THE DISSERTATION IS IN AFRIKAANS:
The multi-linguistic and multi-cultural population of South Africa poses some unique challenges for valid and reliable service delivery by South African audiologists and acousticians, specifically when conducting valid and reliable speech audiometry evaluations. This is examined in the South African context, and set the base for the main aim of this study, namely the comparison of the ideal criteria for speech audiometry with the South African clinical practice of speech audiometry. Many variables can be identified in the course of the test stimuli and subsequent response when conducting speech audiometry. These variables can be divided into two categories, namely stimulus related variables (test content and test procedure) and test subject related variables. The variables are examined in light of the multi-linguistic and multi-cultural South African context, because of the challenges posed by this context to the South African audiologist. The study is conducted in three different phases, according to three sub aims. A thorough review of the subject literature was done to identify ideal criteria for speech audiometry. A questionnaire was sent to South African audiologists and acousticians, to examine the present clinical practice of speech audiometry in South Africa, and compare it to the criteria suggested in the literature in order to investigate the attainability of criteria and to identify problem areas.
The results show low comparison regarding test content between the ideal criteria and South African clinical practice, especially because South African audiologists do not use a test battery consisting of different types of test material. Low comparison can be seen regarding the selection of test items, length of lists and degree of difficulty. Low comparison can also be seen with test procedure, mainly because audiologists rarely use pre-recorded test materials. High levels of comparison are found regarding presentation levels and test environment. With test subject variables, a discrepancy is also found between the ideal criteria and South African clinical practice, mainly because tests are not always conducted in the test subjects’ first language. By using the identified deficiencies in the clinical practice of speech audiometry in South Africa as a starting point, one can use further research to reach the ideal, namely the ideal criteria of conducting speech audiometry. The conclusions of this study can be used as suggestions for solutions for the unique problems that the practicing audiologist in South Africa has to deal with. The complexity of these problems will need further attention from researchers in this and other fields of study.