Maximum speech discrimination
How well can you actually understand speech?
When we test your hearing, it is not only important to know how softly you can hear. It is at least as important to find out how well you can understand what you hear. That is why we also test maximum speech discrimination (MD) as part of a comprehensive hearing assessment.
What is maximum speech discrimination?
Maximum speech discrimination tells us how well you can distinguish and recognise words when sound is presented at a clearly audible level. During the test, you will hear a series of words that you are asked to repeat. We record how many words you perceive correctly, and the result is usually given as a percentage.
It is therefore not a test of how loudly you can hear – but of how well you can understand speech when the volume is sufficiently high.
How is maximum speech discrimination measured?
The patient is presented with a list of standardised words (often monosyllabic words or three-word phrases) through headphones.
The volume (decibels, dB) is gradually increased to find the level at which the patient correctly identifies the greatest possible number of words.
The highest score achieved is referred to as maximum speech discrimination or speech recognition score.
What does the result tell us about hearing?
The result helps distinguish between different types of hearing loss:
Conductive hearing loss: If the hearing loss is related to the eardrum or middle ear, the patient will often achieve close to 100% speech discrimination as long as the sound is amplified sufficiently.
Sensorineural hearing loss: If the damage is located in the cochlea (hair cells) or the auditory nerve itself, sounds are not only quieter but may also become distorted. The patient may never achieve 100% speech recognition, no matter how loudly the sound is presented.
Rollover effect: In some people, speech recognition actually decreases when the sound becomes too loud. This can provide valuable information for medical diagnosis and differential diagnosis.
Why is this useful?
A standard audiogram tells us a lot about your hearing, but it does not necessarily tell the whole story about how well you understand speech. The MD test can provide important information about the quality of your speech perception. Two people can have a very similar degree of hearing loss on an audiogram and yet have very different abilities to perceive and distinguish words.
The results can therefore help us understand your hearing better and provide a stronger basis for further follow-up, selecting the right type of hearing aid, and determining whether you may benefit from additional equipment connected to your hearing aids.
Relevant – even if you already use hearing aids
For hearing aid users, MD testing can be useful when assessing how much your speech perception is affected by your hearing ability and what we can realistically expect to achieve with hearing aid fitting. It can also be useful for monitoring changes over time. Some patients may eventually develop hearing loss and speech discrimination difficulties to such an extent that a cochlear implant (CI) operation may become relevant.
At the same time, the test is just as relevant for people who do not use hearing aids. If you feel that you can hear sounds but still have difficulty understanding what people are saying – particularly in conversations or when there is background noise – an MD test may be useful to carry out alongside a standard hearing test.
We test – and explain the results
At AudioPlus, we test maximum speech discrimination when relevant, and we go through the results with you. You should not simply receive an audiogram and a percentage score. We want you to understand what the results actually mean for your hearing and your everyday life.
Have you been thinking for a while that it is time to have your hearing tested? Or do you feel that you can hear, but do not always understand what is being said?
Book an appointment with AudioPlus today: 📞 990 99 779 or via our contact form
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