Managing Patients with Normal Thresholds-Managing Patients with Normal Thresholds (Handout 1)

Managing Patients with Normal Thresholds (Handout 1)

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The article discusses a simple protocol for determining speech-in-noise (SIN) thresholds, which can be used to validate and verify differences between unaided and aided responses. The inability to understand speech in noisy environments is a common complaint reported by those with hearing loss and traditional hearing aids. Despite recommendations to perform SIN tests, it appears that few audiologists actually do so. The article argues that SIN scores, both unaided and aided, are the most important measure of auditory function and can indicate the amount of help provided by amplification. The article presents a SIN protocol that is quick, reliable, and clinically useful, taking less than 2 minutes to administer. Pilot data obtained from eight individuals with and without hearing loss is presented to demonstrate the effectiveness of the protocol. The article offers calibration guidelines and emphasizes the importance of establishing the SNR-50, the signal-to-noise ratio required to obtain a score of 50 percent correct, in both unaided and aided conditions. The protocol uses four-talker speech babble to reflect real-world difficulty and recommends using 1- and 2-dB steps to acquire a repeatable SNR-50. The article also provides practical tips for conducting SIN testing, including the use of appropriate word lists and the consideration of individual differences in hearing aid benefit. Overall, the article highlights the necessity of SIN testing and offers a simple protocol for implementing it in clinical practice.

Keywords

speech-in-noise thresholds

unaided and aided responses

hearing loss

hearing aids

SIN scores

auditory function

amplification

SIN protocol

SNR-50

SIN testing