PP319 - Survey of U.S. Audiologists' Use of Speech-in-Noise Testing for Adults vs. Pediatrics

Abstract:
Previous surveys suggest that speech-in-noise (SIN) testing is underutilized, but it is not clear why. Understanding practice patterns, facilitators, and barriers may help to improve use. Also, little is known about how SIN testing is used for adults versus pediatrics. We addressed these gaps in knowledge through an online survey of US audiologists. Currently, 60 respondents reported seeing both adults and pediatrics. Preliminary results indicated that SIN testing is used more frequently with adults. Differences in facilitators and barriers to SIN testing were also found for adults versus pediatrics. This study may contribute to improved usage of SIN testing.

Summary:
Rationale
Use of speech-in-noise (SIN) testing has been recommended over the years (reviewed in Billings et al., 2023). However, standard audiologic assessments focus on testing in quiet. Although important, measures of hearing in quiet are not strong predictors of hearing in noise (Fitzgerald et al., 2023; Wilson, 2011). Previous surveys of US audiologists suggest limited use of SIN testing, with estimates ranging from 13-35% of audiologists (ASHA, 2019; Anderson et al., 2018; Clark et al., 2017; Mueller, 2010). These typically included a limited number of questions about SIN testing and did not assess how SIN testing is used for different clinical populations. The goal of the current study was to characterize SIN testing practice patterns, facilitators, and barriers for adult and pediatric populations.

Design
This study involved an anonymous online survey in Qualtrics distributed from October to December 2024. Eligible participants were licensed US audiologists who were performing audiometric testing at the time of survey completion. The survey was designed to take a maximum of 20 minutes. There was a total of 47 questions including demographics, patient populations, and SIN testing practices and attitudes. Some of the survey questions were adapted with permission from ASHA (ASHA, 2019; Mertes & Marquess, 2023; Parmar et al., 2022). The survey was distributed through audiologist message boards, social media, listservs, and word of mouth.

Results
Currently, results have been obtained from 60 respondents who see both adult and pediatric populations. Most (30%) worked in private practice, and there was a median of 11 years of work experience. SIN testing was used more frequently for adults (median of 8 on a scale of 0 to 10) than pediatrics (median of 4 on a scale of 0 to 10). Respondents also reported being more confident in selecting, performing, and interpreting SIN tests for adults compared to pediatrics. The most common reason for performing SIN testing was to validate patient complaints in adults (47%) and for counseling in pediatrics (27%). The most frequently used SIN test was the QuickSIN for adults (78%) and the BKB-SIN for pediatrics (26%). The most common barrier to using SIN testing was lack of time for adults (24%) and patient fatigue for pediatrics (39%).

Conclusion
Preliminary results suggest that SIN testing is used more frequently and with greater confidence for adults than pediatrics, at least for audiologists who see both populations. Additionally, there appear to be different facilitators and barriers to SIN testing for adults and pediatrics. Additional analyses will include associations between variables (e.g., frequency of usage as a function of workplace setting). The results of this study will reveal facilitators and barriers that could improve incorporation of SIN testing in clinic practice. The goal is to make recommendations as to how SIN testing frequency and utility could be improved for all diagnostic populations.