The speech air-bone gap: some clinical reservations

Air-bone gaps derived from speech and from pure-tone testing were compared for an unselected clinic sample of 67 hearing-impaired Ss (80 ears). A moderately high Pearson r was found between the air-bone gap for speech vs for a pure-tone average (of the order of .80), but while the pure-tone air-bone gap predicted all but 5% of the cases of (confirmed) conductive losses, the speech air-bone gap prediction missed over 25%. When audiograms were grouped according to type of configuration, the flat and the high-frequency sloping types exhibited the largest discrepancies between air-bone gaps by speech vs pure tones; when the audiograms were grouped by degree of impairment, those with moderate-to-severe losses exhibited the largest discrepancies. Until a larger body of data is amassed, it was recommended that the air-bone gap for speech be used in conjunction with, not in place of, other audiometric tests.