Audiologists were significantly less confident testing speech discrimination in non-English non-Spanish speakers than Spanish speakers (3.65 vs 2.35)

Description #

In the national survey (n = 87), audiologists rated their confidence in the methods used to test speech discrimination abilities and reported significantly lower confidence for non-English, non-Spanish speakers than for Spanish speakers (3.65 vs 2.35 on a 1–5 scale, P < .01) (Table 3). The same pattern held for otologists counseling patients on surgical hearing rehabilitation options (3.8 vs 3.23, P < .01) (Figure 3). Confidence falls as patient language moves further from the languages for which validated test materials and clinician proficiency exist.

"Audiologists reported significantly lower levels of confidence in the methods used to test speech discrimination abilities of of non‐English, non‐Spanish speakers when compared to Spanish speakers (3.65 vs 2.35, P < .01) (Table 3). A similar trend was observed for otologists counseling patients on surgical hearing rehabilitation options (3.8 vs 3.23, P < .01) (Figure 3)." (Govindan, 2025, p. 1236)

Methods Context #

What? #ⓘ

The observable: provider self-rated confidence (Likert 1 = strongly unconfident … 5 = strongly confident) in speech-discrimination testing methods and surgical-rehabilitation counseling, compared across patient language groups.

"Scale: 1 = strongly unconfident … 5 = strongly confident." (Govindan, 2025, p. 1237)

How? #ⓘ

Cross-sectional online (Qualtrics) survey distributed by email to academic otolaryngology programs and the American Cochlear Implant Alliance membership list (August–October 2022), using Likert-scale confidence measures; results analyzed with regression analysis.

"An online survey developed by T.P.H. and an institutional focus group of neurotologists and audiologists using the Qualtrics Survey Tool (Qualtrics), was distributed via email to academic otolaryngology programs and posted on the American Cochlear Implant Alliance Membership Email from August to October 2022." (Govindan, 2025, p. 1233)

Who? #ⓘ

87 US providers (35 audiologists, 36 otologists, 16 general otolaryngologists) practicing in the United States; 72% spoke only English; most in urban academic centers.

"Eighty‐seven providers (35 audiologists, 36 otologists, 16 general otolaryngologists) completed the survey." (Govindan, 2025, p. 1235)

Other Notes #

A provider-reported confidence gap (a perceived measurement/diagnostic-accuracy limitation), not a measured accuracy outcome. The gradient (Spanish > non-English/non-Spanish) tracks availability of validated language-specific test batteries and bilingual clinicians.

Caveats #

• Small non-uniform sample skewed to Spanish-Chinese languages and away from the Midwest limits generalizability (Govindan 2025) The survey and interview samples each represent only a fraction of US providers serving LEP hearing-health patients, the geographic distribution is non-uniform (notably few Midwest respondents), and the LEP populations sampled are skewed toward Spanish and Chinese languages. The authors state these factors collectively limit the generalizability of the results — so the confidence, effort, and assessment-practice findings may not transfer to providers or LEP language groups outside the sampled distribution.