Evaluation of hearing handicap. The American Academy of Otolaryngology and American Council of Otolaryngology (AA0-ACO).

The American Academy of Otolaryngology and American Council of Otolaryngology (AAO-ACO) define hearing handicap as a disability to understand sentences under everyday vocal and listening conditions, and describe procedures for its estimation from pure-tone threshold hearing levels. Research now reveals that the AAO-ACO procedures underestimate measured hearing handicap by the equivalent of averaged pure-tone threshold losses of 17 dB at high-percentage handicaps to 35 dB at low-percentage handicaps. It is proposed that AAO-ACO procedures be modified as follows: (a) adjust hearing levels for presbycusis when estimating handicap due to noise or other factors than presbycusis; (b) change averaged hearing level "fences" from present 25 dB to 15 dB for 0 percent and from present 92 dB to 75 dB for 100 percent handicap; and (c) change weight for "worse" ear contribution from present 1/6 to 1/4 for binaural listening.