Hearing Aid Efficiency in a Competing Speech Situation

1970 ◽  
Vol 13 (4) ◽  
pp. 789-811 ◽  
Author(s):  
Tom W. Tillman ◽  
Raymond Carhart ◽  
Wayne O. Olsen
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Test Chamber ◽  
Sound Field ◽  
Field Testing ◽  
Sensation Level ◽  
Conductive Loss ◽  
Monosyllabic Words ◽  
The Difference ◽  
Competing Speech

Discrimination for monosyllabic words heard against competing sentences was measured at the same sensation level during unaided and aided listening using four types of subject: normal hearers, conductive loss cases, nonpresbycusic sensorineurals, and presbycusics. There were 12 subjects per group. Listening against competing sentences was binaural, monaural direct, and monaural indirect at nominal primary-to-secondary ratios of +18 and +6 dB. Unaided measures, including SRT and monosyllabic discrimination, were obtained by sound field testing conditions; aided measures were obtained with the subject in a separate room wearing the hearing aid receiver and earmold while the hearing aids were mounted on an artificial head placed in the sound field test chamber. The aided measures were obtained at two sound field levels (70 dB and 60 dB SPL) and at two gain settings (50 dB and 40 dB). The main findings were (1) that the hearing-impaired required more of an increase in SPL, re performance in the sound field, to achieve spondee threshold via the hearing aid than can be accounted for by the difference in methodology alone, (2) that intelligibility of monosyllabic words in quiet was somewhat poorer during aided listening than during unaided listening even though sensation level was held constant, (3) that subjects with presbycusis and other sensorineural losses were less resistant to masking by competing sentences during unaided listening than were subjects with normal hearing or with conductive loss, and (4) that all groups exhibited reduced intelligibility for a constant sensation level. This last effect was particularly severe for patients with presbycusic and other sensorineural hearing loss. The practical implications of these findings are discussed.

scholarly journals Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures

2020 ◽  
Vol 25 (4) ◽  
pp. 215-223
Author(s):  
James R. Dornhoffer ◽  
Ted A. Meyer ◽  
Judy R. Dubno ◽  
Theodore R. McRackan
Keyword(s):  
Hearing Aids ◽  
Patient Reported Outcomes ◽  
Hearing Aid ◽  
Sound Field ◽  
Patient Reported Outcome ◽  
Middle Ear Implant ◽  
Patient Reported ◽  
The Difference ◽  
Patient Reported Measures ◽  
Hearing Aid Benefit

Purpose: To determine the contributions to hearing aid benefit of patient-reported outcomes and audiologic measures. Methods: Independent review was conducted on audiologic and patient-reported outcomes of hearing aid benefit collected in the course of a middle ear implant FDA clinical trial. Unaided and aided data were extracted from the preoperative profiles of 95 experienced hearing aid users, and the relationships between a patient-reported outcome and audiologic measures were assessed. The following data were extracted: unaided and aided pure-tone or warble-tone thresholds (PTA), word recognition in quiet (NU-6), Speech Perception in Noise (low-/high-context SPIN), and patient-reported benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). Hearing aid benefit was defined as the difference in thresholds or scores between unaided and aided conditions, as measured in the sound field. Correlations were computed among audiologic measures and global APHAB and subscale scores of hearing aid benefit. Results: Significant improvements in all audiologic measures and APHAB scores were observed comparing unaided to aided listening (all p < 0.001). However, correlations between audiologic and patient-reported measures of aided performance or hearing aid benefit were low-to-weak or absent. No significant correlations were found between aided audiologic measures (PTA, NU-6, SPIN) and any aided APHAB scores (all p > 0.0125), and significant relationships for hearing aid benefit were absent with only few exceptions. Hearing aid benefit defined by global APHAB using NU-6 and SPIN scores showed significant but weak positive correlations (r = 0.37, p < 0.001; r = 0.28, p = 0.005, respectively) and ease of communication APHAB subscale scores (r = 0.32, p < 0.001; r = 0.33, p = 0.001, respectively). Conclusion: Hearing aid benefit assessed with audiologic measures were poor predictors of patient-reported benefit. Thus, patient-reported outcomes may provide a unique assessment of patient-perceived benefit from hearing aids, which can be used to direct hearing aid programming, training, or recommendations of alternative hearing services.

