Test-retest stability and effects of psychophysical methods on the speech loudness discomfort level

It is generally agreed that the saturation sound pressure level of a hearing aid should not exceed the patient's loudness discomfort level (LDL) for speech. This study investigated (1) the stability of the test and retest LDLs when obtained on different days using McCandless's and Berger's instructional sets and (2) the effects of a psychophysical method (adjustment versus limits) on the speech LDL using McCandless's instructions. Good reliability was observed since one-half of the listeners had test-retest differences of 2 dB or less and nearly all subjects obtained LDLs within 8 dB. The mean LDLs for the respective methods of adjustment and limits were 86.8 and 92.9 dB SPL, and statistically significant. Additionally, a significant interaction between the two methods was observed. The LDL measurement is also discussed in relation to other tests used to evaluate hearing aid performance.