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The people with hearing loss commonly have the greatest difficulty understanding speech in the presence of background noise, it makes sense that speech discrimination tests are also performed with the addition of a noise stimulus. This is often a 'speech babble' played at different volumes relative the loudness of the speech. The client responds by guessing the word or phrase that was spoken in the presence of background noise. The hearing test is performed in many clinics, such as The Art of Hearing which is a hearing aid provider and audiologist.

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