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Colorado Springs

Audiology, Inc.

 

Phone  719.520.1155

LOCATION  & DIRECTIONS

Dr. Gene McHugh

Licensed Audiologist

In Colorado

 

 

OFFICE HOURS

Mountain Time USA

Mon-Thurs

9:00AM-5:00PM

Closed Fridays

 

 © Copyright 2017 

 

 

 

 

 AUDIOMETRIC SCORES AND RELATIVE COMMUNICATIVE DISABILITY
 

WHAT DEGREE OF HEARING LOSS MEANS?

    

 The averaged degree of hearing loss (measured in decibels or dB's and called the pure tone average) defines the predicted level of hearing disability.  Depending upon the audiology facility, hearing is normally tested at five to eight separate frequencies from 250-8000 Hertz (Hz).  The pure tone average or PTA the averaged dB hearing loss at 2,3, or 4 of these frequencies (see Determining Pure Tone average) below.      

 

Normal hearing...means your PURE TONE AVERAGE* was less than 25 decibels (dB HL)

Mild hearing loss.....meaning your average pure tone threshold fell between 25-35dB (HL)

Mild to moderate hearing loss... your average pure tone threshold fell between 35-40dB (HL)

Moderate loss: Your average pure tone threshold fell between 40-65dB (HL)

Moderate to severe: Your average pure tone threshold fell between 65-70dB (HL)

Severe: Your average pure tone threshold fell between 70-85dB (HL)

Severe to profound: Your average pure tone threshold fell between 85-90dB (HL)

Profound: your average pure tone threshold was greater than 90dB (HL)

 

*DETERMINING PURE TONE AVERAGE

There three are different ways to calculate PURE TONE AVERAGE:

1) Two frequency average:  The average of the two best hearing frequencies of 500, 1000 and 2000 Hertz (Hz).

2) Three frequency average:   The average of all three frequencies 500, 1000 and 2000Hz.

3)  Four frequency average:  The average of 1000, 2000, 3000 and 4000Hz.

WHAT'S THE FREQUENCY SHAPE OF THE AUDIOGRAM

     Hearing loss usually differs across frequencies (or pitches) important to speech. Most people with hearing loss have greater hearing loss in the higher frequencies, but not always. Audiologists use terms that relate the general shape of the audiogram since this can influence word understanding or ward clarity. Terms relating to frequency shape of your audiogram starting from lower to higher frequencies include the following:

Flat: Your hearing sensitivity is about the same across the speech spectrum

Reverse: Your hearing is worse in the low pitches as compared to the higher pitches

Sloping high frequency: Your hearing is better in the low pitches as compared to the higher pitches

Mildly sloping high frequency: Your hearing falls off slightly in the higher pitches

Moderately sloping high frequency: Your hearing falls off moderately in the higher pitches

Trough: Your hearing is impaired in the mid-pitches, but you hear better in the low and higher pitches

Dip: There is a specific frequency (or range of frequencies) where testing is worse (common in cases of noise exposure).

WHAT WERE YOUR SCORES ON TESTS OF WORD RECOGNITION?

 

       A discrimination test (sometimes referred to as “word recognition score”) measures one's ability to correctly understand one-syllable words.  Testing is usually conducted with a recording to with the speaker saying, "Say the word ......"  You are to repeat the last word and guess if not sure.  The test is usually presented without background noise, and occasionally with background noise. Your score (in percent) estimates your word understanding ability in everyday communication. Terms relating to discrimination are as follows

Excellent: Your score fell between 96-100%

Good: Your score fell between 90-95%

Mild/slightly impaired: Your score fell between 75-89%

Moderately impaired: Your score fell between 60-74%

Moderate to severely impaired: Your score fell between 50-59%

Severely impaired: Your score fell between 20-49%

Profoundly impaired: Your score was less than 20%

Examples

     The following examples of how I typically relate the findings on the audiogram to the expected effect on an individual. Most audiologists agree this is not an exact science, but attempts to relate the findings from audiometric measurement to communicative disability:

EFFECT OF FLAT, MILD HEARING LOSS: Audiometric loss was described as “flat, mild degree” meaning without amplification, the patient hears some louder voiced speech sounds during normal conversation, but other unvoiced phonemes will occasionally fall below their hearing threshold. This is especially true for the higher speech sounds such as: /s/,/t/,/p/,/k/,/sh/,/h/,/f/ etc.

