Hearing aid technology has improved in leaps and bounds over the years. Despite these improvements, one of the most common complaints from hearing aid users is that they still struggle to understand speech in the presence of background noise. MarkeTrak, a consumer survey of 80,000 households, reports that hearing aid user satisfaction of their hearing aid performance in noisy situations has increased from around 30% in 2002 to approximately 70% in 2009. However, does this mean that the remaining 30% of those unsatisfied with how they hear in noisy situations have to wait for technology to advance further before they are satisfied with their hearing in noisy situations when using their hearing aids?
The answer is no. There is evidence to suggest that satisfaction with hearing aid performance in noise is related to the ability of the hearing aid user to understand speech over background noise. This is something that is tested routinely before recommending hearing aids at Value Hearing. What we test is your signal-to-noise ratio (SNR) loss. Simply put, this refers to how much louder a listener needs the speaker’s voice (the signal) over the background noise (noise) in order to follow the conversation reasonably well.
The standard test battery of most clinics will include a test to measure the softest sounds audible using tones (pure tone audiometry), and a word test of single words presented in a quiet environment (word recognition). Neither of these tests gives any insight into your ability to understand speech in noise. Without this information, it is extremely difficult, if not impossible, to give you realistic expectations on how a hearing aid will potentially improve your hearing in noise.
The standard test battery in a hearing assessment at Value Hearing takes things one step further. By adding a speech in noise test called QuickSIN to the test battery, we are able to obtain more information on your SNR loss. QuickSIN was developed by Etymotic Research to create a more realistic listening scenario to measure the ability to hear over background noise. Testing your ability to hear speech in noise is a good idea, given that good word recognition in quiet does not necessarily mean good word recognition in noise. By obtaining a measurement of your SNR loss, we are better able to recommend the most suitable hearing aid options for you. This can mean focusing on hearing aids with specific features, eliminating certain hearing aid styles, looking at a specific technology level; in short, matching the hearing aid technology to your SNR loss, rather than recommending hearing aid based on your listening environments, irrespective or your actual ability to hear in noise.
Another test that may be performed during a hearing assessment at Value Hearing that is not routinely carried out at other clinics is the Acceptable Noise Level (ANL) test. While ANL & QuickSIN are both measures of your ability to hear in the presence of background noise, ANL is not a measure of word recognition. Rather, it is a test that can quantify what level of background noise you consider acceptable, without the need to understand the language or repeat any sentences. ANL, therefore, can be a good alternative test for people who come from a non-English speaking background, have poor memory or simply struggle to understand the American accent heard in the QuickSIN test. While QuickSIN has been found to give a more accurate indicator of how you can benefit from hearing aids, ANL is still a valid test, providing information on how much background noise you can accept without being annoyed.
What does this all actually mean? Generally, a low SNR loss or ANL score (indicating better ability to hear speech in background noise, or less annoyance in background noise), might indicate that a lower level of hearing aid technology is suitable for you. Without this information, you might be recommended a higher level of hearing aid technology at another clinic, and end up spending more money on features that you don’t necessarily need. If your SNR loss or ANL score is higher, this indicates that you need a higher level of hearing aid technology in order to hear better or with less annoyance in background noise. However, sometimes even the best hearing aid might not give you the results you’re after if your SNR loss or ANL score is severe. While hearing aid technology certainly has improved, there are some instances where extra accessories and technology in addition to your hearing aids are recommended. Obtaining your speech in noise scores helps your audiologist give you all your options and discuss with you what to expect from the hearing aids as well as any potential limitations.
At Value Hearing, we consider speech in noise tests to be invaluable, as it gives both yourself and your audiologist some important information about your hearing. Why complete tests in quiet only, when you’re faced with varied listening environments on a daily basis? We believe that including QuickSIN and/or ANL tests in our standard audiological test battery will assist you in making a more informed decision about hearing aids, and has the potential to contribute to a more successful and positive hearing aid experience.