Speech in Noise

The Speech in Noise element is one element that runs one of three tests, picked at the top of its Design tab:

All three work the same way and follow the lifecycle Design → Settings → Testing → Scoring → Report. To run two tests in one lesson, add a second Speech in Noise element.

On the learner's tabs, the results screen, the report and attempt replay the element is named by its test — FastSIN, WIN or THETA-Bio — numbered only when two elements run the same test ("WIN 1", "WIN 2").

Choosing the test

Adding Speech in Noise creates the element straight away, on your organization's default test (FastSIN unless your element preset names another). The Test picker at the top of the Design tab switches it at any time, and switching loses nothing:

• The element keeps every test's design and scoring. Switch from WIN to FastSIN and back, and WIN's case, set-up and scoring are exactly as you left them.
• A test you open for the first time starts from your preset's defaults for that test — its settings, and its scoring.
• The voices come with you: the test you switch to takes the voices of the test you switched from, so the patient sounds the same whichever test the case runs.

Only the chosen test is in play: the Settings and Scoring & Report tabs show that test alone, under a one-line summary of it (Change goes back to the picker), and only that test reaches learners.

Design

Below the test picker is the case itself. Every case is designed as a result and its category, and the two always agree:

• Category — picking one fills in a result inside that category's range.
• Result — typing an exact SNR loss, SNR-50 or percent re-derives the category. Each result can only come from a whole number of words, so a typed value snaps to the nearest one the test can produce (FastSIN lands on x.5 dB, WIN on 0.8 dB steps, and THETA-Bio depends on how many words the chosen lists have).

On an element that tests each ear separately (see Ears tested below), the Right ear / Left ear tabs above the result pick the ear you're designing: each ear has its own result, category and answer key. With both ears together there is one.

The Patient responses (answer key) section shows every sentence or word with the ones the patient gets right in green, and what the patient says for each. The patient gets exactly enough words right to produce the designed result. In FastSIN and WIN the easier, higher-SNR rows go right first, and in the one row where the patient starts missing, the missed words fall anywhere in that row. In THETA-Bio, where every sentence is at the same level, the misses are spread across the sentences.

Shuffle (beside the answer key) does what the element's mode varies:

• On a fixed element it changes which words the patient gets right, keeping the result. The new pattern is what every attempt gets.
• On a template it draws a new result inside the category, with new words to match. It's only a preview, because each attempt draws its own.

Template vs fixed

The Template / Fixed switch on the element card decides what each attempt gets:

• Fixed — every attempt gets exactly the result and patient responses you designed.
• Template — each attempt draws its own result inside the designed category, with a patient whose responses produce it. Press Shuffle in the designer to see another draw. The category stays fixed; the exact result varies.

Settings

The Settings tab holds the chosen test's set-up. Each setting lives here only (the Design tab keeps the case), and the tab shows the chosen test's settings alone — every other test keeps its own for when you switch back. A change here that shapes the answer key (the lists, THETA-Bio's condition, SNR or cut-offs) rebuilds it at the same designed result.

Ears tested

These tests are run clinically either in each ear separately (WIN was built for it, with one list per ear) or with both ears together (QuickSIN's norms; AzBio's bilateral condition). Ears tested picks which, and new elements start on each ear separately:

• Each ear separately — each ear has its own result, category, lists and answer key (designed with the ear tabs on the Design tab). Switching to it gives the left ear the same result on the next list; change either freely. The learner enters a result and category for each ear, and each is scored and reported separately.
• Both ears together — one run and one result. Switching back keeps the right ear's. Elements made before ears existed run this way.

Lists

WIN uses one word list per run. FastSIN and THETA-Bio can run one, two or three lists back to back (tick them; the last one can't be unticked). In FastSIN the patient gets the same number of key words right in every list, so each list, and therefore their average, gives exactly the designed SNR loss; only which words are missed differs. THETA-Bio scores percent correct over all the selected sentences. On a per-ear element each ear has its own lists, side by side (stacked on a phone).

The lists you pick are the default. In the console the learner can switch any ear to other lists; the patient is the same (the ear's designed result), so the answer key is simply rebuilt for those sentences.

Test protocol

• WIN — a Carrier phrase switch (on by default): each word is introduced as "Say the word ___", as in the published protocol.
• THETA-Bio — the presentation condition (in quiet, or at one fixed SNR), and the category cut-offs: the percent correct where Excellent, Good and Fair start (below Fair is Poor). The designed percent stays put; its category follows the cut-offs.

FastSIN's and WIN's categories are fixed by their published protocols.

Voices

Pick the accent and the examiner and patient voices, exactly as for Speech in Quiet. Presentation only: the answer key never changes. The voices carry over when you switch tests. If the lesson's speech elements give the learner different-sounding patients (a WIN element and a Speech in Quiet test on different patient voices or in different accents, say), a note under the voices says so; it's allowed, but one patient per lesson is usually what you want. Only WIN voices the patient's replies — FastSIN and THETA-Bio replies are shown as text — so only a WIN element counts.

