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

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.

2011 ◽  
Vol 22 (08) ◽  
pp. 515-527 ◽  
Author(s):  
Stephen Julstrom ◽  
Linda Kozma-Spytek ◽  
Scott Isabelle

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.


2012 ◽  
Vol 23 (08) ◽  
pp. 577-589 ◽  
Author(s):  
Mary Rudner ◽  
Thomas Lunner ◽  
Thomas Behrens ◽  
Elisabet Sundewall Thorén ◽  
Jerker Rönnberg

Background: Recently there has been interest in using subjective ratings as a measure of perceived effort during speech recognition in noise. Perceived effort may be an indicator of cognitive load. Thus, subjective effort ratings during speech recognition in noise may covary both with signal-to-noise ratio (SNR) and individual cognitive capacity. Purpose: The present study investigated the relation between subjective ratings of the effort involved in listening to speech in noise, speech recognition performance, and individual working memory (WM) capacity in hearing impaired hearing aid users. Research Design: In two experiments, participants with hearing loss rated perceived effort during aided speech perception in noise. Noise type and SNR were manipulated in both experiments, and in the second experiment hearing aid compression release settings were also manipulated. Speech recognition performance was measured along with WM capacity. Study Sample: There were 46 participants in all with bilateral mild to moderate sloping hearing loss. In Experiment 1 there were 16 native Danish speakers (eight women and eight men) with a mean age of 63.5 yr (SD = 12.1) and average pure tone (PT) threshold of 47. 6 dB (SD = 9.8). In Experiment 2 there were 30 native Swedish speakers (19 women and 11 men) with a mean age of 70 yr (SD = 7.8) and average PT threshold of 45.8 dB (SD = 6.6). Data Collection and Analysis: A visual analog scale (VAS) was used for effort rating in both experiments. In Experiment 1, effort was rated at individually adapted SNRs while in Experiment 2 it was rated at fixed SNRs. Speech recognition in noise performance was measured using adaptive procedures in both experiments with Dantale II sentences in Experiment 1 and Hagerman sentences in Experiment 2. WM capacity was measured using a letter-monitoring task in Experiment 1 and the reading span task in Experiment 2. Results: In both experiments, there was a strong and significant relation between rated effort and SNR that was independent of individual WM capacity, whereas the relation between rated effort and noise type seemed to be influenced by individual WM capacity. Experiment 2 showed that hearing aid compression setting influenced rated effort. Conclusions: Subjective ratings of the effort involved in speech recognition in noise reflect SNRs, and individual cognitive capacity seems to influence relative rating of noise type.


Author(s):  
Kumars Akaberi ◽  
Hamid Jalilvand ◽  
Mohammad Ebrahim Mahdavi ◽  
Ahmadreza Nazeri1 ◽  
Seyed Mehdi Tabatabaee

Background and Aim: It is well known that hearing aid fitting is an effective approach to improve the communication ability of hearingimpaired people. In the past, most of the hearing aids were fitted unilaterally rather than bilaterally. Whereas the unilateral hearing aid fitting improves verbal communication partially, it causes late-onset auditory deprivation. The main aim of this study is to investigate the ANL for each ear among the users with unilateral hearing aid experience. Methods: A total of 23 participants were recruited (14 females, 9 males). The mean age was 74.65 years (ranged from 41 to 83). All subjects had bilateral symmetric sensorineural hearing loss. The most comfortable level (MCL), Background Noise Level (BNL), and acceptable noise level (ANL) were measured for ear with amplification experience and ear without experience. Results: MCL, BNL and ANL in the aided ear was 82.22, 73.48 and 8.74 respectively, in addition in the unaided ear the results for MCL, BNL and ANL was 81.78, 72.13 and 9.65 respectively. Comparing the mean values of MCL, BNL and ANL between two ears showed no significant difference. Conclusion: There was not any difference for BNL and ANL measures Keywords: Bilateral hearing loss; acceptable noise level; late onset auditory deprivation; Hearing aid 


2019 ◽  
Vol 28 (2) ◽  
pp. 274-284 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Louise Hickson ◽  
Carly Meyer

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.


2009 ◽  
Vol 19 (2) ◽  
pp. 72-78
Author(s):  
Rebecca L. Nelson Crowell ◽  
Julie Hanenburg ◽  
Amy Gilbertson

Abstract Audiologists have a responsibility to counsel patients with auditory concerns on methods to manage the inherent challenges associated with hearing loss at every point in the process: evaluation, hearing aid fitting, and follow-up visits. Adolescents with hearing loss struggle with the typical developmental challenges along with communicative challenges that can erode one's self-esteem and self-worth. The feeling of “not being connected” to peers can result in feelings of isolation and depression. This article advocates the use of a Narrative Therapy approach to counseling adolescents with hearing loss. Adolescents with hearing loss often have problem-saturated narratives regarding various components of their daily life, friendships, amplification, academics, etc. Audiologists can work with adolescents with hearing loss to deconstruct the problem-saturated narratives and rebuild the narratives into a more empowering message. As the adolescent retells their positive narrative, they are likely to experience increased self-esteem and self-worth.


2008 ◽  
Vol 18 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Leisha Eiten ◽  
Dawna Lewis

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.


2014 ◽  
Vol 24 (2) ◽  
pp. 74-81
Author(s):  
Monica Weston ◽  
Karen F. Muñoz ◽  
Kristina Blaiser

Purpose This study investigated average hours of daily hearing aid use and speech-language outcomes for children age 3 to 6 years of age with hearing loss. Method Objective measures of hearing aid use were collected via data logging. Speech and language measures included standardized measures GFTA-2, CELF Preschool-2 and additional item analyses for the word structure subtest CELF Preschool-2 and the GFTA-2. Results Hearing aid use was full time for 33% of the children (n=3; M=8.84 hours; Range: 2.9–12.1) at the beginning of the study, and for 78% at the end of the study (n=7; M=9.89 hours; Range 2.6–13.2). All participants demonstrated an improvement in articulation and language standard scores and percentiles however continued to demonstrate areas of weakness in sounds high-frequency in nature. Conclusions Through early identification and fitting, children gain access to speech sounds. Both standardized measures and individual language analysis should be used to identify and support children with hearing loss in language and subsequent literacy development.


1968 ◽  
Vol 11 (1) ◽  
pp. 204-218 ◽  
Author(s):  
Elizabeth Dodds ◽  
Earl Harford

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.


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