scholarly journals The Effects of Extended Input Dynamic Range on Laboratory and Field-Trial Evaluations in Adult Hearing Aid Users

2019 ◽  
Vol 30 (07) ◽  
pp. 634-648
Author(s):  
Patrick N. Plyler ◽  
Mary Easterday ◽  
Thomas Behrens

AbstractDigital hearing aids using a 16-bit analog-to-digital converter (ADC) provide a 96-dB input dynamic range. The level at which the ADC peak clips and distorts input signals ranges between 95 and 105 dB SPL. Recent research evaluated the effect of extending the input dynamic range in a commercially available hearing aid. Although the results were promising, several limitations were noted by the authors. Laboratory testing was conducted using recordings from hearing aids set for a flat 50-dB loss; however, field testing was conducted with hearing aids fitted for their hearing loss. In addition, participants rarely encountered input levels of sufficient intensity to adequately test the feature and were unable to directly compare aids with and without extended input dynamic range (EIDR) under identical conditions.The effects of EIDR under realistic and repeatable test conditions both within and outside the laboratory setting were evaluated.A repeated measures design was used. The experiment was single-blinded.Twenty adults (14 males and six females) between the ages of 30 and 71 years (average age 62 years) who were experienced hearing aid users participated.Each participant was fit with Oticon Opn hearing instruments binaurally using the National Acoustics Laboratory-Nonlinear 1 fitting strategy. Participants completed a two-week trial period using hearing aids with EIDR and a two-week trial period without EIDR. The initial EIDR condition trial period was counterbalanced. After each trial, laboratory evaluations were obtained at 85 dBC using the Connected Speech Test, the Hearing in Noise Test, and the acceptable noise level (ANL). Satisfaction ratings were conducted at 85 dBC using speech in quiet and in noise as well as music. Field-trial evaluations were obtained using the abbreviated profile of hearing aid benefit (APHAB). Satisfaction ratings were also conducted in the field at 85 dBC using speech and music. After the study, each participant indicated which trial period they preferred overall. Repeated measures analysis of variances were conducted to assess listener performance. Pairwise comparisons were then completed for significant main effects.In the laboratory, results did not reveal significant differences between EIDR conditions on any speech perception in noise test or any satisfaction rating measurement. In the field, results did not reveal significant differences between the EIDR conditions on the APHAB or on any of the satisfaction rating measurements. Nine participants (45%) preferred the EIDR condition. Fifteen participants (75%) indicated that speech clarity was the most important factor in determining the overall preference. Sixteen participants (80%) preferred the EIDR condition that resulted in the lower ANL.The use of EIDR in hearing aids within and outside the laboratory under realistic and repeatable test conditions did not positively or negatively impact performance or preference. Results disagreed with previous findings obtained in the laboratory that suggested EIDR improved performance; however, results agreed with previous findings obtained in the field. Future research may consider the effect of hearing aid experience, input level, and noise acceptance on potential benefit with EIDR.

2010 ◽  
Vol 21 (07) ◽  
pp. 461-473 ◽  
Author(s):  
Robert W. Sweetow ◽  
Jennifer Henderson Sabes

Background: 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. Purpose: 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. Research Design: 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. Study Sample: Fourteen hearing-impaired adults with primary complaints of subjective tinnitus. Intervention: 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 Collection and Analysis: Data were collected at the initial visit, one week, 1 mo, 3 mo, and 6 mo. Nonparametric statistics included Wilcoxon matched-pairs signed-rank, χ2, and repeated-measures analyses of variance. Results: 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 range of preferences observed for fractal settings, with most participants preferring fractals with a slow or medium tempo and restricted dynamic range. The majority (86%) indicated that it was easier to relax while listening to fractal signals. Participants had preferences for certain programs and fractal characteristics. Although seven participants rated the noise-only condition as providing the least tinnitus annoyance, only two opted to have noise only as a program during the field trial, and none selected the noise-only condition as the preferred setting. Furthermore, while all four of the experienced hearing aid users selected noise as producing the least annoying tinnitus in the laboratory, only one selected it for field wear. Tinnitus Handicap Inventory and Tinnitus Reaction Questionnaire scores were improved over the course of the 6 mo trial, with clinically significant improvements occurring for over half of the participants on at least one of the measures. Conclusions: The results suggest that use of acoustic stimuli, particularly fractal tones, delivered though hearing aids can provide amplification while allowing for relief for some tinnitus sufferers. It is important to recognize, however, that tinnitus management procedures need to be supplemented with appropriate counseling.


