When is masking applied during WR testing?

Masking is applied during word recognition (WR) testing primarily to prevent the non-test ear from hearing the stimulus being presented to the test ear, ensuring that the results reflect the capabilities of the test ear alone. The correct application of masking is contingent upon the concept of interaural attenuation (IA), which is the difference in sound intensity that the ears can tolerate before one ear hears the sound being presented to the other.

When the difference in hearing thresholds between the two ears exceeds the level of IA for the transducer being used, there is a risk that sound presented to the test ear may be perceived by the non-test ear, compromising the reliability of the results. Therefore, masking must be employed to occlude the non-test ear and ensure that the test is accurately assessing the hearing capability of the target ear. This is crucial for obtaining valid and interpretable WR scores, particularly in cases of significant asymmetry in hearing loss between the ears.

The other scenarios do not provide valid reasons for masking. The patient's request for masking does not create a clinical basis for its use, as masking decisions are driven by auditory test parameters, not patient preference. Similarly, testing in a quiet room or during pure tone threshold measurements does not automatically necessitate masking unless the