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Audiometric Calibration: Air Conduction

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 Audiometric Calibration: Air Conduction
Craig A. Champlin, Ph.D.1 and Tomasz Letowski, Ph.D.2

ABSTRACT

The main goal of this article is to discuss the calibration of air-

conducted signals delivered by an audiometer via an earphone or a
loudspeaker. The common types of earphones used in hearing testing
are described and the importance of calibrating these transducers is
discussed. After covering the instruments used for calibration, the
performance parameters measured in the calibration process are exam-
ined. The limitations of our current methods are discussed and areas for
improvement are considered.

KEYWORDS: Air conduction, output level, pure tone audiometry,

attenuator linearity, frequency accuracy

Learning Outcomes: As a result of this activity, the participant will be able to (1) list four instruments used in
audiometric calibration and (2) describe the measurement parameters of audiometric calibration.

T his article covers the basic elements of BACKGROUND

audiometric calibration of air-conducted signals
delivered via earphones and loudspeakers. The
calibration procedures that are described in-
clude both the normal (125 to 8000 Hz) and
extended (8000 to 16,000 Hz) frequency range.
Margolis and Popelka describe audiometric
calibration procedures for pure tone bone-con-
duction tests in this volume.
Hearing testing via air conduction is directly
tied to the development and evolution of the
audiometer. The first commercially available
device was the Western Electric 1A audiometer
(Western Electric Company, New York, NY),
which was introduced in 1922.1 The instrument
was capable of delivering pure tones of varying
intensity via custom-designed earphones.

1
Department of Communication Sciences and Disorders,
Moody College of Communication, University of Texas at
Austin, Austin, Texas; 2ARL Fellow and Guest
Researcher, U.S. Army Research Laboratory, Aberdeen,
Maryland.
Address for correspondence: Craig A. Champlin,
Ph.D., Department of Communication Sciences and Dis-
orders, Moody College of Communication, University of
Texas at Austin, 2504-A Whitis St., Austin, TX 78712
(e-mail: champlin@austin.utexas.edu).
312
Standards and Calibration. Part 1: Standards Process,
Physical Principles, Pure Tone and Speech Audiometry;
Guest Editor, Robert Burkard, Ph.D.
Semin Hear 2014;35:312–328. Copyright # 2014 by
Thieme Medical Publishers, Inc., 333 Seventh Avenue,
New York, NY 10001, USA. Tel: +1(212) 584-4662.
DOI: http://dx.doi.org/10.1055/s-0034-1390161.
ISSN 0734-0451.

Improved versions of the Western Electric 1A
appeared over the next decade. By 1937, the
audiometer had become sufficiently precise that
standardization of the acoustic output was fea-
sible.1 Stable output levels meant the threshold
of audibility could be defined in terms of
decibels hearing level (HL) rather than sound
pressure level (SPL), which varied across test
frequency. Using standardized audiometers,
hearing tests were performed at octave frequen-
cies on a large number of young adults. These
data were subsequently averaged and used to
define audiometric zero.2 The American Stand-
ards Association (ASA) published the results in
1951 (Table 1). According to the ASA Z24.5
(1951) definition, audiometric threshold (0-dB
HL) at 1000 Hz corresponded to 16.5-dB SPL.
After much study and discussion, the American
National Standards Institute (ANSI) published
an alternative threshold definition of 6.5-dB
SPL in ANSI S3.6 (1969). Since then the
Standard “Specification for Audiometers” has
been revised several times—1989, 1996, 2004,
and most recently in 2010. The latest version
now includes reference thresholds for several
types of earphones, bone-conduction trans-
ducers, and loud speakers. In the sections that
follow, we will consider the instruments and
measurements associated with air-conduction
calibration of pure tone audiometers.
AUDIOMETRIC CALIBRATION
A pure tone audiometer is capable of generating
signals from 125 through 8000 Hz. An extended
high-frequency audiometer covers this frequen-
cy range plus higher frequencies from 8000
through 16,000 Hz (e.g., see Fausti et al3).
Most audiometers also can produce noises
used for masking test signals. The test signals
are delivered by a transducer, which can be an
earphone, loudspeaker, or bone vibrator. Some
audiometers may be able to deliver other kinds
of sounds such as frequency-modulated tones,
pulsed tones, speech sounds, and so on. An
audiometer’s type designation specifies its over-
all facilities. For example, a type 1 audiometer is
the most comprehensive in terms of available
signals and delivery methods (ANSI S3.6 2010).
Earphones are the most common trans-
ducers connected to audiometers. A voltage
AUDIOMETRIC CALIBRATION/CHAMPLIN, LETOWSKI 313
generated by the audiometer drives the ear-
phone, which results in an output measured in
decibels sound pressure level (dB SPL). There
are three kinds of earphones used in audiomet-
ric tests: supra-aural, circumaural, and insert
earphones. The supra-aural earphones have
cushions that press against the pinnae when
positioned on the head. The earphone has a
standard cushion, and this physical characteris-
tic facilitates consistent calibration measure-
ments (ANSI S3.6 2010). Supra-aural
earphones traditionally have been the standard
earphones used with pure tone audiometers.
The circumaural earphones have cushions that
fit around the pinna making little or no contact
with it. Unlike the supra-aural cushion, there is
no single type of cushion for circumaural ear-
phones. However, two types of circumaural
earphones (Senheiser HDA 200 (Senheiser
Electric Corp., Old Lyme, CT) and Koss
HV/1A (Koss Corp., Milwaukee, WI)) are
explicitly mentioned in the audiometer stan-
dard (ANSI S3.6 2010). Circumaural ear-
phones are normally associated with extended
high-frequency audiometers. Insert earphones
have a sound tube with an ear tip, earmold, or
other device that fits into the entrance of the ear
canal. Relative to other earphone types, insert
earphones increase interaural attenuation and
prevent ear canal collapse, and these attributes
have led to their increased popularity. Insert
earphones are used with pure tone audiometers;
however, one insert earphone (Etymotic model
ER-2 (Etymotic Research Inc., Elk Grove
Village, IL) ) is designed for use with extended
high-frequency audiometers (ANSI S3.6
2010).
A subject’s hearing level (dB HL) is evalu-
ated in reference to the normative hearing
threshold (0-dB HL), also called the reference
equivalent sound pressure level (RETSPL), spec-
ified in a relevant standard.4,5 The properties,
ranges, accuracies, and precision of various
functions and parameters of an audiometer’s
performance have to meet certain values speci-
fied in the standard. The more accurate and
precise an audiometer is, the greater the proba-
bility that the audiologist will make a correct
judgment and the lower risk and consequences
of a poor decision (e.g., an incorrect diagnosis or
an inappropriate hearing aid recommendation).
314 SEMINARS IN HEARING/VOLUME 35, NUMBER 4 2014

Table 1 ANSI and International Standards Relevant to Pure Tone Audiometer Calibration

