scholarly journals Slow Cortical Potentials and Amplification—Part I: N1-P2 Measures

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Susan Marynewich ◽  
Lorienne M. Jenstad ◽  
David R. Stapells
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Clinical Use ◽  
Slow Cortical Potentials ◽  
Tonal Stimulus ◽  
Digital Hearing Aids ◽  
Conflicting Evidence ◽  
Reliable Increase ◽  
Cortical Potentials

Slow cortical potentials (SCPs) are currently of great interest in the hearing aid fitting process for infants; however, there is conflicting evidence in the literature concerning the use of SCPs for this purpose. The current study investigated SCP amplitudes and latencies in young normal-hearing listeners in response to a 60 ms duration tonal stimulus (1000 Hz) presented at three intensities (30, 50, and 70 dB SPL) in aided and unaided conditions using three hearing aids (Analog, DigitalA, and DigitalB) with two gain settings (20 and 40 dB). Results showed that SCP amplitudes were smaller for the digital hearing aids compared with the analog hearing aid, and none of the hearing aids resulted in a reliable increase in response amplitude relative to the unaided across conditions. SCP latencies in analog conditions were not significantly different from latencies in the unaided conditions; however, both digital hearing aids resulted in significantly delayed SCP latencies. The results of the current study (as well as several previous studies) indicate that the SCP may not accurately reflect the amplified stimulus expected from the prescribed hearing aids. Thus, “aided-SCP” results must be interpreted with caution, and more research is required concerning possible clinical use of this technique.

scholarly journals Slow Cortical Potentials and Amplification—Part II: Acoustic Measures

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Lorienne M. Jenstad ◽  
Susan Marynewich ◽  
David R. Stapells
Keyword(s):  
Clinical Application ◽  
Hearing Aids ◽  
Rise Time ◽  
Hearing Aid ◽  
Stimulus Onset ◽  
Slow Cortical Potentials ◽  
Digital Hearing Aids ◽  
Acoustic Measures ◽  
Tonal Stimuli ◽  
Reliable Increase

In a previous study, we investigated slow cortical potential (SCP) N1-P2 amplitudes and N1 latencies in aided and unaided conditions, with the finding that despite being set to provide 20 or 40 dB of gain, none of the hearing aids resulted in a reliable increase in SCP response amplitude relative to the unaided (Marynewich et al., in press). The current study investigates the effects of hearing-aid processing on acoustic measures for two 1000-Hz tonal stimuli: short (60 ms) and long (757 ms), presented at three intensities (30, 50, 70 dB SPL) in aided and unaided conditions using three hearing aids (Analog, DigitalA, DigitalB) with two gain settings (20, 40 dB). Acoustic results indicate that gain achieved by the hearing aids, measured at 30 ms after stimulus onset, for both the short and long stimuli, was less than real-ear insertion gain measured with standard hearing aid test signals. Additionally, the digital hearing aids altered the rise time of the stimuli such that maximum gain was reached well past 30 ms after stimulus onset; rise times differed between the digital aids. These results indicate that aided SCP results must be cautiously interpreted and that further research is required for clinical application.

Use of a Mild-Gain Hearing Aid by Middle-Age Normal-Hearing Adults Who Do and Do Not Self-Report Trouble Hearing in Background Noise

2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty
Keyword(s):  
Hearing Aids ◽  
Background Noise ◽  
Middle Age ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Self Report ◽  
Hearing Aid Use ◽  
Hearing Handicap ◽  
Before And After ◽  
Hearing Problems

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.

Performance Improvement of Digital Hearing Aid Systems

2015 ◽  
Vol 1 ◽  
pp. 27
Author(s):  
Isiaka Ajewale Alimi
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Digital Signal Processor ◽  
Speech Intelligibility ◽  
Communication Systems ◽  
Hearing Aid ◽  
Spectral Subtraction ◽  
Residual Spectrum ◽  
Digital Hearing Aids ◽  
Digital Hearing Aid

Digital hearing aids addresses the issues of noise and speech intelligibility that is associated with the analogue types. One of the main functions of the digital signal processor (DSP) of digital hearing aid systems is noise reduction which can be achieved by speech enhancement algorithms which in turn improve system performance and flexibility. However, studies have shown that the quality of experience (QoE) with some of the current hearing aids is not up to expectation in a noisy environment due to interfering sound, background noise and reverberation. It is also suggested that noise reduction features of the DSP can be further improved accordingly. Recently, we proposed an adaptive spectral subtraction algorithm to enhance the performance of communication systems and address the issue of associated musical noise generated by the conventional spectral subtraction algorithm. The effectiveness of the algorithm has been confirmed by different objective and subjective evaluations. In this study, an adaptive spectral subtraction algorithm is implemented using the noise-estimation algorithm for highly non-stationary noisy environments instead of the voice activity detection (VAD) employed in our previous work due to its effectiveness. Also, signal to residual spectrum ratio (SR) is implemented in order to control the amplification distortion for speech intelligibility improvement. The results show that the proposed scheme gives comparatively better performance and can be easily employed in digital hearing aid system for improving speech quality and intelligibility.

