Background: The Words-in-Noise Test (WIN) was developed as an instrument to quantify the ability of listeners to understand monosyllabic words in background noise using multitalker babble (Wilson, 2003). The 50% point, which is calculated with the Spearman-Kärber equation (Finney, 1952), is used as the evaluative metric with the WIN materials. Initially, the WIN was designed as a 70-word instrument that presented ten unique words at each of seven signal-to-noise ratios from 24 to 0 dB in 4 dB decrements. Subsequently, the 70-word list was parsed into two 35-word lists that achieved equivalent recognition performances (Wilson and Burks, 2005). This report involves the development of a third list (WIN List 3) that was developed to serve as a practice list to familiarize the participant with listening to words presented in background babble. Purpose: To determine - on young listeners with normal hearing and on older listeners with sensorineural hearing loss - the psychometric properties of the WIN List 3 materials. Research Design: A quasi-experimental, repeated-measures design was used. Study Sample: Twenty-four young adult listeners (M=21.6 yr)with normal pure-tone thresholds (≤20 dB HL at 250 to 8000 Hz) and 24 older listeners (M=65.9 yr) with sensorineural hearing loss participated. Data Collection and Analysis: The level of the babble was fixed at 80 dB SPL with the level of the words varied from 104 to 80 dB SPL in 4 dB decrements. Results: For listeners with normal hearing, the 50% points for Lists 1 and 2 were similar (4.3 and 5.1 dB S/N, respectively), both of which were lower than the 50% point for List 3 (7.4 dB S/N). A similar relation was observed with the listeners with hearing loss, 50% points for Lists 1 and 2 of 12.2 and 12.4 dB S/N, respectively, compared to 15.8 dB S/N for List 3. The differences between Lists 1 and 2 and List 3 were significant. The relations among the psychometric functions and the relations among the individual data both reflected these differences. Conclusions: The significantz3 dB difference between performances on WIN Lists 1 and 2 and on WIN List 3 by the listeners with normal hearing and the listeners with hearing loss dictates caution with the use of List 3. The use of WIN List 3 should be reserved for ancillary purposes in which equivalent recognition performances are not required, for example, as a practice list or a stand alone measure.

Background: The Speech Recognition in Noise Test (SPRINT) is a word-recognition instrument that presents the 200 Northwestern University Auditory Test No. 6 (NU-6) words binaurally at 50 dB HL in a multitalker babble at a 9 dB signal-to-noise ratio (S/N) (Cord et al, 1992). The SPRINT was developed by and used by the Army as a more valid predictor of communication abilities (than pure-tone thresholds or word-recognition in quiet) for issues involving fitness for duty from a hearing perspective of Army personnel. The Words-in-Noise test (WIN) is a slightly different word-recognition task in a fixed level multitalker babble with 10 NU-6 words presented at each of 7 S/N from 24 to 0 dB S/N in 4 dB decrements (Wilson, 2003; Wilson and McArdle, 2007). For the two instruments, both the babble and the speakers of the words are different. The SPRINT uses all 200 NU-6 words, whereas the WIN uses a maximum of 70 words. Purpose: The purpose was to compare recognition performances by 24 young listeners with normal hearing and 48 older listeners with sensorineural hearing on the SPRINT and WIN protocols. Research Design: A quasi-experimental, mixed model design was used. Study Sample: The 24 young listeners with normal hearing (19 to 29 years, mean = 23.3 years) were from the local university and had normal hearing (≤20 dB HL; American National Standards Institute, 2004) at the 250-8000 Hz octave intervals. The 48 older listeners with sensorineural hearing loss (60 to 82 years, mean = 69.9 years) had the following inclusion criteria: (1) a threshold at 500 Hz between 15 and 30 dB HL, (2) a threshold at 1000 Hz between 20 and 40 dB HL, (3) a three-frequency pure-tone average (500, 1000, and 2000 Hz) of ≤40 dB HL, (4) word-recognition scores in quiet ≥40%, and (5) no history of middle ear or retrocochlear pathology as determined by an audiologic evaluation. Data Collection and Analysis: The speech materials were presented bilaterally in the following order: (1) the SPRINT at 50 dB HL, (2) two half lists of NU-6 words in quiet at 60 dB HL and 80 dB HL, and (3) the two 35-word lists of the WIN materials with the multitalker babble fixed at 60 dB HL. Data collection occurred during a 40-60 minute session. Recognition performances on each stimulus word were analyzed. Results: The listeners with normal hearing obtained 92.5% correct on the SPRINT with a 50% point on the WIN of 2.7 dB S/N. The listeners with hearing loss obtained 65.3% correct on the SPRINT and a WIN 50% point at 12.0 dB S/N. The SPRINT and WIN were significantly correlated (r = -0.81, p < .01), indicating that the SPRINT had good concurrent validity. The high-frequency, pure-tone average (1000, 2000, 4000 Hz) had higher correlations with the SPRINT, WIN, and NU-6 in quiet than did the traditional three-frequency pure-tone average (500, 1000, 2000 Hz). Conclusions: Graphically and numerically the SPRINT and WIN were highly related, which is indicative of good concurrent validity of the SPRINT.

