Speech-in-Noise Testing in Lafayette, LA
If you can hear people talking but cannot understand what they are saying in restaurants, meetings, or family gatherings, a standard hearing test may not tell the full story. Speech-in-noise testing measures how well you understand speech when background noise is present. It is a short, well-validated test that most audiology practices skip. At ACI Hearing Center in Lafayette, our four Doctors of Audiology use speech-in-noise testing as part of comprehensive evaluations and hearing aid fittings, because a normal audiogram is not the same as normal listening.
What speech-in-noise testing is
Speech-in-noise testing is a short listening exam done in the sound booth as part of your evaluation or fitting appointment. You listen through headphones or through speakers while the audiologist plays sentences at decreasing signal-to-noise ratios (SNR). Multi-talker babble noise plays behind the sentences. Your job is to repeat back the target words you hear. The test measures how much louder speech has to be than noise for you to understand it as well as a normal-hearing listener.
The two most common validated tests used in audiology clinics are:
- QuickSIN (Etymotic Research). Six sentences with 5 target words each, played at SNRs from 25 dB down to 0 dB. Takes about 1 minute per list, typically 2 lists per ear. Yields a SNR loss score in decibels.
- HINT (Hearing in Noise Test). Adaptive sentences presented in quiet and in noise from the front, right, and left. More sensitive to spatial hearing than QuickSIN. Takes 10 to 15 minutes.
Total time: 5 to 15 minutes on top of your standard hearing test.
Why a standard audiogram is not enough
The standard audiogram measures whether you can detect a tone at different pitches. It is a test of the outer, middle, and inner ear. It does not test how your brain separates a talker's voice from surrounding noise. Two people with identical audiograms can have very different real-world listening ability. One follows conversation fine in a busy restaurant. The other cannot follow dinner conversation across a small table.
That gap is called SNR loss, and it is only measurable with a speech-in-noise test. A patient with a normal audiogram and a moderate SNR loss has real, treatable hearing difficulty even though a standard test looks fine. This profile is what many audiologists call hidden hearing loss.
How rare speech-in-noise testing really is
According to a 2013 Hearing Review report by Douglas Beck and Michael Nilsson, along with follow-up surveys, only about 20 to 30 percent of dispensing audiologists routinely administer speech-in-noise testing before a hearing aid fitting. The test is quick, standardized, and often reimbursable under CPT code 92620. It has been available since QuickSIN was validated in 2004. Yet most patients never receive it.
If you are shopping for a hearing evaluation or a hearing aid, the second most powerful question you can ask a provider (after do you perform real ear measurement) is: Do you perform speech-in-noise testing as part of the evaluation? That single question separates about 1 in 4 providers from the rest.
What speech-in-noise testing looks like at ACI Hearing Center
Here is how speech-in-noise testing fits into a comprehensive evaluation at ACI Hearing Center:
- Intake and history. Your audiologist asks specific questions about the situations where you have trouble understanding: restaurants, meetings, TV, phone, one-on-one, groups, spouse across the room, and so on. This shapes which speech-in-noise measures make the most sense.
- Standard audiometric testing. Pure-tone air and bone conduction, speech reception threshold, and word recognition in quiet. This is the baseline.
- QuickSIN. Two lists of 6 sentences played at SNRs from 25 dB down to 0 dB. You repeat back the target words. Your SNR loss score is calculated from the number of correct words at each SNR level.
- Results interpretation. Your audiologist walks you through your audiogram, your word recognition in quiet, and your SNR loss score together. You will see exactly which finding matches your day-to-day difficulty.
- Programming decisions. If a hearing aid is recommended, your SNR loss score guides directional microphone use, noise reduction strength, and program setup. A patient with a 3 dB SNR loss needs a different setup than a patient with a 12 dB SNR loss.
- Verification. Hearing aid programming is verified with real ear measurement. Together, speech-in-noise testing plus real ear measurement is what audiologists call the gold-standard fitting pipeline.
What your SNR loss score means
Your SNR loss score is measured in decibels. It represents how much louder speech has to be than noise for you to understand it as well as a normal-hearing listener does. Here is what different ranges mean in real-world terms:
- 0 to 3 dB (normal): You follow conversation in noise about as well as a person with normal hearing. Standard hearing aid programming, if any, works fine.
- 3 to 7 dB (mild SNR loss): Restaurants, group meetings, and family gatherings are noticeably harder than for a normal-hearing listener. Directional microphones on hearing aids help significantly.
- 7 to 15 dB (moderate SNR loss): You often ask people to repeat themselves in noise. Group conversation is exhausting. You benefit from strong directional microphones, aggressive noise reduction, and possibly a remote microphone accessory for restaurants and meetings.
- Greater than 15 dB (severe SNR loss): You avoid noisy situations. Hearing aids alone may not be enough. You are a strong candidate for remote microphone systems, FM systems, or in some cases cochlear implant evaluation.
These ranges are guidance, not diagnosis. Your audiologist interprets your score in the context of your audiogram, your word recognition in quiet, and your specific listening situations.
Who benefits most from speech-in-noise testing
- Anyone who says I can hear but I cannot understand. Especially in noisy places.
- Musicians, teachers, and restaurant industry workers. Occupational listening in complex sound environments.
- Contractors, first responders, and open-plan office workers. Communication in noise is safety-critical or productivity-critical.
- Patients with normal audiograms who still struggle to hear. Hidden hearing loss shows up here or nowhere.
- Patients whose current hearing aids are not helping in noise. Programming can often be improved once we know the SNR loss score.