Measurements of Loudness Growth in 1/2-Octave Bands for Children and Adults With Normal Hearing

1999 ◽  
Vol 8 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Melisa R. Ellis ◽  
Michael K. Wynne
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Age Groups ◽  
Lower Boundary ◽  
Normal Hearing ◽  
Boundary Values ◽  
Simple Modification ◽  
Point Data ◽  
Loudness Growth

The loudness growth in 1/2-octave bands (LGOB) procedure has been shown previously to provide valid estimates of loudness growth for adults with normal hearing and those with hearing loss (Allen, Hall, & Jeng, 1990), and it has been widely incorporated into fitting strategies for adult hearing aid users by a hearing aid manufacturer. Here, we applied a simple modification of LGOB to children and adults with normal hearing and then compared the loudness growth functions (as obtained from end-point data) between the two age groups. In addition, reliability data obtained within a single session and between test sessions were compared between the two groups. Large differences were observed in the means between the two groups for the lower boundary values, the upper boundary values, and the range between boundaries both within and across all frequencies. The data obtained from children also had greater variance than the adult data. In addition, there was more variability in the data across test sessions for children. Many test-retest differences for children exceeded 10 dB. Adult test-retest differences were generally less than 10 dB. Although the LGOB with the modifications used in this study may be used to measure loudness growth in children, its poor reliability with this age group may limit its clinical use for children with hearing loss. Additional work is needed to explore whether loudness growth measures can be adapted successfully to children and whether these measures contribute worthwhile information for fitting hearing aids to children.

scholarly journals Perception Mechanism of Bone-Conducted Ultrasound and Its Clinical Use

2021 ◽  
Vol 11 (2) ◽  
pp. 244-253
Author(s):  
Tadashi Nishimura ◽  
Tadao Okayasu ◽  
Akinori Yamashita ◽  
Hiroshi Hosoi ◽  
Tadashi Kitahara
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Speech Signals ◽  
Clinical Use ◽  
Reported Speech ◽  
Sound Therapy ◽  
Profound Deafness ◽  
Tinnitus Treatment

It is generally believed that ultrasound cannot be heard. However, ultrasound is audible when it is presented through bone conduction. Bone-conducted ultrasound (BCU) has unique characteristics; the most interesting is its perception in patients with profound deafness. Some patients can perceive it and discriminate speech-modulated BCU. Previous reports have suggested that BCU can be used for a hearing aid or tinnitus sound therapy. In this review, the perception of BCU at both the peripheral and central levels was investigated based on previous studies, although some of them remain controversial. We also investigated the clinical use of BCU. To develop hearing aids utilizing BCU, the encoding of speech signals into BCU has to be established. The outcomes of the reported speech modulations were evaluated. Furthermore, the suppression of tinnitus by BCU was reviewed, and the feasibility of the application of BCU to tinnitus treatment was investigated.

Verification of In Situ Thresholds and Integrated Real-Ear Measurements

2010 ◽  
Vol 21 (10) ◽  
pp. 663-670 ◽  
Author(s):  
Jeffrey J. DiGiovanni ◽  
Ryan M. Pratt
Keyword(s):  
Measurement System ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Analysis Tool ◽  
Ohio University ◽  
Positive Direction ◽  
Significant Difference ◽  
Threshold Measurement

