Using the Speech Understanding in Noise (SUN) Test for Adult Hearing Screening

Purpose: To develop a novel speech-in-noise test for adult hearing screening--the Speech Understanding in Noise (SUN) test. The goal was to design a fast, automated, easy-to-use test to identify difficulties in speech communication. Method: The SUN test consists of a short list of intervocalic consonants in noise presented in a forced-choice paradigm by means of a touch screen. The SUN test was developed and evaluated in an overall population of >6,000 participants. The test is available in various languages (i.e., English, French, German, and Italian) and continues to be developed in others (e.g., Spanish, Portuguese, and Mandarin). Results: Test time was <1 min/ear. Test-retest reliability was very good. The test showed good agreement with conventional clinical measures (e.g., pure-tone testing, speech-in-noise testing, and self-reported hearing handicap). The test's sensitivity and specificity to identify disabling hearing impairment were 84% and 75%, respectively. The same results were obtained in low and high ambient noise. Conclusion: The SUN test is fast, repeatable, easy to use, self-explanatory, specific to the impairment, and robust to ambient noise. It may be a viable approach for adult hearing screening in clinical as well as nonclinical settings.