Michael J. Nilsson
House Ear Inst., 2100 West Third St., Los Angeles, CA 90057
House Ear Clinic, Los Angeles, CA 90057
Sigfrid D. Soli
House Ear Inst., Los Angeles, CA 90057
Three methods of estimating hearing handicap were compared in subjects with bilateral sensorineural losses. Sentence speech-reception thresholds (sSRT) measured in quiet and 65 dB(A) noise were compared to the American Medical Association (AMA) method, based on pure-tone thresholds above 25 dB HL, and to a self-evaluation of handicap (Hearing Handicap Inventory for Adults, HHIA). The AMA correlated highest with sSRTs in quiet (r=0.92), followed by sSRTs in noise (r=0.81), and directional hearing in noise (r=0.84). The HHIA was confounded by age effects, and increasing age decreasing perceived handicap. Thresholds were also measured with noise at a sensation level (SL) 25 dB above sSRTs to partially compensate for audibility differences among subjects. In this noise condition, the AMA correlated with sSRTs in noise (r=0.76) and directional hearing in noise (r=0.58), though the directional hearing is better predicted by pure-tone thresholds at 3 kHz (r=0.64). Stepwise regression analysis suggests handicap continues below 0% AMA handicap in the quiet and 25-dB SL noise conditions.