You raise very good questions. Part of what you are asking is standard
of care - why are certain tests always performed with certain material.
The other is the relation between those tests and the real world.
A great deal of what we do and how we do it is done to ensure we have an
accurate result without contamination form outside sources. As seen in
recent court trials, the need to have a clean laboratory when examining
crime scene samples becomes a matter of life, death, or justice. This
is true in hearing testing. Hence quiet rooms. If we want noise, we
have it in carefully prepared material where we know the parameters. It
looks and (no pun intended) sounds simple, but isn't. What you don't
seen is years of research and clinical experience to bring you an
accurate result regardless of where you are tested in the country, the
continent, or the world. This doesn't begin to address the years of
training and continuing education the audiologist has invested.
Spondee words are a traditional for measuring where speech reception
begins. They are easily identified at thresholds levels. The word
lists have been standardized. This allows us to compare performance
over time and detect if hearing is becoming worse (or better) as well as
allow for internal checks of accuracy.
Tests are done in sound treated rooms to eliminate sounds that could
contaminate the results and lead to an error in interpretation. If this
were not done, you could easily be referred to another specialist to
rule out a progressive disease
For decades audiologists, speech pathologists, teachers of the hearing
impaired, and researchers have recognized the problem, differences, and
relations between our tests and the real world. This is not a new
subject. We all wish for more and better tests. This takes research
and research takes money. Yet, for all the increasing wealth of the
United States, the portion for funding research have been shrinking. If
more parents like yourself would write your state and federal
representatives, this may change.
On a more direct level, please discuss these issues with your child's
audiologist. There are many tests available to measure different
aspects of audition. Whether they are appropriate for your child, will
help in diagnosis and management, or worth the expense is best determine
by a frank and open discussion.