Why don't audiologists give me a speech test in the soundroom to compare how I do with and without hearing aids and even between different sets of hearing aids.

At our clinic, we use Quick Speech in Noise testing with and without hearing aids to simulate a real-world situation most individuals with hearing loss struggle with. This can help to verify whether or not the hearing aids will benefit you in the real world.

This is a question that many patients ask.  Speech testing in a soundproof room does not give enough information as to how we hear.  If the audiologist uses best practices, real ear measurements or speech mapping will be used.  These measurements are the standard tools used to assess and assure that soft voices are heard, that average speech is comfortable and that loud speech and loud sounds are not uncomfortable.  Based on the hearing test and ear anatomy we all have specific needs. These measurements are the best way to address individual differences.

What you are referring to is called sound field testing.  While it is useful for comparing different sets of aids to no hearing aids the results are of limited value because you are in an "ideal" listening environment which rarely exists in our normal day to day life.  We often do live speech testing in the presence of background noise which replicates real life scenarios much more closely.  To me this measurement is much more useful to gauge the benefit you are receiving from any particular pair of hearing aids.  One big issue is that it takes the brain several months to really adapt to hearing with hearing aids so the results of live speech test with a new pair of aids may be lower than the actual benefit you will receive as the brain adapts to the new hearing aids over time.  As was mentioned in another answer, I find your feedback over time to be more valuable in insuring you are getting the best possible results. 

It is definitely an option to do the speech testing with the hearing aids in, and I have done that with more difficult cases, but the reality is that simulated situations can only take us so far.  To get really accurate results I find taking a patient's real world experiences and feedback is a much better measurement of how you are doing, and what needs to be changed.

Great question!! If your audiologist or hearing aid dealer is using best practices, they should be taking measurements of how the aids work in your ear via. probe microphone/real ear measures/speech mapping. This allows us to evaluate the output of each hearing aid, individually, in your own ear and determine if it is providing optimal amplification for speech reception based on prescriptive targets. Sound field speech testing can be beneficial in select cases when comparing aided vs. unaided conditions, however, it is less effective at diagnosing ear specific variance. Speech mapping allowed me to realize one of my patients needed a longer receiver size on one ear vs. the other just last week to acheive optimal insertion depth to capture propper amplification of select frequencies in that individual ear due to the unique curvature and ear canal volume. These things cannot be ascertained with out taking real ear measures which should be part of the fitting process with any qualified audiologist. 

I hope that is helpful!

It is very reasonable to ask for this to be done.  We often spend more time comparing toasters or dishwashers than the sound quality that can be achieved with different hearing aids.  When a patient in our practice is not sure about which hearing aid or which settings to choose, our staff will certainly take the time to do these kind of practical steps.  Another respondent mentioned that the office/sound booth is not "real world."  That is true, but you can at least get a ball park idea of which sound quality you prefer even if your speech scores don't change very much between devices.

1. Comparing with and without hearing aids is only useful for a mild or a moderate hearing loss.  With a severe loss the score would be "0" without hearing aids. 
2. Comparing scores between sets of hearing aids is not that useful unless the concern is comparing old aids that are no longer up to par, with new ones. The reason is the speech test is not sensitive enough to show meaningful differences between hearing aids with similar settings. In fact, the research shows there is no specific test that is sensitive enough to predict a successful outcome of hearing loss treatment. That is why multiple measures of outcome are recommended: a questionnaire survey completed by the patient, real ear measurements, and aided performance in quiet and noise all together are the gold standard of a true assessment of treatment outcomes.

I am not an Audiologist but a Hearing Aid Specialist. We do live speech testing on every patient on every visit. It doesn't take long and verifies the outcome of the fitting. It's a great way to see how the old aids compare to the new aids.

Testing the difference or the improvement between hearing aids in noise is informative. A test that most professionals have but don't use is "real ear measurements". A test that is rarely used but very important is for auditory processing. The results from this testing will gauge the patients potential. Wouldn't you like to know how well it is possible for you to do with hearing aids. These tests allow the professional to guide the patient to the level of technology they can get the most benefit from without wasting money on technology that is of little or no benefit to them. When you only use a hammer everyone starts looking like a nail.  Over the counter hearing aids are a shot in the dark. Audiologists need to convince the public of the value they bring to the optimum fitting of hearing aids. Go to the best fully equipped professional you can find. It will pay dividends. 

If you are working with a competent audiologist, they will.  Not only should they be evaluating your speech comprehension with/without hearing aids (and different sets if necessary), but in quiet and  background noise as well. The diagnosis and medical treatment of hearing loss requires testing in a manner where outcomes can be measured objectively; and calibrated sound field testing is one of the most effective ways of accomplishing that.  When used properly, there will be no question that you are properly treating your hearing loss.  In short, if they are NOT approaching your treatment in this way, find another audiologist.