The National Academies of Sciences, Engineering, and Medicine (NASEM) has released the report Evaluating Hearing Loss for Individuals with Cochlear Implants.

The Social Security Administration (SSA) requested that NASEM study and recommend generalized testing procedures and criteria for evaluating the level of functional hearing ability needed to make a disability determination in adults and children after cochlear implantation.

The SSA relies on Listing of Impairments (Listings), lists of medical conditions that qualify a candidate for disability benefits. The Listing currently used by SSA for hearing loss in individuals with cochlear implants requires the use of the Hearing-in-Noise Test (HINT) performed in a quiet sound field with specific criteria. However, the Listing for hearing loss not treated with cochlear implants does not require use of a specific test such as HINT. Still having comparable levels of validity and specificity, sensitivity, and reliability, the SSA was seeking to have general criteria that could be evaluated using other hearing tests and not just HINT.

NASEM convened a consensus study group consisting of a distinguished panel of audiologists, physicians, and other researchers to use published evidence and professional judgment to make recommendations. The report offers an in-depth analysis of different test options and offers a comparison to HINT. The study group provides the following overall recommendation:

Given the limitations of the Hearing-in-Noise Test, the committee recommends the use of a monosyllabic word-recognition test to assess hearing loss in individuals treated with cochlear implantation, consistent with what the U.S. Social Security Administration currently uses to determine disability in adults and children with hearing loss not treated with cochlear implantation. The administration of the word test should include a full word list that is standardized and phonetically or phonemically balanced.

Furthermore, the study group provides recommendations for a standardized test setup and the 60-decibel sound pressure level with a score of 40 percent or less on a monosyllabic word test as the cut-off criterion.

Read the full report from the National Academies Press.

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