Speech-In-Noise Testing Proposed for All Diagnostic Tests and Hearing Aid Evaluations
Beck and Nilsson (2013) note the primary complaint of all people with hearing loss and the primary complaint of all people with hearing aids is difficulty understanding speech in noise (SIN). They advocate SIN testing should be part of every diagnostic and hearing aid evaluation procedure. Further, they state audiograms were not designed or meant to be counseling tools—and audiograms should not be the "primary foundation upon which hearing aid selections (or counseling) are based." Indeed, the only way to know whether auditory rehabilitation (AR) protocols and/or hearing aid fittings have improved the patient’s ability to understand speech in noise is to measure it, as hearing thresholds simply cannot predict (and do not indicate) an individual’s ability to understand speech in noise.
Beck and Nilsson state that although "conventional wisdom" indicates people with mild hearing losses don’t need advanced circuitry, in fact, people with mild hearing losses are the ones who need and benefit the most from advanced circuitry (such as noise reduction, adaptive directionality, extended bandwidths, remote mics and more). Beck and Nilsson report "insufficient clinical time" is often quoted as the default reason for not performing complete best practice protocols, yet the evidence clearly demonstrates when verification and validation measures are employed, office visits are decreased by 1.2 total office visits. SIN tests often just take a few moments to administer and although commercially available SIN tests (HINT, WIN, QuickSIN, BKB-SIN etc) are advocated, "no-cost home-made" SIN tests are addressed and described (also see American Academy of Audiology Interview with Barbara Weinstein).
For More Information, References, and Recommendations
Beck DL. (2013) Reflections on Change, Fitting Protocols, Counseling, Audiograms, and More! (in the) International Hearing Society Soundboard, April/May.
Beck DL, Nilsson M. (2013) Speech-in-Noise Testing –A pragmatic Addendum to hearing Aid Fittings. Hearing Review May.