Adaptation and Validation of the Perceptual Performance Test in Malayalam

Abstract

Background and Objectives: The discrepancies between the objective and subjective measurements used to select and fit hearing aids indirectly impact the perceived benefit and perception in the presence of noise. This study aimed to bridge the gap between objective and subjective measurements in hearing aid fitting by adapting and validating the “Perceptual Performance Test (PPT)” in Malayalam.Subjects and Methods: Standardized Malayalam-language sentences were used to adapt PPT and administer it to 65 native Malayalam speakers (30 normal and 35 hearing impaired). Performance and perception speech recognition thresholds in noise (SRTN) and Performance-Perceptual Discrepancy (PPDIS) were evaluated at various noise levels along with Hearing Handicap Inventory for the Elderly (HHIE) or Adults (HHIA).Results: Both perceptual and performance SRTNs were better among normal-hearing individuals than in the hearing-impaired group. Moreover, the participants with hearing impairment were found to have a significant effect of noise level on both the measures, which was otherwise not seen among normal-hearing individuals. The normative criteria for PPDIS were established to categorize the individuals as under-, over-, or accurate estimators. The performance and perception outcomes varied significantly between groups (normal hearing and hearing impaired) and across noise levels. Furthermore, there was a positive correlation between perceptual and performance SRTNs with emotional and social subscales and total HHIE/A scores. Additionally, a negative association was noted between PPDIS values and HHIE/A scores.Conclusions: The adapted test is a valid and reliable tool for evaluating the benefit of hearing aids. PPDIS can provide crucial information to audiologists regarding an individual’s judgement about their hearing ability, with an explanation for the discrepancy between objective and subjective reports of hearing impairments.