Hearing Aid Evaluation

1993 ◽  
Vol 36 (3) ◽  
pp. 621-633 ◽  
Author(s):  
Harvey Dillon
Keyword(s):  
Hearing Aid ◽  
Internal Noise ◽  
Sound Field ◽  
Monosyllabic Word ◽  
Index Method ◽  
Monosyllabic Words ◽  
Importance Function ◽  
The Difference ◽  
Highly Correlated ◽  
Intensity Functions

In this study, hearing aid gain for speech was defined as the difference in level between the aided and unaided performance-intensity functions measured at any specific value of percentage of items correct. The articulation index method was used to predict speech gain based on the subject’s unaided sound field thresholds, ambient room noise, hearing aid internal noise, hearing aid insertion gain, and the subject’s unaided performance-intensity function. Predicted speech gain agreed with measured speech gain with rms errors of only 3 dB for 11 subjects with mild or moderate hearing loss tested with monosyllabic words and continuous discourse. The speech gain provided by a hearing aid can thus be predicted from electroacoustic measures, which generally can be obtained in a shorter time. Importance functions believed to be applicable to nonsense syllables, words, and continuous discourse were used to make the predictions, but prediction accuracy was not affected by the importance function chosen. Speech gain measured with the monosyllabic word test was highly correlated with speech gain measured with the continuous discourse test, provided that similar presentation levels were used.

scholarly journals Hearing Aid Self-Adjustment: Effects of Formal Speech-Perception Test and Noise

2020 ◽  
Vol 24 ◽  
pp. 233121652093054
Author(s):  
Carol L. Mackersie ◽  
Arthur Boothroyd ◽  
Harinath Garudadri
Keyword(s):  
Speech Perception ◽  
Hearing Aids ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Sound Field ◽  
Online Processing ◽  
Starting Point ◽  
Wide Range ◽  
Monosyllabic Words ◽  
Response Amplification

While listening to recorded sentences with a sound-field level of 65 dB SPL, 24 adults with hearing-aid experience used the “Goldilocks” explore-and-select procedure to adjust level and spectrum of amplified speech to preference. All participants started adjustment from the same generic response. Amplification was provided by a custom-built Master Hearing Aid with online processing of microphone input. Primary goals were to assess the effects of including a formal speech-perception test between repeated self-adjustments and of adding multitalker babble (signal-to-noise ratio +6 dB) during self-adjustment. The speech test did not affect group-mean self-adjusted output, which was close to the National Acoustics Laboratories’ prescription for Non-Linear hearing aids. Individuals, however, showed a wide range of deviations from this prescription. Extreme deviations at the first self-adjustment fell by a small but significant amount at the second. The multitalker babble had negligible effect on group-mean self-selected output but did have predictable effects on word recognition in sentences and on participants’ opinion regarding the most important subjective criterion guiding self-adjustment. Phoneme recognition in monosyllabic words was better with the generic starting response than without amplification and improved further after self-adjustment. The findings continue to support the efficacy of hearing aid self-fitting, at least for level and spectrum. They do not support the need for inclusion of a formal speech-perception test, but they do support the value of completing more than one self-adjustment. Group-mean data did not indicate a need for threshold-based prescription as a starting point for self-adjustment.

Comparison of In-the-Ear and Over-the-Ear Hearing Aid Fittings

1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Comparative Evaluation ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
The Difference ◽  
Functional Gain ◽  
The Relationship

A custom in-the-ear (ITE) hearing aid fitting was compared to two over-the-ear (OTE) hearing aid fittings for each of 9 subjects with mild to moderately severe hearing losses. Speech intelligibility via the three instruments was compared using the Speech Intelligibility Rating (SIR) test. The relationship between functional gain and coupler gain was compared for the ITE and the higher rated OTE instruments. The difference in input received at the microphone locations of the two types of hearing aids was measured for 10 different subjects and compared to the functional gain data. It was concluded that (a) for persons with mild to moderately severe hearing losses, appropriately adjusted custom ITE fittings typically yield speech intelligibility that is equal to the better OTE fitting identified in a comparative evaluation; and (b) gain prescriptions for ITE hearing aids should be adjusted to account for the high-frequency emphasis associated with in-the-concha microphone placement.

Modified Earpieces and CROS for High Frequency Hearing Losses

1968 ◽  
Vol 11 (1) ◽  
pp. 204-218 ◽  
Author(s):  
Elizabeth Dodds ◽  
Earl Harford
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Sound Field ◽  
Intensity Level ◽  
Test Results ◽  
High Frequency Hearing Loss ◽  
Increased Sensitivity ◽  
Difficult Cases

Persons with a high frequency hearing loss are difficult cases for whom to find suitable amplification. We have experienced some success with this problem in our Hearing Clinics using a specially designed earmold with a hearing aid. Thirty-five cases with high frequency hearing losses were selected from our clinical files for analysis of test results using standard, vented, and open earpieces. A statistical analysis of test results revealed that PB scores in sound field, using an average conversational intensity level (70 dB SPL), were enhanced when utilizing any one of the three earmolds. This result was due undoubtedly to increased sensitivity provided by the hearing aid. Only the open earmold used with a CROS hearing aid resulted in a significant improvement in discrimination when compared with the group’s unaided PB score under earphones or when comparing inter-earmold scores. These findings suggest that the inclusion of the open earmold with a CROS aid in the audiologist’s armamentarium should increase his flexibility in selecting hearing aids for persons with a high frequency hearing loss.

