Effect of response method in participants with sensorineural hearing loss

Rajkishor Mishra, Preeti Sahu, Debadatta Mahallik


Background:Aim of the study was to compare the speed of response, false-alarm rate, and subject preference of different response methods i.e. raising a hand, using response switch, and oral response mode for measuring pure-tone thresholds.

Methods:Forty five participants (female-21 and 24 male) were included in the study with sensorineural hearing loss of various degree. Response method order was randomly assigned to 3 different sessions. Air-conduction thresholds were mea­sured thrice for each participant in octave intervals between 250 Hz and 8000 Hz. The 2nd and 3rd session were performed for different response method on a different day but within 2 weeks of the 1st session.

Results:Difference in the time was noted when compared with the extent of time required to complete the test for each response method. On an average, using the push­button method took 3.02 to 3.42 minutes less than using hand-raise or verbal response methods. There was also a significant participant preference for using the response button. No significant difference between response method for thresh­old level and number of false positives (P = 0.15) was found.

Conclusion:This study supports the use of the response button when measuring auditory thresholds for sensorineural hearing loss.



Pure tone threshold, Oral response, False alarm rate, Response method

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ANSI. American national standard specifications for artificial head-bone for the calibration of audiometer bone vibrators (S3.13-1972). New York: ANSI; 1973.

American Speech-Language-Hearing Association. Guidelines for manual pure-tone threshold audiometry. Rockville, MD: ASLHA; 2005.

Arlinger SD. Comparison of ascending and bracketing methods in pure tone audiometry: a multi-laboratory study. Scand Audiol. 1979;8:247-51.

Burk MH, Wiley TL. Continuous versus pulsed tones in audiometry. Am J Audiol. 2004;13:54-61.

Carhart R, Jerger J. Preferred method for clinical determination of pure-tone thresholds. J Speech Hearing Disord. 1959;24:330-45.

Harris JD. Optimum threshold crossings and time window validation in threshold pure-tone audiometry. J Acoust Soc Am. 1979;66:1545-7.

Hughson W, Westlake HD. Manual for program outline for rehabilitation of aural casualties both military and civilian. Transact Am Acad Ophthalmol Otolaryngol. 1944;48(Suppl):1-15.

Mineau SM, Schlauch RS. Threshold measurement for patients with tinnitus: pulsed or continuous tones. Am J Audiol. 1997;6:52-6.

Reger SN. Standardization of pure-tone audiometer testing technique. Laryngoscope. 1950;60:161-85.

Borton TE, Nolen BL, Luks SB, Meline NC. Clinical application of insert earphone for audiometry. Audiology. 1989;28:61-70.

Lindgren F. A comparison of the variability in the threshold measured with insert and conventional supra aural headphone. Scand Audiol. 1990;19:19-23.

Tyler RS, Wood EJ. A comparison of manual methods for measuring hearing levels. Audiology. 1980;29:316-29.

American Speech and Hearing Association. Guidelines for manual pure-tone threshold audiometry. Rockville, MD: ASHA; 1978.

Bogardus ST, Yeuh B, Shekelle PG. Screening and management of adult hearing loss in primary care: clinical applications. J Am Med Assoc. 2003;289:1986-90.

Hamill TA, Haas WH. The relationship of pulsed, continuous, and warble extended high-frequency thresholds. J Comm Dis. 1986;19:227-35.

DiGiovanni, Jennifer NR. Response method in audiometry. Am J Audiol. 2007;16:145-8.

Jerger J, Jerger SJ, Mauldin L. Studies in impedance audiometry in normal and sensorineural ears. Arch Otolaryngol. 1972;9:513-23.

Dancer J, Ventry IM, Hill W. Effect of stimulus presentation and instruction on pure tone threshold and false alarm rate. J Speech Hearing Disord. 1976;41:315-22.