Sources of variability of speech,spatial, and qualities of hearing scale (SSQ) scores in normal-hearing and hearing-impaired populations

Objective: To identify and quantify sources of variability in scores on the speech, spatial, and qualities of hearing scale (SSQ) and its short forms among normal-hearing and hearing-impaired subjects using a French-language version of the SSQ. Design: Multi-regression analyses of SSQ scores were performed using age, gender, years of education, hearing loss, and hearing-loss asymmetry as predictors. Similar analyses were performed for each subscale (Speech, Spatial, and Qualities), for several SSQ short forms, and for differences in subscale scores. Study sample: One hundred normal-hearing subjects (NHS) and 230 hearing-impaired subjects (HIS). Results: Hearing loss in the better ear and hearing-loss asymmetry were the two main predictors of scores on the overall SSQ, the three main subscales, and the SSQ short forms. The greatest difference between the NHS and HIS was observed for the Speech subscale, and the NHS showed scores well below the maximum of 10. An age effect was observed mostly on the Speech subscale items, and the number of years of education had a significant influence on several Spatial and Qualities subscale items. Conclusion: Strong similarities between SSQ scores obtained across different populations and languages, and between SSQ and short forms, underline their potential international use.     

Hearing-related,health-related quality of life in patients who have undergone otosclerosis surgery: A long-term follow-up study

Objectives: The aims of the study were to assess health-related quality of life and hearing-related disability in subjects with otosclerosis 30 years after surgery. Design: An observational study was performed. Medical records were reviewed, a clinical examination as well as audiometric assessments were performed. Generic health-related quality of life was assessed by the SF-36v2 and hearing disability by a shortened version of SSQ (speech spatial and qualities of hearing scale). Study sample: Sixty-five individuals, who had undergone stapedectomy in 1977-79 at a tertiary referral center. Results: Generic health-related quality of life according to SF-36 subscale scores was comparable to that of an age- and sex-matched reference population. The SF-36 mental component summary score (MCS) was, however, significantly better than that of the reference population. The mental and physical summary component scores correlated significantly to hearing disability measured by the SSQ but not to hearing impairment. Hearing disability was displayed in all SSQ sub-scores, especially in more complex listening situations and in the localization of sounds. Conclusions: This study shows that individuals with otosclerosis, 30 years after surgery, have a good generic health-related quality of life, despite moderate to severe hearing loss and significant hearing disabilities.     

Development and validation of a smartphone-based digits-in-noise hearing test in South African English

Objective: The objective of this study was to develop and validate a smartphone-based digits-in-noise hearing test for South African English. Design: Single digits (0–9) were recorded and spoken by a first language English female speaker. Level corrections were applied to create a set of homogeneous digits with steep speech recognition functions. A smartphone application was created to utilize 120 digit-triplets in noise as test material. An adaptive test procedure determined the speech reception threshold (SRT). Experiments were performed to determine headphones effects on the SRT and to establish normative data. Study sample: Participants consisted of 40 normal-hearing subjects with thresholds?≤15?dB across the frequency spectrum (250–8000?Hz) and 186 subjects with normal-hearing in both ears, or normal-hearing in the better ear. Results: The results show steep speech recognition functions with a slope of 20%/dB for digit-triplets presented in noise using the smartphone application. The results of five headphone types indicate that the smartphone-based hearing test is reliable and can be conducted using standard Android smartphone headphones or clinical headphones. Conclusion: A digits-in-noise hearing test was developed and validated for South Africa. The mean SRT and speech recognition functions correspond to previous developed telephone-based digits-in-noise tests.     

Adaptation of the speech,spatial, and qualities of hearing scale for use with children,parents, and teachers

Abstract

Subjective assessment of hearing ability in everyday life complements more objective forms of evaluation. A broad evaluation of the additional benefit provided to children by a second bilateral cochlear implant required such an assessment. As no paediatric tool provided detailed evaluation of performance in the areas of daily listening in which benefit was likely to be demonstrated, an adult questionnaire was adapted. Items of the Speech, Spatial and Qualities of Hearing Scale (SSQ) focused mainly, although not exclusively, on hearing functions requiring the binaural system. The adapted child, parent, and teacher versions of the SSQ retained the structure of rating listening performance in everyday scenarios across the domains of speech perception, spatial hearing, and other qualities of hearing. Modifications were minimized, although deletion of some items and wording changes were required, and some subdomains could not be included. Observation periods were introduced so that parents and teachers observe performance prior to providing ratings. The suggested minimum age is 11 years for the child version and 5 years for the parent and teacher versions. Instructions indicate interview-style administration in which interpretation of the described listening scenarios can be clarified and use of the ruler-style response format demonstrated. Researchers applying the SSQ for parents have reported higher performance ratings for bilateral over unilateral cochlear implants, particularly in the spatial hearing domain. Further research should provide evidence for the target age range, compare child and parent responses, and evaluate modifications for use with younger children.     