2019 ◽  
Vol 30 (04) ◽  
pp. 315-326 ◽  
Author(s):  
Jumana Harianawala ◽  
Jason Galster ◽  
Benjamin Hornsby

AbstractThe hearing in noise test (HINT) is the most popular adaptive test used to evaluate speech in noise performance, especially in context of hearing aid features. However, the number of conditions that can be tested on the HINT is limited by a small speech corpus. The American English Matrix test (AEMT) is a new alternative adaptive speech in noise test with a larger speech corpus. The study examined the relationships between the performance of hearing aid wearers on the HINT and the AEMT.To examine whether there was a difference in performance of hearing aid wearers on the HINT and the AEMT. A secondary purpose, given the AEMT’s steep performance-intensity function, was to determine whether the AEMT is more sensitive to changes in speech recognition resulting from directional (DIR) microphone processing in hearing aids.A repeated measures design was used in this study. Multiple measurements were made on each subject. Each measurement involved a different experimental condition.Ten adults with hearing loss participated in this study.All participants completed the AEMT and HINT, using adaptive and fixed test formats while wearing hearing aids. Speech recognition was assessed in two hearing aid microphone settings—omnidirectional and fixed DIR. All testing was conducted via sound field presentation. Performance on HINT and AEMT were systematically compared across all test conditions using a linear model with repeated measures.The results of this study revealed that adult hearing aid users perform differently on the HINT and AEMT, with adaptive AEMT testing yielding significantly better (more negative) thresholds than the HINT. Slopes of performance intensity functions obtained by testing at multiple fixed signal-to-noise ratios, revealed a somewhat steeper slope for the HINT compared with the AEMT. Despite this steeper slope, the benefit provided by DIR microphones was not significantly different between the two speech tests.The observation of similar DIR benefits of the HINT and AEMT suggests that the HINT and AEMT are equally sensitive to changes in speech recognition thresholds following intervention. Therefore, the decision to use the AEMT or the HINT will depend on the purpose of the study and/or the technology being investigated. Other test related factors such as available sentence corpus, learning effects and test time will also influence test selection.


2009 ◽  
Vol 20 (08) ◽  
pp. 465-479 ◽  
Author(s):  
Francis Kuk ◽  
Denise Keenan ◽  
Petri Korhonen ◽  
Chi-chuen Lau

Background: Frequency transposition has gained renewed interest in recent years. This type of processing takes sounds in the unaidable high-frequency region and moves them to the lower frequency region. One concern is that the transposed sounds mask or distort the original low-frequency sounds and lead to a poorer performance. On the other hand, experience with transposition may allow the listeners to relearn the new auditory percepts and benefit from transposition. Purpose: The current study was designed to examine the effect of linear frequency transposition on consonant identification in quiet (50 dB SPL and 68 dB SPL) and in noise at three intervals—the initial fit, after one month of use (along with auditory training), and a further one month of use (without directed training) of transposition. Research Design: A single-blind, factorial repeated-measures design was used to study the effect of test conditions (three) and hearing aid setting/time interval (four) on consonant identification. Study Sample: Eight adults with a severe-to-profound high-frequency sensorineural hearing loss participated. Intervention: Participants were fit with the Widex m4-m behind-the-ear hearing aids binaurally in the frequency transposition mode, and their speech scores were measured initially. They wore the hearing aids home for one month and were instructed to complete a self-paced “bottom-up” training regimen. They returned after the training, and their speech performance was measured. They wore the hearing aids home for another month, but they were not instructed to complete any auditory training. Their speech performance was again measured at the end of the two-month trial. Data Collection and Analysis: Consonant performance was measured with a nonsense syllable test (ORCA-NST) that was developed at this facility (Office of Research in Clinical Amplification [Widex]). The test conditions included testing in quiet at 50 dB SPL and 68 dB SPL, and at 68 dB SPL in noise (SNR [signal-to-noise ratio] = +5). The hearing aid conditions included no transposition at initial fit (V1), transposition at initial fit (V2), transposition at one month post-fit (V3), and transposition at 2 months post-fit (V4). Identification scores were analyzed for each individual phoneme and phonemic class. Repeated-measures ANOVA were conducted using SPSS software to examine significant differences. Results: For all test conditions (50 dB SPL in quiet, 68 dB SPL in quiet, and 68 dB SPL in noise), a statistically significant difference (p < 0.05 level) was reached between the transposition condition measured at two months postfitting and the initial fitting (with and without transposition) for fricatives only. The difference between transposition and the no-transposition conditions at the 50 dB SPL condition was also significant for the initial and one-month intervals. Analysis of individual phonemes showed a decrease in the number of confusions and an increase in the number of correct identification over time. Conclusions: Linear frequency transposition improved fricative identification over time. Proper candidate selection with appropriate training is necessary to fully realize the potential benefit of this type of processing.