Purpose: To analyze the 50% correct recognition data that were from the Wilson et al (this issue) study and that were obtained from 24 listeners with normal hearing; also to examine whether acoustic, phonetic, or lexical variables can predict recognition performance for monosyllabic words presented in speech-spectrum noise. Research Design: The specific variables are as follows: (a) acoustic variables (i.e., effective root-mean-square sound pressure level, duration), (b) phonetic variables (i.e., consonant features such as manner, place, and voicing for initial and final phonemes; vowel phonemes), and (c) lexical variables (i.e., word frequency, word familiarity, neighborhood density, neighborhood frequency). Data Collection and Analysis: The descriptive, correlational study will examine the influence of acoustic, phonetic, and lexical variables on speech recognition in noise performance. Results: Regression analysis demonstrated that 45% of the variance in the 50% point was accounted for by acoustic and phonetic variables whereas only 3% of the variance was accounted for by lexical variables. These findings suggest that monosyllabic word-recognition-in-noise is more dependent on bottom-up processing than on top-down processing. Conclusions: The results suggest that when speech-in-noise testing is used in a pre- and post-hearing-aid-fitting format, the use of monosyllabic words may be sensitive to changes in audibility resulting from amplification.

Background: So that portions of the classic Miller, Heise, and Lichten (1951) study could be replicated, new recorded versions of the words and digits were made because none of the three common monosyllabic word lists (PAL PB-50, CID W-22, and NU-6) contained the 9 monosyllabic digits (1-10, excluding 7) that were used by Miller et al. It is well established that different psychometric characteristics have been observed for different lists and even for the same materials spoken by different speakers. The decision was made to record four lists of each of the three monosyllabic word sets, the monosyllabic digits not included in the three sets of word lists, and the CID W-1 spondaic words. A professional female speaker with a General American dialect recorded the materials during four recording sessions within a 2-week interval. The recording order of the 582 words was random. Purpose: To determine - on listeners with normal hearing - the psychometric properties of the five speech materials presented in speech-spectrum noise. Research Design: A quasi-experimental, repeated-measures design was used. Study Sample: Twenty-four young adult listeners (M = 23 years) with normal pure-tone thresholds (≤20-dB HL at 250 to 8000 Hz) participated. The participants were university students who were unfamiliar with the test materials. Data Collection and Analysis: The 582 words were presented at four signal-to-noise ratios (SNRs; -7-, -2-, 3-, and 8-dB) in speech-spectrum noise fixed at 72-dB SPL. Although the main metric of interest was the 50% point on the function for each word established with the Spearman-Kärber equation (Finney, 1952), the percentage correct on each word at each SNR was evaluated. The psychometric characteristics of the PB-50, CID W-22, and NU-6 monosyllabic word lists were compared with one another, with the CID W-1 spondaic words, and with the 9 monosyllabic digits. Results: Recognition performance on the four lists within each of the three monosyllabic word materials were equivalent, ±0.4 dB. Likewise, word-recognition performance on the PB-50, W-22, and NU-6 word lists were equivalent, ±0.2 dB. The mean recognition performance at the 50% point with the 36 W-1 spondaic words was ∼6.2 dB lower than the 50% point with the monosyllabic words. Recognition performance on the monosyllabic digits was 1-2 dB better than mean performance on the monosyllabic words. Conclusions: Word-recognition performances on the three sets of materials (PB-50, CID W-22, and NU-6) were equivalent, as were the performances on the four lists that make up each of the three materials. Phonetic/phonemic balance does not appear to be an important consideration in the compilation of word-recognition lists used to evaluate the ability of listeners to understand speech. A companion paper examines the acoustic, phonetic/phonological, and lexical variables that may predict the relative ease or difficulty for which these monosyllable words were recognized in noise (McArdle and Wilson, this issue).

