Speech Testing in Wilmington & Southport, NC
Pure-tone hearing tests tell us how soft a sound needs to be before you can hear it. But hearing is about far more than detecting tones — it’s about understanding speech. Speech audiometry measures how clearly you understand spoken language, and it is a critical component of every comprehensive hearing evaluation at Excel Audiology in Wilmington & Southport, NC.
Why Speech Testing Matters
Two people can have identical audiograms — the same degree of hearing loss at the same frequencies — and yet have dramatically different abilities to understand speech. This is because speech clarity depends not only on audibility but on the health and processing capability of the inner ear and auditory nerve.
Speech testing provides a much more complete picture of your hearing than tone tests alone. It validates and cross-checks pure-tone results, reveals the degree of auditory processing difficulty, predicts hearing aid benefit with greater accuracy, guides hearing aid selection and programming, and identifies patients who may benefit from further evaluation or specialist referral.
Types of Speech Audiometry Tests
Speech Reception Threshold (SRT)
The SRT measures the softest level at which you can correctly identify spondee words — two-syllable words with equal stress on both syllables (e.g., “baseball,” “hotdog,” “airplane”). The SRT should closely agree with the pure-tone average from your audiogram, which helps confirm the validity and reliability of the overall test results.
Most Comfortable Level (MCL) and Uncomfortable Loudness Level (UCL)
These tests identify the range of comfortable listening — the dynamic range in which sound is audible but not uncomfortably loud. This information directly informs hearing aid fitting, particularly for patients with reduced dynamic range, which is a common consequence of inner ear damage.
Word Recognition Score (WRS)
Also called speech discrimination testing, the WRS measures how accurately you can repeat back single-syllable words presented at a comfortable listening level. Results are expressed as a percentage:
| Score | Interpretation |
|---|---|
| 92–100% | Excellent — normal or near-normal speech understanding |
| 80–92% | Mild difficulty |
| 60–80% | Moderate difficulty |
| Below 60% | Poor discrimination — hearing aids may provide limited clarity benefit |
Word recognition scores are among the most clinically important measures in audiology. Patients with poor WRS may hear sounds reasonably well with amplification but still struggle to understand speech clearly. This is critical information for setting realistic expectations around hearing aid outcomes and for guiding referrals.
Speech in Noise Testing
Standard speech testing is conducted in a quiet booth, but most real-world communication happens in noise — at restaurants, family gatherings, social events, and workplaces. Speech-in-noise testing (such as the QuickSIN or BKB-SIN tests) measures how well you understand speech in the presence of competing background noise.
This provides a more realistic assessment of everyday listening difficulty and is particularly helpful for:
- Patients who report struggling specifically in noisy environments
- Selecting hearing aid features that target directional microphones and noise reduction
- Documenting the functional impact of hearing loss on daily communication
How Speech Testing Fits Into Your Evaluation
Speech audiometry is one component of your comprehensive hearing evaluation at Excel Audiology, alongside pure-tone audiometry, and tympanometry. Together, these tests give Dr. Rickman a complete, accurate picture of your auditory system — from the outer ear all the way to the brain’s ability to interpret speech.
- Wilmington: (910) 399-3075
- Southport: (910) 387-9015
Frequently Asked Questions
Is speech testing the same as a hearing test?
Speech audiometry is one part of a comprehensive hearing test. A full evaluation includes pure-tone audiometry, speech testing, tympanometry, and other components — each providing different and complementary information about your hearing.
What does a low word recognition score mean?
A low WRS means you have difficulty understanding speech even when it’s loud enough to hear — indicating that the inner ear or auditory nerve is not processing sound clearly. This can affect how much benefit you receive from hearing aids and is important information when setting realistic expectations.
Does speech testing tell me if I need hearing aids?
Speech testing is one of several factors that guides hearing aid recommendations. Your audiogram, WRS, lifestyle, and communication needs are all considered together when determining the best course of treatment.
Can speech-in-noise testing detect hearing problems not shown on my audiogram?
Yes. Some people have normal or near-normal pure-tone thresholds but significant difficulty understanding speech in noise — a condition sometimes called hidden hearing loss or auditory processing difficulty. Speech-in-noise testing can reveal these challenges even when a standard audiogram looks normal.