A word recognition score (or a speech discrimination score) provides clinicians with valuable information regarding not only an individual’s hearing loss, but which treatment options will be the most appropriate.
WRS information not only assists in determining whether an individual is a good candidate for hearing aids or if another device like a cochlear implant may be indicated, but it can also help determine if there is a neural component to the hearing loss.
Scores are often classified into 1 of 5 categorized; excellent, good, fair, poor, and very poor.
Excellent or within normal limits = 90 - 100% on whole word scoring
Good or slight difficulty = 78 - 88%
Fair to moderate difficulty = 66 - 76%
Poor or great difficulty = 54 - 64 %
Very poor is < 52%
During speech audiometry, an individual's speech recognition threshold is used to determine an appropriate presentation level for obtaining a word recognition score. Alternatively, clinicians can measure a patient’s most comfortable loudness level (MCL) and present there.
Testing is most often performed in quiet but can be completed using background noise as well. Standardized word lists, like the W22 or NU-6 lists, are presented and the individual is asked to repeat back the words heard. A carrier phrase, for example “say the word” is often used. Having this phrase presented before the target word helps the patient prepare to listen and respond and helps the clinician adjust their voice to the proper level before the target word during monitored live-voice presentations.
Note that like with speech reception threshold testing, a recorded word list or live voice can be used derive a word recognition score. When using live voice, a clinician can watch the VU meter included in the Primus software during the carrier phrase to check presentation level.