A self-contained, self-fitting hearing aid (SFHA) is a device that enables the user to perform both threshold measurements leading to a prescribed hearing aid setting and fine-tuning, without the need for audiological support or access to other equipment. The SFHA has been proposed as a potential solution to address unmet hearing health care in developing countries and remote locations in the developed world and is considered a means to lower cost and increase uptake of hearing aids in developed countries. This article reviews the status of the SFHA and the evidence for its feasibility and challenges and predicts where it is heading. Devices that can be considered partly or fully self-fitting without audiological support were identified in the direct-to-consumer market. None of these devices are considered self-contained as they require access to other hardware such as a proprietary interface, computer, smartphone, or tablet for manipulation. While there is evidence that self-administered fitting processes can provide valid and reliable results, their success relies on user-friendly device designs and interfaces and easy-to-interpret instructions. Until these issues have been sufficiently addressed, optional assistance with the self-fitting process and on-going use of SFHAs is recommended. Affordability and a sustainable delivery system remain additional challenges for the SFHA in developing countries. Future predictions include a growth in self-fitting products, with most future SFHAs consisting of earpieces that connect wirelessly with a smartphone and providers offering assistance through a telehealth infrastructure, and the integration of SFHAs into the traditional hearing health-care model. PMID:27072929
Full Text Available A self-contained, self-fitting hearing aid (SFHA is a device that enables the user to perform both threshold measurements leading to a prescribed hearing aid setting and fine-tuning, without the need for audiological support or access to other equipment. The SFHA has been proposed as a potential solution to address unmet hearing health care in developing countries and remote locations in the developed world and is considered a means to lower cost and increase uptake of hearing aids in developed countries. This article reviews the status of the SFHA and the evidence for its feasibility and challenges and predicts where it is heading. Devices that can be considered partly or fully self-fitting without audiological support were identified in the direct-to-consumer market. None of these devices are considered self-contained as they require access to other hardware such as a proprietary interface, computer, smartphone, or tablet for manipulation. While there is evidence that self-administered fitting processes can provide valid and reliable results, their success relies on user-friendly device designs and interfaces and easy-to-interpret instructions. Until these issues have been sufficiently addressed, optional assistance with the self-fitting process and on-going use of SFHAs is recommended. Affordability and a sustainable delivery system remain additional challenges for the SFHA in developing countries. Future predictions include a growth in self-fitting products, with most future SFHAs consisting of earpieces that connect wirelessly with a smartphone and providers offering assistance through a telehealth infrastructure, and the integration of SFHAs into the traditional hearing health-care model.
The research on self-fitting hearing aids is reviewed using evidence-based principles. The evaluation begins with a definition of the research questions followed by a detailed search of the literature and then a review of the relevant studies. Four features of self-fitting hearing aids are reviewed: in-situ threshold measurement, whether an initial fitting prescribed using standard prescription formulae will approximate user preferences, outcomes with training of hearing aids for preferred responses, and assembly and use of the aids. There is at least good quality evidence suggesting that in-situ thresholds can be reliably obtained, that prescribed initial fittings approximate preferred responses, and that users are able to train the hearing aids and would prefer the trained responses. However, evidence on other outcomes and the ability of users to assemble and use such instruments is limited. Gaps in research with self-fitting hearing aids are identified. PMID:22528820
Objective: Age-related hearing loss is an increasingly important public health problem affecting approximately 40% of 55–74 year olds. The primary clinical management intervention for people with hearing loss is hearing aids, however, the majority (80%) of adults aged 55–74 years who would benefit from a hearing aid, do not use them. Furthermore, many people given a hearing aid do not wear it. The aim was to collate the available evidence as to the potential reasons for non-use of hearing aids among people who have been fitted with at least one. Design: Data were gathered via the use of a scoping study. Study sample: A comprehensive search strategy identified 10 articles reporting reasons for non-use of hearing aids. Results: A number of reasons were given, including hearing aid value, fit and comfort and maintenance of the hearing aid, attitude, device factors, financial reasons, psycho-social/situational factors, healthcare professionals attitudes, ear problems, and appearance. Conclusions: The most important issues were around hearing aid value, i.e. the hearing aid not providing enough benefit, and comfort related to wearing the hearing aid. Identifying factors that affect hearing aid usage are necessary for devising appropriate rehabilitation strategies to ensure greater use of hearing aids. PMID:23473329
Keidser, G; Dillon, H; Byrne, D
Fitting guidelines to determine candidacy for multiple memory hearing aids and the choice of amplification for each memory are devised by reviewing studies on the selection of amplification for different listening conditions. The guideline for determining candidacy comprises three factors: (1) difficulty hearing in acoustically diverse conditions, (2) an average high-frequency hearing loss greater than about 55 dB HL, and (3) ability to vary the low-frequency gain by at least 5 dB. People who meet all three criteria are highly likely to benefit from multiple memories. People who meet criteria 1 and 2 or 1 and 3 are possible candidates. The guideline for determining the amplification characteristics needed for each memory also enables the fitter to determine the number of memories needed. The following recommendations for amplification characteristic for various listening conditions are based on the literature review: linear amplification with the prescribed National Acoustic Laboratories' (NAL) frequency response is recommended for listening to speech in quiet; substantial high-frequency compression is recommended for ease of understanding two voices that differed by 10 dB in overall level; a linear response steeper than the NAL response is recommended for ease of understanding speech in a low-frequency background noise; low-frequency compression is recommended to reduce annoyance of low-frequency background noise; and a linear response flatter than the NAL response is recommended for listening in high-frequency background noise, and possibly for listening to music.
Self-reported disability and handicap after hearing-aid fitting and benefit of hearing aids: comparison of fitting procedures, degree of hearing loss, experience with hearing aids and uni- and bilateral fittings
Metselaar, M.; Maat, B.; Krijnen, P; Verschuure, H.; Dreschler, W.A.; Feenstra, L.
Self-reported outcome on hearing disability and handicap as well as overall health-related quality of life were measured after hearing-aid fitting in a large-scale clinical population. Fitting was performed according to two different procedures in a double-blind study design. We used a comparative procedure based on optimizing speech intelligibility scores and a strictly implemented fitting formula. Hearing disability and handicap were assessed with the hearing handicap and disability invento...
R.M. Metselaar (Mick)
textabstractSensorineural hearing loss is a common and chronic disorder that affects almost ten percent of the world population. In the Netherlands, it is also the major disorder in the working population [NCvB, 2008]. Hearing loss leads to restriction in the interaction with others and withdrawal
In the past hearing aid fitting frequently turned out to be a problem in patients with noise-induced hearing loss. Selective amplification in the high frequency range and at the same time natural sound and appropriate wearing comfort (open fitting) could not be achieved in numerous cases. Today these problems can be tackled by modern hearing aid technology providing us with efficient feedback suppression algorithms making open fittings possible for many more patients. This development is particularly beneficial for patients with noise-induced hearing loss. Unfortunately, open fitting is in opposition to wearing hearing aids at noisy workplaces. Tight fittings, however, can be used at work if a special listening program for noisy conditions is available. This dilemma is discussed and possible solutions are pointed out.
Self-reported disability and handicap after hearing-aid fitting and benefit of hearing aids: comparison of fitting procedures, degree of hearing loss, experience with hearing aids and uni- and bilateral fittings
Metselaar, Mick; Maat, Bert; Krijnen, Pieta; Verschuure, Hans; Dreschler, Wouter A.; Feenstra, Louw
Self-reported outcome on hearing disability and handicap as well as overall health-related quality of life were measured after hearing-aid fitting in a large-scale clinical population. Fitting was performed according to two different procedures in a double-blind study design. We used a comparative
Self-reported disability and handicap after hearing-aid fitting and benefit of hearing aids : comparison of fitting procedures, degree of hearing loss, experience with hearing aids and uni- and bilateral fittings
Metselaar, Mick; Maat, Bert; Krijnen, Pieta; Verschuure, Hans; Dreschler, Wouter A; Feenstra, Louw
Self-reported outcome on hearing disability and handicap as well as overall health-related quality of life were measured after hearing-aid fitting in a large-scale clinical population. Fitting was performed according to two different procedures in a double-blind study design. We used a comparative
Oeding, Kristi; Valente, Michael; Chole, Richard
Collapsed ear canals typically occur when an outside force, such as a headset for audiometric testing, is present. However, when a collapsed ear canal occurs without external pressure, this creates a challenge not only for performing audiometric testing but also for coupling a hearing aid to the ear canal. This case report highlights the challenges associated with fitting a hearing aid on a patient with a severe anterior-posterior collapsed ear canal with a mixed hearing loss. A 67-yr-old female originally presented to Washington University in St. Louis School of Medicine in 1996 with a long-standing history of bilateral otosclerosis. She had chronic ear infections in the right ear and a severely collapsed ear canal in the left ear and was fit with a bone anchored hearing aid (BAHA®) on the right side in 2003. However, benefit from the BAHA started to decrease due to changes in hearing, and a different hearing solution was needed. It was proposed that a hearing aid be fit to her collapsed left ear canal; however, trying to couple a hearing aid to the collapsed ear canal required unique noncustom earmold solutions. This case study highlights some of the obstacles and potential solutions for coupling a hearing aid to a severely collapsed ear canal. American Academy of Audiology.
Boymans, Monique; Dreschler, Wouter A.
This study investigated the potential and limitations of a self-fit hearing aid. This can be used in the "developing" world or in countries with large distances between the hearing-impaired subjects and the professional. It contains an on-board tone generator for in situ user-controlled, automated
Alcántara, José I; Moore, Brian C J; Marriage, Josephine
This paper is the second in a series comparing three procedures for the initial fitting of multichannel compression hearing aids. The first paper reported the results for a group of 10 experienced hearing aid users fitted bilaterally. This paper reports the results for a different group of 10 experienced hearing aid users fitted unilaterally. The three procedures were: (1) CAMEQ, which aims to amplify speech so as to give equal loudness per critical band over the frequency range 500-5000 Hz, and to give similar overall loudness to normal over a wide range of speech levels; (2) CAMREST, which aims to amplify speech so as to restore normal specific loudness patterns, over a wide range of speech levels; and (3) DSL [i/o], which aims to map the dynamic range of normal-hearing people into the reduced dynamic range of hearing-impaired people, with full restoration of audibility. Each subject was fitted with one Danalogic 163D digital hearing aid, using each of the three fitting procedures in turn; the order was counter-balanced across subjects. Prescribed insertion gains for 55 and 80 dB SPL input levels were verified using real-ear measurements. Immediately after fitting with a given procedure, and 1 week after fitting. the gains were adjusted, when required, by the minimum amount necessary to achieve acceptable fittings. On average, the adjustments were smallest for the CAMREST procedure, slightly larger for the CAMEQ procedure, and largest of all for DSL [i/o]. For the DSL [i/o] the gain changes were mostly negative, especially for high frequencies and the higher input level. After these gain adjustments, users wore the aids for at least 3 weeks before speech reception thresholds (SRTs) for sentences in quiet and in steady and fluctuating background noise were measured. The APHAB questionnaire was also administered. The hearing aids were then refitted with the next procedure. SRTs and APHAB scores did not differ significantly between the three procedures. We conclude
Hartel, B P; Agterberg, M J H; Snik, A F; Kunst, H P M; van Opstal, A J; Bosman, A J; Pennings, R J E
Usher syndrome is the leading cause of hereditary deaf-blindness. Most patients with Usher syndrome type IIa start using hearing aids from a young age. A serious complaint refers to interference between sound localisation abilities and adaptive sound processing (compression), as present in today's hearing aids. The aim of this study was to investigate the effect of advanced signal processing on binaural hearing, including sound localisation. In this prospective study, patients were fitted with hearing aids with a nonlinear (compression) and linear amplification programs. Data logging was used to objectively evaluate the use of either program. Performance was evaluated with a speech-in-noise test, a sound localisation test and two questionnaires focussing on self-reported benefit. Data logging confirmed that the reported use of hearing aids was high. The linear program was used significantly more often (average use: 77%) than the nonlinear program (average use: 17%). The results for speech intelligibility in noise and sound localisation did not show a significant difference between type of amplification. However, the self-reported outcomes showed higher scores on 'ease of communication' and overall benefit, and significant lower scores on disability for the new hearing aids when compared to their previous hearing aids with compression amplification. Patients with Usher syndrome type IIa prefer a linear amplification over nonlinear amplification when fitted with novel hearing aids. Apart from a significantly higher logged use, no difference in speech in noise and sound localisation was observed between linear and nonlinear amplification with the currently used tests. Further research is needed to evaluate the reasons behind the preference for the linear settings. © 2016 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd.
Hoare, Derek J.; Nicholson, Richard; Smith, Sandra; Hall, Deborah A.
Objectives: In many countries including the United Kingdom, hearing aids are a first line of audiologic intervention for many people with tinnitus and aidable hearing loss. Nevertheless, there is a lack of high quality evidence to support that they are of benefit for tinnitus, and wide variability in their use in clinical practice especially for people with mild hearing loss. The aim of this study was to identify a consensus among a sample of UK clinicians on the criteria for hearing aid candidature and clinical practice in fitting hearing aids specifically for mild hearing loss with and without tinnitus. This will allow professionals to establish clinical benchmarks and to gauge their practice with that used elsewhere. Design: The Delphi technique, a systematic methodology that seeks consensus amongst experts through consultation using a series of iterative questionnaires, was used. A three-round Delphi survey explored clinical consensus among a panel of 29 UK hearing professionals. The authors measured panel agreement on 115 statements covering: (i) general factors affecting the decision to fit hearing aids, (ii) protocol-driven factors affecting the decision to fit hearing aids, (iii) general practice, and (iv) clinical observations. Consensus was defined as a priori ≥70% agreement across the panel. Results: Consensus was reached for 58 of the 115 statements. The broad areas of consensus were around factors important to consider when fitting hearing aids; hearing aid technology/features offered; and important clinical assessment to verify hearing aid fit (agreement of 70% or more). For patients with mild hearing loss, the greatest priority was given by clinicians to patient-centered criteria for fitting hearing aids: hearing difficulties, motivation to wear hearing aids, and impact of hearing loss on quality of life (chosen as top five by at least 64% of panelists). Objective measures were given a lower priority: degree of hearing loss and shape of the
Zenker Castro, F; Fernández Belda, R; Barajas de Prat, J J
The purpose of the Newborn Hearing Screening Program is to achieve early. Identification and appropriate intervention for hearing loss. Hearing aids are the most frequent intervention for deafness. Paediatric specific clinical protocols for fitting hearing aids always recommend accurate characterisation of hearing thresholds in newborns. In this sense, electrophysiological procedures are specially indicated in determined hearing sensibility from the first age of life since it is an objective and reliable procedure. 20 normal hearing subject and 17 hearing loss subjects participated in this study. Auditory Steady State Responses (ASSR) were obtained from all of them. Hearing aid fitting was established from the electrophysiological responses. Dynamic range, gain, compression ratio and maximum output of the hearing aid were obtained from the intensity amplitude function of the ASSR. The procedure discussed in this study is specially indicated in newborns and very young children in which other test are not suitable.
Penteado, Silvio Pires
Full Text Available Introduction: Currently, the Brazilian government has certificated nearly 140 specialized centers in hearing aid fittings through the Brazilian National Health System (SUS. Remote fitting through the Internet can allow a broader and more efficient coverage with a higher likelihood of success for patients covered by the SUS, as they can receive fittings from their own homes instead of going to the few and distant specialized centers. Aim: To describe a case of remote fitting between 2 cities, with revision of the literature. Method: Computer gears, a universal interface, and hearing aids were used. Case study: An audiologist located in a specialized center introduced a new hearing aid and its fitting procedure to a remote center (200 km away. The specialized center helped the remote center in fitting a hearing aid in 2 patients, and performed fitting in one of its own patients. The whole process was done through the Internet with audio and video in real time. Results: Three patients were fitted remotely. Three audiologists were remotely trained on how to fit the hearing aids. Conclusions: Remote fitting of hearing aids is possible through the Internet, as well as further supplying technical training to a remote center about the fitting procedures. Such a technological approach can help the government advance public policies on hearing rehabilitation, as patients can be motivated about maintaining their use of hearing aids with the option to ask for help in the comfort of their own homes.
Penteado, Silvio Pires; Ramos, Sueli de Lima; Battistella, Linamara Rizzo; Marone, Silvio Antonio Monteiro; Bento, Ricardo Ferreira
Summary Introduction: Currently, the Brazilian government has certificated nearly 140 specialized centers in hearing aid fittings through the Brazilian National Health System (SUS). Remote fitting through the Internet can allow a broader and more efficient coverage with a higher likelihood of success for patients covered by the SUS, as they can receive fittings from their own homes instead of going to the few and distant specialized centers. Aim: To describe a case of remote fitting between 2 cities, with revision of the literature. Method: Computer gears, a universal interface, and hearing aids were used. Case study: An audiologist located in a specialized center introduced a new hearing aid and its fitting procedure to a remote center (200 km away). The specialized center helped the remote center in fitting a hearing aid in 2 patients, and performed fitting in one of its own patients. The whole process was done through the Internet with audio and video in real time. Results: Three patients were fitted remotely. Three audiologists were remotely trained on how to fit the hearing aids. Conclusions: Remote fitting of hearing aids is possible through the Internet, as well as further supplying technical training to a remote center about the fitting procedures. Such a technological approach can help the government advance public policies on hearing rehabilitation, as patients can be motivated about maintaining their use of hearing aids with the option to ask for help in the comfort of their own homes. PMID:25991960
Moore, B C; Alcántara, J I; Marriage, J
We compared the effectiveness of three procedures for the initial fitting of hearing aids with multi-band compression: (1) CAMEQ, which aims to amplify speech so as to give equal loudness per critical band over the frequency range important for speech intelligibility, and to give similar overall loudness to 'normal': (2) CAMREST, which aims to amplify speech so as to restore 'normal' specific loudness patterns, over a wide range of speech levels; (3) DSL I/O, which aims to map the dynamic range of normally hearing people into the reduced dynamic range of hearing-impaired people, with 'full' restoration of audibility. Ten experienced hearing aid users with moderate sensorineural loss were fitted bilaterally with Danalogic 163D digital hearing aids, using each procedure in turn; the order was counterbalanced across subjects. The fitting required specification of gains for input levels of 55 and 80 dB SPL at six centre frequencies. Real-ear measurements were made to ensure that target gains were reached (+/-3 dB). Immediately after fitting with a given procedure, and one week after fitting, the gains were adjusted when required by the minimum amount necessary to achieve acceptable fittings. The amount of adjustment required provides one measure of the adequacy of the initial fitting. On average, the adjustments were smallest for the CAMEQ procedure. The gain changes were slightly larger for the CAMREST procedure and were largest of all for DSL I/O. For the latter, the gain changes were mostly negative, especially for high frequencies and the higher input level. This indicates that the DSL I/O procedure prescribes more high-frequency gain than is preferred by adult users. After these gain adjustments, users wore the aids for at least three weeks before filling out the APHAB questionnaire and taking part in laboratory measurements of the speech reception threshold (SRT) for sentences in quiet and in steady and fluctuating background noise at levels of 60 and 75 dB SPL
Barbosa, Mirna Rossi; Medeiros, Daniel de Sousa; Rossi-Barbosa, Luiza Augusta Rosa; Silveira, Marise Fagundes; de Barros Lima Martins, Andrea Maria Eleutério; Caldeira, Antônio Prates
To evaluate the impact of hearing aid (HA) fittings among elderly patients through the Hearing Handicap Inventory for the Elderly (HHIE). The present study was carried out with 125 hearing-impaired individuals over aged 65 years in the northern region of Minas Gerais, Brazil. The instrument used was the HHIE self-assessment questionnaire. HHIE were completed before and after HA fittings. Data were analyzed using the non-parametric Wilcoxon test and the McNemar χ(2)-test. There were significant decreases in general, social and emotional handicap after HA use (P < 0.001). The percentage of patients with severe hearing handicap decreased from 45.6% to 8.8% with HA use. The greatest difficulty reported by respondents, both before and after HA use, was "hearing when someone whispers". Although HA use significantly improves the hearing handicap, some older adults still maintain social and emotional limitations. The HHIE instrument can be a great ally in helping professionals understand and rehabilitate the difficulties that remain after amplification. © 2014 Japan Geriatrics Society.
Curran, James R.
As early as the 1930s the term Master Hearing Aid (MHA) described a device used in the fitting of hearing aids. In their original form, the MHA was a desktop system that allowed for simulated or actual adjustment of hearing aid components that resulted in a changed hearing aid response. Over the years the MHA saw many embodiments and contributed to a number of rationales for the fitting of hearing aids. During these same years, the MHA was viewed by many as an inappropriate means of demonstrating hearing aids; the audio quality of the desktop systems was often superior to the hearing aids themselves. These opinions and the evolution of the MHA have molded the modern perception of hearing aids and the techniques used in the fitting of hearing aids. This article reports on a history of the MHA and its influence on the fitting of hearing aids. PMID:23686682
Launer, Stefan; Moore, Brian C J
Many researchers have proposed that hearing aids should process sounds so as to restore loudness perception to 'normal'. We describe how a model for predicting loudness for people with cochlear hearing loss can be implemented in a digital hearing aid so as to calculate the frequency-dependent gains that would be required to achieve that goal. It is assumed that the input signal is processed using brief segments or 'frames'. For each frame, the spectrum is calculated, usually via a fast Fourier transform (FFT). From the spectrum, an excitation pattern is calculated for a normal car and for the impaired ear of the patient. The loudness model is then used to calculate the gain required at the centre frequency of each channel in the aid, so as to match the specific loudness in the normal and impaired ears. The whole process is repeated for each successive frame, with overlap of frames and with smoothing of the gain changes across frames. We describe both an 'exact' model, which prescribes a 'curvilinear' compression characteristic at each frequency, and an approximation using 'straight' compression, which is computationally less intensive. Limitations of the present approach are described, and the approach is compared with more traditional approaches using multichannel compression, and with previous approaches using loudness models for fitting hearing aids.
Caporali, Sueli Aparecida; Schmidt, Erik; Eriksson, Asa; Sköld, Birgitta; Popecki, Barbara; Larsson, Josefina; Auriemmo, Jane
In spite of early identification and intervention efforts achieved by Early Hearing Detection and Intervention (EHDI) programs, many infants with hearing loss experience delays in early vocabulary development in comparison to peers with normal hearing (Mayne, Yoshinaga-Itano, Sedey, 2000a; Mayne, Yoshinaga-Itano, Sedey, Carey, 2000b; Moeller et al, 2007a, 2007b). One of the several factors that may contribute to individual differences in outcomes is inconsistent hearing aid use in this age group. This may be associated with the physical fit when using traditional behind-the-ear (BTE) hearing aids, since they are relatively large in comparison with the small and soft ear of an infant. Receiver-in-the-ear (RITE) hearing aids may be advantageous for use in pediatric fittings, since they are very tiny and lightweight and therefore sit comfortably on a small soft ear. To evaluate the use of a RITE hearing aid with an instant ear-tip especially developed for infants in terms of physical fit, stability, safety, and security of the device, as well as the use of retention tools (remedies for keeping the hearing aid securely on the ear) with this age group. A longitudinal study with hearing impaired infants fitted with RITE hearing aids was performed. Eighteen infants with mild to moderate/severe hearing loss participated in the study. The age range was 2-36 mo. Sixteen infants had worn hearing aids prior to their participation in the study. Each hearing impaired infant was fitted with the RITE hearing aid and an instant ear-tip, the size of which was chosen by the audiologist. The infants used the device for a period of 2-5 mo. Audiologists and parents completed questionnaires at every visit (5-7 visits in total). Responses were obtained using a category rating scale (Stevens, 1975) from 0 to 10. The data were analyzed using descriptive statistics and nonparametric statistics. Sixteen of the 18 children completed the study. At the end of the study, 11 of the 16 children
Meister, Hartmut; Rählmann, Sebastian; Walger, Martin; Margolf-Hackl, Sabine; Kießling, Jürgen
To examine the association of cognitive function, age, and hearing loss with clinically assessed hearing aid benefit in older hearing-impaired persons. Hearing aid benefit was assessed using objective measures regarding speech recognition in quiet and noisy environments as well as a subjective measure reflecting everyday situations captured using a standardized questionnaire. A broad range of general cognitive functions such as attention, memory, and intelligence were determined using different neuropsychological tests. Linear regression analyses were conducted with the outcome of the neuropsychological tests as well as age and hearing loss as independent variables and the benefit measures as dependent variables. Thirty experienced older hearing aid users with typical age-related hearing impairment participated. Most of the benefit measures revealed that the participants obtained significant improvement with their hearing aids. Regression models showed a significant relationship between a fluid intelligence measure and objective hearing aid benefit. When individual hearing thresholds were considered as an additional independent variable, hearing loss was the only significant contributor to the benefit models. Lower cognitive capacity - as determined by the fluid intelligence measure - was significantly associated with greater hearing loss. Subjective benefit could not be predicted by any of the variables considered. The present study does not give evidence that hearing aid benefit is critically associated with cognitive function in experienced hearing aid users. However, it was found that lower fluid intelligence scores were related to higher hearing thresholds. Since greater hearing loss was associated with a greater objective benefit, these results strongly support the advice of using hearing aids regardless of age and cognitive function to counter hearing loss and the adverse effects of age-related hearing impairment. Still, individual cognitive capacity might
Keidser, Gitte; Hartley, Lisa
A self-fitting hearing aid is a personal amplification device that is designed to be assembled, programmed, and fine-tuned by the user, without the need for additional equipment or professional support. A written description of the device was presented to 80 older adults with a hearing impairment, all of whom were residents of an urban area in a developed country. In response to a structured questionnaire, the majority of participants reported that the self-fitting hearing aid concept was a good idea (83%), would be of personal benefit (60%), and could be managed independently by the user (90%). Overall, half of the participant group agreed with all three statements. Two were uncertain about the concept, but none of the participants rejected it outright. There were no significant differences between the opinions of participants with previous hearing aid experience and those without. Participant responses to open-ended questions revealed that the main benefits of a self-fitting hearing aid were thought to be the ability to self-adjust the device’s settings (reported by 33% of participants) and increased convenience (20% of participants). The main drawback, mentioned by 25% of participants, was a preference for professional guidance through the fitting process. These results suggest that the self-fitting hearing aid may present as an alternative product in developed countries for those users who prefer to be in control of the fitting process. PMID:22079900
Abrams, Harvey B; Chisolm, Theresa H; McManus, Megan; McArdle, Rachel
Despite evidence suggesting inaccuracy in the default fittings provided by hearing aid manufacturers, the use of probe-microphone measures for the verification of fitting accuracy is routinely used by fewer than half of practicing audiologists. The present study examined whether self-perception of hearing aid benefit, as measured through the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox and Alexander, 1995), differed as a function of hearing aid fitting method, specifically, manufacturer's initial-fit approach versus a verified prescription. The prescriptive fit began at NAL-NL1 targets, with adjustments based on participant request. Each of the two fittings included probe-microphone measurement. A counterbalanced, cross-over, repeated-measures, single-blinded design was utilized to address the research objectives. Twenty-two experienced hearing aid users from the general Bay Pines VA Healthcare System audiology clinic population were randomized into one of two intervention groups. At the first visit, half of the participants were fit with new hearing aids via the manufacturer's initial fit while the second half were fit to a verified prescription using probe-microphone measurement. After a wear period of 4-6 wk, the participants' hearing aids were refit via the alternate method and worn for an additional 4-6 wk. Participants were blinded to the method of fitting by utilizing probe-microphone measures with both approaches. The APHAB was administered at baseline and at the end of each intervention trial. At the end of the second trial period, the participants were asked to identify which hearing aid fitting was "preferred." The APHAB data were subjected to a general linear model repeated-measures analysis of variance. For the three APHAB communication subscales (i.e., Ease of Communication, Reverberation, and Background Noise) mean scores obtained with the verified prescription were higher than those obtained with the initial-fit approach, indicating
Moore, B C; Alcántara, J I; Stone, M A; Glasberg, B R
A model for predicting loudness for people with cochlear hearing loss was applied to the problem of the initial fitting of a multi-channel compression hearing aid. The fitting was based on two constraints: (1) The specific loudness pattern evoked by speech of a moderate level (65 dB SPL) should be reasonably flat (equal loudness per critical band), and the overall loudness should be similar to that evoked in a normal listener by 65-dB speech (about 23 sones for binaural listening); (2) Speech with an overall level of 45 dB SPL should just be audible in all frequency bands from 500 Hz up to about 4 kHz, provided that this does not require compression ratios exceeding about 3. These two constraints were used to determine initial values for the gain, compression ratio and compression threshold in each channel of a multi-channel compression system. This initial fitting was based entirely on audiometric thresholds; it does not require suprathreshold loudness measures. The fitting method was evaluated using an experimental fast-acting four-channel compression system. The initial fitting was followed by an adaptive procedure to 'fine tune' the fitting, and the aids were then used in everyday life. Performance was evaluated by use of questionnaires and by measures of speech intelligibility. Although the fine tuning resulted in modest changes in the fitting parameters for some subjects, on average the frequency response shapes and compression ratios were similar before and after the fine tuning. The fittings led to satisfactory loudness impressions in everyday life and to high speech intelligibility over a wide range of levels. It was concluded that the initial fitting method gives reasonable starting values for the fine tuning.
Grugel, Richard N. (Inventor)
Progress in hearing aids has come a long way. Yet despite such progress hearing aids are not the perfect answer to many hearing problems. Some adult ears cannot accommodate tightly fitting hearing aids. Mouth movements such as chewing, talking, and athletic or other active endeavors also lead to loosely fitting ear molds. It is well accepted that loosely fitting hearing aids are the cause of feedback noise. Since feedback noise is the most common complaint of hearing aid wearers it has been the subject of various patents. Herein a hearing aid assembly is provided eliminating feedback noise. The assembly includes the combination of a hearing aid with a headset developed to constrict feedback noise.
Convery, Elizabeth; Keidser, Gitte; Hartley, Lisa; Caposecco, Andrea; Hickson, Louise; Meyer, Carly
A self-fitting hearing aid, designed to be assembled and programmed without audiological or computer support, could bring amplification to millions of people in developing countries, who remain unaided due to the lack of a local, professional, audiological infrastructure. The ability to assemble and insert a hearing aid is fundamental to the successful use of a self-fitting device. In this study, the management of such tasks was investigated. Eighty older, urban-dwelling, hearing-impaired adults in a developed country were asked to follow a set of written, illustrated instructions to assemble two slim-fit behind-the-ear hearing aids. Participants were allowed to access assistance with the task from an accompanying partner. A range of personal and audiometric variables was measured through the use of structured questionnaires and standardized tests of health literacy, cognitive function, and manual dexterity. The results showed that 99% of participants were able to complete the hearing aid assembly task, either on their own or with assistance. Health literacy, or the ability to read and understand health-related text, and gender most strongly influenced participants' ability to complete the assembly task independently and accurately. Higher levels of health literacy were associated with an increased likelihood of independent and successful task completion. Male participants were more likely to complete the task on their own, while female participants were more likely to assemble the device without errors. The results of this study will inform future work regarding development of educational material for the self-fitting hearing aid as well as candidacy for such a device.
de Wolf, Maarten J F; Hol, Myrthe K S; Mylanus, Emmanuel A M; Snik, Ad F M; Cremers, Cor W R J
To evaluate the benefits of a bone-anchored hearing aid (BAHA) in the daily lives of hearing-impaired children. Retrospective questionnaire study. Nijmegen Medical Centre, Nijmegen, the Netherlands. Thirty-eight BAHA users with a minimum age of 4 years at BAHA fitting and 1 to 4 years of use, divided into groups with bilateral conductive or mixed hearing loss and either normal cognition or mental disability and a group with unilateral conductive hearing loss. Scores on the Glasgow Children's Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit, and Health Utilities Index Mark 3. The Glasgow Children's Benefit Inventory showed a subjective overall benefit of +32, +16, and +26 in the 3 groups (on a scale of -100 to +100). The Abbreviated Profile of Hearing Aid Benefit also showed an overall mean benefit in the groups. On an individual level, a clinically significant benefit was reported by more children in the group with bilateral hearing loss and normal cognition (7 patients [70%]) than in the unilateral hearing loss group (4 patients [27%]). Overall mean health utility scores and disability index scores on the Health Utility Index Mark 3 were comparable among the 3 groups. Overall, BAHA fitting can be considered effective and beneficial in children with bilateral or unilateral hearing loss.
Full Text Available Hartmut Meister,1 Sebastian Rählmann,1 Martin Walger,2 Sabine Margolf-Hackl,3 Jürgen Kießling3 1Jean Uhrmacher Institute for Clinical ENT-Research, University of Cologne, Cologne, Germany; 2Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany; 3Department of Othorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany Purpose: To examine the association of cognitive function, age, and hearing loss with clinically assessed hearing aid benefit in older hearing-impaired persons.Methods: Hearing aid benefit was assessed using objective measures regarding speech recognition in quiet and noisy environments as well as a subjective measure reflecting everyday situations captured using a standardized questionnaire. A broad range of general cognitive functions such as attention, memory, and intelligence were determined using different neuropsychological tests. Linear regression analyses were conducted with the outcome of the neuropsychological tests as well as age and hearing loss as independent variables and the benefit measures as dependent variables. Thirty experienced older hearing aid users with typical age-related hearing impairment participated.Results: Most of the benefit measures revealed that the participants obtained significant improvement with their hearing aids. Regression models showed a significant relationship between a fluid intelligence measure and objective hearing aid benefit. When individual hearing thresholds were considered as an additional independent variable, hearing loss was the only significant contributor to the benefit models. Lower cognitive capacity – as determined by the fluid intelligence measure – was significantly associated with greater hearing loss. Subjective benefit could not be predicted by any of the variables considered.Conclusion: The present study does not give evidence that hearing aid benefit is critically associated with cognitive
Stone, Michael A; Moore, Brian C J; Meisenbacher, Katrin; Derleth, Ralph P
Open canal fittings are a popular alternative to close-fitting earmolds for use with patients whose low-frequency hearing is near normal. Open canal fittings reduce the occlusion effect but also provide little attenuation of external air-borne sounds. The wearer therefore receives a mixture of air-borne sound and amplified but delayed sound through the hearing aid. To explore systematically the effect of the mixing, we simulated with varying degrees of complexity the effects of both a hearing loss and a high-quality hearing aid programmed to compensate for that loss, and used normal-hearing participants to assess the processing. The off-line processing was intended to simulate the percept of listening to the speech of a single (external) talker. The effect of introducing a delay on a subjective measure of speech quality (disturbance rating on a scale from 1 to 7, 7 being maximal disturbance) was assessed using both a constant gain and a gain that varied across frequency. In three experiments we assessed the effects of different amounts of delay, maximum aid gain and rate of change of gain with frequency. The simulated hearing aids were chosen to be appropriate for typical mild to moderate high-frequency losses starting at 1 or 2 kHz. Two of the experiments used simulations of linear hearing aids, whereas the third used fast-acting multichannel wide-dynamic-range compression and a simulation of loudness recruitment. In one experiment, a condition was included in which spectral ripples produced by comb-filtering were partially removed using a digital filter. For linear hearing aids, disturbance increased progressively with increasing delay and with decreasing rate of change of gain; the effect of amount of gain was small when the gain varied across frequency. The effect of reducing spectral ripples was also small. When the simulation of dynamic processes was included (experiment 3), the pattern with delay remained similar, but disturbance increased with increasing
Chrzan, R; Miechowicz, S; Urbanik, A; Markowska, O; Kudasik, T
Rapid prototyping is the technology of automatic freeform fabrication of physical objects from virtual CAD (computer aided design) models. For medical objects the models may be created using data from CT, MR or rotational angiography. We descriobe the case of a 83-year-old woman with essential bilateral hearing impairment as the effect of chronic otitis media. An individually fitted hearing aid was produced for the patient using stereolithography technology and vacuum casting based on data obtained during ear CT. Rapid prototyping may help in manufacturing individually adjusted biomedical prostheses, reducing the time of device production and improving its fitting.
Barbosa, Mirna Rossi; Medeiros, Daniel de Sousa; Rossi-Barbosa, Luiza Augusta Rosa; Caldeira, Antônio Prates
To analyze the self-reported outcomes after hearing aid fitting among individuals in the northern region of Minas Gerais and associated factors. A cross-sectional and analytical study with a random sample of adults and elderly attending the public health care service was conducted in the northern region of Minas Gerais (86 municipalities), Brazil. Study's participants answered International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires. Data were analyzed descriptively and analytically with Poisson regression analysis. We interviewed 272 adults and 112 individuals reported not using their hearing aids regularly. The mean of IOI-HA global score was lower than expected. The individual's relationship with their hearing aid (Factor 1) was worse than the individual's relationship with their environment (Factor 2). Lower global scores were statistically associated with no work. The observed scores for the study's population are lower than those recorded in other studies. The results suggest that there are limitations in the fitting and follow-up of individuals who received hearing aids.
Moore, Brian C J; Füllgrabe, Christian
A method for fitting multichannel compression hearing aids with an extended high-frequency response, called CAMEQ2-HF, was described by . This study describes an evaluation of the method, using a 16-channel behind the ear hearing aid incorporating slow-acting compression and providing gain for frequencies up to 7500 Hz. Eleven participants with mild to moderate cochlear hearing loss were fitted bilaterally using the gains prescribed by CAMEQ2-HF. The fittings were checked using real-ear measurements with swept sinusoidal signals, and adjustments were made so that the target gains at the center frequency of each channel were achieved with a typical tolerance of +/-3 dB for an input level of 65 dB and with a typical tolerance of +/-5 dB for levels of 50 and 80 dB SPL. Participants were asked to wear the hearing aids as much as possible in their everyday lives and to fill in questionnaires and a structured diary about their experience of loudness and their listening problems in everyday life, both for listening unaided and after a period of use of the aids. Scores obtained using the Profile of Aided Loudness (PAL) indicated that the hearing aids led to a clear increase in loudness (relative to unaided listening) for weak sounds and to smaller increases in loudness for sounds of medium and high intensity. For aided listening, strong sounds were typically rated as "loud, but OK." Satisfaction ratings for loudness obtained using the PAL showed only small differences between unaided and aided listening. Responses obtained via the structured diary (for aided listening only) indicated that target speech was usually judged as "loud enough" in a variety of situations. Clarity judgments ranged from "reasonably clear" to "OK" for most situations, but fell to "not very clear" for a noisy group situation. The loudness of background sounds was mostly judged as "OK," except for the noisy group situation in which the background was judged "bit loud." Results from the Abbreviated
Francart, Tom; McDermott, Hugh J
The addition of acoustic stimulation to electric stimulation via a cochlear implant has been shown to be advantageous for speech perception in noise, sound quality, music perception, and sound source localization. However, the signal processing and fitting procedures of current cochlear implants and hearing aids were developed independently, precluding several potential advantages of bimodal stimulation, such as improved sound source localization and binaural unmasking of speech in noise. While there is a large and increasing population of implantees who use a hearing aid, there are currently no generally accepted fitting methods for this configuration. It is not practical to fit current commercial devices to achieve optimal binaural loudness balance or optimal binaural cue transmission for arbitrary signals and levels. There are several promising experimental signal processing systems specifically designed for bimodal stimulation. In this article, basic psychophysical studies with electric acoustic stimulation are reviewed, along with the current state of the art in fitting, and experimental signal processing techniques for electric acoustic stimulation.
Johansen, Benjamin; Petersen, Michael Kai; Pontoppidan, Niels Henrik
. A significant difference between program usage, and weekdays versus weekends, were found. Users not only changed programs to modify aspects of directionality and noise reduction, but also continuously adjusted the volume. Rethinking hearing instruments as devices that adaptively learn behavioral patterns based...
Stiles, Derek J.; McGregor, Karla K.; Bentler, Ruth A.
Purpose: To determine whether children with mild-to-moderately severe sensorineural hearing loss (CHL) present with disturbances in working memory and whether these disturbances relate to the size of their receptive vocabularies. Method: Children 6 to 9 years of age participated. Aspects of working memory were tapped by articulation rate, forward…
Moore, B C; Glasberg, B R; Stone, M A
A model for predicting loudness for people with cochlear hearing loss is applied to the problem of the initial fitting of multi-channel fast-acting compression hearing aids. The fitting is based entirely on the pure tone audiogram, and does not require measures of loudness growth. One constraint is always applied: the specific loudness pattern evoked by speech of a moderate level (65 dB SPL) should be reasonably flat (equal loudness per critical band), and the overall loudness should be similar to that evoked in a normal listener by 65-dB speech. This is achieved using the 'Cambridge' formula. For hearing aids where the compression threshold in each channel can be set to a very low value, an additional constraint is used: speech with an overall level of 45 dB SPL should be audible over its entire dynamic range in all frequency channels from 500 Hz up to about 4 kHz. For hearing aids where the compression thresholds cannot be set to very low values, a different additional constraint is used: the specific loudness pattern evoked by speech of a high level (85 dB SPL, and with the spectral characteristics of shouted speech) should be reasonably flat, and the overall loudness should be similar to that evoked in a normal listener by 85-dB speech. For both cases, compression ratios are limited to values below 3. For each of these two cases, we show how to derive compression ratios and gains, and for the first case, compression thresholds, for each channel. The derivations apply to systems with any number of channels. A computer program implementing the derivations is described. The program also calculates target insertion gains at the centre frequency of each channel for input levels of 50, 65 and 80 dB SPL, and target gains at the eardrum measured relative to the level at the reference microphone of a probe microphone system.
Zarenoe, Reza; Hällgren, Mathias; Andersson, Gerhard; Ledin, Torbjörn
Tinnitus is a common condition and there is a need to evaluate effects of tinnitus management in relation to moderating factors such as degree of hearing loss. As it is possible that tinnitus influences concentration, and thus is likely to disturb cognitive processing, the role of cognitive functioning also needs to be investigated. To compare a group of patients with sensorineural hearing loss and tinnitus to a control group with only sensorineural hearing loss (and no tinnitus). To investigate working memory, sleep, and hearing problems measured before and after hearing rehabilitation. A prospective study. The sample consisted of 100 patients, 50 with hearing loss and tinnitus, and 50 controls with hearing loss but no tinnitus. All patients were between 40 and 82 yr old and had a pure-tone average (PTA; average of 0.5, 1, 2, and 4 kHz) hearing aids with regard to their working memory capacity, sleep quality, hearing problems, speech recognition, and tinnitus annoyance. Eight patients dropped out of the study. Thus, a total of 92 patients were included for analysis, with 46 in each group. As a consequence of unplanned age and PTA differences between the groups, an age-matched subsample (n = 30 + 30) was selected for further analysis. Tests including the Reading Span, Hearing-in-Noise Test (HINT), Tinnitus Handicap Inventory (THI), Hearing Handicap Inventory for the Elderly (HHIE), and Pittsburgh Sleep Quality Index (PSQI) were administered before and after hearing aid rehabilitation. There were no between-group differences at baseline in the full sample (n = 92), with the exception of the THI (p hearing loss and tinnitus group had significantly higher scores. Pre/post changes were significant for both groups on the Reading Span, and HHIE. However, these improvements were significantly larger for the patients in the hearing loss and tinnitus group on the Reading Span test (p hearing loss also exhibited significantly improved THI scores at follow-up, compared to
Stiles, Derek J; McGregor, Karla K; Bentler, Ruth A
To determine whether children with mild-to-moderately severe sensorineural hearing loss (CHL) present with disturbances in working memory and whether these disturbances relate to the size of their receptive vocabularies. Children 6 to 9 years of age participated. Aspects of working memory were tapped by articulation rate, forward and backward digit span in the auditory and visual modalities, Corsi span, parent surveys, and a sequential encoding task. Articulation rate, digit spans, and Corsi spans were also administered in low-level broadband noise. CHL and children with normal hearing (CNH) demonstrated auditory advantage in forward serial recall. CHL demonstrated slower articulation rates than CNH, but similar memory spans. CHL with poor executive function presented with poorer performance on the Corsi span task. The presence of background noise had no effect on performance in either group. CHL presented with significantly smaller receptive vocabularies than their CNH peers. Across groups, receptive vocabulary size was positively correlated with digit span in quiet, Corsi span in noise, and articulation rate. In the presence of mild-to-moderately severe hearing loss, children demonstrated resilient working memory systems. For all children, working memory and vocabulary were related; that is, children with poorer working memory had smaller vocabulary sizes.
Full Text Available In order to develop oral communication, hearing impaired infants and young children must be able to hear speech comfortably and consistently. To day children with all degrees of hearing loss may be condidates for some kinds of amlification. As children differ from adults, many Factors should be consider in hearing aid selection, evaluation and fitting. For example the child age when he or she is candidate for custom instruments? Do we consider programmable Hearing aid? Are multi memory instruments appropriate for them? What about directional microphones? What style of hearing aid do we select? In this paper such questions are Answered.
Marriage, Josephine; Moore, Brian C J; Alcántara, José I
We assessed whether gain requirements differ for experienced users and new users when fitted with multi-band compression hearing aids Three procedures for initial fitting were used: the Cambridge method for loudness equalization (CAMEQ), the Cambridge method for loudness restoration (CAMREST), and the desired sensation level input/output (DSL[i/o]) method. Twenty experienced hearing aid users and 20 new users with mild-to-severe sensorineural loss were fitted with Danalogic 163D digital hearing aids, using each procedure in turn in a counter-balanced order. The new users were given a pre-fitting with slightly reduced gains prior to the 'formal' fitting. Immediately after formal fitting with a given procedure, and 1 week after fitting, the gains were adjusted by the minimum amount necessary to achieve acceptable fittings. The amount of adjustment required provided the main measure of the adequacy of the initial fitting. On average, new users required decreases in gain for all procedures, the decreases being larger for DSL[i/o] than for CAMEQ or CAMREST. For experienced users, gain adjustments were small for CAMEQ and CAMREST, but were larger and mostly negative for DSL[i/o]. After these gain adjustments, users wore the aids for at least 3 weeks before filling out the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and taking part in laboratory measurements of the speech reception threshold (SRT) for sentences in quiet and in steady and fluctuating background noise at levels of 60 and 75 dBSPL. The scores on the APHAB test and the SRTs did not differ significantly for the three procedures. We conclude that the CAMEQ and CAMREST procedures provide more appropriate initial fittings than DSL[i/o]. For inexperienced users, gains typically need to be reduced by about 3dB relative to those prescribed by CAMEQ or CAMREST, although the amount of reduction may depend on hearing loss. An analysis of gain adjustments as a function of order of testing provided
... Consumer Devices Consumer Products Hearing Aids Types of Hearing Aids Share Tweet Linkedin Pin it More sharing ... are some features for hearing aids? What are hearing aids? Hearing aids are sound-amplifying devices designed ...
Madsen, Sara M K; Moore, Brian C J
The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. © The Author(s) 2014.
Moore, Brian C. J.
The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. PMID:25361601
Heinemann, Trine; Matthews, Ben; Raudaskoski, Pirkko Liisa
to the interaction during hearing aid fitting. This report of a Danish pilot study describes two such problems. The first problem arises from the requirement that the audiologist needs to ‘translate’ the patient’s subjective hearing description for making technological decisions. The second problem is the way...... in which the hearing aid user’s implicit and often unrealistic expectations are handled. This kind of research has potential application for developing a model of best practices....
Souza, Pamela E; Sirow, Lynn
Several laboratory studies have demonstrated that working memory may influence response to compression speed in controlled (i.e., laboratory) comparisons of compression. In this study, the authors explored whether the same relationship would occur under less controlled conditions, as might occur in a typical audiology clinic. Participants included 27 older adults who sought hearing care in a private practice audiology clinic. Working memory was measured for each participant using a reading span test. The authors examined the relationship between working memory and aided speech recognition in noise, using clinically fit hearing aids with a range of compression speeds. Working memory, amount of hearing loss, and age each contributed to speech recognition, but the contribution depended on the speed of the compression processor. For fast-acting compression, the best performance was obtained by patients with high working memory. For slow-acting compression, speech recognition was affected by age and amount of hearing loss but was not affected by working memory. Despite the expectation of greater variability from differences in compression implementation, number of compression channels, or attendant signal processing, the relationship between working memory and compression speed showed a similar pattern as results from more controlled, laboratory-based studies.
Amberley V. Ostevik
Full Text Available Open-fit hearing aids (OFHAs may be of benefit for some individuals with chronic outer and middle ear conditions for which boneanchored hearing devices (BAHDs are normally recommended. The purpose of this study was to compare performance between OFHAs and BAHDs. A Starkey Destiny 800 OFHA was fit on eight adult BAHD users and speech perception measures in quiet and in background noise were compared under two different test conditions: i BAHD only and ii OFHA only. Equivalent outcome measure performance between these two conditions suggests that the OFHA was able to provide sufficient amplification for mild to moderate degrees of hearing loss (pure-tone averages (PTAs less than 47 dB HL. The improved speech perception performances and increased loudness ratings observed for several of the participants with moderately-severe to severe degrees of hearing loss (PTAs of 47 dB HL or greater in the BAHD only condition suggest that the OFHA did not provide sufficient amplification for these individuals. Therefore, OFHAs may be a successful alternative to the BAHD for individuals with no more than a moderate conductive hearing loss who are unable or unwilling to undergo implant surgery or unable to wear conventional hearing aids due to allergies, irritation, or chronic infection associated with the ear being blocked with a shell or earmold.
Convery, Elizabeth; Keidser, Gitte; Caposecco, Andrea; Swanepoel, De Wet; Wong, Lena L N; Shen, Eed
The purpose of the study was twofold: (1) to assess the ability of hearing-impaired adults in the developing world to independently and accurately assemble a pair of hearing aids by following instructions that were written and illustrated according to best-practice health literacy principles; and (2) to determine which factors influence independent and accurate task completion. Correlational study. Forty South African and 40 Chinese adults with a hearing loss and their partners. The participant group included 42 females and 38 males ranging in age from 32 to 92 years. Ninety-five percent of South African and 60% of Chinese participants completed the assembly task, either on their own or with assistance from their partners. Better health literacy, younger age, and a more prestigious occupation were significantly associated with independent task completion for the South African and Chinese participants. Task accuracy was significantly linked to higher levels of cognitive function among South African participants, while a paucity of valid data prevented an analysis of accuracy from being conducted with the Chinese data. Individuals of diverse backgrounds can manage the self-fitting hearing-aid assembly task as long as health literacy levels and cultural differences are considered.
Wolf, M.J. de; Hol, M.K.S.; Mylanus, E.A.M.; Snik, A.F.M.; Cremers, C.W.R.J.
OBJECTIVE: To evaluate the benefits of a bone-anchored hearing aid (BAHA) in the daily lives of hearing-impaired children. DESIGN: Retrospective questionnaire study. SETTING: Nijmegen Medical Centre, Nijmegen, the Netherlands. PATIENTS: Thirty-eight BAHA users with a minimum age of 4 years at BAHA
Busch, Susan; Kruck, Stefanie; Spickers, Dirk; Leuwer, Rudolf; Hoth, Sebastian; Praetorius, Mark; Plinkert, Peter K; Mojallal, Hamidreza; Schwab, Burkard; Maier, Hannes; Lenarz, Thomas
Patients with moderate-to-severe mixed hearing losses (MHLs) are hard to provide sufficient benefit with currently available conventional hearing aids. Here, the long-term safety of a direct acoustic cochlear stimulator (DACS) and the effectiveness compared with conventional "high-performance" hearing aids were investigated. Prospective, within patient reference, nonrandomized, interventional multicenter clinical study performed at these 3 centers: Medical University Hannover, University of Heidelberg, and Helios Hospital Krefeld. Ten otosclerosis patients with severe-to-profound MHL were preoperatively fitted with state-of-the-art conventional hearing aids (HA). After 2 months of testing conventional HA, 9 of the patients decided to be implanted with a DACS. Air conduction (AC) and bone conduction (BC) aided and unaided thresholds, speech discrimination before and after implantation and at 3, 6, and 12 months after activation. The subjective benefit was assessed by the Abbreviated Profile of Hearing Aid Benefit (APHAB). Preoperative hearing thresholds were preserved over the 12 month observation time after activation. Average functional gain (0.5-4 kHz) achieved with conventional HA was 47 dB compared with 56 dB with the DACS. Speech-in-noise tests revealed a lower SNR for DACS (3.1 dB) than for the HA (6.6 dB) and patients were more satisfied with the DACS. The DACS significantly improved hearing, speech intelligibility, and satisfaction in patients with a severe-to-profound mixed hearing loss and can be considered a safe and useful alternative to conventional hearing aids.
Moore, Brian C J; Füllgrabe, Christian; Stone, Michael A
To determine preferred parameters of multichannel compression using individually fitted simulated hearing aids and a method of paired comparisons. Fourteen participants with mild to moderate hearing loss listened via a simulated five-channel compression hearing aid fitted using the CAMEQ2-HF method to pairs of speech sounds (a male talker and a female talker) and musical sounds (a percussion instrument, orchestral classical music, and a jazz trio) presented sequentially and indicated which sound of the pair was preferred and by how much. The sounds in each pair were derived from the same token and differed along a single dimension in the type of processing applied. For the speech sounds, participants judged either pleasantness or clarity; in the latter case, the speech was presented in noise at a 2-dB signal-to-noise ratio. For musical sounds, they judged pleasantness. The parameters explored were time delay of the audio signal relative to the gain control signal (the alignment delay), compression speed (attack and release times), bandwidth (5, 7.5, or 10 kHz), and gain at high frequencies relative to that prescribed by CAMEQ2-HF. Pleasantness increased with increasing alignment delay only for the percussive musical sound. Clarity was not affected by alignment delay. There was a trend for pleasantness to decrease slightly with increasing bandwidth, but this was significant only for female speech with fast compression. Judged clarity was significantly higher for the 7.5- and 10-kHz bandwidths than for the 5-kHz bandwidth for both slow and fast compression and for both talker genders. Compression speed had little effect on pleasantness for 50- or 65-dB SPL input levels, but slow compression was generally judged as slightly more pleasant than fast compression for an 80-dB SPL input level. Clarity was higher for slow than for fast compression for input levels of 80 and 65 dB SPL but not for a level of 50 dB SPL. Preferences for pleasantness were approximately equal
Kim, Hannah; Ricketts, Todd A
To investigate the test-retest reliability of real-ear aided response (REAR) measures in open and closed hearing aid fittings in children using appropriate probe-microphone calibration techniques (stored equalization for open fittings and concurrent equalization for closed fittings). Probe-microphone measurements were completed for two mini-behind-the-ear (BTE) hearing aids which were coupled to the ear using open and closed eartips via thin (0.9 mm) tubing. Before probe-microphone testing, the gain of each of the test hearing aids was programmed using an artificial ear simulator (IEC 711) and a Knowles Electronic Manikin for Acoustic Research to match the National Acoustic Laboratories-Non-Linear, version 1 targets for one of two separate hearing loss configurations using an Audioscan Verifit. No further adjustments were made, and the same amplifier gain was used within each hearing aid across both eartip configurations and all participants. Probe-microphone testing included real-ear occluded response (REOR) and REAR measures using the Verifit's standard speech signal (the carrot passage) presented at 65 dB sound pressure level (SPL). Two repeated probe-microphone measures were made for each participant with the probe-tube and hearing aid removed and repositioned between each trial in order to assess intrasubject measurement variability. These procedures were repeated using both open and closed domes. Thirty-two children, ages ranging from 4 to 14 yr. The test-retest standard deviations for open and closed measures did not exceed 4 dB at any frequency. There was also no significant difference between the open (stored equalization) and closed (concurrent equalization) methods. Reliability was particularly similar in the high frequencies and was also quite similar to that reported in previous research. There was no correlation between reliability and age, suggesting high reliability across all ages evaluated. The findings from this study suggest that reliable probe
Frank, Bastien Alphous Marie; Boymans, Monique; Dreschler, Wouter Albert
The main purpose of this study is to examine the applicability of an adaptive and interactive optimization strategy to fine-tune three hearing-aid algorithms simultaneously: dynamic compression, temporal signal enhancement, and noise reduction. The optimal combination of these three algorithms was
Glista, Danielle; Scollie, Susan; Sulkers, Jacob
Purpose: In this study, the authors evaluated the effect of frequency compression hearing aids on speech perception ability and the time course and magnitude of acclimatization-related changes. Method: Participants included children ages 11-18 years. Speech perception ability was evaluated over well-controlled baseline, treatment, and withdrawal…
... of hearing loss. Hearing loss can have a negative effect on communication, relationships, school/work performance, and emotional ... the President's Council of Advisors on Science and Technology (PCAST), and the ... in Effect Guidance Document: Conditions for Sale for Air-Conduction ...