ANSI S1.4 1983 (R 2006) American National Standard Specification for Sound Level Meters
ANSI S1.40 2006 (R 2011) American National Standard Specifications and Verification Procedures for
Sound Calibrators
ANSI S1.15 (Part 1) American National Standard Measurement Microphones—Part 1: Specifica-
1997 (R 2011) tions for Laboratory Standard Microphones
ANSI S3.1 1999 (R 2008) American National Standard Maximum Permissible Ambient Noise Levels
for Audiometric Test Rooms
ANSI S3.6 2010 American National Standard Method for Coupler Calibration of Earphones
ANSI S3.7 1995 (R 2008) American National Standard Method for Coupler Calibration of earphones
ANSI S3.21 2004 (R 2009) American National Standard Methods for Manual Pure-Tone Threshold
Audiometry
ANSI S3.25 2009 American National Standard for an Occluded Ear Simulator
ANSI S3.55 2014 American National Standard Electroacoustics—Simulators of Human Head
and Ear—Part 1: Ear Simulator for the Measurement of Supra-aural and
Circumaural Earphones
ASA Z24.5 1951 American Standard Specification for Audiometers for General Diagnostic
Purposes
IEC 60126 1973 Reference Coupler for the Measurement of Hearing Aids Using Earphones
Coupled to the Ear by Mean of Ear Insert (withdrawn and superseded by
IEC 60318–5:2006)
IEC 60318-1 2009 Electroacoustics—Simulators of Human Head and Ear—Part 1: Ear Simula-
tor for the Measurement of Supra-aural and Circumaural Earphones
IEC 60318-2 2005 Electroacoustics—Simulators of Human Head and Ear—Part 2: Ear Simula-
tor for the Calibration of Supra-aural and Circumaural Earphones
IEC 60318-3 1998 Electroacoustics—Simulators of Human Head and Ear—Part 3: Acoustic
Coupler for the Calibration of Supra-aural Earphones Used in Audiometry
IEC 60318-4 2010 Electroacoustics—Simulators of Human Head and Ear—Part 4: Occluded-
Ear Simulator for the Measurement of Earphones Coupled to the Ear by
Means of an e
IEC 60318-5 2006 Electroacoustics—Simulators of Human Head and Ear—Part 5: 2 cm3
Coupler for the Measurement of Hearing Aids and Earphones Coupled to
the Ear by Means of Ear Inserts
IEC 60645-1 2012 Electroacoustics – Part 1: Equipment for pure-Tone Audiometry
IEC 60711 1981 Specification for Occluded-Ear Simulator for the Measurement of Ear-
phones Coupled to the Ear by Ear Inserts (withdrawn and superseded by
IEC 60318–4: 2010)
ISO 389-1 2000 Acoustics—Reference Zero for the Calibration of Audiometric Equipment—
Part 1: Reference Equivalent Threshold Sound Pressure Levels for Pure
Tones and Supra-aural Earphones
ISO 389-2 1994 Acoustics—Reference Zero for the Calibration of Audiometric Equipment—
Part 2: Reference Equivalent threshold Sound Pressure Levels for Pure
Tones and Insert Earphones
ISO 389-4 1994 Acoustics—Reference Zero for the Calibration of Audiometric Equipment—
Part 4: Reference Levels for Narrow-Band Masking Noise
ISO 389-5 2006 Acoustics—Reference Zero for the Calibration of Audiometric Equipment—
Part 5: Reference Equivalent Threshold Sound Pressure Levels for Pure
Tones in the Frequency Range 8 kHz to 16 kHz
 AUDIOMETRIC CALIBRATION/CHAMPLIN, LETOWSKI 315

ISO 389-7 2005 Acoustics—Reference Zero for the Calibration of Audiometric Equipment—
Part 7: Reference Threshold of Hearing Under Free-field and Diffuse-field
Listening Conditions
ISO 389-8 2008 Acoustics—Reference Zero for the Calibration of Audiometric Equipment—
Part 8: Reference Equivalent Threshold Sound Pressure Levels for Pure
Tones and Circumaural Earphones
ISO 389-9 2009 Acoustics—Reference Zero for the Calibration of Audiometric Equipment—
Part 8: Preferred Test Conditions for the Determination of Reference
Hearing Threshold Levels
ISO 8253-1 2010 Acoustics—Audiometric Test Methods—Part 1: Pure Tone Air and Bone
Conduction Audiometry
ISO 8253-2 2009 Acoustics—Audiometric Test Methods—Part 2: Sound Field Audiometry
with Pure-tone and Narrow-band Test Signals

Abbreviations: ANSI, American National Standards Institute; IEC, International Electrotechnical Commission; ISO,
International Organization of Standards.

