The purpose of this study was to investigate the use of the SPAR test (Sensitivity Prediction by the Acoustic Reflex) on a sample of older adults who professed negative otologic histories. Twenty-seven subjects, ranging in age from sixty-four to eighty-three years of age (54 ears) were ultimately chosen as subjects. A young adult group, ranging in age from eighteen to thirty years of age, with normal audiometric hearing levels served as controls. Reflex threshold levels were obtained using 500 Hz., 1000 Hz., and 2000 Hz. pure tones and noise stimuli. Assessment of hearing loss was calculated on the difference between measures to ascertain hearing loss category and slope of loss according to a formula developed by Jerger (1974). The following conclusions were made on the basis of data collected in this investigation: The SPAR test was significant in assessing hearing sensitivity levels among the sample of geriatric subjects. The SPAR test was not statistically significant in assessing slope of loss in this sample of geriatric subjects. Reflex thresholds were consistently higher for aging than for a sample of young adults with normal hearing. This was true even among elderly subjects with average pure tone thresholds in the normal range. A significant portion of this carefully screened older adult sample displayed abnormal middle-ear function (as measured by tympanometry) in the absence of conventional audiometric indications of this. A significant portion of this older adult sample provided audiometric evidence of middle-ear pathology.

Previous studies show that pure tone thresholds are strongly correlated with distortion product otoacoustic emission amplitudes when evaluating the frequency range from 1 to 8 kHz (Avan & Bonfils, 1993). Little is known about correlations between these two measures at higher frequencies from 9-16 kHz. This study compared pure tone thresholds and distortion product otoacoustic emissions (DPOAEs) in this high frequency range for 29 normal hearing subjects ages 18-30. Pure tone thresholds were obtained at 250-16 kHz and distortion product otoacoustic emissions (DPOAE) 2,211-17,675 were measured in the same ears. DPOAE amplitudes were measured using a constant F1/F2 ratio of 1.2, with F2 values ranging from 2,211-17,675 Hz. Data obtained from 50 ears showed a decline in DPOAE amplitude with increasing frequency of the F1 and F2 primary stimulus tones. Behavioral thresholds demonstrated an increase with increasing frequency of the pure tone stimulus. Pearson r-correlation analysis demonstrated a weak relationship between measures. Further investigation revealed that equipment variables prevented accurate readings.

The use of speech audiometry is essential in audiological testing. One of the most important elements of speech audiometry is speech reception threshold. To provide services for the growing population of non-English speaking people, audiologists need speech audiometry materials in a variety of languages. The purpose of this study was to develop, digitally record, evaluate, and equate Arabic bisyllabic words for use in testing speech reception threshold. Ninety frequently used bisyllabic words were digitally recorded by a male talker of standard Arabic. These words were presented to 20 normally hearing subjects in 2 dB increments at intensity levels ranging from -10 to 22 dB HL. Psychometric functions were then determined for all 90 words using logistic regression. Words with steep psychometric functions were selected for inclusion in the test CD. The intensities of these selected words were adjusted to match the mean subject PTA within 2 dB, and a list of words was developed which was homogenous with respect to slope and audibility. The words are contained on tracks 2 and 3 of the Brigham Young University Arabic Speech Audiometry Materials (Disc 1.0) CD.

The purpose of this study was to examine the effect of talker and listener dialect on the validity and reliability of word recognition scores from two sets of Mandarin speech audiometry materials. Four lists of bisyllabic words in Mainland Mandarin and Taiwan Mandarin dialects were administered to 16 participants of each dialect with normal hearing across two test sessions. The performance on materials presented in the native dialect was compared to performance on non-native dialect assessment to determine validity and reliability of test materials. Statistical analysis indicated significant differences between word recognition scores across test sessions, talker and listener dialect, and among lists. However it is unclear if such differences constitute clinically significant differences.

