Noise Lecture

Audiogram

K. Pathak
 Audiogram

An audiogram is a graph that shows the audible threshold for

standardized frequencies as measured by an audiometer. The Y
axis represents intensity measured in decibels and the X axis
represents frequency measured in Hertz.

An audiogram is a quantitative measure, not a measure

of quality (i.e. clarity of speech and other sounds). An
audiogram is a graph, with frequency, from low to high,
across the top or horizontal axis and intensity, from soft to
loud, down the vertical axis.

The audiogram charts hearing ability, specifically, the softest sounds that can be heard in ears at various
low-to-high frequencies. These sounds are called thresholds.

Technically, a person's hearing threshold is defined as "the softest sounds a person hears at each
frequency approximately 50% of the time."
An audiometer is an instrument that is used to measure the accuracy of hearing.

The audiometer works by presenting the same type of sound at different frequency
levels. People with hearing loss actually may respond to some type of frequency which is
much lower to normal level or even higher to normal level. So, different levels of
frequencies are tried out with the patient and a careful observation of the person's
response to the various frequencies of sound is observed. If the person expresses
interest in the frequency or level of sound being shown to him or her, then one can be
certain that it is not a complete hearing loss.

Learning Activity:
From the internet find out the specifications of 3 different makes of
audiometers. Explore the meaning of each of the specifications and
briefly explain their meaning. Compare the specification ranges of the
three and comment on their applicabilities.
You can form 3 groups and each group will work on one make. Discuss
on your findings and prepare a common report after the combined
discussions on the groups observations.
Time: 3 days.
 In an Audiogram the Intensity is measured in decibels hearing level (dB HL).
The top line, at 0 decibels (dB HL), represents a very soft sound, with each
horizontal line below representing successively louder sounds.
Zero (0) dB HL does not mean that there is no sound at all. Rather, it is the
softest sound that a person with "normal" hearing ability would be able to
detect at least 50% of the time. (Some audiograms, in fact, begin at -10 dB HL
or lower.)

Audiologists consider 0 -15 dB HL to be "normal hearing" in children (0 - 25

dB HL in adults).

The most important frequencies for speech fall into the 250-6000 Hz
range. The vowel sounds of speech are typically low frequency sounds
that make up the loudness of speech.

The consonant sounds like "f", "s", and "th" are high frequency sounds.
 A child of 5 years was under audiometric test and his response to sound is shown in the graph
below. Comment on his hearing ability.

Click for the answer

The white area represents the sounds that the child cannot hear
(softer than his/her thresholds) and the yellow area indicates all
of the sounds that the child can hear (louder than his/her
thresholds).

The audiologists consider 0-15 dB HL to be normal in children.

Thus it is obvious that this child has a hearing problem.

0 dB HL is the softest sound that a person with "normal" hearing ability would
be able to detect at least 50% of the time.
Hearing loss ranges, defined in dB HLs, have been established to help people identify how much
difficulty they should expect from a hearing loss. The ranges that are listed below -- normal, mild,
moderate, severe, and profound

NORMAL 015 dB HL (infant)

0-25 dB HL (adult)

MILD 20-40 dB HL
Unable to hear soft sounds. Can hear a normal
conversation in a quiet room but has difficulty in a noisy
environment. Cannot hear whispered conversation or
speech from a distance.

MODERATE 40-70 dB HL
Has difficulty hearing a normal conversation in a quiet
room. Must lip-read or use amplification to understand
most words.

SEVERE 70-90 dB HL
Cannot hear a conversation unless the speaker speaks
loudly near the ear.

PROFOUND 90+ dB HL
Cannot understand speech even if the speaker shouts.
Can only hear very loud sounds such as a motorcycle
engine, if at all.
 Interpret Audiogram

Masked air thresholds: Note that in the lower frequencies, the hearing
This shows a mild hearing loss in both ears in the high
sensitivity is normal in both ears, but falls sharply into the moderate hearing
frequencies. On average, however, hearing is normal
loss range beginning at 2000 Hz.

Here we see striking differences between the ears. The

left ear shows normal hearing in the low frequencies
A bilateral mild sloping to profound hearing loss.
sloping to a severe high frequency hearing loss. The right
ear shows a moderate to severe hearing loss
Hearing a sound and Understanding conversation is different.
1. vowels fall in the "louder" ranges (They lie lower on the chart.);
2. consonants are higher-pitched than vowels (They lie more to the right on the chart.);
3.consonants are spoken more softly than vowel. (They lie higher on the chart, in the lower decibel ranges.)

Bilateral normal sloping to

Bilateral normal sloping to moderate hearing loss. Both
mild hearing loss. Under ears hear the vowels and the
perfect listening conditions, lower-frequency consonants,
this child will miss a few but miss "s", "th" and "t,"
words off and on because of among others. This child
not hearing "s" and "th," for would not be able to
example. Under noisy distinguish plural from
conditions, he/she will have singular forms.
even more difficulty.

Bilateral mild sloping to

profound hearing loss. With
Normal sloping to profound only a few consonant and
hearing loss in the left ear. vowels sounds audible, this
Moderate to severe hearing child would miss most of the
loss in the right ear. This child distinguishing speech
can hear no conversation in the features.
right ear. The left ear, however,
hears all but the soft, upper
frequency