Telecoil-Mode Hearing Aid Compatibility Performance Requirements for Wireless and Cordless Handsets: Magnetic Signal Levels

2011 ◽  
Vol 22 (08) ◽  
pp. 515-527 ◽  
Author(s):  
Stephen Julstrom ◽  
Linda Kozma-Spytek ◽  
Scott Isabelle
Keyword(s):  
Magnetic Field ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Telecommunications Industry ◽  
Background Information ◽  
Magnetic Signal ◽  
Field Orientation ◽  
Wide Range ◽  
Magnetic Level

Background: In the development of the requirements for telecoil-compatible magnetic signal sources for wireless and cordless telephones to be specified in the American National Standards Institute (ANSI) C63.19 and ANSI/Telecommunications Industry Association–1083 compatibility standards, it became evident that additional data concerning in-the-field telecoil use and subjective preferences were needed. Purpose: Primarily, the magnetic signal levels and, secondarily, the field orientations required for effective and comfortable telecoil use with wireless and cordless handsets needed further characterization. (A companion article addresses user signal-to-noise needs and preferences.) Research Design: Test subjects used their own hearing aids, which were addressed with both a controlled acoustic speech source and a controlled magnetic speech source. Each subject's hearing aid was first measured to find the telecoil's magnetic field orientation for maximum response, and an appropriate large magnetic head-worn coil was selected to apply the magnetic signal. Subjects could control the strength of the magnetic signal, first to match the loudness of a reference acoustic signal and then to find their Most Comfortable Level (MCL). The subjective judgments were compared against objective in-ear probe tube level measurements. Study Sample: The 57 test subjects covered an age range of 22 to 79 yr, with a self-reported hearing loss duration of 12 to 72 yr. All had telecoils that they used for at least some telecommunications needs. The self-reported degree of hearing loss ranged from moderate to profound. A total of 69 hearing aids were surveyed for their telecoil orientation. Data Collection and Analysis: A guided intake questionnaire yielded general background information for each subject. A custom-built test jig enabled hearing aid telecoil orientation within the aid to be determined. By comparing this observation with the in-use hearing aid position, the in-use orientation for each telecoil was determined. A custom-built test control box fed by prepared speech recordings from computer files enabled the tester to switch between acoustic and magnetic speech signals and to read and record the subject's selected magnetic level settings. Results: The overwhelming majority of behind-the-ear aids tested exhibited in-use telecoil orientations that were substantially vertical. An insufficient number of participants used in-the-ear aids to be able to draw general conclusions concerning the telecoil orientations of this style aid. The subjects showed a generally consistent preference for telecoil speech levels that subjectively matched the level that they heard from 65 dB SPL acoustic speech. The magnetic level needed to achieve their MCL, however, varied over a 30 dB range. Conclusions: Producing the necessary magnetic field strengths from a wireless or cordless telephone's handset in an in-use vertical orientation is vital for compatibility with the vast majority of behind-the-ear aids. Due to the very wide range of preferred magnetic signal levels shown, only indirect conclusions can be drawn concerning required signal levels. The strong preference for a 65 dB SPL equivalent level can be combined with established standards addressing hearing aid performance to derive reasonable source level requirements. Greater consistency between in-the-field hearing aid telecoil and microphone sensitivity adjustments could yield improved results for some users.

Telecoil-Mode Hearing Aid Compatibility Performance Requirements for Wireless and Cordless Handsets: Magnetic Signal-to-Noise

2011 ◽  
Vol 22 (08) ◽  
pp. 528-541 ◽  
Author(s):  
Stephen Julstrom ◽  
Linda Kozma-Spytek ◽  
Scott Isabelle
Keyword(s):  
Hearing Loss ◽  
Noise Level ◽  
Hearing Aid ◽  
Telecommunications Industry ◽  
Background Information ◽  
Signal To Noise ◽  
Excellent Performance ◽  
Magnetic Signal ◽  
Field Orientation ◽  
Noise Type

