Conduct Pure Tone Audiometry and Find Pure Tone Thresholds Using the GSI 61 Audiometer

Introduction
These instructions were designed to show how to perform a pure tone audiometry test and to determine the pure tone thresholds of a persons hearing, by using the GSI 61 Clinical Audiometer. Students in the Speech Language Hearing Sciences program at Minnesota State University Moorhead (MSUM) should find these useful, as this testing is within the scope of the major. While those without a background in the subject will be able to understand the process, having a background in hearing science will be helpful in understanding these instructions. A GSI 61 Audiometer can be found in room 223N of Murray Hall at MSUM. These instructions will show how to do an air conduction test to determine whether someone has hearing loss or normal hearing, and will discuss how to find hearing thresholds for those who do not have prior knowledge on doing so. The purpose of finding pure tone thresholds is to determine the softest decibel level at which a person is able to hear at certain frequencies. These instructions are limited to air conduction testing only, and bone conduction will not be covered. Note: The tester should be familiar with the testing procedures before testing a client. Students should not conduct these tests without the supervision of an Audiologist.

Description of Equipment
All of the equipment needed to complete the test is already in the sound booth in Murray Hall, but you should bring a pen or pencil and a copy of an audiogram (used for marking the results). The sound booth has two parts: 1 - the control side has the audiometer and controls, and is where the tester sits 2 - the exam side is where the client sits

Major parts of an Audiometer:

This is the Audiometer you will see in the booth

This is the screen on the Audiometer. It shows you what you have selected as your settings. Use it as a way to double check you have set the correct settings.

This is the control board of the Audiometer. Only the left side is needed for this procedure, and all of the buttons are labeled on the audiometer.

1 - Adjusting the Transducer, Stimulus Routing, and Selecting the Stimulus Type 2 - Attenuator dial, Interrupter switch 3 - Frequency Selector, Talk Forward button

Frequently Used Terms

Frequency, also called the pitch, is measured in Hertz (Hz) A decibel (dB) is the unit the measures the intensity, or volume, of the sound presented Audiometer Buttons Attenuator - adjust the dB level, (the round dials) Interrupter switch - present the stimulus, (the long, skinny buttons) Frequency selector - adjust the frequency to be presented

Directions
Instructing the client 1) Show the client to their seat in the exam room. 2) Explain the general process to the client, including: a. That they will be wearing headphones. b. They will hear beeps, and should respond even when they hear them faintly. c. They can use the handheld button, give a vocal response, or raise their hand to show when theyve heard the sounds presented. (Give the handheld response button to the client if theyve chosen that option)

3) Place the headphones on your client, with the Red side over the clients Right ear and Blue over the Left as seen in the photos at the left. 4) Close the outer door to the exam room and go to the control room of the sound booth.

Preparing to give the test 5) Turn on the audiometer using the power strip on the floor. 6) Arrange the following settings on the Channel 1 side only: a. Set Transducer to phone b. Set Stimulus to tone c. Set Routing to right ear d. Use the signal selector to choose a pulsed tone 7) Put on the headset/microphone as shown in the picture at the left. 8) Hold the Talk Forward button and inform your client that the test is beginning.

The following are instructions for performing a Threshold Search. If you are already familiar with this process, move on to Step 9 under Giving the Test. Finding Pure Tone Threshold: 1. Present the initial tone at 1,000 Hz and 30 dB, presenting the stimulus for 3-5 beeps using the interrupter switch on the audiometer. a. If the client responds to the tone decrease intensity by 10 dB and present again. b. If the client does not respond to the tone increase intensity by 20 dB and present again. 2. When the client responds correctly, decrease the intensity by 10 dB. When the client does not respond correctly, increase the intensity by 5 dB. 3. The clients threshold for that frequency is found when the client has responded correctly in one half or more of a series of ascending trials. (For example, they have responded correctly at that dB level in 2 of the 4 runs) 4. Once the threshold is found mark the audiogram with the appropriate notations: a. Mark an O where the threshold is for the Right ear, under the appropriate frequency level. b. Mark an X where the threshold is for the Left ear, under the appropriate frequency level. 5. Repeat steps 1-6 at 2,000, 4,000, 8,000, 250, and 500 Hz. 6. After finding the threshold at all frequencies determine if the clients hearing is within normal limits.
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Giving the test 9) Start by testing the right ear at 30 dB HL at 1000 Hz. 10) Present the stimulus for 3-5 beeps. 11) Find the air conduction thresholds at 1000, 2000, 4000, 8000, 250 and 500 Hz in the right ear. 12) Record the responses on the audiogram. A sample audiogram is shown at the left. 13) Switch routing to left ear. 14) Repeat threshold search at 1000, 2000, 4000, 8000, 250 and 500 Hz with the left ear. 15) Record threshold responses on the audiogram. A sample audiogram. Lines are drawn between the thresholds of both ears to make it easier to see any trends that might occur.

Evaluating Test Results 16) Look at the clients thresholds and determine whether hearing is normal or not in each ear. a. Any thresholds where the dB level was less than 25 dB are considered within normal hearing. b. If there are thresholds with a dB level greater than 25 dB, the client should see an Audiologist for further testing and evaluation.

Troubleshooting
If the screen on the audiometer does not turn on, check that the power strip has been turned on. When doing the threshold search, if your client does not respond at 30 dB, or after youve gone up to 50 dB, only increase in 10 dB steps from this point on, until you get a response. It is okay to retest for the thresholds if you lose count or are not sure on their responses. You may need to adjust things as you go, such as the clients earphones, or their position if you notice an issue with their responses or cannot see/hear their responses.