Updating Disyllabic Word Lists for Italian Speech Audiometry

ABSTRACT Objective To describe a standardized clinical for Italian speech audiometry using new disyllabic word lists and to report preliminary validation and normative parameters in normal‐hearing subjects. Methods In accordance with ISO 8253‐3 guidelines, phonetically balanced disyllabic word lists were administered to 12 normal‐hearing native Italian speakers (aged 18–25 years, pure‐tone average ≤ 10 dB HL). Word Recognition Scores (WRS) were assessed across a descending intensity gradient (30–0 dB HL) to derive psychometric functions. Inter‐list equivalence and 1‐week test–retest reliability were evaluated in quiet and background noise (cocktail party noise). Reliability was quantified using intraclass correlation coefficients (ICC), Bland–Altman analysis, and repeated‐measures ANOVA. Results Mean speech recognition threshold (SRT50%) was 5.9 ± 2.2 dB HL, with a steep, highly sensitive average slope of 4.9%/dB near threshold. Maximum intelligibility (SRT 100%) was reached at 30 dB HL, across all lists. Intrasubject test‐list variability was negligible (< 5% difference, ANOVA p > 0.05). Bland–Altman showed high temporal stability (mean bias: +0.88%; Limits of Agreement: ±1.5 words/list). Test–retest reliability was excellent (ICC = 0.957, 95% CI: 0.932–0.973, p < 0.001). In background noise, stable reproducibility was maintained, showing a well‐contained coefficient of variation (14.5%–14.7%) at SNR 0 dB and a perfect ceiling effect at SNR +10. Good equivalence among lists were observed. Conclusion The new 10‐item lists demonstrate robust equivalence and high test–retest reliability under ISO criteria. This validation workflow offers a time‐efficient paradigm that is methodologically applicable to other languages, supporting standardized cross‐linguistic clinical assessments. Level of Evidence 4.