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Do audiologists even do UCL's

Glen R. Meier gtniowa at netins.net
Mon Apr 14 20:16:10 EST 1997

John Richards wrote:
> I hear that most audiologists do not tests childrens UCL at any age?  Why?

It is hard for many children to differentiat between loud and
uncomfortably loud not to mention the other levels that the UCL test is
normed on.  Because of the variation in responses that many children
will give (ex..90 dBHL they report as too loud, but 100 dBHL, which is
more intense, is only reported as loud) it is difficult to establish a
reliable UCL.  Thresholds are often more reliable then UCL's as children
CAN often understand the concepts of hearing a sound vs. not hearing it.

Many audiologist's have attempted to define an average UCL and also
target sensation levels based on thresholds.  Using these approachs
(Desired Sensation Level (DSL), FIG6, IHAFF), we can predict a comfort
range and target intensities by frequency.  The newest versions are
computerized and I have found them to be very helpful.  The key is to
remember that the targets are only targets and that the formula that are
used are based on averages.  Therefore, modifications should be done for
each child as needed.

Because of the above reasons, some audiologists may elect to use a
threshold based formula to predict UCL rather then attempt to test for
it using a standardized UCL test.  Just because the test for UCL is not
done, it does not always mean that it is not being accounted for.

>  If you did test the child and the child only had a dynamic range of 0-
> 15dB's between the UCL and the hearing threshold, then what?

If the child has a 0 dB dynamic range, there will have to be further
testing done as this would indicate that any sound at all would be
uncomfortable for the child.  Reduced dynamic ranges are possible and so
hearing aids would need to accomodate that.  Compression and other
technology is addressing the needs of people with reduced dynamic
range.  They are not perfected yet, but improvements are always on the

> I guess if
> I do not get a response on this then that will mean that the audiologists
> on e-mail do not even know what UCL's are and how about the Real-ear or
> even MPO?

Real ear is often used in hearing aid fitting and even in threshold
testing at some facilities.  As childrens ear canals are not the 2cc
that most adults have, real-ear test measures provide valuable
information about what the actual output of the hearing aid is in the
child's ear instead of in a 2cc coupler at a factory.  Again, there are
some norms for those that may not have the equipment or the time or
inclination to use it.

>  Please show your knowledge.  There could even be a hearing aid
> despensor who could answer these question better than some audiologist.
> I will pass-on to other hearing aid consumers on the e-mail.  So show
> your knowledge.  We are looking for good professionals around the US...
> John

You will have to decide if the information I gave was good or not, but I
hope it helps.  I do like to see people educating themselves about
hearing and hearing aids.  The more informed you are, the more likely
you are going to be able to tell good service providers from poor ones.

For more specific information, references to specific articles on UCL
and real-ear for children can be made available via personal e-mail at
my address below.

Best of luck to you,


Glen R. Meier, M.S., CCC-A
gtniowa at netins.net
Home of the "Audiologist Finder"

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