Plural Publishing produces leading academic, scientific and clinical publications in the fields of speech-language pathology, audiology, and otolaryngology.


Science to Practice

Second Edition
Steven Kramer
426 pages, Illustrated (B/W), Softcover, 8.5 x 11"
Release Date:



Audiology: Science to Practice, Second Edition is comprehensive and challenging textbook for undergraduate courses in audiology and hearing science, and for graduate students beginning an AuD program who may not have a previous background in the subject. It is designed to cover the content of both two-course sequences (Hearing Science and Principles of Audiology) as well as combined courses - providing a level of consistency in presentation. Chapters cover hearing science, diagnostic procedures, an introduction to hearing aids, and extensive coverage of anatomy and physiology of the auditory and vestibular systems. The author has taught an "Introduction to Audiology" course for more than 20 years, and has truly designed this text with the student in mind.

The second edition has been updated and reorganized, and also includes two brand new chapters, one on clinical-pure tone masking and another on hearing screening. Additional details and figures have been added on vestibular anatomy and physiology, acoustic resonance, speech acoustics, middle ear wide-band power (MEWP) measures of the middle ear, and masking for speech testing. In addition, James Jerger has revised his contributed chapter on the historical pathways in audiology, including the addition of an educational audiology path, thanks to the contribution of Cheryl DeConde Johnson. Gus Mueller and Earl Johnson have also revised their chapter on hearing aids to reflect the many updates that have taken place with amplification options over the past five years.

Read Doug Beck's interview with the author about the new edition here.
Interview republished with permission from the American Academy of Audiology. Copyright 2013


  • Easy to read format and style
  • Difficult concepts are well supported by figures and tables
  • Chapters begin with a list of key learning objectives
  • Chapters are punctuated with synopses which included bulleted highlights for review
  • Includes a comprehensive Glossary of key words that are italicized within each chapter
  • Audiograms and calibration values are based on the newest standards set by the American National Standards Institute

Audiology Workbook
To facilitate learning, the principles and procedures described in this textbook are further enhanced through the use of the Audiology Workbook , in which there are extensive sets of related questions and activities.


  • Andrew J. Vermiglio, Au.D., CCC-A, FAAA Assistant Professor California State University Northridge, Review of the First Edition (2012):
    "Overall I think this is a great text book and I have heard many favorable comments from the students regarding this text. I'd like to see Dr. Kramer write text books for hearing science, aural rehab and pediatric audiology."

  • Jackson Roush, University of North Carolina- Chapel Hill (2013):
    "I was already using the [first edition] and I like the changes made for the second edition."

  • Suad Hashim, Senior Audiologist; South Warwickshire NHS Trust, UK, ENT & Audiology News (Vol 25, No 5) (November/December 2016):
    "This textbook is an exceptional read and is likely to facilitate improved clinical practices. . . . "Audiology: Science to Practice, Second Edition, reflects advances in audiology well and I would recommend this book to those with interest in the world of audiology, existing practitioners and those keen to extend their knowledge in this field. The easy-to-read format and style, use of figures and tables, learning objectives and companion workbook ensure that even the most challenging topics are easy to grasp."



1 Anatomy of the Auditory and Vestibular Systems
General Orientation to the Parts of the Auditory and Vestibular Systems
Outer Ear
Middle Ear
Synopsis 1–1
Inner Ear
Synopsis 1–2
Auditory and Vestibular Neural Pathways
Synopsis 1–3

2 Properties of Sound
Simple Vibrations and Sound Transmission
Synopsis 2–1
Intensity and Pressure
Synopsis 2–2
Audibility by Frequency
Complex Sounds
Acoustics of Speech
Synopsis 2–3
Temporal Integration

3 Functions of the Auditory and Vestibular Systems
Air-to-Fluid Impedance Mismatch
Functions of the Outer Ear
Functions of the Middle Ear
Middle Ear Amplifier
Acoustic Reflex
Equalizing Middle Ear Pressure
Synopsis 3–1
Functions of the Inner Ear
Traveling Waves in the Cochlea
Transduction through the Inner Hair Cells
Auditory Nerve Fibers
Synopsis 3–2
Tuning Curves
Role of the Outer Hair Cells
Frequency Coding
Intensity Coding
Synopsis 3–3
Vestibular System Function
Semicircular Canals
Utricle and Saccule
Vestibulo-Ocular Reflex
Other Central Vestibular Connections
Synopsis 3–4


