IHS Audiometric Testing Procedures 3 — Questions and Answers
Question 1: What is the primary purpose of speech recognition threshold (SRT) testing?
- To determine the highest intensity at which speech becomes uncomfortable
- To confirm pure-tone average and assess functional hearing for speech (Correct answer)
- To evaluate the patient's ability to discriminate between phonemes
- To measure otoacoustic emissions during speech stimulation
Correct answer: To confirm pure-tone average and assess functional hearing for speech
The SRT validates the pure-tone average and establishes the softest level at which a patient can correctly repeat 50% of spondee words.
Question 2: Which type of words are standardly used in Speech Recognition Threshold (SRT) testing?
- Monosyllabic CVC words
- Spondee words (Correct answer)
- Nonsense syllables
- Sentences with contextual cues
Correct answer: Spondee words
Spondee words (two-syllable words with equal emphasis on each syllable, like 'baseball' or 'airplane') are used because they have predictable audibility.
Question 3: What is the acceptable agreement range between the pure-tone average (PTA) and the speech recognition threshold (SRT)?
- Within 5 dB
- Within 10 dB (Correct answer)
- Within 15 dB
- Within 20 dB
Correct answer: Within 10 dB
The SRT should agree within 10 dB of the three-frequency pure-tone average; a larger discrepancy suggests test reliability concerns.
Question 4: In word recognition testing, what percentage score typically indicates normal word recognition ability?
- 70% or higher
- 80% or higher
- 90% or higher (Correct answer)
- 95% or higher
Correct answer: 90% or higher
A word recognition score of 90% or higher is generally considered within normal limits for speech discrimination ability.
Question 5: What presentation level is most commonly used for word recognition testing in clinical practice?
- At the patient's SRT level
- 40 dB above the SRT
- 30-40 dB above the SRT or most comfortable loudness level (Correct answer)
- At 80 dB HL regardless of thresholds
Correct answer: 30-40 dB above the SRT or most comfortable loudness level
Word recognition testing is typically performed at 30–40 dB above the SRT or at the patient's most comfortable loudness level to maximize audibility.
Question 6: What does a 'rollover' phenomenon in word recognition testing suggest?
- Conductive hearing loss
- Normal cochlear function
- Retrocochlear pathology such as acoustic neuroma (Correct answer)
- Noise-induced hearing loss
Correct answer: Retrocochlear pathology such as acoustic neuroma
Rollover occurs when word recognition scores decrease at higher intensity levels, which is a hallmark sign of retrocochlear (neural) pathology.
Question 7: Which audiometric finding best describes a 'flat' audiogram configuration?
- Equal hearing loss across all frequencies tested (Correct answer)
- Greater hearing loss in the high frequencies than low
- Greater hearing loss in the low frequencies than high
- Hearing loss only at 4,000 Hz
Correct answer: Equal hearing loss across all frequencies tested
A flat audiogram shows approximately equal threshold elevations across all tested frequencies, with no more than 20 dB variation.
IHS Audiometric Testing Procedures 3
What is the primary purpose of speech recognition threshold (SRT) testing?