Wilber, Laukli, and Burkard in this issue
provide the general classification and discussion of
various types of standards used in audiometry.
Fedtke and Grason, also in this issue, describe
instrumentation required for audiometer calibra-
tion. The reader is referred to Fedtke and Grason
for specific information on instrumentation men-
tioned in this article. Additionally, each audio-
meter’s layout and method of operation may be
different. Therefore, the user is strongly encour-
aged to review the owner’s manual and technical
references for specific details. The reader also may
find helpful general textbooks devoted to instru-
mentation in audiology and hearing science (e.g.,
see Decker and Carrell6).
Technical, instrument-based assessment of
an audiometer is typically referred to as electro-
acoustic calibration and this term will be used in
this article to differentiate it from the supple-
mentary biological calibration described below.
Electroacoustic calibration ensures that the
audiometer performs within its specifications
and ensures that the readings from the instru-
ment are consistent with readings from other
audiometers conforming to the same common
standard.7,8 The required accuracy of calibra-
tion is described in the standard and has to be
met or exceeded. A list of international and
national standards that apply to pure tone
testing in normal and extended frequency
ranges is provided in Table 1.
In the United States, all standards related to
audiometry are the domain of the Standards
Committee S3 (Bioacoustics) of the American
National Standard Institute (ANSI).5 The pur-
view of the S3 Committee is to develop and
publish standards, specifications, methods of
measurement and test, and terminology in the
fields of psychological and physiological acoustics,
including aspects of general acoustics, which
pertain to biological safety, tolerance, and com-
fort. Most of the ANSI standards are aligned with
international standards published by the Interna-
tional Organization of Standards (ISO) and
International Electrotechnical Commission
(IEC). The primary ANSI standard related to
audiometric tests is ANSI S3.6 (2010) American
National Standard Specification of Audiometers.
All procedures or values described in this article
without reference to a specific standard refer to
ANSI S3.6 (2010); references to other standards
are provided as appropriate.
The time-induced changes (drift) in
parameters of the audiometer diminish accuracy
and reliability of measurement results. To en-
sure that the drifts do not exceed specified
tolerances, an electroacoustic calibration of
the audiometer needs to be performed periodi-
cally by an accredited laboratory or a qualified
individual. All actions related to the calibration
procedure should be assigned as the responsi-
bility of a single person to minimize the proba-
bility of miscommunication and incomplete
calibration. A calibration certificate is issued
only when an audiometer operates within its
tolerances and satisfies its intended purpose.
In addition to drift, parameters and properties
of the audiometer may change due to mechanical
and electrical failures resulting from wear and tear
or mishandling of the instrument. To identify
316 SEMINARS IN HEARING/VOLUME 35, NUMBER 4 2014
such changes and to initiate a corrective action if
needed, a daily biological or listening check of the
instrument needs to be performed by the user.
BIOLOGICAL CHECK
The person with primary responsibility for the
audiometric testing should perform biological
checks.9,10 These checks should be done each
day prior to client testing or anytime during the
day when there is reason to suspect that the
audiometer is not performing properly.
The biological check consists of two ele-
ments: the self-listening check and the hearing
threshold check. The listening check involves
listening for static, hum, noise, crackling and
popping sounds, and sound intensity changes
while gently wiggling all wires attached to the
audiometer. Presence of any of these undesired
sounds requires further investigation and reme-
diation. If remediation is not successful, a
qualified service technician should be consulted.
The hearing threshold check should involve
threshold measurement of a person with known
and stable hearing thresholds. As a minimum, a
hearing threshold on the better ear of the
listener should be performed with right (red)
and left (blue) earphones. If measurements do
not differ by more than
5 dB from each other
and from the known threshold of this person,
the audiometer may be considered in calibra-
tion. If they differ more than
5 dB, the
audiometer needs an electroacoustic calibration.
As mentioned previously, electroacoustic
calibration should be undertaken at least once a
year or more frequently if circumstances dictate.
Calibration is considered exhaustive if it in-
volves the comprehensive measurement of sig-
nal characters including output levels,
attenuator linearity, frequency accuracy, har-
monic distortion, and signal switching.4 These
diverse measurements necessitate the use of
several different devices and instruments.
INSTRUMENTATION FOR
CALIBRATION
Acoustic Couplers
A device that is used for the calibration of
earphone output is the acoustic coupler. An
acoustic coupler is a cavity of specific shape and
volume that, with a calibrated microphone,
permits measurement of the sound pressure
developed in the cavity. Couplers serve as the
connecting interface between the earphone and
the measuring instrument, which in this case is
the sound level meter.
It is important to stress that the primary
function of a coupler is to provide a standard
load to the earphone to allow for repeatable
testing conditions. In addition, a coupler must
be standardized, reproducible, and stable. It is
also desirable for the coupler to simulate the
impedance of the human ear but the early
couplers did not perform well compared with
the human ear.11 The later, more sophisticated
couplers perform much better, and such cou-
plers are called ear simulators. However, no
existing acoustic coupler simulates acoustic
properties of the human ear in the full range
of auditory frequencies. Therefore, an ear sim-
ulator can only be specified by a frequency range
in which such simulation is achieved. This is not
to say that an ear simulator cannot be used
outside this range. It can, but it becomes just a
standard acoustic coupler operating outside its
specific frequency range.
Because earphones come in different types (e.
g., supra-aural, insert, and circumaural), several
types of acoustic couplers exist (ANSI S3.6
2010).12 The oldest of the currently used acoustic
couplers, the National Bureau of Standards
(NBS) 9-A coupler, was developed to calibrate
supra-aural earphones (ASA Z24.5 1951), and it
can be used for measurement of supra-aural
audiometric earphones in the frequency range
from 125 to 8000 Hz (IEC 60318-3 1998).
The coupler is designed in such a way that the
cushion of the earphone fits squarely over the
mounting ring on top of the coupler. A micro-
phone is located in the base of the coupler, and
there is air space between the earphone and the
microphone. The volume of this space is 6 cm3,
which simulates the average volume of the adult
ear canal. Given this specific volume, the NBS 9-
A coupler is commonly known as a 6-cc coupler.
During calibration, the earphone is held in place
on the coupler with a standard 500-g weight.
The NBS 9-A coupler poorly represents
the acoustical properties of the human ear.
More recently, another coupler that better

