ACT quick guide blog

The Audible Contrast Test (ACT) Quick Guide


This quick guide offers key information you need on the new Audible Contrast Threshold Test (ACT™) developed by Interacoustics. Learn what ACT™ is, tips on performing the test, how the ACT™ value is implemented in hearing aid fittings, and how to add ACT™ to your existing audiology equipment.

The Audible Contrast Threshold Test (ACT™) is a language-independent test designed to quantify a person's ability to hear in noise. ACT™ uses existing pure tone audiometry equipment, its results offer clear hearing aid fitting guidance, and takes on average 2 to 3 minutes to perform.

To perform ACT™, an audiogram containing air conduction thresholds at 250 Hz, 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz is mandatory. If inter-octave frequencies are tested, they will be considered in the ACT™ test.

The starting presentation level is based on the patient's audiogram. ACT™ presents stimuli at supra-threshold levels, ensuring all sounds are within the patient's audible range for accurate results.

Using the Interacoustics Affinity Suite as an example, to start ACT™, navigate to Menu --> Tests and select ACT™. Once ACT™ is selected, the software will display instructions and offer the ability to play the noise, the siren, and the siren plus noise sound to your patient.
Interacoustics suggests it may be helpful to counsel the client on the meaning of the test before beginning. Here is their recommended script:

Begin presenting sounds, bracketing according to the traditional modified Hughson Westlake procedure. The test stops automatically after three out of five responses in the ascending trial, providing the ACT™ value.

ACT Flow Chart

Once the ACT™ test is completed, the ACT™ value is expressed as a normalized Contrast Level (nCL) value, ranging from –4 nCL to 16 dB nCL.

A higher ACT™ value suggests poorer aided performance prediction in noise, akin to QuickSIN or dB values in an audiogram where a lower number is preferable.

ACT Chart


Utilizing the ACT™ value, you can tailor advanced features on hearing aids for optimal patient performance. The ACT™ value offers objective guidance during fitting, potentially enhancing outcomes and performance in noisy environments, reducing follow-up visits.

For example, adjustments can be made for two individuals with the same hearing loss but different ACT™ values. A low ACT™ value may mean less reliance on advanced features, allowing natural sound processing, while a high value indicates a greater need for features like directionality in noisy settings.

ACT™ values can be applied within the hearing aid fitting software two ways: automatically or manually.

Automatic hearing aid adjustment is available for Oticon, Phillips, Bernafon and Sonic hearing aid brands.
Manual adjustments are possible if the fitting software lacks a direct input option for the ACT™ value.

The ACT™ value serves as a quantitative measure to address your patients' noise-related challenges, aiding in recommending appropriate hearing aid technology levels and prescribing assistive listening devices. This integration of targeted approaches empowers patients with essential information and tools to efficiently manage and optimize their hearing across different scenarios.

The compatible devices listed below can be upgraded via a remote upload of the software.

ACT™ currently is available for:
• Interacoustics Affinity Compact
• Grason-Stadler AudioStar Pro Version 2
• MedRx AVANT ARC, AVANT A2D+, AWRC, and AVANT (Stealth)

• New devices are shipping with ACT™ included.
• Your Affinity Suite software version must be at least 2.21.

ACT pricing tiers

• New devices are shipping with ACT™ included.
• Must be on firmware 2.1 or higher.
• Contact your local e3 Diagnostics Sales Manager for further information.

• New devices are shipping with ACT™ included.
• ACT™ is only compatible with Studio software.
• Upgrade cost is $500 for compatible devices plus Studio software upgrade (if needed).

Interested in ACT™? Contact your local e3 Diagnostics sales representative today or visit our ACT™ product pages below to submit a request.

Contact Local Office

Audible Contrast Threshold (ACT™) for Affinity Compact
Audible Contrast Threshold (ACT™) for GSI AudioStar Pro V2

Other Helpful ACT™ Resources
Audible Contrast Threshold (ACT™) Test: A Complete Guide | Interacoustics
Grason-Stadler AudioStar Pro ACT™ Quick Guide

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