言语、空间与听觉质量量表在老年听力损失者助听器验配中的应用

目的探讨言语、空间与听觉质量量表(speech,spatial and qualities of hearing scale,SSQ)用于老年听力损失患者佩戴助听器的效果评估作用。方法以100例老年感音神经性听力损失者(60~90岁)为研究对象,采用横断面研究和前瞻性研究,其中,无助听器使用经验者44例(75.8±8.1岁,气导纯音平均听阈59.8±13.3 dB HL)、有助听器使用经验者34例(77.5±6.3岁,气导纯音平均听阈64.5±17.8 dB HL,助听器佩戴时间大于三个月)进行横断面研究;22例(74.3±8.6岁,气导纯音平均听阈58.1±12.6 dB HL)首次配戴助听器者进行前瞻性研究;二组参与横断面研究者进行一次SSQ评估,前瞻性研究组分别在助听前和佩戴助听器1个月后进行二次SSQ评估,均采用面对面问答方式用SSQ量表评估三组受试者在言语理解能力、空间定位能力和声音聆听质量方面的变化。结果横断面研究结果显示,有助听经验组SSQ问卷言语理解(97.29±23.43分)、空间听觉(131.94±19.27分)、声音质量(143.53±20.31分)和总分(372.76±51.92分)均显著高于无助听经验组(分别为58.66±30.13、99.41±37.09、108.09±43.28、266.16±78.18分)。前瞻性研究结果显示,受试者初次佩戴助听器一个月后的SSQ问卷言语理解(106.27±13.86分)、空间听觉(136.00±14.09分)、声音质量(151.73±13.91分)和总分(394.00±34.70分)均显著高于佩戴助听器前(分别为65.64±21.89、115.09±17.17、111.91±25.41、292.64±45.58分),横断面研究和前瞻性研究结果均显示,老年听力损失患者佩戴助听器后在言语理解能力、空间声源定位能力和声音聆听质量方面均有显著改善(P<0.05)。结论SSQ量表可以有效评估老年听力损失患者助听器使用效果;老年听力损失患者佩戴助听器后在言语理解能力、空间定位能力和声音聆听质量方面均有显著提高。     

Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation

Objective: To examine post-implantation benefit and time taken to acclimate to the cochlear implant for adult candidates with more hearing in the contralateral non-implanted ear than has been previously considered within local candidacy guidelines. Design: Prospective, within-subject experimental design. Study sample: Forty postlingual hearing-impaired adult subjects with a contralateral ear word score in quiet ranging from 27% to 100% (median 67%). Results: Post-implantation improvement of 2.4?dB and 4.0?dB was observed on a sentence in coincident babble test at presentation levels of 65 and 55?dB SPL respectively, and a 2.1?dB benefit in spatial release from masking (SRM) advantage observed when the noise location favoured the implanted side. Significant post-operative group mean change of between 2.1 and 3.0 was observed on the sub-scales of the speech, spatial, and qualities (SSQ) questionnaire. Degree of post-implantation speech reception threshold (SRT) benefit on the coincident babble test and on perception of soft speech and sounds in the environment was greater for subjects with less contralateral hearing. The degree of contralateral acoustic hearing did not affect time taken to acclimate to the device. Conclusions: The findings from this study support cochlear implantation for candidates with substantial acoustic hearing in the contralateral ear, and provide guidance regarding post-implantation expectations.     

