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Ryan Holden, H.A.D.
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Jan 14, 2026
Have you ever had a hearing test that said everything looked “fine,” yet you still struggle to follow conversations in restaurants or family gatherings?
You’re not imagining it — traditional hearing tests don’t always tell the whole story.
That’s because those tests are performed in total silence. No background chatter, no dishes clinking, no grandkids talking over each other. Real life doesn’t work that way.
That’s why I include a speech-in-noise test, called the QuickSIN, with every hearing evaluation I perform. It’s a simple five-minute test that helps me see how well you understand speech when the world around you isn’t quiet — because that’s when most people actually need help.
Why “I Hear Fine, I Just Can’t Understand People” Is So Common
When new patients come in, the number one complaint I hear is:
“I can hear people talking… I just can’t understand them when there’s background noise.”
Nearly everyone says it. And yet, most clinics don’t measure how you perform in noise — even though that’s where most people notice their hearing problems.
A standard hearing test (the audiogram) only measures the softest sounds you can detect in quiet. But it doesn’t measure how your brain separates speech from background noise. That’s a very different skill — and it’s often where the biggest hearing challenges hide.
What the QuickSIN Measures — and Why It Matters
QuickSIN stands for Quick Speech-in-Noise. It’s designed to show exactly how much background noise affects your ability to understand words.
Here’s how it works:
You listen to short sentences with background chatter playing behind them.
After each one, you repeat what you heard.
With every sentence, the background noise gets a little louder.
By the end, even people with normal hearing start to struggle — which is perfectly normal. The goal is to see how much louder speech needs to be compared to the background noise for you to understand it. That’s called your Signal-to-Noise Ratio (SNR) loss.
In simple terms, it tells us how much harder your brain is working to keep up in noise.
If a person with normal hearing can understand speech with only a small difference between voice and background (say, 2 decibels), and you need 8 decibels more, that means you need voices to be roughly one and a half times louder than normal to keep up.
That’s a big deal — and it explains a lot about why so many people say, “I hear you, but I can’t understand you.”
The Patient Story That Says It All
One of my patients, Linda (not her real name), had been wearing hearing aids for nearly two years. Her audiogram looked mild, her hearing aids were working fine, but she was still miserable in restaurants.
Her previous provider told her, “Your hearing looks good — it’s just the environment.”
When I ran a QuickSIN test, her score showed she needed 12 decibels more clarity than average to understand speech in noise. That meant her problem wasn’t the restaurant — it was that her hearing aids weren’t optimized for the level of difficulty she was facing.
With that information, I fine-tuned her settings, added a small remote microphone, and taught her a few strategies for noisy settings. A week later she called to say, “Dinner with my family was the first time in years I could actually follow the conversation.”
That one five-minute test completely changed her experience.
Why Most Clinics Don’t Do It
So why doesn’t everyone test this way?
Two reasons: time and billing. Speech-in-noise testing takes extra effort and isn’t required by insurance. Many providers skip it and rely on the basic hearing test instead.
But if you think about it, that’s like testing someone’s eyesight by asking them to read in perfect lighting, and then wondering why they can’t see well at night.
If the main complaint patients have is “I can’t hear in noise,” then it only makes sense to measure that directly.
How the Results Guide Your Treatment
Your QuickSIN score tells me much more than whether you “need hearing aids.” It helps me:
Pick the right technology — not all hearing aids perform the same in noise.
Adjust programming to match your real-world listening needs.
Recommend accessories like a remote mic that can dramatically improve speech clarity in tough environments.
Set realistic expectations and show measurable improvement after fitting.
It takes the guesswork out of the process and replaces it with real data about how you function in daily life.
Why I Test Every Patient
I believe speech-in-noise testing is the single biggest indicator of how well you’ll perform with hearing aids. That’s why I make it a standard part of every hearing evaluation — no exceptions.
You deserve to know more than just your hearing thresholds. You deserve to understand how your hearing performs in the situations that matter most — restaurants, family gatherings, meetings, and conversations with friends.
The Bottom Line
If you’ve been told your hearing is “fine” but you still struggle to keep up in noise, you might be missing the most important part of the evaluation. The QuickSIN test takes just a few minutes but can make a world of difference in understanding your hearing and choosing the right solution.
Find out how well you really hear in the real world.
Schedule your hearing test today — and make sure it includes speech-in-noise testing.
