IDENTIFICATION OF PSEUDOHYPACUSIS USING SPEECH RECOGNITION THRESHOLDS

Objective: To determine the extent to which procedural variations affe ct pure-tone average-spondee threshold (PTA-SRT) agreement in pseudohy pacusis, to propose a theoretical framework to account for threshold d ifferences due to procedural variations, and to devise an effective sc reening test for identification of pseudohypacusis. Design: The subjec ts were normally hearing listeners who feigned a hearing loss. One exp erimental group received an ascending pure-tone (PT) technique combine d with an ascending SRT procedure. A second experimental group receive d an ascending PT technique paired with a descending SRT procedure. A third experimental group received an ascending SRT procedure paired wi th a descending PT procedure. Results: The group mean difference betwe en the three-frequency PTA and the SRT was 10.6, 2.3, and 41.6 dB for the first, second, and third experimental groups, respectively, Compar ison SRTs and PTAs from cooperative patients with hearing loss showed that a two-frequency PTA yielded a more effective test for pseudohypac usis than did a three-frequency PTA. Conclusions: The procedural diffe rences noted in this study are consistent with a loudness bias. It is recommended that clinicians employ an ascending procedure to measure S RTs and a descending procedure to measure PT thresholds to maximize th e effectiveness of a screening test for pseudohypacusis based on PTA-S RT differences.