matches the impedance of the human ear, the
IEC 318 coupler, has been introduced (IEC
60318-1 2009; IEC 60318-2 1998; ANSI S3.7
1995). The IEC 318 coupler has general fea-
tures similar to the NBS 9-A. However, the two
differ internally in that the IEC 318 coupler has
three tuned tubes or ports. The effect of these
small cavities is to closely match the acoustic
impedance of the air present in the ear canal.
This design feature enables a better approxima-
tion of the acoustics of the human ear, and
therefore this coupler is frequently referred to as
an ear simulator. It operates as an ear simulator
in the 100- to 10,000-Hz frequency range. Like
the NBS 9-A coupler, the IEC 318 coupler can
be used to calibrate supra-aural earphones.
However, the latter device also has provisions
to be used to measure the output of circumaural
earphones. In this context, the conical mount-
ing ring of the coupler is replaced with a flat
metal plate. The plate has a hole in its center to
accommodate a microphone. The circumaural
earphone is positioned directly over the hole,
and a standard mass of 500 g is placed on top of
the earphone to secure it on the plate.
Figure 1 Common types of couplers for calibrating insert earphones. (A) Occluded ear simulator (see
American National Standards Institute [ANSI] S3.25); (B) HA-2 coupler (see ANSI S3.7) and (c) HA-1 coupler
(see ANSI S3.7). Note: All dimensions are in millimeters. (From Figure 2 in ANSI S3.6–2010, Acoustical
Society of America, used with permission.)
AUDIOMETRIC CALIBRATION/CHAMPLIN, LETOWSKI 317
As the name implies, insert earphones are
inserted into the ear canal rather than placed
over its entrance. This method of linking the
earphone to the ear requires another type of
coupler to measure sound pressure. Compared
with either a supra-aural or circumaural ear-
phone, a smaller amount of air is trapped in the
ear canal when an insert earphone is properly
placed. This volume approximates 2 cm3, and
devices simulating this volume are referred to as
2-cc couplers. Three different types of 2-cc
couplers currently are used to calibrate insert
earphones. The HA-1 and HA-2 couplers are
two variants of the IEC 126 coupler that differ
in the way they connect hearing aids to instru-
mentation used in the electroacoustic analysis
(IEC 60126 1973; IEC 60318-5 2006; ANSI
S3.7 1995). The IEC 126 coupler was not
intended to measure the actual performance
of a hearing aid but rather served as consistent
means for exchanging data. The third type of
2-cc coupler is known as the IEC 711 coupler or
occluded ear simulator (ANSI S3.25 2009; IEC
60318-4 2010). Fig. 1 shows an insert earphone
connected to three common 2-cc couplers.
318 SEMINARS IN HEARING/VOLUME 35, NUMBER 4 2014
Like other couplers, the 2-cc couplers have
a microphone attachment in their base. After
the foam ear tip is removed, the insert earphone
is attached to the HA-2 coupler or occluded ear
simulator via a plastic sound tube and a tube
adapter. It is not necessary to remove the ear tip
to connect the insert earphone to the HA-1
coupler. The ease of consistently attaching the
insert earphone to the HA-2 or occluded ear
simulator and greater repeatability of results
obtained with the HA-2 coupler facilitate mea-
surement reliability, and therefore calibration
with the HA-2 coupler is generally preferred
over calibration with the HA-1 coupler.
The IEC 711 ear simulator has an equiva-
lent volume of 1.26 cm3 and was initially
designed to simulate human ear impedance
from 100 to 7,000 Hz. This range of frequencies
has been subsequently extended to 10,000 Hz
and later to 16,000 Hz. It was developed in
Europe in 1973 and standardized by IEC in
1979. In the United States, a slightly different
ear simulator was developed by Zwislocki13 and
standardized by ANSI in 1971 (ANSI S3.25
2009). This simulator is commonly called the
Zwislocki occluded ear simulator. Although the
Zwislocki ear simulators still exist and are used,
they are more difficult to make than IEC 711
simulators, and the Zwislocki coupler is no
longer in production.
Sound Level Meter
The output level of an earphone or loudspeaker
is measured with a sound level meter.14 The
sound level meter has a microphone that detects
minute fluctuations in air pressure (ANSI S1.15
Part 1 1997). The microphone is extremely
sensitive and its operation can be affected by
temperature and humidity. Fortunately, most
calibration is conducted in a climate-controlled
environment, so the temperature and humidity
are relatively stable. However, before audiomet-
ric calibration activities are undertaken, the
sound level meter itself should be calibrated.
This is accomplished by attaching a calibrator
(also known as a pistonphone) to the micro-
phone. The calibrator emits a fixed frequency,
fixed level (e.g., 94- or 114-dB SPL) tone
(ANSI S1.40 2006). The sound level meter is
adjusted to match precisely the level of the tone.
Additionally, the microphone is not equally
sensitive to all audiometric test frequencies.
These deviations from zero need to be taken
into account. Using the frequency response
chart that accompanies the microphone, the
output level is adjusted up (if positive) or down
(if negative) by the amount of the deviation.
One final comment: microphones are classified
as pressure, field, or random incidence and are used
for different applications. A pressure micro-
phone is appropriate to use for earphone cali-
bration, while a field or random incidence
microphone is used to calibrate a loudspeaker.
The meter shows SPL (in decibels) on
either an analog (needle-type) or digital display
(ANSI S1.4 1983). Sound level meters are
categorized by type, which relates to measure-
ment precision. A type 1 sound level meter is
the most precise and is required for exhaustive
calibration. A sound level meter typically has
two or more time scales that can be selected by
the user. The “slow” time scale corresponds to a
1-second time constant of integration. In other
words, the display updates every second. The
“fast” time scale indicates a time constant of
0.125 seconds. With this setting, the meter
updates more rapidly at 8 times per second.
Because output levels are continuous during
audiometric calibration, the slow time scale is
recommended. A sound level meter also has
different frequency scales or weights. Each
frequency weight essentially describes a broad
spectral configuration. When calibrating pure
tones, these broad-frequency scales are es-
chewed in favor of the more specific (i.e.,
narrower) spectral analysis permitted by band-
pass filters. A filter in the sound level meter can
be set to a particular test frequency, and this
helps reduce the effects of ambient noise that
can cause measurement variability. The filters
are typically one octave wide, although it is not
uncommon to find one-third octave filters on
more expensive sound level meters.
Multimeter
A multimeter is used to measure attenuator
linearity. Attenuator linearity refers to the
change in output level of the audiometer as
the HL dial is manipulated. The multimeter is
so named because it can measure the three basic

electrical properties of voltage, current, and
resistance. Voltage is the appropriate multi-
meter setting for quantifying output level. It
is important to note that most multimeters
measure voltage on a linear scale (e.g., volts
RMS). If this is the case, then the output
voltage must be converted to a logarithmic or
decibel scale before comparison with the hear-
ing level of the audiometer can be undertaken.
Because attenuator performance is the focus,
the multimeter is inserted between the output
of the audiometer and the earphone. This type
of connection is readily accomplished with a Y-
cord. The cord is interposed between the audi-
ometer at one end; the multimeter and ear-
phone connected on either branch of the Y at
the other end.
Frequency Counter
A frequency counter is used to assess the
accuracy of an audiometer’s pure tone genera-
tor. As with the multimeter, the frequency
counter is connected directly to the audio-
meter’s output. The measured frequency is
read from the digital display in a straightfor-
ward way.
Spectrum Analyzer
Frequency accuracy also can be measured with a
spectrum analyzer. This instrument displays the
output level on either a linear or logarithmic
(decibel) scale as a function of frequency. A
cursor is moved to a given location to get
specific reading of frequency and level. An
added benefit of the spectrum analyzer is that
because it displays a range of frequencies, it is
possible to determine whether the audiometer
is generating significant harmonic distortion.
Oscilloscope
The oscilloscope has a screen for display pur-
poses. The scope shows the waveform, which is
the output level as a function of time. The scope
is especially helpful for examining a pure tone
signal as it is turned on and off. The time it
takes for the signal to go from completely off to
on is known as the rise time. The fall time is just
the opposite. The rise and fall times cannot be
AUDIOMETRIC CALIBRATION/CHAMPLIN, LETOWSKI 319
too abrupt or audible transients may occur.
These audible transients contain frequencies
other than the test frequency and their presence
reduces the specificity of the hearing test.
Because the audiometer’s switch reacts very
quickly, an analog storage oscilloscope or a
digital oscilloscope is required to capture the
on-off events accurately.
OVERVIEW OF CALIBRATION
Output Level of Earphones
When one thinks of audiometric calibration,
the most common conception is measuring the
output level of an earphone. This is a relatively
simple process, requiring only an appropriate
coupler, microphone, and a sound level meter.
In fact, if the equipment is available, it is
advisable to measure output levels more fre-
quently than once per year. The authors of this
article suggest 3-month intervals. The output
level is assessed relative to known standardized
hearing thresholds. These thresholds are
known more formally as RETSPLs (ANSI
S3.6 2010; ISO 389-5 2006). RETSPLs repre-
sent the SPL that is necessary to achieve abso-
lute thresholds of hearing as measured in
population of otologically normal subjects.
As noted above in the section on acoustic
couplers, there are three types of earphones and
they vary in size and have different physical
characteristics and thus cannot be accommo-
dated with a single coupler. Additionally, the
human ear is not equally sensitive across fre-
quency due to the variation in its mechanics.
These differences need to be accounted for in
calibration, so RETSPLs have been established
according to the type of earphone, coupler, and
the test frequency. The RETSPLs for several
popular earphone-coupler combinations are
shown in Table 2.
It is important when measuring output
levels that background noise does not affect
the results. To help minimize this problem,
RETSPLs are acquired at a level that is well
above typical hearing thresholds. Although any
output level can be used, it is common practice
to set the dial to 70-dB HL. The output level is
then measured on the sound level meter. Recall
that the sound level meter measures the output
320 SEMINARS IN HEARING/VOLUME 35, NUMBER 4 2014

