The Contour Test of Loudness Perception

OBJECTIVE: This article presents the underlying rationale, normative data, and reliability data for a test of loudness perception (the Contour Test) that was devised for use in clinical hearing aid fitting. The Contour Test yields data describing the sound level required for each of seven categories of loudness ranging from very soft to uncomfortably loud. DESIGN: Two experiments are described. Experiment 1 yielded norms for the test. The subjects were 23 male and 22 female normal-hearing listeners. Test stimuli included warble tones at six frequencies and broad band speech. Experiment 2 assessed the reliability of the test results. Ten hearing-impaired listeners responded to the test at two frequencies on two occasions separated by several days. Both experiments also evaluated the effect of using different stimulus increment sizes on the measured levels of loudness categories. RESULTS: Based on the data from experiment 1, norms for each category of each stimulus are reported in terms of mean level and typical between-subject variation in responses. Data are provided in HA-12 cm3 coupler levels as well as in hearing levels (dB HL). The shape of the loudness growth function for warble tones was somewhat different from that for speech. When data were expressed in HL, there were no differences in mean loudness category levels across warble tone test frequencies. Thus, test frequencies were combined and equations were generated to describe the upper and lower limits of typical normal performance for warble tone stimuli. These equations can be used to construct a template for clinical comparison of normative values to patient loudness growth curves. Experiment 2 provided information about the test-retest variability of data yielded by the Contour Test. Reliability appears to be similar to that of the few other category scaling tests described in the literature. Most test-retest differences were 6 dB or less. Although a moderate variation in test increment size did not significantly affect the loudness category levels for young normal-hearing listeners, levels corresponding to loudness categories were significantly higher when larger increments were used with elderly hearing-impaired listeners. CONCLUSIONS: Evidence from this and other research indicates that standardized measurement of loudness perception is an achievable goal for clinical practice. The Contour Test appears to offer a viable approach to clinical measurement of loudness perception: It has good patient acceptance and combines fairly rapid administration with acceptable reliability. Details of test procedures and scoring sheets for manual administration can be downloaded from the Internet at www.ausp.memphis.edu/harl. However, it is important to keep in mind that the application of loudness perception data for narrowband stimuli (such as warble tones) to hearing aid prescription is complicated by the need to account for the effects of loudness summation across bandwidth. There is a need for additional research to establish an empirical link between clinically measured loudness perception and optimal amplification characteristics.