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Related Experiment Video

Updated: Apr 20, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
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Effective identification of functional hearing loss using behavioral threshold measures.

Robert S Schlauch, Tess K Koerner, Lynne Marshall

    Journal of Speech, Language, and Hearing Research : JSLHR
    |November 26, 2014
    PubMed
    Summary

    The spondee and 3-tone protocols effectively identified feigned hearing loss, achieving 100% accuracy in detecting non-organic hearing impairments. These methods are recommended for clinical use and occupational hearing conservation.

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    Area of Science:

    • Audiology
    • Occupational Health

    Background:

    • Functional hearing loss, or non-organic hearing loss, can be challenging to diagnose.
    • Accurate identification is crucial for appropriate patient management and legal/compensation purposes.

    Purpose of the Study:

    • To evaluate the effectiveness of four distinct protocols in identifying simulated hearing loss.
    • To compare the diagnostic accuracy of different audiological testing methods for feigned hearing impairment.

    Main Methods:

    • Thirty participants feigned hearing loss on an initial audiogram and a screening test.
    • Four protocols were assessed: two-tone, 3-tone, noise-band, and spondee, using ascending and descending thresholds.
    • Testing was repeated without participants feigning hearing loss to establish baseline differences.

    Main Results:

    • When participants feigned hearing loss, the spondee protocol showed the largest average threshold difference (30.8 dB).
    • The other protocols yielded smaller threshold differences (19.6-22.2 dB) when feigning occurred.
    • Minimal threshold differences were observed between ascending and descending tones in non-feigning participants across all protocols.

    Conclusions:

    • The spondee and 3-tone protocols demonstrated 100% true positives and 0% false positives for detecting functional hearing loss.
    • These protocols are highly effective and suitable for clinical audiology and occupational hearing conservation programs.