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How well do you hear in noise?
  • Dec 23, 2019

How well do you hear in noise?

Normal hearing tests are not an accurate assessment of how well you should be performing in background noise.
Speech understanding in noise cannot be reliably predicted from the pure tone audiogram (Killion & Niquette, 2000).
A common issue with people with a hearing loss is their ability (lack of it) to hear well in background noise.

Speech in Noise Testing

One test used by some audiologists is called QuickSIN™ (Speech in Noise Test). It can provide a one-minute estimate of SNR loss.
Essentially an audiologist play sentences at an audible level and the patient repeats those sentences back, but with each sentence the background noise gets louder and louder and louder.

This can even get to the point where even someone who has normal hearing will have difficulty repeating those sentences.
The audiologist scores this test on how many words you got correct when repeating those sentences back, and subtract it from a baseline score.

The QuickSIN™ test indicates how well you should be performing in a background noise situation.
Second, it lets helps evaluate if additional high frequency will either improve your score or decrease your score.
And third, it lets us know if we need to recommend something additional other than just traditional hearing aids. (for example a hearing aid accessory that will help you hear in noisy meetings)

Example-QuickSIN-Test

The scores will range anywhere from zero to 26. If you score zero it means you hear better than a normal hearing person in a background noise situation.

If you score a 26, it basically means if there's any background noise, whatsoever, you're not able to understand a thing.

What is SNR Loss?

This score is ultimately indicating your SNR loss or signal to noise ratio loss - much like that used in electronics.

SNR loss is the increase in signal to noise ratio required by a hearing impaired individual to understand speech in noise, compared to someone who hears normally.
It indicates, how much separation we need in speech from background noise to be able to understand the words.

Someone with normal hearing needs much less separation, someone who has really bad hearing in noise needs a larger separation.

SNR Loss is defined as the dB increase in signal-to-noise ratio required by a hearing-impaired person to understand speech in noise, compared to someone with normal hearing.

Knowing the score allows a hearing care professional to understand what treatment is necessary to help you hear better in noise.

The SIN and QuickSIN tests use a four-talker babble recording (Auditec of St. Louis) with one male and three females. The four-talker babble represents a realistic simulation of a social gathering, in which the listener may "tune out" the target talker and "tune in" one or more of the background talkers. It provides a good representation of the difficulty that patients face—the situation in which what they want to hear is speech, and what they don’t want to hear is also speech. During the QuickSIN test development, research subjects frequently commented, "This is what it sounds like to me; this is what it sounds like to have a hearing loss and try to listen in a noisy place!"

Directional Microphones

Virtually all hearing aids today come with directional microphones. However where a person has a high SNR loss the directional microphones are less effective. refer Audiology Case for Quicksin.

Phonak Audeo Paradise may help here -:

A University of Toronto study found nearly 3/4 of the test subjects preferred their ability to understand speech with motion sensors active.

ReSound ONE has a host of features that work to improve understanding in noise.

It is clear the new generation of hearing aids are working towards helping people who struggle in with a high SNR loss.

Accessories

Streaming microphones allow you to place the microphone on or near the speaker. One example is Phonak - Partner Mic works a treat for people with a high SNR loss.
Phonak Partner Mic Diagram

Do you want to cook dinner, listen to the news and sit on the couch whilst having a conversation with your family and not miss a syllable?

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