Comparison of Procedures for Obtaining Thresholds and Maximum Acceptable Loudness Levels With the Nucleus Cochlear Implant System

Two stimulus paradigms and two presentation methods were combined to form three procedures (keyboard, knob, and ascending loudness judgments with knob [ALJK]) to obtain detection thresholds and maximum acceptable loudness levels (MALs) from 11 adults with the Nucleus cochlear implant. Thresholds at which subjects correctly counted the number of stimulus bursts also were obtained. Keyboard detection thresholds were higher (Scheffé, p = .01) than knob and ALJK detection thresholds. Counted thresholds were obtained most efficiently by using keyboard detection thresholds as the initial level for testing. Keyboard MALs were highest, knob MALs intermediate, and ALJK MALs lowest (Scheffé, p = .001). MALs were obtained most efficiently with the ALJK procedure. Implications of these results for clinical practice are discussed.