Table 2 Reference Equivalent Threshold Sound Pressure Levels for Supra-aural, Insert, and
Circumaural Earphones
Frequency Supra-aural Earphones Insert Earphones Circumaural
(Hz) Earphones
TDH39† TDH39‡ TDH49/50 DT 48§ ER-3A ER-3A ER-3A ER-2 HDA200 HV/1A
IEC 318 NBS 9A NBS 9A NBS 9A IEC 711¶ HA-1j HA-2 IEC 711¶ IEC 318†† IEC 318‡‡

125 45.0 45.0 47.5 47.5 28.0 26.5 26.0 30.5

160 38.5 37.5 40.5 24.5 22.0 22.0 26.0
200 32.5 31.5 34.0 21.5 19.5 18.0 22.0
250 27.0 25.5 26.5 23.5 17.5 14.4 14.0 18.0
315 22.0 20.0 23.0 15.5 15.0 12.0 16.5
400 17.0 15.0 18.5 13.0 10.5 9.0 13.5
500 13.5 11.5 13.5 14.5 9.5 6.0 5.5 11.0
630 10.5 8.5 11.5 7.5 4.5 4.0 8.0
750 9.0 7.5 8.5 9.5 6.0 2.0 2.0 6.0
800 8.5 7.0 9.0 5.5 1.5 1.5 6.0
1000 7.5 7.0 8.5 8.0 5.5 0.0 0.0 5.5 16.0
1250 7.5 6.5 7.5 8.5 1.0 2.0 6.0
1500 7.5 6.5 7.5 7.5 9.5 0.0 2.0 5.5
1600 8.0 7.0 7.5 9.5 1.5 2.0 5.5
2000 9.0 9.0 11.0 8.0 11.5 2.5 3.0 4.5
2500 10.5 9.5 7.0 13.5 2.5 4.0 3.0
3000 11.5 10.0 9.5 6.0 13.0 2.5 3.5 2.5
3150 11.5 10.0 6.0 13.0 2.5 4.0 4.0
4000 12.0 9.5 10.5 5.5 15.0 0.0 5.5 9.5 8.0
5000 11.0 13.0 7.0 18.5 1.5 5.0 14.0
6000 16.0 15.5 13.5 8.0 16.0 2.5 2.0 17.0
6300 21.0 15.0 9.0 16.0 2.0 2.0 17.5
8000 15.5 13.0 13.0 14.5 15.5 3.5 0.0 19.0 17.5 15.5
9000 16.0 19.0 19.5
10,000 20.0 22.0 24.0
11,200 30.5 23.0 23.0
12,500 37.0 27.5 24.5
14,000 43.5 35.0 34.5
16,000 53.0 56.0 52.0

Speech 20.0 19.5 20.0 20.0 18.0 12.5 12.5 19.0 28.5

All levels listed in this table are from ANSI S3.6 2010 unless indicated otherwise. Abbreviations: ANSI, American
National Standards Institute; IEC, International Electrotechnical Commission; NBS, National Bureau of Standards.

This value is listed in ANSI S3.6 2004 but not in ANSI S3.6 2010.
†
TDH 39 with MX41/15 or M51 cushion or any supra aural earphone having characteristics described in ANSI S3.6
clause 9.1.1 or ISO 389–1.
‡
TDH 39 with MX41/15 or M51 cushion; values from IEC 60318-1 2013 except for speech value.
§
DT 48 with flat cushion; values from IEC 60318-1 2013 except for speech value.
¶
Occluded ear simulator IEC 711 (ANSI S3.6 2010, Fig. 2A).
j

HA-1 coupler (IEC 126 with foam ear tip sealed to the top of the coupler; ANSI S3.6 2010, Fig. 2C).
HA-2 coupler (IEC 126 with rigid tube; ANSI S3.6 2010 Fig. 2B).
††
IEC 318 ear simulator with type 1 Adaptor (IEC 60318-2 1998, Fig. 1); values from ISO 389-8 2001 except for
speech value.
‡‡
IEC 318 ear simulator with type 2 Adaptor (ISO 389-2 1994, Fig. 2B).

SPL in decibels. To determine whether the to the hearing level setting on the dial. For
output level falls within an acceptable range, the example, let us say the measured output level is
expected level must be determined. This is 79-dB SPL. Given the hearing level dial is
handled by adding the appropriate RETSPL 70 dB, the test frequency is 1000 Hz, and a
 AUDIOMETRIC CALIBRATION/CHAMPLIN, LETOWSKI 321

Figure 2 Times associated with the rise (from B to C) and fall (from E to G) of signal envelope. (From Fig. 1
in American National Standards Institute [ANSI] S3.6–2010, Acoustical Society of America, used with
permission.)

TDH 39 supra-aural earphone is mounted on
an NBS 9-A coupler, the expected level is 77.5-
dB SPL (7.5 dB [from Table 2] þ 70 dB), so
the measured signal is 1.5 dB higher than
expected value. Thus, in this example, the
audiometer is delivering a signal that is
1.5 dB greater than the expected level. The
calibration form shown in Table 3 can be
used to record measurements and make the
calculations described here for both supra-aural
and insert earphones; relevant values for cir-
cumaural earphones are not shown in the table
due to space limitations.
We should note that for an audiometer to
be considered in calibration, it is not essential
for the measured SPL to match exactly the
expected SPL. In other words, there is a range
of acceptable values referred to as a tolerance
range. This range depends on the test frequency.
From 125 to 5000 Hz, the range is
3 dB; for

Table 3 Calibration Form for Earphone Output Levels (re: ANSI S3.6 2010)
Transducer Frequency (Hz)
125 250 500 750 1000 1500 2000 3000 4000 6000 8000

1. Right supra-aural earphone

2. Attenuator control þ RETSLP
3. Difference (line 2 minus line 1)
4. Right supra-aural correctionc
5. Left supra-aural earphonea
6. Attenuator control þ RETSLP
7. Difference (line 6 minus line 5)
8. Left supra-aural correction†
9. Right insert earphone‡
10. Attenuator control þ RETSLP
11. Difference (line 10 minus line 9)
12. Right insert correction†
13. Left insert earphone‡
14. Attenuator control þ RETSLP
15. Difference (line 14 minus line 13)
16. Right insert correctionc

Abbreviations: ANSI, American National Standards Institute; SPL, sound pressure level; RETSPL, reference
equivalent sound pressure level.

