Advances in Hearing Healthcare Informatics: The Measurement of Speech Recognition Ability in an Aging Population



National Technical Institute for the Deaf, Rochester Institute of Technology, NY, US

Series: Audiology and Hearing Research Advances
BISAC: MED007000

In the United States, it is estimated that 48 million individuals suffer from some level of hearing loss. Of this number, a staggering 80% who could benefit from hearing aids do not use them. Fewer than 30% of adults aged 70+ years who could benefit from hearing aids actually use them. Reasons vary, but affordability and accessibility are major barriers to the intervention and treatment of hearing loss.

Whereas the hearing healthcare needs of an increasing number of Americans have not been met by current market models, the Over the Counter (OTC) Hearing Aid Act was introduced in March of 2017 by Senators Elizabeth Warren and Chuck Grassley. On August 18, 2017, President Donald Trump signed into law the Food and Drug Administration (FDA) Reauthorization Act of 2017, legislation that includes the OTC Hearing Aid Act, designed to enable adults with “perceived” mild-to-moderate hearing loss to access OTC hearing aids directly, without the need to be seen by a hearing healthcare professional.

The new legislation carries with it the requirement that the FDA create and regulate a new category of OTC hearing aids that meets the same high standards for safety and consumer protection applied to other medical devices. However, the legislation is vague (i.e., “perceived” hearing loss) on the evaluative component that is required to guide the consumer in the purchase of an OTC hearing aid.

Automated technologies for hearing screening in adults currently exist, many involving the use of pure-tones. However, without a way to control the sound level and the user’s selection of a transducer (earphones or speakers), the delivery of hearing screening tests that use pure-tones over the internet and on mobile devices has proven to be very problematic. An automated hearing screening procedure using speech-based materials is shown in this work to provide a desirable alternative to testing conducted outside the clinical setting.

This publication details the development of a hearing screening application that is: (1) Self-administering; (2) Can be taken in the privacy of one’s home; (3) Short in duration; and (4) Freely available for use. The application is shown to serve as a proxy for pure-tone hearing screening methods, using the criteria established by the American Speech-Language-Hearing Association (ASHA). A variety of reports are provided following an interactive testing session. The application includes a training component intended to acclimate new users to hearing aid function. It also enables consumers to measure the personal benefits afforded (or not) by the purchase of a hearing aid.

Table of Contents

Table of Contents


Chapter 1. Hearing Loss in the USA

Chapter 2. Threshold and Suprathreshold Measures: Pure-Tone and Speech Tests

Chapter 3. Methods and Materials for a Sentence-Based Speech Recognition Test

Chapter 4. Psychophysics and the Rasch Measurement Model

Chapter 5. NSRT® Screening for Hearing Loss in Adults

Chapter 6. Diagnostic Uses of NSRT® Test Results

Chapter 7. Teleaudiology: Enhancements to Hearing Healthcare Delivery


Keywords: Hearing Loss (Bilateral), Hearing Tests, Presbycusis, Hearing Thresholds, Speech Recognition, Speech Audiometry, Auditory Training, Phonetic Analysis, Adaptive Testing, Item Response Theory, Rasch Measurement, Software

Audience: This publication will be of interest primarily to hearing healthcare students, practitioners and professionals. This includes graduate students in Audiology programs in universities, individuals involved in the design and manufacture of hearing aids and personal sound amplification devices (see, for example, at for a relatively new entrant to the hearing instrument industry), individuals providing hearing testing and treatment services in government agencies (e.g., Veterans Administration), as well as advocacy organizations (e.g., Hearing Loss Association of America).
NOTE: The monograph will be of interest to professionals involved in training and delivery of hearing healthcare services. The software upon which the book is based will attract the interest of the general public.

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