scholarly journals Listener Performance with a Novel Hearing Aid Frequency Lowering Technique

2017 ◽  
Vol 28 (09) ◽  
pp. 810-822 ◽  
Author(s):  
Benjamin J. Kirby ◽  
Judy G. Kopun ◽  
Meredith Spratford ◽  
Clairissa M. Mollak ◽  
Marc A. Brennan ◽  
...  
Keyword(s):  
Signal Processing ◽  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Sound Quality ◽  
Processing Strategy ◽  
Listening Effort ◽  
At Home

AbstractSloping hearing loss imposes limits on audibility for high-frequency sounds in many hearing aid users. Signal processing algorithms that shift high-frequency sounds to lower frequencies have been introduced in hearing aids to address this challenge by improving audibility of high-frequency sounds.This study examined speech perception performance, listening effort, and subjective sound quality ratings with conventional hearing aid processing and a new frequency-lowering signal processing strategy called frequency composition (FC) in adults and children.Participants wore the study hearing aids in two signal processing conditions (conventional processing versus FC) at an initial laboratory visit and subsequently at home during two approximately six-week long trials, with the order of conditions counterbalanced across individuals in a double-blind paradigm.Children (N = 12, 7 females, mean age in years = 12.0, SD = 3.0) and adults (N = 12, 6 females, mean age in years = 56.2, SD = 17.6) with bilateral sensorineural hearing loss who were full-time hearing aid users.Individual performance with each type of processing was assessed using speech perception tasks, a measure of listening effort, and subjective sound quality surveys at an initial visit. At the conclusion of each subsequent at-home trial, participants were retested in the laboratory. Linear mixed effects analyses were completed for each outcome measure with signal processing condition, age group, visit (prehome versus posthome trial), and measures of aided audibility as predictors.Overall, there were few significant differences in speech perception, listening effort, or subjective sound quality between FC and conventional processing, effects of listener age, or longitudinal changes in performance. Listeners preferred FC to conventional processing on one of six subjective sound quality metrics. Better speech perception performance was consistently related to higher aided audibility.These results indicate that when high-frequency speech sounds are made audible with conventional processing, speech recognition ability and listening effort are similar between conventional processing and FC. Despite the lack of benefit to speech perception, some listeners still preferred FC, suggesting that qualitative measures should be considered when evaluating candidacy for this signal processing strategy.

Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss

2018 ◽  
Vol 29 (03) ◽  
pp. 243-254 ◽  
Author(s):  
Angeline Seeto ◽  
Grant D. Searchfield
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Sound Quality ◽  
Significant Benefit ◽  
Band Frequency ◽  
Significant Difference ◽  
Moderate Hearing Loss

AbstractAdvances in digital signal processing have made it possible to provide a wide-band frequency response with smooth, precise spectral shaping. Several manufacturers have introduced hearing aids that are claimed to provide gain for frequencies up to 10–12 kHz. However, there is currently limited evidence and very few independent studies evaluating the performance of the extended bandwidth hearing aids that have recently become available.This study investigated an extended bandwidth hearing aid using measures of speech intelligibility and sound quality to find out whether there was a significant benefit of extended bandwidth amplification over standard amplification.Repeated measures study designed to examine the efficacy of extended bandwidth amplification compared to standard bandwidth amplification.Sixteen adult participants with mild-to-moderate sensorineural hearing loss.Participants were bilaterally fit with a pair of Widex Mind 440 behind-the-ear hearing aids programmed with a standard bandwidth fitting and an extended bandwidth fitting; the latter provided gain up to 10 kHz.For each fitting, and an unaided condition, participants completed two speech measures of aided benefit, the Quick Speech-in-Noise test (QuickSIN™) and the Phonak Phoneme Perception Test (PPT; high-frequency perception in quiet), and a measure of sound quality rating.There were no significant differences found between unaided and aided conditions for QuickSIN™ scores. For the PPT, there were statistically significantly lower (improved) detection thresholds at high frequencies (6 and 9 kHz) with the extended bandwidth fitting. Although not statistically significant, participants were able to distinguish between 6 and 9 kHz 50% better with extended bandwidth. No significant difference was found in ability to recognize phonemes in quiet between the unaided and aided conditions when phonemes only contained frequency content <6 kHz. However significant benefit was found with the extended bandwidth fitting for recognition of 9-kHz phonemes. No significant difference in sound quality preference was found between the standard bandwidth and extended bandwidth fittings.This study demonstrated that a pair of currently available extended bandwidth hearing aids was technically capable of delivering high-frequency amplification that was both audible and useable to listeners with mild-to-moderate hearing loss. This amplification was of acceptable sound quality. Further research, particularly field trials, is required to ascertain the real-world benefit of high-frequency amplification.

