LDL Measures An Efficient Use of Clinic Time? Face-to-Face
Face-to-Face  |   November 01, 1991
LDL Measures
Author Affiliations & Notes
  • David B. Hawkins
    University of South Carolina, Columbia, SC
  • Donald J. Schum
    Department of Otolaryngology University of Iowa, Iowa City, IA
Article Information
Hearing Disorders / Hearing Aids, Cochlear Implants & Assistive Technology / Face-to-Face
Face-to-Face   |   November 01, 1991
LDL Measures
American Journal of Audiology, November 1991, Vol. 1, 8-10. doi:10.1044/1059-0889.0101.08
American Journal of Audiology, November 1991, Vol. 1, 8-10. doi:10.1044/1059-0889.0101.08
I would disagree with this statement, given certain constraints. To begin, LDLs are a waste of time if three basic considerations are not met. First, the client must be able to make loudness judgments. My experience has been that about 75% of cooperative adults can give reliable and valid LDLs. An experienced clinician can spot those who can’t handle this task during the standard audiometric evaluation or within the first 30 s of attempting to determine an LDL. Second, the instructions must be clear and categories of loudness must be given to the client. Otherwise, I believe the results are often meaningless. Instructions that use words like “tolerate,” or that don’t carefully define what uncomfortable loudness means, simply invite unreliable and invalid judgments. Third, the LDL value must be expressed in proper and useful values, that is, SPL in a 2-cc coupler. The ideal transducer is the insert earphone, because its output is expressed directly in 2-cc values. Then the values are useful in selecting the SSPL90. My own clinical procedure is to measure LDLs through an insert ear phone with a probe tube also in the ear canal to measure the SPL in the ear canal at the point of loudness discomfort. (See Stuart, Durieux-Smith, & Stenstrom, 1991, for a description of a similar approach with children.)
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