Speech in Quiet
Design, run, score, and report the three speech-in-quiet tests — Speech Recognition Threshold (SRT), Word Recognition Score (WRS), and Sound Sensitivity (SAT / MCL / UCL) — all derived from a linked audiogram.
Speech in Quiet covers the speech-audiometry measures you take in a quiet booth, with no competing noise. In Theta it isn't a single test but a group of three you can mix and match in one element:
- SRT — Speech Recognition Threshold (the ~50% spondee point)
- WRS — Word Recognition Score (PB-max, the percent of words repeated correctly)
- Sound Sensitivity — the loudness measures: SAT (Speech Awareness Threshold), MCL (Most Comfortable Level), and UCL (Uncomfortable Loudness Level)
You choose which of these the learner performs, the values are generated from the patient's hearing, and the learner discovers them at a simulated speech audiometer that looks and behaves like the pure-tone audiometer — two channels, ear and transducer selectors, and a masking channel.
A linked audiogram is required
Every speech-in-quiet test is derived from an audiogram. When you add the element you pick which audiogram in the lesson it reads from; SRT, WRS, SAT, MCL, and UCL are all anchored to that patient's thresholds. Because of this link, a speech element inherits the audiogram's template/fixed state — you don't set it separately. No linked audiogram means no values to derive, so wire up the audiogram first.
Like every element, speech in quiet follows the same lifecycle — Design → Settings → Testing → Scoring → Report. This page walks the lifecycle once, calling out what's specific to each of the three tests as it goes.
The three tests
| Test | Measures | Anchor point |
|---|---|---|
| SRT | The softest level at which the patient correctly repeats ~50% of two-syllable spondee words. | 50% on the performance curve. |
| WRS | The percent of single-syllable words the patient repeats correctly at a comfortable level (PB-max). | The peak of the performance curve. |
| Sound Sensitivity | Three loudness landmarks on a continuous speech passage — SAT (just audible), MCL (comfortable), and UCL (too loud). | 0% (SAT), comfort (MCL), and tolerance (UCL). |
All three sit on one Performance-Intensity Function (PIF) — a curve of percent correct against presentation level. SAT anchors the bottom (0%), SRT the 50% point, WRS the peak at MCL, and UCL marks the ceiling. You'll see this curve in the designer, in the saved-runs view during submission, and on the report.
Choosing which tests run
You don't have to use all three. In Settings → Tests in this lesson you tick the tests the learner performs (SRT and WRS are on by default). Unticked tests are hidden from the submission entirely. The three submission tabs — SRT, WRS, and Sound Sensitivity (which holds SAT/MCL/UCL together) — appear only for the tests you've enabled.
Design
The designer shows two things side by side: the live PIF chart and a Designed values table with a Right (red) and Left (blue) column. Editing a value reshapes the curve immediately.
Template vs. fixed
This is inherited from the linked audiogram, not set here:
- Template — the audiogram is a template, so each learner gets a freshly generated patient. Speech values are derived and read-only; you shape the profile with the design knobs (see below) rather than typing exact numbers. A violet banner marks this mode.
- Fixed — the audiogram is fixed, so you set each value exactly. The PIF updates live as you type, and an emerald banner marks this mode.
Designed values
The table holds one row per measure, for each ear:
| Row | What it is |
|---|---|
| SAT | Speech Awareness Threshold, in dB. |
| SRT | Speech Recognition Threshold, in dB, with a Masking checkbox marking whether masking is needed to find it cleanly. |
| SRT–PTA agreement (template only) | A knob — SRT–PTA agree, PTA higher, or SRT higher — that offsets the generated SRT relative to the audiogram's pure-tone average, so you can design good or poor agreement. |
| WRS | The classification category (Excellent → Very poor) plus a PB-max % and a presentation level. In template mode you pick the category and Theta draws a matching percentage; in fixed mode you type the exact percent (a small amber warning appears if the number falls outside the chosen category's range — you can keep the override). |
| Rollover | A 0–60% slider (per ear) that designs a retrocochlear pattern — above MCL the curve decays instead of plateauing. At or above ~20% a POS flag appears, marking clinically meaningful rollover the learner should be able to find by testing WRS at high levels. |
| MCL | Most Comfortable Level, in dB. |
| UCL | Uncomfortable Loudness Level, in dB. |
All five measures are always designed even if you only score some of them, so the PIF curve is fully anchored. Which tests are part of the lesson, the word lists, the classification ranges, and masking all live in the Settings tab; how each test is scored lives in the Scoring tab.
Settings
The Settings tab is the case-wide configuration that isn't a designed value.
Tests in this lesson
Tick the tests the learner performs (SAT, SRT, WRS, MCL, UCL). Unticked tests are hidden from the submission. Scoring disposition is independent and set in the Scoring tab — a test can be part of the lesson but not scored.
Source
Derive from audiogram is the source mode, with a picker for which audiogram in the lesson to read. With a single audiogram in the lesson it's selected automatically.