Modified Earpieces and CROS for High Frequency Hearing Losses

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

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

Cochlear Implantation in Children with Postlingual Progressive Steeply Sloping High-Frequency Hearing Loss

2017 ◽  
Vol 28 (10) ◽  
pp. 913-919 ◽  
Author(s):  
Margaret A. Meredith ◽  
Jay T. Rubinstein ◽  
Kathleen C. Y. Sie ◽  
Susan J. Norton
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Cochlear Implantation ◽  
High Frequency ◽  
Case Series ◽  
Hearing Preservation ◽  
Rapid Improvement ◽  
Retrospective Case ◽  
Monosyllabic Word

Background: Children with steeply sloping sensorineural hearing loss (SNHL) lack access to critical high-frequency cues despite the use of advanced hearing aid technology. In addition, their auditory-only aided speech perception abilities often meet Food and Drug Administration criteria for cochlear implantation. Purpose: The objective of this study was to describe hearing preservation and speech perception outcomes in a group of young children with steeply sloping SNHL who received a cochlear implant (CI). Research Design: Retrospective case series. Study Sample: Eight children with steeply sloping postlingual progressive SNHL who received a unilateral traditional CI at Seattle Children’s Hospital between 2009 and 2013 and had follow-up data available up to 24 mo postimplant were included. Data Collection and Analysis: A retrospective chart review was completed. Medical records were reviewed for demographic information, preoperative and postoperative behavioral hearing thresholds, and speech perception scores. Paired t tests were used to analyze speech perception data. Hearing preservation results are reported. Results: Rapid improvement of speech perception scores was observed within the first month postimplant for all participants. Mean monosyllabic word scores were 76% and mean phoneme scores were 86.7% at 1-mo postactivation compared to mean preimplant scores of 19.5% and 31.0%, respectively. Hearing preservation was observed in five participants out to 24-mo postactivation. Two participants lost hearing in both the implanted and unimplanted ear, and received a sequential bilateral CI in the other ear after progression of the hearing loss. One participant had a total loss of hearing in only the implanted ear. Results reported in this article are from the ear implanted first. Bilateral outcomes are not reported. Conclusions: CIs provided benefit for children with steeply sloping bilateral hearing loss for whom hearing aids did not provide adequate auditory access. In our cohort, significant improvements in speech understanding occurred rapidly postactivation. Preservation of residual hearing in children with a traditional CI electrode is possible.

Hearing Impaired Children's Preference for, and Performance with, Four Combinations of Directional Microphone and Digital Noise Reduction Technology

2013 ◽  
Vol 24 (09) ◽  
pp. 832-844 ◽  
Author(s):  
Andrea L. Pittman ◽  
Mollie M. Hiipakka
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Noise Reduction ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Directional Hearing ◽  
Short Period ◽  
Children With Hearing Loss ◽  
And Performance ◽  
Noise Management

Background: Before advanced noise-management features can be recommended for use in children with hearing loss, evidence regarding their ability to use these features to optimize speech perception is necessary. Purpose: The purpose of this study was to examine the relation between children's preference for, and performance with, four combinations of noise-management features in noisy listening environments. Research Design: Children with hearing loss were asked to repeat short sentences presented in steady-state noise or in multitalker babble while wearing ear-level hearing aids. The aids were programmed with four memories having an orthogonal arrangement of two noise-management features. The children were also asked to indicate the hearing aid memory that they preferred in each of the listening conditions both initially and after a short period of use. Study Sample: Fifteen children between the ages of 8 and 12 yr with moderate hearing losses, bilaterally. Results: The children's preference for noise management aligned well with their performance for at least three of the four listening conditions. The configuration of noise-management features had little effect on speech perception with the exception of reduced performance for speech originating from behind the child while in a directional hearing aid setting. Additionally, the children's preference appeared to be governed by listening comfort, even under conditions for which a benefit was not expected such as the use of digital noise reduction in the multitalker babble conditions. Conclusions: The results serve as evidence in support of the use of noise-management features in grade-school children as young as 8 yr of age.