Background: During the revision of the American National Standards Institute (ANSI) C63.19 and the development of the ANSI/Telecommunications Industry Association–1083 hearing aid compatibility standards, it became evident that additional data concerning user acceptance of interfering magnetic noises generated by wireless and cordless telephones were needed in order to determine the requirements for telecoil-coupling compatibility. Purpose: Further insight was needed into the magnetic signal-to-noise (S/N) ratios required to achieve specific levels of telephone usability by hearing aid wearers. (A companion article addresses magnetic signal level requirements.) Research Design: Test subjects used their own hearing aids. The magnetic signals were applied through large magnetic head-worn coils, selected for the field orientation appropriate for each hearing aid. After adjusting their aid's volume control to an acoustic speech reference, the subjects adjusted the applied magnetic signal level to find their Most Comfortable Level (MCL). Each subject then adjusted the levels of six of eight different representative interfering noises to three levels of subjective telephone usability: “usable for a brief call,” “acceptable for normal use,” and “excellent performance.” Each subject's objective noise audibility threshold in the presence of speech was also obtained for the various noise types. Study Sample: The 57 test subjects covered an age range of 22 to 79 yr, with a self-reported hearing loss duration of 12 to 72 yr. All had telecoils that they used for at least some telecommunications needs. The self-reported degree of hearing loss ranged from moderate to profound. Data Collection and Analysis: A guided intake questionnaire yielded general background information for each subject. A test control box fed by prepared speech and noise recordings from computer files enabled the subject or the tester, depending on the portion of the test, to select A-weighting-normalized noise interference levels in 1.25 dB steps relative to the selected MCL. For each subject for each tested noise type, the values for the selected S/N ratios were recorded for the three categories of subjective usability and the objective noise threshold. Results: About half of the test subjects needed a minimum 21 dB S/N ratio for them to consider their listening experience “acceptable for normal use” of a telephone. With a 30 dB S/N ratio, about 85% of the subjects reported normal use acceptability. Significant differences were apparent in the measured S/N user requirements among the noise types, though, indicating a deficiency in an A-weighted level measurement's ability to consistently predict the subjective acceptability of the various noises. An improved weighting function having both spectral and temporal components was developed to substantially eliminate these predictive inconsistencies. Conclusions: The interfering noise level that subjects chose for a telephone usability rating of “excellent performance” matched closely their objectively measured noise audibility threshold. A rating of “acceptable for normal use” was typically achieved at a 4 dB higher noise level, and a rating of “usable for a brief call,” at a 10.4 dB higher noise level. These results did not relate significantly to noise type or to the subject's aided noise-in-speech hearing acuity.

scholarly journals The Characteristics of Adults with Severe Hearing Loss

2018 ◽  
Vol 29 (08) ◽  
pp. 764-779 ◽  
Author(s):  
Pamela Souza ◽  
Eric Hoover ◽  
Michael Blackburn ◽  
Frederick Gallun
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Assistive Technology ◽  
Spectral Resolution ◽  
Hearing Aids ◽  
Technology Use ◽  
Hearing Aid ◽  
Published Data ◽  
Severe Hearing Loss ◽  
Wide Range

AbstractSevere hearing loss impairs communication in a wide range of listening environments. However, we lack data as to the specific objective and subjective abilities of listeners with severe hearing loss. Insight into those abilities may inform treatment choices.The primary goal was to describe the audiometric profiles, spectral resolution ability, and objective and subjective speech perception of a sample of adult listeners with severe hearing loss, and to consider the relationships among those measures. We also considered the typical fitting received by individuals with severe loss, in terms of hearing aid style, electroacoustic characteristics, and features, as well as supplementary device use.A within-subjects design was used.Participants included 36 adults aged 54–93 yr with unilateral or bilateral severe hearing loss.Testing included a full hearing and hearing aid history; audiometric evaluation; loudness growth and dynamic range; spectral resolution; assessment of cochlear dead regions; objective and subjective assessment of speech recognition; and electroacoustic evaluation of current hearing aids. Regression models were used to analyze relationships between hearing loss, spectral resolution, and speech recognition.For speech in quiet, 60% of the variance was approximately equally accounted for by amount of hearing loss, spectral resolution, and number of dead regions. For speech in noise, only a modest proportion of performance variance was explained by amount of hearing loss. In general, participants were wearing amplification of appropriate style and technology for their hearing loss, but the extent of assistive technology use was low. Subjective communication ratings depended on the listening situation, but in general, were similar to previously published data for adults with mild-to-moderate loss who did not wear hearing aids.The present data suggest that the range of abilities of an individual can be more fully captured with comprehensive testing. Such testing also offers an opportunity for informed counseling regarding realistic expectations for hearing aid use and the availability of hearing assistive technology.

