Malingering/Nonorganic hearing loss (also called pseudohypacusis)Ocassionally patients wilfully or subconsciously exaggerate their hearing loss. This is functional hearing loss or pseudohypacusis or malingering– The signs in the test behavior that suggest functional component include: a. Inconsistent responses b. Significant differences between the threshold obtained using ascending and descending administration of test stimuli c. A discrepancy of > 8 dB between the SRT (speech reception threshold) and the pure tone average of 500–2000 Hz d. Positive Stenger test Stenger TestIt is used to identify unilateral or asymmetrical functional hearing loss. It is based on the concept that when both ears are stimulated simultaneously by a tone equal in frequency and phase, the auditory percept is lateralized to the ear with better hearing. If speech stimulus is used in Strenger test it is k/a Speech Stenger test or modified Stenger test. Other objective tests which can diagnose functional involvement are:––acoustic reflexes: Pt saying hearing loss but normal acoustic reflex indicates NOHL ––auditory brainstem response ––otoacoustic emission Also Know Other tuning fork tests which can be used to detect malingering but are now outdated are:Teel’s test Lombard’s test Chamini-Moos test Gault test