An Initial-Fit Comparison of Two Generic Hearing Aid Prescriptive Methods (NAL-NL2 and CAM2) to Individuals Having Mild to Moderately Severe High-Frequency Hearing Loss

2013 ◽  
Vol 24 (02) ◽  
pp. 138-150 ◽  
Author(s):  
Earl E. Johnson
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Speech Intelligibility ◽  
Paired Comparison ◽  
Hearing Aid ◽  
Sound Quality ◽  
Individual Subject ◽  
Model Calculations ◽  
High Frequency Hearing Loss

Background: Johnson and Dillon (2011) provided a model-based comparison of current generic hearing aid prescriptive methods for adults with hearing loss based on the attributes of speech intelligibility, loudness, and bandwidth. Purpose: This study compared the National Acoustic Laboratories—Non-linear 2 (NAL-NL2) and Cambridge Method for Loudness Equalization 2—High-Frequency (CAM2) prescriptive methods using adult participants with less high-frequency hearing loss than Johnson and Dillon (2011). Of study interest was quantification of prescribed audibility, speech intelligibility, and loudness. The preferences of participants for either NAL-NL2 or CAM2 and preferred deviations from prescribed settings are also reported. Research Design: Using a single-blind, counter-balanced, randomized design, preference judgments for the prescriptive methods with regard to sound quality of speech and music stimuli were obtained. Preferred gain adjustments from the prescription within the 4–10 kHz frequency range were also obtained from each participant. Speech intelligibility and loudness model calculations were completed on the prescribed and adjusted amplification. Study Sample: Fourteen male Veterans, whose average age was 65 yr and whose hearing sensitivity averaged normal to borderline normal through 1000 Hz sloping to a moderately severe sensorineural loss, served as participants. Data Collection and Analysis: Following a brief listening time (˜10 min), typical of an initial fitting visit, the participants made paired comparison of sound quality between the NAL-NL2 and CAM2 prescriptive settings. Participants were also asked to modify each prescription in the range of 4–10 kHz using an overall gain control and make subsequent comparisons of sound quality preference between prescriptive and adjusted settings. Participant preferences were examined with respect to quantitative analysis of loudness modeling, speech intelligibility modeling, and measured high-frequency bandwidth audibility. Results: Consistent with the lack of difference in predicted speech intelligibility between the two prescriptions, sound quality preferences on the basis of clarity were split across participants while some participants did not have a discernable preference. Considering sound quality judgments of pleasantness, the majority of participants preferred the sound quality of the NAL-NL2 (8 of 14) prescription instead of the CAM2 prescription (2 of 14). Four of the 14 participants showed no preference on the basis of pleasantness for either prescription. Individual subject preferences were supported by loudness modeling that indicated NAL-NL2 was the softer of the two prescriptions and CAM2 was the louder. CAM2 did provide more audibility to the higher frequencies (5–8 kHz) than NAL-NL2. Participants turned the 4–10 kHz gain recommendation of CAM2 lower, on average, by a significant amount of 4 dB when making adjustments while no significant adjustment was made to the initial NAL-NL2 recommendation. Conclusions: NAL-NL2 prescribed gains were more often preferred at the initial fitting by the majority of participating veterans. For those patients with preference for a louder fitting than NAL-NL2, CAM2 is a good alternative. When the participant adjustment from the prescription between 4 and 10 kHz exceeded 4 dB from either NAL-NL2 (2 of 14) or CAM2 (11 of 14), the participants demonstrated a later preference for that adjustment 69% of the time. These findings are viewed as limited evidence that some individuals may have a preference for high-frequency gain that differs from the starting prescription.

