The effect of visual cues on scoring of clinical word-recognition tests

Purpose: During routine clinical speech assessment, if the person being tested were to write down what he or she heard, it would not always match what the audiologist heard while scoring the listener’s vocal responses (Nelson & Chaiklin, 1970). This study demonstrated a method to assess examiner accuracy and whether speechreading cues reduce writedown–talkback errors.

Method: Examiners were divided into 3 categories: normal hearing native speakers of English, normal hearing nonnative speakers of English, and native speakers with hearing loss. Each examiner assessed 4 normal-hearing listeners. Two NU-6 lists were presented to each listener; one was scored without visual cues and one with visual cues. Lists were presented at 50 dB HL in the presence of speech noise at 0 dB signal-to-noise ratio (SNR).

Results: Results analyzed by percentage of correct phonemes and words revealed fewer writedown–talkback discrepancies for all 3 examiner groups when visual cues were added, with a substantial improvement for examiners with hearing loss.

Conclusion: The finding of errors between talkback versus writedown scoring of lists for all of the examiners, even with visual cues, suggests a need for modification of the clinical word-recognition procedure for applications that potentially affect diagnosis, rehabilitation choices, or financial compensation.