Speech recognition threshold (SRT) is an important clinical measure that validates the pure-tone average (PTA), assists in diagnosis and prognosis of hearing and hearing impairment, and helps identify non-organic hearing impairment. Few published, recorded, and standardized materials exist in languages other than English, which results in audiologists testing individuals using materials developed in a non-native language. Research shows that this is problematic, as certain criterion for SRT testing are not met. Thus, performance may reflect test-language deficiency rather than hearing impairment. Currently, there are no known published materials for use in measuring the SRT in individuals whose native language is Tongan. The purpose of this project was to record and develop psychometrically equivalent words in Tongan for measuring the SRT. This study identified 28 trisyllabic words that were relatively homogenous in relation to audibility and psychometric function slope. The intensity of these 28 words was adjusted to equate 50% threshold performance for each word with the mean PTA (5.92 dB HL) for the twenty normally hearing participants. These materials were digitally recorded onto compact disc for distribution and use for SRT testing in Tongan.

Speech audiometry materials are essential for thorough audiological testing. One aspect of speech audiometry is evaluating an individual's speech recognition threshold (SRT). Recorded materials for SRT are available in many languages; however there are no widely published recorded SRT materials available in the Thai language. The goal of this study was to develop relatively psychometrically equivalent SRT materials for evaluating the hearing abilities of native speakers of the Thai language. To accomplish this, 90 commonly used bisyllabic Thai words were digitally recorded by a male and a female talker and evaluated by 20 native Thai listeners. Twenty-eight words with relatively steep and homogeneous psychometric function slopes were selected and adjusted to reduce threshold variability. These 28 selected words were digitally recorded onto compact disc to facilitate SRT testing for native Thai speakers.

The purpose of this study was to develop, digitally record, evaluate, and equate Mongolian monosyllabic and bisyllabic child-appropriate words which can be used in the measurement of word recognition scores and speech-reception threshold (SRT) in children who are native speakers of Mongolian. Based on data collected from a survey of Mongolian child language professionals, a subset of child-appropriate materials was adapted from a set of materials developed for Mongolian adults. Two lists of 50 monosyllabic words and four half-lists of 25 words each were developed for testing the word recognition abilities of Mongolian children. The developed lists and half-lists were found to be statistically equivalent in terms of audibility and psychometric slope, with average psychometric function slopes (at 50% intelligibility) of 6.41 %/dB for the male recordings and 5.84 %/dB for the female recordings. Given the structure and limitations of the study, a valid set of child-appropriate SRT materials could not be developed. It is likely that the inability to obtain a subset of SRT words was due in part to large differences between the mean PTA of the subjects and the threshold for 50% intelligibility, as well as the inability to represent most of the selected words pictographically. However the information gained from this study provides additional insight that may aid the future development of child-appropriate Mongolian SRT materials. Digital recordings of the resulting psychometrically equivalent child- appropriate speech audiometry materials are available on compact disc.

The purpose of this study was to examine the accuracy of English-speakers in determining the word recognition score of native Taiwan Mandarin-speakers. Digitally recorded Mandarin word lists were presented to 10 native Mandarin-speakers from Taiwan (five male, five female), from whom oral and written responses were collected. Oral responses were scored by 30 native English-speakers, 15 of which had no experience with Mandarin and 15 with two to three years of college-level Mandarin courses or equivalent knowledge of Mandarin. The judges who had experience with Mandarin were able to score the WRS tests with 97% accuracy (with scores ranging from 10% below to 4% above the actual score of the test). The judges without experience with Mandarin scored the WRS tests with 88.8% accuracy (with scores ranging from 34% below to 26% above the actual score of the test). An analysis of variance found that there was a significant difference between a judge's knowledge of Mandarin and his or her ability to accurately score the oral responses. An inspection of the performance of the judges in respect to the five different Mandarin tones indicated that there are some tone combinations that are more difficult to score correctly than others. While it is apparent that tone combination may play a role in the ability to accurately score WRS words in Mandarin, the implications of this for a clinical setting are uncertain because words with these tone combinations were not heard often. Tone perception training for the judges or simply making clinicians aware of this difficulty in tone identification may be of benefit in overcoming this obstacle.