A short form of the Speech,Spatial and Qualities of Hearing scale suitable for clinical use: The SSQ12

Abstract

Objective: To develop and evaluate a 12-item version of the Speech, Spatial and Qualities of Hearing scale for use in clinical research and rehabilitation settings, and provide a formula for converting scores between the full (SSQ49) and abbreviated (SSQ12) versions. Design: Items were selected independently at the three centres (Eriksholm Research Centre, MRC Institute of Hearing Research, University of New England) to be representative of the complete scale. A consensus was achieved after discussion. Study sample: The data set (n = 1220) used for a factor analysis (, submitted) was re-analysed to compare original SSQ scores (SSQ49) with scores on the short version (SSQ12). Results: A scatter-plot of SSQ12 scores against SSQ49 scores showed that SSQ12 score was about 0.6 of a scale point lower than the SSQ49 (0–10 scale) in the re-analysis of the Akeroyd et al data. SSQ12 scores lay on a slightly steeper slope than scores on the SSQ49. Conclusions: The SSQ12 provides similar results to SSQ49 in a large clinical research sample. The slightly lower average SSQ12 score and the slightly steeper slope reflect the composition of this short form relative to the SSQ49.     

European multi-centre study of the Nucleus Hybrid L24 cochlear implant

Abstract

Objectives: To investigate the preservation of residual hearing in subjects who received the Nucleus Hybrid L24 cochlear implant. To investigate the performance benefits up to one year post-implantation in terms of speech recognition, sound quality, and quality of life. Design: Prospective, with sequential enrolment and within-subject comparisons. Post-operative performance using a Freedom Hybrid sound processor was compared with that of pre-operative hearing aids. Study sample: Sixty-six adult hearing-impaired subjects with bilateral severe-to-profound high frequency hearing loss. Results: Group median increase in air-conduction thresholds in the implanted ear for test frequencies 125–1000 Hz was < 15 dB across the population; both immediately and one year post-operatively. Eighty-eight percent of subjects used the Hybrid processor at one year post-op. Sixty-five percent of subjects had significant gain in speech recognition in quiet, and 73% in noise (≥ 20 percentage points/2 dB SNR). Mean SSQ subscale scores were significantly improved (+ 1.2, + 1.3, + 1.8 points, p < 0.001), as was mean HUI3 score (+ 0.117, p < 0.01). Combining residual hearing with CI gave 22?26 %age points mean benefit in speech recognition scores over CI alone (p < 0.01). Conclusions: Useful residual hearing was conserved in 88% of subjects. Speech perception was significantly improved over preoperative hearing aids, as was sound quality and quality of life.     

Receptive language as a predictor of cochlear implant outcome for prelingually deaf adults

Abstract

Objective: This study investigated outcomes and predictive factors, specifically language skills, for a group of prelingually hearing-impaired adults who received a cochlear implant. Design: Speech perception data, demographic information, and other related variables such as communication mode, residual hearing, and receptive language abilities were explored. Pre- and post-implant speech perception scores were compared and multiple regression analysis was used to identify significant predictive relationships. Study sample: The study included 43 adults with a prelingual onset of hearing loss, who proceeded with cochlear implantation at the Royal Victorian Eye and Ear Hospital in Melbourne, Australia. Results: The majority of patients experienced benefit from their cochlear implants, with 88% demonstrating significant improvement in speech perception performance. Volunteers achieved better post-operative speech perception scores if they had a shorter duration of severe-to-profound hearing loss, better language skills, and used an exclusively oral communication mode. Conclusions: Although post-operative speech perception performance is significantly poorer for prelingually hearing-impaired adults compared to postlingually hearing-impaired patients, the study group demonstrated significant benefit from their cochlear implants. The variability in post-operative outcomes can be predicted to some extent from the hearing history and language abilities of the individual patient.     

The Speech,Spatial and Qualities of Hearing Scale (SSQ)

The Speech, Spatial and Qualities of Hearing Scale (SSQ) is designed to measure a range of hearing disabilities across several domains. Particular attention is given to hearing speech in a variety of competing contexts, and to the directional, distance and movement components of spatial hearing. In addition, the abilities both to segregate sounds and to attend to simultaneous speech streams are assessed, reflecting the reality of hearing in the everyday world. Qualities of hearing experience include ease of listening, and the naturalness, clarity and identifiability of different speakers, different musical pieces and instruments, and different everyday sounds. Application of the SSQ to 153 new clinic clients prior to hearing aid fitting showed that the greatest difficulty was experienced with simultaneous speech streams, ease of listening, listening in groups and in noise, and judging distance and movement. SSQ ratings were compared with an independent measure of handicap. After differences in hearing level were controlled for, it was found that identification, attention and effort problems, as well as spatial hearing problems, feature prominently in the disability-handicap relationship, along with certain features of speech hearing. The results implicate aspects of temporal and spatial dynamics of hearing disability in the experience of handicap. The SSQ shows promise as an instrument for evaluating interventions of various kinds, particularly (but not exclusively) those that implicate binaural function.     

