Hearing test
Accept PCH and ensure initials were made Enter COSI from PCH Sign PCH Perform test
Pure tones [^1]
Pure tones all frequencies Start at 30, no response jump to 50, no response jump up 20db
UCLs
500, 1k, 2k, 3k, 4k Start at 70db
Bone Conduction
500, 1k, 2k, 4k
Masking Rules for Bone Conduction
Deliver narrowband masking noise to the NTE when the difference between the measured AC and BC thresholds of the TE is 15 dB or greater
Initial Amount of Masking in NTE = AC_N$$_T$$_E + 10 dB + OE
Initial Amount of Masking in NTE for 500Hz = AC_N$$_T$$_E + 10 dB + 15 dB = AC_N$$_T$$_E +25 dB Initial Amount of Masking in NTE for 1000Hz = AC_N$$_T$$_E + 10 dB + 10 dB = AC_N$$_T$$_E +20 dB Initial Amount of Masking in NTE for 2000Hz = AC_N$$_T$$_E + 10 dB + 0 dB = AC_N$$_T$$_E +15 dB Initial Amount of Masking in NTE for 4000Hz = AC_N$$_T$$_E + 10 dB + 0 dB = AC_N$$_T$$_E +15 dB
Occlusion Effect
Table 8-3. Occlusion Effect
textbook pg 153
| Frequency (Hz) | 250 | 500 | 750 | 1000 | 1500 | 2000 | 3000 | 4000 |
|---|---|---|---|---|---|---|---|---|
| Occlusion Effect (dB) | 15 | 15 | 15* | 10 | 0 | 0 | 0 | 0 |
-
- = estimated value
Speech Testing
MCL
MCL script “We are going to measure your most comfortable listening level. As I speak point your finger up if you want the volume louder and down when you want it softer. Please tell me when we reach the loudness level you prefer. Do you have any questions?”
SRT (Speech Recognition Threshold)
textbook pg 167 Start spondee presentation at 30 dB HL, no response jump to 50, no response jump up 20dB
SRT is defined as the lowest level at which at least 50% of the responses are correct, with a minimum of three correct responses at that intensity
SRT should be within 10 dB of the pure tone average (PTA) unless the audiogram exhibits an unusual configuration, such as precipitous or reverse slope
Masking Rules for SRT
textbook pg 170 When masking is needed in the NTE, the initial level of masking is SRT_N$$_T$$_E + 10 dB
Word Recognition (WRS)
textbook pg 172 Never less than 70 dB? Starting volume depends on patient’s threshold at 2000 Hz:
Presentation Levels Based on 2000 Hz Threshold
textbook pg 173
| Patient/Client Threshold at 2000 Hz | Present Words at (dB SL) |
|---|---|
| Below 50 dB HL | 25 dB SL |
| 50–55 dB HL | 20 dB SL |
| 60–65 dB HL | 15 dB SL |
| 70–75 dB HL | 10 dB SL |
If a patient has a 2000 Hz threshold of >75 dB HL, there are two options for determining the presentation intensity for word recognition testing:
- follow the recommendations for patients with a 2000 Hz hearing level of 70-75 dB HL
- present the word recognition list at the 2000 Hz loudness discomfort level (LDL) minus 5 dB HL
Sign printed audiogram Create COSI using PCH Sell hearing aids Make fitting appointment Order hearing aids/place in stock clipboard Print order form and place in new orders folder
Scan PCH Scan audiogram
[^1] pg 127