An attempt keeps the voices it started with, even if you change them later.

Testing

On a per-ear element the console has a Right ear / Left ear switch above Next and Repeat; the sentence (or word) and its babble play in that ear, and the banner shows both ears' tallies. The Lists chips switch the ear under test to other lists — if that ear has already been worked, you're asked first, and its presentations and marks are cleared (the entered result and category stay).

The test runs one item at a time, the way it's given in the clinic:

1. Press Start, then Next for each item after it (in the console at the bottom, or Enter), to present the next sentence or word. The panel plays out the exchange. The examiner's line is spoken word by word, each word lighting up as it's said: the sentence, or for WIN the word, with "Say the word ___" when the carrier phrase is on. Then comes a short pause while the patient listens, and the reply at a normal talking pace. The reply looks the same whether it's right or wrong.

   The item is heard in multi-talker babble at its SNR, like the clinical test each one stands in for. The babble starts just before the item and stops just after it, so the patient answers in quiet:

   Test	Babble	How the SNR changes
   FastSIN	4 talkers	The babble rises 5 dB a sentence (+25 → 0 dB SNR).
   WIN	6 talkers	The babble stays put; the words drop 4 dB a block (+24 → 0 dB SNR).
   THETA-Bio	10 talkers	One fixed SNR, or none at all in quiet.

   Only a WIN reply is heard (a single word). A sentence reply is shown as text: there are far too many ways to half-hear a sentence to record them all. The volume slider under Start / Next and Repeat turns speech and babble up together, so it never changes the SNR. On a phone or tablet only the ear switch and Start / Next / Repeat stay pinned at the bottom; the lists, volume, result and category sit in the page below the sheet.

2. Score it. Scoring is locked while the examiner speaks and opens as soon as the patient starts to answer, so words can be marked as they come in. For a sentence, tap the key words the patient repeated correctly in its (highlighted) row of the sheet below. Tap again to mark a word missed; an unmarked word counts as missed. The ✓ and ✗ buttons at the end of each row mark every key word in it correct or wrong in one tap; on the current sentence they also present the next one straight away. Otherwise, go to the next sentence. For a WIN word, choose Correct or Incorrect, or press C or + for correct and I or − for incorrect, and the next word starts straight away.

3. When the list is done, the learner enters the result (SNR loss, SNR-50 or percent) and picks the category in the console (pinned at the bottom on a computer; below the scoring sheet on a phone or tablet).

Next presents each item once, in order; Repeat plays one again, and the trail records it as a second listen. The sheet keeps every mark, and earlier marks can still be changed. Selecting a presented sentence brings it back into the panel without replaying it (press Repeat to hear it again).

A patient's reply can be the right word, a near-miss ("coat" for "boat"), a dropped word ("The white … jacket"), a "didn't catch it", or no response at all.

The patient's replies are not written out on the scoring sheet: each reply is scored live, as it's heard (Repeat plays an item again). In practice, Show values in the gear menu writes them out on each row.

A banner at the top shows the running count of words marked correct (and each list's own count when several run back to back), but the console never works out the result or the category. Turning the count into a result, and the result into a category, is the skill being assessed, so the formula is hidden: in practice, Show formula in the gear menu puts a one-line reminder under the result box (never in an exam). Each category option shows its range. Show answer key in the gear menu (practice only) reveals the patient's truth for each word and the designed result.

The console's main button reads Start, then Next for each item after. When every item has been presented it becomes Restart, which clears the presentations and marks (the entered result and category stay). Repeat says the current item again; on FastSIN and THETA-Bio, select any presented sentence first to repeat that one (WIN repeats the word just presented).

Scoring

The Scoring & Report tab shows the chosen test's panel only, under the same one-line summary as Settings. Each test keeps its own scoring, so switching tests (and back) never loses it: not even changes you haven't saved yet, which wait on that test's panel until you save them or close the element. A test opened for the first time starts from your preset's scoring for it. Switching tests puts the element's Review scoring badge back, since the tab now holds another test's panel; saving that panel clears it.

The tolerance sits at the top of the Scoring & Report tab: how far the learner's result may be from the designed value and still count as correct. It defaults to 0, meaning an exact match at one decimal place (for example, 25 of 30 words is 83.3%, whether the learner types 83.3 or 83.33).

Below it, each of three fields is Scored, Report-only (on the report, not counted) or Off:

A blank result or category is marked wrong ("Not entered"). A test the learner never touched shows "Not attempted". Setting all three fields to Off removes the test from the score and the report, although the learner still runs it.

Advanced Analytics groups the three tests' results under Speech-in-noise result and their categories under Speech-in-noise category, so a programme can compare learners taught on different tests.

Report

The report titles the element by the test the attempt ran (as the learner's tabs do) and shows the scoring table (expected vs entered, per field) beside the reference: the designed result, category and word count, plus each item's answer key alongside the learner's marks. Attempt replay shows each mark, the result and category the learner entered, and any answers they changed.