4 Pure-tone Audiometry
The Audiometer
Types of Audiometers
Basic Components of Pure-Tone Audiometers
Insert Earphone
Supra-aural Earphones
Ultra-High-Frequency Earphone
Sound-Field Speakers
Bone Conduction Vibrator
Air Conduction Versus Bone Conduction Testing
The Test Environment
Synopsis 4–1
Procedures for Obtaining Pure-Tone Thresholds
Examples of How to Establish Thresholds
Variables Influencing Thresholds
Techniques for Testing Infants and Toddlers
Conditioned-Play Audiometry (Ages 2 to 4 Years)
Visual Reinforcement Audiometry (Ages 6 Months to 2 Years)
Synopsis 4–2

5 Audiogram Interpretation
Decibels of Hearing Level (dB HL)
Documentation of Thresholds
Recognizing the Need for Masking
Synopsis 5–1
Describing Audiograms
Degrees of Hearing Loss
Types of Hearing Loss
Shapes of Hearing Loss
Sample Audiograms with Descriptions
Additional Factors to Consider
No Response at Audiometer Limits
Tactile Responses
Collapsed Canals
Pure-Tone Average
Decibels of Sensation Level
Synopsis 5–2

6 Clinical Masking For Pure-tone Audiometry
When Is Masking Needed?
Interaural Attenuation and Cross-hearing
Synopsis 6–1
Rules for When to Mask
When to Mask for Bone Conduction
When to Mask for Air Conduction
Examples Applying the Rules for Masking
How to Mask for Air Conduction Thresholds
How to Mask for Bone Conduction Thresholds
Step-by-Step Procedures for Masking with the Plateau Method
Synopsis 6–2
Masking Examples
Example 1: Air Conduction Masking Resulting in a Worse Masked
Threshold Than the Unmasked Threshold (from the NTE)
Example 2: Bone Conduction Masking Resulting in a Sensorineural Loss
Example 3: Bone Conduction Masking Resulting in a Conductive Loss
Example 4: Masking Dilemma

7 Speech Audiometry
Speech Testing Equipment and Calibration
Speech Threshold Measures
Speech Recognition Threshold
Speech Detection Threshold
Synopsis 7–1
Suprathreshold Speech Recognition
Count-the-Dots Audiogram
Most Comfortable and Uncomfortable Loudness Levels
Suprathreshold Speech Recognition Procedures
Selection of the Presentation Level for WRS Testing
Performance-Intensity Function for WRS
Procedure for Obtaining WRS
Synopsis 7–2
Interpretation of WRS Measures
Critical Differences in WRS Based on Binomial Distribution
Differential Diagnosis of Cochlear Versus 8th Nerve
Speech-in-Noise Tests
Variations with Young Children or Difficult-to-Test Populations
Speech Recognition Thresholds (SRT)
Suprathreshold Speech Recognition Scores
Masking for Speech Testing
Masking for SRT
Masking for WRS Tests
Synopsis 7–3

8 Physiological Measures
Ear Canal Equivalent Volume
Tympanometric Width
Sensitivity and Specificity of Tympanometric Measures
Types of Tympanograms
Synopsis 8–1
Multicomponent and Multifrequency Tympanometry
Wideband Middle Ear Power ( WMEP) Measures
Acoustic Reflex Thresholds
Recording Principles
Clinical Interpretations of Acoustic Reflex Thresholds
Clinical Examples of ART Interpretations
Acoustic Reflex Decay
Synopsis 8–2
Otoacoustic Emissions (OAEs)
Transient Evoked Otoacoustic Emissions (TEOAEs)
Distortion Product Otoacoustic Emissions (DPOAEs)
Auditory Brainstem Response
ABR and Auditory Sensitivity
ABR and 8th Nerve Pathologies
Auditory Steady-State Response (ASSR)
Synopsis 8–3