Purpose: The purpose of this study was to examine in listeners with normal hearing and listeners with sensorineural hearing loss the within- and between-group differences obtained with 4 commonly available speech-in-noise protocols. Method: Recognition performances by 24 listeners with normal hearing and 72 listeners with sensorineural hearing loss were compared for 4 speech-in-noise protocols that varied with respect to the amount of contextual cues conveyed in the target signal. The protocols studied included the Bamford-Kowal-Bench Speech-in-Noise Test (BKB-SIN; Etymōtic Research, 2005; J. Bench, A. Kowal, & J. Bamford, 1979; P. Niquette et al., 2003), the Quick Speech-in-Noise Test (QuickSIN; M. C. Killion, P. A. Niquette, G. I. Gudmundsen, L. J. Revit, & S. Banerjee, 2004), and the Words-in-Noise test (WIN; R. H. Wilson, 2003; R. H. Wilson & C. A. Burks, 2005), each of which used multitalker babble and a modified method of constants, as well as the Hearing in Noise Test (HINT; M. Nilsson, S. Soli, & J. Sullivan, 1994), which used speech-spectrum noise and an adaptive psychophysical procedure. Results: The 50% points for the listeners with normal hearing were in the 1- to 4-dB signal-to-babble ratio (S/B) range and for the listeners with hearing loss in the 5- to 14-dB S/B range. Separation between groups was least with the BKB-SIN and HINT (4-6 dB) and most with the QuickSIN and WIN (8-10 dB). Conclusion: The QuickSIN and WIN materials are more sensitive measures of recognition performance in background noise than are the BKB-SIN and HINT materials.

The purpose of this study was to examine the feasibility of using digit triplets in multitalker babble as a paradigm to measure the ability of patients to understand speech in background noise. Nine digits (one to ten, excluding seven) were randomized into triplet sets and embedded in multitalker babble at 6- to -20-dB signal-to-babble (S/B) ratios. Recognition performances by 24 listeners with normal hearing and 48 listeners with sensorineural hearing loss were measured for the digit triplets and for monosyllabic words both in multitalker babble presented at 80-dB SPL. There was essentially no overlap between the distributions of performances by the two groups of listeners on either of the materials. For both groups of listeners, the difference between performances on the materials at the 50% point was approximately 18 dB. Both the word and digit materials in a background of multitalker babble are sensitive to the inabilities of listeners with hearing loss to understand speech in background noise.

