Pure tone audiograms fail to predict speech-in-noise listening difficulties

Evidence

People with normal hearing acuity usually can follow a conversation with their friends at a noisy party, a phenomenon known as the “cocktail party effect” (Cherry 1953 ). This remarkable ability to attend to target sounds in background noise deteriorates with age and hearing loss. Yet, people who have been diagnosed in the clinic as having a very mild hearing loss or even normal hearing based on their pure tone audiogram (the clinical gold standard for identifying hearing loss) still often report considerable difficulty communicating with others in such noisy environments (King and Stephens 1992 ). The conventional pure tone audiogram, the cornerstone of hearing loss diagnosis, is not always the best predictor for these kinds of difficulties. — Dijk, Pim van, Physiology, Psychoacoustics and…, 5758

People with normal hearing acuity usually can follow a conversation with their friends at a noisy party, a phenomenon known as the “cocktail party effect” (Cherry 1953 ). This remarkable ability to attend to target sounds in background noise deteriorates with age and hearing loss. Yet, people who have been diagnosed in the clinic as having a very mild hearing loss or even normal hearing based on their pure tone audiogram (the clinical gold standard for identifying hearing loss) still often report considerable difficulty communicating with others in such noisy environments (King and Stephens 1992 ). The conventional pure tone audiogram, the cornerstone of hearing loss diagnosis, is not always the best predictor for these kinds of difficulties. — Dijk, Pim van, Physiology, Psychoacoustics and…, 5757

Categorization

• QUESTION: What physiological deficit explains normal audiograms but impaired cocktail-party hearing? This is a genuine open question worth chasing.
• XREF: Connects to the reader’s broader interest in why standard audiological tests underdiagnose real listening problems. — connects to: Audiometric pure-tone thresholds predict speech intelligibility even after sensitivity adjustment; The audiogram cannot predict which hearing-impaired listeners have temporal processing deficits — Jennifer Lentz, Psychoacoustics- Perception of Normal…, 1088; The audiogram does not predict pitch perception deficits in hearing loss (+2 more)
• DEFINE: Defines the cocktail party effect and the pure-tone audiogram’s clinical gold-standard status in one compact passage.
• corroborated: 7 independent passages support this claim — Dijk, Pim van, Physiology, Psychoacoustics and…, 5758; Dijk, Pim van, Physiology, Psychoacoustics and…, 5757

Broader Connections

• Audiometric pure-tone thresholds predict speech intelligibility even after sensitivity adjustment #contradicts (0.92)
• The audiogram cannot predict which hearing-impaired listeners have temporal processing deficits #exemplifies (0.90) — Jennifer Lentz, Psychoacoustics- Perception of Normal…, 1088
• Perceptual deficits correlate poorly with audiogram thresholds and vary widely #corroborates (0.88)
• The audiogram does not predict pitch perception deficits in hearing loss #exemplifies (0.85)