How is speech reception threshold (SRT) measured?

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How Speech Reception Threshold (SRT) is Measured

Speech reception threshold (SRT) is measured as the minimum hearing level (signal-to-noise ratio) at which an individual can correctly recognize 50% of presented speech material, typically using an adaptive procedure that adjusts stimulus levels based on the patient's responses to successive sentences or words. 1, 2

Core Measurement Methodology

The SRT test is conducted independently for each ear using the following approach:

  • Starting point: The initial sound level is determined from pure tone thresholds (PTTs) obtained via pure-tone audiometry, typically using the pure tone average (PTAv) 1
  • Adaptive procedure: The signal-to-noise ratio (SNR) of successive sentences is adjusted up or down based on the subject's scores on previous sentences 2
  • Endpoint determination: The SRT is estimated as either the mean of a subset of the SNR levels tested, or by fitting a psychometric function to the data 2

Clinical Application Context

In clinical practice, particularly for sudden sensorineural hearing loss assessment:

  • Recovery assessment: Complete recovery is defined as follow-up SRT improving to within 10 dB of pre-hearing loss levels 3
  • Partial recovery: Follow-up SRT improves to within 50% of pre-hearing loss levels 3
  • Significance threshold: Any change must exceed 10 dB to be considered clinically significant, as smaller changes fall within test-retest reliability limits 3

Key Measurement Parameters

Fixed vs. adaptive noise levels: SRT can be measured at either a fixed absolute noise level (e.g., 80 dBA) or at a fixed sensation level (e.g., 25 dB above threshold), with the choice affecting comparability between normal-hearing and hearing-impaired listeners 4

Test reliability factors:

  • Patients with poor speech discrimination yield worse SRT reliability and greater sensitivity to the starting hearing level 5
  • The number of repetitive adjustments directly impacts both patient and audiologist fatigue, potentially compromising test reliability 1

Optimization Strategies

To improve efficiency and reduce testing time:

  • Initial level estimation: More accurate initial sound level estimation (closer to the final SRT value) reduces the number of repetitions required 1
  • Conversion methods: When tests use steady-state masking noise matching the speech spectrum, SRT values can be converted to percentage-correct scores and vice versa without requiring pure tone threshold information 6

References

1
Research

A novel approach for estimating initial sound level for speech reception threshold test.

Technology and health care : official journal of the European Society for Engineering and Medicine, 2024

3
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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