Personal Amplification for School-Age Children with Auditory Processing Disorders

2008 ◽  
Vol 19 (06) ◽  
pp. 465-480 ◽  
Author(s):  
Francis Kuk ◽  
Amy Jackson ◽  
Denise Keenan ◽  
Chi-chuen Lau
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Auditory Processing ◽  
Performance Test ◽  
Dynamic Range ◽  
Hearing Aid ◽  
Word List ◽  
School Age Children ◽  
Auditory Processing Disorders ◽  
Directional Microphone

Background: Children with auditory processing disorders (APD) are described to have a signal-to-noise ratio (SNR) difficulty. Frequency-modulated (FM) systems have been reported to improve this situation. Yet the use of personal amplification that may be more portable has not been attempted. Purpose: To determine whether personal amplification would result in improvement in speech-in-noise performances (attentiveness and speech recognition) and daily functioning in children with diagnosed APD. In addition, the desired hearing aid features (such as required gain, directional microphone and noise reduction, and open-ear fitting) are examined. Research Design: A single-blind, longitudinal descriptive study in which subjects served as their own control in various hearing aid conditions. Study Sample: Fourteen normal hearing children who had a diagnosis of APD and who were between the ages of 7 and 11 participated. Intervention: All subjects wore bilateral, mild-gain, behind-the-ear, wide dynamic range compression hearing aids fitted in an open-ear mode. Gain on the hearing aids was adjusted to provide approximately 10 dB of insertion gain for conversational input. Directional microphone and noise reduction were used on the hearing aids. Subjects wore the hearing aids home and were encouraged to use them as much as possible in their daily environments (school, home, and social activities). Subjects were seen four times: an initial visit where hearing aids were fitted, then visits at 2 weeks, 3 months, and 6 months after the initial fitting. The majority of the testing was completed during these final three visits. Data Collection and Analysis: The children were evaluated on the Northwestern University word-list (NU–6) and the Auditory Continuous Performance Test (ACPT) in noise at most visits. The hearing aids were evaluated in the omnidirectional microphone mode only, omnidirectional microphone with noise reduction (NR) mode, and directional microphone with NR mode. The children's parents and teachers were asked to complete the Children's Auditory Processing Performance Scale (CHAPS) questionnaire both before and at the end of the study. Results: The results showed that the use of hearing aids in the omnidirectional microphone mode alone did not improve speech identification in noise over the unaided condition. However, the inclusion of the NR algorithm and directional microphones improved speech understanding in noise. Amplification reduced the number of errors on the ACPT and improved several areas on the CHAPS; however, the results were not statistically significant. Conclusions: The use of mild-gain, open-ear fitting hearing aids with a directional microphone and noise reduction algorithm may be attempted on some children with APD on a trial basis.

The Effects of Hearing Aid Directional Microphone and Noise Reduction Processing on Listening Effort in Older Adults with Hearing Loss

2016 ◽  
Vol 27 (01) ◽  
pp. 029-041 ◽  
Author(s):  
Jamie L. Desjardins
Keyword(s):  
Hearing Loss ◽  
Cognitive Load ◽  
Noise Reduction ◽  
Cognitive Processing ◽  
Hearing Aids ◽  
Background Noise ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Listening Effort ◽  
Directional Microphone

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.

Speech and Language of Children Using Hearing Aids With Adaptive Directional and Noise Reduction Features

2010 ◽  
Vol 11 (4) ◽  
pp. 126-132
Author(s):  
Jane Auriemmo ◽  
Patti Stenger
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Expressive Language ◽  
Hearing Aid ◽  
School Age Children ◽  
School Age ◽  
Language Outcomes ◽  
Speech And Language ◽  
Speech Language Pathologist

Abstract This paper reviews longitudinal speech-language outcomes of a group of school age children using hearing aid noise reduction and adaptive directional features. These results, obtained through collaboration between school audiologist and speech-language pathologist, reveal that receptive and expressive language scores are stable or improved over a three-year period of use.