EFFECT OF MILD HIGH FREQUENCY HEARING LOSS: Audiometric loss was described as “mild high frequency” in degree meaning without amplification, the patient hears most voiced speech sounds during normal conversation, but other unvoiced phonemes will occasionally fall below their hearing threshold. This is especially true for the higher speech sounds such as: /s/,/t/,/p/,/k/,/sh/,/h/,/f/ etc. Amplification is sometimes recommended depending upon the effect on word discrimination.

EFFECT OF MILD DISCRIMINATION LOSS (75-89%): This suggests that as long as the patient can hear with speaker with sufficient loudness, it will be understood with or without speech-reading. If amplification is used, prognosis is usually “good to excellent”.

EFFECT OF FLAT, MODERATE HEARING LOSS: the patient’s audiometric loss was described as “moderate flat” meaning without amplification, the patient hears only the louder speech sounds at normal conversational loudness and may depend upon occasional use of speech reading cues to augment what has been lost. Amplification is normally recommended for this degree of hearing impairment.

EFFECT OF MODERATE HIGH FREQUENCY HEARING DISABILITY: The patient’s audiometric loss was described as “high frequency moderate degree” meaning without amplification, the patient’s limited hearing in the high frequency range results in particular difficulty with the following phonemes: /s/,/f/,/h/,/t/,/k/,/sh/,/ch/,/th/, and /p/. Patient will often rely upon watching people’s lips to understand consonant sounds correctly. They will have greatest difficulty hearing at a distance or when the speaker turns his or her back.

EFFECT OF MODERATE DISCRIMINATION LOSS (60-74%): This suggests that even though the patient can hear the speaker with sufficient loudness, approximately one out of every four words will be confused without the opportunity to speech-read. When hearing aids are used, prognosis is usually “fair to good.”

EFFECT OF MODERATELY-SEVERE DISCRIMINATION (50-59%): This suggests that even though the individual can hear the speaker with sufficient loudness, approximately one-half of the conversation will be misunderstood. Without the benefit of a speech-reading. If hearing aids are used, prognosis is usually guarded, typically requiring more time than usual to adapt to their hearing aid(s).

EFFECT OF SEVERE FLAT HEARING LOSS: The patient’s audiometric loss was described as “moderate flat” meaning without amplification, the patient hears practically no speech sounds even at louder conversational levels and depends almost completely on speech reading cues. Amplification is strongly recommended for this degree of hearing impairment.

EFFECT OF SEVERE HIGH FREQUENCY HEARING LOSS: Audiometric loss was described as “severe high frequency” in degree meaning without amplification, the patient hears some lower frequency speech sounds without difficulty but phonemes in the higher frequency range will be frequently confused. As such, the patient will have particular difficulty with the following phonemes: /s/,/f/,/h/,/t/,/k/,/sh/,/ch/,/th/, and /p/. High frequency hearing impairment is most noticeable while in the presence of background noise. High frequency amplification in both ears is strongly recommended for this degree of hearing impairment.

EFFECT OF SEVERE DISCRIMINATION LOSS (20-49%): This suggests that even though the individual can hearing the speaker with sufficient loudness, most of the conversation will be misunderstood without any speech-reading. If hearing aids are used, prognosis is usually guarded, or very poor, typically requiring extensive time to adapt to their hearing aids.

EFFECT OF PROFOUND DISCRIMINATION LOSS (less than 20%): This suggests that even though the individual may hear the speaker with sufficient loudness, little if any conversation will be understood without speech-reading. If hearing aids are used, prognosis is poor