Effective Identification of Functional Hearing Loss Using Behavioral Threshold Measures

• Published in: Journal of speech, language, and hearing research Vol. 58; no. 2; pp. 453 - 465
• Main Authors: Schlauch, Robert S, Koerner, Tess K, Marshall, Lynne
• Format: Journal Article
• Language: English
• Published: United States American Speech-Language-Hearing Association (ASHA) 01-04-2015
• Subjects: Acoustic Stimulation - methods; Adult; Audiometry, Pure-Tone - methods; Auditory Threshold; Comparative Analysis; Female; Hearing Impairments; Hearing Loss, Functional - diagnosis; Hearing Tests - methods; Humans; Identification; Intonation; Male; Measurement Techniques; Noise; Psychoacoustics; Screening Tests
• ISSN: 1092-4388; 1558-9102
• DOI: 10.1044/2014_JSLHR-H-14-0066

Purpose: Four functional hearing loss protocols were evaluated. Method: For each protocol, 30 participants feigned a hearing loss first on an audiogram and then for a screening test that began a threshold search from extreme levels (-10 or 90 dB HL). Two-tone and 3-tone protocols compared thresholds for ascending and descending tones for 2 (0.5 and 1.0 kHz) and 3 (0.5, 1.0, and 2.0 kHz) frequencies, respectively. A noise-band protocol compared an ascending noise-band threshold with that for 2 descending tones (0.5 and 1.0 kHz). A spondee protocol compared an ascending spondee threshold with that for 2 descending tones (0.5 and 1.0 kHz). These measures were repeated without the participants feigning losses. Results: With nonfeigning participants, ascending and descending threshold differences were minimal for all protocols. When the participants feigned a loss, the spondee protocol produced the largest average threshold difference (30.8 dB), whereas the other protocols produced smaller differences (19.6-22.2 dB). Conclusions: Using both the screening test and a comparison of the initial audiogram with the screening test, the spondee and 3-tone protocols resulted in 100% true positives and 0% false positives for functional hearing loss. Either of these protocols could be used clinically or in occupational hearing conservation programs.