Evaluation of a Second-Order Directional Microphone Hearing Aid: II. Self-Report Outcomes

2006 ◽  
Vol 17 (03) ◽  
pp. 190-201 ◽  
Author(s):  
Catherine Palmer ◽  
Ruth Bentler ◽  
Gustav H. Mueller
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Second Order ◽  
Self Report ◽  
Subjective Ratings ◽  
Directional Microphone ◽  
Hearing Aid Use ◽  
Nonlinear Version ◽  
Automatic Switching

This clinical trial was undertaken to evaluate the subjective benefit obtained from hearing aids employing automatic switching second-order adaptive directional microphone technology, used in conjunction with digital noise reduction, as compared to a fixed directional microphone or omnidirectional microphone response with the same digital noise reduction. Data were collected for 49 participants across two sites. Both new and experienced hearing aid users were fit bilaterally with behind-the-ear hearing aids using the NAL-NL1 (National Acoustics Laboratory—Nonlinear version 1) prescriptive method with manufacturer default settings for various signal processing (e.g., noise reduction, compression parameters, etc.). During ten days of hearing aid use, participants responded to daily journal questions. Subjective ratings for each of the three hearing aid responses (omnidirectional, automatic-adaptive directional, and automatic-fixed directional) were similar. Overall preference for a microphone condition was equally distributed between no preference, omnidirectional, and automatic adaptive and/or fixed directional.

Directional Microphone Hearing Aids in School Environments: Working Toward Optimization

2017 ◽  
Vol 60 (1) ◽  
pp. 263-275 ◽  
Author(s):  
Todd A. Ricketts ◽  
Erin M. Picou ◽  
Jason Galster
Keyword(s):  
Hearing Aids ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Sound Level ◽  
School Age Children ◽  
School Environments ◽  
Switching Algorithm ◽  
Directional Microphone ◽  
Automatic Switching ◽  
Typical School

PurposeThe hearing aid microphone setting (omnidirectional or directional) can be selected manually or automatically. This study examined the percentage of time the microphone setting selected using each method was judged to provide the best signal-to-noise ratio (SNR) for the talkers of interest in school environments.MethodA total of 26 children (aged 6–17 years) with hearing loss were fitted with study hearing aids and evaluated during 2 typical school days. Time-stamped hearing aid settings were compared with observer judgments of the microphone setting that provided the best SNR on the basis of the specific listening environment.ResultsDespite training for appropriate use, school-age children were unlikely to consistently manually switch to the microphone setting that optimized SNR. Furthermore, there was only fair agreement between the observer judgments and the hearing aid setting chosen by the automatic switching algorithm. Factors contributing to disagreement included the hearing aid algorithm choosing the directional setting when the talker was not in front of the listener or when noise arrived only from the front quadrant and choosing the omnidirectional setting when the noise level was low.ConclusionConsideration of listener preferences, talker position, sound level, and other factors in the classroom may be necessary to optimize microphone settings.

Evaluation of a Second-Order Directional Microphone Hearing Aid: I. Speech Perception Outcomes

2006 ◽  
Vol 17 (03) ◽  
pp. 179-189 ◽  
Author(s):  
Ruth Bentler ◽  
Catherine Palmer ◽  
Gustav H. Mueller
Keyword(s):  
Speech Perception ◽  
Noise Reduction ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Second Order ◽  
Directional Microphones ◽  
Noise Environment ◽  
Directional Microphone ◽  
Nonlinear Version ◽  
Omnidirectional Microphones

This clinical trial was undertaken to evaluate the benefit obtained from hearing aids employing second-order adaptive directional microphone technology, used in conjunction with digital noise reduction. Data were collected for 49 subjects across two sites. New and experienced hearing aid users were fit bilaterally with behind-the-ear hearing aids using the National Acoustics Laboratory—Nonlinear version 1 (NAL-NL1) prescriptive method with manufacturer default settings for various parameters of signal processing (e.g., noise reduction, compression, etc.). Laboratory results indicated that (1) for the stationary noise environment, directional microphones provided better speech perception than omnidirectional microphones, regardless of the number of microphones; and (2) for the moving noise environment, the three-microphone option (whether in adaptive or fixed mode) and the two-microphone option in its adaptive mode resulted in better performance than the two-microphone fixed mode, or the omnidirectional modes.