Relations between psychophysical measures of spatial hearing and self-reported spatial-hearing abilities

Objective: The aim of the present study was to investigate how well the virtual psychophysical measures of spatial hearing from the preliminary auditory profile predict self-reported spatial-hearing abilities. Design: Virtual spatial-hearings tests (conducted unaided, via headphones) and a questionnaire were administered in five centres in Germany, the Netherlands, Sweden, and the UK. Correlations and stepwise linear regression models were calculated among a group of hearing-impaired listeners. Study sample: Thirty normal-hearing listeners aged 19–39 years, and 72 hearing-impaired listeners aged 22–91 years with a broad range of hearing losses, including asymmetrical and mixed hearing losses. Results: Several significant correlations (between 0.24 and 0.54) were found between results of virtual psychophysical spatial-hearing tests and self-reported localization abilities. Stepwise linear regression analyses showed that the minimum audible angle (MAA) test was a significant predictor for self-reported localization abilities (5% extra explained variance), and the spatial speech reception threshold (SRT) benefit test for self-reported listening to speech in spatial situations (6% extra explained variance). Conclusions: The MAA test and spatial SRT benefit test are indicative measures of everyday binaural functioning. The binaural SRT benefit test was not found to predict self-reported spatial-hearing abilities.     

Tolerable delay for speech production and perception: effects of hearing ability and experience with hearing aids

Objective: Processing delay is one of the important factors that limit the development of novel algorithms for hearing devices. In this study, both normal-hearing listeners and listeners with hearing loss were tested for their tolerance of processing delay up to 50?ms using a real-time setup for own-voice and external-voice conditions based on linear processing to avoid confounding effects of time-dependent gain. Design: Participants rated their perceived subjective annoyance for each condition on a 7-point Likert scale. Study sample: Twenty normal-hearing participants and twenty participants with a range of mild to moderate hearing losses. Results: Delay tolerance was significantly greater for the participants with hearing loss in two out of three voice conditions. The average slopes of annoyance ratings were negatively correlated with the degree of hearing loss across participants. A small trend of higher tolerance of delay by experienced users of hearing aids in comparison to new users was not significant. Conclusion: The increased tolerance of processing delay for speech production and perception with hearing loss and reduced sensitivity to changes in delay with stronger hearing loss may be beneficial for novel algorithms for hearing devices but the setup used in this study differed from commercial hearing aids.     

Assessing speech recognition abilities with digits in noise in cochlear implant and hearing aid users

Objective: The primary objective of the study was to investigate the feasibility, reliability, and validity of the Dutch digits in noise (DIN) test for measuring speech recognition in hearing aid and cochlear implant users and compare results to the standard sentences-in-noise (SIN) test. Design: The relation between speech reception thresholds for DIN test and SIN test was analysed to determine the validity of the DIN test. As linguistic skills were expected to make different contributions in these tests, their influence was analysed. Study sample: Participants were 12 normal-hearing listeners, 24 hearing aid users, and 24 cochlear implant users. Results: The DIN test was feasible for more participants than the SIN test. Intraclass correlation coefficients showed high reliability. The standard error of measurement was smaller for the DIN test than for the SIN test. DIN test and SIN test were highly correlated (r = 0.95 and r = 0.56 for NH+ HA and CI users respectively). In the regression analysis no significant contribution of basic linguistic skills or personal factors was found. Conclusion: In the assessment of speech recognition in noise of aided hearing-impaired listeners with hearing aids or cochlear implants, the DIN test is a feasible, reliable and valid test.     

The interaction of hearing loss and level-dependent hearing protection on speech recognition in noise

Abstract

Objectives: To determine the effects of different control settings of level-dependent hearing protectors on speech recognition performance in interaction with hearing loss. Design: Controlled laboratory experiment with two level-dependent devices (Peltor^® PowerCom Plus? and Nacre QuietPro^®) in two military noises. Study sample: Word recognition scores were collected in protected and unprotected conditions for 45 participants grouped into four hearing profile categories ranging from within normal limits to moderate-to-severe hearing loss. Results: When the level-dependent mode was switched off to simulate conventional hearing protection, there were large differences across hearing profile categories regarding the effects of wearing the devices on speech recognition in noise; participants with normal hearing showed little effect while participants in the most hearing-impaired category showed large decrements in scores compared to unprotected listening. Activating the level-dependent mode of the devices produced large speech recognition benefits over the passive mode at both low and high gain pass-through settings. The category of participants with the most impaired hearing benefitted the most from the level-dependent mode. Conclusions: The findings indicate that level-dependent hearing protection circuitry can provide substantial benefits in speech recognition performance in noise, compared to conventional passive protection, for individuals covering a wide range of hearing losses.     

