SUN-test (Speech Understanding in Noise): A Method for Hearing Disability Screening

The SUN-test (Speech Understanding in Noise) is a speech-in-noise test to screen adults and older adults for hearing disability. The SUN-test consists in a short list of intervocalic consonants (VCV, vowel-consonant-vowel) in noise that are presented in a three-alternatives forced choice (3AFC) paradigm by means of a touch-screen interface. Based on the number of stimuli correctly identified, the tested subject gets one of three possible test outcomes: no listening difficulties, a hearing check would be advisable, or a hearing check is recommended. This paper reviews the main results obtained with the SUN-test in the Italian language in a population of nearly 1,300 adults and older adults with varying degrees of audiometric thresholds and audio-metric configurations, tested both in low and in high ambient noise settings. Results obtained in the tested population revealed that the outcomes of the SUN-test were in line with the outcomes of pure-tone testing, and that the test performance was similar both in low and in high ambient noise (up to 65 dB A). Results obtained with the SUN-test were not biased by the age of the subject because the performance of younger and older subjects in the test was similar. The mean duration of the SUN-test was nearly 40 s/ear, and was lower than 1 minute per ear even in subjects older than 80 years so that both ears could be tested, on average, in 2 minutes. The SUN-test was considered easy or slightly difficult by nearly 90% of subjects; test duration was judged short or fair by nearly 95% of subjects, and the overall evaluation of the test was pleasant, or neutral, in more than 90% of subjects. Overall, results of this study indicated that the SUN-test might be feasible for application in adult hearing screening. The test is fast, easy, self convincing, and reflects differences in hearing sensitivity between the tested subjects. The outcomes of the SUN-test were not influenced by the noise level in the test room (up to 65 dB A) indicating that the test, as such, might be feasible to screen adults and older adults both in clinical and in non clinical settings, such as convenient care clinics, hearing aid providers, or pharmacies, where the ambient noise is, typically, not controlled.

[1]  L Hickson,et al.  Candidature for and delivery of audiological services: special needs of older people , 2003, International journal of audiology.

[2]  R. Klein,et al.  Prevalence of hearing loss in older adults in Beaver Dam, Wisconsin. The Epidemiology of Hearing Loss Study. , 1998, American journal of epidemiology.

[3]  Paul G Shekelle,et al.  Screening and management of adult hearing loss in primary care: scientific review. , 2003, JAMA.

[4]  D. Stephens,et al.  Acceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models. , 2007, Health technology assessment.

[5]  Judy R Dubno,et al.  Guest editorial: accessible and affordable hearing health care for adults with mild to moderate hearing loss. , 2010, Ear and hearing.

[6]  G. Gates,et al.  Cross-Sectional Age-Changes of Hearing in the Elderly , 2008, Ear and hearing.

[7]  G F Smoorenburg,et al.  Speech reception in quiet and in noisy conditions by individuals with noise-induced hearing loss in relation to their tone audiogram. , 1989, The Journal of the Acoustical Society of America.

[8]  Adult Hearing Screening: The Cyprus Pilot Program , 2011, Audiology research.

[9]  Gurjit Singh,et al.  Effects of Age on Auditory and Cognitive Processing: Implications for Hearing Aid Fitting and Audiologic Rehabilitation , 2006, Trends in amplification.

[10]  C. Mulrow,et al.  Screening for hearing impairment in the elderly: rationale and strategy. , 1991, Journal of general internal medicine.

[11]  K. D. Zylan,et al.  Article , 1996, Physiology & Behavior.

[12]  P. Heagerty,et al.  Long‐Term Effectiveness of Screening for Hearing Loss: The Screening for Auditory Impairment—Which Hearing Assessment Test (SAI‐WHAT) Randomized Trial , 2010, Journal of the American Geriatrics Society.

[13]  M. Akeroyd.  Are individual differences in speech reception related to individual differences in cognitive ability? A survey of twenty experimental studies with normal and hearing-impaired adults , 2008, International journal of audiology.

[14]  P. Divenyi,et al.  Decline of speech understanding and auditory thresholds in the elderly. , 2005, The Journal of the Acoustical Society of America.

[15]  C. Möller,et al.  International classification of functioning, disability, and health core sets for hearing loss: A discussion paper and invitation , 2010, International journal of audiology.

[16]  A. Boonen,et al.  The international classification for functioning, disability and health , 2007, Clinical Rheumatology.

[17]  G. Tognola,et al.  Pilot Initiatives of Adult Hearing Screening in Italy , 2011, Audiology research.

[18]  Bosman Aj,et al.  Intelligibility of Dutch CVC Syllables and Sentences for Listeners with Normal Hearing and with Three Types of Hearing Impairment , 1995 .

[19]  Chuan-Fen Liu,et al.  Long-term cost-effectiveness of screening strategies for hearing loss. , 2011, Journal of rehabilitation research and development.

[20]  Karen J. Cruickshanks,et al.  Epidemiology of Age-Related Hearing Impairment , 2010 .

[21]  S. Kramer,et al.  The self-reported handicapping effect of hearing disabilities. , 1998, Audiology : official organ of the International Society of Audiology.

[22]  Alessia Paglialonga,et al.  Hearing Screening in Older Adults is Gaining Momentum . The European Project AHEAD III on Adult Hearing , 2010 .

[23]  R L Schow,et al.  Considerations in selecting and validating an adult/elderly hearing screening protocol. , 1991, Ear and hearing.

[24]  A. Vansant,et al.  The International Classification of Functioning, Disability and Health. , 2006, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[25]  Rachel A McArdle,et al.  An Evaluation of the BKB-SIN, HINT, QuickSIN, and WIN Materials on Listeners With Normal Hearing and Listeners With Hearing Loss. , 2007, Journal of speech, language, and hearing research : JSLHR.

[26]  Stig Arlinger,et al.  Negative consequences of uncorrected hearing loss—a review , 2003, International journal of audiology.

[27]  Mead C. Killion,et al.  What can the pure‐tone audiogram tell us about a patient's SNR loss? , 2000 .

[28]  I M Ventry,et al.  Hearing impairment and social isolation in the elderly. , 1982, Journal of speech and hearing research.

[29]  S. Gordon-Salant.  The aging auditory system , 2010 .

[30]  G. Frisoni,et al.  Sensory Impairment and Quality of Life in a Community Elderly Population , 1993, Journal of the American Geriatrics Society.

[31]  Bruce A. Schneider,et al.  Effects of Senescent Changes in Audition and Cognition on Spoken Language Comprehension , 2010 .

[32]  G F Smoorenburg,et al.  Intelligibility of Dutch CVC syllables and sentences for listeners with normal hearing and with three types of hearing impairment. , 1995, Audiology : official organ of the International Society of Audiology.