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Purpose: Critical differences state by how much 2 test results have to differ in order to be significantly different. Critical differences for discrimination scores have been available for several decades, but they do not exist for speech reception thresholds (SRTs). This study presents and discusses how critical differences for SRTs can be estimated by Monte Carlo simulations. As an application of this method, critical differences are proposed for a 5-word sentences test (a matrix test) using 2 widely implemented adaptive test procedures., Method: For each procedure, simulations were performed for different parameters: the number of test sentences, the j factor, the distribution of the subjects' true SRTs, and the slope of the discrimination function. For 1 procedure and 1 parameter setting, simulation data are compared with results found by listening tests (experimental data)., Results: The critical differences were found to depend on the parameters tested, including interactive effects. The critical differences found by simulation agree with data found experimentally., Conclusions: As the critical differences for SRTs rely on multiple parameters, they must be determined for each parameter setting individually. However, with knowledge of the test setup, rules of thumb can be derived.

Objective: Examination of Danish data for medico-legal compensations regarding hearing disabilities. The study purposes are: (1) to investigate whether discrimination scores (DSs) relate to patients' subjective experience of their hearing and communication ability (the latter referring to audio-visual perception), (2) to compare DSs from different discrimination tests (auditory/audio-visual perception and without/with noise), and (3) to relate different handicap measures in the scaling used for compensation purposes in Denmark., Design: Data from a 15 year period (1999-2014) were collected and analysed., Study Sample: The data set includes 466 patients, from which 50 were omitted due to suspicion of having exaggerated their hearing disabilities., Results: The DSs relate well to the patients' subjective experience of their speech perception ability. By comparing DSs for different test setups it was found that adding noise entails a relatively more difficult listening condition than removing visual cues. The hearing and communication handicap degrees were found to agree, whereas the measured handicap degrees tended to be higher than the self-assessed handicap degrees., Conclusions: The DSs can be used to assess patients' hearing and communication abilities. The difference in the obtained handicap degrees emphasizes the importance of collecting self-assessed as well as measured handicap degrees.

Objective: The purpose of this study was to implement and evaluate a user-operated speech in noise test., Design: The test is based on the Danish speech material Dantale II, which consists of five words sentences ( Wagener et al, 2003 ). For each word presented the subject selected a response from ten alternative words. Two versions of the test were made: one with and one without the possibility that for each word presented the subject could answer "I do not know" (?-button). Using a listening test the two versions were evaluated against a traditional test, where the subjects orally repeated the words that were perceived., Study Sample: Twenty-four normal-hearing subjects., Results: The speech intelligibility as a function of the signal-to-noise ratio can be described by logistic functions in the different user-operated tests and in the traditional test. The logistic parameters obtained from the user-operated test with the ?-button agree with the parameters obtained in a traditional test. The homogeneity of the speech material is uninfluenced when the material is used in a user-operated test., Conclusions: It is reasonable to use the Dantale II speech material for a user-operated speech in noise test, and the use of the ?-button is favourable.