Amplification in the form of well-fitted hearing aids is an important habilitation tool for listeners with hearing loss. This requires audiologists to appropriately select, fit, verify and validate the hearing aid(s) with each listener. Historically, the aided audiogram has been used in clinical settings to assist audiologists in evaluating performance with amplification, and to ensure that each listener is receiving the maximum benefit from his or her technology.
There are several known limitations to standard procedures used in measuring aided pure-tune thresholds; these are related to the use of non-speech stimuli to evaluate aided thresholds with modern, nonlinear hearing aid technology, and lack of standardized sound field calibration. However, aided threshold measures are easy to perform, are not time consuming, and can be used to assess basic detection ability. The application of aided threshold measures can extend beyond basic assessment of performance in aided versus unaided conditions to include evaluation of performance across different aided conditions and performance with other assistive devices such as cochlear implants.
Researchers at Western University have developed a modified aided threshold measure offering a calibrated version of naturally produced speech sounds in dB HL for evaluation of detection thresholds. The newest version of this measure is referred to as the Ling 6(HL) Test v2.0. Stimuli have been chosen to include the Ling sounds, originally proposed for use in the screening of appropriate aided hearing using monitored live voice (Ling, 1989). The Ling 6(HL) test includes pre-recorded, calibrated stimuli that span from low to high frequencies of speech. It can provide clinicians with frequency-specific information to assist with validation of device fitting and fine-tuning
The Ling-6(HL) test includes level corrected stimuli allowing for speech sound detection threshold evaluation in dB HL. It was originally developed and validated with adult listeners (Scollie et al., 2012). A follow-up study, including active collaboration from pediatric audiologists across Canada, evaluated and refined the tool for use in pediatric hearing aid outcome measurement using an integrated knowledge translation framework (Glista, Scollie, Moodie, Easwar & The Network of Pediatric Audiologists of Canada, 2014). The Ling 6(HL) Test can be run using clinically available equipment, such as a CD player and commercial audiometer. The test includes a CD with eight tracks including a calibration tone to adjust the VU meter of an audiometer, calibration noise to ensure sound field calibration, and six stimuli corresponding to the Ling 6 phonemes (/m/), /u/, /a/, /i/, /?/ and /s/). Testing set-up instructions are provided along with scoring tools. This includes an audiogram that has been preconfigured to include normative performance ranges for adult and child listeners, as well as typical aided performance ranges for children with hearing loss ranging from mild to severe.
• Allows for aided threshold measurement using speech stimuli instead of pure-tones
• Includes sound field stimulus calibration in dB HL, allowing for repeatability, scoring and interpretation of test results
• Ling 6(HL) test provides a valid approach for measuring aided and/or unaided speech detection thresholds
• Aided thresholds can be measured to compare performance across different hearing aid conditions or with other assistive devices
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monitored live voice
testing set-up instructions
aided threshold measures
well-fitted hearing aids
important habilitation tool