Speech-clarity judgments of hearing-aid-processed speech in noise: Differing polar patterns and acoustic environments

This investigation assessed the extent to which listeners’ preferences for hearing aid microphone polar patterns vary across listening environments, and whether normal-hearing and inexperienced and experienced hearing-impaired listeners differ in such preferences. Paired-comparison judgments of speech clarity (i.e. subjective speech intelligibility) were made monaurally for recordings of speech in noise processed by a commercially available hearing aid programmed with an omnidirectional and two directional polar patterns (cardioid and hypercardioid). Testing environments included a sound-treated room, a living room, and a classroom. Polar-pattern preferences were highly reliable and agreed closely across all three groups of listeners. All groups preferred listening in the sound-treated room over listening in the living room, and preferred listening in the living room over listening in the classroom. Each group preferred the directional patterns to the omnidirectional pattern in all room conditions. We observed no differences in preference judgments between the two directional patterns or between hearing-impaired listeners’ extent of amplification experience. Overall, findings indicate that listeners perceived qualitative benefits from microphones having directional polar patterns.     

Acceptable noise level (ANL) with Danish and non-semantic speech materials in adult hearing-aid users

Abstract

Objective: The acceptable noise level (ANL) test is used for quantification of the amount of background noise subjects accept when listening to speech. This study investigates Danish hearing-aid users’ ANL performance using Danish and non-semantic speech signals, the repeatability of ANL, and the association between ANL and outcome of the international outcome inventory for hearing aids (IOI-HA). Design: ANL was measured in three conditions in both ears at two test sessions. Subjects completed the IOI-HA and the ANL questionnaire. Study sample: Sixty-three Danish hearing-aid users; fifty-seven subjects were full time users and 6 were part time/non users of hearing aids according to the ANL questionnaire. Results: ANLs were similar to results with American English speech material. The coefficient of repeatability (CR) was 6.5–8.8 dB. IOI-HA scores were not associated to ANL. Conclusions: Danish and non-semantic ANL versions yield results similar to the American English version. The magnitude of the CR indicates that ANL with Danish and non-semantic speech materials is not suitable for prediction of individual patterns of future hearing-aid use or evaluation of individual benefit from hearing-aid features. The ANL with Danish and non-semantic speech materials is not related to IOI-HA outcome.     

Spatial hearing disability after acoustic neuroma removal

OBJECTIVES/HYPOTHESIS: Previous studies on hearing loss (HL) after acoustic neuroma removal concentrate mainly on pure-tone hearing results rather than hearing disability. Our objectives were to use the Speech, Spatial and Qualities of Hearing scale (SSQ), a comprehensively validated questionnaire, to characterize and quantify the auditory disabilities that patients experience with a profound unilateral HL after acoustic neuroma removal. STUDY DESIGN: Forty-four patients with profound unilateral HL after acoustic neuroma surgery completed the SSQ. Their findings were compared with those of a control population sample matched for age, sex, and hearing level in the better hearing ear. RESULTS: In comparison with controls, with use of analysis of variance, acoustic neuroma patients scored poorly on all items except for the identification of sounds and objects (P = .123). The greatest difficulties involved speech in the presence of noise, situations of multiple speech-streams and switching (such as listening to someone speaking and the television at the same time), the location of unseen objects, and increased listening effort (P < .05). CONCLUSION: This study demonstrates that, compared with a control population, these patients experience a significant range of auditory disabilities. It is important that clinicians be aware of the impact of such a profound unilateral HL and its potential to affect daily life. Patient counseling prior to surgery is essential, especially in patients whose loss of binaural hearing could constitute a major disability.     

