At this year’s EUHA congress in Nuremberg, Interacoustics launched the Audible Contrast Threshold test - a new hearing test with the potential to be a new industry standard. The test is a result of deep collaboration and knowledge sharing between Demant’s Diagnostics and Hearing Aids business areas and will be a step towards helping more people with hearing loss, benefitting both the hearing care professional, the client and the ones close to them.

“For the first time in history, we can measure a client’s hearing-in-noise ability in less than two minutes in clinics around the world with one single standardised test,” explains Søren Laugesen, Research Manager at Interacoustics Research Unit (IRU), who has spearheaded the development of the new test. And that is exactly what the quick and easy to conduct test does. It addresses a very common issue for people with hearing loss and is a long-awaited add-on to pure tone audiometry.

For more than 100 years, hearing aids have – in terms of diagnostic tests – been fitted solely based on the pure-tone audiogram, which measures a person’s hearing thresholds across frequencies. The pure-tone audiogram is very accurate when it comes to measuring the quantity of a client’s hearing, but it tells us little about the client’s hearing-in-noise ability - the quality of a client’s hearing.

Most of our lives we are exposed to complex soundscapes, where our ability to communicate and understand relies on the degree to which we can distinguish important sound inputs from other sound impressions. Imagine a dinner party, where many people are talking and there are sounds of glasses and cutlery on plates or imagine talking to a friend at a café in the city with traffic noise in the background. If we can’t distinguish the sounds we want to hear from the background noise, it becomes difficult to engage in conversations. This ability is called hearing-in-noise, and until now there has been no objective evidence-based diagnostic test available for it.

“The Audible Contrast Threshold test enables the hearing care professional to measure the client’s hearing-in-noise ability. The test is objective and independent of language – making it useable with every client around the world irrespective of language background. It takes an average of only two minutes to complete and uses the same set-up as pure-tone audiometry - headphones (or inserts) and a client response button,” says Søren Laugesen.

ACT is a result of the collaboration between Demant’s Diagnostics and Hearing Aids business areas, specifically Interacoustics and Oticon and their respective research units - Interacoustics Research Unit and Eriksholm Research Centre. It has been under development for seven years.

A seamless fit with Oticon hearing aids

ACT will be available in Interacoustics, Grason-Stadler and MedRx’ products from October and going forward, and the ACT value can be automatically transferred to hearing aid fitting software via the industry-standard database Noah. And this is where we really see the benefits of the collaboration between Demant's hearing aids and diagnostics businesses. Oticon will incorporate the feature in their Genie 2 fitting software from their next release, enabling the hearing aids to be automatically fitted based on the client’s individual ACT value, thus adjusting the hearing aid’s help-in-noise features according to the user’s individual needs.

“At Oticon, we have dedicated decades of research into BrainHearing™, and have demonstrated the considerable effort for hearing-aid users to understand speech in complex noise environments, such as cafés. A hearing aid should support a user in tackling this prominent challenge optimally and with an ACT assessment, hearing care professionals can ensure our advanced hearing aids do that to the best of their ability,” says Thomas Behrens, Vice President of Audiology in Oticon.

With ACT, hearing care professionals will for the first time in history have a diagnostic measure available, which can help them address the hearing-aid users’ no. 1 complaint: hearing in noise. The ambition is to make ACT an integral part of best practice, and in this way ACT has the potential to be a game-changer for hearing-aid fitting,” Søren Laugesen concludes.


How ACT works

  1. The hearing care professional puts a headset on the client, like you would for pure-tone audiometry
  2. The client will hear episodes of noise. The noise will be interrupted by a sound which is similar to a siren. The client presses the response button every time they hear the siren sound
  3. Once the test is complete, a value is generated that predicts the client’s aided hearing-in-noise performance
  4. Based on the client's responses, the outcome of the test - the so-called ACT value – informs the hearing care professional about the quality of the client's hearing and thus their ability to hear in noise
  5. The ACT value is imported to the Oticon fitting software either automatically or manually and the fitting settings are adjusted accordingly
  6. The hearing care professional provides counselling and recommendations to the client regarding the hearing aid to ensure the optimal foundation for the client’s rehabilitation and ability to hear in noise