Background: Accurate prescriptive gain results in a more accurate fit, lower return rate in hearing aids, and increased patient satisfaction. In situ threshold measurements can be used to determine required gain. The Widex Corporation uses an in situ threshold measurement strategy, called the Sensogram. Real-ear measurements determine if prescriptive gain targets have been achieved. Starkey Laboratories introduced an integrated real-ear measurement system in their hearing aids. Purpose: To determine whether the responses obtained using the Widex Sensogram were equivalent to those obtained using current clinical threshold measurement methods. To determine the accuracy of the Starkey IREMS™ (Integrated Real Ear Measurement System) in measuring RECD (real-ear to coupler difference) values compared to a dedicated real-ear measurement system. Research Design: A verification design was employed by comparing participant data measured from standard, benchmark equipment and procedures against new techniques offered by hearing-aid manufacturers. Study Sample: A total of 20 participants participated in this study. Ten participants with sensorineural hearing loss were recruited from the Ohio University Hearing, Speech, and Language Clinic participated in the first experiment. Ten participants with normal hearing were recruited from the student population at Ohio University participated in both experiments. The normal-hearing group had thresholds of 15 dB HL or better at the octave frequencies of 250–8000 Hz. The hearing-impaired group had thresholds of varying degrees and configurations with thresholds equal to or poorer than 25 dB HL three-frequency pure-tone average. Data Collection and Analysis: The order of measurement method for both experiments was counterbalanced. In Experiment 1, thresholds obtained via the Widex Sensogram were compared to thresholds obtained for each participant using a clinical audiometer and ER-3A insert ear phones. In Experiment 2, RECD values obtained via the Starkey IREMS were compared to RECD values obtained via the Audioscan Verifit™. A repeated-measures analysis of variance (ANOVA) was used for statistical analysis, and a Fisher's LSD (least significant difference) was used as a post hoc analysis tool. Results: A significant difference between Sensogram thresholds and conventional audiometric thresholds was found with the Sensogram method resulting in better threshold values at 0.5, 1.0, and 2.0 kHz for both groups. In Experiment 2, a significant difference between RECD values obtained by the Starkey IREMS and the Audioscan Verifit system was found with significant differences in RECD values found at 0.25, 0.5, 0.75, 1.5, 2.0, and 6.0 kHz. Conclusions: The Sensogram data differ significantly from traditional audiometry at several frequencies important for speech intelligibility. Real-ear measures are still required for verification of prescribed gain, however, calling into question any claims of shortened fitting time. The Starkey IREMS does perform real-ear measurements that vary significantly from benchmark equipment. These technologies represent a positive direction in prescribing accurate gain during hearing-aid fittings, but a stand-alone system is still the preferred method for real-ear measurements in hearing-aid fittings.

Expectations, Prefitting Counseling, and Hearing Aid Outcome

2009 ◽  
Vol 20 (05) ◽  
pp. 320-334 ◽  
Author(s):  
Gabrielle H. Saunders ◽  
M Samantha Lewis ◽  
Anna Forsline
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Well Being ◽  
Fine Tuning ◽  
Initial Contact ◽  
High Expectations ◽  
Digital Hearing Aids ◽  
The Impact ◽  
Unrealistic Expectations

Background: Data suggest that having high expectations about hearing aids results in better overall outcome. However, some have postulated that excessively high expectations will result in disappointment and thus poor outcome. It has been suggested that counseling patients with unrealistic expectations about hearing aids prior to fitting may be beneficial. Data, however, are mixed as to the effectiveness of such counseling, in terms of both changes in expectations and final outcome. Purpose: The primary purpose of this study was to determine whether supplementing prefitting counseling with demonstration of real-world listening can (1) alter expectations of new hearing aid users and (2) increase satisfaction over verbal-only counseling. Secondary goals of the study were to examine (1) the relationship between prefitting expectations and postfitting outcome, and (2) the effect of hearing aid fine-tuning on hearing aid outcome. Research Design: Sixty new hearing aid users were fitted binaurally with Beltone Oria behind-the-ear digital hearing aids. Forty participants received prefitting counseling and demonstration of listening situations with the Beltone AVE™ (Audio Verification Environment) system; 20 received prefitting counseling without a demonstration of listening situations. Hearing aid expectations were measured at initial contact and following prefitting counseling. Reported hearing aid outcome was measured after eight to ten weeks of hearing aid use. Study Sample: Sixty new hearing aid users aged between 55 and 81 years with symmetrical sensorineural hearing loss. Intervention: Participants were randomly assigned to one of three experimental groups, between which the prefitting counseling and follow-up differed: Group 1 received prefitting counseling in combination with demonstration of listening situations. Additionally, if the participant had complaints about sound quality at the follow-up visit, the hearing aids were fine-tuned using the Beltone AVE system. Group 2 received prefitting counseling in combination with demonstration of listening situations with the Beltone AVE system, but no fine-tuning was provided at follow-up. Group 3 received prefitting hearing aid counseling that did not include demonstration of listening, and the hearing aids were not fine-tuned at the follow-up appointment. Results: The results showed that prefitting hearing aid counseling had small but significant effects on expectations. The two forms of counseling did not differ in their effectiveness at changing expectations; however, anecdotally, we learned from many participants that that they enjoyed listening to the auditory demonstrations and that they found them to be an interesting listening exercise. The data also show that positive expectations result in more positive outcome and that hearing aid fine-tuning is beneficial to the user. Conclusions: We conclude that prefitting counseling can be advantageous to hearing aid outcome and recommend the addition of prefitting counseling to address expectations associated with quality of life and self-image. The data emphasize the need to address unrealistic expectations prior to fitting hearing aids cautiously, so as not to decrease expectations to the extent of discouraging and demotivating the patient. Data also show that positive expectations regarding the impact hearing aids will have on psychosocial well-being are important for successful hearing aid outcome.

