Hearing a sound is not the same as understanding it.
WHICH IS WHY WE SHOULD
DITCH THE “BEEP”
Traditional hearing screenings use pure tones (“beeps”) in a quiet environment to measure whether the ear can detect sound. While this is important, it does not reflect how we actually listen in everyday life.
Real-world listening is complex. It requires the brain to process speech in noise, filter competing sounds, and make sense of rapid, constantly changing information. Many children and adults can detect tones normally but still struggle to understand speech—especially in classrooms, conversations, and noisy environments.
Speech-in-noise testing evaluates how well the auditory system functions under these real-world conditions. It measures not just whether sound is heard, but whether it is processed, organized, and understood.
This is why individuals can “pass” a traditional hearing test and still experience significant listening difficulties.
If we want to find the kids who are struggling,
we have to test the way they listen.
Billings CJ, Olsen TM, Charney L, Madsen BM, Holmes CE. Speech-in-Noise Testing: An Introduction for Audiologists. Semin Hear. 2023 Sep 11;45(1):55-82. doi: 10.1055/s-0043-1770155. PMID: 38370518; PMCID: PMC10872656. Access article here
Sanchez VA, Arnold ML, Moore DR, Clavier O, Abrams HB. Speech-in-noise testing: Innovative applications for pediatric patients, underrepresented populations, fitness for duty, clinical trials, and remote services. J Acoust Soc Am. 2022 Oct;152(4):2336. doi: 10.1121/10.0014418. PMID: 36319253; PMCID: PMC9722269. Access article here
British Society of Audiology. Practice guidance: speech-in-noise testing. Published 2019. Accessed 05/02/2026. https://www.thebsa.org.uk Access guidelines here
Wilson RH. 20Q: Speech-in-noise testing—what clinicians need to know. AudiologyOnline. Published 2021. Accessed [insert date]. https://www.audiologyonline.com Access article here