Convery, Elizabeth; Keidser, Gitte; Seeto, Mark; Yeend, Ingrid; Freeston, Katrina
A reliable and valid method for the automatic in situ measurement of hearing thresholds is a prerequisite for the feasibility of a self-fitting hearing aid, whether such a device becomes an automated component of an audiological management program or is fitted by the user independently of a clinician. Issues that must be addressed before implementation of the procedure into a self-fitting hearing aid include the role of real-ear-to-dial difference correction factors in ensuring accurate results and the ability of potential users to successfully self-direct the procedure. The purpose of this study was to evaluate the reliability and validity of an automatic audiometry algorithm that is fully implemented in a wearable hearing aid, to determine to what extent reliability and validity are affected when the procedure is self-directed by the user, and to investigate contributors to a successful outcome. Design was a two-phase correlational study. A total of 60 adults with mild to moderately severe hearing loss participated in both studies: 20 in Study 1 and 40 in Study 2. Twenty-seven participants in Study 2 attended with a partner. Participants in both phases were selected for inclusion if their thresholds were within the output limitations of the test device. In both phases, participants performed automatic audiometry through a receiver-in-canal, behind-the-ear hearing aid coupled to an open dome. In Study 1, the experimenter directed the task. In Study 2, participants followed a set of written, illustrated instructions to perform automatic audiometry independently of the experimenter, with optional assistance from a lay partner. Standardized measures of hearing aid self-efficacy, locus of control, cognitive function, health literacy, and manual dexterity were administered. Statistical analysis examined the repeatability of automatic audiometry; the match between automatically and manually measured thresholds; and contributors to successful, independent completion of
Davidson, Lisa S; Firszt, Jill B; Brenner, Chris; Cadieux, Jamie H
A coordinated fitting of a cochlear implant (CI) and contralateral hearing aid (HA) for bimodal device use should emphasize balanced audibility and loudness across devices. However, guidelines for allocating frequency information to the CI and HA are not well established for the growing population of bimodal recipients. The study aim was to compare the effects of three different HA frequency responses, when fitting a CI and an HA for bimodal use, on speech recognition and localization in children/young adults. Specifically, the three frequency responses were wideband, restricted high frequency, and nonlinear frequency compression (NLFC), which were compared with measures of word recognition in quiet, sentence recognition in noise, talker discrimination, and sound localization. The HA frequency responses were evaluated using an A B₁ A B₂ test design: wideband frequency response (baseline-A), restricted high-frequency response (experimental-B₁), and NLFC-activated (experimental-B2). All participants were allowed 3-4 weeks between each test session for acclimatization to each new HA setting. Bimodal benefit was determined by comparing the bimodal score to the CI-alone score. Participants were 14 children and young adults (ages 7-21 yr) who were experienced users of bimodal devices. All had been unilaterally implanted with a Nucleus CI24 internal system and used either a Freedom or CP810 speech processor. All received a Phonak Naida IX UP behind-the-ear HA at the beginning of the study. Group results for the three bimodal conditions (HA frequency response with wideband, restricted high frequency, and NLFC) on each outcome measure were analyzed using a repeated measures analysis of variance. Group results using the individual "best bimodal" score were analyzed and confirmed using a resampling procedure. Correlation analyses examined the effects of audibility (aided and unaided hearing) in each bimodal condition for each outcome measure. Individual data were
Sojkin, Bogdan; Pruszewicz, Antoni; Swidzińska, Anna; Swidziński, Piotr
The developing of free market in Poland gives medical firms of opportunities but also necessity of adoption for more and more individual needs of customers. This article presents some aspects of marketing on the hearing aids market. The conclusions are based on long observation and empirical research. Problems mentioned in it are connected with principles like distribution channels, specific customers services and promotion. It also shows relations between medical firms, specialists, doctors, audiologists and real customers.
Bennett, Rebecca J; Laplante-Lévesque, Ariane; Meyer, Carly J; Eikelboom, Robert H
To gather perspectives of hearing aid owners and hearing healthcare clinicians with regard to problems that arise after hearing aid fitting and use these perspectives to generate a conceptual framework to gain a better understanding of these problems. Participants included a group of 17 hearing aid owners and a group of 21 hearing healthcare clinicians; data collection occurred separately for each group. Participants each attended two group sessions in Perth, Western Australia, wherein they: (1) generated statements describing the problems associated with hearing aids and (2) grouped and rated the statements to identify key themes. Concept mapping was used to generate a conceptual framework. Participants identified four concepts regarding hearing aid problems as follows: (1) hearing aid management; (2) hearing aid sound quality and performance; (3) feelings, thoughts, and behaviors; and (4) information and training. While hearing aid owners and clinicians generated similar results regarding the concepts derived, the clinicians reported that the problems identified had a greater negative impact on hearing aid success than did hearing aid owners. The magnitude and diversity of hearing aid problems identified in this study highlight the ongoing challenges that hearing aid owners face and suggest that current processes for hearing aid fitting can be improved. Problems relating to hearing aid management were most often deemed to have the greatest impact on hearing aid success and be the most preventable/solvable, and thus are a good starting point when addressing hearing aid-related problems.
Sound lateralization ability of patients with bilateral microtia and atresia after bilateral reconstruction of auricles and external auditory canals and fitting of new canal-type hearing aids to replace a bone conduction hearing aid.
Kaga, Kimitaka; Asato, Hirotaka
Each of eight patients with bilateral microtia and atresia underwent bilateral reconstruction of the auricles and external auditory canals and were fitted bilateral canal-type hearing aids in the operated ears to replace a bone conduction hearing aid. The ability to discriminate inter-aural intensity difference (IID) and even inter-aural time difference (ITD) was retained in all these patients. This study studied the post-operative sound lateralization ability of patients with bilateral microtia and atresia after total reconstruction of both auricles and external auditory canals, followed by fitting of bilateral canal-type hearing aids. Eight patients with bilateral microtia and atresia ranging in age from 13-43 years were recruited in this study. Each of them underwent bilateral reconstruction of the auricles and external auditory canals and were fitted canal-type hearing aids in both the operated ears to replace a bone conduction hearing aid. A sound lateralization test was conducted to determine IID and ITD discrimination ability thresholds. In all the patients, the IID discrimination ability thresholds of the patients were more than 3-fold those of the controls, the ITD discrimination ability threshold was more than 5-fold those of controls, and binaural hearing was retained.
Ching, Teresa Y C; Quar, Tian Kar; Johnson, Earl E; Newall, Philip; Sharma, Mridula
An important goal of providing amplification to children with hearing loss is to ensure that hearing aids are adjusted to match targets of prescriptive procedures as closely as possible. The Desired Sensation Level (DSL) v5 and the National Acoustic Laboratories' prescription for nonlinear hearing aids, version 1 (NAL-NL1) procedures are widely used in fitting hearing aids to children. Little is known about hearing aid fitting outcomes for children with severe or profound hearing loss. The purpose of this study was to investigate the prescribed and measured gain of hearing aids fit according to the NAL-NL1 and the DSL v5 procedure for children with moderately severe to profound hearing loss; and to examine the impact of choice of prescription on predicted speech intelligibility and loudness. Participants were fit with Phonak Naida V SP hearing aids according to the NAL-NL1 and DSL v5 procedures. The Speech Intelligibility Index (SII) and estimated loudness were calculated using published models. The sample consisted of 16 children (30 ears) aged between 7 and 17 yr old. The measured hearing aid gains were compared with the prescribed gains at 50 (low), 65 (medium), and 80 dB SPL (high) input levels. The goodness of fit-to-targets was quantified by calculating the average root-mean-square (RMS) error of the measured gain compared with prescriptive gain targets for 0.5, 1, 2, and 4 kHz. The significance of difference between prescriptions for hearing aid gains, SII, and loudness was examined by performing analyses of variance. Correlation analyses were used to examine the relationship between measures. The DSL v5 prescribed significantly higher overall gain than the NAL-NL1 procedure for the same audiograms. For low and medium input levels, the hearing aids of all children fit with NAL-NL1 were within 5 dB RMS of prescribed targets, but 33% (10 ears) deviated from the DSL v5 targets by more than 5 dB RMS on average. For high input level, the hearing aid fittings of
Kessinger, R.; Polhemus, J. T.; Waring, J. G.
Hearing aids are automatically checked by circuit that applies half-second test signal every thirty minutes. If hearing-aid output is distorted, too small, or if battery is too low, a warning lamp is activated. Test circuit is incorporated directly into hearing-aid package.
... Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for ... well. For example, if you want to play music, ask your audiologist about a program designed for ...
Full Text Available Background: Accurate diagnosis and management of hearing loss (HL is based on valid and accurate ear-specific and frequency-specific information. This is especially relevant as non-optimal hearing amplification as part of early hearing detection and intervention programmes may result in further delays in the speech and language development of children with HL. Audiological measures utilised may vary according to the age, cognitive ability and physical ability of the infant or child. It is therefore important to compare and critically evaluate current clinical practice in order to recommend guidelines for paediatric audiology in South Africa.Objectives: To determine the availability of audiological equipment and clinical protocols used by audiologists in Gauteng for paediatric audiological assessment and hearing aid (HA fitting.Method: A descriptive, cross-sectional survey research design was utilised to describe the availability of clinical audiological equipment and protocols used by audiologists in Gauteng, South Africa for paediatric assessment and HA fitting. Eighteen audiology departments, eleven public hospitals and seven private practices were included in the study.Results: Results revealed the limited availability of departmental protocols within departments for paediatric assessment and HA fitting. Although there appeared to be a wide variety of equipment available to audiologists in public sector hospitals and private practice, a lack of high-frequency tympanometers and equipment for real ear measurements was revealed.Conclusion: These findings highlight the need for the development and use of current, evidence-based practice guidelines for paediatric audiological assessment and HA fitting in South Africa. These guidelines should include a list of essential equipment required for paediatric assessment and HA fitting. Current, evidence-based practice guidelines for paediatric HA fitting are important in ensuring that secondary
à Wengen, D F
Conventional acoustic hearing aids are limited in their performance. Due to physical laws their amplification of sound is limited to within 5 kHz. However, the frequencies between 5 and 10 kHz are essential for understanding consonants. Words can only be understood correctly if their consonants can be understood. Furthermore noise amplification remains a problem with hearing aids. Other problems consist of recurrent infections of the external auditory canal, intolerance for occlusion of the ear canal, feedback noise, and resonances in speech or singing. Implantable middle ear hearing aids like the Soundbridge of Symphonix-Siemens and the MET of Otologics offer improved amplification and a more natural sound. Since the first implantation of a Soundbridge in Switzerland in 1996 almost one thousand patients have been implanted worldwide. The currents systems are semi-implantable. The external audio processor containing the microphone, computer chip, battery and radio system is worn in the hair bearing area behind the ear. Implantation is only considered after unsuccessful fitting of conventional hearing aids. In Switzerland the cost for these implantable hearing aids is covered by social insurances. Initially the cost for an implant is higher than for hearing aids. However, hearing aids need replacement every 5 or 6 years whereas implants will last 20 to 30 years. Due to the superior sound quality and the improved understanding of speech in noise, the number of patients with implantable hearing aids will certainly increase in the next years. Other middle ear implants are in clinical testing.
Walker, Elizabeth A.; McCreery, Ryan W.; Spratford, Meredith; Roush, Patricia A.
Background Up to 15% of children with permanent hearing loss have auditory neuropathy spectrum disorder (ANSD), which involves normal outer hair cell function and disordered afferent neural activity in the auditory nerve or brainstem. Given the varying presentations of ANSD in children, there is a need for more evidence-based research on appropriate clinical interventions for this population. Purpose This study compared the speech production, speech perception, and language outcomes of children with auditory neuropathy spectrum disorder (ANSD) who are hard of hearing and children with similar degrees of mild to moderately-severe sensorineural hearing loss (SNHL), all of whom were fitted with bilateral hearing aids based on the American Academy of Audiology (AAA) pediatric amplification guidelines. Research design Speech perception and communication outcomes data were gathered in a prospective accelerated longitudinal design, with entry into the study between six months and seven years of age. Three sites were involved in participant recruitment: Boys Town National Research Hospital, the University of North Carolina at Chapel Hill, and the University of Iowa. Study sample: The sample consisted of 12 children with ANSD and 22 children with SNHL. The groups were matched based on better-ear pure-tone average, better-ear aided speech intelligibility index, gender, maternal education level, and newborn hearing screening result (i.e., pass or refer). Data collection and analysis Children and their families participated in an initial baseline visit, followed by visits twice a year for children under age 2 years and once a year for children older than 2 years. Paired-sample t-tests were used to compare children with ANSD to children with SNHL. Results Paired t-tests indicated no significant differences between the ANSD and SNHL groups on language and articulation measures. Children with ANSD displayed functional speech perception skills in quiet. Although the number of
Franck, Bastien Alphons Marie; Boymans, Monique; Dreschler, Wouter Albert
The main purpose of this study is to examine the applicability of an adaptive and interactive optimization strategy to fine-tune three hearing-aid algorithms simultaneously: dynamic compression, temporal signal enhancement, and noise reduction. The optimal combination of these three algorithms was determined by a multidirectional pattern search with an adaptive step size. Additionally, we applied a round-robin procedure to validate the results of the optimization procedure. For both procedures the listeners were asked to compare two consecutive, differently processed sentences in continuous and fluctuating background noises on speech intelligibility. Ten hearing-impaired and four normal-hearing subjects participated. The reliability and consistency of the multidirectional pattern search was low, especially for the fluctuating noise condition. The results of the round-robin procedure did not correspond closely with the pattern search results. These findings suggest that the current implementation of a multidirectional optimization procedure has not yet proven to be applicable for the necessary individual fine tuning of complex signal processing strategies, when the objective is to maximize speech intelligibility.
McDermott, Ann-Louise; Williams, Jo; Kuo, Michael; Reid, Andrew; Proops, David
To evaluate the self-rated quality of life and benefits associated with the use of a Bone-Anchored Hearing Aid (BAHA). To assess any change in health status after a BAHA. This was a retrospective postal questionnaire study. The Glasgow Children's Benefit Inventory was the validated tool used.Children with a BAHA on the Birmingham pediatric Bone-Anchored Hearing Aid Programme from February 1992 to February 2007 were included. One hundred fifteen children were sent a postal questionnaire. Eighty-four were returned, giving a response rate of 73%. All children had worn their BAHA for more than 6 months. Children with an implant-retained auricular prosthesis were excluded from the study, as were children who were older than 16 years at the time of the questionnaire. Patients with bilateral BAHA were advised to answer the questionnaire with reference to their first BAHA. The BAHA was a success in the pediatric population. All 84 children reported a positive benefit with their BAHA. The median benefit score was +54. No child demonstrated deterioration in health status after their BAHA. The use of a BAHA significantly enhanced general well-being, improved patient state of health (quality of life), and finally, was considered a success by patients and their families. This study demonstrates a significant benefit from BAHA as measured by the Glasgow Children's Benefit Inventory.
Moore, B C
Many researchers have proposed that multi-channel compression hearing aids should process sounds so as to restore loudness perception to 'normal'. However, procedures for achieving this have generally been based on measurements or calculations using narrowband stimuli, and these procedures may not be accurate for broadband sounds such as speech. Here, a model for predicting loudness for people with cochlear hearing loss is used to calculate the frequency- and level-dependent gains that would be required to restore loudness perception to 'normal' for speech-like signals. The calculations are based entirely on the pure tone audiogram, and do not require measures of loudness growth. The model was applied to several different hypothetical hearing losses, varying in slope and severity. In each case, the model was used to calculate the insertion gains (IGs) that would be required as a function of frequency so that speech-shaped noise with a level of 65 dB SPL would evoke a specific loudness pattern matching that for a normal ear. A similar procedure was applied using speech-shaped noise with a level of 85 dB SPL (with the spectral characteristics of shouted speech). The results were used to derive functions relating the required IG to hearing loss for each audiometric frequency and each speech-shaped noise level. These functions were used in turn to derive compression ratios and gains for each channel of a multi-channel compression system. The derivations apply to systems with any number of channels. The outcome is a method than can be used for the initial fitting of multichannel compression hearing aids, so as to restore loudness perception to near 'normal' for broadband speech-like signals.
Nishimura, Tadashi; Hosoi, Hiroshi; Saito, Osamu; Shimokura, Ryota; Yamanaka, Toshiaki; Kitahara, Tadashi
To assess the benefits of a new type of hearing aid using cartilage conduction (CC) in patients with severe conduction hearing loss and evaluate its potential for practical use. Consecutive, prospective case series. Forty-one subjects (21 with bilateral aural atresia; 15 with unilateral aural atresia; and 5 others) participated in this study. Fitting and gain adjustments of the CC hearing aids were performed to the ear(s) with conduction hearing loss. The function gains were measured. Evaluation of the measurements of speech performance-intensity functions, speech recognition scores, tolerance of environmental noise, and subject questionnaires were also performed, and judged according to the "Guidelines for the evaluation of hearing aid fitting" established by the Japan Audiological Society. The thresholds were significantly improved by CC hearing aids. The functional gains for CC hearing aids were nearly equivalent to that for their previously used hearing aids. The style of the transducer fixation and the type of aural atresia had no significant influence on the functional gains. Most of the assessment results were judged to be sufficient. Before the trial, bone conduction hearing aids had been used most frequently by bilateral aural atresia subjects. However, after the trial, most subjects continued to use CC hearing aids instead of reverting back to their original device. Overall, 39 subjects continued use of the CC hearing aids. No severe adverse effects were noted in the trial. Cartilage conduction hearing aids could be an additional and beneficial option for severe conduction hearing loss from aural atresia.
Schmitt, Nicola; Winkler, Alexandra; Boretzki, Michael; Holube, Inga
Outcomes with hearing aids (HAs) can be assessed using various speech tests, but many tests are not sensitive to changes in high-frequency audibility. A Phoneme Perception Test (PPT), designed for the phonemes /s/ and /ʃ/, has been developed to investigate whether detection and recognition tasks are able to measure individual differences in phoneme audibility and recognition for various hearing instrument settings. These capabilities were studied using two different fricative stimulus materials. The first set of materials preserves natural low-level sound components in the low- and mid-frequency ranges (LF set); the second set of materials attempts to limit the audibility to high-frequency fricative noise (nLF set). To study the effect on phoneme detection and recognition when auditory representations of /s/ and /ʃ/ are modified, a too strong nonlinear frequency compression (NLFC) setting was applied. Repeated measure design was used under several different conditions. A total of 31 hearing-impaired individuals participated in this study. Of the 31 participants, 10 individuals did not own HAs but were provided with them during the study and 21 individuals owned HAs and were experienced users. All participants had a symmetrical sensorineural hearing loss. The present study applied a phoneme detection test and a recognition test with two different stimulus sets under different amplification conditions. The statistical analysis focused on the capability of the PPT to measure the effect on audibility and perception of high-frequency information with and without HAs, and between HAs with two different NLFC settings ("default" and "too strong"). Detection thresholds (DTs) and recognition thresholds (RTs) were compared with respective audiometric thresholds in the free field for all available conditions. Significant differences in thresholds between LF and nLF stimuli were observed. The thresholds for nLF stimuli showed higher correlation to the corresponding
Full Text Available In this study, we investigated the relation between the use of hearing aids at the initial stages of hearing loss and age-related changes in the auditory and cognitive abilities of elderly persons. 12 healthy elderly persons participated in an annual auditory and cognitive longitudinal examination for three years. According to their hearing level, they were divided into 3 subgroups - the normal hearing group, the hearing loss without hearing aids group, and the hearing loss with hearing aids group. All the subjects underwent 4 tests: pure-tone audiometry, syllable intelligibility test, dichotic listening test (DLT, and Wechsler Adult Intelligence Scale-Revised (WAIS-R Short Forms. Comparison between the 3 groups revealed that the hearing loss without hearing aids group showed the lowest scores for the performance tasks, in contrast to the hearing level and intelligibility results. The other groups showed no significant difference in the WAIS-R subtests. This result indicates that prescription of a hearing aid during the early stages of hearing loss is related to the retention of cognitive abilities in such elderly people. However, there were no statistical significant correlations between the auditory and cognitive tasks.
Anderson, Melinda C; Arehart, Kathryn H; Souza, Pamela E
Current guidelines for adult hearing aid fittings recommend the use of a prescriptive fitting rationale with real-ear verification that considers the audiogram for the determination of frequency-specific gain and ratios for wide dynamic range compression. However, the guidelines lack recommendations for how other common signal-processing features (e.g., noise reduction, frequency lowering, directional microphones) should be considered during the provision of hearing aid fittings and fine-tunings for adult patients. The purpose of this survey was to identify how audiologists make clinical decisions regarding common signal-processing features for hearing aid provision in adults. An online survey was sent to audiologists across the United States. The 22 survey questions addressed four primary topics including demographics of the responding audiologists, factors affecting selection of hearing aid devices, the approaches used in the fitting of signal-processing features, and the strategies used in the fine-tuning of these features. A total of 251 audiologists who provide hearing aid fittings to adults completed the electronically distributed survey. The respondents worked in a variety of settings including private practice, physician offices, university clinics, and hospitals/medical centers. Data analysis was based on a qualitative analysis of the question responses. The survey results for each of the four topic areas (demographics, device selection, hearing aid fitting, and hearing aid fine-tuning) are summarized descriptively. Survey responses indicate that audiologists vary in the procedures they use in fitting and fine-tuning based on the specific feature, such that the approaches used for the fitting of frequency-specific gain differ from other types of features (i.e., compression time constants, frequency lowering parameters, noise reduction strength, directional microphones, feedback management). Audiologists commonly rely on prescriptive fitting formulas and
Hearing aids often develop malfunctions that are not detected by the wearer. This is particularly true when the wearers are school-age children. Studies of selected groups showed that from 30 to more than 50 percent of school children were not getting adequate benefit from their hearing aids because of unrecognized malfunctions, usually low or dead batteries. This can be serious because hearing impairment retards a child's educational progress. NASA technology incorporated in the Hearing Aid Malfunction Detection Unit (HAMDU), the device pictured, is expected to provide an effective countermeasure to the childrens' hearing aid problem. A patent license has been awarded to a minority-owned firm, Hopkins International Company, a subsidiary of H. H. Aerospace Design Co., Inc., Elmford, New York. The company plans early commercial availability of its version of the device.
Johannesen, Peter T.; Pérez-González, Patricia; Blanco, José L.; Kalluri, Sridhar; Edwards, Brent
Over 360 million people worldwide suffer from disabling hearing loss. Most of them can be treated with hearing aids. Unfortunately, performance with hearing aids and the benefit obtained from using them vary widely across users. Here, we investigate the reasons for such variability. Sixty-eight hearing-aid users or candidates were fitted bilaterally with nonlinear hearing aids using standard procedures. Treatment outcome was assessed by measuring aided speech intelligibility in a time-reversed two-talker background and self-reported improvement in hearing ability. Statistical predictive models of these outcomes were obtained using linear combinations of 19 predictors, including demographic and audiological data, indicators of cochlear mechanical dysfunction and auditory temporal processing skills, hearing-aid settings, working memory capacity, and pretreatment self-perceived hearing ability. Aided intelligibility tended to be better for younger hearing-aid users with good unaided intelligibility in quiet and with good temporal processing abilities. Intelligibility tended to improve by increasing amplification for low-intensity sounds and by using more linear amplification for high-intensity sounds. Self-reported improvement in hearing ability was hard to predict but tended to be smaller for users with better working memory capacity. Indicators of cochlear mechanical dysfunction, alone or in combination with hearing settings, did not affect outcome predictions. The results may be useful for improving hearing aids and setting patients’ expectations. PMID:28929903
Nielsen, Jens Brehm; Nielsen, Jakob; Jensen, Bjørn Sand
Modern digital hearing aids require and offer a great level of personalization. Today, this personalization is not performed based directly on what the user actually perceives, but on a hearing-care professional’s interpretation of what the user explains about what is perceived. In this paper......, an interactive personalization system based on Gaussian process regression and active learning is proposed, which personalize the hearing aids based directly on what the user perceives. Preliminary results demonstrate a significant difference between a truly personalized setting obtained with the proposed system...
... a microwave or conventional oven, or using a hair dryer on them. Clean hearing aids as instructed. Earwax and ear drainage can damage your aids. Avoid using hairspray and other hair care products while wearing your hearing aids. Turn ...
Hodgetts, William E; Hagler, Paul; Hakansson, Bo E V; Soli, Sigfrid D
Current approaches to fit bone-anchored hearing aid (Baha) rely heavily on patient feedback of "loudness" and "sound quality." Audiologists are limited to this approach for two reasons: (1) the technology in current models of Baha does not allow for much fine-tuning of frequency response or maximum output on an individual basis and (2) there has not been a valid approach to verify the frequency response or maximum output on an individual basis. The objectives of this study are to (1) describe an alternative approach to fit Baha, an "audibility-derived (AD)" fitting, and (2) test whether outcomes improve with this new fitting compared with the current "patient-derived (PD)" fitting. This study used a repeated measures design where each subject experienced both the AD and PD fittings in random order. Subjects were tested on a variety of outcome measures including output levels of aided speech, hearing in noise test (quiet and in noise), consonant recognition in noise, aided loudness, and subjective percentage of words understood. Electromechanical testing revealed significantly higher aided output with the AD fitting, especially in the high frequencies. Subjects performed significantly better in all outcome measures with the AD fitting approach except when testing aided loudness and subjective perception for which the differences were nonsignificant. When the input levels to the Baha were soft, advantages for the AD fitting were emerging on these tests, but they did not reach significance. This study presents a more objective, fitting approach for Baha that leads to better outcomes in the laboratory. The next steps will be to test these fittings in the real world and to make the approach generally available to clinicians fitting Bahas.
Thielemans, Thijs; Pans, Donné; Chenault, Michelene; Anteunis, Lucien
The aim of this study was to derive an independent fitting assistant based on expert consensus. Two questions were asked: (1) what (Dutch) terms do hearing impaired listeners use nowadays to describe their specific hearing aid fitting problems? (2) What is the expert consensus on how to resolve these complaints by adjusting hearing aid parameters? Hearing aid dispensers provided descriptors that impaired listeners use to describe their reactions to specific hearing aid fitting problems. Hearing aid fitting experts were asked "How would you adjust the hearing aid if its user reports that the aid sounds…?" with the blank filled with each of the 40 most frequently mentioned descriptors. 112 hearing aid dispensers and 15 hearing aid experts. The expert solution with the highest weight value was considered the best solution for that descriptor. Principal component analysis (PCA) was performed to identify a factor structure in fitting problems. Nine fitting problems could be identified resulting in an expert-based, hearing aid manufacturer independent, fine-tuning fitting assistant for clinical use. The construction of an expert-based, hearing aid manufacturer independent, fine-tuning fitting assistant to be used as an additional tool in the iterative fitting process is feasible.
... pitches. A proper fit can also reduce feedback. Digital Noise Reduction (DNR) Improves listener comfort and communication ... t think you’ll use it, skip it. Economy hearing aids may provide the advantages you need ...
Knudsen, Line Vestergaard; Öberg, Marie; Nielsen, Claus; Naylor, Graham; Kramer, Sophia E.
Objectives: This descriptive summary of the literature provides an overview of the available studies (published between January 1980 and January 2009) on correlates of help-seeking behavior for hearing loss, hearing-aid uptake, hearing-aid use, and satisfaction with the device. Methods: Publications were identified by structured searches in Pubmed and Cinahl and by inspecting the reference lists of relevant articles. The articles covered different stages that a person with hearing impairment may go through: prior to hearing aid fitting, the period covering the fitting and the period post hearing aid fitting. Inclusion of articles occurred according to strict inclusion and exclusion criteria. Data were extracted by two independent researchers. Thirty-nine papers were included that identified 31 factors examined in relation to the four outcome measures. These covered personal factors (e.g., source of motivation, expectation, attitude), demographic factors (e.g., age, gender) and external factors (e.g., cost, counseling). Only two studies covered the actual fitting process. There was only one factor positively affecting all four outcome variables. This was self-reported hearing disability. The vast majority of studies showed no relationship of age and gender with any of the outcome domains. Discussion and conclusion: Whereas research of the last 28 years yielded valuable information regarding relevant and irrelevant factors in hearing aid health care, there are still many relevant issues that have never been investigated in controlled studies. These are discussed. PMID:21109549
... a result of the aging process and/or noise exposure, but also may be secondary to head trauma, ... tested for word understanding in quiet and in noise, and for improvement in ... environments. Then eventually work up to wearing your hearing aids all waking ...
Munoz, Karen; Roberts, Mallory; Mullings, Day; Harward, Richard
This study addresses parent experiences in obtaining and managing hearing aids for their young child. The purpose was to identify challenges parents encounter to determine what state agencies can do to improve parent access to amplification. Data were collected July through September of 2010; 40 parents of children ages birth to 3 years old…
Başkent, Deniz; Eiler, Cheryl L; Edwards, Brent
To present a comprehensive analysis of the feasibility of genetic algorithms (GA) for finding the best fit of hearing aids or cochlear implants for individual users in clinical or research settings, where the algorithm is solely driven by subjective human input. Due to varying pathology, the best settings of an auditory device differ for each user. It is also likely that listening preferences vary at the same time. The settings of a device customized for a particular user can only be evaluated by the user. When optimization algorithms are used for fitting purposes, this situation poses a difficulty for a systematic and quantitative evaluation of the suitability of the fitting parameters produced by the algorithm. In the present study, an artificial listening environment was generated by distorting speech using a noiseband vocoder. The settings produced by the GA for this listening problem could objectively be evaluated by measuring speech recognition and comparing the performance to the best vocoder condition where speech was least distorted. Nine normal-hearing subjects participated in the study. The parameters to be optimized were the number of vocoder channels, the shift between the input frequency range and the synthesis frequency range, and the compression-expansion of the input frequency range over the synthesis frequency range. The subjects listened to pairs of sentences processed with the vocoder, and entered a preference for the sentence with better intelligibility. The GA modified the solutions iteratively according to the subject preferences. The program converged when the user ranked the same set of parameters as the best in three consecutive steps. The results produced by the GA were analyzed for quality by measuring speech intelligibility, for test-retest reliability by running the GA three times with each subject, and for convergence properties. Speech recognition scores averaged across subjects were similar for the best vocoder solution and for the
A. Karimaneh A. Eftekharian
Full Text Available The acceptability of hearing aids in people with presbyacusis has been improved but assessment of whether there is a need for more counseling to increase the number of regular hearing-aid users seems to be important. The aim of this study was to determine if the hearing aid was worn regularly and over a long period of time in people with presbyacusis. A questionnaire survey of patients with presbyacusis who had been fitted with a monaural behind the ear hearing aid for the first time was undertaken. The patients were divided into four groups ranging from 6 months to 3 years after fitting. Overall regular long-term use of the hearing aid was found in the majority of patients with presbyacusis. The main dropout point was within the first year after fitting the hearing aid. The study furthermore revealed a relatively high demand for further help and advice with the hearing aid in all groups.
BACKGROUND: The technique for applying bone-anchored hearing aids (BAHAs) by the use of osseointegration is today widely established for both adults and children. The BAHA concept is suitable for patients with recurrent ear infections or car malformations who cannot use conventional hearing aids, which are placed altogether or partially in the ear canal. Long-term results are well documented in adults but are lacking in children. Most patients are fitted with unilateral BAHA...
Chen, Xueqing; Li, Jing; Wu, Yanjun; Zhang, Hua; Liu, Haihong; Wang, Shuo; Kong, Ying; Liu, Sha; Liu, Bo; Mo, Lingyan; Qi, Beier
The purpose of this study is to investigate the effects of hearing level on auditory performance in infants with hearing aids and provide a clinical database for their hearing and speech habilitation. A total of 32 infants with prelingual hearing loss participated in this study, ranging in age at hearing aid fitting from 3 to 34 months with a mean of 16 months. According to their hearing level, they were divided into three groups. Infants in group A were with moderate hearing loss (41-60 dB HL). Infants in group B were with severe hearing loss (61-80 dB HL). Infants in group C were with profound hearing loss (>81 dB HL). The infant-toddler meaningful auditory integration scale (IT-MAIS) was used to evaluate their auditory performance. The evaluation was performed before hearing aid fitting and 1, 3, 6, 9, 12 months after fitting. The mean scores of auditory performance showed significant improvements with time of hearing aid use for the three groups of infants (P hearing aid fitting and at 1 month after fitting (P hearing aid fitting and at 1, 3 months after fitting (P hearing aid fitting and at 1, 3, 6 months after fitting (P 0.05). However, significant differences were observed between group A and C at 3, 6, 9, 12 months after fitting (P hearing loss developed significantly with the use of hearing aids within the first year after fitting. The degree of hearing loss in infants had significant influence on the development of auditory performance.
Dawes, Piers; Munro, Kevin J
It is widely recognized by hearing aid users and audiologists that a period of auditory acclimatization and adjustment is needed for new users to become accustomed to their devices. The aim of the present study was to test the idea that auditory acclimatization and adjustment to hearing aids involves a process of learning to "tune out" newly audible but undesirable sounds, which are described by new hearing aid users as annoying and distracting. It was hypothesized that (1) speech recognition thresholds in noise would improve over time for new hearing aid users, (2) distractibility to noise would reduce over time for new hearing aid users, (3) there would be a correlation between improved speech recognition in noise and reduced distractibility to background sounds, (4) improvements in speech recognition and distraction would be accompanied by self-report of reduced annoyance, and (5) improvements in speech recognition and distraction would be associated with higher general cognitive ability and more hearing aid use. New adult hearing aid users (n = 35) completed a test of aided speech recognition in noise (SIN) and a test of auditory distraction by background sound amplified by hearing aids on the day of fitting and 1, 7, 14, and 30 days post fitting. At day 30, participants completed self-ratings of the annoyance of amplified sounds. Daily hearing aid use was measured via hearing aid data logging, and cognitive ability was measured with the Wechsler Abbreviated Scale of Intelligence block design test. A control group of experienced hearing aid users (n = 20) completed the tests over a similar time frame. At day 30, there was no statistically significant improvement in SIN among new users versus experienced users. However, levels of hearing loss and hearing aid use varied widely among new users. A subset of new users with moderate hearing loss who wore their hearing aids at least 6 hr/day (n = 10) had significantly improved SIN (by ~3-dB signal to noise ratio
Holder, Jourdan T; Picou, Erin M; Gruenwald, Jill M; Ricketts, Todd A
The American National Standards Institute (ANSI) provides standards used to govern standardization of all hearing aids. If hearing aids do not meet specifications, there are potential negative implications for hearing aid users, professionals, and the industry. Recent literature has not investigated the proportion of new hearing aids in compliance with the ANSI specifications for quality control standards when they arrive in the clinic before dispensing. The aims of this study were to determine the percentage of new hearing aids compliant with the relevant ANSI standard and to report trends in electroacoustic analysis data. New hearing aids were evaluated for quality control via the ANSI S3.22-2009 standard. In addition, quality control of directional processing was also assessed. Seventy-three behind-the-ear hearing aids from four major manufacturers, that were purchased for clinical patients were evaluated before dispensing. Audioscan Verifit (version 3.1) hearing instrument fitting system was used to complete electroacoustic analysis and directional processing evaluation of the hearing aids. Frye's Fonix 8000 test box system (Fonix 8000) was also used to cross-check equivalent input noise (EIN) measurements. These measurements were then analyzed for trends across brands and specifications. All of the hearing aids evaluated were found to be out of specification for at least one measure. EIN and attack and release times were the measures most frequently out of specification. EIN was found to be affected by test box isolation for two of the four brands tested. Systematic discrepancies accounted for ∼93% of the noncompliance issues, while unsystematic quality control issues accounted for the remaining 7%. The high number of systematic discrepancies between the data collected and the specifications published by the manufacturers suggests there are clear issues related to the specific protocols used for quality control testing. These issues present a significant
This presentation reviews hearing-aid development from analog to advanced digital technology. A basic hearing aid consists of a microphone, an amplification circuit that provides a gain that varies with frequency to accommodate variations in hearing loss with frequency, and a small earphone. In recent years, hearing aid technology has developed rapidly. Digital hearing aids have become commonplace and their share of the marketplace is increasing rapidly. Therefore, the main focus of this talk is signal-processing schemes in advanced digital hearing aids, including microphones with digitally controlled directional characteristics, wide-dynamic-range compression in multiple channels that allow the compression characteristics to vary with frequency, noise reduction, and feedback cancellation. Each of these signal-processing functions help address the needs of individuals with hearing losses.
Ferguson, Melanie A; Kitterick, Pádraig T; Chong, Lee Yee; Edmondson-Jones, Mark; Barker, Fiona; Hoare, Derek J
The main clinical intervention for mild to moderate hearing loss is the provision of hearing aids. These are routinely offered and fitted to those who seek help for hearing difficulties. By amplifying and improving access to sounds, and speech sounds in particular, the aim of hearing aid use is to reduce the negative consequences of hearing loss and improve participation in everyday life. To evaluate the effects of hearing aids for mild to moderate hearing loss in adults. The Cochrane ENT Information Specialist searched the ENT Trials Register; the Cochrane Register of Studies Online; MEDLINE; PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 23 March 2017. Randomised controlled trials (RCTs) of hearing aids compared to a passive or active control in adults with mild to moderate hearing loss. We used the standard methodological procedures expected by Cochrane. The primary outcomes in this review were hearing-specific health-related quality of life and the adverse effect pain. Secondary outcomes were health-related quality of life, listening ability and the adverse effect noise-induced hearing loss. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics. We included five RCTs involving 825 participants. The studies were carried out in the USA and Europe, and were published between 1987 and 2017. Risk of bias across the studies varied. Most had low risk for selection, reporting and attrition bias, and a high risk for performance and detection bias because blinding was inadequate or absent.All participants had mild to moderate hearing loss. The average age across all five studies was between 69 and 83 years. The duration of the studies ranged between six weeks and six months.There was a large beneficial effect of hearing aids on hearing-specific health-related quality of life associated with participation in daily life as
... news/fullstory_167033.html A Cheaper Alternative to Hearing Aids? Devices performed almost as well and are much ... that almost 30 million people could benefit from hearing aids. But hearing aids can cost thousands of dollars, ...
Boymans, M.; Goverts, S.T.; Kramer, S.E.; Festen, J.M.; Dreschler, W.A.
Purpose: The goal of this study was to find factors for refining candidacy criteria for bilateral hearing aid fittings. Clinical files of 1,000 consecutive hearing aid fittings were analyzed. Method: Case history, audiometric, and rehabilitation data were collected from clinical files, and an
Boymans, Monique; Goverts, S. Theo; Kramer, Sophia E.; Festen, Joost M.; Dreschler, Wouter A.
Purpose: The goal of this study was to find factors for refining candidacy criteria for bilateral hearing aid fittings. Clinical files of 1,000 consecutive hearing aid fittings were analyzed. Method: Case history, audiometric, and rehabilitation data were collected from clinical files, and an extensive questionnaire on long-term outcome measures…
... National Library of Medicine) Article: Hearing Loss in Adults. Article: Bilateral versus unilateral hearing aids for bilateral hearing impairment in... Article: Preliminary audiologic and peri-operative outcomes ...
Executive Summary Objective The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of bone-anchored hearing aid (BAHA) in improving the hearing of people with conduction or mixed hearing loss. The Technology The (BAHA) is a bone conduction hearing device that includes a titanium fixture permanently implanted into the mastoid bone of the skull and an external percutaneous sound processor. The sound processor is attached to the fixture by means of a skin penetrating abutment. Because the device bypasses the middle ear and directly stimulates the cochlea, it has been recommended for individuals with conduction hearing loss or discharging middle ear infection. The titanium implant is expected to last a lifetime while the external sound processor is expected to last 5 years. The total initial device cost is approximately $5,300 and the external sound processor costs approximately $3,500. Review of BAHA by the Medical Advisory Secretariat The Medical Advisory Secretariat’s review is a descriptive synthesis of findings from 36 research articles published between January 1990 and May 2002. Summary of Findings No randomized controlled studies were found. The evidence was derived from level 4 case series with relative small sample sizes (ranging from 30-188). The majority of the studies have follow-up periods of eight years or longer. All except one study were based on monaural BAHA implant on the side with the best bone conduction threshold. Safety Level 4 evidence showed that BAHA has been be implanted safely in adults and children with success rates of 90% or higher in most studies. No mortality or life threatening morbidity has been reported. Revision rates for tissue reduction or resiting were generally under 10% for adults but have been reported to be as high as 25% in pediatric studies. Adverse skin reaction around the skin penetration site was the most common complication reported. Most of these
Grantham, D Wesley; Ashmead, Daniel H; Haynes, David S; Hornsby, Benjamin W Y; Labadie, Robert F; Ricketts, Todd A
: One purpose of this investigation was to evaluate the effect of a unilateral bone-anchored hearing aid (Baha) on horizontal plane localization performance in single-sided deaf adults who had either a conductive or sensorineural hearing loss in their impaired ear. The use of a 33-loudspeaker array allowed for a finer response measure than has previously been used to investigate localization in this population. In addition, a detailed analysis of error patterns allowed an evaluation of the contribution of random error and bias error to the total rms error computed in the various conditions studied. A second purpose was to investigate the effect of stimulus duration and head-turning on localization performance. : Two groups of single-sided deaf adults were tested in a localization task in which they had to identify the direction of a spoken phrase on each trial. One group had a sensorineural hearing loss (SNHL group; N = 7), and the other group had a conductive hearing loss (CHL group; N = 5). In addition, a control group of four normal-hearing adults was tested. The spoken phrase was either 1250 msec in duration (a male saying "Where am I coming from now?") or 341 msec in duration (the same male saying "Where?"). For the longer-duration phrase, subjects were tested in conditions in which they either were or were not allowed to move their heads before the termination of the phrase. The source came from one of nine positions in the front horizontal plane (from -79° to +79°). The response range included 33 choices (from -90° to +90°, separated by 5.6°). Subjects were tested in all stimulus conditions, both with and without the Baha device. Overall rms error was computed for each condition. Contributions of random error and bias error to the overall error were also computed. : There was considerable intersubject variability in all conditions. However, for the CHL group, the average overall error was significantly smaller when the Baha was on than when it was off
Faraji-Khiavi, Farzad; Dashti, Rezvan; Sameni, Seyyed-Jalal; Bayat, Arash
Hearing loss is one of the most disabling impairments. Using a hearing aid as an attempt to improve the hearing problem can positively affect the quality of life for these people. This research was aimed to assess satisfaction of hearing impaired patients with their hearing aids regarding the employed technology and style. This descriptive-analytic cross-sectional research was conducted on 187 subjects with hearing loss who were using a hearing aid. The subjects were over 18 years of age and were using a hearing aid for at least 6 months. The Persian version of Satisfaction with Amplification in Daily Life (SADL) questionnaire was the instrument which was used for assessing satisfaction with the hearing aid. Cronbach's alpha was calculated to be 0.80 for instrument reliability. A significant difference was observed among satisfaction subscales' mean scores with hearing aid technology. Also a significant difference was observed between the total satisfaction score and the hearing aid model. With respect to the analysis of satisfaction with the hearing aid and its style, cost and services was the only subscale which showed a significant difference (P=0.005). Respondents using hearing aids with different technology and style were estimated to be quite satisfied. Training audiologists in using more appropriate and fitting hearing aids in addition to using self-reporting questionnaires like SADL for estimating patients' social condition and participation in their life can essentially change their disability condition and countervail their hearing loss.
Cox, Robyn M; Schwartz, Kathryn S.; Noe, Colleen M.; Alexander, Genevieve C.
Objectives Most practitioners believe that use of two hearing aids is the ideal fitting for adults with bilateral symmetrical hearing loss. However, previous research has consistently shown that a substantial proportion of these patients actually prefer to use only one hearing aid. The current study explored whether this pattern of preferences is seen with technologically advanced hearing aids. In addition, a selection of variables that were available pre-fitting were used to attempt to predict which patients will prefer one hearing aid rather than two. Design The study was designed as a 12-week field trial including structured and unstructured use of one and two hearing aids. Ninety-four subjects with mild to moderate bilaterally symmetrical hearing loss were bilaterally fit with 2005-2007 era hearing aids. Potential predictors included demographic, audiometric, auditory lifestyle, personality, and binaural processing variables. After the field trial, each subject stated his/her preference for one or two hearing aids and completed three self-report outcome questionnaires for their preferred fitting. Results Previous research was confirmed with modern technology hearing aids: after the field trial 46% of the subjects preferred to use one hearing aid rather than two. Subjects who preferred two hearing aids tended to report better real-world outcomes than those who preferred one. Subjects who reported more hearing problems in daily life, who experienced more binaural loudness summation, and whose ears were more equivalent in dichotic listening were more likely to prefer to use two hearing aids. Contrary to conventional wisdom (ideas that are generally accepted as true), audiometric hearing loss and auditory lifestyle were not predictive of aiding preference. However, the best predictive approach from these data yielded accurate predictions for only two-thirds of subjects. Conclusions Evidence-based practice calls for a conscientious melding of current evidence
Hickson, Louise; Meyer, Carly; Lovelock, Karen; Lampert, Michelle; Khan, Asad
To examine associations between audiological and non-audiological factors and successful hearing aid use in older adults. In a retrospective study, audiological factors, attitudinal beliefs (as derived from the health belief model), client demographics, psychological factors, and age-related factors were evaluated. Participants included 160 individuals, 60 years or older, with unilateral or bilateral hearing impairment (HI), fitted with hearing aids for the first time in the previous two years. Participants were assigned to either an unsuccessful hearing aid owner group (n=75) or a successful hearing aid owner group (n=85) based on their self-reported hearing aid use and benefit. A multivariate, binomial logistic regression model indicated five factors associated with group membership: participants who had greater support from significant others; more difficulties with hearing and communication in everyday life before getting hearing aids; more positive attitudes to hearing aids; coupled with greater perceived self-efficacy for advanced handling of hearing aids; or who were receiving more gain from their devices; were more likely to be successful hearing aid owners. These findings highlight the importance of addressing non-audiological factors in order to assist older adults achieve success with hearing aids.
Rauterkus, Erik P; Palmer, Catherine V
The hearing aid effect is the term used to describe the assignment of negative attributes to individuals using hearing aids. The effect was first empirically identified in 1977 when it was reported that adults rating young children with and without hearing aids assigned negative attributes to the children depicted with hearing aids. Investigations in the 1980s and 1990s reported mixed results related to the extent of the hearing aid effect but continued to identify, on average, some negative attributes assigned to individuals wearing hearing aids. The specific aim of this research was to investigate whether the hearing aid effect has diminished in the past several decades by replicating the methods of previous studies for testing the hearing aid effect while using updated devices. Five device configurations were rated across eight attributes. RESULTS for each attribute were considered separately. A total of 24 adults judged pictures of young men wearing various ear level technologies across 8 attributes on a 7-point Likert scale. Five young men between ages 15 and 17 yr were photographed wearing each of five device configurations including (1) a standard-sized behind-the-ear (BTE) hearing aid coupled to an earmold with #13 tubing, (2) a mini-BTE hearing aid with a slim tube open-fit configuration, (3) a completely-in-the-canal hearing aid that could not be seen because of its location in the ear canal, (4) an earbud, and (5) a Bluetooth receiver. The 24 raters saw pictures of each of the 5 young men with each wearing one of the 5 devices so that devices and young men were never judged twice by the same observer. All judgments of each device, regardless of the young man modeling the device, were combined in the data analysis. The effect of device types on judgments was tested using a one-way between-participant analysis of variance. There was a significant difference on the judgment of age and trustworthiness level among the five devices. However, our post hoc
Ridgway, Jason; Hickson, Louise; Lind, Christopher
To use the self-determination theory of motivation to investigate whether different forms of motivation were associated with adults' decisions whether or not to adopt hearing aids. A quantitative approach was used in this cohort study. Participants completed the treatment self-regulation questionnaire (TSRQ), which measured autonomous and controlled motivation for hearing aid adoption. Sociodemographic data and audiometric information were also obtained. Participants were 253 adults who had sought information about their hearing but had not consulted with a hearing professional. Participants were categorized as hearing aid adopters if they had been fitted with hearing aids 4-6 months after completing the TSRQ, and as non-adopters if they had not. Multivariate logistic regression was used to examine associations between autonomous and controlled motivation, sociodemographic and audiometric variables, and hearing aid adoption (n = 160). Three factors were significantly associated with increased hearing aid adoption when the influence of other variables was accounted for: autonomous motivation, perceived hearing difficulty, and poorer hearing. Controlled motivation was not found to influence hearing aid adoption. These empirical findings that link autonomous motivation to decisions of hearing help-seekers have implications for the ways practitioners may evaluate motivation and could inform discussions with clients about hearing aid adoption.
Yetter, Carol J.
This hearing aid primer is designed to define the differences among the three levels of hearing instrument technology: conventional analog circuit technology (most basic), digitally programmable/analog circuit technology (moderately advanced), and fully digital technology (most advanced). Both moderate and advanced technologies mean that hearing…
Walker, Elizabeth; McCreery, Ryan; Spratford, Meredith; Roush, Patricia
Up to 15% of children with permanent hearing loss (HL) have auditory neuropathy spectrum disorder (ANSD), which involves normal outer hair cell function and disordered afferent neural activity in the auditory nerve or brainstem. Given the varying presentations of ANSD in children, there is a need for more evidence-based research on appropriate clinical interventions for this population. This study compared the speech production, speech perception, and language outcomes of children with ANSD, who are hard of hearing, to children with similar degrees of mild-to-moderately severe sensorineural hearing loss (SNHL), all of whom were fitted with bilateral hearing aids (HAs) based on the American Academy of Audiology pediatric amplification guidelines. Speech perception and communication outcomes data were gathered in a prospective accelerated longitudinal design, with entry into the study between six mo and seven yr of age. Three sites were involved in participant recruitment: Boys Town National Research Hospital, the University of North Carolina at Chapel Hill, and the University of Iowa. The sample consisted of 12 children with ANSD and 22 children with SNHL. The groups were matched based on better-ear pure-tone average, better-ear aided speech intelligibility index, gender, maternal education level, and newborn hearing screening result (i.e., pass or refer). Children and their families participated in an initial baseline visit, followed by visits twice a year for children children >2 yr of age. Paired-sample t-tests were used to compare children with ANSD to children with SNHL. Paired t-tests indicated no significant differences between the ANSD and SNHL groups on language and articulation measures. Children with ANSD displayed functional speech perception skills in quiet. Although the number of participants was too small to conduct statistical analyses for speech perception testing, there appeared to be a trend in which the ANSD group performed more poorly in
Löhler, J; Akcicek, B; Wollenberg, B; Schönweiler, R
Upon review of the statutory health insurance reimbursement guidelines, a specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germany's public healthcare system. APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. Another new aspect of the national guidelines is inclusion of free-field measurements in noise with and without hearing aids. Part 2 of this review describes new diagnostic aspects of speech audiometry. In addition to adaptive speech audiometry, a proposed method for applying the gold standard of speech audiometry - the Freiburg monosyllabic speech test - in noise is described. Finally, the quality assurance questionnaire will be explained as an appendix to template 15 of the regulations governing hearing aids.
Ticiana Cristina de Freitas Zambonato
Full Text Available Afissura labiopalatina, por provocar alterações nas estruturas do lábio e do palato, pode causar comprometimento auditivo, devido às otites médias recorrentes. O tratamento mais adequado é controverso, podendo ser indicado o uso de antibióticos e inserção do tubo de ventilação, ou o acompanhamento otorrinolaringológico, audiológico e reabilitação aural, com uso de aparelho de amplificação sonora individual (AASI. OBJETIVO: Caracterizar o perfil dos pacientes com fissura labiopalatina e deficiência auditiva, adaptados com AASI e acompanhados pelo setor de Otorrinolaringologia e Fonoaudiologia de um hospital especializado em anomalias craniofaciais e deficiência auditiva. Estudo Retrospectivo. MATERIAL E MÉTODO: Análise retrospectiva de 131 prontuários de pacientes com fissura labiopalatina operada e deficiência auditiva, adaptados com AASI pelo referido centro. RESULTADOS: O perfil geral (n=131 caracterizou-se pela predominância do gênero feminino (53%, fissura transforame incisivo unilateral (27%, presença de anomalias associadas (51%, histórico de alterações de orelha média (56% e intervenção cirúrgica (56%. CONCLUSÃO: O perfil geral dos pacientes com fissura labiopalatina e deficiência auditiva, adaptados com AASI, caracterizou-se pela predominância da fissura de lábio e palato, histórico positivo de alteração de orelha média, intervenção cirúrgica e deficiência auditiva sensorioneural bilateral.Cleft palates cause alterations in palate and lip structures, and it may also cause hearing loss because of recurrent otitis media. The appropriate treatment is controversial. It may include the prescription of antibiotics and insertion of a ventilation tube, or even otorhinolaryngological and audiological assistance, and hearing rehabilitation, with the use of an individual sound amplifier aid (ISAA. AIM: To characterize the profile of individuals with cleft palate and hearing loss, users of ISAA are
Stiles, Derek J.; Bentler, Ruth A.; McGregor, Karla K.
Purpose: To determine whether a clinically obtainable measure of audibility, the aided Speech Intelligibility Index (SII; American National Standards Institute, 2007), is more sensitive than the pure-tone average (PTA) at predicting the lexical abilities of children who wear hearing aids (CHA). Method: School-age CHA and age-matched children with…
Choi, A Young; Shim, Hyun Joon; Lee, Sung Hee; Yoon, Sang Won; Joo, Eun-Jeong
In the present study, we investigated whether speech-related cognitive function and speech recognition ability under background noise in adults with hearing impairment are improved with the use of hearing aids. Participants were recruited from the ENT Department of Eulji Hospital from September 2008 to July 2009. The study group comprised 18 participants (mean age, 69.5±8.3 years) with sensorineural hearing loss who were fitted with hearing aids, and the control group comprised 11 participants of equivalent age (mean age, 63.1±11.8 years) who were not fitted with hearing aids. All participants were assessed using the computerized Korean visual verbal learning test (VVLT) and words-in-noise (WIN) test prior to fitting of hearing aids for the study group and initially for the control group. Both groups were reassessed in both tests after 6 months. For each group, differences in the results between the two assessments were compared using the Friedman test. There was no difference in mean age between the study group and control group. In the study group, total VVLT score (reflecting short-term memory) was significantly improved from before hearing aid use to 6 months after hearing aid use (Plearning ability) was also significantly improved from before hearing aid use to 6 months after hearing aid use (P0.05). The speech-related cognitive function of individuals with hearing impairment improved after using hearing aids. This finding indicates that hearing aids may induce acclimatization of the central auditory system.
Jenstad, L M; Pumford, J; Seewald, R C; Cornelisse, L E
The goal of this study was to test the theoretical advantages of a single-channel wide dynamic range compression (WDRC) circuit fitted using the DSL method for increased dynamic range and normalized loudness growth. Ten adolescents and young adults with moderate to severe sensorineural hearing loss were fitted monaurally with the Siemens Viva 2 Pro behind-the-ear instrument set to DSL 4.0 targets for both linear gain and WDRC processing. Threshold, upper limit of comfort and loudness growth were measured in the unaided, linear gain and WDRC conditions for warble tones, environmental sounds and speech. Twelve adult listeners with normal hearing also were tested monaurally in the unaided condition to provide normative data for comparison purposes. The WDRC hearing aid provided a greater input dynamic range than the linear circuit for all stimuli. The dynamic range was normalized for more subjects with the WDRC than the linear hearing aid. In addition, exponential loudness growth functions fitted to the loudness growth data showed that, on average, loudness growth was more normalized with the WDRC hearing aid fitted to DSL[i/o] targets than the linear hearing aid fitted to DSL[i/o] targets. WDRC processing, fitted using the DSL[i/o] method, has potential applications in hearing aid fittings for listeners with moderate to severe hearing loss because it provides an audible, comfortable and tolerable amplified signal across a wider range of inputs than linear gain processing, without the need for volume control adjustments.
