Speech in noise: hearing loss, neurocognitive disorders, aging, traumatic brain injury and more

When people complain about not being able to listen or attend to a primary speaker, or when they report difficulty understanding speech in noise (SIN), audiologists should test and diagnose deeper than a simple audiogram. Indeed, simply hearing pure tones at normal loudness levels does not predict or correlate with understanding speech in noise. A comprehensive audiologic evaluation which includes acoustic reflexes, SIN tests, auditory brainstem response, otoacoustic emissions and more is often useful and worthy of exploration, to lead the clinician to a detailed and patient-specific diagnosis, as well as to set appropriate and realistic aural rehabilitative goals.