Hearing Aid Design and Evaluation for a Patient with a Severe Discrimination Loss for Speech

1967 ◽  
Vol 10 (2) ◽  
pp. 367-372 ◽  
Author(s):  
James D. Miller ◽  
Arthur F. Niemoeller

Results of intelligibility tests on a single patient with a severe discrimination loss for speech are reported. The patient was tested with four different hearing aids and with no aid, and the effects of opportunity for lipreading, background noise, and reverberation were evaluated. The tests appear to allow an accurate estimate of the amount of help to be expected in various situations and show that an aid with good fidelity is clearly superior to the others tested. The destructive effects of background noise and reverberation are demonstrated separately and in combination.

2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty

Purpose The aim of the study was to assess how the use of a mild-gain hearing aid can affect hearing handicap, motivation, and attitudes toward hearing aids for middle-age, normal-hearing adults who do and do not self-report trouble hearing in background noise. Method A total of 20 participants (45–60 years of age) with clinically normal-hearing thresholds (< 25 dB HL) were enrolled in this study. Ten self-reported difficulty hearing in background noise, and 10 did not self-report difficulty hearing in background noise. All participants were fit with mild-gain hearing aids, bilaterally, and were asked to wear them for 2 weeks. Hearing handicap, attitudes toward hearing aids and hearing loss, and motivation to address hearing problems were evaluated before and after participants wore the hearing aids. Participants were also asked if they would consider purchasing a hearing aid before and after 2 weeks of hearing aid use. Results After wearing the hearing aids for 2 weeks, hearing handicap scores decreased for the participants who self-reported difficulty hearing in background noise. No changes in hearing handicap scores were observed for the participants who did not self-report trouble hearing in background noise. The participants who self-reported difficulty hearing in background noise also reported greater personal distress from their hearing problems, were more motivated to address their hearing problems, and had higher levels of hearing handicap compared to the participants who did not self-report trouble hearing in background noise. Only 20% (2/10) of the participants who self-reported trouble hearing in background noise reported that they would consider purchasing a hearing aid after 2 weeks of hearing aid use. Conclusions The use of mild-gain hearing aids has the potential to reduce hearing handicap for normal-hearing, middle-age adults who self-report difficulty hearing in background noise. However, this may not be the most appropriate treatment option for their current hearing problems given that only 20% of these participants would consider purchasing a hearing aid after wearing hearing aids for 2 weeks.


2012 ◽  
Vol 23 (08) ◽  
pp. 606-615 ◽  
Author(s):  
HaiHong Liu ◽  
Hua Zhang ◽  
Ruth A. Bentler ◽  
Demin Han ◽  
Luo Zhang

Background: Transient noise can be disruptive for people wearing hearing aids. Ideally, the transient noise should be detected and controlled by the signal processor without disrupting speech and other intended input signals. A technology for detecting and controlling transient noises in hearing aids was evaluated in this study. Purpose: The purpose of this study was to evaluate the effectiveness of a transient noise reduction strategy on various transient noises and to determine whether the strategy has a negative impact on sound quality of intended speech inputs. Research Design: This was a quasi-experimental study. The study involved 24 hearing aid users. Each participant was asked to rate the parameters of speech clarity, transient noise loudness, and overall impression for speech stimuli under the algorithm-on and algorithm-off conditions. During the evaluation, three types of stimuli were used: transient noises, speech, and background noises. The transient noises included “knife on a ceramic board,” “mug on a tabletop,” “office door slamming,” “car door slamming,” and “pen tapping on countertop.” The speech sentences used for the test were presented by a male speaker in Mandarin. The background noises included “party noise” and “traffic noise.” All of these sounds were combined into five listening situations: (1) speech only, (2) transient noise only, (3) speech and transient noise, (4) background noise and transient noise, and (5) speech and background noise and transient noise. Results: There was no significant difference on the ratings of speech clarity between the algorithm-on and algorithm-off (t-test, p = 0.103). Further analysis revealed that speech clarity was significant better at 70 dB SLP than 55 dB SPL (p < 0.001). For transient noise loudness: under the algorithm-off condition, the percentages of subjects rating the transient noise to be somewhat soft, appropriate, somewhat loud, and too loud were 0.2, 47.1, 29.6, and 23.1%, respectively. The corresponding percentages under the algorithm-on were 3.0, 72.6, 22.9, and 1.4%, respectively. A significant difference on the ratings of the transient noise loudness was found between the algorithm-on and algorithm-off (t-test, p < 0.001). For overall impression for speech stimuli: under the algorithm-off condition, the percentage of subjects rating the algorithm to be not helpful at all, somewhat helpful, helpful, and very helpful for speech stimuli were 36.5, 20.8, 33.9, and 8.9%, respectively. Under the algorithm-on condition, the corresponding percentages were 35.0, 19.3, 30.7, and 15.0%, respectively. Statistical analysis revealed there was a significant difference on the ratings of overall impression on speech stimuli. The ratings under the algorithm-on condition were significantly more helpful for speech understanding than the ratings under algorithm-off (t-test, p < 0.001). Conclusions: The transient noise reduction strategy appropriately controlled the loudness for most of the transient noises and did not affect the sound quality, which could be beneficial to hearing aid wearers.


