Testing results
92-100% excellent
82-90% good
72-80% fair
52-70% poor
22-50% very poor
0-20% extremely poor
normal speech compared to background noise
8dB louder than background noise
speech scores for cochlear disorders
normally consistent with the degree of hearing loss:
the greater the loss, the poorer the WRS
speech scores for retrocochlear disorders
the score is usually much poorer than expected based on the degree of hearing loss.
Performance Intensity Function
if WRS goes down when intensity is increased above a certain level then sign of possible retrocochlear disorder
peak PB max
the point on the ordinate where the WRS is highest
rollover effect
where the WRS begins to go down as intensity is increased
what ultimately do the speech test do
verify the results of the Pure Tone tests and help determine the extent of patients loss, loudness tolerance, and speech recognition as well as determine where the problem lies and determine what type of treatment