Background: This is a case study of an 18-year-old female who suffered a bilateral idiopathic sensorineural hearing loss that was coincident with the removal of four impacted wisdom teeth. Throughout childhood the patient had normal hearing for pure tones bilaterally as measured at the pediatrician's office. One month prior to dental surgery (May) the patient volunteered to participate in an auditory experiment at which time her pure-tone audiogram was normal. Immediately following surgery (June), the patient had substantial swelling of the face and complained of some hearing loss with no other auditory/vestibular complaints. The following month (July) during the course of a routine physical examination a pure-tone audiogram revealed bilateral, air-conduction thresholds of 30-35 dB HL (500-4000 Hz) and 20 dB HL (8000 Hz). Because bone conduction was not tested, it is impossible to know whether the hearing loss was conductive, mixed, or sensorineural. The pediatrician thought that the hearing loss was conductive and would resolve as the edema subsided. A month later (August) the subject again volunteered for an auditory experiment at which time her hearing again was tested. Purpose: The purpose of this report is to detail the dental procedures involved in the extraction of the wisdom teeth, to report the results of a variety and series of post-op hearing tests, and to discuss the possible mechanisms that might be involved in the ''idiopathic'' bilateral sensorineural hearing loss. Research Design: Case report. Results: During the August visit to the laboratory, hearing for pure tones bilaterally was 0 to 5 dB HL at 250-1000 Hz with a 40-45 dB HL notch at 2000 Hz with a return to 10 dB HL at 8000 Hz. Air conduction and bone conduction thresholds were equivalent. Word recognition in quiet was ≥92 percent correct for both ears, whereas the signal-to-noise ratio (SNR) hearing loss measured with the Words-in-Noise test was high normal in the left ear with a mild SNR hearing loss in the right ear. Tympanometry and acoustic reflex thresholds were normal. Distortion product otoacoustic emissions were reduced in the 1000-3000 Hz region for both ears, which is consistent with cochlear hearing loss. The hearing loss has remained unchanged for the past 19 months. Conclusions: The possible etiologies, including insults to the cochleae by vibration trauma and through alterations in the blood supply to the cochleae, are considered.

Retest stability and retest reliability were assessed for the Words-in-Noise Test (WIN) in two experiments involving older listeners with sensorineural hearing loss. In Experiment 1, the 70-item WIN protocol was administered during two sessions 12 months apart to examine retest stability on a sample of 315 veterans from four VA Medical Centers. The mean 50% points on the WIN were 12.5- and 12.8-dB S/N for the two sessions with a critical difference of 3.5 dB and an intra-class correlation coefficient of 0.88. [Normal recognition performance on the WIN (50% point) is ≤6-dB S/N.] In Experiment 2, intra- and inter-session retest reliability was examined for the two 35-word WIN protocols on 96 veterans, 48 of whom had mild-to-severe hearing loss (Group 1) and 48 of whom had a moderate-to-severe hearing loss (Group 2). The mean 50% points on the WIN during the two sessions (separated by 40 days) were 13.0- and 13.4-dB S/N (Group 1) and 15.3- and 15.8-dB S/N (Group 2) with no significant intra-session differences. A 3.1-dB critical difference was calculated for the groups combined with intraclass correlations of 0.89 and 0.91 for Group 1 and Group 2, respectively.

The Words-in-Noise (WIN) test uses monosyllabic words in seven signal-to-noise ratios of multitalker babble (MTB) to evaluate the ability of individuals to understand speech in background noise. The purpose of this study was to evaluate the criterion validity of the WIN by comparing recognition performances under MTB and speech-spectrum noise (SSN) using listeners with normal hearing and listeners with hearing loss. The MTB and SSN had identical rms and similar spectra but different amplitude-modulation characteristics. The performances by the listeners with normal hearing, which were 2 dB better in MTB than in SSN, were about 10 dB better than the performances by the listeners with hearing loss, which were about 0.5 dB better in MTB with 56% of the listeners better in MTB and 40% better in SSN. The slopes of the functions for the normal-hearing listeners (8-9%/dB) were steeper than the functions for the listeners with hearing loss (5-6%/dB). The data indicate that the WIN has good criterion validity.

In an initial experiment (Wilson and Weakley, 2004), word recognition was assessed with six digit triplets presented at 14 signal-to-babble ratios (S/B) in 2 dB steps. An abbreviated version of the protocol was developed for clinic use involving three digit triplets at 7 S/Bs in 4 dB steps. The purpose of this experiment was to examine the relationship between the two digit protocols with comparisons made with other variables including age, pure-tone thresholds, subjective measures of understanding speech in quiet and in noise, and word recognition of monosyllabic words in quiet and in babble. Ninety-six listeners with sensorineural hearing loss participated. For equivalent performance, the short version of the digit triplets required (1) a 2.6 dB more favorable S/B than the long version and (2) a 15.1 dB less favorable S/B than the words. Age, hearing loss, and subjective evaluation of the ability to understand speech in quiet and in noise were not related to performance on digits or words in multitalker babble.