1990 ◽  
Vol 33 (4) ◽  
pp. 676-689 ◽  
Author(s):  
David A. Fabry ◽  
Dianne J. Van Tasell

The Articulation Index (AI) was used to evaluate an “adaptive frequency response” (AFR) hearing aid with amplification characteristics that automatically change to become more high-pass with increasing levels of background noise. Speech intelligibility ratings of connected discourse by normal-hearing subjects were predicted well by an empirically derived AI transfer function. That transfer function was used to predict aided speech intelligibility ratings by 12 hearing-impaired subjects wearing a master hearing aid with the Argosy Manhattan Circuit enabled (AFR-on) or disabled (AFR-off). For all subjects, the AI predicted no improvements in speech intelligibility for the AFR-on versus AFR-off condition, and no significant improvements in rated intelligibility were observed. The ability of the AI to predict aided speech intelligibility varied across subjects. However, ratings from every hearing-impaired subject were related monotonically to AI. Therefore, AI calculations may be used to predict relative—but not absolute—levels of speech intelligibility produced under different amplification conditions.


1991 ◽  
Vol 34 (3) ◽  
pp. 679-685 ◽  
Author(s):  
Anna K. Nabelek ◽  
Frances M. Tucker ◽  
Tomasz R. Letowski

One of the frequently quoted reasons for the rejection of hearing aids is amplification of background noise. The relationship between hearing aid use and toleration of background noise was assessed. Four groups of elderly subjects (at least 65 years old) and one group of young subjects with normal hearing participated in the study. Each group consisted of 15 subjects. The young subjects and elderly subjects in one group with relatively good hearing were tested for comparison with the hearing-impaired subjects. Elderly subjects in the three remaining groups had acquired hearing losses and had been fitted with hearing aids. The subjects were assigned to three groups on the basis of hearing aid use: full-time users, part-time users, and nonusers. The amount of background noise tolerated when listening to speech was tested. The speech stimulus was a story read by a woman and set at an individually chosen most comfortable level. The maskers were a babble of voices, speech-spectrum noise, traffic noise, music, and the noise of a pneumatic drill. There was a significant interaction between groups and noises. The full-time users tolerated significantly higher levels of music and speech-spectrum noise than part-time users and nonusers. In addition, the full-time users, but not the part-time users, assessed themselves as less handicapped in everyday functions when they wore hearing aids than when they did not wear their hearing aids


2013 ◽  
Vol 24 (10) ◽  
pp. 980-991 ◽  
Author(s):  
Kristi Oeding ◽  
Michael Valente

Background: In the past, bilateral contralateral routing of signals (BICROS) amplification incorporated omnidirectional microphones on the transmitter and receiver sides and some models utilized noise reduction (NR) on the receiver side. Little research has examined the performance of BICROS amplification in background noise. However, previous studies examining contralateral routing of signals (CROS) amplification have reported that the presence of background noise on the transmitter side negatively affected speech recognition. Recently, NR was introduced as a feature on the receiver and transmitter sides of BICROS amplification, which has the potential to decrease the impact of noise on the wanted speech signal by decreasing unwanted noise directed to the transmitter side. Purpose: The primary goal of this study was to examine differences in the reception threshold for sentences (RTS in dB) using the Hearing in Noise Test (HINT) in a diffuse listening environment between unaided and three aided BICROS conditions (no NR, mild NR, and maximum NR) in the Tandem 16 BICROS. A secondary goal was to examine real-world subjective impressions of the Tandem 16 BICROS compared to unaided. Research Design: A randomized block repeated measures single blind design was used to assess differences between no NR, mild NR, and maximum NR listening conditions. Study Sample: Twenty-one adult participants with asymmetric sensorineural hearing loss (ASNHL) and experience with BICROS amplification were recruited from Washington University in St. Louis School of Medicine. Data Collection and Analysis: Participants were fit with the National Acoustic Laboratories’ Nonlinear version 1 prescriptive target (NAL-NL1) with the Tandem 16 BICROS at the initial visit and then verified using real-ear insertion gain (REIG) measures. Participants acclimatized to the Tandem 16 BICROS for 4 wk before returning for final testing. Participants were tested utilizing HINT sentences examining differences in RTS between unaided and three aided listening conditions. Subjective benefit was determined via the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire between the Tandem 16 BICROS and unaided. A repeated measures analysis of variance (ANOVA) was utilized to analyze the results of the HINT and APHAB. Results: Results revealed no significant differences in the RTS between unaided, no NR, mild NR, and maximum NR. Subjective impressions using the APHAB revealed statistically and clinically significant benefit with the Tandem 16 BICROS compared to unaided for the Ease of Communication (EC), Background Noise (BN), and Reverberation (RV) subscales. Conclusions: The RTS was not significantly different between unaided, no NR, mild NR, and maximum NR. None of the three aided listening conditions were significantly different from unaided performance as has been reported for previous studies examining CROS hearing aids. Further, based on comments from participants and previous research studies with conventional hearing aids, manufacturers of BICROS amplification should consider incorporating directional microphones and independent volume controls on the receiver and transmitter sides to potentially provide further improvement in signal-to-noise ratio (SNR) for patients with ASNHL.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Cliff Franklin ◽  
Laura V. Johnson ◽  
Letitia White ◽  
Clay Franklin ◽  
Laura Smith-Olinde

