A User-Operated Test of Suprathreshold Acuity in Noise for Adult Hearing Screening: The SUN (Speech Understanding in Noise) test

A novel, user-operated test of suprathreshold acuity in noise for use in adult hearing screening (AHS) was developed. The SUN test (Speech Understanding in Noise) is a speech-in-noise test that makes use of a list of VCV (vowel-consonant-vowel) stimuli in background noise presented in a three-alternative forced choice (3AFC) paradigm by means of a touch sensitive screen. The test is automated, easy-to-use, and provides self-explanatory results (i.e., 'no hearing difficulties', or 'a hearing check would be advisable', or 'a hearing check is recommended'). The test was developed from its building blocks (VCVs and speech-shaped noise) through two main steps: i) development of the test list through equalization of the intelligibility of test stimuli across the set; and ii) optimization of the test results through maximization of the test sensitivity and specificity. The test had 82.9% sensitivity and 85.9% specificity compared to conventional pure-tone screening, and 83.8% sensitivity and 83.9% specificity to identify individuals with disabling hearing impairment. Results obtained so far showed that the test could be easily performed by adults and older adults in less than one minute per ear and that its results were not influenced by ambient noise (up to 65 dBA), suggesting that the test might be a viable method for AHS in clinical as well as non-clinical settings.