Exploring the Relationship Between Hearing Aid Self-Efficacy and Hearing Aid Management

2014 ◽  
Vol 21 (2) ◽  
pp. 56-62 ◽  
Author(s):  
Brittney A. Dullard ◽  
Kathleen M. Cienkowski
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Self Efficacy ◽  
Hearing Aid ◽  
Adult Population ◽  
Rehabilitation Outcomes ◽  
Hearing Aid Use ◽  
Wide Range ◽  
The Relationship

Hearing loss is a highly prevalent condition affecting a significant portion of the adult population. Hearing aids are an effective and common rehabilitation strategy for individuals with hearing loss. A wide range of factors, however, can hamper and even preclude successful hearing aid use. Self-efficacy, a concept that reflects perceptions of one's ability to perform particular tasks or behaviors, has been shown to be an important factor in the successful management of chronic illness including conditions such as diabetes, cardiovascular disease, as well as arthritis and other sources of chronic pain. Improving or strengthening patients' self-efficacy beliefs can improve health outcomes. The role of self-efficacy in the management of hearing loss and hearing aids is still being explored; hence, the extent to which, and the ways in which, self-efficacy may be related to audiologic outcomes remains largely unexplained. The purpose of this article is to examine emerging evidence regarding the relationship between perceived self-efficacy and rehabilitation outcomes among adult hearing aid users and to discuss an apparent discrepancy between patients' reported self-efficacy and their demonstrated skill in managing hearing aids.

A Comparison of Conventional and In-Situ Audiometry on Participants with Varying Levels of Sensorineural Hearing Loss

2015 ◽  
Vol 26 (01) ◽  
pp. 068-079 ◽  
Author(s):  
Jürgen Kiessling ◽  
Melanie Leifholz ◽  
Steffen Unkel ◽  
Jörn Pons-Kühnemann ◽  
Charlotte Thunberg Jespersen ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Research Design ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Threshold ◽  
Sensorineural Hearing ◽  
Threshold Levels ◽  
Wide Range

Background: In-situ audiometry is a hearing aid feature that enables the measurement of hearing threshold levels through the hearing instrument using the built-in sound generator and the hearing aid receiver. This feature can be used in hearing aid fittings instead of conventional pure-tone audiometry (PTA), particularly in places where no standard audiometric equipment is available. Differences between conventional and in-situ thresholds are described and discussed for some particular hearing aids. No previous investigation has measured and compared these differences for a number of current hearing aid models by various manufacturers across a wide range of hearing losses. Purpose: The purpose of this study was to perform a model-based comparison of conventionally and in-situ measured hearing thresholds. Data were collected for a range of hearing aid devices to study and generalize the effects that may occur under clinical conditions. Research Design: Research design was an experimental and regression study. Study Sample: A total of 30 adults with sensorineural hearing loss served as test persons. They were assigned to three subgroups of 10 subjects with mild (M), moderate to severe (MS), and severe (S) sensorineural hearing loss. Intervention: All 30 test persons underwent both conventional PTA and in-situ audiometry with four hearing aid models by various manufacturers. Data Collection and Analysis: The differences between conventionally and in-situ measured hearing threshold levels were calculated and evaluated by an exploratory data analysis followed by a sophisticated statistical modeling process. Results: At 500 and 1500 Hz, almost all threshold differences (conventional PTA minus in-situ data) were negative, i.e., in the low to mid frequencies, hearing loss was overestimated by most devices relative to PTA. At 4000 Hz, the majority of differences (7 of 12) were positive, i.e., in the frequency range above 1500 Hz, hearing loss was frequently underestimated. As hearing loss increased (M→MS→S), the effect of the underestimation decreased. At 500 and 1500 Hz, Resound devices showed the smallest threshold deviations, followed by Phonak, Starkey, and Oticon instruments. At 4000 Hz, this observed pattern partly disappeared and Starkey and Oticon devices showed a reversed effect with increasing hearing loss (M→MS→S). Because of high standard errors for the estimates, only a few explicit rankings of the devices could be established based on significant threshold differences (5% level). Conclusions: Differences between conventional PTA and in-situ threshold levels may be attributed to (1) frequency, (2) device/hearing loss, and (3) calibration/manufacturer effects. Frequency effects primarily resulting in an overestimation of hearing loss by in-situ audiometry in the low and mid frequencies are mainly due to sound drain-off through vents and leaks. Device/hearing loss effects may be due to leakage as well as boundary effects because in-situ audiometry is confined to a limited measurement range. Finally, different calibration approaches may result in different offset levels between PTA and in-situ audiometry calibration. In some cases, the observed threshold differences of up to 10–15 dB may translate to varied hearing aid fittings for the same user depending on how hearing threshold levels were measured.