scholarly journals Comparison of In-Situ and Retrospective Self-Reports on Assessing Hearing Aid Outcomes

2020 ◽  
Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Octav Chipara ◽  
Anna Gudjonsdottir ◽  
Jacob Oleson ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Outcome Data ◽  
Self Report ◽  
Data Collection And Analysis ◽  
Self Reports ◽  
Outcome Difference ◽  
The Difference ◽  
Ecological Momentary

Abstract Background Ecological momentary assessment (EMA) is a methodology involving repeated surveys to collect in-situ self-reports that describe respondents' current or recent experiences. Audiology literature comparing in-situ and retrospective self-reports is scarce. Purpose To compare the sensitivity of in-situ and retrospective self-reports in detecting the outcome difference between hearing aid technologies, and to determine the association between in-situ and retrospective self-reports. Research Design An observational study. Study Sample Thirty-nine older adults with hearing loss. Data Collection and Analysis The study was part of a larger clinical trial that compared the outcomes of a prototype hearing aid (denoted as HA1) and a commercially available device (HA2). In each trial condition, participants wore hearing aids for 4 weeks. Outcomes were measured using EMA and retrospective questionnaires. To ensure that the outcome data could be directly compared, the Glasgow Hearing Aid Benefit Profile was administered as an in-situ self-report (denoted as EMA-GHABP) and as a retrospective questionnaire (retro-GHABP). Linear mixed models were used to determine if the EMA- and retro-GHABP could detect the outcome difference between HA1 and HA2. Correlation analyses were used to examine the association between EMA- and retro-GHABP. Results For the EMA-GHABP, HA2 had significantly higher (better) scores than HA1 in the GHABP subscales of benefit, residual disability, and satisfaction (p = 0.029–0.0015). In contrast, the difference in the retro-GHABP score between HA1 and HA2 was significant only in the satisfaction subscale (p = 0.0004). The correlations between the EMA- and retro-GHABP were significant in all subscales (p = 0.0004 to <0.0001). The strength of the association ranged from weak to moderate (r = 0.28–0.58). Finally, the exit interview indicated that 29 participants (74.4%) preferred HA2 over HA1. Conclusion The study suggests that in-situ self-reports collected using EMA could have a higher sensitivity than retrospective questionnaires. Therefore, EMA is worth considering in clinical trials that aim to compare the outcomes of different hearing aid technologies. The weak to moderate association between in-situ and retrospective self-reports suggests that these two types of measures assess different aspects of hearing aid outcomes.

Fitting Frequency-Lowering Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Updates and Protocols

2016 ◽  
Vol 27 (03) ◽  
pp. 219-236 ◽  
Author(s):  
Susan Scollie ◽  
Danielle Glista ◽  
Julie Seto ◽  
Andrea Dunn ◽  
Brittany Schuett ◽  
...  
Keyword(s):  
Signal Processing ◽  
Frequency Response ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Fine Tuning ◽  
Sensation Level ◽  
Response Level ◽  
Strong Basis ◽  
Wide Range ◽  
Signal Processors

Background: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying technologies can supplement such guidelines. One such technology is frequency-lowering signal processing. Children require access to a broad bandwidth of speech to detect and use all phonemes including female /s/. When access through conventional amplification is not possible, the use of frequency-lowering signal processing may be considered as a means to overcome limitations. Fitting and verification protocols are needed to better define candidacy determination and options for assessing and fine tuning frequency-lowering signal processing for individuals. Purpose: This work aims to (1) describe a set of calibrated phonemes that can be used to characterize the variation in different brands of frequency-lowering processors in hearing aids and the verification with these signals and (2) determine whether verification with these signal are predictive of perceptual changes associated with changes in the strength of frequency-lowering signal processing. Finally, we aimed to develop a fitting protocol for use in pediatric clinical practice. Study Sample: Study 1 used a sample of six hearing aids spanning four types of frequency lowering algorithms for an electroacoustic evaluation. Study 2 included 21 adults who had hearing loss (mean age 66 yr). Data Collection and Analysis: Simulated fricatives were designed to mimic the level and frequency shape of female fricatives extracted from two sources of speech. These signals were used to verify the frequency-lowering effects of four distinct types of frequency-lowering signal processors available in commercial hearing aids, and verification measures were compared to extracted fricatives made in a reference system. In a second study, the simulated fricatives were used within a probe microphone measurement system to verify a wide range of frequency compression settings in a commercial hearing aid, and 27 adult listeners were tested at each setting. The relation between the hearing aid verification measures and the listener’s ability to detect and discriminate between fricatives was examined. Results: Verification measures made with the simulated fricatives agreed to within 4 dB, on average, and tended to mimic the frequency response shape of fricatives presented in a running speech context. Some processors showed a greater aided response level for fricatives in running speech than fricatives presented in isolation. Results with listeners indicated that verified settings that provided a positive sensation level of /s/ and that maximized the frequency difference between /s/ and /∫/ tended to have the best performance. Conclusions: Frequency-lowering signal processors have measureable effects on the high-frequency fricative content of speech, particularly female /s/. It is possible to measure these effects either with a simple strategy that presents an isolated simulated fricative and measures the aided frequency response or with a more complex system that extracts fricatives from running speech. For some processors, a more accurate result may be achieved with a running speech system. In listeners, the aided frequency location and sensation level of fricatives may be helpful in predicting whether a specific hearing aid fitting, with or without frequency-lowering, will support access to the fricatives of speech.