SPL in NBS 9-A coupler with attenuator control setting of 70 dB.
‡
SPL in HA-2 coupler with an attenuator control setting of 70 dB.
†
Difference rounded to nearest 5-dB retaining sign.
322 SEMINARS IN HEARING/VOLUME 35, NUMBER 4 2014
frequencies greater than 5000 Hz, the range
increases slightly to
5 dB (ANSI S3.6 2010).
If a measured value falls outside the specified
range, a qualified technician usually can adjust
the audiometer to bring it back into line. An
internal adjustment, however, may not always
be feasible. In such cases, manual correction of
the output level is necessary. A correction chart
is created and posted on the front of the
audiometer. The correction chart should be
arranged by earphone (left or right) and test
frequency. Subtracting the expected level from
the one measured and then rounding the dif-
ference to the closest 5-dB increment yields the
correction factor. The sign (plus or minus) of
the difference is meaningful, yet it is often
confusing. A negative number means the true
output level of the audiometer is greater than
expected, and thus the measured hearing
threshold must be adjusted accordingly. Once
the hearing threshold is obtained in the stan-
dard way, the appropriate correction factor is
subtracted from (because the sign is negative) the
hearing threshold and the result is recorded as
the final value. The opposite applies for positive
correction factors—the value is added to the
hearing threshold before recording it. The
measurements recorded in Table 3 can be
used to derive correction factors.
Output Level of Loudspeakers
As with earphones, the test signals presented into
the test room via a loudspeaker need to be
calibrated (ASHA 199115). No coupler is in-
volved in the calibration of loudspeakers and no
specific type of loudspeaker is recommended in
the standards. Instead, a standardized reference
point is determined and the RETSPLs required
at this point are listed. The reference point must
be at least 1 m away from the front of the
loudspeaker and the subject is not present in
the test room during calibration. More specifical-
ly, the reference point is located approximately
where the center of the subject’s head would be
during testing. A sound level meter is mounted
vertically on a sturdy tripod and oriented so that
the microphone is at the reference point. It is
important to note that a free-field-type micro-
phone pointed toward the sound source at a 0-
degree angle of incidence is used for sound-field
calibration. This is different from the pressure-
type microphone used for earphone calibration. If
a free-field type of microphone is not available, a
pressure microphone may be used but it should be
oriented at grazing incidence (90 degrees) to the
propagating sound wave. The signal is a frequen-
cy-modulated (FM) tone, called also a warble
tone, or one-third octave band noise. The hearing
level control of the audiometer is set to the desired
setting, which is typically 70 dB. Care must be
taken to ensure the person making the measure-
ments does not block or otherwise interfere with
the signal’s path to the reference point.
The RETSPLs for sound-field testing are
listed in ANSI S3.6 (2010). These RETSPLs are
shown in Table 4 for listening in the free and
diffuse-field listening. Because RETSPLs in the
free field depend on the angle of incidence of the
sound source, values are given at 0, 45, and 90
degrees of incidence relative to the direction the
listener is facing. A sample form is shown
in Table 5. In this case, the signal is assumed to
be an FM tone and the RETSPLs are for binaural
listening in free field at 0-degree incidence.
The output level is measured at the refer-
ence point and recorded on the calibration form.
The difference between the measured output
level and the expected level (i.e., attenuator HL
dial plus RETSPL) should not exceed 2.5 dB.
Additionally, measurements are made at six
locations around the reference point. The sound
level meter is positioned 0.15 m along the right–
left and up–down axes from the reference point.
The tolerance range for each of the four loca-
tions is
2 dB compared with the output level
measured at the reference point. The sound level
meter is positioned 0.1 m in the front–back axis.
The tolerance range for each of the two locations
is
1 dB compared with the measurement at
the reference point. Those tolerances have to be
met to accommodate slightly different positions
of the subjects due to their height and posture
differences. If a difference at any location ex-
ceeds the tolerance, a qualified technician
should adjust the output of the audiometer.
Attenuator Linearity
It is critical that the audiometer’s output change
predictably as the hearing level control is ad-
justed. In other words, if the control is
 AUDIOMETRIC CALIBRATION/CHAMPLIN, LETOWSKI 323

Table 4 Reference Equivalent Threshold Sound Pressure Levels for Sound-Field Testing
Frequency Hz Binaural Listeninga in Free Field Diffuse-fielda
0 Degree Incidence 45 Degree Incidence 90 Degree Incidence

125 22.1 21.6 21.1 22.1

160 17.9 16.9 16.4 17.9
200 14.4 13.4 12.9 14.4
250 11.4 10.4 9.4 11.4
315 8.6 7.1 6.1 8.4
400 6.2 3.7 2.7 5.8
500 4.4 1.4 0.1 3.8
630 3 0.5 2 2.1
750 2.4 1.1 2.6 1.2
800 2.2 1.3 2.8 1
1000 2.4 1.6 3.1 0.8
1250 3.5 0.5 2.5 1.9
1500 2.4 1.1 2.6 1
1600 1.7 1.8 2.8 0.5
2000 1.3 4.3 3.3 1.5
2500 4.2 7.7 6.2 3.1
3000 5.8 10.5 8.3 4
3150 6 11 8 4
4000 5.4 9.4 4.9 3.8
5000 1.5 7.5 5.5 1.8
6000 4.3 3.2 5.2 1.4
6300 6 1.5 4 2.5
8000 12.6 7.1 4.1 6.8
9000 13.8 8.8 6.8 8.4
10000 13.9 9.4 7.9 9.8
11200 13 9 6 11.5
12500 12.3 10.8 4.3 14.4
14000 18.4 23.2
16000 40.2 43.7
18000 73.2
a
ISO 389-7 2005 Reference Threshold of Hearing Under Free Field and Diffuse Field Conditions.

decreased 5 dB, then the output should de-
crease 5 dB, too. Furthermore, this relationship
should hold across the range of attenuator
control from the lowest level to the highest
one. Attenuator linearity is usually assessed
electrically. The output of the audiometer is
connected to the input of the multimeter, which
is the preferred instrument to use. This electri-
cal connection is made with a Y-cord, with the
multimeter connected to one arm of the branch
and the earphone attached to the other arm.
The multimeter/spectrum analyzer may display
the measured output in decibel units. If not, the
value must be converted to decibel volts using
the following formula: dB V ¼ 20 log (mea-
sured voltage).
To record and analyze the results, a simple
table can be constructed with three columns.
The first column lists the range of HL dial
settings in 5-dB steps; the second column lists
the measured values (in decibel volts); the third
column lists the decibel change or difference
between a given measurement and the one
obtained in the step immediately preceding it.
(The first cell column 3 is skipped.) The
attenuator is linear if the measured decibel
 324
Table 5 Calibration Form for Output Levels of Loud Speakers in Sound Field (re: ANSI S3.6 2010)
Audiometer Serial # Channel Date Calibrated by
Frequency in Hertz (Hz)