The Federal Highway Administration (FHWA) currently requires that all persons seeking a commercial driver's license for interstate commerce possess a certain minimal level of hearing. After an extensive literature review on topics related to hearing and driving, a human factors engineering approach was used to evaluate the appropriateness of this hearing requirement, the methods currently specified to test drivers' hearing, and the appropriate hearing levels required. Task analysis, audiometry, dosimetry, in-cab noise measurements, and analytical prediction of both speech intelligibility and masked thresholds were all used in performing the evaluation. One of the methods currently used to test truck driver hearing, the forced-whisper test, was also evaluated in a laboratory experiment in order to compare its effectiveness to that of standard pure-tone audiometry. Results indicated that there are truck driving tasks which require the use of hearing, that truck drivers may be suffering permanent hearing loss as a result of driving, that team drivers may be approaching a 100% OSHA noise dose over 24 hours, and that truck-cab noise severely compromises the intelligibility of live and CB speech, as well as the audibility of most internal and external warning signals. The forced whisper experiment demonstrated that there is significant variability in the sound pressure level of whispers produced using this technique (in the words, word types, and trials main effects). The test was found to be repeatable for a group of listeners with good hearing, but was found to have only a weak relationship to the results of pure-tone audiometry for a group of 21 subjects with hearing levels ranging from good to very poor. Several truck cab and warning signal design changes, as well as regulatory changes, were recommended based on the overall results of this evaluation. / Ph. D.