scholarly journals Vibrant Soundbridge and Bone Conduction Hearing Aid in Patients with Bilateral Malformation of External Ear

2015 ◽  
Vol 20 (01) ◽  
pp. 034-038 ◽  
Author(s):  
Maria Mondelli ◽  
Thais Mariano ◽  
Heitor Honório ◽  
Rubens Brito
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Bone Conduction ◽  
External Ear ◽  
Vibrant Soundbridge ◽  
Mixed Hearing Loss ◽  
Bone Conduction Hearing ◽  
Bone Conduction Hearing Aid

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.

A Comparison of Personal Sound Amplification Products and Hearing Aids in Ecologically Relevant Test Environments

2018 ◽  
Vol 27 (4) ◽  
pp. 581-593 ◽  
Author(s):  
Lisa Brody ◽  
Yu-Hsiang Wu ◽  
Elizabeth Stangl
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Best Practice ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Sound Quality ◽  
Listening Effort ◽  
Speech Intelligibility Index ◽  
Sound Amplification

Purpose The aim of this study was to compare the benefit of self-adjusted personal sound amplification products (PSAPs) to audiologist-fitted hearing aids based on speech recognition, listening effort, and sound quality in ecologically relevant test conditions to estimate real-world effectiveness. Method Twenty-five older adults with bilateral mild-to-moderate hearing loss completed the single-blinded, crossover study. Participants underwent aided testing using 3 PSAPs and a traditional hearing aid, as well as unaided testing. PSAPs were adjusted based on participant preference, whereas the hearing aid was configured using best-practice verification protocols. Audibility provided by the devices was quantified using the Speech Intelligibility Index (American National Standards Institute, 2012). Outcome measures assessing speech recognition, listening effort, and sound quality were administered in ecologically relevant laboratory conditions designed to represent real-world speech listening situations. Results All devices significantly improved Speech Intelligibility Index compared to unaided listening, with the hearing aid providing more audibility than all PSAPs. Results further revealed that, in general, the hearing aid improved speech recognition performance and reduced listening effort significantly more than all PSAPs. Few differences in sound quality were observed between devices. All PSAPs improved speech recognition and listening effort compared to unaided testing. Conclusions Hearing aids fitted using best-practice verification protocols were capable of providing more aided audibility, better speech recognition performance, and lower listening effort compared to the PSAPs tested in the current study. Differences in sound quality between the devices were minimal. However, because all PSAPs tested in the study significantly improved participants' speech recognition performance and reduced listening effort compared to unaided listening, PSAPs could serve as a budget-friendly option for those who cannot afford traditional amplification.

Fitting Noise Management Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Verification Protocols

2016 ◽  
Vol 27 (03) ◽  
pp. 237-251 ◽  
Author(s):  
Susan Scollie ◽  
Charla Levy ◽  
Nazanin Pourmand ◽  
Parvaneh Abbasalipour ◽  
Marlene Bagatto ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Clinical Practice ◽  
Noise Reduction ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Sound Quality ◽  
Speech In Noise ◽  
Verification Systems ◽  
Clinical Verification ◽  
Noise Management

Background: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying some technologies are not always available. One such technology is noise management in children’s hearing aids. Children are frequently in high-level and/or noisy environments, and many options for noise management exist in modern hearing aids. Verification protocols are needed to define specific test signals and levels for use in clinical practice. Purpose: This work aims to (1) describe the variation in different brands of noise reduction processors in hearing aids and the verification of these processors and (2) determine whether these differences are perceived by 13 children who have hearing loss. Finally, we aimed to develop a verification protocol for use in pediatric clinical practice. Study Sample: A set of hearing aids was tested using both clinically available test systems and a reference system, so that the impacts of noise reduction signal processing in hearing aids could be characterized for speech in a variety of background noises. A second set of hearing aids was tested across a range of audiograms and across two clinical verification systems to characterize the variance in clinical verification measurements. Finally, a set of hearing aid recordings that varied by type of noise reduction was rated for sound quality by children with hearing loss. Results: Significant variation across makes and models of hearing aids was observed in both the speed of noise reduction activation and the magnitude of noise reduction. Reference measures indicate that noise-only testing may overestimate noise reduction magnitude compared to speech-in-noise testing. Variation across clinical test signals was also observed, indicating that some test signals may be more successful than others for characterization of hearing aid noise reduction. Children provided different sound quality ratings across hearing aids, and for one hearing aid rated the sound quality as higher with the noise reduction system activated. Conclusions: Implications for clinical verification systems may be that greater standardization and the use of speech-in-noise test signals may improve the quality and consistency of noise reduction verification cross clinics. A suggested clinical protocol for verification of noise management in children’s hearing aids is suggested.