Improving speech-in-noise recognition for children with hearing loss: Potential effects of language abilities,binaural summation,and head shadow

Abstract

Objective: This study examined speech recognition in noise for children with hearing loss, compared it to recognition for children with normal hearing, and examined mechanisms that might explain variance in children's abilities to recognize speech in noise. Design: Word recognition was measured in two levels of noise, both when the speech and noise were co-located in front and when the noise came separately from one side. Four mechanisms were examined as factors possibly explaining variance: vocabulary knowledge, sensitivity to phonological structure, binaural summation, and head shadow. Study sample: Participants were 113 eight-year-old children. Forty-eight had normal hearing (NH) and 65 had hearing loss: 18 with hearing aids (HAs), 19 with one cochlear implant (CI), and 28 with two CIs. Results: Phonological sensitivity explained a significant amount of between-groups variance in speech-in-noise recognition. Little evidence of binaural summation was found. Head shadow was similar in magnitude for children with NH and with CIs, regardless of whether they wore one or two CIs. Children with HAs showed reduced head shadow effects. Conclusion: These outcomes suggest that in order to improve speech-in-noise recognition for children with hearing loss, intervention needs to be comprehensive, focusing on both language abilities and auditory mechanisms.     

The impact of tinnitus on cognitive performance in normal-hearing individuals

Objective: The aim of this study was to investigate whether the previously reported differences in cognitive performance as assessed using a Stroop paradigm between individuals with and without tinnitus is present in normal-hearing individuals. Design: Participants completed audiometric evaluation, a visual Stroop test, as well as the Swedish version of the hospital anxiety and depression scale (HADS) questionnaire. In addition individuals with tinnitus participated in a short interview regarding tinnitus characteristics as well as a follow up data collection of the tinnitus questionnaire (TQ). Study sample: Forty individuals participated in this study. Twenty had tinnitus (tinnitus group) and 20 had not (control group). The groups were age- and sex-matched and all participants had normal hearing thresholds (20 dB HL or better). Results: No differences in terms of cognitive performances were found between individuals with tinnitus compared to individuals without tinnitus. Conclusion: In contrast to previous studies of hearing-impaired subjects with tinnitus, the results of the present found no signs of cognitive interference in normal-hearing subjects with tinnitus when assessed using intensive short duration tasks.     

Preferred overall loudness. II: Listening through hearing aids in field and laboratory tests

In a laboratory study, we found that normal-hearing and hearing-impaired listeners preferred less than normal overall calculated loudness (according to a loudness model of Moore & Glasberg, ). The current study verified those results using a research hearing aid. Fifteen hearing-impaired and eight normal-hearing participants used the hearing aid in the field and adjusted a volume control to give preferred in median loudness. The hearing aid logged the preferred volume control setting and the calculated loudness at that setting. The hearing-impaired participants preferred loudness levels of ?14 phon re normal for input levels from 50 to 89?dB?SPL. The normal-hearing participants preferred close to normal overall loudness. In subsequent laboratory tests, using the same hearing aid, both hearing-impaired and normal-hearing listeners preferred less than normal overall calculated loudness, and larger reductions for higher input levels. In summary, the hearing-impaired listeners preferred less than normal overall calculated loudness, whereas the results for the normal-hearing listeners were inconclusive.

Sumario

En un estudio de laboratorio encontramos que normoacúsicos o hipoacúsicos prefieren una intensidad subjetiva global menor que la calculada (de acuerdo con el modelo de intensidad subjetiva de Moore & Glasberg, ). Este estudio verificó esos resultados usando un auxiliar auditivo de investigación. Quince hipoacúsicos y ocho normoacúsicos usaron el auxiliar auditivo en campo libre y ajustaron el control de volumen hasta el nivel de intensidad subjetiva preferido. El auxiliar auditivo conservó el nivel de control de volumen preferido y el nivel de intensidad subjetiva calculado para esa posición. Los hipoacúsicos prefirieron niveles de intensidad subjetiva de ?14 phon re normal, para niveles de presentación de 50 a 89?dB SPL. Los normoacúsicos prefirieron niveles de intensidad subjetiva globales cerca de lo normal. En unas pruebas de laboratorio subsecuentes, usando el mismo auxiliar auditivo tanto los hipoacúsicos como los normoacúsicos prefirieron una intensidad subjetiva global menor que la calculada como normal así como amplias reducciones para los niveles de presentación mayores. En resumen, los hipoacúsicos prefieren intensidades subjetivas globales menores que las calculadas como normales, mientras que los resultados para los normoacúsicos no fueron concluyentes.