Hong, Ju Young; Oh, In-Hwan; Jung, Tae Suk; Kim, Tae Hyun; Kang, Ho Min; Yeo, Seung Geun
Increases in older aged populations and exposure to complicated noise environments have increased the number of hearing-impaired patients, creating greater demands for hearing aids. We have assessed the reasons that individuals rejected wearing and returned properly prescribed hearing aids, as well as differences in individual factors between younger and elderly adults. Of 1138 patients for whom hearing aids were prescribed at Kyung Hee University Medical Center Hearing Aid Clinic, 81 (6.14%) returned their hearing aids, including 36 patients aged hearing-related, and hearing aid-related factors were assessed by retrospective chart analysis and phone survey and compared in the two groups. The primary symptoms reported by the 81 patients who returned their hearing aids were hearing disturbance, ringing, and fullness in the ear, in that order and in both groups. The rate of hearing aid return was similar in elderly females and males (p=0.288). The spondee recognition threshold was significantly higher in younger than in elderly adults (63.3±14.0 dB vs. 55.6±14.74 dB, p=0.019), but the hearing aid return rate was highest in patients with moderate hearing loss in both groups. In evaluating the reasons for return of hearing aids, we found that ineffectiveness of the device was the most frequent reason, accounting for 32.0% of returns, the highest percentage in both groups, with the most frequent patient problem caused by management difficulty in elderly and financial difficulty in younger adults. The reasons for hearing aid return were different in two groups. Financial considerations were cited more by younger adults, while difficulties in managing hearing aids were cited more frequently by elderly adults. Patients in both groups, however, reported that the most frequent reasons for return were inadequate hearing improvement and inconvenience wearing the hearing aid due to noise amplification.
Full Text Available Background Hearing loss is developing when age is rising. Initiation and progression rates of hearing loss vary among different individuals and groups. Objectives The current study aimed to determine satisfaction of the elderly with their hearing aids in different types of hearing loss and comorbidities. Patients and Methods The study was conducted on 40 elderly subjects suffering from hearing loss and using hearing aids. The data collection method included assessment of hearing loss in addition to using a questionnaire to estimate respondents' satisfaction with their hearing aids in daily life. The Persian version of the Satisfaction with Amplification in Daily Life (SADL questionnaire was administered. The data were analyzed using descriptive and inferential statistics by SPSS software version19. Results The mean satisfaction scores of the elderly were 4.83 ± 0.51 and 5.36 ± 0.30 in the sensorineural loss groups. There was no significant difference between different comorbidities. There was a significant difference between satisfaction level of cost and services subscales in the symmetrical styles of hearing loss (P value = 0.04. Conclusions The findings of the study indicated a high satisfaction of the elderly with their hearing aids, considering the type of hearing loss. Despite all the efforts to improve the audiologic services during verification process, the elderly should be consulted specifically in order to fit their hearing aid as well as their expectations from aid.
The invention comprises a hearing aid, which has a casing containing a signal receiving part for receiving an audio signal, an audio transducer for providing an audio signal to the user, a signal transmission path between the signal receiving part and the audio transducer, whereby a battery is pr...
Thorup, Nicoline; Santurette, Sébastien; Jørgensen, Søren
INTRODUCTION: Hearing-impaired (HI) listeners often complain about difficulties communicating in the presence of background noise, although audibility may be restored by a hearing-aid (HA). The audiogram typically forms the basis for HA fitting, i.e. people with similar audiograms are given...... the same prescription by default. This study aimed at identifying clinically relevant tests that may serve as an informative addition to the audiogram and which may relate more directly to HA satisfaction than the audiogram does. METHODS: A total of 29 HI and 26 normal-hearing listeners performed tests...... of spectral and temporal resolution, binaural hearing, speech intelligibility in stationary and fluctuating noise and a working-memory test. Six weeks after HA fitting, the HI listeners answered a questionnaire evaluating HA treatment. RESULTS: No other measures than masking release between fluctuating...
Thorup, Nicoline; Santurette, Sébastien; Jørgensen, Søren
resolution, binaural hearing, speech intelligibility in stationary and fluctuating noise and a working-memory test. Six weeks after HA fitting, the HI listeners answered a questionnaire evaluating HA treatment. RESULTS: No other measures than masking release between fluctuating and stationary noise......Hearing-impaired (HI) listeners often complain about difficulties communicating in the presence of background noise, although audibility may be restored by a hearing-aid (HA). The audiogram typically forms the basis for HA fitting, i.e. people with similar audiograms are given the same prescription...... correlated significantly with audibility. The HI listeners who obtained the least advantage from fluctuations in background noise in terms of speech intelligibility experienced greater HA satisfaction. CONCLUSION: HI listeners have difficulties in different hearing domains that are not predictable from...
Thorup, Nicoline; Santurette, Sébastien; Jørgensen, Søren
of spectral and temporal resolution, binaural hearing, speech intelligibility in stationary and fluctuating noise and a working-memory test. Six weeks after HA fitting, the HI listeners answered a questionnaire evaluating HA treatment. RESULTS: No other measures than masking release between fluctuating......INTRODUCTION: Hearing-impaired (HI) listeners often complain about difficulties communicating in the presence of background noise, although audibility may be restored by a hearing-aid (HA). The audiogram typically forms the basis for HA fitting, i.e. people with similar audiograms are given...... and stationary noise correlated significantly with audibility. The HI listeners who obtained the least advantage from fluctuations in background noise in terms of speech intelligibility experienced greater HA satisfaction. CONCLUSION: HI listeners have difficulties in different hearing domains...
Jørgensen, Ivan Harald Holger
Designing modern hearing aids is a formidable challenge. The size of hearing aids is constantly decreasing, making them virtually invisible today. Still, as in all other modern electronics, more and more features are added to these devices driven by the development in modern IC technology....... The demands for performance and features at very low supply voltage and power consumption constantly prove a challenge to the physical design of hearing aids and not at least the design of the ICs for these. As a result of this all large hearing aid manufacturers use fully customized ASICs in their products...... to produce a competitive advantage. This presentation will give a brief insight into the hearing aid market and industry, a brief view of the historic development of hearing aids and an introduction to how a modern hearing is constructed showing the amplifier as the key component in the modern hearing aid...
Bellier, Ludovic; Veuillet, Evelyne; Vesson, Jean-François; Bouchet, Patrick; Caclin, Anne; Thai-Van, Hung
Millions of people across the world are hearing impaired, and rely on hearing aids to improve their everyday life. Objective audiometry could optimize hearing aid fitting, and is of particular interest for non-communicative patients. Speech Auditory Brainstem Response (speech ABR), a fine electrophysiological marker of speech encoding, is presently seen as a promising candidate for implementing objective audiometry; yet, unlike lower-frequency auditory-evoked potentials (AEPs) such as cortical AEPs or auditory steady-state responses (ASSRs), aided-speech ABRs (i.e., speech ABRs through hearing aid stimulation) have almost never been recorded. This may be due to their high-frequency components requesting a high temporal precision of the stimulation. We assess here a new approach to record high-quality and artifact-free speech ABR while stimulating directly through hearing aids. In 4 normal-hearing adults, we recorded speech ABR evoked by a /ba/ syllable binaurally delivered through insert earphones for quality control or through hearing aids. To assess the presence of a potential stimulus artifact, recordings were also done in mute conditions with the exact same potential sources of stimulus artifacts as in the main runs. Hearing aid stimulation led to artifact-free speech ABR in each participant, with the same quality as when using insert earphones, as shown with signal-to-noise (SNR) measurements. Our new approach consisting in directly transmitting speech stimuli through hearing aids allowed for a perfect temporal precision mandatory in speech ABR recordings, and could thus constitute a decisive step in hearing impairment investigation and in hearing aid fitting improvement. Copyright © 2015 Elsevier B.V. All rights reserved.
Schmidt, Juliane; Herzog, Diana; Scharenborg, Odette; Janse, Esther
Normal-hearing listeners use acoustic cues in speech to interpret a speaker's emotional state. This study investigates the effect of hearing aids on the perception of the emotion dimensions arousal (aroused/calm) and valence (positive/negative attitude) in older adults with hearing loss. More specifically, we investigate whether wearing a hearing aid improves the correlation between affect ratings and affect-related acoustic parameters. To that end, affect ratings by 23 hearing-aid users were compared for aided and unaided listening. Moreover, these ratings were compared to the ratings by an age-matched group of 22 participants with age-normal hearing.For arousal, hearing-aid users rated utterances as generally more aroused in the aided than in the unaided condition. Intensity differences were the strongest indictor of degree of arousal. Among the hearing-aid users, those with poorer hearing used additional prosodic cues (i.e., tempo and pitch) for their arousal ratings, compared to those with relatively good hearing. For valence, pitch was the only acoustic cue that was associated with valence. Neither listening condition nor hearing loss severity (differences among the hearing-aid users) influenced affect ratings or the use of affect-related acoustic parameters. Compared to the normal-hearing reference group, ratings of hearing-aid users in the aided condition did not generally differ in both emotion dimensions. However, hearing-aid users were more sensitive to intensity differences in their arousal ratings than the normal-hearing participants.We conclude that the use of hearing aids is important for the rehabilitation of affect perception and particularly influences the interpretation of arousal.
Chen, Xianghong; Zhou, Huifang; Zhang, Jing; Wang, Liqun
By matching patients with presbycusis hearing aids,hearing aid performance assessment questionnaire to fill out to assess the effect of its use and targeted to solve problems encountered in its use and improve the quality of life of older persons. Through face to face way to investigate and analyse patients with hearing aids fitting, totally 30 subjects accepted the analysis, preliminary assessment of the use of hearing aids in patient with presbycusis results and solve problems encountered in its use by using SPSS software to analyze the collecting data. HHIE questionnaire on statistical analysis, obtained in patients with hearing loss use hearing aids after the problem is a significant improvement statistical analysis of the SADL questionnaire, the conclusion is relatively satisfied with the overall satisfaction. Effects Assessment Questionnaire in patients with hearing aids hearing impairment can be epitomized the disabled after use to improve the situation and understand the satisfaction of patients with hearing aids can be an initial effect as the rehabilitation of a reliable subjective assessment of the impact assessment indicators.
Kramer, Sophia E.; Goverts, S. Theo; Dreschler, Wouter A.; Boymans, Monique; Festen, Joost M.
This paper presents data on the Dutch translation of the International Outcome Inventory for Hearing Aids (IOI-HA). The inventory was used as an additional postal tool in a nationwide study on the benefits of bilateral hearing aid fitting. Responses of 505 hearing aid users were analysed.
Núñez-Batalla, Faustino; Jáudenes-Casaubón, Carmen; Sequí-Canet, Jose Miguel; Vivanco-Allende, Ana; Zubicaray-Ugarteche, Jose
The latest scientific literature considers early diagnosis of deafness as the key element to define the educational and inclusive prognosis of the deaf child, because it allows taking advantage of the critical period of development (0-4 years). Highly significant differences exist between deaf people who have been stimulated early and those who have received late or improper intervention. Early identification of late-onset disorders requires special attention and knowledge on the part of every childcare professional. Programs and additional actions beyond neonatal screening should be designed and planed to ensure that every child with a significant hearing loss is detected early. For this purpose, the CODEPEH would like to highlight the need for continuous monitoring of children's auditory health. Consequently, CODEPEH has drafted the recommendations included in the present document. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.
In this paper I wish to offer a characterization of 'skilled practitioners' from an Ethnomethodological perspective. The skilled practitioner in question is a generic 'hard of hearing' person. The ambition is that such a characterization, both in its making and its final state, may be an intrinsic...... part of design practices concerning the development of hearing aids. Within design studies, the idea of a skilled practitioner has a host of brothers and sisters all prefaced with the family name 'skilled'- skilled users, skilled workers, skilled employees - but the basic idea is the same for all...... might be realized through the introspective and observational study of the 'natural' techniques the hard of hearing employ in everyday life....
Dawes, Piers; Maslin, Michael; Munro, Kevin J
To describe getting used to hearing aids from the perspective of adult hearing-aid users. Three focus group discussions were carried out. A topic guide and discussion exercises were used to elicit views on getting used to hearing aids. Discussion was audio recorded, transcribed verbatim, and subjected to qualitative content analysis. Adult hearing aid users (n = 16). Participants described getting used to hearing aids as a multi-factorial process which included adjusting to altered sensory input, practical matters such as cleaning and maintenance, and managing the psychosocial impact of hearing-aid use, such as on self-image. Users reported a process of discovering benefits and limitations of hearing aids leading to individual patterns of use that was relatively independent of input from audiologists. Getting used to hearing aids is a challenging multi-factorial process with both psychosocial and practical difficulties besides demands of adjusting to hearing-aid input.
Ali Asghar Danesh
Full Text Available Many people around the world are in need for using hearing aid, a prothesis which is prescribed for compensating the hearing loss in hard of hearing patients.Although Hearing aid has crucial role in improving hearing skills in such patients, it has many psychological effects and Social premonitions for the users.we will discuss some of these distresses and the common approaches for resolving economical, cosmetic and the emotional and social problems relted to hearing aid will be discussed.
Full Text Available Binaural hearing is an important phenomenon in hearing for human being. Nowadays, the role of binaural hearing in the process of amplification has been focused. Since hearing aids act separately in the process of amplification and hearing, the attentions has been devoted to designing a system for binaural amplification by means of Beam forming which will be explained in more details in the current article.
Blamey, Peter J; Martin, Lois F A
Hearing aids amplify low-intensity sounds to make them audible while keeping high-intensity sounds at an acceptable loudness for listeners with impaired hearing. The purpose of this analysis was to assess loudness and satisfaction at the same time using a combined loudness and satisfaction questionnaire to rate 18 everyday environmental sounds. Ten sets of data from four studies, covering three conditions, were analyzed. The three conditions were unaided, wide dynamic range compression (WDRC), and adaptive dynamic range optimization (ADRO). In total, there were 61 subjects giving over 3,000 pairs of ratings for loudness and satisfaction. The analysis found a strong relationship between loudness and satisfaction ratings for this set of listeners and conditions. The maximum satisfaction ratings corresponded to sounds with "comfortable" loudness ratings. Satisfaction was lowest for sounds that were "uncomfortably loud." Sounds that were very soft or inaudible also received low satisfaction ratings unless the sounds were expected to be soft, such as the sound of one's own breathing. Hearing aid fittings that place most sounds at a comfortable level are likely to be more satisfactory than hearing aid fittings that produce more sounds close to hearing thresholds or discomfort levels. Aided conditions gave higher loudness and satisfaction ratings than the unaided condition, and the ADRO hearing aids gave significantly higher satisfaction ratings than the WDRC hearing aids.
Humes, Larry E
Following a brief tutorial on the application of factor analysis to hearing aid outcome measures, three studies of hearing aid outcome measures in elderly adults are presented and analyzed. Two of the studies were completed at Indiana University (IU-1 and IU-2), and one was a collaborative multisite study by the Veterans Administration and the National Institute of Deafness and other Communication Disorders (NIDCD/VA). IU-1 measured hearing aid outcome in 173 elderly wearers of single-channel, linear, in-the-ear hearing aids with output-limiting compression, whereas IU-2 obtained the same extensive set of outcome measures from 53 elderly wearers of two-channel, wide-dynamic-range compression, in-the-canal hearing aids. In the NIDCD/VA study, 333 to 338 participants wore three single-channel circuits in succession, with each circuit housed within an in-the-ear shell. The three circuits included in that study and in this analysis were: (1) linear with peak clipping, (2) linear with output-limiting compression, and (3) single-channel, wide-dynamic-range compression. Evaluation of the many outcome measures completed in each study using principal components factor analysis revealed that from three (both IU studies) to five (NIDCD/VA study) principal components captured the individual differences in hearing aid outcome. This was independent of hearing aid type (in-the-ear or in-the-canal) and circuitry. Subsequent multiple regression analyses of individual differences in performance along each dimension of hearing aid outcome revealed that these individual differences could be accounted for reasonably well by various prefit variables for some dimensions of outcome, but not others. In general, measures of speech recognition performance were well accounted for by prefit measures, with the best predictors being hearing loss, cognitive performance, and age. Measures of hearing aid usage were less well accounted for by prefit measures, with the most accurate predictor of
Gan, Richard Wei Chern; Overton, Parisa; Benton, Claire; Daniel, Matija
ENT surgeons may refer children with otitis media with effusion (OME) to audiology for consideration of hearing aids. They are an option for the treatment of OME, but are only effective if the child actually wears them. Our study investigated what proportion of children referred for hearing aids actually receive them, and whether children use them. Retrospective study of children referred to audiology from November 2013 to August 2014, including 70 children referred by ENT for hearing aids for OME, plus a further 5 children with OME given hearing aids through direct access audiology service. During the study period, there were 202 referrals of children to audiology, of which 70 (34.7%) were for consideration of hearing aids for OME. Of these 70 referred children, 37 (52.9%) were not fitted with hearing aids due to normal audiometry (23), asymptomatic mild hearing loss (7), nonattendance (3), clinical decision to just monitor hearing (1), parental decline (2), and unrecorded reason (1). A total of 38 children (including direct access patients) were fitted with hearing aids for OME. Majority (36/38) of children issued aids used them, 16 all day, 7 only at school, 1 only at home, 3 only when needed, and 9 used them for an unspecified duration; 1 child's use of hearing aids was unrecorded, and 1 child refused to use it. 21 were fitted bilaterally and 17 unilaterally. 37 were behind the ear aids and 1 a BAHA softband. A third of referrals to paediatric audiology by ENT are for consideration of hearing aids for OME. Only about half of children referred to audiology for hearing aids for OME actually receive them, as by the time they see audiology the hearing loss has frequently resolved or is asymptomatic so that aiding is unwarranted. Once fitted, they appear to be well accepted. Hearing aids have fair utilization in children fitted with them for OME. Copyright © 2017 Elsevier B.V. All rights reserved.
Bone-Anchored Hearing Aid (BAHA) has proven performance and advantages for patients with aural atresia or chronic ear drainage who cannot wear air-conduction hearing aids. The BAHA has both cosmetic and acoustic advantages over most conventional hearing aids and hence is becoming increasingly popular. Moreover, BAHA improves the quality of life and has also significantly reduces ear discharge. This extensive review of the literature pertaining to BAHA discus the history, the indications, the ...
Surr, R K; Cord, M T; Walden, B E
This study compared hearing aid benefit obtained 6 weeks and a minimum of 1 year after fitting to determine if changes occurred over time. Fifteen individuals with mild-to-moderate sensorineural hearing losses, who were successful users of linear amplification, were fitted binaurally with the Resound BT2 Personal Hearing System. These hearing aids are programmable in two frequency bands that provide wide dynamic range compression (WDRC) amplification. The manufacturer's recommended loudness growth in octave bands (LGOB) and audiogram programming algorithm and fitting procedures were used. Following an initial 6-week period and again following a minimum of 1 year of use, the Profile of Hearing Aid Benefit (PHAB) was administered. Similarly, speech recognition performance was tested using the Connected Speech Test (CST) in a six-talker speech babble at 50 dBA, +10 signal-to-noise (S/N); 60 dBA, +5 SNR; and 70 dBA, +2 SNR; and in quiet with a reverberation time of 0.78 seconds. Significant aided benefit was shown. These short-term benefit scores for the PHAB and CST were compared with those obtained after 1 year of full-time use. Results revealed no significant change in hearing aid benefit with long-term use, suggesting that a 6-week acclimatization period is sufficiently long for clinical trials of this type of WDRC amplification.
Bone-Anchored Hearing Aid (BAHA) has proven performance and advantages for patients with aural atresia or chronic ear drainage who cannot wear air-conduction hearing aids. The BAHA has both cosmetic and acoustic advantages over most conventional hearing aids and hence is becoming increasingly popular. Moreover, BAHA improves the quality of life and has also significantly reduces ear discharge. This extensive review of the literature pertaining to BAHA discus the history, the indications, the advantages, the prediction of the outcome and the complications of this device as well as comparing it to the conventional hearing aids.
Rahne, Torsten; Ehelebe, Thomas
Patients suffering from conductive or mixed hearing loss may benefit from bone-conduction hearing systems (BAHS). The amount of amplification provided by the hearing system is selected based on the individual’s sensorineural frequency-specific threshold. With patients who are not able to provide thresholds behaviorally, such as young children, objective methods are required to estimate the unaided and aided hearing threshold and thus the success of the hearing system fitting. In a prospective...
Singh, Gurjit; Launer, Stefan
Hearing rehabilitation tends to focus on the influence of intraindividual factors and concepts such as readiness for change and health beliefs. In contrast, less is known about the role of social context and the potential role of significant others on hearing aid adoption. This explorative retrospective study investigated whether hearing aid adoption is associated with significant other attendance at audiology appointments. The study sample consisted of 33,933 and 27,031 individuals who attended appointments either alone or with a significant other, respectively (n = 60,964). It was found that hearing aid adoption was significantly greater when patients attended audiology appointments with a significant other (63.8%) than when attending appointments alone (50.6%). The association between hearing aid adoption and attendance by a significant other was hearing dependent, with 96% higher hearing aid adoption for patients with mild hearing losses when patients attended appointments with a significant other than when attending appointments alone. Hearing aid return rates were comparable when patients attended appointments alone (27%) or with a significant other (24%). Several potential explanations for the observed association are discussed. The pattern of results is consistent with the view that greater adherence is observed when audiologic care is provided from a patient-centered care perspective. Future research should establish whether there is a causal relationship between attendance at appointments by significant others and hearing aid adoption and should attempt to better understand the mechanisms underpinning the relationship between these variables. © The Author(s) 2016.
Hickson, L M
In this tutorial, the characteristics of compression amplification in analog hearing aids and the experimental results obtained with single- and multichannel compression amplification systems are reviewed. Single-channel compression systems are classified into four broad groups on the basis of their static and dynamic characteristics: compression limiters, syllabic compressors, automatic volume control (AVC) systems, and "others," those with adaptive recovery time (aRT) and dual frontend automatic gain control (AGC) (Moore, 1990; Moore & Glasberg, 1988). Multichannel compression devices have, to date, used a variety of different types of compression, with syllabic compression in each frequency channel being the most popular. Experimental evidence suggests that compression limiting is generally superior to peak clipping as a means of controlling output, except for some individuals with severe to profound hearing loss. There is some evidence that syllabic compression and AVC systems enhance speech perception in quiet compared to conventional linear amplification; however, this improvement is not consistently maintained in the presence of background noise. The majority of recent research has focused on multichannel compression, and favorable results have been obtained with some systems. Research findings about the efficacy of using compression amplification for people with hearing loss have been extremely variable, and possible reasons for this are discussed.
Ana Tereza de Matos Magalhães
Full Text Available OBJETIVO: caracterizar o perfil audiométrico e demográfico de pacientes candidatos ao implante coclear encaminhados ao setor de prótese auditiva e entre esses, a frequência de indivíduos que se beneficiaram da amplificação sonora. MÉTODOS: foram estudados os pacientes atendidos no período de maio de 2007 a dezembro 2008. Foi realizado o levantamento do perfil da população segundo sexo, idade, escolaridade e etiologia. Foi calculada a média da melhor e pior orelha e classificada segundo Frota (2003. A média dos limiares auditivos com as próteses auditivas indicadas foi calculada e considerada como benefício quando permitia acesso aos sons da fala do português brasileiro (Russo e Behlau, 1993. RESULTADOS: foram avaliados nesse período 194 prontuários. 108 pacientes já eram usuários de próteses auditivas (55,6%, 100 do sexo masculino (52%, 94 do sexo feminino (48%, 109 eram crianças (56% e 85 eram adultos (44%. A média de idade foi 4,8 anos (crianças e 41,9 anos (adultos. Entre os adultos, 24 possuíam ensino fundamental incompleto (33%. A etiologia mais frequente foi a desconhecida (33%. Dezenove pacientes se beneficiaram do uso da prótese auditiva (10%. No grupo de pacientes que se beneficiaram da prótese auditiva, a média dos limiares em campo livre com amplificação foi de 47 dBNA e 48 dBNA, na melhor e na pior orelha, respectivamente, nas crianças e 50 dBNA e 45 dBNA, respectivamente, nos adultos. CONCLUSÃO: o perfil dos pacientes foi: na maioria criança, sexo masculino, etiologia desconhecida, já usuários de próteses auditivas com média de idade 4,8 anos (crianças e 41,9 anos (adultos, audiometria com perda auditiva neurossensorial profunda bilateral, sendo que a prótese beneficiou 10% dos pacientes.PURPOSE: to characterize the audiometric and demographic profile of cochlear implant candidates who were referred to hearing aid sector, and if they benefit from the amplification of the hearing aid. METHODS
Chan, Stephen; Hixon, Brian; Adkins, Margaret; Shinn, Jennifer B; Bush, Matthew L
The objective of this study was to compare the timing of hearing aid (HA) acquisition between adults in rural and urban communities. We hypothesized that time of acquisition of HA after onset of hearing loss is greater in rural adults compared with urban adults. Secondary objectives included assessment of socioeconomic/educational status and impact of hearing loss and hearing rehabilitation of urban and rural HA recipients. Cross-sectional questionnaire survey. We assessed demographics, timing of HA fitting from onset of hearing loss, and impact of hearing impairment in 336 adult HA recipients (273 urban, 63 rural) from a tertiary referral center. Amplification benefit was assessed using the International Outcome Inventory for Hearing Aids (IOI). The time to HA acquisition was greater for rural participants compared to urban participants (19.1 vs. 25.7 years, P = 0.024) for those with untreated hearing loss for at least 8 years. Age at hearing loss onset was correlated with time to HA acquisition (P = -0.54, P hearing specialists (68 vs. 32 minutes, P Hearing impairment caused job performance difficulty in 60% of all participants. Rural adults are at risk for delayed HA acquisition, which may be related to distance to hearing specialists. Further research is indicated to investigate barriers to care and expand access for vulnerable populations. 4. Laryngoscope, 127:2362-2367, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Nielsen, Jens Brehm; Nielsen, Jakob
Due to the large amount of options offered by the vast number of adjustable parameters in modern digital hearing aids, it is becoming increasingly daunting—even for a fine-tuning professional—to perform parameter fine tuning to satisfactorily meet the preference of the hearing aid user. In addition......, the communication between the fine-tuning professional and the hearing aid user might muddle the task. In the present paper, an interactive system is proposed to ease and speed up fine tuning of hearing aids to suit the preference of the individual user. The system simultaneously makes the user conscious of his own...... preferences while the system itself learns the user’s preference. Since the learning is based on probabilistic modeling concepts, the system handles inconsistent user feedback efficiently. Experiments with hearing impaired subjects show that the system quickly discovers individual preferred hearing...
Bailey, H A; Pappas, J J; Graham, S S; Winston, M E; Parrott, P
Roles of the otolaryngologist and the audiologist in providing hearing health care are expanding as a result of current trends in amplification technology, legislation, and patient populations. Within clinic dispensing of hearing aids has become a part of this role expansion. Requirements for setting up a dispensary, fitting procedures, fee analysis, and statistical results of 4 1/2 years' experience are discussed. On the basis of the benefits described, direct dispensing is advocated.
Weinstein, Barbara E; Sirow, Lynn W; Moser, Sarah
Hearing loss is a risk factor for social isolation and loneliness. We investigated the buffering effects of hearing aid use on perceived social and emotional loneliness. Forty older adults participated. Prior to and following the hearing aid fitting, participants completed the De Jong Gierveld Loneliness Scale (De Jong Gierveld & Kamphuis, 1985); a change in feelings of loneliness following hearing aid use was the outcome indicator. There was a significant decline in perceptions of loneliness following 4 to 6 weeks of hearing aid use. A dose effect emerged with persons with moderate-to-severe hearing loss experiencing the greatest reduction in perceived loneliness with hearing aid use. Associated with poorer health status and higher consumption of health care services, perceived loneliness is a challenge to treat. Hearing aid use appears to be a buffer against the experience of loneliness.
Kozlowski, Lorena; Ribas, Angela; Almeida, Gleide; Luz, Idalina
Introduction The impact of auditory sensory deprivation in the life of an individual is enormous because it not only affects one's ability to properly understand auditory information, but also the way people relate to their environment and their culture. The monitoring of adult and elderly subjects with hearing loss is intended to minimize the difficulties and handicaps that occur as a consequence of this pathology. Objective To evaluate the level of user satisfaction with hearing aids. Methods A clinical and experimental study involving 91 elderly hearing aid users. We used the questionnaire Satisfaction with Amplification in Daily Life to determine the degree of the satisfaction provided by hearing aids. We evaluated mean global score, subscales, as well as the variables time to use, age, and degree of hearing loss. Results Mean global score was 4.73, the score for Positive Effects 5.45, Negative Factors 3.2, demonstrating that they were satisfied; Services and Costs 5.98: very satisfied ; 3.65 Personal Image: dissatisfied. We observed statistically significant difference for the time of hearing aid use, age, and degree of hearing loss. Conclusion The SADL is a tool, simple and easy to apply and in this study we can demonstrate the high degree of satisfaction with the hearing aids by the majority of the sample collected, increasing with time of use and a greater degree of hearing loss.
Tomblin, J Bruce; Oleson, Jacob J; Ambrose, Sophie E; Walker, Elizabeth; Moeller, Mary Pat
IMPORTANCE Hearing loss (HL) in children can be deleterious to their speech and language development. The standard of practice has been early provision of hearing aids (HAs) to moderate these effects; however, there have been few empirical studies evaluating the effectiveness of this practice on speech and language development among children with mild-to-severe HL. OBJECTIVE To investigate the contributions of aided hearing and duration of HA use to speech and language outcomes in children with mild-to-severe HL. DESIGN, SETTING, AND PARTICIPANTS An observational cross-sectional design was used to examine the association of aided hearing levels and length of HA use with levels of speech and language outcomes. One hundred eighty 3- and 5-year-old children with HL were recruited through records of Universal Newborn Hearing Screening and referrals from clinical service providers in the general community in 6 US states. INTERVENTIONS All but 4 children had been fitted with HAs, and measures of aided hearing and the duration of HA use were obtained. MAIN OUTCOMES AND MEASURES Standardized measures of speech and language ability were obtained. RESULTS Measures of the gain in hearing ability for speech provided by the HA were significantly correlated with levels of speech (ρ179 = 0.20; P = .008) and language: ρ155 = 0.21; P = .01) ability. These correlations were indicative of modest levels of association between aided hearing and speech and language outcomes. These benefits were found for children with mild and moderate-to-severe HL. In addition, the amount of benefit from aided hearing interacted with the duration of HA experience (Speech: F4,161 = 4.98; P < .001; Language: F4,138 = 2.91; P < .02). Longer duration of HA experience was most beneficial for children who had the best aided hearing. CONCLUSIONS AND RELEVANCE The degree of improved hearing provided by HAs was associated with better speech and language development in children
Ibrahim, Iman; Parsa, Vijay; Macpherson, Ewan; Cheesman, Margaret
Wireless synchronization of the digital signal processing (DSP) features between two hearing aids in a bilateral hearing aid fitting is a fairly new technology. This technology is expected to preserve the differences in time and intensity between the two ears by co-ordinating the bilateral DSP features such as multichannel compression, noise reduction, and adaptive directionality. The purpose of this study was to evaluate the benefits of wireless communication as implemented in two commercially available hearing aids. More specifically, this study measured speech intelligibility and sound localization abilities of normal hearing and hearing impaired listeners using bilateral hearing aids with wireless synchronization of multichannel Wide Dynamic Range Compression (WDRC). Twenty subjects participated; 8 had normal hearing and 12 had bilaterally symmetrical sensorineural hearing loss. Each individual completed the Hearing in Noise Test (HINT) and a sound localization test with two types of stimuli. No specific benefit from wireless WDRC synchronization was observed for the HINT; however, hearing impaired listeners had better localization with the wireless synchronization. Binaural wireless technology in hearing aids may improve localization abilities although the possible effect appears to be small at the initial fitting. With adaptation, the hearing aids with synchronized signal processing may lead to an improvement in localization and speech intelligibility. Further research is required to demonstrate the effect of adaptation to the hearing aids with synchronized signal processing on different aspects of auditory performance.
Full Text Available Wireless synchronization of the digital signal processing (DSP features between two hearing aids in a bilateral hearing aid fitting is a fairly new technology. This technology is expected to preserve the differences in time and intensity between the two ears by co-ordinating the bilateral DSP features such as multichannel compression, noise reduction, and adaptive directionality. The purpose of this study was to evaluate the benefits of wireless communication as implemented in two commercially available hearing aids. More specifically, this study measured speech intelligibility and sound localization abilities of normal hearing and hearing impaired listeners using bilateral hearing aids with wireless synchronization of multichannel Wide Dynamic Range Compression (WDRC. Twenty subjects participated; 8 had normal hearing and 12 had bilaterally symmetrical sensorineural hearing loss. Each individual completed the Hearing in Noise Test (HINT and a sound localization test with two types of stimuli. No specific benefit from wireless WDRC synchronization was observed for the HINT; however, hearing impaired listeners had better localization with the wireless synchronization. Binaural wireless technology in hearing aids may improve localization abilities although the possible effect appears to be small at the initial fitting. With adaptation, the hearing aids with synchronized signal processing may lead to an improvement in localization and speech intelligibility. Further research is required to demonstrate the effect of adaptation to the hearing aids with synchronized signal processing on different aspects of auditory performance.
Full Text Available Wireless synchronization of the digital signal processing (DSP features between two hearing aids in a bilateral hearing aid fitting is a fairly new technology. This technology is expected to preserve the differences in time and intensity between the two ears by co-ordinating the bilateral DSP features such as multichannel compression, noise reduction, and adaptive directionality. The purpose of this study was to evaluate the benefits of wireless communication as implemented in two commercially available hearing aids. More specifically, this study measured speech intelligibility and sound localization abilities of normal hearing and hearing impaired listeners using bilateral hearing aids with wireless synchronization of multichannel Wide Dynamic Range Compression (WDRC. Twenty subjects participated; 8 had normal hearing and 12 had bilaterally symmetrical sensorineural hearing loss. Each individual completed the Hearing in Noise Test (HINT and a sound localization test with two types of stimuli. No specific benefit from wireless WDRC synchronization was observed for the HINT; however, hearing impaired listeners had better localization with the wireless synchronization. Binaural wireless technology in hearing aids may improve localization abilities although the possible effect appears to be small at the initial fitting. With adaptation, the hearing aids with synchronized signal processing may lead to an improvement in localization and speech intelligibility. Further research is required to demonstrate the effect of adaptation to the hearing aids with synchronized signal processing on different aspects of auditory performance.
Park, Hee-Sung; Moon, Il Joon; Jin, Sun Hwa; Choi, Ji Eun; Cho, Yang-Sun; Hong, Sung Hwa
The aims of this study were to find and compare the effect of directional (DIR) processing of two different hearing aids via both subjective and objective methods, to determine the association between the results of the subjective and objective evaluations, and to find out individual predictive factors influencing the DIR benefit. Twenty-six hearing aid users fitted unilaterally with each two different experimental hearing aid performed modified Korean Hearing in Noise Test (K-HINT) in three DIR conditions; omnidirectional (OMNI) mode, OMNI plus noise reduction feature, fixed DIR mode. In order to determine benefits from DIR benefit within a hearing aid and compare performance of the DIR processing between hearing aids, a subjective questionnaire was administrated on speech quality (SQ) and discomfort in noise (DN) domain. Correlation analysis of factors influencing DIR benefit was accomplished. Benefits from switching OMNI mode to DIR mode within both hearing aids in K-HINT were about 2.8 (standard deviation, 3.5) and 2.1 dB SNR (signal to ratio; SD, 2.5), but significant difference in K-HINT results between OMNI and OMNI plus noise reduction algorithm was not shown. The subjective evaluation resulted in the better SQ and DN scores in DIR mode than those in OMNI mode. However, the difference of scores on both SQ and DN between the two hearing aids with DIR mode was not statistically significant. Any individual factors did not significantly affect subjective and objective DIR benefits. DIR benefit was found not only in the objective measurement performed in the laboratory but also in the subjective questionnaires, but the subjective results was failed to have significant correlation with the DIR benefit obtained in the K-HINT. Factors influencing individual variation in perceptual DIR benefit were still hard to explain.
Nash-Kille, Amy; Sharma, Anu
Although brainstem dys-synchrony is a hallmark of children with auditory neuropathy spectrum disorder (ANSD), little is known about how the lack of neural synchrony manifests at more central levels. We used time-frequency single-trial EEG analyses (i.e., inter-trial coherence; ITC), to examine cortical phase synchrony in children with normal hearing (NH), sensorineural hearing loss (SNHL) and ANSD. Single trial time-frequency analyses were performed on cortical auditory evoked responses from 41 NH children, 91 children with ANSD and 50 children with SNHL. The latter two groups included children who received intervention via hearing aids and cochlear implants. ITC measures were compared between groups as a function of hearing loss, intervention type, and cortical maturational status. In children with SNHL, ITC decreased as severity of hearing loss increased. Children with ANSD revealed lower levels of ITC relative to children with NH or SNHL, regardless of intervention. Children with ANSD who received cochlear implants showed significant improvements in ITC with increasing experience with their implants. Cortical phase coherence is significantly reduced as a result of both severe-to-profound SNHL and ANSD. ITC provides a window into the brain oscillations underlying the averaged cortical auditory evoked response. Our results provide a first description of deficits in cortical phase synchrony in children with SNHL and ANSD. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
S. J. Pérez-Ruiz
Full Text Available In this work we show the results obtained from several measurements, on hearing aid (HA prototype carried out atthe Acoustic Laboratory of the Centro de Ciencias Aplicadas y Desarrollo Tecnológico (CCADET at the UniversidadNacional Autónoma de México (UNAM. The hearing aid has been developed at the Electronics Laboratory of thesame Center. All the electroacoustic measurements have been made according to the recommendationsestablished in the ANSI and IEC Standards for hearing aids.
Cabral, Jamile; Tonocchi, Rita; Ribas, Ângela; Almeida, Gleide; Rosa, Marine; Massi, Giselle; Berberian, Ana Paula
The use of hearing aids has been one of the strategies to reduce tinnitus perception and improve sufferers' quality of life when this symptom is associated to hearing impairment. To assess the remission of emotional and auditory tinnitus impacts on users of hearing aids. It is an experimental, descriptive study carried out with 17 users of unilateral or bilateral hearing aids, reporting tinnitus, submitted to otorhinolaryngological screening, tonal audiometry, logoaudiometry and acoustic imittance testing, who also answered the Iowa Tinnitus Activities Questionnaire, as well as the Iowa Tinnitus Handicap Questionnaire. There was significant difference in tinnitus data scoring before the use of hearing aids and after fitting the hearing aids. Analysis of the results evidences that the use of hearing aids improves tinnitus patients' quality of life, mainly regarding their emotional and auditory aspects.
Mourtou, Eleni; Meis, Markus
This chapter provides background information for researchers who wish to become familiar with some basic medical and audiological aspects of hearing loss and the technology of hearing aids. It introduces (1) the disciplines involved in research on hearing loss, (2) the medical categories of hearing...
Paulsen, Rasmus Reinhold; Nielsen, Claus; Laugesen, Søren
Today the design of custom completely-in-the-canal hearing aids is a manual process and therefore there is a variation in the quality of the finished hearing aids. Especially the placement of the so-called faceplate on the hearing aid strongly influences the size and shape of the hearing aid. Since...
Bennett, Rebecca J; Meyer, Carly J; Eikelboom, Robert H; Atlas, Marcus D
The purpose of this study is to identify hearing aid owners' and clinicians' opinions of the knowledge, skills, and tasks required for hearing aid management and the importance of each of these to overall success with hearing aids. Concept mapping techniques were used to identify key themes, wherein participants generated, sorted, and rated the importance of statements in response to the question "What must hearing aid owners do in order to use, handle, manage, maintain, and care for their hearing aids?" Twenty-four hearing aid owners (56 to 91 years of age; 54.2% men, 45.8% women) and 22 clinicians (32 to 69 years of age; 9.1% men, 90.9% women) participated. Participants identified 111 unique items describing hearing aid management within 6 concepts: (a) "Daily Hearing Aid Use," (b) "Hearing Aid Maintenance and Repairs," (c) "Learning to Come to Terms with Hearing Aids," (d) "Communication Strategies," (e) "Working With Your Clinician," and (f) "Advanced Hearing Aid Knowledge." Clinicians' opinions of the importance of each statement varied only slightly from the opinions of the hearing aid owner group. Hearing aid owners indicated that all 6 concepts were of similar importance, whereas clinicians indicated that the concept "Advanced Hearing Aid Knowledge" was significantly less important than the other 5 concepts. The results highlight the magnitude of information and skill required to optimally manage hearing aids. Clinical recommendations are made to improve hearing aid handling education and skill acquisition.
Nielsen, Jens Brehm; Nielsen, Jakob; Larsen, Jan
Personalization of multi-parameter hearing aids involves an initial fitting followed by a manual knowledge-based trial-and-error fine-tuning from ambiguous verbal user feedback. The result is an often suboptimal HA setting whereby the full potential of modern hearing aids is not utilized. This ar...
Skagerstrand, Åsa; Stenfelt, Stefan; Arlinger, Stig; Wikström, Joel
The noises in modern soundscapes continue to increase and are a major origin for annoyance. For a hearing-impaired person, a hearing aid is often beneficial, but noise and annoying sounds can result in non-use of the hearing aid, temporary or permanently. The purpose of this study was to identify annoying sounds in a daily soundscape for hearing-aid users. A diary was used to collect data where the participants answered four questions per day about annoying sounds in the daily soundscape over a two-week period. Sixty adult hearing-aid users. Of the 60 participants 91% experienced annoying sounds daily when using hearing aids. The annoying sound mentioned by most users, was verbal human sounds, followed by other daily sound sources categorized into 17 groups such as TV/radio, vehicles, and machine tools. When the hearing-aid users were grouped in relation to age, hearing loss, gender, hearing-aid experience, and type of signal processing used in their hearing aids, small and only few significant differences were found when comparing their experience of annoying sounds. The results indicate that hearing-aid users often experience annoying sounds and improved clinical fitting routines may reduce the problem.
Maria Fernanda Capoani Garcia Mondelli
Full Text Available A presbiacusia é um dos distúrbios comum nos idosos, que causa perda auditiva, podendo contribuir para o desenvolvimento de alguns distúrbios psiquiátricos, favorecendo o isolamento, devido à dificuldade de comunicação com o meio social. OBJETIVO: Verificar por meio do instrumento WHOQOL (World Health Organization of Life Questionnaire, a qualidade de vida do indivíduo deficiente auditivo antes e após a adaptação do aparelho de amplificação sonora individual (AASI. MÉTODO: Participaram da pesquisa 30 indivíduos portadores de perda auditiva, com mais de 60 anos, atendidos em uma Clínica de Fonoaudiologia. O paciente respondeu às questões do instrumento WHOQOL, sem o uso do AASI e após uso efetivo da amplificação por um período de três meses responderam novamente o questionário. O WHOQOL - Bref é formado por 26 questões, duas gerais, associadas à qualidade de vida e 24 que discriminam quatro aspectos: físico, psicológico, meio ambiente e relações sociais. RESULTADOS: Houve melhora significativa na qualidade de vida em geral quanto às oportunidades de atividades de lazer; não houve grandes mudanças quanto à frequência de sentimentos negativos; mesmo após a adaptação do AASI, os pacientes continuam apresentando tais sentimentos. CONCLUSÃO:O uso do AASI favoreceu a qualidade de vida geral dos indivíduos avaliados.Presbycusis is a common disorder in the elderly, which causes hearing loss and may contribute to the development of some psychiatric disorders, leading to isolation due to communication difficulties in the social environment. OBJECTIVE: To identify through the WHOQOL (World Health Organization Quality of Life Questionnaire, the quality of life of hearing impaired individuals before and after hearing aid fittings. METHOD: We had 30 individuals with hearing loss, all over 60 years of age - patients from a Speech Therapy Clinic. The patients answered the WHOQOL questions without the use of hearing aids
Petersen, Eline Borch; Lunner, Thomas
The working memory plays an important role in successfully overcoming adverse listening conditions and should consequently be considered when designing and testing hearing aids. A number of studies have established the relationship between hearing in noise and working memory involvement, but with the Sentence-final Word Identification and Recall (SWIRL) test, it is possible to show that working memory is also involved in listening under favorable conditions and that noise reduction has a positive influence in situation with very little noise. Although the capacity of the working memory is a finite individual size, its involvement can differ with fatigue and other factors and individualization of hearing aids should take this into account to obtain the best performance. A way of individually adapting hearing aids is based on changes in the electrical activity of the brain (EEG). Here we present the possibilities that arise from using EEG and show that ear-mounted electrodes is able to record useful EEG that can be explored for individualization of hearing aids. Such an adaptation could be done based on changes in the electrical activity of the brain (EEG). Here we present the possibilities that arise from using EEG and show that ear-mounted electrodes is able to record useful EEG that can be explored for individualization of hearing aids.
Ribeiro Nunes, Rui; Migueis, António Carlos
The three-dimensional characteristic of heari ng as a neurosensory loss can be associated with distortions in the axes of intensity, frequency and also temporal. This type of distortions can be isolated or combined, with many functional characteristics which complicate the fixing of the hearing aid and makes its result extremely variable. The ENT specialist in charge of the prescription of the hearing aid must know the various types of available devices, its indications and limitations. The different current hearing aids by acoustic stimulation are described, behind the ear, intra-auricular, intra-canal, micro-behind the ear with receiver in the canal (RIC). Some clinical and audiometric elements make it possible to envisage the difficulty of such equipment as the air bone gap, the dynamic, the frequential shift, the hearing discrimination. Concerning the hearing aid itself, the amplifier represents the fundamental part allowing the compensation of the quatitative loss; it presents however many possibilities of adaptation (multifrequential compression, the adaptive directionnality coming from the directional microphones, the suppression of the acoustic feedback, the increase of the bandwidth and software of statistical analysis of environmental acoustics as well as procedures of decision). Finally software of treatment of the signal like the software of suppression of acoustic feedback, identification of the speech and noise, of adaptive directionality, of measurement of the hearing thresholds (which is possible on certain prosthesis for each channel) refine the adjustment of the hearing aid. The knowledge of these technological possibilities currently available, like their indications and limitations, allows the ENT specialist to get an active role in the process of acceptation of the hearing aid.
Henry, James A; McMillan, Garnett; Dann, Serena; Bennett, Keri; Griest, Susan; Theodoroff, Sarah; Silverman, Shien Pei; Whichard, Susan; Saunders, Gabrielle
Whereas hearing aids have long been considered effective for providing relief from tinnitus, controlled clinical studies evaluating this premise have been very limited. The purpose of this study was to systematically determine the relative efficacy of conventional receiver-in-the-canal hearing aids (HA), the same hearing aids with a sound generator (HA+SG), and extended-wear, deep fit hearing aids (EWHA), to provide relief from tinnitus through a randomized controlled trial. Each of these ear-level devices was a product of Phonak, LLC. Participants were randomized to HA, HA+SG, or EWHA and wore bilaterally fit devices for about 4 months. Fittings, adjustments, and follow-up appointments were conducted to comply with company guidelines and to ensure that all participants attended appointments on the same schedule. At 4-5 months, participants returned to complete final outcome measures, which concluded their study participation. Participants were 55 individuals (mean age: 63.1 years) with mild to moderately-severe hearing loss who: (a) did not currently use hearing aids; (b) reported tinnitus that was sufficiently bothersome to warrant intervention; and (c) were suitable candidates for each of the study devices. The primary outcome measure was the Tinnitus Functional Index (TFI). Secondary outcome measures included hearing-specific questionnaires and the Quick Speech in Noise test (QuickSIN). The goal of the analysis was to evaluate efficacy of the EWHA and HA+SG devices versus the HA standard device. There were 18 participants in each of the HA and EWHA groups and 19 in the HA+SG group. Gender, age, and baseline TFI severity were balanced across treatment groups. Nearly all participants had a reduction in tinnitus symptoms during the study. The average TFI change (improvement) from baseline was 21 points in the HA group, 31 points in the EWHA group, and 33 points in the HA+SG group. A "clinically significant" improvement in reaction to tinnitus (at least 13-point
Bastos, Bárbara Guimarães
Full Text Available Introduction The family has ultimate responsibility for decisions about the use and care during the daily routine and problem solving in the manipulation of hearing aids (HA in infants and children. Objective The purpose of the study was to assess technical and content quality of Babies' Portal website Hearing Aid section by audiologists. Methods Letters and e-mails were sent inviting professionals to surf the website and anonymously fill out an online form with 58 questions covering demographic data as well as the website's technical (Emory questionnaire with the subscales of accuracy, authorship, updates, public, navigation, links, and structure and content quality. Results A total of 109 professionals (tree men and 106 women with mean age of 31.6 years participated in the study. Emory percentage scores ranged from 90.1 to 96.7%. The Hearing Aid section contents were considered good or very good. Conclusion The website was deemed to have good technical and content quality, being suitable to supplement informational counseling to parents of hearing-impaired children fitted with hearing aids.
Hearing aid processing of loud speech and noise signals: Consequences for loudness perception and listening comfort. Sound processing in hearing aids is determined by the fitting rule. The fitting rule describes how the hearing aid should amplify speech and sounds in the surroundings, such that t......Hearing aid processing of loud speech and noise signals: Consequences for loudness perception and listening comfort. Sound processing in hearing aids is determined by the fitting rule. The fitting rule describes how the hearing aid should amplify speech and sounds in the surroundings...... research -for example investigations of loudness perception in hearing impaired listeners. Most research has been focused on speech and sounds at medium input-levels (e.g., 60-65 dB SPL). It is well documented that for speech at conversational levels, hearing aid-users prefer the signal to be amplified...... in regard to perceived level variation, loudness and overall acceptance. In the second experiment, two signals containing speech and noise at 75 dB SPL RMS-level, were compressed with six compression ratios from 1:1 to 10:1 and three release times from 40 ms to 4000 ms. In this experiment, subjects rated...
Holmes, Alice E.
Persons with hearing loss can obtain great benefit from hearing aids but there are many situations that traditional amplification devices will not provide enough help to ensure optimal communication. Assistive listening and signaling devices are designed to improve the communication of the hearing impaired in instances where traditional hearing aids are not sufficient. These devices are designed to help with problems created by listening in noise or against a competing message, improve distance listening, facilitate group conversation (help with problems created by rapidly changing speakers), and allow independence from friends and family. With the passage of the Americans with Disabilities Act in 1990, assistive listening devices (ALDs) are becoming more accessible to the public with hearing loss. Employers and public facilities must provide auxiliary aids and services when necessary to ensure effective communication for persons who are deaf or hard of hearing. However many professionals and persons with hearing loss are unaware of the various types and availability of ALDs. An overview of ALDs along with a discussion of their advantages and disadvantages will be given.
Löhler, J; Akcicek, B; Wollenberg, B; Schönweiler, R; Verges, L; Langer, Ch; Machate, U; Noppeney, R; Schultz, K; Kleeberg, J; Junge-Hülsing, B; Walther, L E; Schlattmann, P; Ernst, A
The Freiburger Speech Test (FST) has been the gold standard in speech testing by word recognition score in Germany for many years. Recently, it has been demonstrated that for an amount of 104 test-persons there is no significant deviation within the lists. The objective of this study was to determine the percentiles of the distinct measuring situations in quiet and with noise (e.g. applied in hearing aid fitting) and the average benefit using hearing aids. In this prospective study, 623 patients with SNHL and equipped with hearing aids for at least 3 months have been investigated by means of the Freiburger monosyllabic test (FBE) without and with hearing aids and in quiet or with noise (CCITT noise, 65/60 dB signal-noise ratio) in free field conditions at 65 dB to determine the ratio of intelligibility. To investigate the different diagnostic conditions a linear mixed model was applied. The dependent binary variable corresponds to the number of understood syllables. The average age of all subjects was about 72.6 years. The average rate of understanding in the FBE without hearing aids and in quiet was 38.5 %, with hearing aids and in quiet 67.7 %, without hearing aids and with noise 22.4 %, and with hearing aids and with noise 39.8 %. All results were presented with the depending confidence intervals. The extent of hearing loss and the quality of hearing aid fitting can be successfully measured using the FST in quiet and with background noise (CCITT noise). In quiet, an average hearing improving gain of 29.2 % points and with noise a gain of 17.4 % points could be estimated with a successful hearing aid fitting.
Tao Zhang; Mustiere, Fred; Micheyl, Christophe
The first revolution in hearing aids came from nonlinear amplification, which allows better compensation for both soft and loud sounds. The second revolution stemmed from the introduction of digital signal processing, which allows better programmability and more sophisticated algorithms. The third revolution in hearing aids is wireless, which allows seamless connectivity between a pair of hearing aids and with more and more external devices. Each revolution has fundamentally transformed hearing aids and pushed the entire industry forward significantly. Machine learning has received significant attention in recent years and has been applied in many other industries, e.g., robotics, speech recognition, genetics, and crowdsourcing. We argue that the next revolution in hearing aids is machine intelligence. In fact, this revolution is already quietly happening. We will review the development in at least three major areas: applications of machine learning in speech enhancement; applications of machine learning in individualization and customization of signal processing algorithms; applications of machine learning in improving the efficiency and effectiveness of clinical tests. With the advent of the internet of things, the above developments will accelerate. This revolution will bring patient satisfactions to a new level that has never been seen before.
Ho, Hsu-Chueh; Wu, Yu-Hsiang; Hsiao, Shih-Hsuan; Zhang, Xuyang
The objective of this prospective study was to investigate the relationship between acceptable noise level (ANL), which was measured using Taiwanese and the international speech test signal (ISTS), and real-world hearing-aid success for listeners who were representative of the population commonly seen in clinics. Unaided ANLs were measured pre-hearing-aid fitting. Hearing-aid success was assessed three months post-fitting using the international outcome inventory for hearing aids (IOI-HA) and a hearing-aid use questionnaire. Eighty adults with hearing impairment completed the study. Both Taiwanese and ISTS ANLs were significantly associated with hearing-aid success, with higher ANLs suggesting poorer outcomes. However, the ANL's prediction accuracy for the probability of hearing-aid success was either much lower than that suggested by some literature, or was not much different from that of simply predicting all listeners as successful users. The current study suggested the possibility of using ANL to predict hearing-aid success. However, the usefulness of ANL as a clinical tool is unlikely to be as great as indicated by the literature.
context and can therefore result in more accountable hearing aid fittings taking place. The test can further be used as a counseling tool to assist audiologists and patients in understanding the problems they experience regarding music perception and might be used for future musical training in areas where participants experience problems to customize individual fittings
Full Text Available There have been a number of studies on screening of hearing in adult populations. Despite the high importance of interventions following screening for hearing (Wilson and Jungner, 1968 there is a dearth of information on the nature of interventions following such screening, other than hearing aid fitting (HA or referral to audiology/ENT departments (Pronk et al., 2011. In the late 1980s and early 1990s four studies were performed in Wales, which offered such other interventions to those individuals indicating hearing disabilities in screening questionnaires (eg Stephens et al., 1990; Davis et al., 1992. The majority of the patient notes from these studies were still accessible and have been examined to extract the following information: - what interventions were used other than hearing aids? - who received these interventions? - would they have been more appropriate than HAs for some of those fitted? The aim of this paper is to list the interventions provided in these studies and relate them to the initial complaints of those indicating hearing problems.
