During a manual hearing test, what is the recommended starting level for presenting stimuli?

In a manual hearing test, it is recommended to start presenting stimuli at a level of 30 dB HL (hearing level) for a few important reasons. First, 30 dB is typically above the threshold of normal hearing for most people, meaning that most individuals with no hearing impairment would be able to hear and respond to the stimuli effectively. This starting point allows the tester to gather reliable initial responses and ensure the stimuli are audible without being excessively loud.

Starting at a lower level such as 20 dB could lead to missed responses from individuals with mild hearing loss, as some may not respond until stimuli are presented at a higher level. Conversely, starting at a level too high, like 40 dB or above, may create discomfort for those with normal hearing and does not provide an accurate assessment of hearing ability, particularly for those with slight to moderate hearing impairments.

This approach ensures a balance between eliciting responses from individuals across various hearing capabilities while minimizing discomfort and the risk of missing responses from those with slight hearing loss. It's important in audiometric testing to have a standardized method for starting levels to maintain consistency and reliability in the results.