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.

Hearing Technology Use and Management in School-Age Children: Reports from Data Logs, Parents, and Teachers

2017 ◽  
Vol 28 (10) ◽  
pp. 883-892 ◽  
Author(s):  
Samantha J. Gustafson ◽  
Todd A. Ricketts ◽  
Anne Marie Tharpe
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Parent Report ◽  
School Age Children ◽  
School Age ◽  
Data Logging ◽  
Hearing Aid Use ◽  
System Use ◽  
Children With Hearing Loss

Background: Consistency of hearing aid and remote microphone system use declines as school-age children with hearing loss age. One indicator of hearing aid use time is data logging, another is parent report. Recent data suggest that parents overestimate their children’s hearing aid use time relative to data logging. The potential reasons for this disparity remain unclear. Because school-age children spend the majority of their day away from their parents and with their teachers, reports from teachers might serve as a valuable and additional tool for estimating hearing aid use time and management. Purpose: This study expands previous research on factors influencing hearing aid use time in school-age children using data logging records. Discrepancies between data logging records and parent reports were explored using custom surveys designed for parents and teachers. Responses from parents and teachers were used to examine hearing aid use, remote microphone system use, and hearing aid management in school-age children. Study Sample: Thirteen children with mild-to-moderate hearing loss between the ages of 7 and 10 yr and their parents participated in this study. Teachers of ten of these children also participated. Data Collection and Analysis: Parents and teachers of children completed written surveys about each child’s hearing aid use, remote microphone system use, and hearing aid management skills. Data logs were read from hearing aids using manufacturer’s software. Multiple linear regression analysis and an intraclass correlation coefficient were used to examine factors influencing hearing aid use time and parent agreement with data logs. Parent report of hearing aid use time was compared across various activities and school and nonschool days. Survey responses from parents and teachers were compared to explore areas requiring potential improvement in audiological counseling. Results: Average daily hearing aid use time was ˜6 hr per day as recorded with data logging technology. Children exhibiting greater degrees of hearing loss and those with poorer vocabulary were more likely to use hearing aids consistently than children with less hearing loss and better vocabulary. Parents overestimated hearing aid use by ˜1 hr per day relative to data logging records. Parent-reported use of hearing aids varied across activities but not across school and nonschool days. Overall, parents and teachers showed excellent agreement on hearing aid and remote microphone system use during school instruction but poor agreement when asked about the child’s ability to manage their hearing devices independently. Conclusions: Parental reports of hearing aid use in young school-age children are largely consistent with data logging records and with teacher reports of hearing aid use in the classroom. Audiologists might find teacher reports helpful in learning more about children’s hearing aid management and remote microphone system use during their time at school. This supplementary information can serve as an additional counseling tool to facilitate discussion about remote microphone system use and hearing aid management in school-age children with hearing loss.

scholarly journals Smartphone-Based System for Learning and Inferring Hearing Aid Settings

2016 ◽  
Vol 27 (09) ◽  
pp. 732-749 ◽  
Author(s):  
Gabriel Aldaz ◽  
Sunil Puria ◽  
Larry J. Leifer
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
User Study ◽  
Hearing Aid ◽  
Sensor Data ◽  
Significant Preference ◽  
Environmental Sound ◽  
Sound Environment ◽  
Study Participants ◽  
Hearing System

