Clinical measurement of various aspects of hearing impairment and their relation to auditory functioning: the development of an Auditory Profile

In terms of disability and handicap, problems in auditory function involve much more than a reduced sensitivity to soft sounds, the most commonly used measure of hearing impairment. In daily life, many hearing-impaired (HI) listeners suffer more from impaired processing of audible sounds, than from missing inaudible sounds. For example, people can have difficulties understanding speech in noisy situations or localizing sounds. The degree of these types of disabilities does not only depend on hearing thresholds, but also on other aspects of the auditory system such as loudness recruitment and spectral and temporal resolutions as well as non-auditory factors, such as cognition. All these aspects in hearing are widely investigated in research settings using many different, often time-consuming tests, but there are very few applications in clinical audiology.
In clinical audiology, pure-tone audiometry is traditionally used and sometimes supplemented with speech audiometry for functional diagnostics, hearing aid fitting and counselling. As a result, many hearing aid fittings are based on audiogram data only, although modern hearing aids have a large number of fitting parameters that should ideally be set based on individual hearing capacities.
The present thesis focuses on clinically applicable tests that could complement the pure-tone audiogram for functional diagnostics. The clinical usability and relevance of these tests for speech perception or broader auditory function is investigated. The end result is a battery of tests that could serve as a standard in extensive diagnostics or in audiological research: the (preliminary) Auditory Profile.