2015 ◽  
Vol 26 (07) ◽  
pp. 607-614 ◽  
Author(s):  
Patrick Plyler ◽  
Mark Hedrick ◽  
Brittany Rinehart ◽  
Rebekah Tripp

Background: Both wide dynamic range compression (WDRC) and ChannelFree (CF) processing strategies in hearing aids were designed to improve listener comfort and consonant identification, yet few studies have actually compared them. Purpose: To determine whether CF processing provides equal or better consonant identification and subjective preference than WDRC. Research Design: A repeated-measures randomized design was used in which each participant identified consonants from prerecorded nonsense vowel–consonant–vowel syllables in three conditions: unaided, aided using CF processing, and aided using WDRC processing. For each of the three conditions, syllables were presented in quiet and in a speech-noise background. Participants were also asked to rate the two processing schemes according to overall preference, preference in quiet and noise, and sound quality. Study Sample: Twenty adults (seven females; mean age 69.7 yr) with ≥1 yr of hearing aid use participated. Ten participants had previous experience wearing aids with WDRC, and 10 had previous experience with CF processing. Participants were tested with both WDRC and CF processing. Data Collection and Analysis: Number of consonants correct were measured and used as the dependent variable in analyses of variance with subsequent post hoc testing. For subjective preference, a listener rating form was employed with subsequent χ2 analysis. Results: Overall results showed that signal-processing strategy did not significantly affect consonant identification or subjective preference, nor did previous hearing aid use influence results. Listeners with audiometric slopes exceeding 11 dB per octave, however, preferred CF processing and performed better in noise with CF processing. Conclusion: CF processing is a viable alternative to WDRC for listeners with more severely sloping audiometric contours.


Author(s):  
Isiaka Ajewale Alimi

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.


2021 ◽  
Vol 11 (2) ◽  
pp. 200-206
Author(s):  
Gennaro Auletta ◽  
Annamaria Franzè ◽  
Carla Laria ◽  
Carmine Piccolo ◽  
Carmine Papa ◽  
...  

Background: The aim of this study was to compare, in users of bimodal cochlear implants, the performance obtained using their own hearing aids (adjusted with the standard NAL-NL1 fitting formula) with the performance using the Phonak Naìda Link Ultra Power hearing aid adjusted with both NAL-NL1 and a new bimodal system (Adaptive Phonak Digital Bimodal (APDB)) developed by Advanced Bionics and Phonak Corporations. Methods: Eleven bimodal users (Naìda CI Q70 + contralateral hearing aid) were enrolled in our study. The users’ own hearing aids were replaced with the Phonak Naìda Link Ultra Power and fitted following the new formula. Speech intelligibility was assessed in quiet and noisy conditions, and comparisons were made with the results obtained with the users’ previous hearing aids and with the Naída Link hearing aids fitted with the NAL-NL1 generic prescription formula. Results: Using Phonak Naìda Link Ultra Power hearing aids with the Adaptive Phonak Digital Bimodal fitting formula, performance was significantly better than that with the users’ own rehabilitation systems, especially in challenging hearing situations for all analyzed subjects. Conclusions: Speech intelligibility tests in quiet settings did not reveal a significant difference in performance between the new fitting formula and NAL-NL1 fittings (using the Naída Link hearing aids), whereas the performance difference between the two fittings was very significant in noisy test conditions.


