This document provides information on various speech recognition tests: - Speech Recognition Threshold (SRT) measures the decibel level required for a patient to correctly identify 50% of two-syllable words. It should be 20dB above pure tone average and use the same bracketing method as pure tone testing. - Most Comfortable Listening Level (MCL) establishes a comfortable intensity for speech using "cold running speech" and increases the level 20dB above SRT. - Word Recognition tests speech discrimination as a percentage of correctly identified words from phonetically balanced word lists at the MCL level. It is conducted for each ear separately and both ears together.

1. Speech Recognition Testing (SRT)
*Speech recognition testing should not be
confused with Speech Awareness Testing
(SAT).
*SRT is the measurement defined when
speech is recognized.
*SAT is the value recorded when the
patient/client has an awareness that a
speech signal is present.

2. Speech Recognition Threshold (SRT)
*SRT measurements are obtained using
two syllable Spondaic Words.
*SAT measurements are obtained using
“cold running speech”.

3. Speech Recognition Threshold (SRT)
For SRT testing, the test level
should begin twenty decibels above
the test ear pure tone average.

4. Speech Recognition Threshold
(SRT)
*The speech signal should be
monitored by the tester using the
audiometer volume unit (VU) meter.
*The syllables should peak at zero on
the VU meter.

5. Speech Recognition Threshold (SRT)
*For each list the common number of
two syllable spondaic words is thirty-six.
*However, rarely are all of the words
used to determine the fifty percent
response/score required to establish the
speech threshold.

6. Speech Recognition Threshold
(SRT)
*Its threshold is defined as the decibel
level required for fifty percent of the
words to be correctly identified.
*The same bracketing method used to
obtain pure tone thresholds should
also be used to obtain speech
thresholds.

7. Speech Recognition Threshold
(SRT)
NOTE: The SRT decibel level results
should be in agreement with the pure
tone average threshold level obtained
during pure tone air conduction
testing (plus or minus 10dbHL).

8. Speech Recognition Threshold
(SRT)
NOTE: Speech testing using a bone
conduction oscillator is normally not a
calibrated test method.
*Results from bone conduction speech
tests are not accurate.

9. Speech Recognition Threshold (SRT)
*The difference between 0dbHL and
the revealed speech recognition
threshold (SRT), is the patient/client’s
hearing loss for speech.

10. Most Comfortable Listening Level
(MCL)
*This test uses “cold running speech”
as its stimulus.
*The purpose of MCL testing is to
establish a comfortable intensity level
for listening to speech.

11. Most Comfortable Listening Level
(MCL)
*The intensity level should be set
twenty decibels above the SRT.
*It should be gradually increased to
find the most comfortable listening
level (MCL) for “cold running
speech”.

12. Most Comfortable Listening Level
(MCL)
*The patient/client should be
instructed to indicate whether the
“cold running speech” is too soft, too
loud, or comfortable i.e. “like their TV
or radio”.

13. Most Comfortable Listening Level
(MCL)
*Measurements should be made for
each ear (monaural), as well as, both
ears (binaural).

14. Most Comfortable Listening Level
(MCL)
*Since speech testing measures the higher
levels of sound recognition, the affect that
occurs from speech stimulation of each
temporal lobe is generally summated in the
midbrain.
*This summation normally results in a
decrease/reduction of five decibels of
intensity.

15. Uncomfortable Loudness Level
(UCL)
*This is another speech test using
“cold running speech”.
*It is often used to determine the
level at which speech sound is no
longer tolerated.

16. Uncomfortable Loudness Level (UCL)
Please note: Uncomfortable
Loudness, measured by frequency instead
of speech, generates more useful
information when creating an aural
rehabilitation program or when
programming digital hearing instruments.

17. Word Recognition (WR)
*This test is often referred to as speech
discrimination testing.
*We will use Word Recognition testing.
*It is expressed as a percentage of words
correctly identified during the
presentation of phonetically balanced
(PB) words at the MCL intensity level.

18. Word Recognition
*The intensity level used, should be
the decibel level identified during
Most Comfortable Listening (MCL)
testing.
*Testing of each ear (monaural), as
well as both ears (binaural) should be
conducted.

19. Word Recognition
*The word lists used are single
syllable phonetically balanced (PB)
words.
*The most commonly used are fifty
word lists either W-22 or NU-6.

20. Word Recognition
Please note:
*Research has found that reliable
results may be obtained using twenty-
five of the fifty words.
*Some clinicians will choose to use the
short list to expedite the test battery.

21. Word Recognition
NOTE: Cochlear disorders
usually exhibit word recognition
scores which deteriorate (become
worse), with the increase of
sensorineural hearing loss.

22. Word Recognition
NOTE: Retro-cochlear (higher
level) disorders usually exhibit word
recognition scores which are
significantly worse than the pure tone
hearing loss might indicate.