Lee, J M; Jeon, J H; Moon, I S; Choi, J Y
In this retrospective chart review we compared the subjective and objective benefits of active middle ear implants (AMEIs) with conventional hearing aids (HAs) in patients with sloping high tone hearing loss. Thirty-four patients with sensorineural hearing loss were treated with AMEIs. Of these, six had sloping high tone hearing loss and had worn an HA for more than 6 months. Objective assessments, a pure-tone audiogram, as well as a word recognition test, and the Korean version of the Hearing in Noise Test (K-HINT), and a subjective assessment, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, were performed. Tests were conducted under three circumstances: 1) the unaided state before surgery; 2) the HA-aided state before surgery; and 3) the AMEI-aided state 3 months after surgery. The average high-frequency hearing gain (≥ 2 kHz) was significantly better with AMEIs than with HAs. Although the result had no statistical significance, AMEIs showed a superior word recognition score (WRS) compared to HAs. However, the most comfortable hearing level at which the WRS was tested was significantly decreased with an AMEI compared to an HA. In the K-HINT, patients with an AMEI showed greater recognition than those fitted with an HA under both quiet and noisy conditions. The APAHB scores revealed that patients were more satisfied with an AMEI rather than an HA on all subscales. The use of vibroplasty in patients with sloping high tone loss resulted in positive hearing outcomes when compared to conventional HAs. Based on the data from this study, AMEIs provided better objective and subjective results and could, therefore, be a better alternative for the treatment of sloping hearing loss. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.
Stelmachowicz, P G; Kopun, J; Mace, A L; Lewis, D E
Non-speech stimuli typically are used to estimate the electroacoustic characteristics of a hearing aid. At present, there is no consensus as to what type of input stimulus will best represent the gain for real speech. The purpose of this study was to measure hearing aid gain using continuous discourse and to compare these values with gain measured with five different types of simpler stimuli. Hearing aid gain as a function of frequency was measured in a 2 cm3 coupler for 20 commercially available hearing aids. Circuitry included features such as linear peak clipping, compression limiting, 1-, 2-, and 3-channel full dynamic range compression, and adaptive compression. Input stimuli were a) 15 sec of continuous discourse, b) swept pure tones (SPTs), c) speech weighted composite noise (SWCN), d) simulated speech, e) speech weighted warble tones, and f) speech modulated noise. Input levels ranged from 50 to 80 dB SPL. In general, both SPTs and SWCN tended to underestimate the high-frequency gain for real speech. These discrepancies increased as a function of input intensity. On average, the SPT produced the greatest departure from the gain for real speech, producing differences for individual hearing aids as large as 10 to 14 dB. An analysis by circuit type revealed that discrepancies most likely occurred when a hearing aid was operating in a nonlinear mode. Of the five non-speech stimuli used, speech modulated noise and simulated speech seemed to provide the closest approximation to the gain measured with continuous discourse. When a hearing aid is operating in a nonlinear mode, non-speech stimuli will tend to underestimate the gain for real speech, particularly in the high frequencies. Under some conditions, these discrepancies may impact clinical decisions during the hearing aid fitting process. Additional studies are needed to elucidate the factors that contribute to the gain discrepancies observed in this study and to explore the use of additional stimuli
Looi, V; Lee, Z Z; Loo, J H Y
The Children Using Hearing Devices Quality of Life Questionnaire (CuHDQOL) is a new parent-administered hearing-specific questionnaire for children fitted with hearing devices. The aim of this study was to assess outcomes for hearing-impaired children in Singapore using this measure, as well as to examine its applicability for use in a clinical setting. The CuHDQOL has 26 items, uses a recall period of 1 month, and is divided into three sections: parental perspectives and expectations (eight items), impact on the family (eight items) and hearing-related quality of life (QOL) of the child (10 items). Responses are made on a 5-point Likert scale, and transformed to a score from 0-100. Twenty-two parents of children with hearing aids and 14 parents of children with cochlear implants completed the CuHDQOL. The mean total CuHDQOL scores was 62/100 for the children using hearing aids and 53/100 for children with cochlear implants. Scores for the children using hearing aids were higher across all subscales, with a linear regression showing this to be significant for the parental perspectives and expectations subscale (B=-10.58, P=0.041). Analyses of Variance showed that both the 'Parent Perspective and Expectations' and the 'Hearing-related QOL' subscales were significantly higher than the 'Impact on Family' subscale for both groups (P≤0.003). The CuHDQOL was found to be a simple, efficient questionnaire that could easily be incorporated into clinical practice to provide a more holistic evaluation of a child's outcomes post intervention, and/or to monitor their progress over time. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Xu, Qingqing; Zhou, Huijfang; Zhang, Jing; Guo, Yuxi; Wang, Xiuzhen
To compare and analysis outcomes of different age paragraph hearing aid users by questionnaires. The questionnaire was deployed to 90 hearing aid users, 40 females and 50 males, with ages between 19 and 80 years-from junior high school education to university education, suffering binaural severe or moderate sensorineural deafness. The subjects were devided into 3 groups, the A group with ages between 19 and 40 years, the B group with ages between 41 and 60 years, the C group with ages between 61 and 80 years. After being fitted with hearing aids for 6 weeks, 6 months and 12 months, SADL and IOI-HA were applied to evaluating 90 subjects. The study was carried out through face to face interview or by telephone. There were significant differences in SADL scores of positive effect, service and Personal image among the 3 groups (P paragraph is improved with the wearing time growth, but the outcome and satisfaction of hearing aids are decreased with the age growth.
Johnson, Jani A; Cox, Robyn M; Alexander, Genevieve C
This study was undertaken for two purposes: First, to provide a comparison of subjective performance and benefit measured with the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire for two groups. One group included hearing-impaired individuals using 1990s-era linear processing hearing aids. The other group included hearing-impaired individuals using more current wide-dynamic range compression (WDRC)-capable hearing aids fit using current practice protocols. The second purpose of this study was to determine whether APHAB norms derived from scores for current hearing aid users were different from the original 1995 norms. It was hypothesized that technology improvements would result in improved subjective performance for modern hearing aid wearers. A systematic sampling method was used to identify and recruit subjects from seven private-practice audiology clinics located across the United States. Potential subjects were limited to older hearing-impaired individuals who were wearing hearing aids capable of WDRC processing. One hundred fifty-four subjects returned completed APHAB questionnaires. Participants reported mostly moderate to moderately severe subjective hearing difficulty. No differences in perceived difficulty with speech communication were observed between the two groups. However, aversiveness of amplified sound was less frequently reported for users of WDRC-capable hearing aids. Norms were generated using data from all of the operationally defined successful hearing aid users in the sample and compared with the original 1995 norms. Differences between the 1995 and 2005 norms were minimal for the speech communication subscales. However, the 2005 group consistently reported less frequent difficulties with sound aversiveness (AV subscale) in the aided condition. In addition to these findings, an improvement was observed in the rate of successful adjustment to hearing aids between 1995 (43%) and 2005 (82%). Overall, problems understanding
Uys, Marinda; van Dijk, Catherine
more effective hearing-aid fittings taking place. The test can be used as a counselling tool to assist audiologists and patients in understanding the problems they experience regarding music perception, and might be used for future musical training in areas where participants experience problems in customising individual fittings.
Hayes, D E; Cormier, K L
This study was a double blind comparison of three types of hearing aid circuits: Class A linear peak clipping, Class D compression limiting and K-Amp wide dynamic range compression. Subjective ratings, speech perception tests, real ear measurements and questionnaire data were obtained from a group of 17 new hearing aid users with mild to moderate sensorineural hearing loss. The results indicate a similar performance for all three circuits. We saw no evidence of performance degradation due to saturation distortion, even in the presence of high levels of speech and noise. Our primary conclusions include recommending K-Amps to new hearing aid users with mild to moderate hearing loss, mostly on the basis of battery life, while cautioning about the use of compression knee-point controls and recognizing that Class A and Class D amplifiers are virtually equivalent in every performance measurement.
Dashti, Rezvan; Khiavi, Farzad Faraji; Sameni, Seyyed Jalal; Bayat, Arash
The evaluation of subjective benefits and positive effects of hearing aids in daily is important for measuring the treatment outcome. The aim of this project was to investigate the degree of satisfaction of aged users with their hearing aids using the Satisfaction with Amplification in Daily Life (SADL) scale, which emphasizes non-auditory factors contributing to satisfaction as well as benefit. The Persian version of SADL scale was completed by 40 patients who received monaural hearing aid fitting at south of the Iran from December 2013 and March 2014. SADL subscales of the SADL were evaluated according to the type and degree of hearing loss, the pure tone audiogram pattern and shape and type of the hearing aid. The results associated with the SADL subscales revealed a greater satisfaction associated with the Positive Effect and Service and Costs subscales. Subjects with different degree of hearing loss were very satisfied in terms of positive effect subscale. Participants reported a considerable level of satisfaction with their hearing aids. Appropriate guidance for using hearing aids and spending more time for counseling can improve the satisfaction level of this age group.
The bone-anchored hearing aid (Baha) was introduced in 1977 by Tjellström and colleagues and has now been used clinically for over 30 years. Generally, the outcomes are good, and several studies have shown improved audiological- and quality of life outcomes. The principle of the Baha is, that sound...
... if it provides internal means for effective use with hearing aids that are designed to be compatible... 47 Telecommunication 3 2010-10-01 2010-10-01 false Hearing aid-compatible telephones. 68.4 Section... (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK General § 68.4 Hearing aid-compatible...
...-504 Magnetic Field Intensity Criteria for Telephone Compatibility With Hearing Aids Table of Contents... communications since the 1940's. Magnetic pick-ups in hearing-aids have provided for coupling to many, but not... useful to anyone engaged in the manufacture of telephone terminal equipment and hearing-aids and to those...
Freyaldenhoven, Melinda C.; Plyler, Patrick N.; Thelin, James W.; Muenchen, Robert A.
Purpose: To examine whether the effects of speech presentation level on acceptance of noise could differentiate full-time, part-time, and nonusers of hearing aids and whether these effects could predict hearing aid use. Method: Participants were separated into 3 groups on the basis of hearing aid use: (a) full-time use, (b) part-time use, or (c)…
Gioia, Carmine; Ben-Akiva, Moshe; Jørgensen, Ole
Background: Professional recommendations to patients concerning hearing instrument (HI) technology levels are not currently evidence-based. Pre-fitting parameters have not been proven to be the primary indicators for optimal patient outcome with different HI technology levels. This results...... in subjective decision-making as regards the technology level recommendation made by professionals. Purpose: The objective of this study is to gain insight into the decision-making criteria utilized by professionals when recommending HI technology levels to hearing-impaired patients....
Palmer, Catherine; Bentler, Ruth; Mueller, H Gustav
This clinical trial was undertaken to evaluate the subjective benefit obtained from hearing aids employing automatic switching second-order adaptive directional microphone technology, used in conjunction with digital noise reduction, as compared to a fixed directional microphone or omnidirectional microphone response with the same digital noise reduction. Data were collected for 49 participants across two sites. Both new and experienced hearing aid users were fit bilaterally with behind-the-ear hearing aids using the NAL-NL1 (National Acoustics Laboratory-Nonlinear version 1) prescriptive method with manufacturer default settings for various signal processing (e.g., noise reduction, compression parameters, etc.). During ten days of hearing aid use, participants responded to daily journal questions. Subjective ratings for each of the three hearing aid responses (omnidirectional, automatic-adaptive directional, and automatic-fixed directional) were similar. Overall preference for a microphone condition was equally distributed between no preference, omnidirectional, and automatic adaptive and/or fixed directional.
Park, Lisa R; Teagle, Holly F B; Buss, Emily; Roush, Patricia A; Buchman, Craig A
The primary objective of this study is to evaluate the benefits of nonlinear frequency compression (NLFC) hearing aids in the nonimplanted ears of children with unilateral cochlear implants (CIs). It is hypothesized that speech perception performance will benefit from complementary auditory cues provided by the CI and the hearing aid, particularly with the increased access to high-frequency sounds provided by NLFC. Eleven children using unilateral CIs with usable residual hearing in the nonimplanted ears were enrolled in the study and fitted with NLFC hearing aids. The test protocol included consonant-nucleus-consonant words in quiet, the Hearing in Noise Test sentences presented in speech noise and two-talker maskers, and a consonant identification task. Subjects were tested in a CI-alone condition as well as bimodally, with and without NLFC enabled. The results support previous work in adults and children, demonstrating the beneficial effects of bimodal listening. Frequency compression did not significantly affect performance for the children enrolled in this study, although some preferred using NLFC. The results yield suggestions regarding test methods for pediatric bimodal listeners, and considerations regarding validation and audibility of the compressed signal. Hearing aid use in the contralateral ear of unilaterally implanted children is beneficial. Children and young adults who are fitted bimodally should be tested both in quiet and in complex listening situations to determine bimodal benefit. In the current test battery, the inclusion of frequency compression in the hearing aid fitting does not seem to provide significant improvement beyond standard hearing aid fittings or any bilateral interference symptoms for this group of bimodal listeners.
Liston, R; Solomon, S; Banerjee, A. K.
BACKGROUND. Deterioration of hearing with advancing age is well documented. However, the proportion of elderly people with hearing problems who wear hearing aids is low. AIM. The aim of this study was to assess the prevalence of hearing disability in a group of elderly patients in hospital and to determine their attitudes to hearing difficulties and the wearing of hearing aids. METHOD. A random sample of patients who were convalescing were interviewed. A detailed questionnaire was administere...
This paper discusses trends and issues in selecting amplification for new, mainly nonlinear, types of hearing aids. Some-concerns are that nonvalidated prescription formulae may proliferate; that, through concentration on loudness normalization, alternative rationales are not being evaluated; and that most new fitting procedures for nonlinear hearing aids ignore the findings of research with linear amplification. A possible philosophical concern is that the hearing aid fitter may lose control of the fitting process. The achieving of any particular loudness relationship, among different frequency components of amplified speech, may be unimportant in itself but may be critical for achieving other objectives such as maximizing audibility over a wide frequency range when speech is at a comfortable level. Amplification selection should seek to achieve objectives by the simplest means (linear frequency shaping, automatic volume control) and should proceed to more complex, but potentially detrimental, processing (syllabic compression) only to the extent necessary. New prescriptive procedures should build on established procedures because, for typical speech levels, amplification requirements should be similar, regardless of whether linear or nonlinear amplification is used.
Cox, Robyn M; Alexander, Genevieve C; Gray, Ginger A
In hearing aid research, it is commonplace to combine data across subjects whose hearing aids were provided in different service delivery models. There is reason to question whether these types of patients are always similar enough to justify this practice. To explore this matter, this investigation evaluated similarities and differences in self-report data obtained from hearing aid patients derived from public health (Veterans Affairs, VA) and private practice (PP) settings. The study was a multisite, cross-sectional survey in which 230 hearing aid patients from VA and PP audiology clinic settings provided self-report data on a collection of questionnaires both before and after the hearing aid fitting. Subjects were all older adults with mild to moderately severe hearing loss. About half of them had previous experience wearing hearing aids. All subjects were fitted with wide-dynamic-range-compression instruments and received similar treatment protocols. Numerous statistically significant differences were observed between the VA and PP subject groups. Before the fitting, VA patients reported higher expectations from the hearing aids and more severe unaided problems compared with PP patients with similar audiograms. Three wks after the fitting, VA patients reported more satisfaction with their hearing aids. On some measures VA patients reported more benefit, but different measures of benefit did not give completely consistent results. Both groups reported using the hearing aids an average of approximately 8 hrs per day. VA patients reported age-normal physical and mental health, but PP patients tended to report better than typical health for their age group. These data indicate that hearing aid patients seen in the VA public health hearing services are systematically different in self-report domains from those seen in private practice services. It is therefore risky to casually combine data from these two types of subjects or to generalize research results from one
Lewis, M Samantha; Valente, Michael; Horn, Jane Enrietto; Crandell, Carl
Hearing impairment has been associated with decline in psychosocial function. Previous investigations have reported that the utilization of hearing aids can ameliorate these reductions in psychosocial function. To date, few investigations have examined the effects of frequency modulation technology on hearing handicap, adjustment to hearing loss, and communicative strategies. The purpose of this investigation was to examine these effects and to compare them to the benefits obtained when using hearing aids alone. Subjects ranged in age from 34 to 81 years and had mean pure-tone thresholds consistent with a bilateral moderate to severe sloping sensorineural hearing loss. All subjects wore hearing aids only and hearing aids plus FM system in a randomized fashion. The Communication Profile for the Hearing Impaired (CPHI) was administered prior to fitting the study devices and once a month for three months in each of the two conditions. A statistically significant difference between device conditions was obtained for the Importance of Communication in Work Situations subscale. Additionally, statistically significant differences over time were noted in several CPHI subscales. Despite statistical significance, none of these results were clinically significant. The implications of these results will be discussed.
Pottackal Mathai, Jijo; Mohammed, Hasheem
To investigate the effect of compression time settings and presentation levels on speech perception in noise for elderly individuals with hearing loss. To compare aided speech perception performance in these individuals with age-matched normal hearing subjects. Twenty (normal hearing) participants within the age range of 60-68 years and 20 (mild-to-moderate sensorineural hearing loss) in the age range of 60-70 years were randomly recruited for the study. In the former group, SNR-50 was determined using phonetically balanced sentences that were mixed with speech-shaped noise presented at the most comfortable level. In the SNHL group, aided SNR-50 was determined at three different presentation levels (40, 60, and 80 dB HL) after fitting binaural hearing aids that had different compression time settings (fast and slow). In the SNHL group, slow compression time settings showed significantly better SNR-50 compared to fast release time. In addition, the mean of SNR-50 in the SNHL group was comparable to normal hearing participants while using a slow release time. A hearing aid with slow compression time settings led to significantly better speech perception in noise, compared to that of a hearing aid that had fast compression time settings.
Ellis, Rachel J; Munro, Kevin J
The aim was to investigate whether frequency compression (FC) hearing aids provide additional benefit to that conferred by conventional amplification. Participants wore the same hearing aid with FC enabled and disabled for six weeks (ABA design) in each condition. Speech recognition tests (in both quiet and in noise) were administered alongside two questionnaires. Performance was compared across the two signal processing conditions and at different time points. Twelve experienced hearing-aid users (aged 65-84 years old) with moderate-to-severe high-frequency hearing loss participated in the study. FC resulted in statistically significantly higher mean scores in all of the administered speech tests. Improvements over time were limited to high frequency phoneme perception. No effect of FC on self-report outcomes was observed. FC may lead to significant improvements in speech perception outcomes in both quiet and noise for many individuals. No participant was significantly disadvantaged by the use of FC.
Caposecco, Andrea; Hickson, Louise; Meyer, Carly
The aim of this study was to analyse the content, design, and readability of printed hearing aid user guides to determine their suitability for older adults, who are the main users of hearing aids. Hearing aid user guides were assessed using four readability formulae and a standardized tool to assess content and design (SAM - Suitability Assessment of Materials). A sample of 36 hearing aid user guides (four user guides from nine different hearing aid manufacturers) were analysed. Sixty nine percent of user guides were rated 'not suitable' and 31% were rated 'adequate' for their suitability. Many scored poorly for scope, vocabulary, aspects of layout and typography, and learning stimulation and motivation. The mean reading grade level for all user guides was grade 9.6 which is too high for older adults. The content, design, and readability of hearing aid user guides are not optimal for older adults and thus may serve as a barrier to successful hearing aid outcomes for this population.
Moore, B C
The design of a two-channel compression hearing aid for persons with moderate sensorineural hearing losses with recruitment is described. The aid applies slow-acting automatic gain control (AGC) to the whole signal, and then splits the signal into two bands, with separate fast-acting (syllabic) AGC in each band. Trials evaluating the aid have shown that it allows speech in quiet to be understood over a wide range of sound levels without any need to adjust the controls on the aid. It also gives speech intelligibility in noise superior to that allowed by a comparable linear (non-compression) aid, a comparable single-channel compression aid, and by unaided listening. Pilot experiments comparing two different methods for fitting the aid suggest that fitting using speech as the test signal is superior to fitting using narrow band tonal signals.
Processo de adaptação de próteses auditivas em usuários atendidos em uma instituição pública federal: parte II: resultados dos questionários de auto-avaliação Hearing aid fitting process in users fitted in a federal public institution: part II - self-assessment questionnaire results
Carine Dias de Freitas
Full Text Available Uma reabilitação eficiente deve reduzir os efeitos da deficiência sobre as habilidades auditivas e comunicativas do indivíduo e aumentar o bem-estar psicossocial. OBJETIVOS:Verificar a viabilidade do uso de questionários de auto-avaliação e comparar os resultados da protetização em usuários de uma instituição pública federal, com e sem queixas relacionadas às características da amplificação. MATERIAL E MÉTODOS:25 indivíduos, de 13 a 77 anos de idade, usuários de próteses auditivas. Foram aplicados os questionários de auto-avaliação HHIE-S/HHIA (Hearing Handicap Inventory for the Elderly Screening Version ou for Adult e APHAB (Abbreviated Profile of Hearing Aid Benefit, nos indivíduos sem (Grupo 1 e com queixas relacionados às características da amplificação (Grupo 2. RESULTADOS: Diferenças significantes não foram encontradas entre os grupos nos protocolos HHIE-S/HHIA e APHAB, exceto na subescala facilidade de comunicação do APHAB, onde o Grupo 1 obteve melhor benefício. Também evidenciou-se redução significativa da incapacidade auditiva com o uso das próteses em situações favoráveis de comunicação, ambientes reverberantes e na presença de ruído ambiental para ambos os grupos. CONCLUSÃO: Os questionários revelaram ser excelentes preditores das dificuldades enfrentadas pelos usuários, e diferenças significantes foram encontradas em situações favoráveis de comunicação, onde o grupo sem queixas obteve melhor benefício.An efficient rehabilitation must be able to reduce impairment effects over the auditory and communication skills of individuals and promote psychosocial well being. AIMS: check the feasibility of using self-assessment questionnaires and compare the results achieved by hearing aid fitting in users from a federal public institution, with and without complaints related to hearing amplification characteristics. MATERIALS AND METHODS: 25 individuals, from 13 to 77 years of age, users of
Matsumoto, Nozomu; Suzuki, Nobuyoshi; Iwasaki, Satoshi; Ishikawa, Kazuha; Tsukiji, Hiroki; Higashino, Yoshie; Tabuki, Tomoko; Nakagawa, Takashi
Voice-aligned compression (VAC) is a method used in Oticon's hearing aids to provide more comfortable hearing without sacrificing speech discrimination. The complex, non-linear compression curve for the VAC strategy is designed based on the frequency profile of certain spoken Western languages. We hypothesized that hearing aids could be further customized for Japanese-speaking users by modifying the compression curve using the frequency profile of spoken Japanese. A double-blind randomized controlled crossover study was performed to determine whether or not Oticon's modified amplification strategy (VAC-J) provides subjectively preferable hearing aids for Japanese-speaking hearing aid users compared to the same company's original amplification strategy (VAC). The participants were randomized to two groups. The VAC-first group received a pair of hearing aids programmed using the VAC strategy and wore them for three weeks, and then received a pair of hearing aids programmed using VAC-J strategy and wore them for three weeks. The VAC-J-first group underwent the same study, but they received hearing aids in the reverse sequence. A Speech, Spatial and Qualities (SSQ) questionnaire was administered before beginning to use the hearing aids, at the end of using the first pair of hearing aids, and at the end of using the second pair of hearing aids. Twenty-five participants that met the inclusion/exclusion criteria from January 1 to October 31, 2016, were randomized to two groups. Twenty-two participants completed the study. There were no statistically significant differences in the increment of SSQ scores between the participants when using the VAC- or the VAC-J-programmed hearing aids. However, participants preferred the VAC-J strategy to the VAC strategy at the end of the study, and this difference was statistically significant. Japanese-speaking hearing aid users preferred using hearing aids that were fitted with the VAC-J strategy. Our results show that the VAC strategy
Yuvaraj, Pradeep; Mannarukrishnaiah, Jayaram
The purpose of the present study was to investigate the relationship between cortical processing of speech and benefit from hearing aids in individuals with auditory dys-synchrony. Data were collected from 38 individuals with auditory dys-synchrony. Participants were selected based on hearing thresholds, middle ear reflexes, otoacoustic emissions, and auditory brain stem responses. Cortical-evoked potentials were recorded for click and speech. Participants with auditory dys-synchrony were fitted with bilateral multichannel wide dynamic range compression hearing aids. Aided and unaided speech identification scores for 40 words were obtained for each participant. Hierarchical cluster analysis using Ward's method clearly showed four subgroups of participants with auditory dys-synchrony based on the hearing aid benefit score (aided minus unaided speech identification score). The difference in the mean aided and unaided speech identification scores was significantly different in participants with auditory dys-synchrony. However, the mean unaided speech identification scores were not significantly different between the four subgroups. The N2 amplitude and P1 latency of the speech-evoked cortical potentials were significantly different between the four subgroups formed based on hearing aid benefit scores. The results indicated that subgroups of individuals with auditory dys-synchrony who benefit from hearing aids exist. Individuals who benefitted from hearing aids showed decreased N2 amplitudes compared with those who did not. N2 amplitude is associated with greater suppression of background noise while processing speech.
Jerram, J C; Purdy, S C
This study examined the influence of technology, demographic factors, and prefitting expectations, attitudes, and adjustment to hearing loss on hearing aid outcome. Clients obtaining new hearing aids completed questionnaires measuring personal adjustment to hearing loss, expectations of and attitudes toward hearing aids, and hearing aid benefit. Eighty-one percent of the 200 subjects completing the prefitting questionnaires returned questionnaires evaluating hearing aid outcome. Factors affecting hearing aid use, overall satisfaction, and benefit were investigated using regression analyses. Higher use time was associated with higher prefitting expectations and greater acceptance of hearing loss. Greater benefit in easy and difficult listening situations was predicted by higher prefitting expectations. Multiple-memory hearing aids produced higher satisfaction. Benefit was greater for multiple-memory, multiple-channel, and wide dynamic range compression aids. Findings were consistent with previous studies showing positive outcomes for newer technologies but also showed that two subjective factors, prefitting hearing aid expectations and acceptance of hearing loss, significantly influenced hearing aid outcome.
Kelly-Campbell, Rebecca J; Wendel, Katrin
The purpose of this study was to assess the level of cognitive anxiety experienced by first-time hearing aid adopters and their significant others before, during, and after hearing aid fitting. A total of 16 couples were interviewed at three points: (1) at the initial consultation for hearing aids, (2) during the hearing aid trial, and (3) 1 month following the final clinical appointment in which the hearing aids were formally adopted. Cognitive anxiety was assessed through a content analysis of the interviews using the Cognitive Anxiety Scale. Results of this study show that the levels of cognitive anxiety generally decreased across the entire consultation process for both adults with hearing impairment and their significant others. The results also indicated that couples generally experienced similar levels of cognitive anxiety at initial consultation, but their levels of cognitive anxiety differed throughout the remainder of the study. These findings highlight the importance of inclusion of significant others in the rehabilitation process. The reader will be able to: (1) discuss the relationship between cognitive anxiety and hearing impairment, (2) define cognitive anxiety, (3) discuss the impact of hearing impairment on significant others, (4) describe the experience of cognitive anxiety through the hearing aid consultation process. Copyright © 2015 Elsevier Inc. All rights reserved.
Ng, Elaine H N; Classon, Elisabet; Larsby, Birgitta; Arlinger, Stig; Lunner, Thomas; Rudner, Mary; Rönnberg, Jerker
The present study aimed to investigate the changing relationship between aided speech recognition and cognitive function during the first 6 months of hearing aid use. Twenty-seven first-time hearing aid users with symmetrical mild to moderate sensorineural hearing loss were recruited. Aided speech recognition thresholds in noise were obtained in the hearing aid fitting session as well as at 3 and 6 months postfitting. Cognitive abilities were assessed using a reading span test, which is a measure of working memory capacity, and a cognitive test battery. Results showed a significant correlation between reading span and speech reception threshold during the hearing aid fitting session. This relation was significantly weakened over the first 6 months of hearing aid use. Multiple regression analysis showed that reading span was the main predictor of speech recognition thresholds in noise when hearing aids were first fitted, but that the pure-tone average hearing threshold was the main predictor 6 months later. One way of explaining the results is that working memory capacity plays a more important role in speech recognition in noise initially rather than after 6 months of use. We propose that new hearing aid users engage working memory capacity to recognize unfamiliar processed speech signals because the phonological form of these signals cannot be automatically matched to phonological representations in long-term memory. As familiarization proceeds, the mismatch effect is alleviated, and the engagement of working memory capacity is reduced. © The Author(s) 2014.
This thesis focuses on the wireless coupling between hearing aids close to a human head. Hearing aids constitute devices withadvanced technology and the wireless communication enables the introduction of a range of completely new functionalities. Such devices are small and the available power...... the ear-to-ear wireless communication channel by understanding the mechanisms that control the propagations of the signals and the losses. The second objective isto investigate the properties of magneto-dielectric materials and their potential in antenna miniaturization. There are three approaches...... to study the ear-to-ear wireless communication link; a theoretical approach models the human head asa sphere that has the electrical properties of the head, a numerical approach implements a more realistic geometry of the head, and an experimental approach measures directly the coupling between...
Hearing aids: How to choose the right one Many types of hearing aids exist. So which is best for you? Find out what to consider when choosing a hearing ... used to the device and decide if it's right for you. Have the dispenser put in writing ...
Bosman, A.J.; Hol, M.K.S.; Snik, A.F.M.; Mylanus, E.A.M.; Cremers, C.W.R.J.
In nine patients with unilateral deafness and normal hearing in the contralateral ear, measurements of sound localization and speech perception were obtained before intervention, with a conventional contralateral routing of sound (CROS) hearing aid and later with a bone-anchored hearing aid (BAHA)
Henry, James A; Frederick, Melissa; Sell, Sara; Griest, Susan; Abrams, Harvey
Most patients with tinnitus also have hearing loss. Hearing aids have been well-documented to provide amelioration for both hearing and tinnitus problems. Some hearing aids have built-in noise/sound generators that are intended to provide added benefit to patients with tinnitus. It has not been proven, however, whether these "combination instruments" are more effective for tinnitus management than hearing aids alone. The purpose of this study was to collect initial data addressing this question. Thirty individuals meeting study requirements (bothersome tinnitus, hearing aid candidate, and no use of hearing aids for the previous 12 months) were enrolled. All participants initially completed the primary outcome questionnaire (Tinnitus Functional Index [TFI]) and then returned to be fitted with combination instruments. The hearing aid portion of the devices was adjusted to optimize hearing ability. Participants were then randomized to either the experimental group (n = 15) or the control group (n = 15). The experimental group had the noise feature of the instruments activated and adjusted to achieve optimal relief from tinnitus. The control group did not have the noise portion activated. Following the hearing aid fitting, all study participants also received brief tinnitus counseling. Participants returned 1 to 2 weeks later for a follow-up appointment to confirm proper fit of the instruments and to make any necessary programming adjustments. Additionally, they returned 3 months after the fitting to complete the TFI, which also concluded their participation in the study. Both groups revealed significant improvement, as indicated by reductions in mean TFI index scores. Differences between groups at 3 months were not statistically significant. However, the experimental group showed a mean reduction in the TFI score that was 6.4 points greater than that for the control group. The difference approached significance (p = 0.09), suggesting that a larger group of
Chandra, Navshika; Searchfield, Grant D
Despite evidence that hearing aids can improve the social and psychological functioning of older hearing-impaired adults, hearing aid uptake is low. High cost of hearing aids and poor access to audiology services in rural areas are potential barriers to hearing aid acquisition. Methods of hearing aid delivery deviating from the traditional clinician-based model have been available to consumers for many years. One such method is Internet hearing aid sales. However, research exploring Internet-based hearing aid delivery, as a method to improve hearing aid uptake in this population, is limited. The purpose of this study was to explore the perceptions of older hearing aid users (aged ≥65 yr) toward Internet-based hearing aid delivery. A qualitative approach was adopted to investigate older adults' perceptions of buying hearing aids online. The sample consisted of 18 participants aged between 64 and 81 yr. Fourteen men and four women participated in this study. Participants were all experienced hearing aid users. Face-to-face semistructured interviews were conducted. An interview schedule guided the interview. Interviews were recorded with a voice recorder and transcribed verbatim. Thematic analysis of the data was carried out. Seven main themes emerged from the data. A general lack of awareness, but willingness to learn more about Internet hearing aid sales, was found. Two perceived benefits of Internet-based hearing aid delivery were identified: lower cost of hearing aids and greater convenience or physical accessibility. Numerous concerns and limitations were communicated. Concerns regarding the availability of clinical procedures, such as hearing tests, obtaining the correct-sized earmolds, and fine-tuning of hearing aids, were expressed. Participants conveyed distrust in online retailers. However, trust in and a preference for audiologists' expertise, which was not perceived to be available online, was found. Participants further conveyed a preference for face
Ricketts, Todd; Henry, Paula; Gnewikow, David
The purpose of this experiment was to systematically examine hearing aid benefit as measured by speech recognition and self-assessment methods across omnidirectional and directional hearing aid modes. These data were used to compare directional benefit as measured by speech recognition in the laboratory to hearing aid wearer's perceptions of benefit in everyday environments across full-time directional, full-time omnidirectional, and user selectable directional fittings. Identification of possible listening situations that resulted in different self reported hearing aid benefit as a function of microphone type was a secondary objective of this experiment. Fifteen adults with symmetrical, sloping sensorineural hearing loss were fitted bilaterally with in-the-ear (ITE) directional hearing aids. Measures of hearing aid benefit included the Profile of Hearing Aid Benefit (PHAB), the Connected Sentence Test (CST), the Hearing in Noise Test (HINT), and a daily use log. Additionally, two new subscales were developed for administration with the PHAB. These subscales were developed to specifically address situations in which directional hearing aids may provide different degrees of benefit than omnidirectional hearing aids. Participants completed these measures in three conditions: omnidirectional only (O), directional only with low-frequency gain compensation (D), and user-selectable directional/omnidirectional (DO). Results from the speech intelligibility in noise testing indicated significantly more hearing aid benefit in directional modes than omnidirectional. PHAB results indicated more benefit on the background noise subscale (BN) in the DO condition than in the O condition; however, this directional advantage was not present for the D condition. Although the reliability of the newly proposed subscales is as yet unknown, the data were interpreted as revealing a directional advantage in situations where the signal of interest was in front of the participant and a
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hearing aid calibrator and analysis system. 874... aid calibrator and analysis system. (a) Identification. A hearing aid calibrator and analysis system... sound intensity characteristics emanating from a hearing aid, master hearing aid, group hearing aid or...
Piers Dawes; Richard Emsley; Cruickshanks, Karen J.; Moore, David R.; Heather Fortnum; Mark Edmondson-Jones; Abby McCormack; Munro, Kevin J.
Hearing loss is associated with poor cognitive performance and incident dementia and may contribute to cognitive decline. Treating hearing loss with hearing aids may ameliorate cognitive decline. The purpose of this study was to test whether use of hearing aids was associated with better cognitive performance, and if this relationship was mediated via social isolation and/or depression. Structural equation modelling of associations between hearing loss, cognitive performance, social isolation...
Johnson, Carole E; Danhauer, Jeffrey L; Ellis, Blakely B; Jilla, Anna Marie
, even considering that most of the studies in this systematic review were limited, somewhat dated, and used analog and early digital technology available when the studies were conducted. Clinical recommendations may be even stronger as future studies become available for patients fit with modern styles and high-technology hearing aids. American Academy of Audiology.
... Products For Consumers Home For Consumers Consumer Updates Hearing Aids and Personal Sound Amplifiers: Know the Difference ... that FDA launched today. Signs of Loss of Hearing Mann says that consumers who suspect they suffer ...
Kim, Min-Beom; Chung, Won-Ho; Choi, Jeesun; Hong, Sung Hwa; Cho, Yang-Sun; Park, Gyuseok; Lee, Sangmin
The object was to evaluate speech perception improvement through Bluetooth-implemented hearing aids in hearing-impaired adults. Thirty subjects with bilateral symmetric moderate sensorineural hearing loss participated in this study. A Bluetooth-implemented hearing aid was fitted unilaterally in all study subjects. Objective speech recognition score and subjective satisfaction were measured with a Bluetooth-implemented hearing aid to replace the acoustic connection from either a cellular phone or a loudspeaker system. In each system, participants were assigned to 4 conditions: wireless speech signal transmission into hearing aid (wireless mode) in quiet or noisy environment and conventional speech signal transmission using external microphone of hearing aid (conventional mode) in quiet or noisy environment. Also, participants completed questionnaires to investigate subjective satisfaction. Both cellular phone and loudspeaker system situation, participants showed improvements in sentence and word recognition scores with wireless mode compared to conventional mode in both quiet and noise conditions (P Bluetooth-implemented hearing aids helped to improve subjective and objective speech recognition performances in quiet and noisy environments during the use of electronic audio devices.
Leeuw, A. R.; Dreschler, W. A.
In this study, two types of hearing aids were used. Both aids had the same frequency characteristics for frontal sound, but one employed an omnidirectional microphone and the other a directional microphone. The frequency characteristics of both hearing aids were measured for five azimuths on KEMAR
Full Text Available Hearing loss is associated with poor cognitive performance and incident dementia and may contribute to cognitive decline. Treating hearing loss with hearing aids may ameliorate cognitive decline. The purpose of this study was to test whether use of hearing aids was associated with better cognitive performance, and if this relationship was mediated via social isolation and/or depression. Structural equation modelling of associations between hearing loss, cognitive performance, social isolation, depression and hearing aid use was carried out with a subsample of the UK Biobank data set (n = 164,770 of UK adults aged 40 to 69 years who completed a hearing test. Age, sex, general health and socioeconomic status were controlled for as potential confounders. Hearing aid use was associated with better cognition, independently of social isolation and depression. This finding was consistent with the hypothesis that hearing aids may improve cognitive performance, although if hearing aids do have a positive effect on cognition it is not likely to be via reduction of the adverse effects of hearing loss on social isolation or depression. We suggest that any positive effects of hearing aid use on cognition may be via improvement in audibility or associated increases in self-efficacy. Alternatively, positive associations between hearing aid use and cognition may be accounted for by more cognitively able people seeking and using hearing aids. Further research is required to determine the direction of association, if there is any direct causal relationship between hearing aid use and better cognition, and whether hearing aid use results in reduction in rates of cognitive decline measured longitudinally.
Dawes, Piers; Emsley, Richard; Cruickshanks, Karen J; Moore, David R; Fortnum, Heather; Edmondson-Jones, Mark; McCormack, Abby; Munro, Kevin J
Hearing loss is associated with poor cognitive performance and incident dementia and may contribute to cognitive decline. Treating hearing loss with hearing aids may ameliorate cognitive decline. The purpose of this study was to test whether use of hearing aids was associated with better cognitive performance, and if this relationship was mediated via social isolation and/or depression. Structural equation modelling of associations between hearing loss, cognitive performance, social isolation, depression and hearing aid use was carried out with a subsample of the UK Biobank data set (n = 164,770) of UK adults aged 40 to 69 years who completed a hearing test. Age, sex, general health and socioeconomic status were controlled for as potential confounders. Hearing aid use was associated with better cognition, independently of social isolation and depression. This finding was consistent with the hypothesis that hearing aids may improve cognitive performance, although if hearing aids do have a positive effect on cognition it is not likely to be via reduction of the adverse effects of hearing loss on social isolation or depression. We suggest that any positive effects of hearing aid use on cognition may be via improvement in audibility or associated increases in self-efficacy. Alternatively, positive associations between hearing aid use and cognition may be accounted for by more cognitively able people seeking and using hearing aids. Further research is required to determine the direction of association, if there is any direct causal relationship between hearing aid use and better cognition, and whether hearing aid use results in reduction in rates of cognitive decline measured longitudinally.
Bagatto, Marlene; Moodie, Sheila; Brown, Christine; Malandrino, April; Richert, Frances; Clench, Debbie; Scollie, Susan
Guidelines and protocols for pediatric hearing aid fitting are necessary to meet the goals of Early Hearing Detection and Intervention (EHDI) programs. The American Academy of Audiology published an update to their Pediatric Amplification Guideline in 2013. Ontario's Infant Hearing Program (IHP) offers specific protocols that aim to fulfill recommended guidelines. It has recently been updated to align with the American Academy of Audiology Guideline and other evidence. A summary of the updates to the Ontario IHP's Amplification Protocol is described. In addition, data illustrating hearing-related outcomes of the program are offered. The updated Ontario protocol is based on evidence, wherever possible. Where research is not yet available, clinical decision support has been described in a systematic way. Outcomes of the Ontario IHP were obtained through a longitudinal clinical observation study. One hundred and fifteen children with hearing loss, who wore hearing aids, were included in the outcome analyses (mean = 28.6 mo; range = 1.3-115.3 mo). Hearing losses ranged from mild to profound, unilateral or bilateral sensorineural (pure-tone average = 52.3 dB HL). They were recruited from four IHP clinics within Ontario. Children with complexities in addition to hearing loss were included. The children were fitted with hearing aids following Ontario's Amplification Protocol. During routine clinical appointments, IHP Audiologists administered questionnaires to the parents of their pediatric patients using a systematic outcome measurement protocol (University of Western Ontario Pediatric Audiological Monitoring Protocol). Hearing aid fitting details (e.g., speech intelligibility index) were also gathered to describe the quality of the hearing aid fittings in relation to the functional outcomes. Regression analyses were conducted to characterize scores on the questionnaires and the impact of important variables. Children with complexities were analyzed separately from those
King, A B; Martin, M C
Three different functions of Automatic Gain Control (AGC) circuits in hearing aids are distinguished and the evidence for their benefits is considered. The value of AGC's function as a relatively distortion-free means of limiting output has been well established. With regard to compression, the benefit of short-term or 'syllabic' compression has not been demonstrated convincingly. Most evaluations of this type of AGC have looked for increase in speech intelligibility, but theoretical predictions of its effect do not appear to take account of the acoustic cues to consonant contrasts actually used by hearing impaired people, and empirical studies have often used listening conditions which do not give a realistic test of benefit. Relatively little attention has been paid to long-term compression, or to the effect of AGC on comfort rather than intelligibility. Listening tests carried out at the RNID and reported here have shown that AGC can benefit hearing aid users by allowing them to listen to a wider range of sound levels without either strain or discomfort, and, if time constants are well chosen, without adverse effects on speech intelligibility in quiet or in noise.
Larson, Vernon D; Williams, David W; Henderson, William G; Luethke, Lynn E; Beck, Lucille B; Noffsinger, Douglas; Bratt, Gene W; Dobie, Robert A; Fausti, Stephen A; Haskell, George B; Rappaport, Bruce Z; Shanks, Janet E; Wilson, Richard H
Although numerous studies have demonstrated that hearing aids provide significant benefit, carefully controlled, multi-center clinical trials have not been conducted. A multi-center clinical trial was conducted to compare the efficacy of three commonly used hearing aid circuits: peak clipping, compression limiting, and wide dynamic range compression. Patients (N = 360) with bilateral, sensorineural hearing loss were studied using a double blind, three-period, three-treatment crossover design. The patients were fit with each of three programmable hearing aid circuits. Outcome tests were administered in the unaided condition at baseline and then after 3 mo usage of each circuit, the tests were administered in both aided and unaided conditions. The outcome test battery included tests of speech recognition, sound quality and subjective scales of hearing aid benefit, including patients' overall rank-order rating of the three circuits. Each hearing aid circuit improved speech recognition markedly, with greater improvement observed for soft and conversationally loud speech in both quiet and noisy listening conditions. In addition, a significant reduction in the problems encountered in communication was observed. Some tests suggested that the two compression hearing aids provided a better listening experience than the peak clipping hearing aid. In the rank-order ratings, patients preferred the compression limiting hearing aid more frequently than the other two hearing aids. The three hearing aid circuits studied provide significant benefit both in quiet and in noisy listening situations. The two compression hearing aids appear to provide superior benefits compared to the linear circuit, although the differences between the hearing aids were smaller than the differences between unaided and aided conditions.
Thorup, Nicoline; Santurette, Sébastien; Jørgensen, Søren
and temporal resolution, binaural hearing, speech intelligibility in stationary and fluctuating noise, and a working-memory test. Six weeks after HA fitting they answered the International Outcome Inventory – Hearing Aid evaluation. The HI group was homogeneous based on the audiogram, but only one test......Hearing-impaired (HI) listeners often complain about communicating in the presence of background noise, although audibility may be restored by a hearing-aid (HA). The audiogram typically forms the basis for HA fitting, such that people with similar audiograms are given the same prescription...... was correlated to pure-tone hearing thresholds. Moreover, HI listeners who took the least advantage from fluctuations in background noise in terms of speech intelligibility experienced greater HA benefit. Further analysis of whether specific outcomes are directly related to speech intelligibility in fluctuating...
Alodail, Abdullah Kholifh
Hearing aid devices are worn within people's ears to help them hear the sounds around them. Teachers have to accept the use of hearing aids in the classroom as a device to assist students with hearing loss (Plumley, 2008). Further study is helpful to hearing aid research because it demonstrates the importance of hearing aid benefit awareness in…
Arlinger, Stig; Nordqvist, Peter; Öberg, Marie
The purpose of this study was to analyze a database of completed International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires obtained from over 100,000 clients fitted with new hearing aids in Sweden during the period of 2012-2016. Mean IOI-HA total scores were correlated with degree of hearing loss, unilateral versus bilateral fitting, first-time versus return clients, gender, and variation among dispensing clinics. The correlations with expectations, service quality, and technical functioning of the hearing aids were also analyzed. Questionnaires containing the 7 IOI-HA items as well as questions concerning some additional issues were mailed to clients 3-6 months after fitting of new hearing aids. The questionnaires were returned to and analyzed by an independent research institute. More than 100 dispensing clinics nationwide take part in this project. A response rate of 52.6% resulted in 106,631 data sets after excluding incomplete questionnaires. Forty-six percent of the responders were women, and 54% were men. The largest difference in mean score (0.66) was found for the IOI-HA item "use" between return clients and first-time users. Women reported significantly higher (better) scores for the item "impact on others" compared with men. The bilaterally fitted subgroup reported significantly higher scores for all 7 items compared with the unilaterally fitted subgroup. Experienced users produced higher scores on benefit and satisfaction items, whereas first-time users gave higher scores for residual problems. No correlation was found between mean IOI-HA total score and average hearing threshold level (pure-tone average [PTA]). Mean IOI-HA total scores were found to correlate significantly with perceived service quality of the dispensing center and with the technical functionality of the hearing aids. When comparing mean IOI-HA total scores from different studies or between groups, differences with regard to hearing aid experience, gender, and unilateral
Full Text Available Background and Aim: Studies have shown that long-term use of monaural hearing aid in symmetrical hearing losses may lead to physiological changes. In this research, the possibility of plasticity occurrence in bilaterally hearing impaired listeners fitted with only one hearing aid was investigated.Methods: Our study was carried out on 12 elderly listeners with a mean age of 61.92 years who had symmetrical moderate to severe sensory neural hearing loss in both ears. All of the participants had minimum monaural hearing aid experience of 2 years. We used auditory brainstem response (ABR testing in order to compare absolute latency and amplitude of wave V between the two ears of cases. Air conduction click stimuli were presented monaurally at 80, 90 and 100 dB nHL.Results: Despite the shorter absolute latency of wave V in the fitted ear, no significant difference was found between the two ears (p>0.389. The difference between wave V amplitude of both ears was greater in 90 dB nHL level (p=0.043. Women showed shorter mean latency than men and the mean amplitude of women was greater than men. Significant gender difference was observed in absolute latency of wave V (p<0.037.Conclusion: Our findings indicate that the use of monaural hearing aid in symmetrical hearing losses can induce neural plasticity within auditory brainstem pathways which can be displayed by auditory brainstem response test.
Full Text Available Hearing impairment has far reaching consequences for affected individuals, in terms of quality of life indicators. In a developing South African context the hearing impaired population is faced with limited aural rehabilitation services. This study evaluated self-reported outcomes of aural rehabilitation in a group of adults in the public healthcare sector with a standardized outcomes measurement tool (IOI-HA. Sixty-one respondents participated (44% males; 56% females, with a mean age of 69.7 years. Results revealed that the majority of respondents experienced favourable outcomes in all domains of the inventory comprising of: daily use of hearing aids, benefits provided by hearing aids, residual activity limitation, satisfaction with hearing aids, residual participation restriction, impact of hearing difficulties on others, and changes in quality of life. Statistically significant relationships were obtained between the daily use of hearing aids, the degree of hearing loss, and the type of hearing aids fitted, as well as the benefits received from hearing aids in difficult listening environments (p < 0.05. Despite challenges of developing contexts, the mean scores distribution compared positively to similar reports from developed countries. Outcomes of improved quality of life emphasize the importance of providing affordable hearing aids and services to all hearing impaired individuals in South Africa.
Gieseler, Anja; Tahden, Maike A S; Thiel, Christiane M; Colonius, Hans
There is converging evidence for altered audiovisual integration abilities in hearing-impaired individuals and those with profound hearing loss who are provided with cochlear implants, compared to normal-hearing adults. Still, little is known on the effects of hearing aid use on audiovisual integration in mild hearing loss, although this constitutes one of the most prevalent conditions in the elderly and, yet, often remains untreated in its early stages. This study investigated differences in the strength of audiovisual integration between elderly hearing aid users and those with the same degree of mild hearing loss who were not using hearing aids, the non-users, by measuring their susceptibility to the sound-induced flash illusion. We also explored the corresponding window of integration by varying the stimulus onset asynchronies. To examine general group differences that are not attributable to specific hearing aid settings but rather reflect overall changes associated with habitual hearing aid use, the group of hearing aid users was tested unaided while individually controlling for audibility. We found greater audiovisual integration together with a wider window of integration in hearing aid users compared to their age-matched untreated peers. Signal detection analyses indicate that a change in perceptual sensitivity as well as in bias may underlie the observed effects. Our results and comparisons with other studies in normal-hearing older adults suggest that both mild hearing impairment and hearing aid use seem to affect audiovisual integration, possibly in the sense that hearing aid use may reverse the effects of hearing loss on audiovisual integration. We suggest that these findings may be particularly important for auditory rehabilitation and call for a longitudinal study.
Islam, Aminul; Li, Xiaoliu
) mode was adopted in this work to simulate the injection molding process of a hearing aid shell made of Polybutylene Terephthalate (PBT) filled with 30% glass fiber. The typical hearing aid shells are complex thin-walled structures made by injection molding. Highly sophisticated molds and lots...... of process optimizations by trial and errors are needed to make successful shells for hearing aids. In this context, a dedicated simulation tool can be very useful to reduce the time and cost for developing the new hearing aids. In this work, the injection molding experimental validation of the Moldex3D...
Keidser, Gitte; Hartley, Lisa; Caposecco, Andrea; Hickson, Louise; Meyer, Carly
A self-fitting hearing aid, designed to be assembled and programmed without audiological or computer support, could bring amplification to millions of people in developing countries, who remain unaided due to the lack of a local, professional, audiological infrastructure. The ability to assemble and insert a hearing aid is fundamental to the successful use of a self-fitting device. In this study, the management of such tasks was investigated. Eighty older, urban-dwelling, hearing-impaired adults in a developed country were asked to follow a set of written, illustrated instructions to assemble two slim-fit behind-the-ear hearing aids. Participants were allowed to access assistance with the task from an accompanying partner. A range of personal and audiometric variables was measured through the use of structured questionnaires and standardized tests of health literacy, cognitive function, and manual dexterity. The results showed that 99% of participants were able to complete the hearing aid assembly task, either on their own or with assistance. Health literacy, or the ability to read and understand health-related text, and gender most strongly influenced participants’ ability to complete the assembly task independently and accurately. Higher levels of health literacy were associated with an increased likelihood of independent and successful task completion. Male participants were more likely to complete the task on their own, while female participants were more likely to assemble the device without errors. The results of this study will inform future work regarding development of educational material for the self-fitting hearing aid as well as candidacy for such a device. PMID:22200734
Negahban, Hossein; Bavarsad Cheshmeh Ali, Mahtab; Nassadj, Gholamhossein
While a few studies have investigated the relationship between hearing acuity and postural control, little is known about the effect of hearing aids on postural stability in elderly with hearing loss. The aim was to compare static balance function between elderly with hearing loss who used hearing aids and those who did not use. The subjects asked to stand with (A) open eyes on rigid surface (force platform), (B) closed eyes on rigid surface, (C) open eyes on a foam pad, and (D) closed eyes on a foam pad. Subjects in the aided group (n=22) were tested with their hearing aids turned on and hearing aids turned off in each experimental condition. Subjects in the unaided group (n=25) were tested under the same experimental conditions as the aided group. Indicators for postural stability were center of pressure (COP) parameters including; mean velocity, standard deviation (SD) velocity in anteroposterior (AP) and mediolateral (ML) directions, and sway area (95% confidence ellipse). The results showed that within open eyes-foam surface condition, there was greater SD velocity in the off-aided than the on-aided and the unaided than the on-aided (paided and unaided group (p=0.56 and p=0.77 for SD velocity in AP and ML, respectively). Hearing aids improve static balance function by reducing the SD velocity. Clinical implications may include improving hearing inputs in order to increase postural stability in older adults with hearing loss. Copyright © 2017 Elsevier B.V. All rights reserved.
Shayman, Corey S; Earhart, Gammon M; Hullar, Timothy E
To evaluate whether wearing auditory assistive devices can improve gait and dynamic balance. Three adult users of bilateral hearing assistive devices: one with cytomegalovirus exposure wearing cochlear implants, one with Ménière's disease wearing hearing aids, and one with presbystasis wearing hearing aids. Rehabilitative intervention involved participants performing gait and dynamic posture tasks with and without their hearing assistive devices. Gait velocity and Mini-BESTest score. The participant with Ménière's disease showed a clinically significant improvement in gait in the aided versus the unaided condition (20.5 cm/s higher velocity and five point better Mini-BESTest score). The other two participants also improved with augmented audition, but to a lesser degree. Bilateral hearing augmentation may promote clinically significant improvements in gait, although the effects are not uniform among patients. Hearing aids or cochlear implants may be important interventions for improving stability during walking in some people with hearing loss.
Uriarte, Margaret; Denzin, Lauren; Dunstan, Amy; Sellars, Jillian; Hickson, Louise
The aims of this study were to investigate hearing aid satisfaction for a group of older Australians fitted with government-funded hearing aids using the Satisfaction with Amplification in Daily Life (SADL) questionnaire; to compare the Australian data gathered with the provisional normative data reported by Cox and Alexander (1999); and to investigate the relationship between SADL satisfaction and several participant variables, hearing aid variables, and other outcome measures. The SADL questionnaire and a Client Satisfaction Survey (CSS) were distributed by mail to 1284 adults fitted with government-funded hearing aids three to six months previously. 1014 surveys were returned. The mean age of participants was 75.32 years; 54.4% of participants were male, and 54.8% were fitted binaurally. Participants were fitted primarily with digitally programmable hearing aids of various styles (22.5% BTEs, 34.8% ITEs, 41.8% ITCs, 0.9% nonstandard [NS] devices). Overall, participants reported a considerable level of satisfaction with their devices. SADL Global and subscale scores were significantly higher for the Australian sample than the U.S. norms described by Cox and Alexander (1999).
Jenstad, L M; Seewald, R C; Cornelisse, L E; Shantz, J
The goal of this study was to test the theoretical advantages of a single-channel wide dynamic range compression (WDRC) circuit for speech intelligibility and loudness comfort for five speech spectra. Twelve adolescents and young adults with moderate to severe hearing loss were fitted with the Siemens Viva 2 Pro behind-the-ear instrument set to DSL 4.0 targets for both linear gain and WDRC processing. Speech intelligibility was measured in the unaided, linear gain and WDRC conditions using two tasks in quiet: nonsense words and sentences. The items were digitally filtered to represent five speech spectra: average speech at 4 m, average speech at 1 m, own voice at ear level, classroom at 1 m, and shouted speech at 1 m. The subjects also rated the loudness of each hearing aid/speech spectrum combination using a categorical rating scale. Both the linear gain and WDRC settings provided improved speech recognition relative to the unaided condition, and the two circuits resulted in equivalent performance for average speech input levels. On average, the WDRC aid resulted in high and uniform speech recognition scores across the five spectra. In contrast, the linear gain aid resulted in a lower recognition score for soft speech and shouted speech relative to that obtained with an average speech level. Analysis of individual speech recognition benefit scores revealed that 11 out of 12 subjects had equal or greater performance with the WDRC processing than the linear processing. Subjective loudness ratings in the linear gain condition were compatible with decreased sensation level for soft speech and loudness discomfort for shouted speech. WDRC processing has potential applications in hearing aid fittings for listeners with moderate to severe hearing loss because it provides a consistently audible and comfortable signal across a wide range of listening conditions in quiet without the need for volume control adjustments.