Transducer 125 250 500 750 1000 1500 2000 3000 4000 6000 8000
1. RIGHT speakera
2. Attenuator Control þ RETSLPb 92.1 81.4 74.4 72.4 72.4 72.4 68.7 64.2 64.6 74.3 85.6
3. Difference (line 2 minus line 1)
4. RIGHT speaker right/left locationc
5. RIGHT speaker up/down locationd
6. RIGHT speaker front/back locatione
7. LEFT speakera
8. Attenuator Control þ RETSLPb 92.1 81.4 74.4 72.4 72.4 72.4 68.7 64.2 64.6 74.3 85.6
9. Difference (line 8 minus line 7)
SEMINARS IN HEARING/VOLUME 35, NUMBER 4

10. LEFT speaker right/left locationc

11. LEFT speaker up/down locationd
2014

12. LEFT speaker front/back locatione

a
Measured at reference point with FM tone and Hearing Level setting of 70 dB
b
Binaural listening in free field at 0 degree incidence (facing speaker). Error is þ/2.5 dB
c
Measured 0.15 M to right and 0.15 M to left of reference point. Error is þ/2 dB
d
Measured 0.15 M above and 0.15 M below reference point. Error is þ/2 dB
e
Measured 0.1 M in front of and 0.1 M behind reference point. Error is þ/1 dB

change matches the step size on the HL control.
As with output levels, some deviation in the
amount of decibel change is permitted. If the
difference is 5 dB, then the measured value
must be within
1.5 dB of this decibel change
(ANSI S3.6 2010). ANSI S3.6 (2010) also
states that the maximum deviation from linear-
ity at any dB HL shall not exceed 2 dB.
Frequency Accuracy
After checking the performance of the audio-
meter’s attenuator, the accuracy of its pure tone
generator must be assessed. The setup is similar
as the one used to evaluate attenuator linearity.
The same Y-cord is connected to output of the
audiometer while one branch of the Y is con-
nected to an earphone. The difference is a
frequency counter replaces the multimeter in
the other branch. The attenuator control is set
to 70-dB HL to ensure a strong signal. The
frequency associated with each of the frequency
control settings is measured. The permissible
deviation is
1% of the test frequency (ANSI
S3.6 2010). In the case when an FM rather than
pure tone signals are used, the carrier frequency
shall be within
3% of the nominal frequency
and the modulation frequency shall be in a
range of 5 to 25% of the carrier frequency
with a tolerance of
10% of its stated value
(ANSI S3.6 2010).
Harmonic Distortion
Harmonic distortion refers to the presence of
frequency components at harmonics (i.e., inte-
ger multiples) of the test frequency. For exam-
ple, if the test frequency is 500 Hz, the presence
of frequency components (harmonics) at 1000,
1500, 2000 Hz, and so on is indicative of
harmonic distortion. Because the audiometer
and/or the earphone can generate distortion, it
is necessary to make measurements at the
output of the earphone. This requires mounting
the earphone on a coupler connected to a sound
level meter that preferably has a set of one-third
octave filters. Alternatively, the alternating cur-
rent output (and electrical output) of the sound
level meter can be routed to the input of a
spectrum analyzer. To increase the likelihood of
detecting distortion, the hearing level control is
AUDIOMETRIC CALIBRATION/CHAMPLIN, LETOWSKI 325
set to its maximal level, which varies by fre-
quency. When using filters internal to the
sound level meter, the first measurement is at
the test frequency (e.g., 500 Hz) and so that is
the one selected on the filter. The next mea-
surement is at the second harmonic (1000 Hz)
and consequently the filter is adjusted to this
frequency; however, the frequency control of
the audiometer remains unchanged. The filter
is then moved to the third harmonic (1500 Hz),
the filter is again adjusted, and the measure-
ment is taken. This process continues until no
harmonic energy is detectable or the highest
available filter setting is reached, whichever
occurs first. The most common measure is total
harmonic distortion (THD), which is given as a
percentage of the combined sound pressure of
the second harmonic and above relative to the
sound pressure of the test frequency. Before
combining (i.e., adding) sound pressures, each
level measured must be converted from decibels
to pascals. This is accomplished with the fol-
lowing formula: p ¼ 10(SPL/20þlog(20)) where p
is pressure (in pascals) and SPL is decibels.
Once these conversions have been made, the
THD can be calculated as follows: THD
¼ 100 ((p22 þ p32 þ p42þ . . . pn2)/(p12))1/2
where p1 is the test frequency (or first harmon-
ic), p2 is the second harmonic, p3 is the third
harmonic, and pn is the nth harmonic (ANSI
S3.7 1995). An alternative calculation of
total harmonic distortion can also be used:
THD ¼ 100 ((p22 þ p32 þ p42þ . . . pn2)/
(p12 þ p22þ p32 þ p42þ . . . pn2))1/2. Note
that each pressure value is squared. The THD
is assessed for both earphones at all test fre-
quencies. The THD is considered excessive if it
exceeds 2.5% (ANSI S3.6 2010).
Signal Switching
The pure tone signal is delivered to the listener by
pressing the interrupter switch. Three factors
associated with the function of the switch are
checked during calibration: on–off ratio, crosstalk,
and rise and fall time. The on–off ratio describes
the output level of the signal when the tone is on
(i.e., the switch is pressed or closed) versus when
the signal is off (i.e., the switch is released or
open). The setup for evaluating the on–off ratio is
the same one used to measure attenuator linearity.
326 SEMINARS IN HEARING/VOLUME 35, NUMBER 4 2014
One end of a Y-cord is connected to the output of
the audiometer and the other two ends are
connected to a multimeter (or spectrum analyzer)
and earphone, respectively. The attenuator con-
trol is set for maximal output. The output level is
measured with the tone on and then again with
the tone off. If necessary, the two values are
converted to decibels, and then the decibel values
are subtracted from one another. The on–off ratio
is unacceptable if the difference is less than 70 dB
(ANSI S3.6 2010).
Crosstalk is present if the signal in one
channel of the audiometer can be heard in the
other channel. The setup to assess crosstalk is
the same as above. However, after measuring
the output level for the test earphone, the
level of the nontest earphone is measured.
Crosstalk is a problem if the difference be-
tween these two measures is less than 70 dB
(ANSI S3.6 2010).
Rise time refers to the time it takes for the
signal to go from off to on. Conversely, fall time
refers to the time it takes for the signal to go from
on to off. The concept of switching is illustrated
in Fig. 2, and the points for measuring the rise and
fall times are labeled. Measuring rise and fall times
requires a storage or digital oscilloscope so the
pure tone signal can be monitored as it is turned
on and off. The same Y-cord arrangement de-
scribed previously is used to evaluate rise and
fall times except the multimeter (or spectrum
analyzer) is replaced with the oscilloscope (note
that many spectrum analyzers can display time-
domain results, and hence in fact are also digital
oscilloscopes). When set up properly, a stable
image of the signal’s envelope is captured on the
screen. Sloping ramps should be visible as the
signal comes on and goes off. The rise and fall
times can be ascertained by measuring the dura-
tion of the leading and trailing ramps, respective-
ly. According to ANSI S3.6 (2010), the rise and/
or fall times of the on–off switch cannot be less
than 20 milliseconds or greater than 200 milli-
seconds. In the case of pulsed mode of presenta-
tion, the pulses should be at least 150 milliseconds
in duration and rise and fall times shall not exceed
50 milliseconds. Overshoot refers to the situation
when the signal onset very briefly surpasses its
steady-state level. If overshoot occurs, it cannot
exceed the steady-state level by more than 1 dB
(ANSI S3.6 2010; Fig. 2).
Masking Noises
Some pure tone audiometers provide masking
noise that is used in testing procedures. The
white noise or narrow-band noise must be
measured in a coupler or ear simulator. If a
white noise masker is presented, it shall
nominally extend from 250 Hz to 5000 Hz
with a pressure spectrum level that is within
5 dB of the level at 1000 Hz through this
frequency range. Narrow-band noises are
centered geometrically on the test frequency.
Band limits (in hertz) and band reference
levels (in decibels) are specified in Table 4
of the Specification for Audiometers (ANSI
S3.6 2010, p. 19). Individual bands are one-
third (minimum) to one-half (maximum)
octave wide. They are wider than the critical
bands required for effective masking to mini-
mize the tonal character of narrow-band
noise. (The critical band specifies a range of
frequencies centered on the test signal that
interfere with its detectability.) This is done
to prevent the listener from confusing the
masker with the signal. The reference levels
in Table 4 of ANSI S3.6 (2010) are given
as correction values to be added to the
RETSPL values for the respective pure
tone signals. These correction values are
based on the assumption that noise having a
critical bandwidth just masks the tone in its
geometrical center at the signal-to-noise ratio
of 4 dB.
All the narrow-band noise measurements
should be made with a spectrum analyzer. Both
the bandwidth and level of each noise must be
verified as meeting the audiometer specifications.
Narrow-band noises with center frequencies up to
3.15 kHz need to be measured in an acoustic
coupler or ear simulator that is appropriate for the
earphone used. Measurements for bands with
center frequencies above 3.15 kHz may not accu-
rately be described due to inherent problems with
the frequency response of transducers and acoustic
couplers. Therefore, output levels in the higher-
frequency range should be determined electrically
by measuring voltages across the terminals of the
transducer. A given voltage should correspond to
the voltage that appears across the same terminals
when the transducer produces an SPL equal to
the RETSPL at the test frequency (ANSI S3.6
2010).

