Loudness discomfort level for speech: comparison of two instructional sets for saturation sound pressure level selection.

This study was undertaken to compare the speech loudness discomfort levels (LDL's) with two instructional sets which have been proposed for saturation sound pressure level selection of hearing aids. The phraseology recommended by McCandless and by Berger was presented to normal-hearing and hearing-impaired listeners. The normal-hearing subjects obtained mean LDL's of 94.6 and 111.9 dB SPL for these respective instructions, which was statistically significant. The hearing-impaired listeners also showed LDL's with Berger's instructions (114.7 dB SPL) to be significantly higher than with McCandless' instructional set (109.3 dB SPL). Consequently, this investigation suggests that these two instructional sets may lead to substantially different saturation sound pressure levels. Further studies are needed to determine the most appropriate phraseology for LDL measurement, including the assessment of speech intelligibility at various saturation sound pressure levels. Another instructional set was constructed which (1) includes an explanation to patients of the purpose and importance of the test, (2) requests listeners to indicate the upper level they are "willing" to listen as opposed to the level they are "able" to listen, (3) instructs patients to search thoroughly around their LDL before making a final judgment, and (4) contains a statement that the LDL should be made with the understanding that the speech could be listened to for a period of time. Whatever instructions are used, clinicians are advised to interpret their LDL's very cautiously until validational studies are available.