Made available in DSpace on 2016-04-27T18:12:12Z (GMT). No. of bitstreams: 1 Denise Torreao Correa da Silva.pdf: 13435475 bytes, checksum: 0ee13ef29957b217cb6d5b50c30944cf (MD5) Previous issue date: 2016-02-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / To estimate the measurement uncertainty of the pure-tone audiometry by air-conduction, in the frequencies from 250 Hz to 8000 Hz, and bone-conduction, at frequencies of 500 Hz to 4000 Hz. Method: This is an observational, descriptive and cross sectional study. Accuracy measurement tests under repeatability conditions were conducted (same measurement procedure, operator, measuring system, operating conditions and site, in a short time interval). Each of the nine participants took part in two trials with five repetitions each through air and bone conduction, in the right and left ear. In Trial 1 the interval between each repetition was five minutes. In Trial 2 the interval between repetitions was sixty minutes. To calculate the combined uncertainty the type A uncertainty, derived from repeatability, and Type B uncertainty derived from the audiometer calibration certificate, the audiometer resolution, and the conditions of the test environment were considered. Results: There was no statistically significant difference intra-individuals in different time intervals (p> 0,05), in both air and bone conduction. The median of type A uncertainty ranged from 0 dB to 2,7 dB in the right ear, and 0 dB to 3,5 dB in the left ear for air conduction. In bone conduction the median of type A uncertainty ranged from 2.2 dB to 2.7 dB in both ears. Type B uncertainties, for air and bone conduction, derived from the contribution of the equipment used for the test (0,4 dB), of the equipment resolution (1,4 dB), and the test environment (5,0 dB). Considering the median of type A uncertainty derived from accuracy measurement, and type B uncertainties mentioned above, the estimated of measurement uncertainty of pure tone audiometry, air and bone conduction, in this study, for the confidence level of 95% (k=1.96) and 95.45% (k=2.0) were 10 dB or 11 dB, for the frequencies tested, in both Trials 1 and Trial 2, in both ears. Conclusions: This study demonstrates the feasibility of accuracy measurement tests under repeatability conditions, as proposed in this work. In this study the contribution of type B uncertainties, derived from the audiometer calibration certificate, potentiometer and test environment, this latter being more prevalent, was higher than that of type A uncertainty derived from repeatability, indicating the need to keep control of these variables. The expression of measurement uncertainty can increase even more the sensitivity and specificity of audiometry, respectively increasing the rate of true positives and true negatives, since it is considered the gold standard. In this study the expanded uncertainty, for the confidence level of 95% and 95,45% ranged between 10 and 11 dB, in air and bone conduction. The reliability of the pure-tone audiometry test depends on the expression of its uncertainty; only so results obtained with the same subject in different places and times can be compared. Therefore the expression of uncertainty should be taken into consideration when delivering results and in preparing reports, for subsidizing decisions on hearing aids prescription, selection and adaptation procedures, as well as assessment of social security benefit payments, labor actions and health surveillance actions / Estimar a Incerteza de Medição no exame de audiometria tonal por via aérea, nas frequências de 250 Hz a 8 000 Hz, e por via óssea, nas frequências de 500 Hz a 4 000 Hz. Método: Nesta pesquisa, de natureza observacional, descritiva e transversal, foram realizados ensaios de precisão de medição sob condições de repetibilidade (mesmo procedimento de medição, operador, sistema de medição, condições de operação e mesmo local, em curto intervalo de tempo). Cada um dos nove participantes realizou dois ensaios, com cinco repetições de audiometria cada, por vias aérea e óssea, orelhas direita e esquerda. No Ensaio 1 o intervalo entre cada repetição foi de cinco minutos. No Ensaio 2 o intervalo entre as repetições foi de sessenta minutos. Para cálculo da incerteza padrão combinada considerou-se a incerteza do tipo A, derivada da repetibilidade, e as incertezas do tipo B, derivadas do certificado de calibração do audiômetro, da resolução do audiômetro, e das condições do ambiente de teste. Resultados: Para as vias aérea e óssea não houve diferença estatisticamente significante intraindivíduos nos diferentes intervalos de tempo (p > 0,05). A mediana da incerteza do tipo A variou de 0 dB a 2,7 dB, na orelha direita, e de 0 dB a 3,5 dB na orelha esquerda, para a via aérea. Na via óssea a mediana da incerteza do tipo A variou de 2,2 dB a 2,7 dB, em ambas as orelhas. As incertezas do tipo B, tanto para via aérea quanto para a via óssea, foram derivadas da contribuição do equipamento utilizado para o exame (0,4 dB), da resolução do equipamento (1,4 dB), e do ambiente de teste (5,0 dB). Levando-se em consideração a mediana das incertezas do tipo A e as incertezas do tipo B citadas acima, a estimativa da incerteza de medição da audiometria tonal por vias aérea e óssea, neste estudo, para os níveis da confiança de 95% (k=1,96) e 95,45% (k=2,0), foi de 10 dB ou 11 dB, nas frequências testadas, tanto no Ensaio 1 quanto no Ensaio 2, em ambas as orelhas. Conclusões: Este estudo demonstra a viabilidade de ensaios de precisão de medição sob condições de repetibilidade, conforme proposto neste trabalho. Neste estudo a contribuição das incertezas do tipo B, derivadas do certificado de calibração do audiômetro, do potenciômetro e do ambiente de teste, preponderando esta última, foi maior do que a incerteza do tipo A, derivada da repetibilidade, indicando a necessidade de manter-se controle sobre estas variáveis. A expressão da incerteza de medição da audiometria pode elevar, ainda mais, a sensibilidade, e a especificidade da audiometria, respectivamente aumentando a taxa de verdadeiros positivos e de verdadeiros negativos, uma vez que é considerada padrão ouro. Neste estudo a incerteza de medição expandida, para os níveis da confiança de 95% e 95,45% variou entre 10 dB e 11 dB, tanto para via aérea quanto para via óssea. A confiabilidade do exame de Audiometria Tonal, ou Audiometria de Tons Puros depende da expressão de sua incerteza; somente assim resultados obtidos com o mesmo sujeito, em locais e épocas diferentes, podem ser comparados. Portanto a expressão da incerteza deve ser levada em consideração quando da entrega de resultados e confecção de relatórios, seja para decisão sobre procedimentos de indicação, seleção e adaptação de aparelhos de amplificação sonora individual, assim como para avaliação de concessão de benefícios previdenciários, ações trabalhistas e ações de vigilância em saúde