- Patients considering cochlear implants. Speech-in-noise scores are one of the required criteria for cochlear implant candidacy per the American Cochlear Implant Alliance 2023 revised guidelines.
Speech-in-noise testing plus real ear measurement
Speech-in-noise testing tells us how much noise-management you need. Real ear measurement tells us whether the hearing aid is actually delivering it in your ear. Together, they are the two clinical measurements that separate a well-fit hearing aid from a poorly-fit one. Most Lafayette practices do neither. ACI does both.
Meet our audiology team
All four of ACI Hearing Center's Doctors of Audiology use speech-in-noise testing as part of comprehensive evaluations and hearing aid fittings:
- Dr. Kimberly L. Allred, Au.D. Owner and lead audiologist. Trained at the University of Florida. Serving Lafayette since 1984.
- Dr. Elizabeth LeMaire, Au.D. Doctor of Audiology with ULL and LSU Health training.
- Dr. Sarah Lalande-Davies, Au.D. LSU and LSU Health New Orleans trained.
- Dr. Courtney Barbier, Au.D. Doctor of Audiology with ULL and LSU Health training.
For each provider's full credentials, see our audiology team page.
Frequently Asked Questions
What is speech-in-noise testing?
Speech-in-noise testing measures how well you understand words and sentences when background noise is present. It is a separate test from the standard audiogram, which only measures whether you can detect pure tones at different pitches. The most common versions used in audiology clinics are the QuickSIN test (about 5 minutes) and the HINT test (about 10 to 15 minutes). Both give a score in decibels of signal-to-noise ratio loss, which is how much louder speech has to be than noise for you to understand it compared to a normal-hearing listener.
Why is a standard hearing test not enough?
A standard audiogram tells us the softest sound you can detect at each pitch. It does not tell us how your brain processes speech when noise is competing for attention. Many patients have a normal or near-normal audiogram but still struggle to understand speech in restaurants, meetings, or family gatherings. That is called hidden hearing loss, and it only shows up on speech-in-noise testing. If your audiogram is normal but you still say I can hear people, I just cannot understand them, speech-in-noise testing is the test you need.
Do all audiologists perform speech-in-noise testing?
No. Based on a 2013 Hearing Review report by Beck and Nilsson and follow-up surveys, only about 20 to 30 percent of dispensing audiologists routinely perform speech-in-noise testing before a hearing aid fitting. It takes 5 to 15 minutes, is well-validated, and is often reimbursable. Yet most practices skip it. Any audiologist you consult should be able to answer yes to the question, Do you perform speech-in-noise testing as part of a hearing aid evaluation?
Does ACI Hearing Center perform speech-in-noise testing?
Yes. Speech-in-noise testing is part of comprehensive audiologic evaluations and hearing aid fittings at ACI Hearing Center. Our four Doctors of Audiology use validated speech-in-noise measures to identify the specific type and severity of your listening difficulty, and to inform how we program noise-management features on your hearing aids.
What is a good SNR loss score?
For most adults with normal hearing, an SNR loss of 0 to 3 dB is normal. A score of 3 to 7 dB is a mild SNR loss, 7 to 15 dB is a moderate SNR loss, and greater than 15 dB is a severe SNR loss. A person with an SNR loss of 10 dB needs speech to be 10 dB louder than the noise to understand it as well as a normal-hearing listener does at 0 dB SNR. That difference explains why some people cannot follow conversation in a busy restaurant even when their audiogram looks fine.
Do hearing aids help with SNR loss?
Yes, but only if they are programmed correctly. Modern hearing aids include directional microphones, noise reduction algorithms, and speech-in-noise programs. However, these features need to be tuned to the patient. Speech-in-noise testing measures how much noise-management the patient needs, and how well the hearing aid delivers it. Programming a hearing aid without SNR loss data is like tailoring a suit without measurements.
Is speech-in-noise testing covered by insurance?
In most cases, yes. Speech-in-noise testing is billed under CPT code 92620 (evaluation of central auditory function with speech in noise) and is generally covered when medically necessary. Coverage depends on your specific insurance plan. Our team verifies coverage before your appointment and explains any out-of-pocket cost in advance.
How long does the test take?
The QuickSIN version takes about 5 minutes total. Two lists of 6 sentences each are typical. The HINT version takes about 10 to 15 minutes. Both are part of your regular evaluation appointment, not a separate visit.
Should I get speech-in-noise testing if my audiogram was normal?
Yes, especially if you notice difficulty understanding speech in restaurants, meetings, noisy work environments, or family gatherings. A normal audiogram plus a poor SNR loss score is a specific and treatable finding. Many patients with this profile benefit from communication strategies, workplace accommodations, or in some cases mild-gain hearing aids with strong noise-management features.
Who benefits most from speech-in-noise testing?
Anyone who says I can hear people but I cannot understand them, especially in noise. Musicians, teachers, restaurant industry workers, contractors, and people who work in open-plan offices see the most obvious benefit. Patients with a normal audiogram who still struggle with speech in noise are the group most helped, because their hearing loss is otherwise invisible on a standard test.
Schedule a speech-in-noise evaluation
Call ACI Hearing Center at (337) 223-9448 or request an appointment online. We are located at 103 Saint Thomas Street, Lafayette, LA 70506. Same-week appointments are typically available. If you already have hearing aids and want to know your SNR loss score, mention that when you call so we can schedule the right amount of time.
For financing options on new hearing aids, see our financing page (Cherry, CareCredit, PowerPay, HSA and FSA).