The Unparalleled Importance of Speech-in-Noise in 2015
Beck and Repovsch (2013) stated that “speech-in-noise (SIN) testing is quite possibly the single most important functional (i.e., non-diagnostic) test we can perform….” They reported SIN tests measure and represent the most common reason patients come to see us—difficulty understanding speech-in-noise! The authors remind us that the goal is not simply to describe how well or how poorly the patient can repeat words, but that the goal is to describe the maximal speech understanding ability of the patient in the most difficult acoustic listening situations. Beck (2015) stated that “the goal is not simply to document peripheral hearing loss…the goal is to diagnose or describe the auditory-based communication disorder….” Beck and Nilsson (2013) stated that SIN testing should be a part of every hearing aid evaluation and diagnostic evaluation. They reported the primary complaint of people with hearing impairment is their inability “…to clearly understand speech in challenging acoustic environments.” As such, they concluded that “the only way to know we have defined and improved the single most common complaint (SIN) is to measure it at two moments in time; pre-treatment and post-treatment.”
Lindley (2015) reports that only a small minority of audiologists test speech-in-noise ability. He states that while it is likely someone who has poor word recognition in quiet would also have poor word recognition in noise, it is not true that people with good word recognition ability would necessarily have good word recognition in noise. Indeed, Lindley states that the person with good word recognition in quiet may “exhibit significant deficits in noise.” He notes that the QuickSIN (available via Etymotic Research. See Killion et al, 2004) is easy to administer, can be used with a one channel audiometer, and requires (usually) less than five minutes of clinical time. Lindley notes that “there is value in actually measuring speech in noise capability rather than trying to infer it…”And he reports that “adding a speech in noise measure to your test battery will help fill some gaps and allow you (i.e., the clinician) to personalize the recommendations…”
For More Information, References, and Recommendations
Beck DL. (2015) Invisible Hearing Loss (Op-Ed). March 11.
Beck DL, Nilsson M. (2013) Speech-In-Noise Testing: A Pragmatic Addendum to Hearing Aid Fittings. Hearing Review. May 6.
Beck DL, Repovsch JL. (2013) Observations on Speech, Speech in Noise and Embedded Tests. Hearing Review. July 25.
Killion M, Niquette P, Gudmundsen G. (2004) Development of a quick speech in noise test for measuring signal-to-noise ratio loss in normal hearing and hearing impaired listeners. JASA.116(4):2395-2405.
Lindley G. (2015) They Say “I Can’t Hear in Noise,” We say “Say the Word Base.” Audiology Today. 27(4):45-49.