J Am Acad Audiol 2020; 31(03): 176-184
DOI: 10.3766/jaaa.18059
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Development of a Revised Performance-Perceptual Test Using Quick Speech in Noise Test Material and Its Norms

Hua Ou
*   Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI
Matthew Wetmore
†   Happy Ears Hearing Center, Phoenix, AZ
› Author Affiliations
Further Information

Publication History

Publication Date:
24 May 2020 (online)



Two audiometric speech measures have been recognized to have associations with hearing aid use success: the Quick Speech in Noise (QuickSIN) test and the Performance-Perceptual Test (PPT). The PPT involves using the same speech test material (Hearing in Noise Test [HINT]) twice, to evaluate patients’ objective and subjective speech recognition performance in noise and the discrepancy between the two measures (Performance-Perceptual Discrepancy [PPDIS]). Using the QuickSIN to conduct the PPT (revised-PPT) may provide clinicians two pieces of important information from one test to help predict hearing aid use success and the need for counseling. Moreover, we could achieve the desired clinical efficiency without purchasing additional test materials.


This study aimed (1) to evaluate the validity and reliability of using the QuickSIN speech material to administer the PPT and (2) to establish normative data across listeners with normal hearing (NH) and hearing loss (HL).

Research Design:

This study used a repeated measures design.

Study Sample:

Of the total 65 participants between 18 and 88 years of age, 20 (31%) had NH and 45 (69%) had sensorineural HL, ranging from mild to profound in both ears. Thirty-two of the 45 participants with HL were hearing aid users.

Data Collection and Analysis:

All participants completed the original PPT using HINT and the revised-PPT using QuickSIN, via sound field. Generalized linear mixed models were used to compare the performance, perceptual, and PPDIS data between the two test materials across all participants. Normative data for the revised-PPT were established from all participants.


Significant main effects for both the test material and hearing status were found for the performance and perceptual data. All interactions were nonsignificant. There were no significant PPDIS differences between the original PPT and the revised-PPT. Normative values for the revised-PPT were established and comparable to the norms for the original PPT in the present study. The test–retest results suggested that the revised-PPT has good reliability. In addition, it appeared that there was a negative association between underestimation of hearing ability and hearing aid use success.


It is concluded that the QuickSIN speech material can replace HINT to measure PPT. The revised-PPT may serve as a useful and efficient clinical tool in any clinics for hearing aid fitting and counseling.

This research study was supported in part by the American Speech–Language–Hearing Association's Advancing Academic-Research Careers Award to Dr. Hua Ou.

Partial data were previously presented at the International Hearing Aid Research Conference (IHCON) in Tahoe City, CA, August 10–14, 2016.


  • American National Standards Institute (ANSI) 1996. American National Standard: Specification for Audiometers (ANSI S3.6). New York, NY: ANSI;
  • Chien W, Lin F. 2012; Prevalence of hearing aid use among older adults in the United States. Arch Intern Med 172: 292-293
  • Chisolm T, Johnson C, Danhauer J, Portz L, Abrams H, Lesner S, McCarthy P, Newman C. 2007; A systematic review of health-related quality of life and hearing aids: final report of the American Academy of Audiology Task Force on the Health-Related Quality of Life Benefits of Amplification in Adults. J Am Acad Audiol 18: 151-183
  • Cox R, Alexander G. 2002; The International Outcome Inventory for Hearing Aids (IOI-HA): psychometric properties of the English version. Int J Audiol 41: 30-35
  • Fischer M, Cruickshanks K, Wiley T, Klein B, Klein R, Tweed T. 2011; Determinants of hearing aid acquisition in older adults. Am J Public Health 101: 1449-1455
  • Hickson L, Meyer C, Lovelock K, Lampert M, Khan A. 2014; Factors associated with success with hearing aids in older adults. Int J Audiol 53 (1, Suppl) S18-S27
  • Killion M, Niquette P, Gudmundsen G, Revit L, Banerjee S. 2004; Development of a quick speech-in-noise test for measuring signal-to-noise ratio loss in normal-hearing and hearing-impaired listeners. J Acoust Soc Am 116: 2395-2405
  • Killion M, Villchur E. 1993; Kessler was right – partly: but SIN test shows some aids improve hearing in noise. Hear J 46: 31-35
  • McArdel R, Wilson R. 2006; Homogeneity of the 18 QuickSIN lists. J Am Acad Audiol 17: 157-167
  • Mueller HG. 2010; Three pre-tests: what they do and why experts say you should use them more. Hear J 63: 17-24
  • Mueller HG, Johnson EE, Weber J. 2010 Fitting hearing aids: a comparison of three pre-fitting speech tests. Audiology Online https://www.audiologyonline.com/articles/fitting-hearing-aids-comparison-three-861
  • Mueller HG, Ricketts TA, Bentler R. 2014. Pre-fitting testing using speech material. In Modern Hearing Aids: Pre-Fitting Testing and Selection Considerations 1st ed. San Diego, CA: Plural Publishing; 123-193
  • Nilsson M, Soli SD, Sullivan JA. 1994; Development of the Hearing in Noise Test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am 95: 1085-1099
  • Saunders G. 2009; Understanding in noise: perception vs. performance. Hear J 62: 10-16
  • Saunders G, Forsline A. 2006; The performance-perceptual test and its relationship to aided reported handicap and hearing aid satisfaction. Ear Hear 27: 229-242
  • Saunders G, Forsline A. 2012; Hearing-aid counseling: comparison of single-session informational counseling with single-session performance-perceptual counseling. Int J Audiol 51: 754-764
  • Saunders G, Forsline A, Fausti S. 2004; The performance-perceptual test and its relationship to unaided reported handicap. Ear Hear 25: 117-126
  • Sperry J, Wiley T, Chial M. 1997; Word recognition performance in various background competitors. J Am Acad Audiol 8: 71-80
  • Walden T, Walden B. 2004; Predicting success with hearing aids in everyday living. J Am Acad Audiol 15: 342-352
  • Wilson R, Mcardle R, Smith S. 2007; An evaluation of the BKB-SIN, HINT, QuickSIN, and WIN materials on listeners with normal hearing and listeners with hearing loss. J Speech Lang Hear Res 50: 844-856