The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction

2019 ◽  
Vol 28 (2) ◽  
pp. 274-284 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Louise Hickson ◽  
Carly Meyer
Keyword(s):  
Decision Making ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Clinical Decision Making ◽  
Hearing Aid ◽  
Well Being ◽  
Self Report ◽  
Self Management ◽  
Hearing Aid Benefit ◽  
The Relationship

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.

FM Verification for the 21 st Century

2008 ◽  
Vol 18 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Leisha Eiten ◽  
Dawna Lewis
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Current Technology ◽  
The Past ◽  
Technological Advances ◽  
Children With Hearing Loss

Background: For children with hearing loss, the benefits of FM systems in overcoming deleterious effects of noise, distance, and reverberation have led to recommendations for use beyond classroom settings. It is important that audiologists who recommend and fit these devices understand the rationale and procedures underlying fitting and verification. Objectives: This article reviews previousguidelines for FM verification, addresses technological advances, and introduces verification procedures appropriate for current FM and hearing-aid technology. Methods: Previous guidelines for verification of FM systems are reviewed. Those recommendations that are appropriate for current technology are addressed, as are procedures that are no longer adequate for hearing aids and FM systems utilizing more complex processing than in the past. Technological advances are discussed, and an updated approach to FM verification is proposed. Conclusions: Approaches to verification andfitting of FM systems must keep pace with advances in hearing-aid and FM technology. The transparency approach addressed in this paper is recommended for verification of FM systems coupled to hearing aids.

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.

Feasibility of smartphone-based hearing-aid apps for patients with mild hearing loss: an exploratory pilot study (Preprint)

2020 ◽  
Author(s):  
Willy Nguyen ◽  
Miseung Koo ◽  
Seung Ha Oh ◽  
Jun Ho Lee ◽  
Moo Kyun Park
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Clinical Performance ◽  
Hearing Aid ◽  
National Standards ◽  
Hearing In Noise ◽  
Mild Hearing Loss ◽  
Consumer Devices ◽  
Selection Of

BACKGROUND Underuse of hearing aids is caused by several factors, including the stigma associated with hearing disability, affordability, and lack of awareness of rising hearing impairment associated with the growing population. Thus, there is a significant opportunity for the development of direct-to-consumer devices. For the past few years, smartphone-based hearing-aid apps have become more numerous and diverse, but few studies have investigated them. OBJECTIVE This study aimed to elucidate the electroacoustic characteristics and potential user benefits of a selection of currently available hearing-aid apps. METHODS We investigated the apps based on hearing-aid control standards (American National Standards Institute) using measurement procedures from previous studies. We categorized the apps and excluded those we considered inefficient. We investigated a selection of user-friendly, low-end apps, EarMachine and Sound Amplifier, with warble-tone audiometry, word recognition testing in unaided and aided conditions, and hearing-in-noise test in quiet and noise-front conditions in a group of users with mild hearing impairment (n = 7) as a pilot for a future long-term investigation. Results from the apps were compared with those of a conventional hearing aid. RESULTS Five of 14 apps were considered unusable based on low scores in several metrics, while the others varied across the range of electroacoustic measurements. The apps that we considered “high end” that provided lower processing latencies and audiogram-based fitting algorithms were superior overall. The clinical performance of the listeners tended to be better when using hearing aid, while the low end hearing-aid apps had limited benefits on the users. CONCLUSIONS Some apps showed the potential to benefit users with limited cases of minimal or mild hearing loss if the inconvenience of relatively poor electroacoustic performance did not outweigh the benefits of amplification.

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.

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.

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