Objectives. This study examined the relationship between acceptable noise level (ANL) and personality. ANL is the difference between a person’s most comfortable level for speech and the loudest level of background noise they are willing to accept while listening to speech. Design. Forty young adults with normal hearing participated. ANLs were measured and two personality tests (Big Five Inventory, Myers-Briggs Type Indicator) were administered. Results. The analysis revealed a correlation between ANL and the openness and conscientious personality dimensions from the Big Five Inventory; no correlation emerged between ANL and the Myers-Briggs personality types. Conclusions. Lower ANLs are correlated with full-time hearing aid use and the openness personality dimension; higher ANLs are correlated with part-time or hearing aid nonuse and the conscientious personality dimension. Current data suggest that those more open to new experiences may accept more noise and possibly be good hearing aid candidates, while those more conscientious may accept less noise and reject hearing aids, based on their unwillingness to accept background noise. Knowing something about a person’s personality type may help audiologists determine if their patients will likely be good candidates for hearing aids.


2021 ◽  
Vol 42 (03) ◽  
pp. 295-308
Author(s):  
David A. Fabry ◽  
Achintya K. Bhowmik

AbstractThis article details ways that machine learning and artificial intelligence technologies are being integrated in modern hearing aids to improve speech understanding in background noise and provide a gateway to overall health and wellness. Discussion focuses on how Starkey incorporates automatic and user-driven optimization of speech intelligibility with onboard hearing aid signal processing and machine learning algorithms, smartphone-based deep neural network processing, and wireless hearing aid accessories. The article will conclude with a review of health and wellness tracking capabilities that are enabled by embedded sensors and artificial intelligence.


2014 ◽  
Vol 25 (06) ◽  
pp. 605-623 ◽  
Author(s):  
Karrie L. Recker ◽  
Martin F. McKinney ◽  
Brent W. Edwards

Background/Purpose: The acceptable noise level (ANL) test is the only test that is known to predict success with hearing aids with a high degree of accuracy. A person’s ANL is the maximal amount of background noise that he or she is “willing to put up with” while listening to running speech. It is defined as the speech level minus the noise level, in decibels (dB). People who are willing to put up with high levels of background noise are generally successful hearing-aid wearers, whereas people who are not willing to put up with high levels of background noise are generally unsuccessful hearing-aid wearers. If it were known what cues that listeners are using to decide how much background noise they are willing to tolerate, then it might be possible to create technology that reduces these cues and improves listeners’ chances of success with hearing aids. As a first step toward this goal, this study investigated whether listeners are using loudness as a cue to determine their ANLs. Research Design and Study Sample: Twenty-one individuals with normal hearing and 21 individuals with sensorineural hearing loss participated in this study. In each group of 21 participants, 7 had a low ANL (<7 dB), 7 had a mid ANL (7–13 dB), and 7 had a high ANL (>13 dB). Data Collection/Analysis: Participants performed a modified version of the ANL in which the speech was fixed at four different levels (50, 63, 75 and 88 dBA), and participants adjusted the background noise (multitalker babble) to the maximal level at which they were willing to listen while following the speech. These results were compared with participants’ equal-loudness contours for the multitalker babble in the presence of speech. Equal-loudness contours were measured by having the participants perform a loudness-matching task in which they matched the level of the background noise (multitalker babble), played concurrently with speech, to a reference condition (also multitalker babble). During the test condition, the speech played at 50, 63, 75, or 88 dBA. All testing was performed in a sound booth with the speech and the noise presented from a loudspeaker at a 0° azimuth, 3 feet in front of the participant. Each condition was presented multiple times, and the results were averaged. Presentation order was randomized. Participants were tested unaided. Results: Participants' ANLs were compared with their equal-loudness contours for the background noise. ANLs that ran parallel to the equal-loudness contours were considered consistent with a loudness-based listening strategy. This pattern was observed for only two participants – both hearing-impaired. Conclusions: The majority of listeners showed no consistent trend between their ANLs and their loudness-matched data, suggesting that they are using cues other than loudness to determine their ANLs. ANLs were consistent with loudness-matched data for a small subset of listeners, suggesting that they may be using loudness as a cue for determining their ANLs.


