Journal of speech, language, and hearing research : JSLHR · 2026
Examination of the Words-in-Noise Test Signal-to-Noise Ratio Thresholds From the National Institutes of Health Toolbox for Children and Adults.
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Humes Larry E, Dhar Sumitrajit
Аннотация
PURPOSE: The purpose of this study was to establish and evaluate normative values for the Words-in-Noise (WIN) test from the National Institutes of Health (NIH) Toolbox for children and adults.
METHOD: NIH Toolbox conducted a large national standardization study of the WIN test, in both English and Spanish languages, in 2011 to allow for normative comparisons in a nationally representative sample of children and adults, ages 3-85 years. Clinical and university centers at 10 sites around the United States participated. WIN thresholds were available for either ear from 323 English-speaking adults, 18- to 85-year-olds, as well as from 813 English-speaking children 3- to 17-year-olds. Smaller samples of English-speaking adults and children were tested a second time to determine the test-retest reliability of the measurements.
RESULTS: The main dependent measure was the signal-to-noise ratio (SNR) in decibels from the WIN test. Age was the primary variable affecting the WIN SNR, with a curvilinear function observed across the age range of 3-85 years, worse (highest) SNRs at the age extremes. WIN SNRs from the NIH Toolbox generally agreed with those from other data sets in the literature. Analyses of covariance controlling for pure-tone hearing loss found that gender and race/ethnicity had significant, but generally small (≤ 1 dB), effects on WIN SNRs, but age had a stronger effect, with SNRs for 70- to 85-year-olds being 2-3 dB worse compared to all younger age groups. The WIN SNRs for English-speaking adults were reliable with test-retest correlations of .83-.90 for each ear.
CONCLUSION: For English-speaking adults, the WIN SNRs from the NIH Toolbox were found to be valid and reliable.
SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.32774991.
METHOD: NIH Toolbox conducted a large national standardization study of the WIN test, in both English and Spanish languages, in 2011 to allow for normative comparisons in a nationally representative sample of children and adults, ages 3-85 years. Clinical and university centers at 10 sites around the United States participated. WIN thresholds were available for either ear from 323 English-speaking adults, 18- to 85-year-olds, as well as from 813 English-speaking children 3- to 17-year-olds. Smaller samples of English-speaking adults and children were tested a second time to determine the test-retest reliability of the measurements.
RESULTS: The main dependent measure was the signal-to-noise ratio (SNR) in decibels from the WIN test. Age was the primary variable affecting the WIN SNR, with a curvilinear function observed across the age range of 3-85 years, worse (highest) SNRs at the age extremes. WIN SNRs from the NIH Toolbox generally agreed with those from other data sets in the literature. Analyses of covariance controlling for pure-tone hearing loss found that gender and race/ethnicity had significant, but generally small (≤ 1 dB), effects on WIN SNRs, but age had a stronger effect, with SNRs for 70- to 85-year-olds being 2-3 dB worse compared to all younger age groups. The WIN SNRs for English-speaking adults were reliable with test-retest correlations of .83-.90 for each ear.
CONCLUSION: For English-speaking adults, the WIN SNRs from the NIH Toolbox were found to be valid and reliable.
SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.32774991.