Audiometry

The Audiometry element simulates a pure-tone hearing test. You design a patient with a particular hearing loss — by ear, by frequency, by air and bone conduction — and the learner sits at a realistic two-channel audiometer to find that patient's thresholds. They present tones, decide when masking is needed, run the masking procedure, and plot the audiogram, exactly as they would in a real test booth. When they're done, their plotted audiogram is compared against the one you designed.

Like every element, audiometry follows the same lifecycle — Design → Settings → Testing → Scoring → Report. The audiogram is also the foundation other tests build on: the speech elements (SRT, WRS, and Sound Sensitivity) link to an audiogram and derive their patient behaviour from it.

Design

When you add an Audiometry element to a lesson, you create the patient's true hearing — the thresholds the learner is supposed to discover.

Template vs. fixed

Every audiometry element is either a template or fixed, toggled from the element list in the designer:

• Template — you describe each ear at a high level (a degree range, a type, and a configuration) and Theta generates a fresh, plausible audiogram every time a learner starts the lesson. Two learners get two different patients that both match your description. You can't hand-edit individual numbers in template mode.
• Fixed — the exact thresholds you set are the patient, every time. Use this when a specific case matters (a textbook example, a particular masking scenario).

Describing each ear (the profile)

For both the Right and Left ear you set:

Use the Create Audiogram button to (re)generate thresholds from these profiles. In template mode the profile is the design; in fixed mode it's a fast way to lay down a starting pattern you can then refine by hand.

Changing any profile field regenerates the thresholds from it. On a fixed case where you have already edited thresholds by hand, Theta asks first — cancel to keep your numbers and change only the profile label.

Editing exact values (fixed only)

In fixed mode, open Manually Adjust Values to edit the underlying numbers directly:

• Thresholds — the patient's true (masked) thresholds per frequency, for R/L × AC/BC. You edit these; the unmasked shadow is derived automatically from the true thresholds and the interaural-attenuation rules, so there's no unmasked row to hand-enter.
• Comfort levels — MCL and UCL per air-conduction frequency, used when the learner runs comfort-level testing.
• Masking variables — the reference masking levels (ISL, IML, plateau start/end, saved masking level) and the required-frequency checkboxes that control which points the learner is expected to obtain.

The plot at the top of the editor previews exactly what you've built. The Appearance menu lets you combine the two ears onto one plot, show the PTA, show the audiometer's output limits, and overlay the degree-of-loss bands.

Auto-fill (giving the learner a head start)

By default the learner starts with a blank audiogram. In Settings you can instead auto-fill part of it:

• Off — blank; the learner finds everything.
• Unmasked only — the unmasked thresholds are pre-plotted; the learner still has to perform masking to establish the final thresholds.
• Complete audiogram — the entire audiogram is provided. Nothing on the audiogram is scored — useful when the audiogram is just context for a linked task like speech testing.

A banner appears above the audiometer during the submission telling the learner what was provided.

Settings

The Settings tab (the gear on the element) controls how the test behaves. These are pre-filled from the course's element preset and then owned by this element, so each case is self-contained.

The Classification & Symbols section (inside the element editor) lets you tune the degree-of-loss bands, the configuration taxonomy, and the audiogram symbol set for this case. These determine the names in the profile dropdowns and the symbols drawn on the plot and the report.

Symbols are set as two grids — one for thresholds a response was obtained at and one for no-response thresholds — so an NR point plots the symbol you chose for that exact ear, transducer, and masking state rather than a marked-up version of the response symbol. See element presets for how the two grids stay in step.

Testing

During the submission the learner works at a simulated audiometer. The audiogram is on top; the console with two channels sits below it. (For the full lesson context, see the submission flow.)

The two channels

• Channel 1 is the test channel — the tone presented to the patient.
• Channel 2 is the masker — narrow-band noise sent to the non-test ear.

For each channel the learner sets the ear (R/L), the transducer, the stimulus type (pure, pulsed, warble, pulsed-warble, or narrow-band noise), and the level in dB HL with the +/- buttons (5 dB steps). Levels are clamped to the audiometer's output ceiling for that frequency and transducer. A Power toggle holds the tone on continuously; the Present button delivers a tone while held (and momentarily interrupts a powered-on tone).

If the case uses the simplified console, Channel 2 shrinks to just a masking level and an On/Off button, and automatically tracks the non-test ear.

Presenting tones and reading responses

The learner picks a frequency from the selector (limited to the tested range) and presents tones up and down to bracket the threshold. When the simulated patient hears a tone, a response indicator flashes above the console. The response reflects the designed thresholds, cross-hearing (interaural attenuation and occlusion effect), and any masking in play — so under-masking, over-masking, and masking dilemmas all behave as they should.

You can drive everything from the keyboard (arrow keys to change frequency and level, spacebar to present), or with the mouse.

Recording a threshold

With a value bracketed, the learner presses Save to plot the point at the current frequency, ear, and conduction. If Channel 2 was on, the point is saved as masked and Theta records the masking levels the learner used (initial stimulus and masking levels, plateau start/end, and the saved masker level) for scoring. The save mode can be switched between Threshold, MCL, and UCL — either from the badge on the audiogram or in the console's settings — and the settings menu also offers No response, Vibrotactile, and Masking dilemma flags. Clear point removes the current point; Clear all asks for confirmation, then returns the audiogram to how it started — which on an auto-filled case means the provided thresholds come back rather than being wiped.

Comfort-level testing

In MCL or UCL mode, presenting a tone produces a verbal patient response ("That's comfortable", "Too loud", etc.) shown as a speech bubble. The learner adjusts level until the patient's reaction matches the level they're after, then saves it.

The audiogram view

• A gear menu lets the learner combine the ears, show the true thresholds (a study aid, hidden in exam mode), and overlay the degree bands.
• If a profile or PTA is scored, the learner fills those in below the audiogram — a badge tracks how many profile fields remain.

Scoring

Scoring compares the learner's plotted audiogram against your designed one. Open the Scoring tab to choose what counts. (For how scores roll up across the lesson, see Scoring.)

Each field can be set to one of three states:

• Off — not scored, not shown on the report.
• Scored — compared against the design and counted.
• Report-only — shown on the report for context, but not counted.

You set these per ear (R/L) and per conduction (AC/BC). A Sync ears toggle (on by default) mirrors your choice to both ears at once.

Fields you can score, grouped as in the UI:

Two tolerances let you control strictness:

• Threshold tolerance — how many dB a plotted threshold may differ from the design and still count as correct.
• PTA tolerance — the allowed difference on the Pure Tone Average.

By default, only the final (masked) thresholds are scored — a sensible starting point you can build on.

Report

The generated PDF renders each ear's audiogram as a clean plot, with the learner's results drawn solidly on top of your designed thresholds shown faded behind them — so it's immediately clear where they matched and where they diverged. Symbols follow the case's symbol set — including its dedicated no-response symbols — AC points are connected, and vibrotactile (VT) and masking-dilemma (MD) situations are marked with a small annotation and a legend.

Alongside the plot, a data table lists every scored and report-only field with three columns — the value you designed, the value the learner recorded, and whether it was scored correct — so an instructor can see at a glance what was right, what was off, and by how much. Fields set to Off don't appear.