The bone-anchored hearing aid (Baha) was introduced in 1977 by Tjellström and colleagues and has now been used clinically for over 30 years. Generally, the outcomes are good, and several studies have shown improved audiological- and quality of life outcomes. The principle of the Baha is, that sound vibrations are led directly to the inner ear via the mastoid bone, bypassing the middle ear. This is achieved via an osseointegrated implant and a skin-penetrating abutment. Studies report high success rates and a majority of complications as typically minor in nature.
Mondelli, Maria Fernanda Capoani Garcia
Full Text Available Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.
Jørgensen, Ivan Harald Holger
People with reduced hearing generally want to hide this disability and thus the size of hearing aids is constantly decreasing in the effort to make them virtually invisible. However, as for all other modern electrical devices more and more features are constantly added to hearing aids driven...... by the development in modern IC technology. This has resulted in the modern hearing aid being highly advanced devices where the demands for performance and features at very low supply voltage and power consumption constantly prove a huge challenge to the physical design of hearing aids and not at least the design...... of the ICs for these. This leads to very large demands for system integration at the packing level, SiP (System-in-Package), and not at least at the IC level, SoC (System-on-Chip). As a result of this all large hearing aid manufactures use custom package technology which again uses fully customized ASICs...
Alcántara, José L; Moore, Brian C J; Kühnel, Volker; Launer, Stefan
We evaluated the effectiveness of a noise reduction system implemented in a commercial digital multichannel compression hearing aid. Eight experienced hearing aid wearers with moderate sensorineural hearing loss were fitted bilaterally according to the manufacturer's fitting guidelines. After a 3-month period of regular use of two programs, one with and one without the noise reduction system, speech recognition thresholds (SRTs) were measured in four types of background noise, including steady noise, and noises with spectral and/or temporal dips. SRTs were very similar with and without the noise reduction system; in both cases, SRTs were markedly lower than for unaided listening. SRTs were lower for the noises with dips than for the steady noise, especially for the aided conditions, indicating that amplification can help to 'listen in the dips'. Ratings of sound quality and listening comfort in the aided conditions were uniformly high and very similar with and without the noise reduction system.
Perreau, Ann E; Bentler, Ruth A; Tyler, Richard S
Frequency-lowering signal processing in hearing aids has re-emerged as an option to improve audibility of the high frequencies by expanding the input bandwidth. Few studies have investigated the usefulness of the scheme as an option for bimodal users (i.e., combined use of a cochlear implant and a contralateral hearing aid). In this study, that question was posed. The purposes of this study were (1) to determine if frequency compression was a better bimodal option than conventional amplification and (2) to determine the impact of a frequency-compression hearing aid on speech recognition abilities. There were two separate experiments in this study. The first experiment investigated the contribution of a frequency-compression hearing aid to contralateral cochlear implant (CI) performance for localization and speech perception in noise. The second experiment assessed monaural consonant and vowel perception in quiet using the frequency-compression and conventional hearing aid without the use of a contralateral CI or hearing aid. Ten subjects fitted with a cochlear implant and hearing aid participated in the first experiment. Seventeen adult subjects with a cochlear implant and hearing aid or two hearing aids participated in the second experiment. To be included, subjects had to have a history of postlingual deafness, a moderate or moderate-to-severe hearing loss, and have not worn this type of frequency-lowering hearing aid previously. In the first experiment, performance using the frequency-compression and conventional hearing aids was assessed on tests of sound localization, speech perception in a background of noise, and two self-report questionnaires. In the second experiment, consonant and vowel perception in quiet was assessed monaurally for the two conditions. In both experiments, subjects alternated daily between a frequency-compression and conventional hearing aid for 2 mo. The parameters of frequency compression were set individually for each subject, and
Kunst, S.J.W.; Leijendeckers, J.M.; Mylanus, E.A.M.; Hol, M.K.S.; Snik, A.F.M.; Cremers, C.W.R.J.
OBJECTIVE: To study the audiologic outcome of bone-anchored hearing aid (BAHA) application in patients with congenital unilateral conductive hearing impairment. STUDY DESIGN: Prospective audiometric evaluation on 20 patients. SETTING: Tertiary referral center. PATIENTS: The experimental group
Desjardins, Jamie L
The present study examined the effect of hearing aid use on cognitive test performance using a single-subject treatment design. Six participants 54 to 64 years old with sensorineural hearing loss were fitted with hearing aids. Participants used the hearing aids for approximately 8 hr each day for the duration of the study. A battery of cognitive tests was administered to participants during baseline (pre-hearing aid fitting), treatment (hearing aid use), and withdrawal (post-hearing aid use) study phases over a period of 6 months of hearing aid use. All participants showed significant improvements in performance on the cognitive test measures with hearing aid use. The most significant treatment effects were evidenced at 2 to 4 weeks of hearing aid use on the Listening Span Test and an auditory selective attention task. In many cases, cognitive performance scores returned to baseline levels after the participant stopped using the hearing aids. The findings from this study are consistent with the hypothesis that hearing aid use may improve cognitive performance by improving audibility and decreasing the cognitive load of the listening task.
Nielsen, Claus; Darkner, Sune
, or like talking in a barrel. This problem is caused by the occlusion effect. The effect is primarily due to vibrations of the walls in the soft part of the ear canal, which generate a sound pressure that is trapped in the cavity between the tip of the occluding hearing aid and the tympanic membrane....... If the hearing aid is fitted with a seal in the bony portion of the ear canal, preventing vibration in the soft part of the ear canal from reaching the tympanic membrane, then occlusion problems can be solved or at least reduced in most cases....
Adaptação de prótese auditiva e a privação da audição unilateral: avaliação comportamental e eletrofisiológica Hearing aid fitting and unilateral auditory deprivation: behavioral and electrophysiologic assessment
Margarita Bernal Wieselberg
Full Text Available O fenômeno da Privação Auditiva Unilateral de Início Tardio foi reportado em 1984. No entanto, ainda se observa um expressivo número de adaptações de próteses auditivas unilaterais, nos casos de perdas auditivas bilaterais, justificadas por fatores não auditivos, tais como custo, vaidade, desinformação ou políticas públicas de saúde. OBJETIVO: Investigar, por meio de avaliação comportamental e eletrofisiológica, o desempenho auditivo de adultos que fazem uso de amplificação unilateral, comparados àqueles expostos à estimulação auditiva simétrica bilateral. MÉTODO: Participaram deste estudo 35 indivíduos adultos com perda auditiva sensorioneural bilateral simétrica, usuários regulares de prótese auditiva unilateral, bilateral e não usuários de prótese auditiva por meio de testes de avaliação comportamental e eletrofisiológica. RESULTADOS: A análise de variância revelou que, no grupo usuário de amplificação unilateral, a latência do P300 foi significantemente maior na orelha que sofreu a privação auditiva comparada a orelha com prótese auditiva (p The phenomenon of Late-Onset Unilateral Auditory Deprivation was first reported in 1984. However, a high number of unilateral hearing aid fittings are still carried out in cases of bilateral hearing loss, justified by non-auditory factors such as cost, vanity, misinformation and public health policies. OBJECTIVE: To carry out behavioral and electrophysiological assessment of the auditory performance of adults using unilateral amplification compared with individuals exposed to bilateral symmetric auditory stimulation. METHOD: Thirty five adults, all with symmetric bilateral sensorineural hearing loss, regular users of unilateral hearing aid, bilateral hearing aids and not users of hearing aids, were assessed on behavioral and electrophysiological tests. RESULTS: Variance analysis revealed that in the unilaterally fitted group, P300 latency was significantly
Cox, Robyn M; Johnson, Jani A; Xu, Jingjing
Objectives One of the challenges facing hearing care providers when recommending hearing aids is the choice of device technology level. Major manufacturers market families of hearing aids that are described as spanning the range from basic technology to premium technology. Premium technology hearing aids include acoustical processing capabilities (features) that are not found in basic technology instruments. These premium features are intended to yield improved hearing in daily life compared to basic-feature devices. However, independent research that establishes the incremental effectiveness of premium-feature devices compared to basic-feature devices is lacking. This research was designed to explore reported differences in hearing abilities for adults using premium-feature and basic-feature hearing aids in their daily lives. Design This was a single-blinded, repeated, crossover trial in which the participants were blinded. All procedures were carefully controlled to limit researcher bias. Forty-five participants used carefully fitted bilateral hearing aids for one month and then provided data to describe the hearing improvements or deficiencies noted in daily life. Typical participants were 70 years old with mild to moderate adult-onset hearing loss bilaterally. Each participant used 4 pairs of hearing aids: premium- and basic-feature devices from brands marketed by each of two major manufacturers. Participants were blinded about the devices they used and about the research questions. Results All of the outcomes were designed to capture the participant’s point of view about the benefits of the hearing aids. Three types of data were collected: change in hearing-related quality of life, extent of agreement with six positively worded statements about everyday hearing with the hearing aids, and reported preferences between the premium- and basic-feature devices from each brand as well as across all four research hearing aids combined. None of these measures yielded
Cox, Robyn M; Johnson, Jani A; Xu, Jingjing
One of the challenges facing hearing care providers when recommending hearing aids is the choice of device technology level. Major manufacturers market families of hearing aids that are described as spanning the range from basic technology to premium technology. Premium technology hearing aids include acoustical processing capabilities (features) that are not found in basic technology instruments. These premium features are intended to yield improved hearing in daily life compared with basic-feature devices. However, independent research that establishes the incremental effectiveness of premium-feature devices compared with basic-feature devices is lacking. This research was designed to explore reported differences in hearing abilities for adults using premium- and basic-feature hearing aids in their daily lives. This was a single-blinded, repeated, crossover trial in which the participants were blinded. All procedures were carefully controlled to limit researcher bias. Forty-five participants used carefully fitted bilateral hearing aids for 1 month and then provided data to describe the hearing improvements or deficiencies noted in daily life. Typical participants were 70 years old with mild to moderate adult-onset hearing loss bilaterally. Each participant used four pairs of hearing aids: premium- and basic-feature devices from brands marketed by each of two major manufacturers. Participants were blinded about the devices they used and about the research questions. All of the outcomes were designed to capture the participant's point of view about the benefits of the hearing aids. Three types of data were collected: change in hearing-related quality of life, extent of agreement with six positively worded statements about everyday hearing with the hearing aids, and reported preferences between the premium- and basic-feature devices from each brand as well as across all four research hearing aids combined. None of these measures yielded a statistically significant
Rahne, Torsten; Ehelebe, Thomas
Patients suffering from conductive or mixed hearing loss may benefit from bone-conduction hearing systems (BAHS). The amount of amplification provided by the hearing system is selected based on the individual's sensorineural frequency-specific threshold. With patients who are not able to provide thresholds behaviorally, such as young children, objective methods are required to estimate the unaided and aided hearing threshold and thus the success of the hearing system fitting. In a prospective study with ten adult Baha softband users, aided and unaided frequency-specific thresholds were estimated. Aided thresholds to tone bursts via Baha stimulation were obtained behaviorally and electrophysiologically using cortical auditory evoked potentials (CAEPs) and were compared to pure-tone thresholds using routine clinical audiometry. For all stimulation frequencies, the frequency-specific electrophysiological and behavioral hearing thresholds measured with Baha stimulation were highly correlated and not different. Increased thresholds were observed only with the 0.5 kHz Baha stimulation as compared to the pure-tone audiogram. Objective measurement of frequency-specific hearing thresholds with CAEPs is applicable to BAHS users.
Full Text Available Patients suffering from conductive or mixed hearing loss may benefit from bone-conduction hearing systems (BAHS. The amount of amplification provided by the hearing system is selected based on the individual’s sensorineural frequency-specific threshold. With patients who are not able to provide thresholds behaviorally, such as young children, objective methods are required to estimate the unaided and aided hearing threshold and thus the success of the hearing system fitting. In a prospective study with ten adult Baha softband users, aided and unaided frequency-specific thresholds were estimated. Aided thresholds to tone bursts via Baha stimulation were obtained behaviorally and electrophysiologically using cortical auditory evoked potentials (CAEPs and were compared to pure-tone thresholds using routine clinical audiometry. For all stimulation frequencies, the frequency-specific electrophysiological and behavioral hearing thresholds measured with Baha stimulation were highly correlated and not different. Increased thresholds were observed only with the 0.5 kHz Baha stimulation as compared to the pure-tone audiogram. Objective measurement of frequency-specific hearing thresholds with CAEPs is applicable to BAHS users.
Hoppe, U; Hast, A; Hocke, T
Speech perception is the most important social task of the auditory system. Consequently, speech audiometry is essential to evaluate hearing aid benefit. The aim of the study was to describe the correlation between pure-tone hearing loss and speech perception. In particular, pure-tone audiogram, speech audiogram, and speech perception with hearing aids were compared. In a retrospective study, 102 hearing aid users with bilateral sensorineural hearing loss were included. Pure-tone loss (PTA) was correlated to monosyllabic perception at 65 dB with hearing aid and with maximum monosyllabic perception with headphones. Speech perception as a function of hearing loss can be represented by a sigmoid function. However, for higher degrees of hearing loss, substantial deviations are observed. Maximum monosyllabic perception with headphones is usually not achieved with hearing aids at standard speech levels of 65 dB. For larger groups, average pure-tone hearing loss and speech perception correlate significantly. However, prognosis for individuals is not possible. In particular for higher degrees of hearing loss substantial deviations could be observed. Speech performance with hearing aids cannot be predicted sufficiently from speech audiograms. Above the age of 80, speech perception is significantly worse.
Hearing impairment among the youths and adults nowadays are in the increase, due wrong use of phones of which every ... DEVELOPMENT OF MICROCONTROLLER BASED BINAURAL DIGITAL HEARING AIDS FOR HEARING-IMPAIRED PEOPLE D. B. N. Nnadi, et al ... It is a common disorder associated with aging.
Snik, A.F.M.; Leijendeckers, J.M.; Hol, M.K.S.; Mylanus, E.A.M.; Cremers, C.
In 1984 the Bone-Anchored Hearing Aid, or BAHA, system was introduced. Its transducer is coupled directly to the skull percutaneously to form a highly effective bone-conduction hearing device. Clinical studies on adults with conductive hearing loss have shown that the BAHA system outperforms
Ching, Teresa Y C; Zhang, Vicky W; Hou, Sanna; Van Buynder, Patricia
Hearing loss in children is detected soon after birth via newborn hearing screening. Procedures for early hearing assessment and hearing aid fitting are well established, but methods for evaluating the effectiveness of amplification for young children are limited. One promising approach to validating hearing aid fittings is to measure cortical auditory evoked potentials (CAEPs). This article provides first a brief overview of reports on the use of CAEPs for evaluation of hearing aids. Second, a study that measured CAEPs to evaluate nonlinear frequency compression (NLFC) in hearing aids for 27 children (between 6.1 and 16.8 years old) who have mild to severe hearing loss is reported. There was no significant difference in aided sensation level or the detection of CAEPs for /g/ between NLFC on and off conditions. The activation of NLFC was associated with a significant increase in aided sensation levels for /t/ and /s/. It also was associated with an increase in detection of CAEPs for /t/ and /s/. The findings support the use of CAEPs for checking audibility provided by hearing aids. Based on the current data, a clinical protocol for using CAEPs to validate audibility with amplification is presented.
Skrzypek, Aleksandra; Sekula, Alicja; Deryło, Maria Bratumiła; Kuśmierczyk, Joanna; Talar, Marcin
To assess the hearing impairment in people over 60 years old using hearing aids. This was a single-center study, but it is planned to extend it further to the whole country. The study was focused on patients with hearing aids. During the assessment 57 people were included in the observation in order to control the status of their hearing loss and benefit from traditional hearing aids as well as the possibility to apply the auditory implants in case of a little benefit from hearing aids. The otoscopy and pure tone audiometry were performed as well as the questionnaires on demographic and epidemiological data of patients were collected as well as the quality of their life with hearing aids was subjectively assessed. The results show that 91% of patients have sensorineural hearing loss (SHL), the remaining 9%--severe mixed hearing loss. Severe SHL was found in 22 patients, the moderate hearing loss was observed in 37%, and the profound SHL was the case in 5 patients. Minimal SHL was observed in 7% of patients (n=4). More than 73% of the study subjects were male (n=38). The average age of the patients who completed the survey was 74 years old. Thirty-five patients used their hearing aid over 3 years and less than 70% of them used it every day all day. Hearing aid was not actively used by 10 patients. Over the last year 51.92% of the patients underwent a hearing examination. The bone anchored hearing aid was suggested to 2% of subjects and the cochlear implant was offered to 10 patients. The data analysis shows the need to educate and inform the elderly about alternative methods of hearing loss treatment. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.
Croghan, Naomi B H; Arehart, Kathryn H; Kates, James M
Current knowledge of how to design and fit hearing aids to optimize music listening is limited. Many hearing-aid users listen to recorded music, which often undergoes compression limiting (CL) in the music industry. Therefore, hearing-aid users may experience twofold effects of compression when listening to recorded music: music-industry CL and hearing-aid wide dynamic-range compression (WDRC). The goal of this study was to examine the roles of input-signal properties, hearing-aid processing, and individual variability in the perception of recorded music, with a focus on the effects of dynamic-range compression. A group of 18 experienced hearing-aid users made paired-comparison preference judgments for classical and rock music samples using simulated hearing aids. Music samples were either unprocessed before hearing-aid input or had different levels of music-industry CL. Hearing-aid conditions included linear gain and individually fitted WDRC. Combinations of four WDRC parameters were included: fast release time (50 msec), slow release time (1,000 msec), three channels, and 18 channels. Listeners also completed several psychophysical tasks. Acoustic analyses showed that CL and WDRC reduced temporal envelope contrasts, changed amplitude distributions across the acoustic spectrum, and smoothed the peaks of the modulation spectrum. Listener judgments revealed that fast WDRC was least preferred for both genres of music. For classical music, linear processing and slow WDRC were equally preferred, and the main effect of number of channels was not significant. For rock music, linear processing was preferred over slow WDRC, and three channels were preferred to 18 channels. Heavy CL was least preferred for classical music, but the amount of CL did not change the patterns of WDRC preferences for either genre. Auditory filter bandwidth as estimated from psychophysical tuning curves was associated with variability in listeners' preferences for classical music. Fast
We present an acoustics-based physics entrepreneurship project that identifies problems associated with hearing aids and listening environments such as restaurants and churches. The proposed company "Earcrafters" deals with the alarmingly low market penetration of hearing aids--especially amongst baby boomers--in two key ways: 1) Offering hearing instruments that "sound better" by way of improved frequency response throughout the audio spectrum and 2) applying marketing forces to effectively change the public perception that hearing aids are bulky and tinny-sounding. In contrast, the proposed company "US Sound" recognizes low hearing aid market penetration as a trend that will continue. The company is developing efficient methods to improve the acoustical environment of public areas such as restaurants and churches in order to fill the demand of baby boomers with hearing impairment--a number that has reached staggering proportions.
Parsa, Vijay; Jamieson, Donald
Typical measurements of electroacoustic performance of hearing aids include frequency response, compression ratio, threshold and time constants, equivalent input noise, and total harmonic distortion. These measurements employ artificial test signals and do not relate well to perceptual indices of hearing aid performance. Speech-based electroacoustic measures provide means to quantify the real world performance of hearing aids and have been shown to correlate better with perceptual data. This paper investigates the application of system identification paradigm for deriving the speech-based measures, where the hearing aid is modeled as a linear time-varying system and its response to speech stimuli is predicted using a linear adaptive filter. The performance of three adaptive filtering algorithms, viz. the Least Mean Square (LMS), Normalized LMS, and the Affine Projection Algorithm (APA) was investigated using simulated and real digital hearing aids. In particular, the convergence and tracking behavior of these algorithms in modeling compression hearing aids was thoroughly investigated for a range of compression ratio and threshold parameters, and attack and release time constants. Our results show that the NLMS and APA algorithms are capable of modeling digital hearing aids under a variety of compression conditions, and are suitable for deriving speech-based metrics of hearing aid performance.
Kimball, Suzanne H.
An individual over age 18 can purchase a hearing aid online or through mail order if they sign a waiver declining a medical evaluation, while those under 18 are required to be seen by a physician to obtain medical consent. However, in many states there is nothing to prevent a parent or caregiver from purchasing hearing aids for their child from a…
Klein, Kelsey E.; Walker, Elizabeth A.; Kirby, Benjamin; McCreery, Ryan W.
Purpose: We examined the effects of vocabulary, lexical characteristics (age of acquisition and phonotactic probability), and auditory access (aided audibility and daily hearing aid [HA] use) on speech perception skills in children with HAs. Method: Participants included 24 children with HAs and 25 children with normal hearing (NH), ages 5-12…
Snik, A.F.M.; Bosman, A.J.; Mylanus, E.A.M.; Cremers, C.W.R.J.
The BAHA (bone-anchored hearing aid) is a bone conduction hearing aid with percutaneous transmission of sound vibrations to the skull. The device has been thoroughly evaluated by various implant groups. These studies showed that, in audiological terms, the BAHA is superior to conventional bone
Dyrlund, Ole; Ludvigsen, Carl; Olofsson, Åke
An increasing number of hearing aid types include one or more features which are intentionally non-linear. In such devices measurement of frequency response and distortion using sweep tone measurements are typically of little relevance. Five different non-linear hearing aid types were used to eva...
Difficulty to understand speech in noisy situations is the number-one complaint of hearing aid users. Hearing aid manufacturers take measures against the problem of speech in noise by implementing signal-processing algorithms that should reduce background noise. The most widely applied measure
Meyer, Carly; Hickson, Louise; Fletcher, Amanda
Many older adults with hearing impairment are not confident in their ability to use hearing aids (i.e. experience low hearing aid self-efficacy), which has been found to be a barrier to hearing help-seeking and hearing aid use. This study aimed to determine what factors were associated with achieving adequate hearing aid self-efficacy. A retrospective research design was employed wherein hearing aid self-efficacy was the primary outcome. Explanatory variables included personal demographics, visual disability, and experiences related to participants' hearing ability and hearing aids. A total of 307 older adults with hearing impairment participated in the study (147 non hearing aid owners and 160 hearing aid owners). Non-hearing aid owners were more likely to report adequate hearing aid self-efficacy if they reported no visual disability, had experienced hearing loss for longer, reported more positive support from a significant other, and were not anxious about wearing hearing aids. Hearing aid owners were more likely to report adequate hearing aid self-efficacy if they had had a positive hearing aid experience and no visual disability. More research is needed to develop and evaluate intervention approaches that promote optimal levels of hearing aid self-efficacy among older adults with hearing impairment.
Arehart, Kathryn H; Souza, Pamela; Baca, Rosalinda; Kates, James M
implemented with sinusoidal modeling. These results, together with other studies focused on wide-dynamic range compression, suggest that older listeners with hearing loss and poor working memory are more susceptible to distortions caused by at least some types of hearing aid signal-processing algorithms and by noise, and that this increased susceptibility should be considered in the hearing aid fitting process.
Rahne, Torsten; Böhme, Lars; Götze, Gerrit
The identification and discrimination of timbre are essential features of music perception. One dominating parameter within the multidimensional timbre space is the spectral shape of complex sounds. As hearing loss interferes with the perception and enjoyment of music, we approach the individual timbre discrimination skills in individuals with severe to profound hearing loss using a cochlear implant (CI) and normal hearing individuals using a bone-anchored hearing aid (Baha). With a recent de...
Sakamoto, S; Goto, K; Tateno, M; Kaga, K
Objective of this study is to know how a frequency compression hearing aid with new concepts is beneficial for severe-to-profound hearing impairments. (2) Clinical trials of this hearing aid were conducted for 11 severe-to-profound hearing impaired listeners. These 11 wore the frequency compression hearing aid in their daily life and reported subjectively on its performance. Speech recognition tests with five listeners and audio-visual short sentence recognition tests with three listeners were also conducted. This hearing aid can separately adjust the fundamental frequency from the spectral envelope of input speech and can adjust frequency response by use of a post-processing digital filter. (3) Five listeners out of these 11 came to prefer this hearing aid in their daily life and are still wearing it. The results of the speech recognition tests show that the speech recognition scores were not improved for all listeners and the results of the audio-visual short sentence recognition tests do that the audio-visual recognition scores were improved for two listeners. (4) There were some severe-to-profound hearing impaired listeners who preferred the frequency compression hearing aid finally. It is also suggested that the benefits of this hearing aid may be evaluated correctly using not only speech but also visual materials.
Chasin, Marshall; Hockley, Neil S
Hearing aids are a relatively non-invasive means of reducing the negative effects of hearing loss on an individual who does not require a cochlear implant. Music amplified through hearing aids has some interesting characteristics but high fidelity is not typically one of them. This poses a serious problem for the investigator who wants to perform research on music with hearing impaired individuals who wear hearing aids. If the signal at the tympanic membrane is somewhat distorted then this has consequences for the assessment of music processing when examining both the peripheral and the central auditory system. In this review article on the subject of hearing aids and music, some of the acoustical differences between speech and music will be described. Following this, a discussion about what hearing aids do well and also less well for music as an input will be presented. Finally, some recommendations are made about what can be done for hearing-impaired individuals who wear hearing aids to listen to music. Copyright © 2013 Elsevier B.V. All rights reserved.
Larson, V D; Williams, D W; Henderson, W G; Luethke, L E; Beck, L B; Noffsinger, D; Wilson, R H; Dobie, R A; Haskell, G B; Bratt, G W; Shanks, J E; Stelmachowicz, P; Studebaker, G A; Boysen, A E; Donahue, A; Canalis, R; Fausti, S A; Rappaport, B Z
Numerous studies have demonstrated that hearing aids provide significant benefit for a wide range of sensorineural hearing loss, but no carefully controlled, multicenter clinical trials comparing hearing aid efficacy have been conducted. To compare the benefits provided to patients with sensorineural hearing loss by 3 commonly used hearing aid circuits. Double-blind, 3-period, 3-treatment crossover trial conducted from May 1996 to February 1998. Eight audiology laboratories at Department of Veterans Affairs medical centers across the United States. A sample of 360 patients with bilateral sensorineural hearing loss (mean age, 67.2 years; 57% male; 78.6% white). Patients were randomly assigned to 1 of 6 sequences of linear peak clipper (PC), compression limiter (CL), and wide dynamic range compressor (WDRC) hearing aid circuits. All patients wore each of the 3 hearing aids, which were installed in identical casements, for 3 months. Results of tests of speech recognition, sound quality, and subjective hearing aid benefit, administered at baseline and after each 3-month intervention with and without a hearing aid. At the end of the experiment, patients ranked the 3 hearing aid circuits. Each circuit markedly improved speech recognition, with greater improvement observed for soft and conversationally loud speech (all 52-dB and 62-dB conditions, Phearing aid circuits more frequently (41.6%) than the WDRC (29.8%) and the PC (28.6%) (P =.001 for CL vs both WDRC and PC). Each circuit provided significant benefit in quiet and noisy listening situations. The CL and WDRC circuits appeared to provide superior benefits compared with the PC, although the differences between them were much less than the differences between the aided vs unaided conditions. JAMA. 2000;284:1806-1813.
Most prescriptive methods for nonlinear, wide dynamic range compression (WDRC) hearing aids are based on the assumption that a hearing-impaired listener should perceive amplified sounds at the same overall loudness as would a normal-hearing listener without amplification. However, some previous research on linear amplification has indicated that subjects prefer less overall gain than prescribed by the most commonly used prescriptive method for linear hearing aids, NAL-R, a method that gives close to normal overall loudness for a mid-level input. The current study aims at comparing two prescriptive methods for WDRC hearing aids. The methods differ in the overall loudness they aim to give the hearing aid user. One method, called NormLoudn, is based on a generic method that prescribes gain so that the overall loudness is restored to normal. Another method, called LessLoudn, is based on a hearing aid specific prescription, and gives the hearing aid user less than normal overall loudness. Do first-time hearing aid users prefer the method that restores overall loudness to normal or the method that gives less than normal overall loudness? Twenty-one first-time hearing aid users with typical hearing losses for this group of clients participated in a crossover blinded field study where the two fitting methods were compared using a multi-programmable hearing aid, Danalogic 163D. Preference in the field was evaluated using interview, questionnaire, and diary. The field test was accompanied by laboratory tests, which included paired comparison judgments of preference and loudness and a speech recognition test. Loudness calculations were also used when interpreting the results, and a theoretical comparison with other prescriptive methods for WDRC hearing aids was made. After necessary adjustments, the measured gain for the two methods was similar in gain-frequency shape, but NormLoudn gave more overall gain than LessLoudn. Generally, NormLoudn fittings led to calculated overall
Thorup, Nicoline; Santurette, Sébastien; Jørgensen, Søren
by default. This study aimed at identifying clinically relevant tests that may serve as an informative addition to the audiogram and which may relate more directly to HA satisfaction than the audiogram does. METHODS: A total of 29 HI and 26 normal-hearing listeners performed tests of spectral and temporal...... resolution, binaural hearing, speech intelligibility in stationary and fluctuating noise and a working-memory test. Six weeks after HA fitting, the HI listeners answered a questionnaire evaluating HA treatment. RESULTS: No other measures than masking release between fluctuating and stationary noise...... correlated significantly with audibility. The HI listeners who obtained the least advantage from fluctuations in background noise in terms of speech intelligibility experienced greater HA satisfaction. CONCLUSION: HI listeners have difficulties in different hearing domains that are not predictable from...
Savaş, V A; Gündüz, B; Karamert, R; Cevizci, R; Düzlü, M; Tutar, H; Bayazit, Y A
To compare the auditory outcomes of Carina middle-ear implants with those of conventional hearing aids in patients with moderate-to-severe mixed hearing loss. The study comprised nine patients (six males, three females) who underwent middle-ear implantation with Carina fully implantable active middle-ear implants to treat bilateral moderate-to-severe mixed hearing loss. The patients initially used conventional hearing aids and subsequently received the Carina implants. The hearing thresholds with implants and hearing aids were compared. There were no significant differences between: the pre-operative and post-operative air and bone conduction thresholds (p > 0.05), the thresholds with hearing aids and Carina implants (p > 0.05), or the pre-operative (mean, 72.8 ± 19 per cent) and post-operative (mean, 69.9 ± 24 per cent) speech discrimination scores (p > 0.05). One of the patients suffered total sensorineural hearing loss three months following implantation despite an initial 38 dB functional gain. All except one patient showed clinical improvements after implantation according to quality of life questionnaire (Glasgow Benefit Inventory) scores. Acceptance of Carina implants is better than with conventional hearing aids in patients with mixed hearing loss, although both yield similar hearing amplification. Cosmetic reasons appear to be critical for patient acceptance.
Zhao, Fei; Manchaiah, Vinaya; St Claire, Lindsay; Danermark, Berth; Jones, Lesley; Brandreth, Marian; Krishna, Rajalakshmi; Goodwin, Robin
The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. Information on audiological services in different countries and 'theories related to cross-culture' is presented, followed by a general discussion. Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.
Thümmler, R; Liebscher, T; Hoppe, U
Pure tone and speech audiometry are essential methods for examining the indication for hearing aids, as well as for hearing aid evaluation. Additionally, the subjective benefit of hearing aids has to be evaluated with appropriate questionnaires. The aim of the present study was to investigate the correlation between speech audiometry data and the results of a simple and user-friendly questionnaire, as well as to provide normative data for subjective benefit. Data from 136 hearing aid users with bilateral sensorineural hearing loss were analyzed retrospectively. Pure tone thresholds and Freiburg monosyllabic speech perception in the binaural situation were measured at 65 dB in quiet and in noise (signal-to-noise ratio, SNR = +5 dB), with and without hearing aids. Additionally, subjective hearing in everyday life was recorded using the 12-item Oldenburg Inventory. Improvement of speech perception with hearing aids for the Freiburg monosyllabic test in quiet was 32.0 percentage points on average; in noise, there was an average improvement of 16.4 percentage points. There was a strong correlation between the results of pure tone and speech audiometry. With hearing aids, patients scored their everyday hearing using the Oldenburg Inventory on average 1.4 scale points better than without hearing aids. Results of the Oldenburg Inventory correlate with both pure tone and speech audiometry. Hearing aid evaluation should include both speech audiometry and systematic measurement of the subjective benefit using a suitable questionnaire. In combination, the Freiburg monosyllabic test and the Oldenburg Inventory allow for quick and comprehensive evaluation.
Most, Tova; Shina-August, Ella; Meilijson, Sara
This study characterized the profile of pragmatic abilities among 24 children with hearing loss (HL) aged 6.3-9.4 years, 13 using hearing aids (HAs) and 11 using cochlear implants (CIs), in comparison to those of 13 hearing children with similar chronological and language ages. All the children with HL used spoken language, attended regular…
Haskell, George B; Noffsinger, Douglas; Larson, Vernon D; Williams, David W; Dobie, Robert A; Rogers, Janette L
Subjective measures of performance were assessed on three different hearing aid circuits as part of a large clinical trial. These measurements included the Profile of Hearing Aid Performance and a subjective ranking of individual preference. A multi-center, double-masked clinical trial of hearing aids was conducted at eight VA Medical Centers. Three hearing aid circuits, a linear peak-clipper, a linear compression limiter and a wide dynamic range compressor, were investigated. The experimental design was a three-period, three-treatment crossover design. Subjects (N = 360) were stratified by site and randomized to one of six sequences for the hearing aid circuits. All fittings were binaural and involved a 3-mo trial with each of the three circuits. All subjective measures were administered for unaided and aided conditions at the end of each trial period. While all of the circuits resulted in improved scores on the aided versus the unaided PHAP, there were few conditions in which one circuit outperformed the others. An exception was the aversiveness of sound subscale where the peak clipper frequently scored worse than either the compression limiter or the wide dynamic range compressor. In the subjective ranking scale the compression limiter received more first place rankings than the other two circuits, especially for one subgroup of patients with moderate flat hearing loss. All circuits were perceived as beneficial by these subjects in most situations. The peak clipper scored worse on aversiveness of sound than did the other two circuits for most subjects, while the compression limiter seemed to have a slight advantage in subjective rankings. Most subjects perceived considerable aided benefit in situations involving background noise and reverberation, situations where hearing aid benefit is often questioned.
Stone, Michael A; Moore, Brian C J
We assessed the effects of time delay in a hearing aid on subjective disturbance and reading rates while the user of the aid was speaking, using hearing-impaired subjects and real-time processing. The time delay was constant across frequency. A digital signal processor was programmed as a four-channel, fast-acting, wide-dynamic-range compression hearing aid. One of four delays could be selected on the aid to produce a total delay of 13, 21, 30, or 40 msec between microphone and receiver. Twenty-five subjects, mostly with near-symmetric hearing impairment of cochlear origin, were fitted bilaterally with behind-the-ear aids connected to the processor. The aids were programmed with insertion gains prescribed by the CAMEQ loudness equalization procedure for each subject and ear. Subjects were asked to read aloud from scripts: speech production rates were measured and subjective ratings of the disturbance of the delay were obtained. Subjects required some training to recognize the effects of the delay to rate it consistently. Subjective disturbance increased progressively with increasing delay and was a nonmonotonic function of low-frequency hearing loss. Subjects with mild or severe low-frequency hearing loss were generally less disturbed by the delay than those with moderate loss. Disturbance ratings tended to decrease over successive tests. Word production rates were not significantly affected by delay over the range of delays tested. The results follow a pattern similar to those presented in , obtained using a simulation of hearing loss and normally hearing subjects, except for the nonmonotonic variation of disturbance with low-frequency hearing loss. We hypothesize that disturbance is maximal when the levels in the ear canal of the low-frequency components are similar for the unaided and aided sounds. A rating of 3, which is probably just acceptable, was obtained for delays ranging from 14 to 30 msec, depending on the hearing loss. Some acclimatization to the
Full Text Available Introduction Optimization of the selection, adaptation, and benefit of hearing aids is necessary to characterize and manage hearing loss, user expectations, otolaryngologic symptoms, and systemic comorbidities. Objective To compare the occurrence of otologic complaints, systemic diseases, and effective use of hearing aids in men and women with deafness. Methods Patients from a Unified Health System–accredited hearing health service, who reported problems in adapting to their hearing aids, were evaluated by a physician and audiologist. An anamnesis, ENT evaluation, and audiological evaluation were performed. Results During the data collection period, 278 subjects came in for follow-up visits; of these, 61 (21% reported otologic or operational problems with their equipment. The most prevalent type of hearing loss was basocochlear, a characteristic of presbycusis, in both men and women; the most frequently reported comorbidities were hypercholesterolemia (more significant in women and hypertension (more significant in men. Fourteen subjects reported using their device discontinuously, with no significant difference between genders; the reasons for discontinuation of use were itching and ringing, with more complaints from women. Conclusion The incidence of systemic and audiological complaints is high in this population. These patients should be evaluated thoroughly, as resolutions of these complaints can contribute to improving the quality of life and assist in the process of hearing aid fitting.
Brown, E; Klein, A J; Snydee, K A
The auditory brainstem response (ABR) recorded while wearing a hearing aid may supply supplemental information about the benefit and appropriateness of the hearing aid for certain infants. The purposes of this study were (1) to determine the effects of different output limiting circuits on the acoustics of tone-pip stimuli used for ABR recordings and (2) assess how changes in hearing-aid-processed stimuli affect ABR characteristics. Electroacoustic input/output functions to tone-pip stimuli were constructed for three different output limiting circuits (wide dynamic range compression, output compression, and linear with peak clipping) available in a programmable hearing aid. Wave V latency and amplitude functions were then measured to the same stimuli and hearing aid settings in five normal-hearing adults. Electroacoustic results showed that none of the output limiting circuits, including linear peak clipping, were effectively activated by tone pips compared to the hearing aid performance to continuous tones. Aided wave V latency and amplitude functions were asymptotic to high stimulus levels, suggesting that cochlear output was in saturation.
Stone, M A; Moore, B C
When people who wear hearing aids speak, there are three paths by which they hear their own voices: 1) through the air and leakage around the earmold; 2) via the solid structures of their head; 3) through the air to the hearing aid microphone, and then through the aid circuitry. These paths involve different time delays. Digital processing introduces delays in path 3 from a few to several tens of milliseconds, which could lead to a range of disturbing effects. We examined one purely auditory effect, namely hearing speech through all three of these paths. Subjective disturbance was measured as a function of delay in path 3 using simulations of hearing loss and a simulated hearing aid. With increasing hearing loss, the loudness of sound heard via paths 1 and 2 decreases, and the aid user relies more on path 3. The disturbance produced by the delay then might be less perceptible. To test this idea, four different hearing losses were simulated, varying from mild to moderately severe. Each of two talkers was fitted with a closed earmold, and simultaneous above-ear and in-ear recordings were made of each talker reading prose. The above-ear signal was amplified using a simulated hearing aid with 4-channel full dynamic range compression; compression ratios and gains were selected using an algorithm based on the absolute thresholds used in the simulations of hearing loss. The resultant output was then mixed with the in-ear signal with one of five values of delay, and the combined signal was processed using the four simulations of hearing loss. The resulting stimuli simulated for normal-hearing listeners the experience of having a hearing impairment and listening through a hearing aid while talking, except that the talker's voice was not that of the listener. Twenty normally hearing subjects gave subjective ratings of the disturbance of the echo for each delay and each simulated hearing loss. Disturbance ratings generally increased monotonically with increasing delay
Polanski, José Fernando; Plawiak, Anna Clara; Ribas, Angela
Objective: To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. Case description: 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discom...
Manchaiah, Vinaya; Stein, Gretchen; Danermark, Berth; Germundsson, Per
In our previous studies we explored the social representation of hearing loss and hearing aids. In this study we aimed at exploring if the positive, neutral and negative connotations associated with the social representation of 'hearing loss' and 'hearing aids' for the same categories vary across countries. In addition, we also looked at if there is an association between connotations and demographic variables. A total of 404 individuals from four countries were asked to indicate the words and phrases that comes to mind when they think about 'hearing loss' and 'hearing aids'. They also indicated if the words and phrases they reported had positive, neutral or negative association, which were analyzed and reported in this paper. There are considerable differences among the countries in terms of positive, neutral and negative associations report for each category in relation to hearing loss and hearing aids. However, there is limited connection between demographic variables and connotations reported in different countries. These results suggesting that the social representation about the phenomenon hearing loss and hearing aids are relatively stable within respondents of each country.
McDermott, Hugh J
Recently two major manufacturers of hearing aids introduced two distinct frequency-lowering techniques that were designed to compensate in part for the perceptual effects of high-frequency hearing impairments. The Widex "Audibility Extender" is a linear frequency transposition scheme, whereas the Phonak "SoundRecover" scheme employs nonlinear frequency compression. Although these schemes process sound signals in very different ways, studies investigating their use by both adults and children with hearing impairment have reported significant perceptual benefits. However, the modifications that these innovative schemes apply to sound signals have not previously been described or compared in detail. The main aim of the present study was to analyze these schemes'technical performance by measuring outputs from each type of hearing aid with the frequency-lowering functions enabled and disabled. The input signals included sinusoids, flute sounds, and speech material. Spectral analyses were carried out on the output signals produced by the hearing aids in each condition. The results of the analyses confirmed that each scheme was effective at lowering certain high-frequency acoustic signals, although both techniques also distorted some signals. Most importantly, the application of either frequency-lowering scheme would be expected to improve the audibility of many sounds having salient high-frequency components. Nevertheless, considerably different perceptual effects would be expected from these schemes, even when each hearing aid is fitted in accordance with the same audiometric configuration of hearing impairment. In general, these findings reinforce the need for appropriate selection and fitting of sound-processing schemes in modern hearing aids to suit the characteristics and preferences of individual listeners.
Hugh J McDermott
Full Text Available Recently two major manufacturers of hearing aids introduced two distinct frequency-lowering techniques that were designed to compensate in part for the perceptual effects of high-frequency hearing impairments. The Widex "Audibility Extender" is a linear frequency transposition scheme, whereas the Phonak "SoundRecover" scheme employs nonlinear frequency compression. Although these schemes process sound signals in very different ways, studies investigating their use by both adults and children with hearing impairment have reported significant perceptual benefits. However, the modifications that these innovative schemes apply to sound signals have not previously been described or compared in detail.The main aim of the present study was to analyze these schemes'technical performance by measuring outputs from each type of hearing aid with the frequency-lowering functions enabled and disabled. The input signals included sinusoids, flute sounds, and speech material. Spectral analyses were carried out on the output signals produced by the hearing aids in each condition.The results of the analyses confirmed that each scheme was effective at lowering certain high-frequency acoustic signals, although both techniques also distorted some signals. Most importantly, the application of either frequency-lowering scheme would be expected to improve the audibility of many sounds having salient high-frequency components. Nevertheless, considerably different perceptual effects would be expected from these schemes, even when each hearing aid is fitted in accordance with the same audiometric configuration of hearing impairment. In general, these findings reinforce the need for appropriate selection and fitting of sound-processing schemes in modern hearing aids to suit the characteristics and preferences of individual listeners.
Bento, Ricardo Ferreira; Penteado, Silvio Pires
Hearing loss is a common health issue that affects nearly 10% of the world population as indicated by many international studies. The hearing impaired typically experience more frustration, anxiety, irritability, depression, and disorientation than those with normal hearing levels. The standard rehabilitation tool for hearing impairment is an electronic hearing aid whose main components are transducers (microphone and receiver) and a digital signal processor. These electronic components are manufactured by supply chain rather than by hearing aid manufacturers. Manufacturers can use custom-designed components or generic off-the-shelf components. These electronic components are available as application-specific or off-the-shelf products, with the former designed for a specific manufacturer and the latter for a generic approach. The choice of custom or generic components will affect the product specifications, pricing, manufacturing, life cycle, and marketing strategies of the product. The World Health Organization is interested in making available to developing countries hearing aids that are inexpensive to purchase and maintain. The hearing aid presented in this article was developed with these specifications in mind together with additional contemporary features such as four channels with wide dynamic range compression, an adjustable compression rate for each channel, four comfort programs, an adaptive feedback manager, and full volume control. This digital hearing aid is fitted using a personal computer with minimal hardware requirements in intuitive three-step fitting software. A trimmer-adjusted version can be developed where human and material resources are scarce.
Anderson, David V.
Hearing loss with recruitment results in a frequency-dependent reduced effective dynamic range of the ear. The advance of digital hearing aid capabilities has led to the proliferation of multiband, compression algorithms directed at the recruitment problem. However, results have been mixed at best. We propose an alternative design methodology to designing multiband compressive aids based on attack and release times. In particular, multiband compression hearing aids should be matched to certain characteristics of the ear with a memoryless gain based on the bandlimited envelope function of each band. Under the proposed design method each band has a different effective time-constant.
Lindsey E. Jorgensen
Full Text Available Verification and validation are objective and subjective measurements of hearing aid function. Many studies have provided rationales for performing these measurements as necessary for hearing aid practitioners to provide the highest level of care. Several researchers have suggested that completing these measurements as part of routine clinical care will reduce the number of return visits, reduce the number of aids returned for credit, and increase patient satisfaction. The purpose of this review article is to provide background, method and rationale for practitioners to use these measurements to improve their practice of hearing healthcare.
Penna, Leticia Macedo; Lemos, Stela Maris Aguiar; Alves, Cláudia Regina Lindgren
Hearing loss may impair the development of a child. The rehabilitation process for individuals with hearing loss depends on effective interventions. To describe the linguistic profile and the hearing skills of children using hearing aids, to characterize the rehabilitation process and to analyze its association with the children's degree of hearing loss. Cross-sectional study with a non-probabilistic sample of 110 children using hearing aids (6-10 years of age) for mild to profound hearing loss. Tests of language, speech perception, phonemic discrimination, and school performance were performed. The associations were verified by the following tests: chi-squared for linear trend and Kruskal-Wallis. About 65% of the children had altered vocabulary, whereas 89% and 94% had altered phonology and inferior school performance, respectively. The degree of hearing loss was associated with differences in the median age of diagnosis; the age at which the hearing aids were adapted and at which speech therapy was started; and the performance on auditory tests and the type of communication used. The diagnosis of hearing loss and the clinical interventions occurred late, contributing to impairments in auditory and language development. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Leticia Macedo Penna
Full Text Available INTRODUCTION: Hearing loss may impair the development of a child. The rehabilitation process for individuals with hearing loss depends on effective interventions.OBJECTIVE: To describe the linguistic profile and the hearing skills of children using hearing aids, to characterize the rehabilitation process and to analyze its association with the children's degree of hearing loss.METHODS: Cross-sectional study with a non-probabilistic sample of 110 children using hearing aids (6-10 years of age for mild to profound hearing loss. Tests of language, speech perception, phonemic discrimination, and school performance were performed. The associations were verified by the following tests: chi-squared for linear trend and Kruskal-Wallis.RESULTS: About 65% of the children had altered vocabulary, whereas 89% and 94% had altered phonology and inferior school performance, respectively. The degree of hearing loss was associated with differences in the median age of diagnosis; the age at which the hearing aids were adapted and at which speech therapy was started; and the performance on auditory tests and the type of communication used.CONCLUSION: The diagnosis of hearing loss and the clinical interventions occurred late, contributing to impairments in auditory and language development.
Korhonen, Petri; Lau, Chi; Kuk, Francis; Keenan, Denise; Schumacher, Jennifer
Hearing-impaired listeners localize sounds better unaided than aided. Wide dynamic range compression circuits operating independently at each ear in bilateral fittings, and microphone positions of different hearing aid styles, have been cited as a reason. Two hearing aid features, inter-ear coordinated compression (IE) and pinna compensation (PC), were developed to mitigate the compromised aided localization performance. This study examined the effect of IE and PC on aided localization performance in the horizontal plane with hearing-impaired listeners. A single-blind, repeated-measures design was used. A total of 10 experienced hearing aid users with bilaterally symmetrical sensorineural hearing loss who had previously participated in localization training were evaluated. Localization performance was measured using 12 loudspeakers spaced 30° apart on the horizontal plane. Aided performance was evaluated using a behind-the-ear hearing aid at four settings: omnidirectional microphone (Omni), Omni microphone with the PC feature, Omni microphone with IE, and Omni microphone with the PC feature and IE together. In addition, unaided localization performance was measured. Significant improvement in the localization accuracy was measured for sounds arriving from the back when comparing the PC with the Omni conditions. The use of IE reduced the magnitude of errors for some listeners for sounds originating from ±90°. The average reduction in the errors was 7.3°. This study confirmed that the use of the PC feature improved localization for sounds arriving from behind the listener. The use of IE may improve localization for some listeners for sounds arriving from the sides. American Academy of Audiology.
... Hearing aid devices; professional and patient labeling. (a) Definitions for the purposes of this section... association. (4) Audiologist means any person qualified by training and experience to specialize in the... a user or prospective user of a hearing aid. (6) Used hearing aid means any hearing aid that has...
Automatic DSP (digital signal processing) features, widely available in hearing aids today, are useful because they alleviate the need for the hearing aid wearer to manually adjust the hearing aid as listening conditions change. Although the theoretical basis for the design of these features may be sound, little is known about their behavior in the real world. Data logging offers a glimpse into the life of the individual hearing aid wearer, but there are no published data to date that provide a frame of reference for the interpretation of this information. Further, data logging in hearing aids provides only aggregate summaries for individual features, ignoring complex interactions including the differences between the left and right sides of a bilateral pair. The purpose of this study was to determine the typical behavior of three automatic DSP hearing aid features-expansion, directionality, and noise management-in daily life. Ten individuals with hearing impairment were fitted bilaterally with BTE (behind the ear) hearing aids. The hearing aids were programmed for the individual's hearing loss with expansion, directionality, and noise management set to activate automatically. A PDA (personal digital assistant) logged the input level and status of expansion, directionality, and noise management from both devices at 5 sec intervals. Data were gathered in this manner over a period of 4-5 wk. A total of 741 hr of hearing aid use were logged, 50% of which were spent in environments no louder than 50 dB SPL. Expansion, directionality, and noise management were active 45, 10, and 21% of the time, respectively; the median amount of gain reduction for noise management was ∼1 dB. Although expansion and noise management were always active at the low and high input levels, respectively, activation of directionality never exceeded 50%. Expansion and noise management were sometimes active simultaneously, as were directionality and noise management. Bilateral agreement in
Carioli, Juliana; Teixeira, Adriane Ribeiro
Introduction Hearing loss is among the sensory changes strongly associated with loss of functional capacity. Objective It aims to determine whether the use of hearing aid contributes to the improvement of instrumental activities of daily living (IADL) for middle aged and elderly hearing-impaired individuals. Methods This is a descriptive, longitudinal, and interventional study. We evaluated 17 subjects, 13 (76.5%) female, aged between 58 and 96 years old (mean 77.1 ± 10.4 years). All were new users of hearing aids. Evaluation included social history, pure tone audiometry, and scale of IADL developed by Lawton and Brody. The subjects were presented daily life situations and were expected to respond if they could do them without assistance (3 points), partially assisted (2 points) or if they were unable to perform them (1 point). IADL was applied before the use of hearing aids adaptation and after a three- and six-month period of use. Results Data analysis revealed that before the use of hearing aids the average score obtained by the subjects was 22.94 ± 4.04 points. Three months after beginning the use the average score was 23.29 ± 4.12 and after six months the average score was 23.71 ± 3.69 points. Statistical analysis revealed a significant difference between scores obtained before the use of hearing aids and six months post-fitting (p = 0.015*) Conclusion The use of hearing aids among the subjects evaluated promoted positive changes in performing IADL, especially to using the telephone.
Full Text Available Introduction Hearing loss is among the sensory changes strongly associated with loss of functional capacity. Objective It aims to determine whether the use of hearing aid contributes to the improvement of instrumental activities of daily living (IADL for middle aged and elderly hearing-impaired individuals. Methods This is a descriptive, longitudinal, and interventional study. We evaluated 17 subjects, 13 (76.5% female, aged between 58 and 96 years old (mean 77.1 ± 10.4 years. All were new users of hearing aids. Evaluation included social history, pure tone audiometry, and scale of IADL developed by Lawton and Brody. The subjects were presented daily life situations and were expected to respond if they could do them without assistance (3 points, partially assisted (2 points or if they were unable to perform them (1 point. IADL was applied before the use of hearing aids adaptation and after a three- and six-month period of use. Results Data analysis revealed that before the use of hearing aids the average score obtained by the subjects was 22.94 ± 4.04 points. Three months after beginning the use the average score was 23.29 ± 4.12 and after six months the average score was 23.71 ± 3.69 points. Statistical analysis revealed a significant difference between scores obtained before the use of hearing aids and six months post-fitting (p = 0.015* Conclusion The use of hearing aids among the subjects evaluated promoted positive changes in performing IADL, especially to using the telephone.
José Fernando Polanski
Full Text Available Objective: To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. Case description: 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discomfort caused by skull compression. It was prescribed a model of bone-anchored hearing aid, in soft band format. The results were evaluated through behavioral hearing tests and questionnaires Meaningful Use of Speech Scale (MUSS and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS. Comments: The patient had a higher acceptance of the bone-anchored hearing aid compared to the traditional bone vibration arch. Audiological tests and the speech and auditory skills assessments also showed better communication and hearing outcomes. The bone-anchored hearing aid is a good option in hearing rehabilitation in this syndrome.
Full Text Available Background and Aim: Hearing loss is one of the most prevalent chronic diseases in the elderly; using a hearing aid to alleviate auditory impairment can positively affect their quality of life. This research aimed to determine the level of satisfaction concerning hearing aids in elderly people with hearing impairment based on the type and degree of hearing loss.Methods: An analytic cross-sectional research design was used ; the sample included 40 elderly people who used hearing aids. According to the World Health Organization (WHO age classification, participants were divided into two age groups: 65-74 years (n=20 and 75-90 years (n=20. Satisfaction levels were assessed using a standard satisfaction with amplification in daily life (SADL questionnaire.Results: Satisfaction levels in the 65-74 age group were significantly higher than that in the 75-90 age group (p=0.02. Participants with mixed hearing loss revealed higher satisfaction levels than participants with sensorineural hearing loss (p=0.02. On the negative effects dimension, participants with severe hearing loss exhibited significantly higher satisfaction levels than participants with moderate or moderate to severe hearing loss (p=0.01.Conclusion: Total satisfaction mean scores were relatively high in the elderly participants . Negative features could be reduced via careful consultation regarding the aids’ amplifying capabilities and limitations in groups with moderate or moderate to severe hearing loss.
Smith, Pauline; Davis, Adrian
To investigate the benefits in reported outcomes after providing bluetooth accessories for established hearing aid users. Prospective observational study using validated quantitative outcome measures and detailed patient narrative before and two months after patients were provided with bluetooth accessories. Twelve patients with bilateral NHS hearing aids participated. They had a wide range of ages and hearing loss. After two months, 10 patients reported substantial additional benefit and kept the accessories; two returned them for various reasons. Statistically significant changes were seen in two validated outcome measures: the Glasgow Hearing Aid Benefit Profile and the International Outcome Inventory - Hearing Aids, but not in the Speech, Spatial and Qualities of Hearing Scale. Two notable benefits were reported: some described hearing the emotion and mood in a voice for the first time; others were amazed to report an improved ability to hear film or to hold conversations over the telephone. The provision of bluetooth accessories can give additional reported benefit for some patients - we need better knowledge about who benefits, and whether further support/training to individuals would make a difference.