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

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

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

Professional and Lay Observers' Impressions of Preschoolers Wearing Hearing Aids

1980 ◽  
Vol 45 (3) ◽  
pp. 415-422 ◽  
Author(s):  
Jeffrey L. Danhauer ◽  
Gordon W. Blood ◽  
Ingrid M. Blood ◽  
Nancy Gomez
Keyword(s):  
Factor Analysis ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Semantic Differential ◽  
Normal Hearing ◽  
Semantic Differential Scale ◽  
Body Type ◽  
Factor I ◽  
Factor Ii ◽  
Photographic Slides

This study determined whether professional and lay observers had similar impressions of preschoolers wearing hearing aids and if the size of the aid affected ratings. Stimuli consisted of three photographic slides of nine normally-hearing and speaking male preschoolers wearing (1) a body-type hearing aid, (2) a post-auricular type aid, and (3) no aid. Slides were accompanied by taped speech samples. Stimuli were presented to 75 professional and 75 lay observers who rated the children on a semantic differential scale containing 15 adjectives. Ratings were submitted to a factor analysis revealing Factor I as achievement and Factor II as appearance. Results of MANOVAs revealed that neither professional nor lay observers discriminated against the children on appearance regardless of the presence of a hearing aid, but that both groups rated them significantly poorer on achievement when an aid was present. Lay observers' ratings showed a bias against the size of the aid, while professionals exhibited negative impressions whenever an aid was present, regardless of its size. These findings indicate that the "hearing aid effect" was present on variables of achievement even for normal-hearing preschoolers.

Hearing Aid Outcomes: Effects of Gender and Experience on Patients' Use and Satisfaction

2009 ◽  
Vol 20 (07) ◽  
pp. 422-432 ◽  
Author(s):  
Victoria A. Williams ◽  
Carole E. Johnson ◽  
Jeffrey L. Danhauer
Keyword(s):  
Quality Of Life ◽  
Hearing Aids ◽  
Statistical Power ◽  
Hearing Aid ◽  
Normative Study ◽  
Digital Hearing Aids ◽  
Specific Questionnaire ◽  
Significant Difference ◽  
Experience Effects

Purpose: To use the International Outcome Inventory for Hearing Aids (IOI-HA) with patients having advanced hearing aid technology to assess their satisfaction and benefit focusing on gender and experience effects, compare to norms, and use the IOI-HA and a practice-specific questionnaire to monitor the quality of the services provided by a dispensing practice. Research Design: A study of 160 potential participants who had worn their newly purchased multichannel digital hearing aids having directional microphones for at least three months, completed a trial period, and should have had time to acclimatize to them. English-speaking, private or insurance paying, competent, adult patients from a private practice were mailed a 12-item practice-specific questionnaire and the seven-item IOI-HA. Results: Of the160 questionnaires mailed, 73 were returned for a 46% return rate. Of those, 64 were useable. Participants included male (34) and female (30), new (30) and previous (34) hearing aid users, who self-selected their participation by returning the questionnaires. The practice-specific questionnaire assessed patients' demographics and the quality of services received. The IOI-HA was analyzed according to an overall score and on two different factor scores. A power analysis revealed that 19 respondents per group were needed for the IOI-HA results to have a statistical power of .80 and probability of a Type II error of .20 for detecting a significant difference at the p < 0.05 level. Similar to earlier studies, no significant differences were observed either for any of the main effects or interactions for gender or user experience for the two IOI-HA factors and overall scores. A significant, but weak, positive correlation (r = .34; df = 63; p < .05) was observed between patients' overall satisfaction as indicated from the IOI-HA and the practice-specific quality assurance satisfaction question. T-tests on IOI-HA items 4 (satisfaction) and 7 (quality of life) revealed that the present participants' responses were significantly higher than for those in the normative study. Conclusions: Gender and hearing aid experience did not influence these patients' responses on the IOI-HA, and all respondents were satisfied with their hearing aids and the practice that dispensed them. No major differences were found between these patients' IOI-HA results and normative data suggesting that both sets of respondents were satisfied with their hearing aids. However, limited statistical comparisons for the satisfaction and quality of life items revealed significant differences in favor of these participants' scores over those in the normative study. This suggested that the advanced hearing aid technology used here had a positive effect on patients' ratings and that the IOI-HA norms should be updated periodically to reflect changes in technology.

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