First Advisor

Bright, Kathryn E.

Third Advisor

Stoody, Tina M.

Date Created

5-2017

Abstract

Malingering, or the falsification of hearing loss, is a frequent occurrence in many audiology clinics. This occurs particularly frequently when clinicians participate in the evaluation of individuals involved in medico-legal action such as worker’s compensation cases. The identification of strategies that are commonly used by individuals attempting to feign hearing loss may be beneficial to clinicians when determining the validity of a hearing loss. Additionally, common audiometric indicators such as audiogram configuration, degree of hearing loss, and intratest consistency are crucial elements to better identify falsified hearing loss. The purpose of this study was to identify the strategies that are commonly used by individuals attempting to feign a hearing loss. Other aims of this study were to identify the common audiometric configurations, difference between true and malingered auditory thresholds, relationships between malingered pure-tone and speech responses, and common non-verbal responses that may be observed during a hearing assessment with a malingering patient. Malingered thresholds were compared across two participant groups. The first group of participants consisted of individuals who had prior experience with audiometric testing. The second group had no prior experience with audiometric testing. The aim was to identify how experience contributes to malingering strategies as well as iv intertest and intratest reliability. Two testing methods were used throughout this study. The Hughson-Westlake procedure was compared to malingered thresholds obtained using the Bekesy tracking test. Pulsed and continuous stimuli were used to evaluate changes in malingerer behavior and response patterns based on the type of tone used. Data collected during this study indicated that the most common strategies used by malingering individuals were selection and maintenance of consistent intervals between responses, maintenance of an internal loudness memory, and waiting for a perceptible change or distortion in the stimulus before responding. The experienced group of participants often relied on their prior knowledge of audiometric testing to develop malingering strategies. Flat audiometric configurations were produced most frequently by both groups of participants. In general, the experienced malingerers more consistently produced pure-tone averages and speech reception thresholds that occurred within 10 dB HL of one another. Additionally, experienced malingerers tended to produce more hearing loss than inexperienced malingerers. It is important that clinicians understand the common strategies used by malingerers and the common features of malingered hearing assessments to improve their ability to accurately evaluate hearing sensitivity in individuals who are involved in medico-legal cases.

Keywords

Audiology, Malingering, Hearing assessment

Extent

117 pages

Local Identifiers

ThompsonCapstone2017

Rights Statement

Copyright is held by the author.

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