Noise Exposure Associated With Hearing Aid Use in Industry

1996 ◽  
Vol 39 (2) ◽  
pp. 251-260 ◽  
Author(s):  
Thomas G. Dolan ◽  
James F. Maurer
Keyword(s):  
Hearing Aids ◽  
Noise Exposure ◽  
Hearing Aid ◽  
Sound Field ◽  
High Gain ◽  
Sound Level ◽  
Weighted Averages ◽  
Hearing Aid Use ◽  
Listening Environments ◽  
Level Meter

Although noise may be innocuous in many vocational environments, there is a growing concern in industry that it can reach hazardous levels when amplified by hearing aids. This study examined the daily noise exposures associated with hearing aid use in industry. This was done by both laboratory and site measurements in which hearing aids were coupled to the microphone of an integrating sound level meter or dosimeter. The former method involved the use of recorded railroad and manufacturing noise and a Bruel and Kjaer 4128 Head and Torso simulator. In the latter procedure, a worker wore one of three hearing aids coupled to a dosimeter during 8-hour shifts in a manufacturing plant. Both methods demonstrated that even when amplified by mild-gain hearing aids, noise exposures rose from time-weighted averages near 80 dBA to well above the OSHA maximum of 90 dBA. The OSHA maximum was also exceeded when moderate and high gain instruments were worn in non-occupational listening environments. The results suggest that current OSHA regulations that limit noise exposure in sound field are inappropriate for hearing aid users.

scholarly journals The use of speech sentence audiometry in a free sound field

2020 ◽  
Vol 5 (1) ◽  
pp. 36-39
Author(s):  
Mariya Yu. Boboshko ◽  
Irina P. Berdnikova ◽  
Natalya V. Maltzeva
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Normative Data ◽  
Hearing Aid ◽  
Sound Field ◽  
Normal Hearing ◽  
Significant Difference ◽  
Hearing Aid Benefit

Objectives -to determine the normative data of sentence speech intelligibility in a free sound field and to estimate the applicability of the Russian Matrix Sentence test (RuMatrix) for assessment of the hearing aid fitting benefit. Material and methods. 10 people with normal hearing and 28 users of hearing aids with moderate to severe sensorineural hearing loss were involved in the study. RuMatrix test both in quiet and in noise was performed in a free sound field. All patients filled in the COSI questionnaire. Results. The hearing impaired patients were divided into two subgroups: the 1st with high and the 2nd with low hearing aid benefit, according to the COSI questionnaire. In the 1st subgroup, the threshold for the sentence intelligibility in quiet was 34.9 ± 6.4 dB SPL, and in noise -3.3 ± 1.4 dB SNR, in the 2nd subgroup 41.7 ± 11.5 dB SPL and 0.15 ± 3.45 dB SNR, respectively. The significant difference between the data of both subgroups and the norm was registered (p

Predicted Gain and Functional Gain With Transcranial Routing of Signal Completely-in-the-Canal Hearing Aids

2003 ◽  
Vol 12 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Marc A. Fagelson ◽  
Colleen M. Noe ◽  
Owen D. Murnane ◽  
Jennifer S. Blevins
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Mechanical Vibration ◽  
Signal Frequency ◽  
Unilateral Hearing Loss ◽  
External Canal ◽  
The Difference ◽  
Acoustic Output ◽  
Functional Gain

Transcranial routing of signal (TCROS) was accomplished using completely-in-the-canal (CIC) hearing aids in 5 profoundly unilaterally hearing-impaired individuals. The functional gain realized by the participants far exceeded the gain predicted by measuring the acoustic output and real ear aided response of the hearing aids. The difference between predicted and functional gain increased with signal frequency and was attributed at least in part to mechanical vibration of the hearing aid in the external canal. Implications for fitting unilateral hearing loss using TCROS amplifying systems are discussed.

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