2004 ◽  
Vol 47 (5) ◽  
pp. 1001-1011 ◽  
Author(s):  
Anna K. Nabelek ◽  
Joanna W. Tampas ◽  
Samuel B. Burchfield

Background noise is a significant factor influencing hearing-aid satisfaction and is a major reason for rejection of hearing aids. Attempts have been made by previous researchers to relate the use of hearing aids to speech perception in noise (SPIN), with an expectation of improved speech perception followed by an increased acceptance of hearing aids. Unfortunately, SPIN was not related to hearing-aid use or satisfaction. A new measure of listener reaction to background noise has been proposed. The acceptable noise level (ANL), expressed in decibels, is defined as a difference between the most comfortable listening level for speech and the highest background noise level that is acceptable when listening to and following a story. The ANL measure assumes that speech understanding in noise may not be as important as is the willingness to listen in the presence of noise. It has been established that people who accept background noise have smaller ANLs and tend to be "good" users of hearing aids. Conversely, people who cannot accept background noise have larger ANLs and may only use hearing aids occasionally or reject them altogether. Because this is a new measure, it was important to determine the reliability of the ANL over time with and without hearing aids, to determine the effect of acclimatization to hearing aids, and to compare the ANL to well-established measures such as speech perception scores collected with the SPIN test. Results from 50 listeners indicate that for both good and occasional hearing aid users, the ANL is comparable in reliability to the SPIN test and that both measures do not change with acclimatization. The ANLs and SPIN scores are unrelated. Although the SPIN scores improve with amplification, the ANLs are unaffected by amplification, suggesting that the ANL is inherent to an individual and can be established prior to hearing aid fitting as a possible predictor of hearing-aid use. KEY WORDS : background noise, hearing aids, acceptable noise level, speech perception in noise


2016 ◽  
Vol 27 (01) ◽  
pp. 029-041 ◽  
Author(s):  
Jamie L. Desjardins

Background: Older listeners with hearing loss may exert more cognitive resources to maintain a level of listening performance similar to that of younger listeners with normal hearing. Unfortunately, this increase in cognitive load, which is often conceptualized as increased listening effort, may come at the cost of cognitive processing resources that might otherwise be available for other tasks. Purpose: The purpose of this study was to evaluate the independent and combined effects of a hearing aid directional microphone and a noise reduction (NR) algorithm on reducing the listening effort older listeners with hearing loss expend on a speech-in-noise task. Research Design: Participants were fitted with study worn commercially available behind-the-ear hearing aids. Listening effort on a sentence recognition in noise task was measured using an objective auditory–visual dual-task paradigm. The primary task required participants to repeat sentences presented in quiet and in a four-talker babble. The secondary task was a digital visual pursuit rotor-tracking test, for which participants were instructed to use a computer mouse to track a moving target around an ellipse that was displayed on a computer screen. Each of the two tasks was presented separately and concurrently at a fixed overall speech recognition performance level of 50% correct with and without the directional microphone and/or the NR algorithm activated in the hearing aids. In addition, participants reported how effortful it was to listen to the sentences in quiet and in background noise in the different hearing aid listening conditions. Study Sample: Fifteen older listeners with mild sloping to severe sensorineural hearing loss participated in this study. Results: Listening effort in background noise was significantly reduced with the directional microphones activated in the hearing aids. However, there was no significant change in listening effort with the hearing aid NR algorithm compared to no noise processing. Correlation analysis between objective and self-reported ratings of listening effort showed no significant relation. Conclusions: Directional microphone processing effectively reduced the cognitive load of listening to speech in background noise. This is significant because it is likely that listeners with hearing impairment will frequently encounter noisy speech in their everyday communications.


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