WRS configuration
| Setting | Options |
|---|---|
| Word count | 10, 25, 50, or 100 words. This also sets the score granularity — 10 words = 10% steps, 25 = 4%, 50 = 2%, 100 = 1%. |
| Scoring mode | By word (each word right/wrong) or By phoneme (mark the individual phonemes the patient missed). |
| Presentation level | MCL, MCL + 10, UCL − 5, PBmax (2 kHz + buffer), or a custom range. |
| Carrier phrase | Whether a carrier phrase ("Say the word…") precedes each word. |
| Word lists | Tick the WRS lists available to the learner (filtered to the chosen word count). |
WRS classification ranges
The minimum percent for each category. A score at or above a threshold falls into that category; Very poor is anything below Poor. Defaults:
| Category | Minimum % |
|---|---|
| Excellent | 95 |
| Very good | 87 |
| Good | 79 |
| Fair | 69 |
| Poor | 49 |
| Very poor | below 49 |
SRT configuration
Pick the spondee list the learner uses for SRT.
General settings
| Setting | What it does |
|---|---|
| Variability | None / Low / Medium / High — how much the simulated patient's responses jitter near threshold during SRT. |
| Transducer | Supra-aural, Inserts, or Circum-aural — sets the interaural attenuation used in the masking model. |
| Masking parameters | Interaural attenuation per transducer, the safety pad, and the plateau width that drive the masking-aware patient responses. |
Testing
The learner works at a speech audiometer with Channel 1 (speech) and Channel 2 (masking noise), each with its own level, ear, and transducer. A prominent header shows the live presentation level and the saved values for both ears, and a response strip shows what the patient "said". Keyboard shortcuts mirror the audiometer: arrows change the speech level, Page Up/Down the masking level, M toggles masking, R/L/E switch ears, Space presents, and Enter is the context action.
The enabled tests appear as tabs. A green check on a tab marks a saved result for the current ear.
SRT
A grid of spondee words is shown. The learner sets the speech level, then clicks a word to present it; the patient either repeats it correctly or returns a mis-hearing (a near-miss or a complete miss, depending on how far below threshold the level is). Pressing Save SRT records the current level as the threshold, or No response marks that the patient never identified the words.
Every presentation is logged to a presentation history (level, word, what the patient heard, correct/incorrect), and an optional per-level tally view helps the learner home in on the 50% point. The carrier phrase is shown when enabled.
WRS
The learner presents each word in turn from the active list (10/25/50/100 words). The patient repeats it — correctly or as one of the designed foils — and the learner marks it:
- By word — ✓ Correct / ✗ Incorrect for the whole word.
- By phoneme — chips for each phoneme; click the ones the patient missed.
A running score (e.g. 18/25 (72%)) tracks the current run. Save run stores that run at the current presentation level. Because rollover lives at high levels, the learner can re-test the list at several levels and save each run — a saved-runs view shows the runs in a mini-PIF so a high-level drop is visible. When rollover scoring is on, a Rollover — positive / negative control asks the learner to make the clinical call after testing above MCL.
WRS responses are masking-aware: a masker that crosses back to the test ear reduces the effective level, and the non-test ear can pick up the signal through cross-hearing (reduced by masking at that ear), exactly as in a real masking dilemma.
Sound Sensitivity (SAT / MCL / UCL)
SAT, MCL, and UCL share one Sound Sensitivity tab built around a continuous speech passage (the Rainbow Passage). The learner sets the level and presses Play speech; the words light up and the patient gives a loudness reaction — (no response), Very soft, A little soft, Just right, Comfortably loud, Getting too loud, or Too loud! — which is fully deterministic from the designed SAT/MCL/UCL. The learner sweeps the level and saves each landmark with its own Save SAT / Save MCL / Save UCL button.
Practice vs. exam
Outside exam mode, a gear menu offers Show true values so learners can check their work against the designed answer while practicing, plus the saved-runs and presentation-history views. In exam mode these are hidden.
Scoring
Open the Scoring tab. The first panel lists every test in the lesson with a tri-state control — Scored (counts and on the report), Report only (on the report, not counted), or Off (performed but neither scored nor reported). See Scoring overview for how this tri-state works across elements. Only tests set to Scored get the detailed options below.
All measures score by value tolerance (in dB, or % for WRS) — the submitted value is correct if it's within tolerance of the designed value. Beyond that:
SRT scoring
- Value tolerance (dB).
- Score masking decision / level — was masking used appropriately?
- Score SRT–PTA agreement — does the SRT agree with the pure-tone average, within a separate PTA agreement tolerance?
WRS scoring
- Score tolerance (%).
- Score presentation level — was PB-max tested at an appropriate level?
- Score classification — does the percent land in the right category?
- Score masking decision and mask level classification.
- Score rollover — the learner's positive/absent call. Turning this on is what surfaces the rollover control in the submission.
SAT / MCL / UCL scoring
Each has a single value tolerance (dB).
Report
The report assembles every test marked Scored or Report only.
- PIF chart — a combined Performance-Intensity Function for both ears. The designed curve is drawn per ear (red/blue) with filled markers at the included anchor points (SAT at 0%, SRT at 50%, WRS at MCL), and dashed verticals for MCL and UCL when those are included. The learner's submitted values are overlaid as small × marks, including each saved WRS run — so a rollover pattern reads at a glance.
- Data table — for each included measure, the designed value, the submitted value, and whether it was scored correct, alongside the WRS classification it fell into. Tests set to Off never appear; Report only tests are shown but don't affect the score.