Variables affecting pure tone and speech audiometry in experimentally simulated hearing loss

Area of Science:

• Audiology
• Hearing Science
• Psychoacoustics

Background:

• Functional hearing loss, or exaggerated hearing levels without organic cause, presents a diagnostic challenge in audiology.
• Previous research suggests that simulating hearing loss can yield valuable insights for audiological clinicians.
• Understanding the strategies and reliability of simulated hearing loss is crucial for accurate diagnosis.

Purpose of the Study:

• To investigate the characteristics and reliability of simulated hearing loss in normally-hearing subjects.
• To identify factors influencing the success and strategies employed in feigning hearing loss.
• To compare simulation patterns between subjects with varying levels of audiological testing sophistication.

Main Methods:

• Two groups of normally-hearing subjects (unsophisticated and sophisticated in audiometry) were instructed to feign hearing loss.
• Pure tone and speech audiometry using monosyllabic speech material were conducted.
• Variables influencing simulation success and strategies were analyzed.

Main Results:

• The majority of subjects simulated flat, sensorineural hearing losses.
• No significant effect of ascending or descending approach modes on simulated tonal thresholds was found.
• Four distinct simulation strategies were identified, with fair test/retest reliability observed for both tones and speech.
• Discrepancies were noted, with simulated hearing loss for tones typically exceeding that for speech.
• Sophisticated subjects exhibited fewer correct responses and 'no response' errors during speech audiometry compared to unsophisticated subjects.

Conclusions:

• Simulating hearing loss provides useful data for audiological assessment, particularly in cases of suspected non-organic hearing issues.
• Simulated hearing loss patterns, including discrepancies between tone and speech thresholds, offer insights into feigning strategies.
• While overall simulation patterns were similar, sophisticated subjects showed differences in speech audiometry response patterns, suggesting nuanced simulation approaches.