Why and How we Need to Involve Background Noise in Audiological Assessment

This paper explores the importance of assessing speech recognition in noise for individuals with sensorineural hearing loss, highlighting its relevance in audiological rehabilitation. Traditional assessments like pure tone and speech audiometry in quiet often fail to address patients' real-world listening challenges, particularly in noisy environments. Studies using the Client Oriented Scale of Improvement (COSI) in Australia and Belgium reveal that speech in noise is a common rehabilitation goal, though its prioritization varies by region. The MarkeTrak survey further emphasizes that hearing aid users report significantly higher satisfaction in noisy situations compared to non-users. Despite its clinical relevance, speech in noise testing faces implementation barriers. The Acceptable Noise Level (ANL) test and Speech Audiometry in Noise (SPIN) are discussed, with findings showing that the type and spectral characteristics of background noise significantly affect test outcomes. Specifically, speech-weighted noise yields more reliable and representative results. The paper concludes by recommending the inclusion of speech in noise testing in audiological assessments, using speech-weighted noise or babble matched to the long-term spectrum of the speech material, in line with ISO standard on speech audiometry.