Kuk, Francis; Seper, Eric; Lau, Chi-Chuen; Korhonen, Petri
The benefits offered by noise reduction (NR) features on a hearing aid had been studied traditionally using test conditions that set the hearing aids into a stable state of performance. While adequate, this approach does not allow the differentiation of two NR algorithms that differ in their timing characteristics (i.e., activation and stabilization time). The current study investigated a new method of measuring noise tolerance (Tracking of Noise Tolerance [TNT]) as a means to differentiate hearing aid technologies. The study determined the within-session and between-session reliability of the procedure. The benefits provided by various hearing aid conditions (aided, two NR algorithms, and a directional microphone algorithm) were measured using this procedure. Performance on normal-hearing listeners was also measured for referencing. A single-blinded, repeated-measures design was used. Thirteen experienced hearing aid wearers with a bilaterally symmetrical (≤10 dB) mild-to-moderate sensorineural hearing loss participated in the study. In addition, seven normal-hearing listeners were tested in the unaided condition. Participants tracked the noise level that met the criterion of tolerable noise level (TNL) in the presence of an 85 dB SPL continuous discourse passage. The test conditions included an unaided condition and an aided condition with combinations of NR and microphone modes within the UNIQUE hearing aid (omnidirectional microphone, no NR; omnidirectional microphone, NR; directional microphone, no NR; and directional microphone, NR) and the DREAM hearing aid (omnidirectional microphone, no NR; omnidirectional microphone, NR). Each tracking trial lasted 2 min for each hearing aid condition. Normal-hearing listeners tracked in the unaided condition only. Nine of the 13 hearing-impaired listeners returned after 3 mo for retesting in the unaided and aided conditions with the UNIQUE hearing aid. The individual TNL was estimated for each participant for all test
Miyasaka, Muneo; Akamatsu, Tadashi; Yamazaki, Akihisa; Tanaka, Rica
To improve conventional bone conduction hearing aids, Tjellstrom, Branemark, developed an implant system consisting of a maxillofacial implant that derived from dental implants and a bone conduction hearing aid that was attached directly to the implant. This system has been commercially available as a bone anchored hearing aid (BAHA). More than 10,000 patients have benefited from BAHA in Scandinavia, North America, and many other regions. BAHA first became available in 1977 in Sweden but has not been used in Japan as widely as expected. This paper reports a case of a 8-year use of BAHA for hearing loss caused by microtia and external auditory canal atresia, with a review of literature. The patient has been followed up for 9 years after implant placement. Play audiometry with a loudspeaker showed a hearing loss of 25 dB. The patient says that BAHA is superior to conventional transcutaneous bone conduction hearing aids in easiness of attachment, esthetics, and speech recognition and music recognition. The skin and the bone around the implants remain in favorable condition. She has been free from the use of a headband for a conventional hearing aid.
Bernarding, Corinna; Strauss, Daniel J; Hannemann, Ronny; Seidler, Harald; Corona-Strauss, Farah I
An objective estimate of listening effort could support the hearing aid fitting procedure. Most of the digital hearing aids have already hearing aid settings which are supposed to reduce the listening effort, but the effects of these settings on the individual's listening effort remain unclear. In this study, we propose an objective estimate of listening effort using electroencephalographic data. The new method is based on the phase distribution of the ongoing oscillatory EEG activity. We hypothesize that for a non-effortful listening environment the phase is rather uniformly distributed on the unit circle than for a demanding condition. To prove if the phase is uniformly distributed around the unit circle, the Rayleigh Test was applied to the phase of the EEG. This method was tested in 14 hearing impaired subjects (moderate hearing loss, 65.64 ±7.93 yrs, 7 female). The tested hearing aid settings were a directional microphone combined with a noise reduction algorithm in a medium and a strong setting, the noise reduction setting turned off as well as a setting using omnidirectional microphones. Noise embedded sentences (Oldenburg Sentence Test, OlSa) were used as test materials. The task of the subject was to repeat each sentence. The results indicate that the objective estimate of listening effort maps the subjectively rated effort and for a listening situation like the presented one, the strong setting of the directional microphone requires the smallest effort.
Bentler, Ruth; Palmer, Catherine; Mueller, H Gustav
This clinical trial was undertaken to evaluate the benefit obtained from hearing aids employing second-order adaptive directional microphone technology, used in conjunction with digital noise reduction. Data were collected for 49 subjects across two sites. New and experienced hearing aid users were fit bilaterally with behind-the-ear hearing aids using the National Acoustics Laboratory-Nonlinear version 1 (NAL-NL1) prescriptive method with manufacturer default settings for various parameters of signal processing (e.g., noise reduction, compression, etc.). Laboratory results indicated that (1) for the stationary noise environment, directional microphones provided better speech perception than omnidirectional microphones, regardless of the number of microphones; and (2) for the moving noise environment, the three-microphone option (whether in adaptive or fixed mode) and the two-microphone option in its adaptive mode resulted in better performance than the two-microphone fixed mode, or the omnidirectional modes.
Goehring, Tobias; Chapman, Josie L; Bleeck, Stefan; Monaghan, Jessica J M
Processing delay is one of the important factors that limit the development of novel algorithms for hearing devices. In this study, both normal-hearing listeners and listeners with hearing loss were tested for their tolerance of processing delay up to 50 ms using a real-time setup for own-voice and external-voice conditions based on linear processing to avoid confounding effects of time-dependent gain. Participants rated their perceived subjective annoyance for each condition on a 7-point Likert scale. Twenty normal-hearing participants and twenty participants with a range of mild to moderate hearing losses. Delay tolerance was significantly greater for the participants with hearing loss in two out of three voice conditions. The average slopes of annoyance ratings were negatively correlated with the degree of hearing loss across participants. A small trend of higher tolerance of delay by experienced users of hearing aids in comparison to new users was not significant. The increased tolerance of processing delay for speech production and perception with hearing loss and reduced sensitivity to changes in delay with stronger hearing loss may be beneficial for novel algorithms for hearing devices but the setup used in this study differed from commercial hearing aids.
Rumalla, Kavelin; Karim, Adham M; Hullar, Timothy E
In the United States, falls are the leading cause of accidental deaths in adults aged over 65 years. Epidemiologic studies indicate that there is a correlation between hearing loss and the risk of falling among older people. The vestibular, proprioceptive, and visual systems are known to contribute to postural stability, but the contribution of audition to maintaining balance has not yet been determined. Cross-sectional study to measure postural stability in bilateral hearing-aid users aged over 65 years in aided and unaided conditions. Balance was assessed using the Romberg on foam test and the tandem stance test. Tests were administered in the presence of a point-source broadband white-noise sound (0-4 kHz) source in both unaided and aided conditions in the dark. Subjective measures of balance were made using the Activities-specific Balance Confidence Scale. Performance was significantly better in the aided than the unaided condition (P = 0.005 for both tests). No statistically significant relationship between improvement in balance, and hearing was identified. Participants did not report that they perceived a difference in balance between the two conditions. These results indicate that hearing aids are a novel treatment modality for imbalance in older adults with hearing loss and suggest that wearing hearing aids may offer a significant public-health benefit for avoiding falls in this population. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.
Tokano, Hisashi; Noguchi, Yoshihiro; Kitamura, Ken
In this first case report in Japan, we described 2 patients treated using a bone conductive hearing aid with skin-penetrating implant, or bone-anchored hearing aid (BAHA). Both suffered from chronic otitis media and had received bilateral canal down tympanomastoidectomy. Case 1 was a 61-year-old woman with a conventional air conductive hearing aid in her right ear. There was no aural discharge in either ear. A pure-tone average showed 82.5 dBHL (air), 44.3 dBHL (bone) in the right ear and 93.8 dBHL (air), 48.8 dBHL (bone) in the left ear. Case 2 was a 38-year-old woman with a conventional hearing aid in her left ear, from which there was persistent aural discharge. A pure-tone average showed 48.8 dBHL(air), 15.0 dBHL (bone) in the right ear, and 60.0 dBHL(air), 20.0 dBHL(bone) in the left ear. Both underwent BAHA implant in the right ear without adverse reaction during 9 months of postoperative follow-up after surgery. No difference was seen in the aided hearing level or speech discrimination score between BAHA and air conduction hearing aids but both patients preferred to BAHA because of its greater comfort and audibility.
Picou, Erin M; Ricketts, Todd A
The purpose of this study was to examine speech recognition through hearing aids for seven telephone listening conditions. Speech recognition scores were measured for 20 participants in six wireless routing transmission conditions and one acoustic telephone condition. In the wireless conditions, the speech signal was delivered to both ears simultaneously (bilateral speech) or to one ear (unilateral speech). The effect of changing the noise level in the nontest ear during unilateral conditions was also examined. Participants were fitted with hearing aids using both nonoccluding and occluding dome ear tips. Participants were seated in a room with background noise present and speech was transmitted to the participants without additional noise. There was no effect of changing the noise level in the nontest ear and no difference between unilateral wireless routing and acoustic telephone listening. For wireless transmission, bilateral presentation resulted in significantly better speech recognition than unilateral presentation. Bilateral wireless conditions allowed for significantly better recognition than the acoustic telephone condition for participants fitted with occluding ear tips only. Routing the signal to both hearing aids resulted in significantly better speech recognition than unilateral signal routing. Wireless signal routing was shown to be beneficial compared with acoustic telephone listening and in some conditions resulted in the best performance of all of the listening conditions evaluated. However, this advantage was only evident when the signal was routed to both ears and when hearing aid wearers were fitted with occluding domes. Therefore, it is expected that the benefits of this new wireless streaming technology over existing telephone coupling methods will be most evident clinically in hearing aid wearers who require more limited venting than is typically used in open canal fittings.
Picou, Erin M; Ricketts, Todd A; Hornsby, Benjamin W Y
The purpose of this article was to evaluate factors that influence the listening effort experienced when processing speech for people with hearing loss. Specifically, the change in listening effort resulting from introducing hearing aids, visual cues, and background noise was evaluated. An additional exploratory aim was to investigate the possible relationships between the magnitude of listening effort change and individual listeners' working memory capacity, verbal processing speed, or lipreading skill. Twenty-seven participants with bilateral sensorineural hearing loss were fitted with linear behind-the-ear hearing aids and tested using a dual-task paradigm designed to evaluate listening effort. The primary task was monosyllable word recognition and the secondary task was a visual reaction time task. The test conditions varied by hearing aids (unaided, aided), visual cues (auditory-only, auditory-visual), and background noise (present, absent). For all participants, the signal to noise ratio was set individually so that speech recognition performance in noise was approximately 60% in both the auditory-only and auditory-visual conditions. In addition to measures of listening effort, working memory capacity, verbal processing speed, and lipreading ability were measured using the Automated Operational Span Task, a Lexical Decision Task, and the Revised Shortened Utley Lipreading Test, respectively. In general, the effects measured using the objective measure of listening effort were small (~10 msec). Results indicated that background noise increased listening effort, and hearing aids reduced listening effort, while visual cues did not influence listening effort. With regard to the individual variables, verbal processing speed was negatively correlated with hearing aid benefit for listening effort; faster processors were less likely to derive benefit. Working memory capacity, verbal processing speed, and lipreading ability were related to benefit from visual cues. No
Theunissen, Stephanie C P M; Rieffe, Carolien; Kouwenberg, Maartje; De Raeve, Leo; Soede, Wim; Briaire, Jeroen J; Frijns, Johan H M
The objectives of this study were to examine the levels of anxiety in hearing-impaired children with hearing aids or cochlear implants compared to normally hearing children, and to identify individual variables that were associated with differences in the level of anxiety. Large retrospective cohort study. Self-reports and parent-reports concerning general anxiety, social anxiety, and generalized anxiety disorder were used. The study group (mean age, 11.8 years) consisted of three age-matched subgroups: 32 children with cochlear implants, 51 children with conventional hearing aids, and 127 children without hearing loss. Levels of anxiety in children with cochlear implants and normally hearing children were similar. Early implantation was associated with lower levels of general and social anxiety. Remarkably, children with conventional hearing aids had higher levels of social anxiety, and their parents also reported more generalized anxiety disorder. The outcomes demonstrate that in their level of anxiety, children with cochlear implants might be more comparable to normally hearing children than to children with hearing aids. This positive finding can be the consequence of audiological factors or other aspects of the cochlear implant rehabilitation program. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Lunner, T; Hellgren, J; Arlinger, S; Elberling, C
Three different non-linear digital signal processing algorithms were developed; LinEar, DynEar and RangeEar. All three provided individual frequency shaping via a seven-band low-power filterbank and compression in two channels. RangeEar and DynEar used wide dynamic range syllabic compression in the low-frequency (LF) channel, while LinEar used compression limiting. In the high-frequency (HF) channel, RangeEar used a slow-acting automatic volume control, while DynEar and LinEar used compression limiting. Wearable digital signal processing-based experimental instruments were used to evaluate the fitting algorithms under real world conditions with experienced hearing aid users. Evaluation included laboratory testing of speech recognition in noise and questionnaires on sound quality ratings. Results did not indicate one general good-for-all algorithm, but different algorithms resulting in preference and performance depending on the hearing loss configuration. Preference for any of the new algorithms could be predicted based on auditory dynamic range measurements. It was hypothesized that the different preferences were affected by different susceptibility to masking of HF sounds by amplified LF sounds.
Lustig, L R; Arts, H A; Brackmann, D E; Francis, H F; Molony, T; Megerian, C A; Moore, G F; Moore, K M; Morrow, T; Potsic, W; Rubenstein, J T; Srireddy, S; Syms, C A; Takahashi, G; Vernick, D; Wackym, P A; Niparko, J K
This study evaluates the U.S. experience with the first 40 patients who have undergone audiologic rehabilitation using the BAHA bone-anchored hearing aid. This study is a multicenter, nonblinded, retrospective case series. Twelve tertiary referral medical centers in the United States. Eligibility for BAHA implantation included patients with a hearing loss and an inability to tolerate a conventional hearing aid, with bone-conduction pure tone average levels at 60 dB or less at 0.5, 1, 2, and 4 kHz. Patients who met audiologic and clinical criteria were implanted with the Bone-Anchored Hearing Aid (BAHA, Entific Corp., Gothenburg, Sweden). Preoperative air- and bone-conduction thresholds and air-bone gap; postoperative BAHA-aided thresholds; hearing improvement as a result of implantation; implantation complications; and patient satisfaction. The most common indications for implantation included chronic otitis media or draining ears (18 patients) and external auditory canal stenosis or aural atresia (7 patients). Overall, each patient had an average improvement of 32+/-19 dB with the use of the BAHA. Closure of the air-bone gap to within 10 dB of the preoperative bone-conduction thresholds (postoperative BAHA-aided threshold vs. preoperative bone-conduction threshold) occurred in 32 patients (80%), whereas closure to within 5 dB occurred in 24 patients (60%). Twelve patients (30%) demonstrated 'overclosure' of the preoperative bone-conduction threshold of the better hearing ear. Complications were limited to local infection and inflammation at the implant site in three patients, and failure to osseointegrate in one patient. Patient response to the implant was uniformly satisfactory. Only one patient reported dissatisfaction with the device. The BAHA bone-anchored hearing aid provides a reliable and predictable adjunct for auditory rehabilitation in appropriately selected patients, offering a means of dramatically improving hearing thresholds in patients with
Efeito da estimulação acústica nas habilidades do processamento temporal em idosos antes e após a protetização auditiva Acoustic stimulation effect on temporal processing skills in elderly subjects before and after hearing aid fitting
Maria Madalena Canina Pinheiro
Full Text Available O envelhecimento pode ocasionar alterações no processamento temporal, afetando a percepção da fala. OBJETIVO: Comparar as respostas auditivas do processamento temporal em idosos candidatos e novos usuários de próteses auditivas. MATERIAL E MÉTODO: Participaram do estudo 60 idosos com perda auditiva neurossensorial bilateral. Os procedimentos selecionados foram o Teste Padrão de Duração e Teste de Detecção de gaps no Ruído (GIN, no qual foram analisadas as respostas de identificação correta e o limar de acuidade temporal antes e após a adaptação das próteses auditivas. Forma de Estudo: Pesquisa clínica e experimental com amostra não probabilística por conveniência. RESULTADOS: Os idosos usuários de prótese auditiva apresentaram menor limiar de acuidade temporal, maior reconhecimento de gaps e de discriminação do padrão de duração em relação ao momento em que eram candidatos. CONCLUSÃO: Houve deterioração das habilidades do processamento temporal, independentemente do grau da perda auditiva. O efeito de estimulação acústica pelo uso de prótese auditiva melhorou as habilidades de ordenação e resolução temporal.Aging can alter temporal processing and affect speech perception. AIM: To compare temporal processing auditory processing in elderly subject to and new hearing aid users. MATERIALS AND METHODS: The study included 60 elderly patients with bilateral sensorineural hearing loss. The procedures selected were the Duration Pattern Tests (DPT and gaps in noise (GIN test were used to analyze the responses of correct identification, and the temporal acuity threshold before and after the fitting of hearing aids. Study design: clinical and experimental research with non-probability sample of convenience. RESULTS: There was no statistically significant difference between the responses from GI and GII individuals. The elderly users of hearing aids had a lower gap detection threshold, greater recognition of gaps
Humes, Larry E; Wilson, Dana L; Humes, Lauren; Barlow, Nancy N; Garner, Carolyn B; Amos, Nathan
The objective of this study was to compare the results of two measures of hearing aid satisfaction, an indirect measure (Satisfaction with Amplification in Daily Living, SADL; Cox & Alexander, 1999) and a direct measure (an expanded version of the MarkeTrak-IV survey; Kochkin, 1996), in a group of elderly hearing aid wearers. A total of 43 elderly hearing aid wearers completed both satisfaction measures (order counterbalanced across wearers) after 1 mo of wearing 2-channel wide dynamic range compression (WDRC) in-the-canal (ITC) hearing aids. A correlational research design was employed. The elderly hearing aid wearers in this study yielded results on each measure of hearing aid satisfaction that were generally consistent with those found previously in larger groups of similar samples. The correlation between each measure of satisfaction (r = 0.75) was positive, moderately strong, and significant (p < 0.01) for the global scores of the SADL and MarkeTrak-IV scales. Although different approaches to the measurement of satisfaction were followed in the development of the SADL (indirect approach) and the MarkeTrak-IV (direct measurement) scales, similar results were obtained with each scale. The 15-item SADL instrument, however, is much shorter than the MarkeTrak-IV instrument and, as a result, is more efficient to administer clinically.
Kokx-Ryan, Melissa; Cohen, Julie; Cord, Mary T; Walden, Therese C; Makashay, Matthew J; Sheffield, Benjamin M; Brungart, Douglas S
Frequency-lowering (FL) algorithms are an alternative method of providing access to high-frequency speech cues. There is currently a lack of independent research addressing: (1) what functional, measureable benefits FL provides; (2) which, if any, FL algorithm provides the maximum benefit, (3) how to clinically program algorithms, and (4) how to verify algorithm settings. Two experiments were included in this study. The purpose of Experiment 1 was to (1) determine if a commercially available nonlinear frequency compression (NLFC) algorithm provides benefit as measured by improved speech recognition in noise when fit and verified using standard clinical procedures; and (2) evaluate the impact of acclimatization. The purpose of Experiment 2 was to (1) evaluate the benefit of using enhanced verification procedures to systematically determine the optimal application of a prototype NLFC algorithm, and (2) determine if the optimized prototype NLFC settings provide benefit as measured by improved speech recognition in quiet and in noise. A single-blind, within-participant repeated measures design in which participants served as their own controls. Experiment 1 included 26 participants with a mean age of 68.3 yr and Experiment 2 included 37 participants with a mean age of 68.8 yr. Participants were recruited from the Audiology and Speech Pathology Center at Walter Reed National Military Medical Center in Bethesda, MD. Participants in Experiment 1 wore bilateral commercially available hearing aids fit using standard clinical procedures and clinician expertise. Participants in Experiment 2 wore a single prototype hearing aid for which FL settings were systematically examined to determine the optimum application. In each experiment, FL-On versus FL-Off settings were examined in a variety of listening situations to determine benefit and possible implications. In Experiment 1, speech recognition measures using the QuickSIN and Modified Rhyme Test stimuli were obtained at
Davidson, Lisa S; Skinner, Margaret W
This study examined the relation of audibility for frequency-specific sounds and the Speech Intelligibility Index (SII) to speech perception abilities of children with sensorineural hearing loss using digital signal-processing hearing aids with wide dynamic range compression. Twenty-six children age 5-15 years with pure-tone averages (0.5, 1.0, and 2.0 kHz) from 60-98 dB HL participated. Three subgroups were created based on the compression characteristics of each hearing aid. Minimum audibility was determined using aided thresholds for frequency-modulated tones and the SII calculated at 55 and 70 dB SPL using the simulated real-ear output of the hearing aid. The Lexical Neighborhood Test (LNT; K. I. Kirk, D. B. Pisoni, & M. J. Osberger, 1995) was presented at 50 and 70 dB SPL. LNT scores at 70 dB SPL were significantly higher than at 50 dB SPL. Average aided thresholds at 0.5, 1.0, and 2.0 kHz were negatively correlated with LNT scores at 50 dB SPL, and SIIs at 55 and 70 dB SPL were positively correlated with LNT scores at 50 and 70 dB SPL. Results support using aided thresholds and speech test scores at soft to loud levels as part of the amplification fitting process.
Vo, Quang Thanh; Pham, Dung; Choi, Kevin J; Nguyen, Uyen T T; Le, Lan; Shanewise, Trudy; Tran, Lien; Nguyen, Nga; Lee, Walter T
Hearing loss is a barrier to speech and social and cognitive development. This can be especially pronounced in children living in low- and middle-income countries with limited resources. To determine the feasibility, durability and social impact of ComCare GLW solar-powered hearing aids provided for Vietnamese children with hearing impairment. A retrospective review of data from an international, multi-discipline humanitarian visit was performed. Hearing aids were given to 28 children enrolled at the Khoai Chau Functional Rehabilitation School, Hung Yen Province, Vietnam. Device inspection and observational assessments were performed by teachers using a modified Parents' Evaluation of Aural/Oral Performance of Children and an Infant Hearing Program Amplification Benefit Questionnaire. Qualitative interviews were undertaken to assess the study aims. Hearing aids were well tolerated for use during regular school hours. All units remained functional during the study period (12 months). Teachers noted increased student awareness and responsiveness to surrounding sounds, but the degree of response to amplification varied between children. There was no significant improvement in speech development as all subjects had prelingual deafness. Teachers felt confident in troubleshooting any potential device malfunction. A solar-powered hearing aid may be a viable option for children in low- and middle-income countries. This study demonstrates that device distribution, maintenance and function can be established in countries with limited resources, while providing feasibility data to support future studies investigating how similar devices may improve the quality of life of those with hearing loss.
Walker, Elizabeth A.; Spratford, Meredith; Moeller, Mary Pat; Oleson, Jacob; Ou, Hua; Roush, Patricia; Jacobs, Shana
Purpose: This study investigated predictors of hearing aid (HA) use time for children with mild-to-severe hearing loss (HL). Barriers to consistent HA use and reliability of parent report measures were also examined. Method: Participants included parents of 272 children with HL. Parents estimated the amount of time the child used HAs daily.…
Walker, Elizabeth A.; Holte, Lenore; McCreery, Ryan W.; Spratford, Meredith; Page, Thomas; Moeller, Mary Pat
Purpose: This study examined the effects of consistent hearing aid (HA) use on outcomes in children with mild hearing loss (HL). Method: Five- or 7-year-old children with mild HL were separated into 3 groups on the basis of patterns of daily HA use. Using analyses of variance, we compared outcomes between groups on speech and language tests and a…
Kuk, Francis; Lau, Chi-Chuen; Korhonen, Petri; Crose, Bryan
Although the benefits of hearing aids are generally recognized for soft- and conversational-level sounds, most studies have reported negative benefits (i.e., poorer aided than unaided performance) at high noise inputs. Advances in digital signal processing such as compression, noise reduction, and directional microphone could improve speech perception at high input levels. This could alter our view on the efficacy of hearing aids in loud, noisy situations. The current study compared the aided versus the unaided speech intelligibility performance of hearing-impaired (HI) listeners at various input levels (from 50-100 dB SPL) and signal-to-noise ratios (SNRs; quiet, +6, +3, and -3 dB) in order to document the benefits of modern hearing aids. In addition, subjective preference between aided and unaided sounds (speech and music) at various input levels was also compared. The experiment used a factorial repeated-measures design. A total of 10 HI adults with symmetrical moderate to severe hearing losses served as test participants. In addition, speech intelligibility scores of five normal-hearing (NH) listeners were also measured for comparison. Speech perception was studied at 50 and 65 dB SPL input levels in quiet and also in noise at levels of 65, 85, and 100 dB SPL with SNRs of +6, +3, and -3 dB. This was done for all participants (HI and NH). In addition, the HI participants compared subjective preference between the aided and unaided presentations of speech and music stimuli at 50, 65, 85, and 100 dB SPL in quiet. The data were analyzed with repeated-measures analysis of variance. The results showed a decrease in aided benefits as input levels increased. However, even at the two highest input levels (i.e., 85 and 100 dB SPL), aided speech scores were still higher than the unaided speech scores. Furthermore, NH listeners and HI listeners in the aided condition showed stable speech-in-noise performance between 65 and 100 dB SPL input levels, except that the absolute
Timmer, Barbra H B; Hickson, Louise; Launer, Stefan
Previous research, mostly reliant on self-reports, has indicated that hearing aid (HA) use is related to the degree of hearing impairment (HI). No large-scale investigation of the relationship between data-logged HA use and HI has been conducted to date. This study aimed to investigate if objective measures of overall daily HA use and HA use in various listening environments are different for adults with mild HI compared to adults with moderate HI. This retrospective study used data extracted from a database of fitting appointments from an international group of HA providers. Only data from the participants' most recent fitting appointment were included in the final dataset. A total of 8,489 bilateral HA fittings of adults over the age of 18 yr, conducted between January 2013 and June 2014, were included. Participants were subsequently allocated to HI groups, based on British Society of Audiology and American Speech-Language-Hearing Association audiometric descriptors. Fitting data from participating HA providers were regularly transferred to a central server. The data, with all personal information except age and gender removed, contained participants' four-frequency average (at 500, 1000, 2000, and 4000 Hz) as well as information on HA characteristics and usage. Following data cleaning, bivariate and post hoc statistical analyses were conducted. The total sample of adults' average daily HA use was 8.52 hr (interquartile range [IQR] = 5.49-11.77) in the left ear and 8.51 hr (IQR = 5.49-11.72) in the right ear. With a few exceptions, there were no statistical differences between hours of HA use for participants with mild HI compared to those with moderate impairment. Across all mild and moderate HI groups, the most common overall HA usage was between 8 and 12 hr per day. Other factors such as age, gender, and HA style also showed no relationship to hours of use. HAs were used, on average, for 7 hr (IQR = 4.27-9.96) per day in quiet and 1 hr (IQR = 0.33-1.41) per
Snik, Ad; Leijendeckers, Joop; Hol, Myrthe; Mylanus, Emmanuel; Cremers, Cor
In 1984 the Bone-Anchored Hearing Aid, or BAHA, system was introduced. Its transducer is coupled directly to the skull percutaneously to form a highly effective bone-conduction hearing device. Clinical studies on adults with conductive hearing loss have shown that the BAHA system outperforms conventional bone-conduction hearing aids. Therefore, the next step was to apply the BAHA system in children with congenital or acquired conductive hearing loss. Reviewed data showed that, on average, such children benefited significantly more from the BAHA than from reconstructive surgery. Thus, BAHA application appears to be the best option to achieve normal communication and speech and language development in children with bilateral conductive hearing loss. However, in children under the age of three to four years, a conventional solution must be applied, e.g. a bone conductor with a transcutaneous coupling, because they are too young to undergo BAHA implant surgery. In the case of unilateral congenital conductive hearing loss, there is no convincing evidence in the clinical literature for early intervention. In summary, the BAHA system can be considered a new, indispensable tool for children with bilateral conductive hearing loss.
Kollmeier, Birger; Kiessling, Jürgen
A review about technical and perceptual factors in hearing aid technology, research and development is provided, covering current commercial solutions, underlying models of hearing loss for usage in hearing devices and emerging future technical solutions for hearing aid functionalities. A chain of techniques has provided incremental, but steady increases in user benefit, e.g. in the fields of hearing aid amplification, feedback suppression, dynamic compression, noise reduction and situation adaptation. The models describing the perceptual consequences of sensorineural hearing impairment describe the effects on the acoustical level, the neurosensory level and the cognitive level and provide the framework for compensatory (or even substitutional) functions of hearing aids in terms of the attenuation component, the distortion component and the neural component of the hearing loss. A major factor is the requirement of a strong individualisation of hearing aid solutions calling for an appropriate assessment of the different sensorineural components of a hearing loss, especially with respect to bilateral and binaural hearing aid solutions.
Souza, P E; Kitch, V J
This study compared preferred volume setting for linear peak clipping, compression limiting, and wide dynamic range compression (WDRC) amplification and quantified speech audibility at the preferred volume setting for each amplification type. Ten listeners with mild-to-moderate hearing loss were fitted monaurally with a behind-the-ear hearing aid programmed sequentially with WDRC, compression limiting, and linear peak clipping amplification. Speech was presented in quiet and in noise at a range of input levels. In each condition, the listener adjusted the volume for maximum clarity. Signal levels were measured using a probe microphone system. There was no significant difference in speech audibility between amplification strategies for any speech level regardless of the presence or absence of background noise. These results imply that the improved audibility advantage of WDRC over linear amplification demonstrated in controlled environments may not be maintained in situations where the hearing aid wearer controls the volume.
Davies-Venn, Evelyn; Souza, Pamela; Fabry, David
This study evaluated quality ratings for speech and music stimuli processed using peak clipping (PC), compression limiting (CL), and wide-dynamic range compression (WDRC) hearing aid circuitry. Eighteen listeners with mild-to-moderate hearing loss were binaurally fitted with behind-the-ear (BTE) hearing aids and instructed to rate the quality of speech under various conditions in quiet and noise and two genres of music. Results for speech revealed a slight preference for WDRC at 80 dB SPL, and equivalent ratings for the three circuits under all other listening conditions. Music ratings revealed a marginally significant preference for WDRC and a preference for classical over popular music. For music, judgments on pleasantness were the most influential on overall circuit preference.
Full Text Available Abstract Background The burden of disease of hearing disorders among adults is high, but a significant part goes undetected. Screening programs in combination with the delivery of hearing aids can alleviate this situation, but the economic attractiveness of such programs is unknown. This study aims to evaluate the population-level costs, effects and cost-effectiveness of alternative delivering hearing aids models in Tamil Nadu, India Methods In an observational study design, we estimated total costs and effects of two active screening programs in the community in combination with the provision of hearing aids at secondary care level, and the costs and effects of the provision of hearing aids at tertiary care level. Screening and hearing aid delivery costs were estimated on the basis of program records and an empirical assessment of health personnel time input. Household costs for seeking and undergoing hearing health care were collected with a questionnaire (see Additional file 2. Health effects were estimated on the basis of compliance with the hearing aid, and associated changes in disability, and were expressed in disability-adjusted life years (DALYs averted. Results Active screening and provision of hearing aids at the secondary care level costs around Rs.7,000 (US$152 per patient, whereas provision of hearing aids at the tertiary care level costs Rs 5,693 (US$122 per patient. The cost per DALY averted was around RS 42,200 (US$900 at secondary care level and Rs 33,900 (US$720 at tertiary care level. The majority of people did consult other providers before being screened in the community. Costs of food and transport ranged between Rs. 2 (US$0,04 and Rs. 39 (US$0,83. Conclusion Active screening and provision of hearing aids at the secondary care level is slightly more costly than passive screening and fitting of hearing aids at the tertiary care level, but seems also able to reach a higher coverage of hearing aids services. Although crude
Samtani, Kartik; Thomas, Jobin; Varma, G Abhinav; Sumam, David S; Deepu, S P
Beamforming is a spatial filtering technique used in hearing aids to improve target sound reception by reducing interference from other directions. In this paper we propose improvements in an existing architecture present for two omnidirectional microphone array based adaptive beamforming for hearing aid applications and implement the same on Xilinx Artix 7 FPGA using VHDL coding and Xilinx Vivado® 2015.2. The nulls are introduced in particular directions by combination of two fixed polar patterns. This combination can be adaptively controlled to steer the null in the direction of noise. The beamform patterns and improvements in SNR values obtained from experiments in a conference room environment are analyzed.
Hearing aids improved significantly after the integration of advanced digital signal processing applications. This improvement will continue and evolve through obtaining intelligent, individualized hearing aids integrating top-down (knowledge-based) and bottom-up (signal-based) approaches by making....... Initially, a novel method for automatic speech recognition using binary features from binary masks, is discussed. The performance of binary features in terms of robustness to noise is compared with the ASR state of the art features, mel frequency cepstral coefficients. Secondly, human top-down auditory...
Siau, Richard T K; Dhillon, Baljeet; Siau, Derrick; Green, Kevin M J
This study aimed to report the bone-anchored hearing aid uptake rate and the reasons for their rejection by patients with conductive and mixed hearing losses. A retrospective review was performed of 113 consecutive patients with unilateral or bilateral conductive or mixed hearing loss referred to the Greater Manchester bone-anchored hearing aid (BAHA) programme between September 2008 and August 2011. 98 (86.7 %) patients were deemed audiologically suitable for BAHA implantation. Of these, 38 (38.8 %) had BAHA implanted; 60 (61.2 %) patients declined. Of those who declined, 27 (45 %) cited anxiety over surgery, 18 (30 %) cited cosmetic reasons, 16 (26.7 %) perceived limited benefit from the device and six (10 %) preferred conventional hearing aids. Our study highlights a 38.8 % BAHA uptake rate in audiologically suitable patients. The main reasons cited for rejection of BAHA were anxiety over surgery and cosmetic concerns. It is important that clinicians address these early during consultation with prospective BAHA recipients and avoid rushing to implant these patients with a bone-anchored hearing aid.
Guerra-Zúñiga, María; Cardemil-Morales, Felipe; Albertz-Arévalo, Nicolás; Rahal-Espejo, Maritza
Hearing loss is a condition that affects communication and social insertion, increasing in frequency with increasing age. Explicit Health Guarantees (GES) have placed hearing loss in adults over 65 years old as a health priority in Chile, guaranteeing access to hearing aids to those who need it. However, it has been seen that adherence to their use is hampered by several factors. This was a qualitative study to find items related to the adherence to use of hearing aids. We performed individual and focus group interviews in the Department of Otolaryngology at a hospital in Santiago (Chile) from June to September 2012. Using hearing aids was positive for patients, perceiving an improvement in their relationship with the environment. The severity of hearing loss and the patient's own social life was relevant. For otolaryngologists and audiologists the study highlights the low patient perception of the need for hearing help. Discordance between expectations and the reality of patient adaptation is generated. Another relevant factor identified was the lack of a rehabilitation programme. The elements that influence adherence are associated with 3 groups: patient factors, audiological factors and factors dependent on the health programme. The most important, from the perspective of patients, would be the fear of improper handling; for otolaryngologists, the socio-cultural perception of the hearing aid user as a disabled individual; for audiologists, inadequate prosthetic fitting and the lack of an appropriate rehabilitation program. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Kunst, Sylvia J W; Hol, Myrthe K S; Snik, Ad F M; Mylanus, Emmanuel A M; Cremers, Cor W R J
To evaluate whether the bone-anchored hearing aid (BAHA) can be applied successfully to patients with conductive hearing loss and moderate mental retardation. Retrospective clinical evaluation. Tertiary referral center. Twenty-two patients with congenital moderate mental retardation and conductive or mixed hearing loss were selected to receive a BAHA at the University Medical Centre Nijmegen, the Netherlands. Four of them were fitted despite a limited air-bone gap. Rehabilitative BAHA application. Implantation results, skin reactions, and audiological data were evaluated during a mean follow-up of 36 months. All the patients were still using the BAHA 7 days a week and for more than 8 hours a day after a follow-up period between 5 and 96 months. Two implants (9%) were lost due to insufficient integration but were reimplanted successfully. With the BAHA, mean free-field thresholds showed a clear mean improvement of 9 dB compared with the previous hearing aid. Considerable improvements in daily activities were seen in at least five patients. Moderate mental retardation should no longer be considered as a contraindication for BAHA application. Although implant loss was low, extra attention may be required from the personal care providers to maintain the percutaneous implant. The BAHA was well-accepted by the patients with moderate mental retardation and was being used for most of the day. Implementation of the BAHA as hearing aid treatment in patients with moderate mental retardation proved to be sufficiently effective and may have strongly positive effects on activities at school or at work.
Peltier, Elisabeth; Peltier, Cedric; Tahar, Stephanie; Alliot-Lugaz, Evelyne; Cazals, Yves
Over the last three years of hearing aid dispensing, it was observed that among 74 subjects fitted with a linear octave frequency transposition (LOFT) hearing aid, 60 reported partial or complete tinnitus suppression during day and night, an effect still lasting after several months or years of daily use. We report in more details on 38 subjects from whom we obtained quantified measures of tinnitus suppression through visual analog scaling and several additional psychoacoustic and audiometric measures. The long-term suppression seems independent of subject age, and of duration and subjective localization of tinnitus. A small but significant correlation was found with audiogram losses but not with high frequency loss slope. Long-term tinnitus suppression was observed for different etiologies, but with a low success rate for sudden deafness. It should be noted that a majority of subjects (23) had a history of noise exposure. Tinnitus suppression started after a few days of LOFT hearing aid use and reached a maximum after a few weeks of daily use. For nine subjects different amounts of frequency shifting were tried and found more or less successful for long-term tinnitus suppression, no correlation was found with tinnitus pitch. When the use of the LOFT hearing aid was stopped tinnitus reappeared within a day, and after re-using the LOFT aid it disappeared again within a day. For about one third of the 38 subjects a classical amplification or a non linear frequency compression aid was also tried, and no such tinnitus suppression was observed. Besides improvements in audiometric sensitivity to high frequencies and in speech discrimination scores, LOFT can be considered as a remarkable opportunity to suppress tinnitus over a long time scale. From a pathophysiological viewpoint these observations seem to fit with a possible re-attribution of activity to previously deprived cerebral areas corresponding to high frequency coding.
Full Text Available Over the last three years of hearing aid dispensing, it was observed that among 74 subjects fitted with a linear octave frequency transposition (LOFT hearing aid, 60 reported partial or complete tinnitus suppression during day and night, an effect still lasting after several months or years of daily use. We report in more details on 38 subjects from whom we obtained quantified measures of tinnitus suppression through visual analog scaling and several additional psychoacoustic and audiometric measures. The long-term suppression seems independent of subject age, and of duration and subjective localization of tinnitus. A small but significant correlation was found with audiogram losses but not with high frequency loss slope. Long-term tinnitus suppression was observed for different etiologies, but with a low success rate for sudden deafness. It should be noted that a majority of subjects (23 had a history of noise exposure. Tinnitus suppression started after a few days of LOFT hearing aid use and reached a maximum after a few weeks of daily use. For nine subjects different amounts of frequency shifting were tried and found more or less successful for long-term tinnitus suppression, no correlation was found with tinnitus pitch. When the use of the LOFT hearing aid was stopped tinnitus reappeared within a day, and after re-using the LOFT aid it disappeared again within a day. For about one third of the 38 subjects a classical amplification or a non linear frequency compression aid was also tried, and no such tinnitus suppression was observed. Besides improvements in audiometric sensitivity to high frequencies and in speech discrimination scores, LOFT can be considered as a remarkable opportunity to suppress tinnitus over a long time scale. From a pathophysiological viewpoint these observations seem to fit with a possible re-attribution of activity to previously deprived cerebral areas corresponding to high frequency coding.
Walden, B E; Kasten, R N
Aided speech reception thresholds were obtained from 20 hearing-impaired listeners with three hearing aids adjusted to confort settings, and with the aids adjusted to deliver 40 dB of acoustic gain. The aided speech reception threshold under each condition was substracted from the unaided speech reception threshold to yield a measure of threshold improvement. Threshold improvement and acoustic gain comparisons revealed that, at comfort setting, these two measures were quite similar. However, at the 40-dB gain setting, acoustic gain exceeded threshold improvement by an average of 5.6 dB. For the high-gain condition, it appeared that the threshold improvement obtained by subjects with relatively good unaided sensitivity was limited by the ambient noise in the test chamber.
Bergen, Bruce R.
An investigation was conducted to observe the effects of hearing aids on the ability of 20 blind veterans to localize white noise. In all cases, Ss performed more poorly on a localization task while wearing a hearing aid. (Author)
Wolf, M.J.F. de; Shival, M.L.; Hol, M.K.S.; Mylanus, E.A.M.; Cremers, C.W.R.J.; Snik, A.F.M.
OBJECTIVE: Benefit and quality-of-life analysis in the older adult bone-anchored hearing aid (BAHA) users. STUDY DESIGN: Retrospective evaluation. METHODS: Four questionnaires (Glasgow Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit [APHAB], Nijmegen Cochlear Implant Questionnaire
Giroud, Nathalie; Lemke, Ulrike; Reich, Philip; Matthes, Katarina L; Meyer, Martin
The present study investigates behavioral and electrophysiological auditory and cognitive-related plasticity in three groups of healthy older adults (60-77 years). Group 1 was moderately hearing-impaired, experienced hearing aid users, and fitted with new hearing aids using non-linear frequency compression (NLFC on); Group 2, also moderately hearing-impaired, used the same type of hearing aids but NLFC was switched off during the entire period of study duration (NLFC off); Group 3 represented individuals with age-appropriate hearing (NHO) as controls, who were not different in IQ, gender, or age from Group 1 and 2. At five measurement time points (M1-M5) across three months, a series of active oddball tasks were administered while EEG was recorded. The stimuli comprised syllables consisting of naturally high-pitched fricatives (/sh/, /s/, and /f/), which are hard to distinguish for individuals with presbycusis. By applying a data-driven microstate approach to obtain global field power (GFP) as a measure of processing effort, the modulations of perceptual (P50, N1, P2) and cognitive-related (N2b, P3b) auditory evoked potentials were calculated and subsequently related to behavioral changes (accuracy and reaction time) across time. All groups improved their performance across time, but NHO showed consistently higher accuracy and faster reaction times than the hearing-impaired groups, especially under difficult conditions. Electrophysiological results complemented this finding by demonstrating longer latencies in the P50 and the N1 peak in hearing aid users. Furthermore, the GFP of cognitive-related evoked potentials decreased from M1 to M2 in the NHO group, while a comparable decrease in the hearing-impaired group was only evident at M5. After twelve weeks of hearing aid use of eight hours each day, we found a significantly lower GFP in the P3b of the group with NLFC on as compared to the group with NLFC off. These findings suggest higher processing effort, as
Shanks, Janet E; Wilson, Richard H; Larson, Vern; Williams, David
This study compared speech recognition performance on the Northwestern University Auditory Test No. 6 (NU-6) and the Connected Speech Test (CST) for three hearing aid circuits (peak clipping [PC], compression limiting [CL], and wide dynamic range compression [WDRC]) in adults with symmetrical sensorineural hearing loss. The study also questioned whether or not hearing aid benefit for the three circuits was dependent upon the speech level and the signal-to-babble ratio (S/B) and upon the degree and slope of hearing loss. Unaided speech recognition performance for NU-6 and CST materials presented from a loudspeaker at 0 degrees was measured during Visit 1, and both unaided and aided performance was measured at 3-mo intervals during Visits 2 to 4. The NU-6 was presented in quiet at a conversational speech level of 62 dB SPL. The CST was presented in 10 listening conditions-three S/B (-3, 0, and 3 dB) at each of three speech levels (soft speech at 52 dB SPL, conversational speech at 62 dB SPL, and loud speech at 74 dB SPL) and in quiet at 74 dB SPL. Uncorrelated multi-talker babble was presented from two loudspeakers at 45 degrees on each side of the main speaker. Hearing aid benefit was examined for 360 subjects divided into four groups of hearing loss, pure tone average 10 dB/octave and hearing loss >40 dB HL for the two slope categories. Hearing aid benefit (aided minus unaided performance) measured on the NU-6 in quiet exceeded 31 rau for all three circuits. Although small statistical advantages were found for the WDRC, the differences were approximately 2% and are not considered clinically relevant. Unaided CST performance showed a complex relationship between presentation level and signal-to-babble ratio that was further confounded by the degree of hearing loss. For the two mild hearing loss groups and for each of the three nominal signal-to-babble ratios, CST performance decreased by 20 rau for the -3 dB S/B to 6 rau for the 3 dB S/B as speech level increased
Neher, Tobias; Wagener, Kirsten C; Fischer, Rosa-Linde
Research findings concerning the relation between benefit from hearing aid (HA) noise suppression and working memory function are inconsistent. The current study thus investigated the effects of three noise suppression algorithms on auditory working memory and the relation with reading span. Using a computer simulation of bilaterally fitted HAs, four settings were tested: (1) unprocessed, (2) directional microphones, (3) single-channel noise reduction, and (4) binaural coherence-based noise reduction. Settings 2-4 were matched in terms of the speech-weighted signal-to-noise ratio (SNR) improvement. Auditory working memory was assessed at +6 dB SNR using listening span and N-back paradigms. Twenty experienced HA users aged 55-80 years with large differences in reading span. For the listening span measurements, there was an influence of HA setting on sentence-final word recognition and recall, with the directional microphones leading to ∼6% better performance than the single-channel noise reduction. For the N-back measurements, there was substantial test-retest variability and no influence of HA setting. No interactions with reading span were found. HA noise suppression may affect the recognition and recall of speech at positive SNRs, irrespective of individual reading span. Future work should improve the reliability of the auditory working memory measurements.
Jelmer van Schoonhoven
Full Text Available The aim of this study was to investigate the effect of bilateral hearing aids (HA in subjects with mild and moderate-to-severe hearing loss. This study was designed as a within-subject feasibility study. Bilateral HA use was assessed using different laboratory tests on speech reception, listening effort, noise tolerance, and localization. All data were evaluated with bilateral and unilateral HA fittings. Forty experienced bilateral HA users were included with hearing impairment ranging from mild to moderate-to-severe. Subjects were stratified into two groups based on the degree of hearing loss. Speech reception in noise, listening effort, and localization tests showed a bilateral benefit for the moderate-to-severely hearing-impaired subjects. A bilateral benefit was also observed for listening effort in the mildly hearing-impaired group. The assessment of listening effort shows promise as a measure of bilateral HA benefit for mild hearing impairment. Localization and speech reception in noise tests provide additional value for larger losses. The next step is to compare experienced unilateral with bilateral HA users.
van Schoonhoven, Jelmer; Schulte, Michael; Boymans, Monique; Wagener, Kirsten C; Dreschler, Wouter A; Kollmeier, Birger
The aim of this study was to investigate the effect of bilateral hearing aids (HA) in subjects with mild and moderate-to-severe hearing loss. This study was designed as a within-subject feasibility study. Bilateral HA use was assessed using different laboratory tests on speech reception, listening effort, noise tolerance, and localization. All data were evaluated with bilateral and unilateral HA fittings. Forty experienced bilateral HA users were included with hearing impairment ranging from mild to moderate-to-severe. Subjects were stratified into two groups based on the degree of hearing loss. Speech reception in noise, listening effort, and localization tests showed a bilateral benefit for the moderate-to-severely hearing-impaired subjects. A bilateral benefit was also observed for listening effort in the mildly hearing-impaired group. The assessment of listening effort shows promise as a measure of bilateral HA benefit for mild hearing impairment. Localization and speech reception in noise tests provide additional value for larger losses. The next step is to compare experienced unilateral with bilateral HA users. © The Author(s) 2016.
Jürgens, Tim; Clark, Nicholas R; Lecluyse, Wendy; Meddis, Ray
To use a computer model of impaired hearing to explore the effects of a physiologically-inspired hearing-aid algorithm on a range of psychoacoustic measures. A computer model of a hypothetical impaired listener's hearing was constructed by adjusting parameters of a computer model of normal hearing. Absolute thresholds, estimates of compression, and frequency selectivity (summarized to a hearing profile) were assessed using this model with and without pre-processing the stimuli by a hearing-aid algorithm. The influence of different settings of the algorithm on the impaired profile was investigated. To validate the model predictions, the effect of the algorithm on hearing profiles of human impaired listeners was measured. A computer model simulating impaired hearing (total absence of basilar membrane compression) was used, and three hearing-impaired listeners participated. The hearing profiles of the model and the listeners showed substantial changes when the test stimuli were pre-processed by the hearing-aid algorithm. These changes consisted of lower absolute thresholds, steeper temporal masking curves, and sharper psychophysical tuning curves. The hearing-aid algorithm affected the impaired hearing profile of the model to approximate a normal hearing profile. Qualitatively similar results were found with the impaired listeners' hearing profiles.
Walden, B E; Surr, R K; Cord, M T; Edwards, B; Olson, L
The performance of 40 hearing-impaired adults with the GN ReSound digital BZ5 hearing instrument was compared with performance with linear hearing aids with input compression limiting (AGC-I) or two-channel analog wide dynamic range compression (WDRC) instruments. The BZ5 was evaluated with an omnidirectional microphone, dual-microphone directionality, and a noise reduction circuit in combination with dual-microphone directionality. Participants were experienced hearing aid users who were wearing linear AGC-I or analog WDRC instruments at the time of enrolment. Performance was assessed using the Connected Speech Test (CST) presented at several presentation levels and under various conditions of signal degradation and by the Profile of Hearing Aid Benefit (PHAB). Subjective ratings of speech understanding, listening comfort, and sound quality/naturalness were also obtained using 11-point interval scales. Small performance advantages were observed for WDRC over linear AGC-I, although WDRC did not have to be implemented digitally for these performance advantages to be realized. Substantial performance advantages for the dual microphones over the omnidirectional microphone were observed in the CST results in noise, but participants generally did not perceive these large advantages in everyday listening. The noise reduction circuit provided improved listening comfort but little change in speech understanding.
Barker, C; Dillon, H
Compression in hearing aids can be applied with low compression ratios over a wide range of input levels, but reverts to linear amplification below the compression threshold (CT). In this study, we aimed to determine which of two CTs was preferred by subjects as they used their hearing aids in their own environments, and whether they would prefer to have no low ratio compression at all. Subjects were fitted with a multimemory hearing aid incorporating input controlled compression with a 2:1 compression ratio and output controlled compression limiting. The two memories contained identical programs except that they differed in CT. Sixteen mild to moderately sensorineurally hearing-impaired subjects compared low (approximately 40 dB SPL) and moderate (approximately 65 dB SPL) CTs over 2 mo of field trials using hand held remote controls to switch between the alternatives. In a third month's trial, the preferred option (which also included output controlled compression limiting) was compared with compression limiting alone. The higher CT was preferred by 14 of the subjects. The combination of input compression and output compression limiting was preferred to compression limiting alone by 14 of the subjects. Several real world advantages of frequency independent 2:1 compression with a CT of about 65 dB SPL were demonstrated over linear amplification. Extending the compression to much lower input levels appears to carry more disadvantages than advantages, at least for clients with mild and moderate hearing losses, when fitted with single-channel compression aids with a 2:1 compression ratio.
Neher, Tobias; Wagener, Kirsten C.; Fischer, Rosa-Linde
OBJECTIVE: Research findings concerning the relation between benefit from hearing aid (HA) noise suppression and working memory function are inconsistent. The current study thus investigated the effects of three noise suppression algorithms on auditory working memory and the relation with reading...
Ricketts, Todd A.; Picou, Erin M.; Galster, Jason
Purpose: The hearing aid microphone setting (omnidirectional or directional) can be selected manually or automatically. This study examined the percentage of time the microphone setting selected using each method was judged to provide the best signalto-noise ratio (SNR) for the talkers of interest in school environments. Method: A total of 26…
May, Tobias; Kowalewski, Borys; Fereczkowski, Michal
An accurate estimation of the broadband input signal-to-noise ratio (SNR) is a prerequisite for many hearing-aid algorithms. An extensive comparison of three SNR estimation algorithms was performed. Moreover, the influence of the duration of the analysis window on the SNR estimation performance...
Several in-the-ear (ITE) and behind-the-ear (BTE) hearing aids were tested for audible interference at various distances from five types of digital wireless telephones. The interference which takes the form of a buzzing and a static sound was quantified using a calibrated system including a frequency analyzer and a pressure field microphone. The output of the each hearing aid was coupled to the microphone via Tygon tubing and a standard 2 cc coupler. The highest interference-induced sound pressure level (SPL), 122.5 dB, was measured from a BTE hearing aid placed within 2 cm of a transmitting Global System for Mobile Communications (GSM) phone. In this case, interference was detected up to a separation distance of almost 3 m. While all phones tested produced a similar interference level within 2 cm of this hearing aid, interference SPL from the code division multiple access (CDMA)-based system decreased more rapidly with distance than the time division multiple access (TDMA)-based phones tested.
Müller, A; Hocke, T; Hoppe, U; Mir-Salim, P
Hearing loss is one of the most common disabilities in the elderly. The aim of this study was to investigate the relationship between pure-tone hearing loss and maximum monosyllabic perception and speech perception with hearing aids. The focus of the investigation was elderly patients. In this prospective study, 188 patients with sensorineural hearing loss were included. The pure-tone audiogram (4FPTA), the Freiburg speech intelligibility test with headphones and the word recognition score with hearing aids at 65 dB SPL were measured and evaluated. An increasing age was associated with higher discrepancy between the maximum speech perception and speech understanding with hearing aids. The mean difference between maximum monosyllabic perception and speech perception with hearing aids is about 20% in the elderly population. The intended goal of hearing aid prescription, the match between maximum monosyllabic perception and word recognition score with hearing aids within 5 to 10%, is not achieved in the elderly population.
Rahne, Torsten; Ehelebe, Thomas; Rasinski, Christine; Götze, Gerrit
Patients suffering from conductive or mixed hearing loss and Single-Sided Deafness may benefit from implantable hearing devices relying on bone conducted auditory stimulation. However, with only passively cooperative patients, objective methods are needed to estimate the aided and unaided pure-tone audiogram. This study focuses on the feasibility aspect of an electrophysiological determination of the hearing thresholds with bone-anchored hearing aid stimulation. Therefore, 10 normal-hearing subjects were provided with a Baha Intenso (Cochlear Ltd.) which was temporarily connected to the Baha Softband (Cochlear Ltd.). Auditory evoked potentials were measured by auditory stimulation paradigm used in clinical routine. The amplitudes, latencies, and thresholds of the resulting auditory brainstem responses (ABR) and the cortically evoked responses (CAEP) were correlated with the respective responses without the use of the Baha Intenso. The recording of ABR and CAEP by delivering the stimuli to the Baha results in response waveforms which are comparable to those evoked by earphone stimulation and appears appropriate to be measured using the Baha Intenso as stimulator. At the ABR recordings a stimulus artifact at higher stimulation levels and a constant latency shift caused by the Baha Intenso has to be considered. The CAEP recording appeared promising as a frequency specific objective method to approve the fitting of bone-anchored hearing aids. At all measurements, the ABR and CAEP thresholds seem to be consistent with the normal hearing of the investigated participants. Thus, a recording of auditory evoked potentials using a Baha is in general possible if specific limitations are considered. Copyright © 2010 Elsevier B.V. All rights reserved.
Versfeld, N.J.; Goverts, S.T.
Objective: A common method to assess the functional benefit of hearing aids is by measuring the performance-intensity curve of single words in quiet with and without hearing aids. Currently, virtually all hearing aids use signal processing, which may have a marked effect on gain as a function of
... distinction between hearing aids and personal sound amplification products (PSAPs), as well as the regulatory... protection of the public health, FDA seeks to further clarify the definitions of hearing aids and PSAPs. This... represent the Agency's current thinking on the definitions and regulatory requirements for hearing aids and...
