PP211 - Accommodations for Word Recognition Testing by Audiologists with Hearing Loss

Abstract: Approximately, 2.5 billion individuals globally have some form of hearing loss with presbycusis accounting for 36% of those cases. Nationally, 11.2% of audiologists are 65 and older and by 2035, 25% of audiologists in Texas are predicted to be 65 and older. Given these data, audiologists are at risk of developing hearing loss during their careers. Young adults who have benefitted from early intervention and treatment demonstrate remarkable spoken receptive language abilities and may decide to pursue audiology as a profession. To facilitate the continued accessibility of our profession, we outline a hierarchy of accommodations for word recognition testing.

Summary: Rationale:
Hearing loss can occur at any point across the lifespan. Approximately, 2.5 billion individuals globally have some form of hearing loss with presbycusis accounting for 36% of those cases (Lv et al., 2023). Given these data, it is important to recognize that audiologists are at risk of developing hearing loss during their careers. Furthermore, young adults who received early intervention develop remarkable spoken receptive language abilities (Löfkvist et al., 2025). To facilitate the continued accessibility of our profession to both young and aging audiologists with hearing loss, we investigated the feasibility and benefit of various accommodations for word recognition testing.

Design: A hierarchy of accommodations was developed that could serve as a menu of options for persons with hearing loss. It is arranged by cost and setup feasibility. Input from students in training and preceptors were considered and many ideas were generated to facilitate clinical training. Some of the possible solutions have been evaluated in the Hearing Health Lab at the University of Texas at Dallas and evidence-based support is provided when available. Every person will need to evaluate the possible accommodation or combination of solutions to determine what works best for him or her and their unique listening needs.

Results:
Two of the accommodations, remote microphone technology and voice to text transcription, have been formally evaluated in the UTD Hearing Health Lab. First, the use of the remote microphone on the patient was evaluated by Taylor and Thibodeau (2018), Benefits for Assistive Listening Devices for Scoring Word Recognition Tests. They found that use of a remote microphone worn by the patient could result in significant benefits in scoring word recognition testing presented in babble noise in typical clinical arrangements.

Second, the accuracy of voice to text transcription has been evaluated by Havens and Thibodeau (2021) Speech in Noise Recognition by Voice to Text Applications. The purpose of this project was to obtain results from three voice-to-text applications (Live Transcribe, Otter, and Dragon Anywhere) using an iPhone to determine their accuracy in background noise. Performance in quiet was similar for all three apps, but varied in noise, with the Otter application providing the greatest accuracy.
Since this research was conducted more technology has become available. The pros and cons associated with each option in terms of time, patient feasibility, HIPAA concerns will be included as well as a suggested flowchart to make decisions about selection of options for an individual to try.

Conclusions:
The responsibilities of the audiologist to provide accurate test results relies in part on the sensory system of the examiner to accurately score a patient’s word recognition. When an individual needs an accommodation, one or more of these accommodations may be selected based on one’s personal technology, time constraints, and availability of funding.