Did you know that there’s a way to determine how well you should be hearing in background noise? If you have a hearing loss, you’ve likely experienced difficulty in background noise situations, and traditional hearing tests are not an accurate assessment of how well you should be performing in background noise. This is why speech in noise testing is so critical to perform inside of these hearing evaluations.
One of the most popular forms of these tests is called the quick speech in noise test, otherwise known as the QuickSIN. Why is it called the QuickSIN? Well, because it’s quick. How does the QuickSIN test work?
Basically, we play you sentences at an audible level and we have you repeat those sentences back to us, 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. This background noise is typical of what you would find in a noisy restaurant, and when we score this test, we’re taking how many words you got correct when repeating those sentences back to us, and we subtract it from a baseline score.
First, it tells us how well you should be performing in a background noise situation. Second, it listens to 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. The scores that I talked about earlier will range anywhere from 0 to 26. If you score a 0, it means you hear better than a normal hearing person in a background noise situation, and if you score a 26, it basically means that if there’s any background noise whatsoever, you’re not able to understand a thing.
This score is ultimately telling us your signal to noise ratio loss (SNR loss). The definition of SNR loss is the increase in signal to noise ration required by a hearing-impaired individual, to understand speech in noise, compared to a normal hearing individual. Basically, it indicates to us how much separation we need in speech from background noise. Someone who has normal hearing needs much less separation. Someone who has really bad hearing in noise needs a larger separation. For instance, if a normal hearing individual scored a two on this test, and you scored an eight on this test, it would require you six more decibels in speech in order to separate it from the background noise.
Six decibels is a big deal. It basically means that the speech signal that you’re trying to hear needs to be one-and-a-half times louder than the background noise so you can understand it. Knowing the score is critical for a hearing care professional to understand what treatment is necessary to help you hear better in noise. This can be anything from a better hearing aid all the way to an assistive listening device.
In a study by Leavitt and Flexer in 2012, they measured the SNR loss of participants wearing hearing aids fit without using real ear measures, versus hearing aids fit with real ear measures. The better the SNR loss, the better you would expect to perform in background noise. The study found that hearing aids fit using real ear measurement perform significantly better than those without, and if hearing aids are not fit using real ear measurement, then they don’t even out perform a 10-year-old analog hearing aid.
Now if you don’t know what real ear measurement is, then I highly recommend that you watch my video (https://appliedhearingaz.com/real-ear-measurement/) , because it is the single most important factor to determine how well you will perform with hearing aids, particularly in a background noise situation, and I would highly recommend not buying hearing aids from anyone who doesn’t do real ear measurement.
If you want to get even more improvement than a good hearing aid fit using real ear measurement, then you have to use some kind of an assistive listening device, like a remote microphone. A remote microphone is clipped on to the shirt of the person that you want to hear. Once you get it on their shirt, their speech is six inches away from that microphone, and then that microphone will send that sound directly into your hearing aids, bypassing all that noise that would mix in with it along the way. These things have a massive impact on your ability to hear better in a background noise situation, and it is way better to use one of these than to use even the best hearing aid on the market.
The bottom line is that you need to know what your signal to noise ration loss score is. If you don’t have this score, then your hearing care professional does not know whether it’s you or whether it’s your technology that is restricting your ability to hear better in a background noise situation.
How well should you Hear in Background Noise? With Speech-In-Noise testing, audiologists can predict your level of success. Dr. Clifford Olson, Audiologist and founder of Applied Hearing Solutions in Anthem Arizona, discusses Speech-in-Noise Testing and how it can predict your ability to hear in background noise with hearing aids.How does the Quick Speech-In-Noise (QuickSIN) test work?
Basically it requires that you repeat sentences out loud with increasing background noise to determine your Signal to Noise ratio loss (SNR Loss).This SNR Loss will range from 0 to 26. If you score a 0, you hear better than normal in background noise. If you score a 26, it means that any background noise makes it nearly impossible to hear in background noise. Knowing this score will help a hearing care professional determine what treatment is necessary for you to perform better in noise.
On top of that, it makes Real Ear Measures even more critical to maximize hearing aid performance. Watch the Real Ear Measures video here: https://youtu.be/cHR0Oa6I-wY
If you want to hear better in background noise, you need Real Ear Measures, but you also may need better hearing aids and a remote listening device. A device like a remote microphone will have the largest impact on how well you hear in background noise. Bottom line it, if you struggle to hear in background noise, you need to know your SNR Loss, otherwise, we don't know if it is you or your technology.