BACKGROUND NOISE
REQUIREMENTS
The results of audiometric hearing tests, espe-
cially those conducted at a low-intensity level,
may be affected by the presence of background
(ambient) noise in the test environment. If the
noise level is sufficiently high, it may mask the
presence of a low-level signal and require
greater signal intensity for the signal to be heard
by a subject. As a result, the subject may be
diagnosed with an elevated hearing threshold—
an elevation that is due to the presence of noise
rather than the patient’s otologic condition. To
preclude the presence of noise masking and
noise-confounded audiometric test results,
background noise limits need to be observed
in audiometric test booths.
The maximum permissible ambient noise
levels (MPANLs) in the audiometric booths
have been specified in the ANSI S3.1 (1999)
standard. The MPANLs have been determined
as maximum noise levels in the individual
frequency bands that will produce negligible
masking (2 dB) of pure tones presented at
RETSPLs (0-dB HL) as specified in ANSI
S3.6 (2010). The standard specifies octave-
band and one-third-octave-band (recom-
mended) MPANLs for sound-field and bone-
conduction testing (ears not covered) as well as
earphone testing (ears covered). In case of
earphone testing the standard lists separate
MPANLs for supra-aural (e.g., TDH-39)
and insert (e.g., ER-3A) audiometric earphones
because they differ in their ability to attenuate
external noise. In all cases, the levels are pro-
vided separately for three frequency ranges of
hearing testing: 125 to 8000 Hz, 250 to
8000 Hz, and 500 to 8000 Hz.
The MPANLs should be measured in each
new audiometric booth and then annually and
each time there is a reason to believe that the
acoustic environments (either inside or outside
of the audiometric booth or both) have
changed. The measurement should represent
the worst-case scenario for noise present inside
the audiometric booth during the actual audio-
metric test. The noise levels should be measured
with a sound level meter type I (ANSI S1.4
1983) equipped with a set of bandpass filters
meeting ANSI S1.11 (2004) criteria. The mea-
suring equipment including the microphone
AUDIOMETRIC CALIBRATION/CHAMPLIN, LETOWSKI 327
should have internal noise levels at least 3 dB
below the SPL specified by MPANL for a given
measuring context (e.g., ear coverage, test fre-
quency, and filter bandwidth). When making
measurements, the microphone should be ori-
ented perpendicular to the floor and positioned
in the approximate location of the test subject’s
head. If the person taking the measurements is
located inside the audiometric booth, care must
be taken not to block the path of sound reaching
the microphone.
DISCUSSION OF CURRENT
CALIBRATION PRACTICES
Current calibration procedures of audiometers
with regard to air-conducted tones delivered by
the earphones are well established, and there are
no reports from the testing facilities indicating
major shortcomings of the existing procedures.
This is not the case with sound-field calibration
where the sound-field conditions are not suffi-
ciently well described in the existing standards.
There is considerable variability in the size and
configuration of audiometric test rooms where
hearing measurements are undertaken (e.g.,
Rochlin16). This lack of uniformity of the
physical environment makes the delivery of
consistent SPLs at a given test location chal-
lenging. A specific U.S. standard is needed that
would facilitate greater measurement consis-
tency for sound-field audiometry.
The two elements of the earphone audio-
metric setup that need to be given more atten-
tion are the headphone headband and supra-
aural and circumaural cushions. The force
pressing the headphones against the ears is
specified in the standards, but this force is
usually not assessed during audiometric calibra-
tion. Because headband tension weakens with
the use and age of the headband, the actual force
that it produces should be periodically assessed.
Similarly, all cushion materials deteriorate with
age and the symmetry and quality of cushions
need to be periodically evaluated.
It may be that future calibration of audio-
meters will be quite different from the current
procedures. Calibration methods based on head
simulators rather than ear simulators will be-
come less costly and more common (ANSI
S3.55 Part 1 2014). Additionally, the
328 SEMINARS IN HEARING/VOLUME 35, NUMBER 4 2014
availability of inexpensive, miniature trans-
ducers and small yet high-quality microphones
will, in the future, allow measuring SPL in the
listener’s ear canal during audiometric testing.
A test signal can be set at the time of testing,
response from the ear registered, and proper
calculations of the actual SPL delivered to the
ear made. This in situ or real-ear approach may
eliminate the need for or alter the role of
acoustic couplers in audiometric calibration.
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