9 Selected Disorders of the Auditory System
Describing Auditory Disorders
Outer Ear Disorders
Disorders of the Auricle
Disorders of the External Ear Canal
Synopsis 9–1
Middle Ear Disorders
Otitis Media
Tympanic Membrane Perforation
Ossicular Disarticulation
Glomus Tumors
Synopsis 9–2
Cochlear Disorders
Noise-Induced Hearing Loss
Hearing Loss Due to Aging
Ménière Disease
Temporal Bone Fractures
Sudden Sensorineural Hearing Loss
Neural Disorders
Acoustic Neuroma
Auditory Dyssynchrony (Neuropathy)
Central Auditory Disorders
Nonorganic (Functional) Hearing Loss
Subjective Tinnitus
Objective Tinnitus
Synopsis 9–3

10 Screening for Hearing Loss
Historical and Current Practice Guidelines
Synopsis 10–1
Screening the Hearing of Newborns
Screening High-Risk Infants
Universal Screening
Screening the Hearing of School-Age Children
Screening the Hearing of Adults
Screening Outcomes and Efficacy
Synopsis 10–2

11 Hearing Aids
by H. Gustav Mueller and Earl E. Johnson
Historical Perspective
Recent Hearing Aid Market Trends
Basic Hearing Aid Components and Technology
Other Hearing Aid Features and Signal Processing
Multiple Memory Programs
Multiple Channels
Automatic Gain Control for Output (AGCo)
Automatic Gain Control for Input (AGCi)
Signal Classification System
Automatic Digital Noise Reduction
Adaptive Feedback Reduction
Directional Microphone Technology
Binaural Beamformers (Bilateral Directional Microphone Technology)
Frequency Lowering
Data Logging
Linked Hearing Aids
Trainable Hearing Aids
Wireless Connectivity
Basic Hearing Aid Styles
Synopsis 11–1
Body Hearing Aid
Behind-the-Ear Hearing Aid (BTE)
Custom In-the-Ear Hearing Aid
In-the-Ear (ITE) Hearing Aid
In-the-Canal (ITC) Hearing Aid
Completely-in-the-Canal (CIC) Hearing Aid
Specialized Hearing Aids and Cochlear Implants
Bone-Anchored Hearing Aid (BAHA)
Middle Ear Implant (MEI)
Cochlear Implant (CI)
Synopsis 11–2
Hearing Aid Candidacy
Fitting Strategies
Bilateral Hearing Aid Fittings
CROS Hearing Aid Fittings
Electroacoustic Analysis
Hearing Aid Programming
Prescriptive Fitting Methods
Hearing Aid Verification
Hearing Aid Orientation
Validation of Hearing Aid Benefit
Dispenser Practice Characteristics
Who Can Dispense Hearing Aids?
Where Do Dispensers Work and How Much Do They Earn?
How Many and What Kind of Hearing Aids Are Sold?
Synopsis 11–3
Supplemental Topic: Electroacoustic and Real-Ear Verification
Electroacoustic Characteristics of Hearing Aids
Clinical Verification Procedures for Hearing Aid Fittings
Probe Microphone (Real-Ear) Measurements
Ratings of Loudness
Clinical Speech Measures


12 Audiology as a Career
Education and Professional Requirements
Development of the Profession
What Do Audiologists Do?
Membership Demographics and Work Settings
Synopsis 12–1

13 A Brief History of Audiology in the United States
by James Jerger and Cheryl DeConde Johnson
Historical Overview
The Diagnostic Path
The Rehabilitative Path
Hearing Aids
Auditory Training
Cochlear Implants
The Pediatric/Screening Path
The Auditory Processing Disorder Path
The Hearing Conservation Path
Tinnitus Evaluation and Therapy Path
Educational Audiology Path
Concluding Remarks
Suggested Readings


About The Author

Steven Kramer

Steven Kramer, PhD, is Professor in the School of Speech, Language, and Hearing Sciences at San Diego State University, where he has been a faculty member and administrator since 1985. He served as the department chair from 1990 to 2001 and as the Codirector of the Audiology Doctoral (AuD) Program, offered jointly by San Diego State University (SDSU) and the University California San Diego (UCSD), from 2003 to 2016. He obtained his master's and doctoral degrees in audiology and hearing science from the University of Florida. He was a licensed and certified audiologist for about 40 years. Before his appointment at SDSU, he was a clinical faculty member at the University of Texas Medical Branch in Galveston, Texas. He has taught a wide array of courses at the graduate and undergraduate levels, including hearing science, diagnostics, medical audiology, evoked potentials, and psychoacoustics.

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