Pure-Tone Audiometry and Hearing Disability
When considering whether a person has a hearing disability, pure-tone audiometry is necessary. The audiogram is an artificially created representation of a person's threshold for signal detection, but it does not accurately represent real-world hearing abilities. To obtain audiometric thresholds, an audiologist uses a specific procedure involving a low-intensity presentation and random intensities. However, this procedure does not guarantee that a person's hearing ability has been damaged.
To determine whether someone has a hearing disability, the audiologist presents a tone of 1000 Hz to them at a level of 30 dB and measures their threshold at that level. In cases where the patient is compensated for their hearing loss, the audiologist may use earphones to minimize ambient noise. In cases where the patient is experiencing symptoms of tinnitus, the test may be repeated with the booth door ajar. In both cases, the audiologist should consult the applicable regulatory requirements and begin testing with low-frequency pure tones.
The pure-tone audiometry procedure is divided into two types: screening and threshold search. Screening audiometry is a more basic test in which tones from across the speech spectrum are presented at the upper limits of normal hearing. For adults, this is around 25 to 30 dB, while for children, it is 15 to 20 dB. A pass result indicates the patient's hearing levels are normal. A refer result, on the other hand, indicates that the participant has a hearing loss and should repeat the screening or threshold search.
As mentioned, thresholds are often close to half-octave intervals. Generally, thresholds are defined as the lowest level at which the patient can hear more than half of the presentations. In some cases, a threshold may be higher than 50 dB HL or higher. Generally, thresholds over 90 dB HL are categorized as profound hearing loss and are legally deaf.
Bone conduction audiometry may be inappropriate for some vulnerable populations, such as COVID-19 patients. However, air conduction audiometry can be performed in a sound-treated booth with minimal or no physical contact. Those with CHL will have elevated pure-tone air conduction thresholds, whereas those with purely SNHL will have a higher DIN SRT. It should be noted. However, that bone conduction audiometry does not show a relationship between thresholds and hearing disability.
In addition to air-conduction pure-tone audiometry, the authors conducted an automated audiometry task for detecting the lowest SNR of pure tone in narrowband noise. Their results showed high sensitivity, and the prediction accuracy improved with larger ABGs and lower test frequencies. Overall, a study of this nature can help determine whether a person has a hearing disability. With more studies, these methods may have many potential applications.
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