Background: Previous research has shown that hearing aid wearers can successfully self-train their instruments’ gain-frequency response and compression parameters in everyday situations. Combining hearing aids with a smartphone introduces additional computing power, memory, and a graphical user interface that may enable greater setting personalization. To explore the benefits of self-training with a smartphone-based hearing system, a parameter space was chosen with four possible combinations of microphone mode (omnidirectional and directional) and noise reduction state (active and off). The baseline for comparison was the “untrained system,” that is, the manufacturer’s algorithm for automatically selecting microphone mode and noise reduction state based on acoustic environment. The “trained system” first learned each individual’s preferences, self-entered via a smartphone in real-world situations, to build a trained model. The system then predicted the optimal setting (among available choices) using an inference engine, which considered the trained model and current context (e.g., sound environment, location, and time). Purpose: To develop a smartphone-based prototype hearing system that can be trained to learn preferred user settings. Determine whether user study participants showed a preference for trained over untrained system settings. Research Design: An experimental within-participants study. Participants used a prototype hearing system—comprising two hearing aids, Android smartphone, and body-worn gateway device—for ˜6 weeks. Study Sample: Sixteen adults with mild-to-moderate sensorineural hearing loss (HL) (ten males, six females; mean age = 55.5 yr). Fifteen had ≥6 mo of experience wearing hearing aids, and 14 had previous experience using smartphones. Intervention: Participants were fitted and instructed to perform daily comparisons of settings (“listening evaluations”) through a smartphone-based software application called Hearing Aid Learning and Inference Controller (HALIC). In the four-week-long training phase, HALIC recorded individual listening preferences along with sensor data from the smartphone—including environmental sound classification, sound level, and location—to build trained models. In the subsequent two-week-long validation phase, participants performed blinded listening evaluations comparing settings predicted by the trained system (“trained settings”) to those suggested by the hearing aids’ untrained system (“untrained settings”). Data Collection and Analysis: We analyzed data collected on the smartphone and hearing aids during the study. We also obtained audiometric and demographic information. Results: Overall, the 15 participants with valid data significantly preferred trained settings to untrained settings (paired-samples t test). Seven participants had a significant preference for trained settings, while one had a significant preference for untrained settings (binomial test). The remaining seven participants had nonsignificant preferences. Pooling data across participants, the proportion of times that each setting was chosen in a given environmental sound class was on average very similar. However, breaking down the data by participant revealed strong and idiosyncratic individual preferences. Fourteen participants reported positive feelings of clarity, competence, and mastery when training via HALIC. Conclusions: The obtained data, as well as subjective participant feedback, indicate that smartphones could become viable tools to train hearing aids. Individuals who are tech savvy and have milder HL seem well suited to take advantages of the benefits offered by training with a smartphone.

Effectiveness of Directional Microphones and Noise Reduction Schemes in Hearing Aids: A Systematic Review of the Evidence

2005 ◽  
Vol 16 (07) ◽  
pp. 473-484 ◽  
Author(s):  
Ruth A. Bentler
Keyword(s):  
Systematic Review ◽  
Noise Reduction ◽  
Hearing Aids ◽  
Small Sample Size ◽  
Careful Consideration ◽  
Small Sample ◽  
Experimental Conditions ◽  
Directional Microphones ◽  
Directional Microphone

A systematic review of the literature was undertaken to find evidence of real-world effectiveness of directional microphone and digital noise reduction features in current hearing aids. The evidence was drawn from randomized controlled trials, nonrandomized intervention studies, and descriptive studies. The quality of each study was evaluated for factors such as blinding, power of statistical analyses, and use of psychometrically strong outcome measures. Weaknesses in the identified studies included small sample size, resultant poor power to detect potentially worthwhile differences, and overlapping experimental conditions. Nine studies were identified for directional microphones, and the evidence (albeit weak) supports effectiveness. Two studies were identified for the noise reduction feature, and the evidence was equivocal. For the researcher, such a systematic review should encourage the careful consideration of appropriate methodologies for assessing feature effectiveness. For the clinician, the outcomes reported herein should encourage use of such a systematic review to drive clinical practice.

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