Most individuals seeking help with their hearing cite difficulties understanding speech, and more often speech in noise. While pure tone audiometry provides invaluable data regarding the nature and severity of hearing loss at a variety of frequencies – of which speech is made up – it cannot provide data on the individual's understanding of speech. Speech stimuli are used in the audiometric test battery to ascertain this data. 

There are a variety of commonly used speech stimuli and tests that help paint a complete patient picture.

Speech recognition threshold (SRT) testing is often used to validate your pure tone audiometric results. In other words, does the lowest level an individual can detect speech correlate to the hearing loss obtained through pure tone audiometry? This score is also often used as a starting point in determining your presentation level when performing suprathreshold speech testing like word recognition scores (WRS). 

When obtaining an SRT, spondee words, or phonetically balanced words, like hotdog or baseball, are used. A list of these words is presented to the patient at a comfortable level first – this is called conditioning. Once the patient is familiar with the word list, those same words will be presented in a random order at a decreasing volume level. The patient will be asked to repeat back the words presented. The threshold is defined as the level at which 50% of the words are successfully repeated.  

Words can be presented through monitored live voice or recorded speech. With the Measure audiometer, clinicians have the flexibility to use whichever they prefer. Recorded spondee word lists can be made available in the testing software for a seamless transition from pure tones to speech testing. When using monitored live-voice, a VU meter is clearly displayed so clinicians can observe the level of their voice. 

While pure tones are an invaluable stimulus for measuring hearing loss, they don’t represent what individuals are experiencing day-to-day. Using speech stimuli helps to measure a client’s hearing using words they may encounter in everyday life. 

Additionally, a speech test assesses the client’s full auditory pathway. In other words, the question is, once sound is detected, is the ear able to accurately send that sound to the brain? At times, although able to hear the words presented, individuals may have difficulty processing those words. This is something that can only be detected by using speech audiometry.