What is a speech-discrimination test?

David M. Vernick, MD
Ear, Nose & Throat (Otolaryngology)
Everyone has had this experience: someone is talking to you, and you can hear the words loudly but not clearly. The problem is especially common when you're trying to have a conversation in a noisy room. But with age, many people have this problem even in quiet settings. The words are loud, but they sound garbled.

A speech discrimination test assesses how well you understand words. For this test, the audiologist has you listen to words through the headphones at a decibel level louder than your speech reception threshold, so you won't have any problem with the volume of the speech. This test uses one-syllable words with vowels and consonants that are distributed similarly to those of words used in ordinary conversations -- words such as jar, this, and box. The audiologist asks you to repeat the words you hear. Successfully repeating 90% or more of them is considered excellent.

Although it doesn't mean your hearing is good, a high score on the speech discrimination test is good news. It means that you stand to benefit the most from a hearing aid, because boosting the volume of words will help you understand them better. In other words, your problem is mainly volume, which a hearing aid can help. If you understand only a low percentage of the words, simply turning up the volume with a hearing aid is unlikely to help you hear any more clearly.

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