Moore, B C; Stone, M A; Alcántara, J I
This paper describes a comparison of the electroacoustic characteristics of five hearing aids: (1) a linear BTE aid of the type dispensed under the UK National Health Service (NHS), the BE19; (2) an analogue programmable BTE aid incorporating two-channel wide dynamic range compression, the ReSound BT2; (3) and (4) two digital BTE aids incorporating multi-channel wide dynamic range compression, the Phonak Claro and the Danavox Danalogic; (5) a disposable ITE hearing aid with single-channel compression, the Songbird. Measurements of frequency response using a 2 cc coupler showed that the NHS aid had a distinct undesired peak around 1 kHz. The response rolled off at low and high frequencies, and no gain was applied above about 4000 Hz. The BT2 and Claro both showed somewhat irregular responses with effective upper frequency limits of 5000-6000 Hz. The Danalogic had a reasonably smooth response and provided gain up to 6000 Hz. The Songbird had a smooth response and provided gain up to about 7000 Hz. All aids showed reasonably low harmonic and intermodulation distortion (probably below audible levels for hearing-impaired listeners), the Phonak Claro being the best in this respect. Measures of the effective input noise were obtained using two new methods. The NHS aid had the highest (worst) effective input noise, whereas the Songbird had the lowest, especially at low frequencies. The BT2 and the two digital aids had similar noise levels on one measure, but the BT2 was superior on the other measure. The compression circuits were characterized by measuring attack and release times and by using a method described by Stone and Moore (1992). The aids varied markedly in the extent to which they compressed amplitude modulation at the rates typically occurring in speech (2-10 Hz), the Claro providing the least compression and the Danalogic and Songbird aids providing the most. Overall, the results indicate that the NHS aid performed more poorly in several respects than the other
Henning, Rebecca Warner; Bentler, Ruth
A primary purpose of fitting hearing aids is to improve the audibility of speech; however, hearing aid gain is typically measured by using standardized nonspeech signals, e.g., swept pure tones, speech-weighted broadband noise, or modulated noise. When compression hearing aids are tested with these nonspeech input signals, the measured gain can be substantially different than if a real speech input signal were used. The purpose of this study was to systematically evaluate the effects of release time, compression ratio, and number of compression channels, as well as interactions of these parameters, on the gain difference between several common nonspeech hearing aid test signals and speech. It was hypothesized that the difference in hearing aid gain between static nonspeech signals and speech would increase as release time, compression ratio, and number of channels increased. Speech and several common nonspeech hearing aid test signals, matched at overall root-mean-square levels corresponding to average (65 dB SPL) and loud (80 dB SPL) conversational speech, were input into a master hearing aid circuit, and the gain of the circuit was measured in one-third octave bands. The hearing aid was programmed as a moderate-gain (23 dB) wide dynamic range compression instrument with a compression threshold of 50 dB SPL. The release time, compression ratio, and number of compression channels of the circuit were systematically adjusted by programming software. The one-third octave band gain differences between the nonspeech signals and speech were measured for all combinations of the compression settings. Multiple regression analysis was used to evaluate the effects of each compression parameter, and interactions of the parameters, on the gain difference between each nonspeech signal and speech. One-third octave band gain differences between nonspeech and speech signals (calculated as nonspeech signal minus speech signal) ranged from -3.1 to 10.4 dB, depending on frequency
Shi, Lu-Feng; Doherty, Karen A; Zwislockit, Jozef J
The primary goal of this study was to examine the relationship between listeners' loudness growth and their satisfaction with loudness when wearing wide-dynamic-range compression (WDRC) hearing aids. An absolute-magnitude-estimate procedure was used to obtain listeners' unaided and aided loudness growth functions in response to a 500 and 2000 Hz warble tone. In general, listeners' unaided loudness growth functions were steeper than the average normal-hearing listeners' functions for both frequencies, and their aided loudness growth functions were shallower than their unaided functions. Loudness growth functions tended to be undercompressed for 500 Hz but overcompressed for 2000 Hz. The Profile of Aided Loudness (PAL) questionnaire was administered to determine listeners' loudness satisfaction in everyday listening situations. Most listeners were satisfied with their perception of soft, average, and loud environmental sounds, regardless of how well or not well their WDRC aids normalized their aided loudness growth.
Walravens, Els; Keidser, Gitte; Hickson, Louise
This study set out to obtain information on the impact of trainable hearing aids among clinicians and hearing aid users and candidates. Two online adaptive surveys were developed to evaluate provision, uptake and experience or expectation of trainable hearing aids. Responses from 259 clinicians, 81 hearing aid users and 23 candidates for hearing aids were included. Over half of the clinicians surveyed activated trainable features in hearing aids. Most of these clinicians activated trainable features for selected users and reported positive findings. Most commonly trainable features were not activated because the hearing aid controls had already been disabled for management or client preference. One-third reported that they had no access to trainable aids or they were unsure about the presence or activation of trainable features. The remaining clinicians never activated trainable features. One in five users reported having used trainable aids and 93% would train again. Over 85% of the remaining hearing-impaired adults were interested in trainable aids. Positive reports from most providers and users who had experience with the trainable feature support the provision of trainable aids to selected clients, pending more evidence-based data to support the clinical management of such devices.
House, John W; Kutz, Joe Walter; Chung, Janice; Fisher, Laurel M
Determine the benefit of the bone-anchored hearing aid (BAHA) in patients with unilateral deafness. Retrospective case series and prospective questionnaire study at a tertiary referral center. Patients with unilateral deafness of various etiologies who were implanted with a BAHA (n = 126) or not implanted with a BAHA after a translabyrinthine craniotomy (n = 126) were mailed questionnaires. A total of 139 patients (55%) responded to the questionnaires. Patients who were implanted with a BAHA received a general questionnaire concerning BAHA usage, the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Speech, Spatial, and Qualities of Hearing Questionnaire (SSQ). Patients not implanted with a BAHA received only the SSQ hearing questionnaire. Patients with unilateral deafness demonstrated a benefit with BAHA use on the APHAB. Most improvement with the BAHA was seen in the Background Noise subscale, with a 17.4% improvement. Ease of Communication and Reverberation subscales also demonstrated an 11.6% and 13.2% benefit, respectively. Patients with a BAHA demonstrated better scores in the SSQ Speech subscale when compared to unilaterally deaf patients who did not have a BAHA, although this difference was not significant. The APHAB demonstrated significant benefit with the use of a BAHA in patients with unilateral deafness. Although the SSQ speech subscale showed overall improvement in auditory disability with the use of a BAHA, this difference was not significant. However, the SSQ hearing questionnaire demonstrated specific situations were the BAHA is most useful.
Aldaz, Gabriel; Puria, Sunil; Leifer, Larry J
Previous research has shown that hearing aid wearers can successfully self-train their instruments' gain-frequency response and compression parameters in everyday situations. Combining hearing aids with a smartphone introduces additional computing power, memory, and a graphical user interface that may enable greater setting personalization. To explore the benefits of self-training with a smartphone-based hearing system, a parameter space was chosen with four possible combinations of microphone mode (omnidirectional and directional) and noise reduction state (active and off). The baseline for comparison was the "untrained system," that is, the manufacturer's algorithm for automatically selecting microphone mode and noise reduction state based on acoustic environment. The "trained system" first learned each individual's preferences, self-entered via a smartphone in real-world situations, to build a trained model. The system then predicted the optimal setting (among available choices) using an inference engine, which considered the trained model and current context (e.g., sound environment, location, and time). To develop a smartphone-based prototype hearing system that can be trained to learn preferred user settings. Determine whether user study participants showed a preference for trained over untrained system settings. An experimental within-participants study. Participants used a prototype hearing system-comprising two hearing aids, Android smartphone, and body-worn gateway device-for ∼6 weeks. Sixteen adults with mild-to-moderate sensorineural hearing loss (HL) (ten males, six females; mean age = 55.5 yr). Fifteen had ≥6 mo of experience wearing hearing aids, and 14 had previous experience using smartphones. Participants were fitted and instructed to perform daily comparisons of settings ("listening evaluations") through a smartphone-based software application called Hearing Aid Learning and Inference Controller (HALIC). In the four-week-long training phase
Keidser, Gitte; Dillon, Harvey; Dyrlund, Ole; Carter, Lyndal; Hartley, David
This study aimed to determine the low- and high-frequency compression ratios of a fast-acting device that were preferred by people with moderately severe to profound hearing loss. Three compression ratios (1:1, 1.8:1, and 3:1) were combined in the low and high frequencies to produce nine schemes that were evaluated pair-wise for three weeks in the field using an adaptive procedure. The evaluation was performed by 21 experienced hearing aid users with a moderately severe to profound hearing loss. Diaries and an exit interview were used to monitor preferences. Generally, the subjects preferred lower compression ratios than are typically prescribed, especially in the low frequencies. Specifically, 11 subjects preferred linear amplification in the low frequencies, and 14 subjects preferred more compression in the high than in the low frequencies. Preferences could not be predicted from audiometric data, onset of loss, or past experience with amplification. The data suggest that clients with moderately severe to profound hearing loss should be fitted with low-frequency compression ratios in the range 1:1 to 2:1 and that fine-tuning is essential.
Yund, E William; Roup, Christina M; Simon, Helen J; Bowman, Glen A
Acclimatization was studied in hearing-impaired patients with no previous hearing aid (HA) experience who were fit bilaterally with either wide dynamic range multichannel compression (WDRMCC) or linear amplification (LA) HAs. Throughout 40 weeks of normal HA use, we monitored changes in nonsense syllable perception in speech-spectrum noise. Syllable recognition for WDRMCC users improved by 4.6% over the first 8 weeks, but the 2.2% improvement for LA users was complete in 2 to 4 weeks. Consonant confusion analyses indicated that WDRMCC experience facilitated consonant identification, while LA users primarily changed their response biases. Furthermore, WDRMCC users showed greater improvement for aided than unaided stimuli, while LA users did not. These results demonstrate acclimatization in new users of WDRMCC HAs but not in new users of LA HAs. A switch in amplification type after 32 weeks produced minimal performance change. Thus, acclimatization depended on the type of amplification and the previous amplification experience.
Full Text Available The identification and discrimination of timbre are essential features of music perception. One dominating parameter within the multidimensional timbre space is the spectral shape of complex sounds. As hearing loss interferes with the perception and enjoyment of music, we approach the individual timbre discrimination skills in individuals with severe to profound hearing loss using a cochlear implant (CI and normal hearing individuals using a bone-anchored hearing aid (Baha. With a recent developed behavioral test relying on synthetically sounds forming a spectral continuum, the timbre difference was changed adaptively to measure the individual just noticeable difference (JND in a forced-choice paradigm. To explore the differences in timbre perception abilities caused by the hearing mode, the sound stimuli were varied in their fundamental frequency, thus generating different spectra which are not completely covered by a CI or Baha system. The resulting JNDs demonstrate differences in timbre perception between normal hearing individuals, Baha users, and CI users. Beside the physiological reasons, also technical limitations appear as the main contributing factors.
Rahne, Torsten; Böhme, Lars; Götze, Gerrit
The identification and discrimination of timbre are essential features of music perception. One dominating parameter within the multidimensional timbre space is the spectral shape of complex sounds. As hearing loss interferes with the perception and enjoyment of music, we approach the individual timbre discrimination skills in individuals with severe to profound hearing loss using a cochlear implant (CI) and normal hearing individuals using a bone-anchored hearing aid (Baha). With a recent developed behavioral test relying on synthetically sounds forming a spectral continuum, the timbre difference was changed adaptively to measure the individual just noticeable difference (JND) in a forced-choice paradigm. To explore the differences in timbre perception abilities caused by the hearing mode, the sound stimuli were varied in their fundamental frequency, thus generating different spectra which are not completely covered by a CI or Baha system. The resulting JNDs demonstrate differences in timbre perception between normal hearing individuals, Baha users, and CI users. Beside the physiological reasons, also technical limitations appear as the main contributing factors. PMID:22645422
Powell, R; Wearden, A; Pardesi, S M; Green, K
Bone-anchored hearing aids improve hearing for patients for whom conventional behind-the-ear aids are problematic. However, uptake of bone-anchored hearing aids is low and it is important to understand why this is the case. A narrative review was conducted. Studies examining why people accept or decline bone-anchored hearing aids and satisfaction levels of people with bone-anchored hearing aids were reviewed. Reasons for declining bone-anchored hearing aids included limited perceived benefits, concerns about surgery, aesthetic concerns and treatment cost. No studies providing in-depth analysis of the reasons for declining or accepting bone-anchored hearing aids were identified. Studies of patient satisfaction showed that most participants reported benefits with bone-anchored hearing aids. However, most studies used cross-sectional and/or retrospective designs and only included people with bone-anchored hearing aids. Important avenues for further research are in-depth qualitative research designed to fully understand the decision-making process for bone-anchored hearing aids and rigorous quantitative research comparing satisfaction of people who receive bone-anchored hearing aids with those who receive alternative (or no) treatments.
Carniel, Camila Zorzetto; Sousa, Juliana Cristina Ferreira de; Silva, Carla Dias da; Fortunato-Queiroz, Carla Aparecida de Urzedo; Hyppolito, Miguel Ângelo; Santos, Patricia Leila Dos
To evaluate through standardized questionnaires the quality of life of elderly people with hearing loss diagnosed with and without the use of hearing aids (HA) and elderly without hearing complaints. This is a cross-sectional study with non probabilistic sample, divided into three groups divided as follows: 30 elderly people with diagnosed hearing loss and indication for use of individual sound amplification devices (hearing aids), but have not yet made use of the prosthesis; 30 individuals with hearing impairment who used hearing aids and 30 elderly without hearing complaints. Participants completed a questionnaire investigating sociodemographic and family data, the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) and the World Health Organization Quality of Life - Short version (WHOQOL-BREF). In addition to the descriptive analysis of the data were performed tests to compare the three groups by applying analysis of variance (ANOVA) and the Bonferroni post hoc test. The three groups differed significantly in all domains of quality of life. The group of the elderly people with hearing loss diagnosed and with indication for the use of hearing aids presented lower scores and the group of the elderly with hearing disabilities that used the hearing aid and that the reference group. The AASI group presented the best quality of life results. The hearing loss affects the quality of life of the elderly. The effective use of hearing aid is beneficial to this population, improving their living and health conditions.
Gluth, Michael B; Friedman, Adva B; Atcherson, Samuel R; Dornhoffer, John L
To review the tolerance of hearing aid use after revision and obliteration of a previously unstable canal wall down mastoidectomy cavity. Retrospective case series. Academic tertiary referral center. Adults and children who underwent the described surgical procedure followed by attempted hearing aid use. Surgical revision and obliteration of a chronically unstable canal wall down mastoidectomy cavity and subsequent attempted use of a conventional, ear-level hearing aid. Stability of mastoid cavity after starting conventional hearing aid usage. From a review of 87 consecutive mastoid obliteration procedures performed on previously unstable open cavities, 20 ears in 19 subjects were identified for study inclusion. The indication for hearing aid use was mixed hearing loss in the majority of subjects (85%). Among included ears, 7 (35%) had at least one documented temporary period of hearing aid nonuse because of otorrhea; however, permanent discontinuation of hearing aid use in favor of bone-anchored hearing implant placement only occurred in 3 ears (15%). The mean follow-up from the start of hearing aid use was 49 months. Although failures do exist, attempted use of a hearing aid after revision of an unstable canal wall down mastoidectomy cavity seems feasible and generally well tolerated. However, the exact likelihood of achieving this result is yet uncertain, and hearing performance was not assessed in this study.
Full Text Available While hearing aids are recommended for people with age-related hearing loss, many with impaired hearing do not use them. In this study, we investigated how many elderly people in the study area needed hearing aids, and the factors that determined continued wearing of the devices. The study area was Kurabuchi Town, Japan, where 1,437 residents (those aged 65 years or over were eligible for participation in the study; 1,414 participated, of whom, 103 (7.3% were already using hearing aids at the start of the study. After the primary screening, hearing aids were lent to 68 participants (4.8% who did not already have one, 38 of whom (60.3% of the borrowers, representing 2.7% of the total aged population went on to wear the hearing aid continuously. The Hearing Handicap Inventory for the Elderly (HHIE score was significantly elevated among these 38 participants. This study indicated that hearing aids are of potential benefit to many local residents. Multivariate logistic regression revealed that HHIE scores were associated with the extent of HA usage. The adjusted odds ratio for a 1-unit increase in HHIE score was 1.08 (95% confidence interval: 1.02-1.14. Programs like this, in which people with impaired hearing are identified at the local level and given appropriate assistance, are useful models for future use in societies with aging populations.
Shehorn, James; Marrone, Nicole; Muller, Thomas
The purpose of this laboratory-based study was to compare the efficacy of two hearing aid fittings with and without nonlinear frequency compression, implemented within commercially available hearing aids. Previous research regarding the utility of nonlinear frequency compression has revealed conflicting results for speech recognition, marked by high individual variability. Individual differences in auditory function and cognitive abilities, specifically hearing loss slope and working memory, may contribute to aided performance. The first aim of the study was to determine the effect of nonlinear frequency compression on aided speech recognition in noise and listening effort using a dual-task test paradigm. The hypothesis, based on the Ease of Language Understanding model, was that nonlinear frequency compression would improve speech recognition in noise and decrease listening effort. The second aim of the study was to determine if listener variables of hearing loss slope, working memory capacity, and age would predict performance with nonlinear frequency compression. A total of 17 adults (age, 57-85 years) with symmetrical sensorineural hearing loss were tested in the sound field using hearing aids fit to target (NAL-NL2). Participants were recruited with a range of hearing loss severities and slopes. A within-subjects, single-blinded design was used to compare performance with and without nonlinear frequency compression. Speech recognition in noise and listening effort were measured by adapting the Revised Speech in Noise Test into a dual-task paradigm. Participants were required trial-by-trial to repeat the last word of each sentence presented in speech babble and then recall the sentence-ending words after every block of six sentences. Half of the sentences were rich in context for the recognition of the final word of each sentence, and half were neutral in context. Extrinsic factors of sentence context and nonlinear frequency compression were manipulated, and
Bentler, Ruth; Walker, Elizabeth; McCreery, Ryan; Arenas, Richard M; Roush, Patricia
The research questions of this study were: (1) Are children using nonlinear frequency compression (NLFC) in their hearing aids getting better access to the speech signal than children using conventional processing schemes? The authors hypothesized that children whose hearing aids provided wider input bandwidth would have more access to the speech signal, as measured by an adaptation of the Speech Intelligibility Index, and (2) are speech and language skills different for children who have been fit with the two different technologies; if so, in what areas? The authors hypothesized that if the children were getting increased access to the speech signal as a result of their NLFC hearing aids (question 1), it would be possible to see improved performance in areas of speech production, morphosyntax, and speech perception compared with the group with conventional processing. Participants included 66 children with hearing loss recruited as part of a larger multisite National Institutes of Health-funded study, Outcomes for Children with Hearing Loss, designed to explore the developmental outcomes of children with mild to severe hearing loss. For the larger study, data on communication, academic and psychosocial skills were gathered in an accelerated longitudinal design, with entry into the study between 6 months and 7 years of age. Subjects in this report consisted of 3-, 4-, and 5-year-old children recruited at the North Carolina test site. All had at least at least 6 months of current hearing aid usage with their NLFC or conventional amplification. Demographic characteristics were compared at the three age levels as well as audibility and speech/language outcomes; speech-perception scores were compared for the 5-year-old groups. Results indicate that the audibility provided did not differ between the technology options. As a result, there was no difference between groups on speech or language outcome measures at 4 or 5 years of age, and no impact on speech perception
Steffens, T; Marcrum, S C
For Ear, Nose & Throat specialists, the physiological and psychoacoustical deficits related to hearing impairment and the compensatory capabilities of hearing aids are topics of prime importance. In conductive hearing loss, the foremost deficit is decreased audibility, for which hearing aids can compensate almost entirely through the use of level independent gain. In the instance of sensorineural hearing loss, however, the irreversible loss of outer and inner hair cells causes a distorted sound perception, which is particularly troublesome when trying to understand speech in noisy environments. Unfortunately, this distortion cannot be compensated through the use of hearing aids. Nevertheless, in particular listening environments, its effects can be lessened by reducing background noise levels through the use of directional microphones and, to a lesser extent, digital noise reduction. Noise reduction is in many cases also the main effect to improve speech discrimination in retrocochlear hearing loss.
Heman-Ackah, Yolanda D; Sataloff, Robert T
Endolaryngeal stenting in patients with irregularly shaped larynges can be challenging. In such cases, the use of a moldable yet reasonably rigid endolaryngeal stent is desirable. The purpose of this report is to describe our experience with silicone hearing aid material as a moldable endolaryngeal stent in a patient with an atypically shaped larynx. A patient with relapsing polychondritis that resulted in complete stenosis of the subglottic airway underwent laryngotracheal reconstruction. Moldable silicone, commonly used to prepare ear canal molds for hearing aids, was molded into the neo-endolarynx to serve as a custom-made endolaryngeal stent. The patient tolerated the moldable silicone stent well and had a patent airway with epithelialization 8 months after removal. Silicone mold material is a suitable substance for endolaryngeal stenting. It conforms to the configuration of the individual's airway, is tolerated well, can be removed relatively easily, and is a useful alternative to prefabricated stents in laryngotracheal reconstruction.
Blamey, Peter J; Martin, Lois F A; Fiket, Hayley J
A new amplification strategy (ADRO), based on 64 independently operating channels, was compared with a nine-channel wide dynamic range compression strategy (WDRC). Open-platform in-the-ear hearing instruments were configured either with ADRO or the manufacturer's WDRC strategy. Twenty-two subjects with mild to moderate hearing loss took home the ADRO or WDRC hearing aids. After three weeks' acclimatization, the aids were evaluated using monosyllables in quiet at 50 to 65 dB SPL and sentences in eight-talker babble. The acclimatization and evaluation were repeated in the second phase of the balanced reverse-block blind experimental design. The ADRO program showed a statistically significant mean advantage of 7.85% word score (95% confidence interval 3.19% to 12.51%; p = 0.002) and 6.41% phoneme score for the monosyllables in quiet (95% confidence interval 2.03% to 10.79%; p = 0.006). A statistically significant advantage of 7.25% was also found for the ADRO program in background noise (95% confidence interval 1.95% to 12.55%; p = 0.010). The results are consistent with earlier data for listeners with moderate to severe hearing loss.
Souza, Pamela E; Arehart, Kathryn H; Shen, Jing; Anderson, Melinda; Kates, James M
Previous work suggested that individuals with low working memory capacity may be at a disadvantage in adverse listening environments, including situations with background noise or substantial modification of the acoustic signal. This study explored the relationship between patient factors (including working memory capacity) and intelligibility and quality of modified speech for older individuals with sensorineural hearing loss. The modification was created using a combination of hearing aid processing [wide-dynamic range compression (WDRC) and frequency compression (FC)] applied to sentences in multitalker babble. The extent of signal modification was quantified via an envelope fidelity index. We also explored the contribution of components of working memory by including measures of processing speed and executive function. We hypothesized that listeners with low working memory capacity would perform more poorly than those with high working memory capacity across all situations, and would also be differentially affected by high amounts of signal modification. Results showed a significant effect of working memory capacity for speech intelligibility, and an interaction between working memory, amount of hearing loss and signal modification. Signal modification was the major predictor of quality ratings. These data add to the literature on hearing-aid processing and working memory by suggesting that the working memory-intelligibility effects may be related to aggregate signal fidelity, rather than to the specific signal manipulation. They also suggest that for individuals with low working memory capacity, sensorineural loss may be most appropriately addressed with WDRC and/or FC parameters that maintain the fidelity of the signal envelope.
Picou, Erin M; Ricketts, Todd A
Understanding speech over the telephone when listening in noisy environments may present a significant challenge for listeners with moderate-to-severe hearing loss. The purpose of this study was to compare speech recognition and subjective ratings across several hearing aid-based telephone listening strategies for individuals with moderate-to-severe sensorineural hearing loss. Speech recognition and subjective ratings were evaluated for a simulated telephone signal. The strategies evaluated included acoustic telephone, unilateral telecoil, unilateral wireless streaming, and bilateral wireless streaming. Participants were seated in a noisy room for all evaluations. Eighteen adults, aged 49-88 yr, with moderate-to-severe sensorineural hearing loss participated. Speech recognition scores on the Connected Speech Test were converted to rationalized arcsine units and analyzed using analysis of variance testing and Tukey post hoc analyses. Subjective ratings of ease and comfort were also analyzed in this manner. Speech recognition performance was poorest with acoustic coupling to the telephone and best with bilateral wireless routing. Telecoil coupling resulted in better speech recognition performance than acoustic coupling, but was significantly poorer than bilateral wireless routing. Furthermore, unilateral wireless routing and telecoil coupling generally led to similar speech recognition performance, except in lower-level background noise conditions, for which unilateral routing resulted in better performance than the telecoil. For people with moderate-to-severe sensorineural hearing loss, acoustic telephone listening with a hearing aid may not lead to acceptable performance in noise. Although unilateral routing options (telecoil and wireless streaming) improved performance, speech recognition performance and subjective ratings of ease and comfort were best when bilateral wireless routing was used. These results suggest that wireless routing is a potentially beneficial
Freyaldenhoven, Melinda C.; Nabelek, Anna K.; Tampas, Joanna W.
Purpose: This study investigated the relationship between acceptable noise levels (ANLs) and the Abbreviated Profile of Hearing Aid Benefit (APHAB; R. M. Cox & G. C. Alexander, 1995). This study further examined the APHAB's ability to predict hearing aid use. Method: ANL and APHAB data were collected for 191 listeners with impaired hearing,…
Otavio, Andressa Colares da Costa; Coradini, Patricia Pérez; Teixeira, Adriane Ribeiro
Introduction Presbycusis is a consequence of aging. Prescription of hearing aids is part of the treatment, although the prevalence of use by elderly people is still small. Objective To verify whether or not self-assessment of hearing is a predictor for purchase of hearing aids. Methods Quantitative, cross-sectional, descriptive, and observational study. Participants were subjects who sought a private hearing center for selection of hearing aids. During the diagnostic interview, subjects answered the following question: "On a scale of 1 to 10, with 1 being the worst and 10 the best, how would you rate your overall hearing ability?" After that, subjects underwent audiometry, selected a hearing aid, performed a home trial, and decided whether or not to purchase the hearing aid. The variables were associated and analyzed statistically. Results The sample was comprised of 32 subjects, both men and women, with a higher number of women. Mean age was 71.41 ± 12.14 years. Self-assessment of hearing ranged from 2 to 9 points. Overall, 71.9% of the subjects purchased hearing aids. There was no association between scores in the self-assessment and the purchase of hearing aids (p = 0.263). Among those who scored between 2 and 5 points, 64.7% purchased the device; between 6 and 7 points, 76.09% purchased the device; and between 8 and 9 points, 50% purchased the device, respectively. Conclusion There is evidence that low self-assessment scores lead to the purchase of hearing aids, although no significant association was observed in the sample.
Otavio, Andressa Colares da Costa
Full Text Available Introduction Presbycusis is a consequence of aging. Prescription of hearing aids is part of the treatment, although the prevalence of use by elderly people is still small. Objective To verify whether or not self-assessment of hearing is a predictor for purchase of hearing aids. Methods Quantitative, cross-sectional, descriptive, and observational study. Participants were subjects who sought a private hearing center for selection of hearing aids. During the diagnostic interview, subjects answered the following question: “On a scale of 1 to 10, with 1 being the worst and 10 the best, how would you rate your overall hearing ability?” After that, subjects underwent audiometry, selected a hearing aid, performed a home trial, and decided whether or not to purchase the hearing aid. The variables were associated and analyzed statistically. Results The sample was comprised of 32 subjects, both men and women, with a higher number of women. Mean age was 71.41 ± 12.14 years. Self-assessment of hearing ranged from 2 to 9 points. Overall, 71.9% of the subjects purchased hearing aids. There was no association between scores in the self-assessment and the purchase of hearing aids (p = 0.263. Among those who scored between 2 and 5 points, 64.7% purchased the device; between 6 and 7 points, 76.09% purchased the device; and between 8 and 9 points, 50% purchased the device, respectively. Conclusion There is evidence that low self-assessment scores lead to the purchase of hearing aids, although no significant association was observed in the sample.
Xia, Yin; Zhang, Hua; Gong, Shu-sheng; Wang, Dan-ni; Zheng, Ya-li; Li, Yu-ling; Dong, Bo-ya; Han, De-min
To discuss the indications, surgery methods and effects of the BAHA implantation by analyzing the patients' medical records of bone-anchored hearing aids(BAHA). Retrospective analyzed the records of 16 patients of BAHA implantation, including nine males and seven females. Their average age was 31 years old (8-53ys). Nine of them were congenital ear malformation, two were chronic suppurative otitis media, two were otosclerosis and three were unilateral severe sensorineural deafness. We evaluated their pure tone audiometry (PTA), speech audiometry and temporal CT before the surgery, and evaluated the aided PTA in soundfield and speech audiometry in sound field. These patients received BAHA implantation and installed the speech processor their months later. The average preoperative PTA measurements (PTA at 0.5, 1, 2, 4 kHz) was (63.2 ± 19.0) dB HL and postoperative aided PTA in sound field was (35.5 ± 10.9)dB HL. The average improvement in Hearing In Noise Test (HINT) was 37.0% ± 31.7%. The average improvement in Mandarin Speech Test was 76.0% ± 19.7%. After 4-16 months' follow-up, no significant complications were recorded. BAHA is a safe and effective bone implantable hearing device.
Luque, Amneris E; Orlando, Mark S; Leong, U-Cheng; Allen, Paul D; Guido, Joseph J; Yang, Hongmei; Wu, Hulin
During the earlier years of the HIV/AIDS epidemic, initial reports described sensorineural hearing loss in up to 49% of individuals with HIV/AIDS. During those years, patients commonly progressed to advanced stages of HIV disease and frequently had neurological complications. However, the abnormalities on pure-tone audiometry and brainstem-evoked responses outlined in small studies were not always consistently correlated with advanced stages of HIV/AIDS. Moreover, these studies could not exclude the confounding effect of concurrent opportunistic infections and syphilis. Additional reports also have indicated that some antiretroviral medications may be ototoxic; thus, it has been difficult to make conclusions regarding the cause of changes in hearing function in HIV-infected patients. More recently, accelerated aging has been suggested as a potential explanation for the disproportionate increase in complications of aging described in many HIV-infected patients; hence, accelerated aging-associated hearing loss may also be playing a role in these patients. We conducted a large cross-sectional analysis of hearing function in over 300 patients with HIV-1 infection and in 137 HIV-uninfected controls. HIV-infected participants and HIV-uninfected controls underwent a 2-hr battery of hearing tests including the Hearing Handicap Inventory, standard audiometric pure-tone air and bone conduction testing, tympanometric testing, and speech reception and discrimination testing. Three-way analysis of variance (ANOVA) and logistic regression analysis of 278 eligible HIV-infected subjects stratified by disease stage in early HIV disease (n = 127) and late HIV disease (n = 148) and 120 eligible HIV-uninfected controls revealed no statistically significant differences among the three study groups in either overall 4-frequency pure-tone average (4-PTA) or hearing loss prevalence in either ear. Three-way ANOVA showed significant differences in word recognition scores in the right ear
Sweetow, Robert W; Sabes, Jennifer Henderson
The use of acoustic signals to mask, mix with, or ease the distress associated with tinnitus has been clinically employed for decades. It has been proposed that expanding acoustic options for tinnitus sufferers due to personal preferences is desirable. Fractal tones incorporate many useful characteristics of music while avoiding certain features that could be distracting to some individuals. To assess the effects on relaxation, tinnitus annoyance, tinnitus handicap, and tinnitus reaction from the use of a hearing aid that incorporates combinations of amplification, fractal tones, and white noise. Participants listened to experimental hearing aids containing several acoustic options and were asked to rate the signals in terms of their effect on relaxation and tinnitus annoyance. They subsequently wore the hearing aids for 6 mo and completed tinnitus handicap and reaction scales. Fourteen hearing-impaired adults with primary complaints of subjective tinnitus. Participants were tested wearing hearing aids containing several programs including amplification only, fractal tones only, and a combination of amplification, noise, and/or fractal tones. The fractal tones (now commercially available as the "Zen" feature) were generated by the Widex Mind hearing aid. Rating procedures were conducted in the laboratory, and tinnitus reaction and handicap were assessed during and following a 6 mo field trial. Data were collected at the initial visit, one week, 1 mo, 3 mo, and 6 mo. Nonparametric statistics included Wilcoxon matched-pairs signed-rank, chi(2), and repeated-measures analyses of variance. Thirteen of 14 participants reported that their tinnitus annoyance, as measured by the Tinnitus Annoyance Scale, was reduced for at least one of the amplified conditions (with or without fractal tones or noise), relative to the unaided condition. Nine assigned a lower tinnitus annoyance rating when listening to fractal tones alone versus the amplification-alone condition. There was a
Lavie, Limor; Banai, Karen; Karni, Avi; Attias, Joseph
Purpose: We tested whether using hearing aids can improve unaided performance in speech perception tasks in older adults with hearing impairment. Method: Unaided performance was evaluated in dichotic listening and speech-in-noise tests in 47 older adults with hearing impairment; 36 participants in 3 study groups were tested before hearing aid…
FAN, Yue; CHEN, Xiao-wei; YANG, Hua; ZHANG, Zhi-yong; ZHU, Xiao-li; CAO, Ke-li; GAO, Zhi-qiang
To evaluate the efficacy and satisfaction of bone-anchored hearing aids (BAHA) in patients with outer and middle ear deformities. Seven patients with bilateral microtia and aural atresia, and three patients with unilateral microtia and bilateral middle ear malformation were fitted with soft-band BAHA for a few months, followed by receiving unilateral BAHA implantation. Mean pure-tone thresholds and speech audiometry tests results were compared among patients without hearing aid, with soft-band BAHA, and with implanted BAHA. Scores from the BAHA users' questionnaires and Glasgow children's benefit inventory (GCBI) were used to measure patient satisfaction and subjective health benefit. The mean pure-tone thresholds of the patients were (64.8 ± 5.9) dBHL for those without hearing aid, (30.2 ± 3.7) dBHL for those with soft-band BAHA, and (20.3 ± 3.9) dBHL for those with implanted BAHA. The average decline in pure-tone threshold was (36.2 ± 8.0) dBHL for those with soft-band BAHA, and an additional decline of (12.2 ± 3.4) dBHL was achieved with implanted BAHA. The average gains in speech discrimination scores (SDS) were (3.00 ± 1.07)% for those without hearing aids and (89.39 ± 5.83)% for those with implanted BAHA in sound field of 45dBHL. SDS were (57.55 ± 10.30)% for those without hearing aids and (91.19 ± 4.16)% for those with implanted BAHA in sound field of 65dBHL. The average gains in SDS were (88.21 ± 6.86)% and (38.04 ± 7.56)% tested with 45dBHL and 65dBHL respectively. Sound reception thresholds (SRT) without hearing aids were (63.1 ± 5.9) dBHL and (24.7 ± 3.5) dBHL for those with implanted BAHA. The average gains in SRT was (39.6 ± 6.2) dBHL. The BAHA application questionnaire demonstrated excellent patient satisfaction. The general benefit score was 35.59 ± 14.35. BAHA remains one of the most reliable methods of auditory rehabilitation and improves quality of life for patients with ear deformities.
Dun, Catharina A J; Faber, Hubert T; de Wolf, Maarten J F; Cremers, Cor W R J; Hol, Myrthe K S
In the past 30 years, a large amount of clinical and audiological research on bone conduction hearing devices has been performed. In this review, we give a brief history of the developments in indications, surgical techniques and sound processors with respect to implantable bone conduction devices like the bone-anchored hearing aid or Baha. Starting with the use of Baha in patients with bilateral conductive or mixed hearing loss (HL), the indications for such devices have been extended to patients with unilateral HL, children and moderate mentally retarded patients. Bilateral fitting has been shown to be beneficial in restoring binaural hearing in patients with bilateral acquired or congenital conductive HL. In addition, the surgical techniques used to implant the titanium fixture for Baha application have been modified and further developed to reach two main goals: (a) optimal osseointegration, and (b) preparation of the implant site to minimize the occurrence of soft tissue reactions. Currently, the most used techniques are the pedicled skin flap, dermatome and linear incision techniques. Several generations of the Baha(®) sound processor have been developed by Cochlear(TM) to provide sufficient amplification in different hearing situations. Improvements in sound quality, aesthetics and handling have been major points of interest. The Baha sound processors most often used today are the Baha(®) Divino, the Baha(®) Intenso and the Baha(®) Cordelle. Recently, the more flexible Baha(®) BP100 sound processor was launched. Copyright © 2011 S. Karger AG, Basel.
Ohlenforst, Barbara; Jansma, Elise P.; Wang, Yang; Naylor, Graham; Lorens, Artur; Lunner, Thomas; Kramer, Sophia E.
Objectives: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? Design: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. Results: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low
Parazzini, Marta; Del Bo, Luca; Jastreboff, Margaret; Tognola, Gabriella; Ravazzani, Paolo
This study aimed to compare the effectiveness of tinnitus retraining therapy (TRT) with sound generators or with open ear hearing aids in the rehabilitation of tinnitus for a group of subjects who, according to Jastreboff categories, can be treated with both approaches to sound therapy (borderline of Category 1 and 2). This study was a prospective data collection with a parallel-group design which entailed that each subject was randomly assigned to one of the two treatments group: half of the subjects were fitted binaurally with sound generators, and the other half with open ear hearing aids. Both groups received the same educational counselling sessions. Ninety-one subjects passed the screening criteria and were enrolled into the study. Structured interviews, with a variety of measures evaluated through the use of visual-analog scales and the tinnitus handicap inventory self-administered questionnaire, were performed before the therapy and at 3, 6, and 12 months during the therapy. Data showed a highly significant improvement in both tinnitus treatments starting from the first three months and up to one year of therapy, with a progressive and statistically significant decrease in the disability every three months. TRT was equally effective with sound generator or open ear hearing aids: they gave basically identical, statistically indistinguishable results.
David L Woods
Full Text Available The most common complaint of older hearing impaired (OHI listeners is difficulty understanding speech in the presence of noise. However, tests of consonant-identification and sentence reception threshold (SeRT provide different perspectives on the magnitude of impairment. Here we quantified speech perception difficulties in 24 OHI listeners in unaided and aided conditions by analyzing (1 consonant-identification thresholds and consonant confusions for 20 onset and 20 coda consonants in consonant-vowel-consonant (CVC syllables presented at consonant-specific signal-to-noise (SNR levels, and (2 SeRTs obtained with the Quick Speech in Noise Test (QSIN and the Hearing in Noise Test (HINT. Compared to older normal hearing (ONH listeners, nearly all unaided OHI listeners showed abnormal consonant-identification thresholds, abnormal consonant confusions, and reduced psychometric function slopes. Average elevations in consonant-identification thresholds exceeded 35 dB, correlated strongly with impairments in mid-frequency hearing, and were greater for hard-to-identify consonants. Advanced digital hearing aids (HAs improved average consonant-identification thresholds by more than 17 dB, with significant HA benefit seen in 83% of OHI listeners. HAs partially normalized consonant-identification thresholds, reduced abnormal consonant confusions, and increased the slope of psychometric functions. Unaided OHI listeners showed much smaller elevations in SeRTs (mean 6.9 dB than in consonant-identification thresholds and SeRTs in unaided listening conditions correlated strongly (r = 0.91 with identification thresholds of easily identified consonants. HAs produced minimal SeRT benefit (2.0 dB, with only 38% of OHI listeners showing significant improvement. HA benefit on SeRTs was accurately predicted (r = 0.86 by HA benefit on easily identified consonants. Consonant-identification tests can accurately predict sentence processing deficits and HA benefit in OHI
Brennan, Marc A.; McCreery, Ryan; Kopun, Judy; Hoover, Brenda; Alexander, Joshua; Lewis, Dawna; Stelmachowicz, Patricia G.
Background Preference for speech and music processed with nonlinear frequency compression and two controls (restricted and extended bandwidth hearing-aid processing) was examined in adults and children with hearing loss. Purpose Determine if stimulus type (music, sentences), age (children, adults) and degree of hearing loss influence listener preference for nonlinear frequency compression, restricted bandwidth and extended bandwidth. Research Design Within-subject, quasi-experimental study. Using a round-robin procedure, participants listened to amplified stimuli that were 1) frequency-lowered using nonlinear frequency compression, 2) low-pass filtered at 5 kHz to simulate the restricted bandwidth of conventional hearing aid processing, or 3) low-pass filtered at 11 kHz to simulate extended bandwidth amplification. The examiner and participants were blinded to the type of processing. Using a two-alternative forced-choice task, participants selected the preferred music or sentence passage. Study Sample Sixteen children (8–16 years) and 16 adults (19–65 years) with mild-to-severe sensorineural hearing loss. Intervention All subjects listened to speech and music processed using a hearing-aid simulator fit to the Desired Sensation Level algorithm v.5.0a (Scollie et al, 2005). Results Children and adults did not differ in their preferences. For speech, participants preferred extended bandwidth to both nonlinear frequency compression and restricted bandwidth. Participants also preferred nonlinear frequency compression to restricted bandwidth. Preference was not related to degree of hearing loss. For music, listeners did not show a preference. However, participants with greater hearing loss preferred nonlinear frequency compression to restricted bandwidth more than participants with less hearing loss. Conversely, participants with greater hearing loss were less likely to prefer extended bandwidth to restricted bandwidth. Conclusion Both age groups preferred access to
Brennan, Marc A; McCreery, Ryan; Kopun, Judy; Hoover, Brenda; Alexander, Joshua; Lewis, Dawna; Stelmachowicz, Patricia G
Preference for speech and music processed with nonlinear frequency compression (NFC) and two controls (restricted bandwidth [RBW] and extended bandwidth [EBW] hearing aid processing) was examined in adults and children with hearing loss. The purpose of this study was to determine if stimulus type (music, sentences), age (children, adults), and degree of hearing loss influence listener preference for NFC, RBW, and EBW. Design was a within-participant, quasi-experimental study. Using a round-robin procedure, participants listened to amplified stimuli that were (1) frequency lowered using NFC, (2) low-pass filtered at 5 kHz to simulate the RBW of conventional hearing aid processing, or (3) low-pass filtered at 11 kHz to simulate EBW amplification. The examiner and participants were blinded to the type of processing. Using a two-alternative forced-choice task, participants selected the preferred music or sentence passage. Participants included 16 children (ages 8-16 yr) and 16 adults (ages 19-65 yr) with mild to severe sensorineural hearing loss. All participants listened to speech and music processed using a hearing aid simulator fit to the Desired Sensation Level algorithm v5.0a. Children and adults did not differ in their preferences. For speech, participants preferred EBW to both NFC and RBW. Participants also preferred NFC to RBW. Preference was not related to the degree of hearing loss. For music, listeners did not show a preference. However, participants with greater hearing loss preferred NFC to RBW more than participants with less hearing loss. Conversely, participants with greater hearing loss were less likely to prefer EBW to RBW. Both age groups preferred access to high-frequency sounds, as demonstrated by their preference for either the EBW or NFC conditions over the RBW condition. Preference for EBW can be limited for those with greater degrees of hearing loss, but participants with greater hearing loss may be more likely to prefer NFC. Further
Full Text Available This study investigated eye-movement patterns during emotion perception for children with hearing aids and hearing children. Seventy-eight participants aged from 3 to 7 were asked to watch videos with a facial expression followed by an oral statement, and these two cues were either congruent or incongruent in emotional valence. Results showed that while hearing children paid more attention to the upper part of the face, children with hearing aids paid more attention to the lower part of the face after the oral statement was presented, especially for the neutral facial expression/neutral oral statement condition. These results suggest that children with hearing aids have an altered eye contact pattern with others and a difficulty in matching visual and voice cues in emotion perception. The negative cause and effect of these gaze patterns should be avoided in earlier rehabilitation for hearing-impaired children with assistive devices.
Leeuw, A. R.; Dreschler, W. A.
With respect to acoustical properties, in-the-ear (ITE) aids should give better understanding and directional hearing than behind-the-ear (BTE) aids. Also hearing-impaired subjects often prefer ITEs. A study was performed to assess objectively the improvement in speech understanding and directional
Roland, P S; Shoup, A G; Shea, M C; Richey, H S; Jones, D B
Partially implantable hearing devices have been developed to address some of the user-perceived shortcomings of standard amplification systems. Partially implantable devices are purported to provide improved sound quality as a result of decreased occlusion, decreased feedback, and enhanced clarity resulting from increased high-frequency gain. Such improvements may result in greater user satisfaction. To justify selection of a partially implantable device and undergoing a minor surgical procedure, verification techniques must be used to document user improvement or increased satisfaction over conventional amplification. To evaluate patient satisfaction with the SOUNDTEC direct hearing system. Within-subjects repeated measures design. Objective and subjective evaluation pre- and post-implantation with the SOUNDTEC device. Verification techniques included tonal functional gain measures with traditional amplification and the SOUNDTEC device, word recognition in quiet (NU-6) and in noise (SPIN), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Hough Ear Institute Profile (HEIP). Although there was no significant difference between optimal traditional amplification and the SOUNDTEC device for speech perception measures, the SOUNDTEC device yielded statistically significant increased high-frequency functional gain. Subjective reports indicated that the SOUNDTEC device provides a cleaner, more natural sound without feedback than traditional amplification. Partially implantable hearing aids may address some of the limitations of traditional amplification systems.
Han, Woojae; Lee, Junghak; Kim, Jinsook; Lee, Kyeongwon; Kim, Dongwook
Listeners with sensorineural hearing loss want to compensate for their narrow dynamic range from appropriate compression functions of hearing aids. The present study aimed to determine which compression threshold and release time of nonlinear hearing aids might affect speech recognition and speech quality judgments. Ten elderly listeners with symmetrical moderate-to-severe sensorineural hearing loss participated in the study. To compare two compression threshold (31 dB SPL vs. 61 dB SPL) and two release time (50 ms vs. 500 ms) conditions, subjects' speech recognition was measured using the Korean version of the Hearing in Noise Test in both quiet and noisy situations. All subjects were also asked to rate the degree of speech quality in terms of loudness, sharpness, clarity, and background noise immediately after completing the speech recognition test. Although no significant difference emerged in speech recognition thresholds between the two compression thresholds in the quiet situation, the compression threshold of 31 dB SPL showed a lower (or better) signal-to-noise ratio of speech recognition compared to that of 61 dB SPL. The release times of 50 and 500 ms did not statistically differ in both quiet and noisy situations. Subjective categories were found to be louder and clearer in the 50 ms release time for quiet and noisy, respectively. We expect that these patterns of current results will apply for better-fitting protocol of elderly Korean hearing aid users.
MANGAM, ABEL GLADSTONE
Binaural technology is used to recreate realistic sound to the listener. How- ever, many signal processing and noise cancellation techniques do not pre- serve the binaural characteristics of the binaural sound and thus destroying the realism. Binaural technologies are used in various applications like hear- ing aids, auditory displays, echo location for the blind, etc. The heart of binaural technology is the Head Related Transfer Functions which provide the transfer functions of the human pin...
Bamford, J; McCracken, W; Peers, I; Grayson, P
The study was designed to investigate the efficacy of a 2-channel hearing aid with low-frequency compression and high-frequency linear amplification on a group of school-age hearing aid wearers. The study was a single-center, 2-way crossover design in which 25 children (age 6 to 15 yr) were fitted with 2-channel hearing aids for 12 wk and with their own (single-channel) hearing aids for 12 wk, refitted according to published protocols. Speech perception in quiet and in noise was measured at the end of each 12 wk period; in addition, questionnaires were given to teachers, parents, and children. Two-channel hearing aids showed significantly higher mean scores for speech perception in noise and significantly higher composite questionnaire scores (reflecting aspects of satisfaction and benefit). Final choice of hearing aids at the end of the study by parents and children also favored the 2-channel device. The 2-channel hearing aids appear to be an acceptable management option for audiometrically suitable children. The results provide support for the 2-channel design rationale and suggest the need for further trials.
Full Text Available A concept and architecture of a personal communication system (PCS is introduced that integrates audio communication and hearing support for the elderly and hearing-impaired through a personal hearing system (PHS. The concept envisions a central processor connected to audio headsets via a wireless body area network (WBAN. To demonstrate the concept, a prototype PCS is presented that is implemented on a netbook computer with a dedicated audio interface in combination with a mobile phone. The prototype can be used for field-testing possible applications and to reveal possibilities and limitations of the concept of integrating hearing support in consumer audio communication devices. It is shown that the prototype PCS can integrate hearing aid functionality, telephony, public announcement systems, and home entertainment. An exemplary binaural speech enhancement scheme that represents a large class of possible PHS processing schemes is shown to be compatible with the general concept. However, an analysis of hardware and software architectures shows that the implementation of a PCS on future advanced cell phone-like devices is challenging. Because of limitations in processing power, recoding of prototype implementations into fixed point arithmetic will be required and WBAN performance is still a limiting factor in terms of data rate and delay.
Verhaegen, Veronique J O; Mulder, Jef J S; Mylanus, Emmanuel A M; Cremers, Cor W R J; Snik, Ad F M
We evaluated 5 patients who were changed over from a Baha Cordelle to a cochlear implant (CI). Moreover, the level of phoneme score was determined at which a Baha Cordelle user was better helped with a CI. We offer descriptive case reports and a retrospective evaluation of speech recognition in Baha Cordelle users and CI users. In the CI users with noncompromised cochleas, the 10th percentile of the aided phoneme score in quiet at 65 dB sound pressure level (PS65) was 42%. We consider this PS65 as the cutoff level for switching from a Baha Cordelle to a CI. When patients with mixed hearing loss were using the Baha Cordelle, the PS65 of 42% was obtained at a mean sensorineural hearing loss component of about 70 dB hearing level (HL). This 70-dB HL component was used to consider Baha Cordelle users for cochlear implantation. The results of the 5 patients support these transition criteria. A CI is a valuable option in patients with mixed hearing loss when the sensorineural hearing loss component exceeds 70 dB HL or when the PS65 with a Baha Cordelle is less than about 40%. In such patients, the implantation procedure should be individualized on the basis of the clinical findings in the middle ear and mastoid cavity.
Jensen, Simon Boelt; Drastrup, Mads; Morales, Esteban Chávez
Sound exposure is one of the primary causes of preventable hearing loss. Traditionally, sound exposure has been associated to industrial settings, and as such, treated as an occupational safety issue leading to international standards regulating sound exposure to improve working conditions. High...... levels of sound exposures are experienced in modern society in many different situations such as attending concerts, sport events and others. This leads to an interest in measurement devices which are discreet and simple to use, in order to assess sound exposures encountered in typical daily life...... scenarios. The purpose of this work is to document the use of a modified behind-the-ear (BTE) hearing-aid as a portable sound pressure level (SPL) meter. In order to obtain sound level measurements with a BTE device comparable to sound field values that can be used with existing risk assessment strategies...
Zakis, Justin A; Fulton, Bernadette; Steele, Brenton R
Preferences between low delays and phase-frequency responses of behind-the-ear, open-canal hearing aids were investigated with acoustic conditions deemed sensitive to delay effects by normal-hearing listeners. Hearing aids with the following selectable delay and phase response options were fitted at low insertion gain: (1) 1.4 ms delay, minimum phase; (2) 3.4 ms delay, minimum phase; and (3) 3.4 ms delay, linear phase. Blind paired comparisons were made between processing options and between each option and a muted hearing-aid output with two music stimuli. The three alternative forced choice responses were "Slightly prefer", "Prefer", or "Strongly prefer". Twelve hearing-impaired musicians. At the 3.4-ms delay, the minimum-phase response was significantly preferred to the linear-phase response for one music sample and vice-versa for the other sample with a sign test (p preference strength. Preferences between all other processing conditions were not significant. In acoustic conditions sensitive to delay effects, delays of 1.4 or 3.4 ms were either not detected or no less preferable than no delayed aided signal. It is unclear whether different phase-frequency responses may be preferred with different music stimuli.
Full Text Available Previous work suggested that individuals with low working memory capacity may be at a disadvantage in adverse listening environments, including situations with background noise or substantial modification of the acoustic signal. This study explored the relationship between patient factors (including working memory capacity and intelligibility and quality of modified speech for older individuals with sensorineural hearing loss. The modification was created using a combination of hearing aid processing (wide-dynamic range compression and frequency compression applied to sentences in multitalker babble. The extent of signal modification was quantified via an envelope fidelity index. We also explored the contribution of components of working memory by including measures of processing speed and executive function. We hypothesized that listeners with low working memory capacity would perform more poorly than those with high working memory capacity across all situations, and would also be differentially affected by high amounts of signal modification. Results showed a significant effect of working memory capacity for speech intelligibility, and an interaction between working memory, amount of hearing loss and signal modification. Signal modification was the major predictor of quality ratings. These data add to the literature on hearing-aid processing and working memory by suggesting that the working memory-intelligibility effects may be related to aggregate signal fidelity, rather than on the specific signal manipulation. They also suggest that for individuals with low working memory capacity, sensorineural loss may be most appropriately addressed with wide-dynamic range compression and/or frequency compression parameters that maintain the fidelity of the signal envelope.
Lunner, T; Hellgren, J; Arlinger, S; Elberling, C
In a series of experiments with a wearable binaural digital hearing aid, two hearing aid processing algorithms were compared. Both algorithms provided individual frequency shaping via a seven-band filterbank with compression limiting in the high-frequency channel. They differed in the processing of the low-frequency channel, using dynamic range compression for one (DynEar) and linear processing with compression limiting for the other (LinEar). In a pilot field test we found that LinEar/ DynEar preference based on use time could be predicted from auditory dynamic range data. For the subjects who preferred DynEar, the mean dynamic range was broader for low and mid frequencies and narrower for high frequencies, as compared with the LinEar preference subjects. These groupings were tested as predictors of user preference and performance in a main field test. The main study included 26 hearing aid users with symmetrical sensorineural losses. The algorithms were compared in a one-mo-long blind field test. A data logger function was included for objective recording of the total time each algorithm was used and how the volume controls were used. The preference was based on the time used for each algorithm and on subjective statements. Threshold signal-to-noise ratio (S/N-threshold) for speech was tested, and sound quality ratings were obtained through a questionnaire. We also tested the S/N-thresholds for the subjects' conventional (own) aids. The preference was correctly predicted by the dynamic range data on 12 out of 15 new cases. S/N-thresholds were lower for the preferred fittings compared with the nonpreferred fittings and with the subjects' own aids. In the questionnaire the preferred fittings were rated significantly higher in terms of overall impression and clearness. Because of the systematic way the DynEar-preference subjects adjusted the high-frequency DynEar gain, we speculate that upward spread of masking may have been a factor in preference and performance
Nelson, Lauri H; White, Karl R; Baker, Dirk V; Hayden, Angela; Bird, Scott
In many low- and middle-income countries, the availability of hearing technology is limited, with few options for hearing aid repairs. Minimising moisture damage to hearing aid electronics improves function and longevity; however, desiccants that absorb moisture from hearing aid components are unavailable in many regions. This study compared the effectiveness of uncooked white rice and seven commercial silica gel desiccants in removing moisture from hearing aids. Relative humidity measurements in a test chamber were obtained from a water-saturated BTE hearing aid prior to and after placement in uncooked white rice and seven different silica gel desiccants. Two BTE hearing aids, seven silica gel desiccants and white rice comprised the study sample. All desiccants and the white rice were effective in removing moisture from hearing aids, with Hal Hen Super Dri Aid showing the largest mean reduction in relative humidity. Based on analysis of covariance results, white rice was statistically similar to several of the commercial desiccants. White rice shows promise as an effective alternative to commercial desiccants in reducing moisture in hearing aids when silica gel products are unavailable. As this study was conducted in a relatively dry region, additional research may be needed.
Petros Stagiopoulos; Dionysios Politis; Georgios Kyriafinis; Miltiadis Tsalighopoulos
.... For aural and oral communication these could be hearing aids, prosthetics, implants or radio-electronic appliances that build up a bionic environment with apparent tendencies for virtualization...
Park, Paul K J; Ryu, Hyunsurk; Lee, Jun Haeng; Shin, Chang-Woo; Lee, Kyoo Bin; Woo, Jooyeon; Kim, Jun-Seok; Kang, Byung Chang; Liu, Shih-Chii; Delbruck, Tobi
We report on the neuromorphic sound localization circuit which can enhance the perceptual sensation in a hearing aid system. All elements are simple leaky integrate-and-fire neuron circuits with different parameters optimized to suppress the impacts of synaptic circuit noises. The detection range and resolution of the proposed neuromorphic circuit are 500 us and 5 us, respectively. Our results show that, the proposed technique can localize a sound pulse with extremely narrow duration (∼ 1 ms) resulting in real-time response.