scholarly journals Listening Effort and Speech Recognition with Frequency Compression Amplification for Children and Adults with Hearing Loss

2017 ◽  
Vol 28 (09) ◽  
pp. 823-837 ◽  
Author(s):  
Marc A. Brennan ◽  
Dawna Lewis ◽  
Ryan McCreery ◽  
Judy Kopun ◽  
Joshua M. Alexander
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
High Frequency ◽  
Hearing Aid ◽  
Nonsense Word ◽  
Spectral Distortion ◽  
Listening Effort ◽  
Frequency Compression ◽  
Low Pass ◽  
Adults And Children

AbstractNonlinear frequency compression (NFC) can improve the audibility of high-frequency sounds by lowering them to a frequency where audibility is better; however, this lowering results in spectral distortion. Consequently, performance is a combination of the effects of increased access to high-frequency sounds and the detrimental effects of spectral distortion. Previous work has demonstrated positive benefits of NFC on speech recognition when NFC is set to improve audibility while minimizing distortion. However, the extent to which NFC impacts listening effort is not well understood, especially for children with sensorineural hearing loss (SNHL).To examine the impact of NFC on recognition and listening effort for speech in adults and children with SNHL.Within-subject, quasi-experimental study. Participants listened to amplified nonsense words that were (1) frequency-lowered using NFC, (2) low-pass filtered at 5 kHz to simulate the restricted bandwidth (RBW) of conventional hearing aid processing, or (3) low-pass filtered at 10 kHz to simulate extended bandwidth (EBW) amplification.Fourteen children (8–16 yr) and 14 adults (19–65 yr) with mild-to-severe SNHL.Participants listened to speech processed by a hearing aid simulator that amplified input signals to fit a prescriptive target fitting procedure.Participants were blinded to the type of processing. Participants' responses to each nonsense word were analyzed for accuracy and verbal-response time (VRT; listening effort). A multivariate analysis of variance and linear mixed model were used to determine the effect of hearing-aid signal processing on nonsense word recognition and VRT.Both children and adults identified the nonsense words and initial consonants better with EBW and NFC than with RBW. The type of processing did not affect the identification of the vowels or final consonants. There was no effect of age on recognition of the nonsense words, initial consonants, medial vowels, or final consonants. VRT did not change significantly with the type of processing or age.Both adults and children demonstrated improved speech recognition with access to the high-frequency sounds in speech. Listening effort as measured by VRT was not affected by access to high-frequency sounds.

Effects of Reducing Low-Frequency Amplification on Consonant Perception in Quiet and Noise

1984 ◽  
Vol 27 (4) ◽  
pp. 483-493 ◽  
Author(s):  
Sandra Gordon-Salant
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Low Frequency ◽  
Identification Performance ◽  
Phonetic Feature ◽  
Consonant Recognition

The aim of this study was to assess the effect of low-frequency amplification on speech recognition performance by hearing-impaired listeners. Consonant identification performance by subjects with flat hearing losses and high-frequency hearing losses was assessed in three different hearing aid conditions, in quiet and noise. The experimental hearing aids all provided extra high-frequency amplification but differed in the amount of low-frequency amplification. The results showed that listeners with flat hearing losses benefited by low-frequency amplification, whereas subjects with high-frequency hearing losses exhibited deteriorating scores in conditions with greatest low-frequency amplification. Analyses of phonetic feature perception and individual consonant recognition scores revealed subtle interactions between hearing loss configuration and amplification contour.

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