For decades, familiar sounds audiograms (FSAs) have been used to help families understand what their child with hearing loss can—and cannot—hear. Yet despite their popularity, these audiograms have varied widely in form and accuracy, leading to confusion among parents and professionals alike. In 2023, a landmark study on common sounds audiograms offered analysis and recommendations on the many FSAs, concluding that the inconsistencies highlight the need for a standardized, research-based tool that provides accurate and consistent information for both professionals and families.
Aligned with the Oberkotter Foundation’s strategic plan to strengthen family and professional knowledge and accelerate the translation of hearing science into everyday practice, Hearing First released a new Familiar Sounds Audiogram in early 2025. This updated tool—developed in collaboration with study leaders Dr. Lisa Davidson and Dr. Rosalie Uchanski—is grounded in rigorous research and designed to bridge the understanding gap between audiological results and everyday sound access. It brings much-needed standardization to the field, ensuring that no matter where families receive care, they are introduced to the same evidence-based, common-language resource.
By helping parents better understand their child’s hearing, the new FSA empowers them to make more informed decisions about their child’s care—decisions that can have a lasting impact on developmental outcomes. More than a tool, it’s a critical support for families and a catalyst for stronger partnerships between audiologists and parents.
Now, Oberkotter Foundation’s CEO, Dr. Teresa Caraway, and Senior Vice President of Innovation, Dr. Jace Wolfe expand on why this resource represents a game-changing step forward for pediatric audiology and family-centered hearing care.
Why was there a need to create an updated Familiar Sounds Audiogram?
Dr. Wolfe: The new Familiar Sounds Audiogram directly addresses the inconsistencies found in 36 existing versions across the field. In their research, Dr. Uchanski and Dr. Davidson revealed that these earlier audiograms differed significantly in the types of sounds included, the range of speech represented, and the positioning of specific speech sounds, which can lead to misunderstandings for parents that could affect critical decisions about hearing technology and intervention.
The new audiogram and accompanying eBook It is built on the most up-to-date knowledge of speech acoustics, providing a science-backed, standardized format that professionals can use with confidence. It clearly delineates not just the audibility of speech sounds, but also highlights the regions of speech that contribute most to clarity and prosody, helping families visualize how their child’s hearing loss may affect the understanding speech.
Why did the Oberkotter Foundation and its initiative Hearing First take on the endeavor to create a new familiar sounds audiogram?
Dr. Caraway: The Foundation is resolute in making evidence-based information accessible for all families, and these tools do just that. While Hearing First had published a Familiar Sounds Audiogram and eBook in 2021, with the new research available, it became clear that an update was necessary. The opportunity to collaborate with the lead researchers from the 2023 study meant that we could ensure families can access accurate information grounded in research as they make decisions for their child’s hearing loss.
What makes this version different from other ones?
Dr. Wolfe: In 2021, Hearing First released a Familiar Sounds Audiogram and accompanying eBook that were developed in collaboration with Dr. Carol Flexer based on the latest research available at that time. Downloaded over 19,000 times, the eBook proved to address a need in the industry by offering family-friendly, research-based explanations to the audiogram and what it can tell families about their child’s hearing.
Once Dr. Davidson and Dr. Uchanski released their new study, it became apparent that the audiogram and eBook needed an update to align with the latest research. The new FSA is backed by current research in speech acoustics. We intentionally included a clearly defined “speech region” with markers that denote the portion of the speech region that makes the largest contribution to the clarity of speech and the portion to contributes more to prosody region, so families can visualize not just what their child can detect, but how much clarity and meaning they’re receiving from speech. The audiogram shows the Ling 6 Sounds – "m,” “oo,” “ah,” “ee,” “sh,” and “s” – because those represent the range of frequencies and intensities that matter most for spoken language development. The audiogram excludes environmental sounds like vehicles or music due to their broad, variable acoustics, which lack consistent data. In contrast, the included speech sounds are based on well-defined research specifying the acoustics of an adult female voice at one meter. This resource is meant to start a meaningful conversation with families, not to overwhelm.
How does this tool support professionals working with families?
Dr. Wolfe: It brings consistency to the field. Audiologists, educators, and early interventionists can all rely on the same, science-based visual to guide their discussions. It’s especially helpful when introducing new families to the concept of audiograms, which can be incredibly technical and intimidating at first. The accompanying eBook provides more detailed explanations in parent-friendly terms, making it a powerful tool for professionals to have in their practice. The eBook can guide conversations and help frame important decisions about hearing technology so professionals can reinforce why early and consistent device use is critical for Listening and Spoken Language (LSL) development.
What does the new Familiar Sounds Audiogram mean for families on the LSL journey?
Dr. Caraway: It means empowerment. Parents are their child’s first and most important teachers, and this tool helps them understand how to make the most of everyday interactions—talking, reading, singing, and playing—to build spoken language skills. When families understand their child’s hearing test results and how they connect to speech access, they’re better equipped to partner with professionals and advocate for their child. That collaboration is what leads to the best outcomes. The Familiar Sounds Audiogram empowers families with clear, accurate information, which will hopefully position them to support their children to develop age-appropriate LSL and literacy skills.
The Familiar Sounds Audiogram and eBook from Hearing First aims to be a unifying resource for our field as consistency and accuracy are essential for families and professionals alike. These tools should empower families with clear, evidence-based information and strengthen the partnership between professionals and parents as we strive to ensure that every child with hearing loss has the best possible opportunity to develop age-appropriate listening, talking, and literacy skills.
Learn more and access the new audiogram and eBook at HearingFirst.org/Audiogram.