Gudla, Visweswara Chakravarthy; Ambat, Rajan
the susceptibility of these systems to galvanic corrosion. In this study, traditional behind the ear (BTE) hearing aid systems, which failed during service were analysed. Failure analysis was performed on the dome type battery-spring contact systems. The morphology of the contact areas was observed using scanning...... electron microscopy, and the compositional analysis of the corrosion products and contaminants was performed using energy dispersive X-ray spectroscopy. Wear track morphology was observed on the contact points, and the top coating on the dome was worn out exposing the substrate spring material....... The obtained results were correlated to the underlying corrosion mechanism and the failure mode is presented....
Fischer, Rosa-Linde; Neher, Tobias; Wagener, Kirsten C.
Research findings concerning the relation between outcome from hearing aid (HA) noise suppression and working memory function are unclear. The current study thus investigated the effects of three noise suppression algorithms on auditory working memory as well as the relation with reading span......) improvement. Auditory working memory was assessed at +6 dB SNR using a listening span and an N-back paradigm. Twenty experienced HA users aged 55-80 yr with large differences in reading span took part. For the listening span measurements, there was an influence of HA setting on final word recognition...
Islam, Aminul; Hansen, Hans Nørgaard; Marhöfer, David Maximilian
, the precise dimensional requirement and tolerance make the 2k moulding a technically challenging process. This paper presents an industrial case study of 2k micro moulding covering all the important issues like product design, material selection, moulding and functionality testing of the micro moulded 2k...... parts. An intensive search for suitable 2k materials is made and few combinations of plastic materials are presented in the paper which can be used for highly demanding application areas like hearing aids. By using these material combinations, a demonstrator 2k micro part has been fabricated...
Noffsinger, Douglas; Haskell, George B; Larson, Vernon D; Williams, David W; Wilson, Eleanor; Plunkett, Sheril; Kenworthy, Diane
As part of a large clinical trial that compared three hearing aid circuits using several evaluation methods, judgments about quality of listening experiences were sought from all subjects. Three dimensions were examined: loudness, noise interference and overall liking (quality). Eight Audiology units in VA Medical Centers participated. Three hearing aid circuits were compared: linear peak clipper, compression limiter, and wide dynamic range compressor. The experimental design was a three-period, three-treatment crossover design. Baseline measures were made using a battery of tests in unaided conditions. Subjects (N = 360) were then stratified by participating site and randomized to one of six sequences of the three hearing aid circuits. Each circuit was fit binaurally and all subjects used each of the three circuits for 3 mo. All outcome measures were administered in unaided and aided conditions after each 3-mo period. The study used a double-blind strategy, i.e., neither the audiologist giving the tests nor the subject knew which circuit was being used. A different audiologist programmed the devices. For loudness judgments, soft and loud presentations of speech in quiet and in babble competition were judged more comfortable via the wide dynamic range circuit. The noise interference tasks and overall liking of the listening experience showed few significant differences across circuits. All circuits made the listening experience more comfortably loud for soft and conversation-level speech. Differences across circuits in terms of the overall quality of the listening experience and how noise interference was rated were small. Only isolated conditions, usually favoring the WDRC circuit, reached significance levels. The loudness dimension results were clearer. The WDRC circuit made sounds at either the loud or soft extreme more comfortable. When subjects were grouped by amount and configuration of hearing loss, the advantages for the WDRC and to a lesser extent the
Miller, Christi W; Bates, Emily; Brennan, Marc
Frequency lowering (FL) strategies move high frequency sound into a lower frequency range. This study determined if speech perception differences are observed between some of the different frequency lowering strategies that are available. A cross-sectional, repeated-measures design was used to compare three hearing aids that used wide-dynamic range compression (WDRC) and either non-linear frequency compression (NFC), linear frequency transposition (LFT), or frequency translation (FT). The hearing aids were matched to prescriptive real ear targets for WDRC. The settings for each FL strategy were adjusted to provide audibility for a 6300 Hz filtered speech signal. Sentence recognition in noise, subjective measures of sound quality, and a modified version of the speech intelligibility index (SII) were measured. Ten adults between the ages of 63 to 82 years with bilateral, high frequency hearing loss. LFT and FT led to poorer sentence recognition compared to WDRC for most individuals. No difference in sentence recognition occurred with and without NFC. The quality questionnaire and SII showed few differences between conditions. Under similar fitting and testing conditions of this study, FL techniques may not provide speech understanding benefit in certain background noise situations.
Miller, Christi W.; Bates, Emily; Brennan, Marc
Objective Frequency lowering (FL) strategies move high frequency sound into a lower frequency range. This study determined if speech perception differences are observed between some of the different frequency lowering strategies that are available. Design A cross-sectional, repeated-measures design was used to compare three hearing aids that used wide-dynamic range compression (WDRC) and either non-linear frequency compression (NFC), linear frequency transposition (LFT), or frequency translation (FT). The hearing aids were matched to prescriptive real ear targets for WDRC. The settings for each FL strategy were adjusted to provide audibility for a 6300 Hz filtered speech signal. Sentence recognition in noise, subjective measures of sound quality, and a modified version of the speech intelligibility index (SII) were measured. Study Sample Ten adults between the ages of 63 to 82 years with bilateral, high frequency hearing loss. Results LFT and FT led to poorer sentence recognition compared to WDRC for most individuals. No difference in sentence recognition occurred with and without NFC. The quality questionnaire and SII showed few differences between conditions. Conclusion Under similar fitting and testing conditions of this study, FL techniques may not provide speech understanding benefit in certain background noise situations. PMID:26938846
Schlegel, R E; Ravindran, A R; Raman, S; Grant, H
A multiphase study examining electromagnetic compatibility (EMC) between wireless digital telephones and hearing aids has been under way at the University of Oklahoma EMC Center since May 1995. In a phase 1 clinical study involving 68 hearing aid wearers, interference varied significantly by telephone technology, hearing aid type, and hearing loss characteristics. More than 80 percent of the tests resulted in either no interference or a detection threshold distance less than 1 meter. Metallic shielding of the units yielded positive results. Various elements of phase 2 involved instrument-based tests of hearing aid interference using telephones in a sound-isolation chamber and radio frequency signals in a waveguide, along with clinical studies of speech-to-interference ratios, all leading to the development of standards of measurement and performance criteria for telephone emissions and hearing aid immunity. Results to date confirm that bystander interference is of less concern than user interference, which is the focus of continuing research.
Grutters, Janneke P C; Joore, Manuela A; Kessels, Alfons G H; Davis, Adrian C; Anteunis, Lucien J C
Our objective was to elicit patient preferences for transferring elements of hearing aid provision from the medical sector [Ear Nose and Throat (ENT) specialists and audiological centers] to private hearing aid dispensers, and to understand the trade-offs between different elements of hearing aid provision. A discrete choice experiment was administered from 150 hearing-impaired persons in the Netherlands. Mean age was 71 (range 18-95) and 57% were male. Participants preferred the initial assessment at the dispenser, higher accuracy in identifying persons in need of medical care, shorter duration of the total hearing aid provision, and a follow-up at the ENT specialist. They required compensation of at least euro 17 per 2 mo extra duration, euro 54 for an initial assessment at the ENT specialist, euro 119 per 10% decrease in accuracy, and euro 227 to forgo the follow-up at the ENT specialist. Preferences were influenced by sex, age, educational level, and experience with hearing aid provision. Hearing-impaired persons are receptive to transferring elements of hearing aid provision from the medical sector to private dispensers. Although safety and efficiency issues should also be considered, from the present study we can conclude that in the organization of hearing aid provision hearing-impaired persons prefer an initial assessment at a private dispenser when the dispenser is at least 95% as accurate as the ENT specialist, and prefer a follow-up visit at the ENT specialist.
Hopkins, Kathryn; Khanom, Mumtaz; Dickinson, Ann-Marie; Munro, Kevin J
To determine whether non-linear frequency compression (NLFC) is effective for hearing-impaired adults in a clinical setting. To determine whether benefit from NLFC is related to duration of NLFC experience or severity of high-frequency hearing loss. Participants were fitted with Phonak frequency compression hearing aids as part of their standard clinical care, using the manufacturer's default fitting settings. Participants had been using NLFC for between 1 and 121 weeks at the time of testing. Speech recognition thresholds in noise and consonant recognition in quiet were measured with and without NLFC enabled. Forty-six experienced adult hearing-aid users. Consonant recognition in quiet, but not speech recognition in noise was significantly better with NLFC enabled. There was no significant correlation between duration of frequency compression experience and benefit. Benefit for consonant recognition was negatively correlated with mean audiometric thresholds from 2-6 kHz. NLFC was beneficial for consonant recognition but not speech recognition in noise. There was no evidence to support the idea that a long period of acclimatization is necessary to gain full benefit. The relation between benefit and high-frequency thresholds might be explained by the poor audibility of compressed information for some listeners with severe loss.
Sheehy, Patti; Hansen, Susan Aaberg
Case studies of three hearing-impaired four-year-old children revealed that vibrotactile stimulation aids were effective in teaching speech skills. The aid helped the students become more aware of sounds. (CL)
Sparkes, C; Lacey, N K
The requirement to phase out mercuric oxide (mercury) batteries on environmental grounds has led to the widespread introduction of zinc-air technology. The possibility arises that high drain hearing aids may not be adequately catered for by zinc-air cells, leading to poor performance. This study investigated the hearing aid user's ability to perceive differences between zinc-air and mercury cells in normal everyday usage. The data was collected for 100 experienced hearing aid users in field trials. Users report 50 per cent greater life for zinc-air cells in high power aids and 28 per cent in low power aids. The average life of the zinc-air cells range from 15 days in high power to 34 days in low power aids. Users are able to perceive a difference in sound quality in favour of zinc-air cells for low and medium power aids. The hearing aid population is not disadvantaged by phasing out mercury cells.
Zeitooni, Mehrnaz; Mäki-Torkko, Elina; Stenfelt, Stefan
The purpose of this study is to evaluate binaural hearing ability in adults with normal hearing when bone conduction (BC) stimulation is bilaterally applied at the bone conduction hearing aid (BCHA) implant position as well as at the audiometric position on the mastoid. The results with BC stimulation are compared with bilateral air conduction (AC) stimulation through earphones. Binaural hearing ability is investigated with tests of spatial release from masking and binaural intelligibility level difference using sentence material, binaural masking level difference with tonal chirp stimulation, and precedence effect using noise stimulus. In all tests, results with bilateral BC stimulation at the BCHA position illustrate an ability to extract binaural cues similar to BC stimulation at the mastoid position. The binaural benefit is overall greater with AC stimulation than BC stimulation at both positions. The binaural benefit for BC stimulation at the mastoid and BCHA position is approximately half in terms of decibels compared with AC stimulation in the speech based tests (spatial release from masking and binaural intelligibility level difference). For binaural masking level difference, the binaural benefit for the two BC positions with chirp signal phase inversion is approximately twice the benefit with inverted phase of the noise. The precedence effect results with BC stimulation at the mastoid and BCHA position are similar for low frequency noise stimulation but differ with high-frequency noise stimulation. The results confirm that binaural hearing processing with bilateral BC stimulation at the mastoid position is also present at the BCHA implant position. This indicates the ability for binaural hearing in patients with good cochlear function when using bilateral BCHAs.
Eilers, R E; Cobo-Lewis, A B; Vergara, K C; Oller, D K
Nineteen profoundly deaf children who utilize either cochlear implants (CIs) or multichannel tactile aids plus hearing aids (T + HAs) and who were enrolled in a full-day educational program that specializes in the use of sensory aids were evaluated using a battery of speech perception tests either developed in house or chosen because they were part of a standard battery of tests developed for children with sensory aids. The tests were organized into four perceptual levels ranging from pattern perception at level one to open set word identification at level four. For each level, data were analyzed for changes over time and for differences between performance of CI children and those using T + HAs. The results indicate that overall, across levels, both groups improved significantly over time but no differences were found between users of T + HAs and CIs at any level.
Kunst, S.J.W.; Hol, M.K.S.; Snik, A.F.M.; Mylanus, E.A.M.; Cremers, C.W.R.J.
OBJECTIVE: To evaluate whether the bone-anchored hearing aid (BAHA) can be applied successfully to patients with conductive hearing loss and moderate mental retardation. STUDY DESIGN: Retrospective clinical evaluation. SETTING: Tertiary referral center. PATIENTS: Twenty-two patients with congenital
Most, Tova; Aviner, Chen
This study evaluated the benefits of cochlear implant (CI) with regard to emotion perception of participants differing in their age of implantation, in comparison to hearing aid users and adolescents with normal hearing (NH). Emotion perception was examined by having the participants identify happiness, anger, surprise, sadness, fear, and disgust.…
Heinrich W. Löllmann
Full Text Available A new system for single-channel speech enhancement is proposed which achieves a joint suppression of late reverberant speech and background noise with a low signal delay and low computational complexity. It is based on a generalized spectral subtraction rule which depends on the variances of the late reverberant speech and background noise. The calculation of the spectral variances of the late reverberant speech requires an estimate of the reverberation time (RT which is accomplished by a maximum likelihood (ML approach. The enhancement with this blind RT estimation achieves almost the same speech quality as by using the actual RT. In comparison to commonly used post-filters in hearing aids which only perform a noise reduction, a significantly better objective and subjective speech quality is achieved. The proposed system performs time-domain filtering with coefficients adapted in the non-uniform (Bark-scaled frequency-domain. This allows to achieve a high speech quality with low signal delay which is important for speech enhancement in hearing aids or related applications such as hands-free communication systems.
Meister, Hartmut; Keilmann, Annerose; Leonhard, Katharina; Streicher, Barbara; Müller, Linda; Lang-Roth, Ruth
To compare the real-world verbal communication performance of children provided with cochlear implants (CIs) with their peers with hearing aids (HAs). Cross-sectional study in university tertiary referral centers and at hearing aid dispensers. Verbal communication performance was assessed by the Functioning after Pediatric Cochlear Implantation (FAPCI) instrument. The FAPCI was administered to 38 parents of children using CIs and 62 parents of children with HAs. According to the WHO classification, children with HAs were categorized into three groups (mild-moderate-severe hearing loss). Analysis of variance (ANOVA) was performed on the FAPCI scores, with study group, hearing age (i.e., device experience), and age at hearing intervention as sources of variation. ANOVA showed that hearing age and study group significantly contribute to the FAPCI outcome. In all study groups except the children with mild hearing loss, FAPCI scores increased alongside growing experience with the devices. Children with mild hearing loss using HAs showed higher scores than those with severe hearing loss or implanted children. There were no significant differences between the children with CIs and the children with moderate or severe hearing loss using HAs. Real-world verbal communication abilities of children with CIs are similar to those of children with moderate-to-severe hearing loss using amplification. Because hearing age significantly influences performance, children with moderate-to-severe hearing loss using HAs and implanted children catch up with children with mild hearing loss at a hearing age of approximately 3 years.
Osberger, M J; Robbins, A M; Miyamoto, R T; Berry, S W; Myres, W A; Kessler, K S; Pope, M L
The purpose of this experiment was first, to compare the performance of three matched groups of experimental subjects who used either a single-channel cochlear implant, a multichannel cochlear implant, or a two-channel vibrotactile aid on a battery of speech perception measures, and second, to compare the performance of subjects with residual hearing who used hearing aids to that of the three groups of experimental subjects. The results revealed that the subjects using hearing aids achieved the highest scores on all measures. The performance of the group of multichannel implant users was significantly higher than that of the single-channel implant users on tests involving discrimination of speech features, categorization of stress patterns, closed-set identification of familiar words, and identification of common phrases with and without visual cues. The performance of the subjects using 3M/House and Tactaid II devices was similar on all tests except those requiring integration of auditory or tactile cues and visual cues, on which the 3M/House device users achieved significantly higher scores than did the Tactaid II device users.
The study showed that the hearing-impaired students had poorer knowledge and attitudes to HIV/AIDS compared with their non-hearing-impaired counterparts. There is a pressing need for development. A cross-sectional survey of all the hearing impaired students and an equal number of nonhearing-impaired students ...
Laplante-Lévesque, Ariane; Hickson, Louise; Worrall, Linda
Client involvement in health decision making, or shared decision making, is increasingly being advocated. For example, rehabilitation interventions such as hearing aids and communication programs can be presented as options to adults with hearing impairment seeking help for the first time. Our previous research focused on the predictors of intervention decisions when options were presented with a decision aid. However, not all participants took up the intervention they initially decided upon. Although it is interesting to understand what informs adults with hearing impairment's intervention decisions, it is their intervention uptake and outcomes which best represent the ultimate end result of the rehabilitation process. This prospective study investigated the predictors of uptake and of successful outcomes of hearing aids and communication programs in middle-aged and older adults with hearing impairment seeking help for the first time. Using shared decision making, 153 participants with hearing impairment (average of air conduction thresholds at 0.5, 1, 2, and 4 kHz greater than 25 dB HL in at least one ear) aged 50 yr and older were presented with intervention options: hearing aids, communication programs (group or individual), and no intervention. Each participant received a decision aid and had at least 1 wk to consider intervention options before the intervention decision was made. Outcome measures for both hearing aids and communication programs at 3 mo after intervention completion were benefit (measured with the Client-Oriented Scale of Improvement), composite outcomes (measured with the International Outcome Inventory), and reduction in self-reported hearing disability (measured with the Hearing Handicap Questionnaire). Multivariate analysis (logistic and linear regression) identified predictors of intervention uptake and of successful outcomes when all other variables were held constant. Almost a quarter of the 153 participants (24%) did not take up the
Bárbara Guimarães Bastos
. To verify if attitudes are related to demographical and audiometric data as well as hearing aid characteristics. METHODS: 63 participants (35 men and 28 women, mean age 64.3 years with bilateral sensorineural hearing losses of different degrees, hearing aid candidates or users answered the "Attitudes Towards Hearing Loss Questionnaire" (ALHQ v3.0. The ALHQ scores distribution was analyzed. The correlation between ALHQ scores and demographical and audiological data as well as the hearing aid fitting characteristics were obtained. The ALHQ scores were also compared between groups of hearing aid candidates and users as well as among men and women. RESULTS: ALHQ subscale responses did not follow normal distribution. No correlation was found among demographical data, mean hearing thresholds and ALHQ scores. There were weak but significant correlations between the subscales: "negative coping strategies" and "hearing-related esteem" (rho =-0.39, "denial" and "hearing related esteem" (rho =-0.27, "negative coping strategies" and "negative associations" (rho = 0.25 and "denial" and "negative coping strategies" (rho =-0.30. A statistical difference was found for "negative coping strategies" and "negative associations" subscales between hearing aid candidates and users. No statistical difference was found for ALHQ scores among men and women. CONCLUSION: the existence of negative attitudes towards hearing loss and hearing aids reinforces the need for personal adjustment counseling. It is necessary to validate the ALHQ questionnaire translated into Brazilian Portuguese.
Keidser, Gitte; Rudner, Mary; Seeto, Mark; Hygge, Staffan; Rönnberg, Jerker
Verbal reasoning performance is an indicator of the ability to think constructively in everyday life and relies on both crystallized and fluid intelligence. This study aimed to determine the effect of functional hearing on verbal reasoning when controlling for age, gender, and education. In addition, the study investigated whether hearing aid usage mitigated the effect and examined different routes from hearing to verbal reasoning. Cross-sectional data on 40- to 70-year-old community-dwelling participants from the UK Biobank resource were accessed. Data consisted of behavioral and subjective measures of functional hearing, assessments of numerical and linguistic verbal reasoning, measures of executive function, and demographic and lifestyle information. Data on 119,093 participants who had completed hearing and verbal reasoning tests were submitted to multiple regression analyses, and data on 61,688 of these participants, who had completed additional cognitive tests and provided relevant lifestyle information, were submitted to structural equation modeling. Poorer performance on the behavioral measure of functional hearing was significantly associated with poorer verbal reasoning in both the numerical and linguistic domains (p < 0.001). There was no association between the subjective measure of functional hearing and verbal reasoning. Functional hearing significantly interacted with education (p < 0.002), showing a trend for functional hearing to have a greater impact on verbal reasoning among those with a higher level of formal education. Among those with poor hearing, hearing aid usage had a significant positive, but not necessarily causal, effect on both numerical and linguistic verbal reasoning (p < 0.005). The estimated effect of hearing aid usage was less than the effect of poor functional hearing. Structural equation modeling analyses confirmed that controlling for education reduced the effect of functional hearing on verbal reasoning and showed that
Islam, Aminul; Hansen, Hans Nørgaard; Risager, Flemming
of the main concerns for MIDs in hearing aids is the corrosion of metal tracks. This paper investigates the corrosion of the MID parts based on different base materials, layer thickness and mechanical wear of the MIDs. The results presented in the paper will be useful for designing MIDs in hearing aids...
Brons, Inge; Houben, Rolph; Dreschler, Wouter A.
Purpose: Noise reduction and dynamic-range compression are generally applied together in hearing aids but may have opposite effects on amplification. This study evaluated the acoustical and perceptual effects of separate and combined processing of noise reduction and compression. Design: Recordings of the output of 4 hearing aids for speech in…
Kampinga, W.R.; Wijnant, Ysbrand H.; Bosschaart, C.; de Boer, Andries; Randall, B.
Hearing aids and their components are becoming smaller. This presents new problems for the acoustical components, such as the loudspeaker. A circular membrane of a hearing aid loudspeaker is modeled in this paper. Neglecting air influences, the membrane and its suspension behave as a mass spring
Wong, Lena L. N.; Hang, Na
Purpose: This article reports on the development of a self-report tool--the Chinese Hearing Aid Outcomes Questionnaire (CHAOQ)--to evaluate hearing aid outcomes among Chinese speakers. Method: There were 4 phases to construct the CHAOQ and evaluate its psychometric properties. First, items were selected to evaluate a range of culturally relevant…
Wolf, M.J.F. de; Leijendeckers, J.M.; Mylanus, E.A.M.; Hol, M.K.S.; Snik, A.F.M.; Cremers, C.W.R.J.
OBJECTIVE: To study age-related patient satisfaction with the bone-anchored hearing aid (BAHA) compact. METHODS: A retrospective postal questionnaire, the International Outcome Inventory for Hearing Aids (IOI-HA), was sent to 211 BAHA Compact users. Questionnaire responses from 135 BAHA users were
Vreeken, Hilde L; van Rens, Ger H M B; Kramer, Sophia E; Knol, Dirk L; van Nispen, Ruth M A
Dual sensory loss (DSL; concurrent vision and hearing loss) negatively affects quality of life. As speechreading is hampered, use of hearing aids (HAs) is important for older adults with DSL. However, due to vision loss, use of small and complex HAs is assumed to be difficult. An integrative DSL protocol that addresses rehabilitative care for older adults with DSL, including proper HA use, was implemented in low vision rehabilitation centers. The present study aims to evaluate the effectiveness of the DSL protocol among HA owners on HA outcomes (i.e., HA use, benefit, satisfaction with HAs, and hearing with HAs). In a randomized controlled trial, the DSL protocol was compared to a waiting list control group among clients (aged ≥50 years) of low vision rehabilitation centers with DSL. The International Outcome Inventory for Hearing Aids (IOI-HA) and the HA Fitting Questionnaire (HAFQ) were administered at baseline and 3 months follow-up. Participants (n = 128) were randomly allocated to either the intervention (n = 63) or control group (n = 65). Intention-to-treat analyses showed a near significant effect on IOI-HA Residual problems (effect size, 0.35; p = 0.063). Per-protocol analyses showed similar (nonsignificant) results on the main outcomes, and a ceiling effect was found on the HAFQ. Significant effects were found in subgroups of patients: among patients with low HAFQ scores (HAFQ-Use: effect size = 0.56, p = 0.046; HAFQ-Hearing with HAs: effect size = 0.64, p = 0.019), male participants (effect size = 0.80; p = 0.003), and those with moderate hearing loss (effect size = 0.72; p = 0.028), significantly better IOI-HA scores were found in the intervention group at 3 months follow-up. Although the per-protocol and subgroup analyses need to be interpreted with caution, DSL patients who experience HA difficulties could benefit from the DSL protocol by making better use of their HAs. The increasing prevalence and impact of DSL on a person's independence and social
The objectives of this study were: (1) to examine the effect of wide dynamic range compression (WDRC) and modulation-based noise reduction (NR) algorithms on wind noise levels at the hearing aid output; and (2) to derive effective strategies for clinicians and engineers to reduce wind noise in hearing aids. Three digital hearing aids were fitted to KEMAR. The noise output was recorded at flow velocities of 0, 4.5, 9.0, and 13.5 m/s in a wind tunnel as the KEMAR head was turned from 0° to 360°. Flow noise levels were compared between the 1:1 linear and 3:1 WDRC conditions, and between NR-activated and NR-deactivated conditions when the hearing aid was programmed to the directional and omnidirectional modes. The results showed that: (1) WDRC increased low-level noise and reduced high-level noise; and (2) different noise reduction algorithms provided different amounts of wind noise reduction in different microphone modes, frequency regions, flow velocities, and head angles. Wind noise can be reduced by decreasing the gain for low-level inputs, increasing the compression ratio for high-level inputs, and activating modulation-based noise reduction algorithms.
McCreery, Ryan; Walker, Elizabeth; Spratford, Meredith; Kirby, Benjamin; Oleson, Jacob; Brennan, Marc
amplification. Use of dB HL thresholds and predictions of hearing aid output to set the safety limit resulted in a larger number of children being classified as above the safety limit than when safety limits were based on dB SPL thresholds and measured hearing aid output. Children above the safety limit for the dB SPL criteria tended to be fit above prescriptive targets. Additional research should seek to explain how the Modified Power Law predictions of threshold shift overestimated risk for children who wear hearing aids. American Academy of Audiology.
Fischer, Rosa-Linde; Wagener, Kirsten C.; Vormann, Matthias
successful speech-in-noise perception in aging depend on? Electrophysical correlates of high and low performance in older adults," Neuropsychologia, 70, 43-57 M. Serman, P.J. Schäfer, R.-L. Fischer, F.I. Corona-Strauss and D.J. Strauss (2016). "The influence of aided speech in noise performance on hearing...... aid setting preference in hearing impaired listeners," Poster presented at SPIN conference R.-L. Fischer, T. Neher and K.C. Wagener (2017). "Hearing aid noise suppression and working memory function," Poster presented at the International Symposium on Auditory and Audiological Research (ISAAR), Nyborg......Previous research has shown that hearing aid users can differ substantially in their preference for noise reduction (NR) strength, and that preference for and speech recognition with NR processing typically are not correlated (e.g. Neher 2014; Serman et al. 2016). In other words, hearing aid users...
Joshua G. W. Bernstein
Full Text Available The audiogram predicts <30% of the variance in speech-reception thresholds (SRTs for hearing-impaired (HI listeners fitted with individualized frequency-dependent gain. The remaining variance could reflect suprathreshold distortion in the auditory pathways or nonauditory factors such as cognitive processing. The relationship between a measure of suprathreshold auditory function—spectrotemporal modulation (STM sensitivity—and SRTs in noise was examined for 154 HI listeners fitted with individualized frequency-specific gain. SRTs were measured for 65-dB SPL sentences presented in speech-weighted noise or four-talker babble to an individually programmed master hearing aid, with the output of an ear-simulating coupler played through insert earphones. Modulation-depth detection thresholds were measured over headphones for STM (2cycles/octave density, 4-Hz rate applied to an 85-dB SPL, 2-kHz lowpass-filtered pink-noise carrier. SRTs were correlated with both the high-frequency (2–6 kHz pure-tone average (HFA; R2 = .31 and STM sensitivity (R2 = .28. Combined with the HFA, STM sensitivity significantly improved the SRT prediction (ΔR2 = .13; total R2 = .44. The remaining unaccounted variance might be attributable to variability in cognitive function and other dimensions of suprathreshold distortion. STM sensitivity was most critical in predicting SRTs for listeners < 65 years old or with HFA <53 dB HL. Results are discussed in the context of previous work suggesting that STM sensitivity for low rates and low-frequency carriers is impaired by a reduced ability to use temporal fine-structure information to detect dynamic spectra. STM detection is a fast test of suprathreshold auditory function for frequencies <2 kHz that complements the HFA to predict variability in hearing-aid outcomes for speech perception in noise.
McDermott, H J; Dean, M R; Dillon, H
To fit a hearing aid successfully, it is important to set the Saturated Sound Pressure Level (SSPL) or Maximum Power Output (MPO) appropriately. The SSPL should be low enough to prevent sounds from being amplified to uncomfortable loudness, and yet high enough to maximize speech intelligibility and signal quality. To help attain an optimum SSPL setting, a novel output compression limiting scheme, with shapable MPO (ShaMPO), has been devised. In ShaMPO, the SSPL is shaped across frequencies in accordance with the individual user's loudness discomfort levels (LDLs). The contributions of different frequency regions to loudness are controlled by summing the amplified signal power relative to the LDLs across frequencies, and using this signal to control a wideband compressor. This scheme and a conventional output compression limiting (AGCo) scheme have been implemented in a digital hearing aid. Ten subjects, with moderately-severe to profound sensorineural hearing losses, participated in a study comparing speech intelligibility and listening comfort for the two schemes. Results showed that there were no significant differences in the speech perception scores between AGCo and ShaMPO, even when the speech was presented at 80 dBA, at which level both schemes were in compression much of the time. However, an examination of how subjects selected the SSPL for the two schemes revealed that, in many instances, AGCo would permit some sounds with compact spectra to be amplified above LDL, whereas ShaMPO would not. Thus the ShaMPO scheme can improve listening comfort for some intense sounds without a loss of speech intelligibility. In contrast, half the subjects found speech at 80 dBA to be uncomfortably loud when listening through their own aids.
Clark, Nicholas R; Lecluyse, Wendy; Jürgens, Tim
This technical paper describes a biologically inspired hearing aid algorithm based on a computer model of the peripheral auditory system simulating basilar membrane compression, reflexive efferent feedback and its resulting properties. Two evaluations were conducted on the core part of the algorithm, which is an instantaneous compression sandwiched between the attenuation and envelope extraction processes of a relatively slow feedback compressor. The algorithm's input/output (I/O) function was analysed for different stationary (ambient) sound levels, and the algorithm's response to transient sinusoidal tone complexes was analysed and contrasted to that of a reference dynamic compressor. The algorithm's emergent properties are: (1) the I/O function adapts to the average sound level such that processing is linear for levels close to the ambient sound level and (2) onsets of transient signals are marked across time and frequency. Adaptive linearisation and onset marking, as inherent compressive features of the algorithm, provide potentially beneficial features to hearing-impaired listeners with a relatively simple circuit. The algorithm offers a new, biological perspective on hearing aid amplification.
Kim, Ja-Hee; Lee, Jae Hee; Lee, Ho-Ki
The goal of the present study was to examine whether Acceptable Noise Levels (ANLs) would be lower (greater acceptance of noise) in binaural listening than in monaural listening condition and also whether meaningfulness of background speech noise would affect ANLs for directional microphone hearing aid users. In addition, any relationships between the individual binaural benefits on ANLs and the individuals' demographic information were investigated. Fourteen hearing aid users (mean age, 64 years) participated for experimental testing. For the ANL calculation, listeners' most comfortable listening levels and background noise level were measured. Using Korean ANL material, ANLs of all participants were evaluated under monaural and binaural amplification with a counterbalanced order. The ANLs were also compared across five types of competing speech noises, consisting of 1- through 8-talker background speech maskers. Seven young normal-hearing listeners (mean age, 27 years) participated for the same measurements as a pilot testing. The results demonstrated that directional hearing aid users accepted more noise (lower ANLs) with binaural amplification than with monaural amplification, regardless of the type of competing speech. When the background speech noise became more meaningful, hearing-impaired listeners accepted less amount of noise (higher ANLs), revealing that ANL is dependent on the intelligibility of the competing speech. The individuals' binaural advantages in ANLs were significantly greater for the listeners with longer experience of hearing aids, yet not related to their age or hearing thresholds. Binaural directional microphone processing allowed hearing aid users to accept a greater amount of background noise, which may in turn improve listeners' hearing aid success. Informational masking substantially influenced background noise acceptance. Given a significant association between ANLs and duration of hearing aid usage, ANL measurement can be useful for
Hol, M.K.S.; Bosman, A.J.; Snik, A.F.M.; Mylanus, E.A.M.; Cremers, C.W.R.J.
OBJECTIVE: To evaluate the benefit of a bone-anchored hearing aid contralateral routing of sound hearing aid (BAHA CROS hearing aid) in 29 patients with unilateral inner ear deafness. STUDY DESIGN: Prospective clinical follow-up study. SETTING: Tertiary referral center. PATIENTS: Thirty patients
Blamey, Peter J.; Macfarlane, David S.; Steele, Brenton R.
Results for linear and wide-dynamic range compression were compared with a new 64-channel digital amplification strategy in three separate studies. The new strategy addresses the requirements of the hearing aid user with efficient computations on an open-platform digital signal processor (DSP). The new amplification strategy is not modeled on prior analog strategies like compression and linear amplification, but uses statistical analysis of the signal to optimize the output dynamic range in each frequency band independently. Using the open-platform DSP processor also provided the opportunity for blind trial comparisons of the different processing schemes in BTE and ITE devices of a high commercial standard. The speech perception scores and questionnaire results show that it is possible to provide improved audibility for sound in many narrow frequency bands while simultaneously improving comfort, speech intelligibility in noise, and sound quality.
Allegro Silvia; Launer Stefan; Büchler Michael; Dillier Norbert
A sound classification system for the automatic recognition of the acoustic environment in a hearing aid is discussed. The system distinguishes the four sound classes Ã¢Â€Âœclean speech,Ã¢Â€Â Ã¢Â€Âœspeech in noise,Ã¢Â€Â Ã¢Â€Âœnoise,Ã¢Â€Â and Ã¢Â€Âœmusic.Ã¢Â€Â A number of features that are inspired by auditory scene analysis are extracted from the sound signal. These features describe amplitude modulations, spectral profile, harmonicity, amplitude onsets, and rhythm. They are evaluated togethe...
Neher, Tobias; Wagener, Kirsten C.; Fischer, Rosa-Linde
OBJECTIVE: Research findings concerning the relation between benefit from hearing aid (HA) noise suppression and working memory function are inconsistent. The current study thus investigated the effects of three noise suppression algorithms on auditory working memory and the relation with reading......-to-noise ratio (SNR) improvement. Auditory working memory was assessed at +6 dB SNR using listening span and N-back paradigms. STUDY SAMPLE: Twenty experienced HA users ages 55-80 with large differences in reading span. RESULTS: For the listening span measurements, there was an influence of HA setting....... CONCLUSIONS: HA noise suppression may affect the recognition and recall of speech at positive SNRs, irrespective of individual reading span. Future work should improve the reliability of the auditory working memory measurements....
Büchler, Michael; Allegro, Silvia; Launer, Stefan; Dillier, Norbert
A sound classification system for the automatic recognition of the acoustic environment in a hearing aid is discussed. The system distinguishes the four sound classes "clean speech," "speech in noise," "noise," and "music." A number of features that are inspired by auditory scene analysis are extracted from the sound signal. These features describe amplitude modulations, spectral profile, harmonicity, amplitude onsets, and rhythm. They are evaluated together with different pattern classifiers. Simple classifiers, such as rule-based and minimum-distance classifiers, are compared with more complex approaches, such as Bayes classifier, neural network, and hidden Markov model. Sounds from a large database are employed for both training and testing of the system. The achieved recognition rates are very high except for the class "speech in noise." Problems arise in the classification of compressed pop music, strongly reverberated speech, and tonal or fluctuating noises.
Brenton R. Steele
Full Text Available Results for linear and wide-dynamic range compression were compared with a new 64-channel digital amplification strategy in three separate studies. The new strategy addresses the requirements of the hearing aid user with efficient computations on an open-platform digital signal processor (DSP. The new amplification strategy is not modeled on prior analog strategies like compression and linear amplification, but uses statistical analysis of the signal to optimize the output dynamic range in each frequency band independently. Using the open-platform DSP processor also provided the opportunity for blind trial comparisons of the different processing schemes in BTE and ITE devices of a high commercial standard. The speech perception scores and questionnaire results show that it is possible to provide improved audibility for sound in many narrow frequency bands while simultaneously improving comfort, speech intelligibility in noise, and sound quality.
Liu, C Carrie; Livingstone, Devon; Yunker, Warren K
To systematically review the literature on the audiological and/or quality of life benefits of a bone conduction hearing aid (BCHA) in children with congenital unilateral conductive or sensorineural deafness. A systematic search was performed according to the PRISMA guidelines using the PubMed, Medline, and Embase databases. Data were collected on the following outcomes of interest: speech reception threshold, speech discrimination, sound localization, and quality of life measures. Given the heterogeneity of the data for quantitative analysis, the results are qualitatively summarized. Eight studies were included in the review. Four studies examined the audiological outcomes associated with bone conduction hearing aid implantation. There was a consistent gain in speech reception thresholds and speech discrimination, especially in noisy environments. Results pertaining to sound localization was inconsistent. The studies that examined quality of life measures reported a high usage rate of BCHAs among children. Quality of life improvements are reported with suggested benefit in the subdomain of learning. Given the potential benefits of a BCHA, along with the fact that it can be safely trialed using a headband, it is reasonable to trial a BCHA in children with congenital unilateral deafness. Should the trial offer audiological and/or quality of life benefits for the individual child, then BCHA implantation can be considered. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available Objective: Determining the frequency of hearing disorders and hearing aid using in the clients referring to the Avesina education and health center, audiometry clinic, 1377. Method and Material: This is an assesive-descriptive survey that conducted on more than 2053 (1234 males and 819 females who referred for audiometry after examination by a physician. Case history, otoscopy, PTA, speech and immittance audiometry were conducted for all the clients. The findings were expressed in tables and diagrams of frequency. The age and sex relationship. All types of hearing losses and the number of the hearing-impaired clients need a hearing aid were assessed. Findings: 56% of this population were hearing-impaired and 44% had normal hearing were hearing. 60% were males and 40% females. Of the hearing-impaired, 44% had SNHL, 35.6% CHL and 8.2% mixed hearing loss. The hearing aid was prescribed for 204 (83 females and121 males if they need that only 20 females and 32 males wear it. Conclusion: It this sample, SNHL is of higher frequency. According to this survey, the more the age, the more the hearing aid is accepted (85% of wearer are more than 49 the prevalence of the hearing impaired males are more than females (60% versus 40%. Only 25% of the hearing-impaired wear hearing aids.
Kompis, Martin; Kurz, Anja; Pfiffner, Flurin; Senn, Pascal; Arnold, Andreas; Caversaccio, Marco
To establish whether complex signal processing is beneficial for users of bone anchored hearing aids. Review and analysis of two studies from our own group, each comparing a speech processor with basic digital signal processing (either Baha Divino or Baha Intenso) and a processor with complex digital signal processing (either Baha BP100 or Baha BP110 power). The main differences between basic and complex signal processing are the number of audiologist accessible frequency channels and the availability and complexity of the directional multi-microphone noise reduction and loudness compression systems. Both studies show a small, statistically non-significant improvement of speech understanding in quiet with the complex digital signal processing. The average improvement for speech in noise is +0.9 dB, if speech and noise are emitted both from the front of the listener. If noise is emitted from the rear and speech from the front of the listener, the advantage of the devices with complex digital signal processing as opposed to those with basic signal processing increases, on average, to +3.2 dB (range +2.3 … +5.1 dB, p ≤ 0.0032). Complex digital signal processing does indeed improve speech understanding, especially in noise coming from the rear. This finding has been supported by another study, which has been published recently by a different research group. When compared to basic digital signal processing, complex digital signal processing can increase speech understanding of users of bone anchored hearing aids. The benefit is most significant for speech understanding in noise.
Hol, M.K.S.; Snik, A.F.M.; Mylanus, E.A.M.; Cremers, C.W.R.J.
OBJECTIVES: To study the effect of a bone-anchored hearing aid (BAHA) in patients with unilateral conductive hearing loss. STUDY DESIGN: Prospective evaluation on 18 subjects. METHODS: Aided and unaided binaural hearing was assessed in the sound field using a sound localization test and a speech
Ekberg, Katie; Grenness, Caitlin; Hickson, Louise
It has long been documented that patients may experience emotional reactions to a diagnosis of hearing impairment and recommendation of hearing aids. Because of this, patients may raise psychosocial concerns regarding their hearing rehabilitation during audiology appointments, particularly in relation to getting hearing aids. However, thus far there has been little systematic research exploring how patients' concerns about hearing aids are addressed by audiologists within appointments. This study used conversation analysis to examine a corpus of 63 video-recorded initial audiology appointments with older adults with hearing impairment. The findings demonstrated that when patients expressed concerns regarding hearing aids, these concerns were typically psychosocial in nature and expressed in a way that carried a negative emotional stance. These types of turns thus invited an empathic response. However, patients' concerns were not typically addressed by audiologists during the appointment. As a consequence, patients persistently re-raised their concerns in subsequent turns, leading to expanded sequences of interaction during the management phase of the appointment. Older adults' psychosocial concerns regarding hearing aids may not always be sufficiently addressed within audiology appointments. A greater emphasis on emotionally focused communication within audiology could result in improved outcomes from hearing health care services.
Ono, H; Kanzaki, J; Mizoi, K
We have developed a hearing aid which reduces the low-frequency energy of the input sound according to the input noise level and the spectrum of the environmental noise. The results of speech discrimination tests using speech in noise in 70 hearing-impaired subjects showed improvement in word discrimination scores in noise of over 15% for 50 of 53 subjects with sensorineural hearing loss. This group of hearing-impaired patients was subdivided into categories according to (a) audiogram type [flat, sloping (i.e. gradual high-frequency loss) and abruptly falling (steep high-frequency slope)]; (b) degree of hearing loss (less than or more than 50 dB average loss) and (c) etiology (familial deafness, presbyacusis). Results on 17 subjects with conductive or mixed hearing impairments showed no improvement, but expressed a preference for this system. The subject reported that the sound was more natural and quiet compared with the conventional AGC hearing aids.
Patients with air-bone gaps who cannot be corrected successfully by tympanoplasty or with mixed hearing loss may be treated with bone conduction hearing aids. Their disadvantages are the obvious external fixation components or the biological and psychosocial problems of open implants. We have developed new partially implantable bone conduction hearing aid without a percutaneous abutment and have been using them clinically for 4 years. The principle of these bone conduction hearing aids is a magnetic coupling and acoustic transmission between implanted and external magnets. The goal of this study was to evaluate clinical and audiological results. Magnets are implanted into shallow bone beds in a one step procedure. The skin above the magnets is also reduced to a thickness of 4-5 mm, which reduces the attenuation to less than 10 dB compared to direct bone stimulation. Over 100 patients have been implanted in the last 5 years. Except for temporary pressure marks in 4%, which healed after careful shimming of the external base plate, there were no other complications. The holding strength of the external components is equivalent to partially implantable hearing aids and cochlea implants and the hearing improvement is similar to other bone conduction hearing aids. We have found the comfort and safety of this system is significantly improved compared to conventional or percutaneous bone conduction hearing aids. Copyright © 2011 S. Karger AG, Basel.
Caccamo, Samantha; Voloshchenko, Anastasia; Dankyi, Nana Yaa
The World Health Organization (WHO) estimates that about 280 million people worldwide have a bilateral hearing loss, mostly living in poor countries. Hearing loss causes heavy social burdens on individuals, families, communities and countries. However, due to the lack of accessibility and affordability, the vast majority of people in the world who need hearing aids do not have access to them. Low-income countries are thus pulled into a disability/poverty spiral. From this standpoint, the production of available, accessible and affordable hearing aids for the poorest populations of our planet should be one of the main issues in global hearing healthcare. Designing and producing a brand new low-cost hearing aid is the most effective option. Involving a large producer of hearing aids in the creation of a social business to solve the problem of access to affordable hearing aids is an essential step to reduce hearing disability on a large scale globally. Today's technology allows for the creation of a "minimal design" product that does not exceed $100-$150, that can be further lowered when purchased in large quantities and dispensed with alternative models. It is conceivable that by making a sustainable social business, the low cost product could be sold with a cross-subsidy model in order to recover the overhead costs. Social business is an economic model that has the potential to produce and distribute affordable hearing aids in low- and middle-income countries. Rehabilitation of hearing impaired children will be carried out in partnership with Sahic (Society of Assistance to Hearing Impaired Children) in Dhaka, Bangladesh and the ENT Department of Ospedale Burlo di Trieste, Dr. Eva Orzan.
Maeda, Yukihide; Sugaya, Akiko; Nagayasu, Rie; Nakagawa, Atsuko; Nishizaki, Kazunori
Audiological parameters alone do not determine the choice to use hearing aids (HA). Subjective hearing-related QoL is a major factor that determines whether or not an older person will continue to wear HA. This study aimed to identify which audiological parameters and quality-of-life (QoL) measures determine whether or not older persons will continue wearing HA. Charts of 157 patients aged ≥65 years who attended the HA service unit at the Otolaryngology Department were retrospectively reviewed. After HA fitting and a trial, the patients were divided into groups, depending upon whether or not they wanted to continue wearing the HA (users, 58.2%; non-users, 41.8%) and then audiological parameters were compared between them. At least 4 months after the HA fitting, the self-reported QoL questionnaire, Hearing Handicap Inventory for the Elderly (HHIE), was mailed to all 157 patients and HHIE scores were compared between HA users and non-users. Speech discrimination score and dynamic range did not significantly differ between HA users and non-users. A difference in the average hearing threshold was marginally significant. The response rate to the HHIE was 65.2%. Total HHIE and emotional scores were higher (more impaired) among HA users than non-users.
Stieglitz Ham, Heidi; Bunn, Paul; Meyer, Carly; Khan, Asad; Hickson, Louise
The objective of this study was to explore technology use and its relationship to help-seeking for hearing impairment (HI) and success with hearing aids among older adults. Previous research had suggested a link between higher levels of technology use and hearing aid success. General technology use was evaluated using a purposefully developed 25-item questionnaire. Twelve items related to everyday technology use (e.g. DVD player) and 13 related to advanced technology use (e.g. Bluetooth). Four groups of older adults with HI participated in the study: (1) non-consulters (n=49), (2) consulters (n=62), (3) unsuccessful hearing aid owners (n=61), and (4) successful hearing aid owners (n=79). Preliminary analyses revealed a main effect in the use of everyday and advanced technology across the four participant groups. However, it was found that age and living arrangements accounted for most of the variance in reported everyday technology use (p=.030; p=.029, respectively) and age and gender accounted for the variance in reported advanced technology use (phearing aid owners, our findings did not support this prediction. Technology use did not vary by group membership once the covariates of age, gender, and living arrangements were accounted for.
Borg, Johan; Ekman, Björn Olof; Östergren, Per-Olof
In response to the need for hearing aids in low-income countries, an approach to provide hearing aids through trained community workers was developed. This study compares the effectiveness of the community-based approach with that of a centre-based approach. One hundred and forty adolescents (56% girls; 12-18 years; mean: 15 years) from eleven sub-districts participated in a cluster-randomized trial comparing a community-based service (n = 75) with a centre-based service (n = 65) in Bangladesh. The International Outcome Inventory for Hearing Aids (IOI-HA) was administered to the participants six weeks after fitting of a hearing aid, and its scores were analyzed by Mann-Whitney U-tests and an ordinal regression model. The community-based approach performed as well as the centre-based approach on five out of seven outcome measures. The latter approach performed statistically significantly better on Residual participation restrictions (p = .007) and Impact on others (p = .012), but the effect sizes were small. Controlling for sex, age, hearing loss, place of living and proxy responses did not change the results. The community-based approach is a viable and effective option for hearing aid delivery in low-resourced settings. The approach needs to be adapted to particular contexts, and possible down-sides may need to be counteracted by special interventions. Implications for Rehabilitation Hearing aid use can contribute to improved activity, participation and quality of life among adolescents in low-income countries. Community-based approaches to delivering hearing aids can be viable and effective options to centre-based services.
Rogers, Sara E.; Quigley, Tera M.; Main, Anna K.; Kinney, Dana L.; Herring, Christine
Objectives The objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models. Design The design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups. Setting Older adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic. Participants Participants were adults, ages 55–79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention. Intervention(s) All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model. Primary and Secondary Outcome Measures Primary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained. Results Per-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However
Lunner, T; Hellgren, J; Arlinger, S; Elberling, C
Three digital signal processing algorithms named RangeEar, DynEar, and LinEar were compared with regard to user preference and performance when a wearable digital filterbank hearing aid was used. All three algorithms provided individual frequency shaping via a seven-band filterbank. Compression was used in a low-frequency (LF) and a high-frequency (HF) channel. RangeEar and DynEar used wide dynamic range syllabic compression in the LF channel, whereas LinEar used compression limiting. In the HF channel, RangeEar used a slow acting automatic volume control, whereas DynEar and LinEar used compression limiting. The subjects had access to a manual volume control when using the LinEar or DynEar options. The study included 13 hearing aid users with symmetrical sensorineural losses. In a 1 mo long blind field test, the RangeEar algorithm was compared with the preferred algorithm from an earlier study, DynEar or LinEar. A data logger function was included for objective recording of the total time each algorithm was used and how the volume controls were used. The preference was based on the time used for each algorithm and from subjective statements. Threshold signal-to-noise ratio (S/N-threshold) for speech was tested, and sound quality ratings were obtained through a questionnaire. Of the 13 subjects, six preferred the RangeEar fitting and another four preferred the DynEar fitting. Two subjects preferred the LinEar fitting and one had equal preference for RangeEar and LinEar. The results from the questionnaire showed that the preferred fittings were rated higher concerning overall impression of sound quality and clearness, whereas the S/N for the speech test did not show any differences. Preferences, where stated, could be predicted from auditory dynamic range measurements in the LF and HF frequency ranges. The mean dynamic range was broader for low and narrower for high frequencies for those who preferred the RangeEar or DynEar fitting as compared with those who
Ngo, Kim; van Waterschoot, Toon; Christensen, Mads Græsbøll
and the loudspeaker signal caused by the closed signal loop, in particular when the near-end signal is spectrally colored as is the case for a speech signal. This paper adopts a prediction-error method (PEM)-based approach to AFC, which is based on the use of decorrelating prediction error filters (PEFs). We propose......Acoustic feedback is a well-known problem in hearing aids, caused by the undesired acoustic coupling between the hearing aid loudspeaker and microphone. Acoustic feedback produces annoying howling sounds and limits the maximum achievable hearing aid amplification. This paper is focused on adaptive...
Eman A. Said
Results: There were significant lower aided tonal sound field thresholds (ATSFTs at 0.5, 1, 2 and 4 kHz of hearing aid users when compared with values of non-users at all tested frequencies. Hearing aid users perform better in all domains of WHO QOL-BREF with significant reductions in emotional, social and total scores of HHIE in users group compared with non-users indicated improvement in their QOL. There were no significant differences between scores of males and scores of females. The severity of the hearing loss had statistically significant effects on these scores for non-users but not in users group.
Ma, Guilin; Gran, Fredrik; Jacobsen, Finn
Feedback whistling is one of the severe problems with hearing aids, especially in dynamic situations when the users hug, pick up a telephone, etc. This paper investigates the properties of the dynamic feedback paths of digital hearing aids and proposes a model based on a reflection assumption...... gain. The method is also extended to dual-microphone hearing aids to assess the possibility of relating the two dynamic feedback paths through the reflection model. However, it is found that in a complicated acoustic environment, the relation between the two feedback paths can be very intricate...
Leifholz, M; Margolf-Hackl, S; Kreikemeier, S; Kiessling, J
The acceptance of hearing aids by users with high frequency hearing loss still represents a problem. Processing algorithms that shift high frequency signal components into an audible frequency range are proposed as a solution. We looked into the issue of whether frequency compression becomes more beneficial with increasing high frequency hearing loss or/and for users with cochlear dead regions (DR). A total of 20 hearing aid candidates were assessed audiometrically and classified into two test groups in terms of their hearing loss and the presence of DR. The subjects then evaluated four hearing aid settings that differed solely in the degree of frequency compression. Speech recognition threshold measurements and subjective sound quality ratings were carried out for all four settings. Data showed that 15 of the 20 test subjects understood fricatives with a high frequency spectrum component better, since they were able to distinguish between the two logatomes "Afa" and "Asa". No correlation was found between the beneficial effect of frequency compression and the degree of high frequency hearing loss or the presence of DR. Subjective sound quality ratings indicated no clear preference, but excessive frequency compression was generally deemed counterproductive. Frequency compression may be appropriate for hearing aid users with high frequency hearing loss and can improve speech recognition. The degree of frequency compression required to achieve maximal benefit varies from case to case and has to be optimized on an individual basis.
Sheeley, Eugene C.; McQuiddy, Doris
The first of a series of booklets for parents of deaf blind children presents basic information on using hearing aids. Suggestions are given for protecting the aid and putting in the child's earmold. Parents are advised to put the aid on every day and do simple activities involving music and speech. Keeping a record during listening time is…
Stone, Michael A; Moore, Brian C J
We used real-time processing in a wearable digital hearing aid to examine the effect of processing delay on normal-hearing participants while speaking. Objective and subjective data were recorded so as to permit analysis of both the production and perception of speech read aloud from a script. We also asked participants to rate the disturbance of the echo introduced by the delay. Thirty-two (16M, 16F) participants were fitted binaurally with behind-the-ear (BTE) aids connected to a digital processor. A 4 mm Libby horn, surrounded by an expanding foam earplug, conducted processed sound into each ear canal. The processor provided either linear processing or three-channel, fast-acting wide dynamic range compression, independently to each ear. Insertion gains were set, using a KEMAR manikin, to be 0 dB over a wide frequency range, for frontally presented speech with a free field level of 65 dB SPL. Additionally, the aids introduced one of four selectable delays (7 to 43 msec) between the BTE microphone and receiver. After a short period of acclimatization, each participant read 16 prose passages of about 500 words in length in each of two similar-sized rooms with markedly different acoustics: reverberant and nonreverberant. For each passage, a subjective rating of the level of disturbance of the perceived echo was recorded, as well as simultaneous recordings from a microphone and a Laryngograph, which directly records glottal pulses. Disturbance ratings generally increased monotonically with increasing delay. Averaged results show that a delay between 25 and 30 msec is rated as "disturbing." Measures were also taken of word production rate, speech level and range of level as well as fundamental frequency and range of fundamental frequency. For these measures of speech production, there was no significant effect until the delay exceeded 30 msec. There was little effect of acoustic environment or aid processing (linear or compression). The acceptability of delays
de Wolf, Maarten J F; Hendrix, Sander; Cremers, Cor W R J; Snik, Ad F M
A study performed in the 1990s with analogue linear hearing aids showed that in patients with mixed hearing loss and an air-bone gap that exceeded 25 to 30 dB, speech perception was better with a bone-anchored hearing aid (Baha) than with a conventional behind-the-ear (BTE) device. The objective of the present study was to investigate whether this conclusion applies to today's digital BTEs with feedback cancellation and whether the crossover point still occurs at an air-bone gap of 25 to 30 dB. Case control. Experienced unilateral Baha users with the latest digital Baha processors were fitted with a powerful BTE with feedback cancellation. After an acclimatization period of 4 weeks, aided thresholds and speech recognition scores were determined and compared to those recorded previously with the Baha. To obtain patients' opinions, a disability-specific questionnaire was used. Participants comprised 16 subjects with bilateral mixed hearing loss participated Audiometric and speech recognition data showed similar trends to those described previously, but the crossover point had shifted to an air-bone gap of 30 to 35 dB. In the questionnaire, the BTE was rated higher than the Baha, except by the patients with an air-bone gap that exceeded an average of 45 dB. In patients with mixed hearing loss whose air-bone gap exceeded 35 dB, speech recognition is likely to be better with a Baha than with a BTE. Therefore, the Baha should receive greater consideration when mixed hearing loss is combined with a significant air-bone gap, even when there are no contraindications for BTEs. Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Davidson, Lisa S
range from 88 to 96 dB HL would be expected to have significantly better LNT scores with a cochlear implant. These results should be further examined with research efforts focusing on early intervention with optimally fitted DSP hearing aids and cochlear implants.
Chong, Foong Yen; Jenstad, Lorienne M
Single-microphone noise reduction (SMNR) is implemented in hearing