Common Sounds Audiograms: Quantitative Analyses and Recommendations

A counseling tool routinely used by pediatric audiologists and early intervention-specialists is the often-named common sounds audiogram (CSA). Typically, a child's hearing detection thresholds are plotted on the CSA to indicate that child's audibility of speech and environmental sounds. Importantly, the CSA may be the first item that parents see when their child's hearing loss is explained. Thus, the accuracy of the CSA and its associated counseling information are integral to the parents' understanding of what their child can hear and to the parents' role in the child's future hearing care and interventions. Currently available CSAs were collected from professional societies, early intervention providers, device manufacturers, etc., and analyzed (n = 36). Analysis included quantification of sound elements, presence of counseling information, attribution of acoustic measurements, and errors. The analyses show that currently-available CSAs are wildly inconsistent as a group, not scientifically justified, and omit important information for counseling and interpretation. Variations found among currently available CSAs can lead to very different parental interpretations of the impact of a child's hearing loss on his/her access to sounds, especially spoken language. Such variations, presumably, could also lead to different recommendations regarding intervention and hearing devices. Recommendations are outlined for the development of a new, standard CSA.