This is an assessment of the patient’s ability to understand speech. The patient is played a tape of a series of words at varying intensities. The percentage of words correctly repeated is plotted against the intensity to produce a speech audiogram. Phonetically balanced words are to be used. Outcomes: Normal Hearing – all words are understood if played at a suitable intensity Conductive deafness – all words are again understood but only when played at a much higher intensity Sensorineural deficits – patient may fail to understand all the words despite a higher intensity. Speech discrimination is poor due to loudness recruitment – (a condition associated with cochlear disease in which soft sounds are not heard but loud sounds are heard at their normal or higher intensities).

The testing of hearing is most often carried out by establishing the threshold of hearing, the softest sound which can be perceived in a controlled environment. It is typical to do this testing with pure tones by providing calibrated tones to a person via earphones, allowing that person to increase the level until it can just be heard.

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