2009 ◽  
Vol 20 (05) ◽  
pp. 320-334 ◽  
Author(s):  
Gabrielle H. Saunders ◽  
M Samantha Lewis ◽  
Anna Forsline

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.


1996 ◽  
Vol 39 (5) ◽  
pp. 923-935 ◽  
Author(s):  
Larry E. Humes ◽  
Dan Halling ◽  
Maureen Coughlin

Twenty elderly persons with hearing impairment were fit with binaural in-the-ear hearing aids and followed for a 6-month period post-fit. Several hearing-aid outcome measures were obtained at 0, 7, 15, 30, 60, 90, and 180 days post-fit. Outcome measures included (a) objective measures of benefit obtained with nonsense-syllable materials in quiet (CUNY Nonsense Syllable Test, NST) and sentences in multitalker babble (Hearing in Noise Test, HINT); (b) two subjective measures of benefit, one derived from pre-fit/post-fit comparisons on a general scale of hearing handicap (Hearing Handicap Inventory for the Elderly, HHIE) and the other based on a subjective scale of post-fit hearing-aid benefit (Hearing Aid Performance Inventory, HAPI); (c) a questionnaire on hearing-aid satisfaction; (d) an objective measure of hearing-aid use; and (e) a subjective measure of hearing-aid use. Reliability and stability of each measure were examined through repeated-measures analyses of variance, a series of test-retest correlations, and, where possible, scatterplots of the scores against their corresponding 95% critical differences. Many of the measures were found to be both reliable and stable indicators of hearing-aid outcome.


2018 ◽  
Vol 29 (04) ◽  
pp. 273-278
Author(s):  
Haihong Liu ◽  
Yuanhu Liu ◽  
Ying Li ◽  
Xin Jin ◽  
Jing Li ◽  
...  

AbstractWide dynamic range compression (WDRC) has been widely used in hearing aid technology. However, several reports indicate that WDRC may improve audibility at the expense of speech intelligibility. As such, a modified amplification compression scheme, named adaptive compression, was developed. However, the effect of compression strategies on speech perception in pediatric hearing aid users has not been clearly reported.The purpose of the present study was to investigate the effect of adaptive compression and fast-acting WDRC processing strategies on sentence recognition in noise with Mandarin, pediatric hearing aid users.This study was set up using a double-blind, within-subject, repeated-measures design.Twenty-six children who spoke Mandarin Chinese as their primary language and had bilateral sensorineural hearing loss participated in the study.Sentence recognition in noise was evaluated in behind-the-ear technology with both adaptive compression processing and fast-acting WDRC processing and was selected randomly for each child. Percent correct sentence recognition in noise with fast-acting WDRC and adaptive compression was collected from each participant. Correlation analysis was performed to examine the effect of gender, age at assessment, and hearing threshold of the better ear on signal-to-noise ratio, and a paired-samples t test was employed to compare the performance of the adaptive compression strategy and fast-acting WDRC processing.The mean percentage correct of sentence recognition in noise with behind-the-ear technology with fast-acting WDRC and adaptive compression processing were 62.24% and 68.71%, respectively. The paired-samples t test showed that the performance of the adaptive compression strategy was significantly better than the fast-acting WDRC processing (t = 3.190, p = 0.004).Compared with the fast-acting WDRC, adaptive compression provided better sentence recognition in noise for Mandarin pediatric hearing aid users.


2005 ◽  
Vol 9 (2) ◽  
pp. 45-76 ◽  
Author(s):  
James M. Kates

This article provides an overview of dynamic-range compression in digital hearing aids. Digital technology is becoming increasingly common in hearing aids, particularly because of the processing flexibility it offers and the opportunity to create more-effective devices. The focus of the paper is on the algorithms used to build digital compression systems. Of the various approaches that can be used to design a digital hearing aid, this paper considers broadband compression, multi-channel filter banks, a frequency-domain compressor using the FFT, the side-branch design that separates the filtering operation from the frequency analysis, and the frequency-warped version of the side-branch approach that modifies the analysis frequency spacing to more closely match auditory perception. Examples of the compressor frequency resolution, group delay, and compression behavior are provided for the different design approaches.


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