Pure Tone-Spondee Threshold Relationships in Functional Hearing Loss: A Hypothesis

Abstract

A hypothesis is offered to account for the fact that in functional hearing loss, spondee threshold is frequently significantly lower than the pure-tone average. The hypothesis has three basic components: (1) that patients with functional hearing loss use a loudness criterion in making response decisions to suprathreshold stimuli; (2) that, at suprathreshold levels, pure tones and spondee words appear equally loud at equal sound pressure levels, and (3) that calibration values employed in pure-tone and speech audiometry contribute to the aberrant speech—pure tone relationship. Factors that may confound the speech—pure tone relationship are discussed as are the clinical and research implication of the hypothesis.