scholarly journals Difference between the Default Telecoil (T-Coil) and Programmed Microphone Frequency Response in Behind-the-Ear (BTE) Hearing Aids

2012 ◽  
Vol 23 (05) ◽  
pp. 366-378 ◽  
Author(s):  
Daniel B. Putterman ◽  
Michael Valente

Background: A telecoil (t-coil) is essential for hearing aid users when listening on the telephone because using the hearing aid microphone when communicating on the telephone can cause feedback due to telephone handset proximity to the hearing aid microphone. Clinicians may overlook the role of the t-coil due to a primary concern of matching the microphone frequency response to a valid prescriptive target. Little has been published to support the idea that the t-coil frequency response should match the microphone frequency response to provide “seamless” and perhaps optimal performance on the telephone. If the clinical goal were to match both frequency responses, it would be useful to know the relative differences, if any, that currently exist between these two transducers. Purpose: The primary purpose of this study was to determine if statistically significant differences were present between the mean output (in dB SPL) of the programmed microphone program and the hearing aid manufacturer's default t-coil program as a function of discrete test frequencies. In addition, pilot data are presented on the feasibility of measuring the microphone and t-coil frequency response with real-ear measures using a digital speech-weighted noise. Research Design: A repeated-measures design was utilized for a 2-cc coupler measurement condition. Independent variables were the transducer (microphone, t-coil) and 11 discrete test frequencies (15 discrete frequencies in the real-ear pilot condition). Study Sample: The study sample was comprised of behind-the-ear (BTE) hearing aids from one manufacturer. Fifty-two hearing aids were measured in a coupler condition, 39 of which were measured in the real-ear pilot condition. Hearing aids were previously programmed and verified using real-ear measures to the NAL-NL1 (National Acoustic Laboratories—Non-linear 1) prescriptive target by a licensed audiologist. Data Collection and Analysis: Hearing aid output was measured with a Fonix 7000 hearing aid analyzer (Frye Electronics, Inc.) in a HA-2 2-cc coupler condition using a pure-tone sweep at an input level of 60 dB SPL with the hearing aid in the microphone program and 31.6 mA/M in the t-coil program. A digital speech weighted noise input signal presented at additional input levels was used in the real-ear pilot condition. A mixed-model repeated-measures analysis of variance (ANOVA) and the Tukey Honestly Significant Difference (HSD) post hoc test were utilized to determine if significant differences were present in performance across treatment levels. Results: There was no significant difference between mean overall t-coil and microphone output averaged across 11 discrete frequencies (F(1,102) = 0, p < 0.98). A mixed-model repeated-measures ANOVA revealed a significant transducer by frequency interaction (F(10,102) = 13.0, p < 0.0001). Significant differences were present at 200 and 400 Hz where the mean t-coil output was less than the mean microphone output, and at 4000, 5000, and 6300 Hz where the mean t-coil output was greater than the mean microphone output. Conclusions: The mean t-coil output was significantly lower than the mean microphone output at 400 Hz, a frequency that lies within the typical telephone bandwidth of 300–3300 Hz. This difference may partially help to explain why some patients often complain the t-coil fails to provide sufficient loudness for telephone communication.

2010 ◽  
Vol 21 (04) ◽  
pp. 249-266 ◽  
Author(s):  
Lynzee N. Alworth ◽  
Patrick N. Plyler ◽  
Monika Bertges Reber ◽  
Patti M. Johnstone

Background: Open canal hearing instruments differ in method of sound delivery to the ear canal, distance between the microphone and the receiver, and physical size of the devices. Moreover, RITA (receiver in the aid) and RITE (receiver in the ear) hearing instruments may also differ in terms of retention and comfort as well as ease of use and care for certain individuals. What remains unclear, however, is if any or all of the abovementioned factors contribute to hearing aid outcome. Purpose: To determine the effect of receiver location on performance and/or preference of listeners using open canal hearing instruments. Research Design: An experimental study in which subjects were exposed to a repeated measures design. Study Sample: Twenty-five adult listeners with mild sloping to moderately severe sensorineural hearing loss (mean age 67 yr). Data Collection and Analysis: Participants completed two six-week trial periods for each device type. Probe microphone, objective, and subjective measures (quiet, noise) were conducted unaided and aided at the end of each trial period. Results: Occlusion effect results were not significantly different between the RITA and RITE instruments; however, frequency range was extended in the RITE instruments, resulting in significantly greater maximum gain for the RITE instruments than the RITA instruments at 4000 and 6000 Hz. Objective performance in quiet or in noise was unaffected by receiver location. Subjective measures revealed significantly greater satisfaction ratings for the RITE than for the RITA instruments. Similarly, preference in quiet and overall preference were significantly greater for the RITE than for the RITA instruments. Conclusions: Although no occlusion differences were noted between instruments, the RITE did demonstrate a significant difference in reserve gain before feedback at 4000 and 6000 Hz. Objectively; no positive benefit was noted between unaided and aided conditions on speech recognition tests. These results suggest that such testing may not be sensitive enough to determine aided benefit with open canal instruments. However, the subjective measures (Abbreviated Profile of Hearing Aid Benefit [APHAB] and subjective ratings) did indicate aided benefit for both instruments when compared to unaided. This further suggests the clinical importance of subjective measures as a way to measure aided benefit of open-fit devices.


2017 ◽  
Vol 28 (01) ◽  
pp. 046-057 ◽  
Author(s):  
Petri Korhonen ◽  
Francis Kuk ◽  
Eric Seper ◽  
Martin Mørkebjerg ◽  
Majken Roikjer

AbstractWind noise is a common problem reported by hearing aid wearers. The MarkeTrak VIII reported that 42% of hearing aid wearers are not satisfied with the performance of their hearing aids in situations where wind is present.The current study investigated the effect of a new wind noise attenuation (WNA) algorithm on subjective annoyance and speech recognition in the presence of wind.A single-blinded, repeated measures design was used.Fifteen experienced hearing aid wearers with bilaterally symmetrical (≤10 dB) mild-to-moderate sensorineural hearing loss participated in the study.Subjective rating for wind noise annoyance was measured for wind presented alone from 0° and 290° at wind speeds of 4, 5, 6, 7, and 10 m/sec. Phoneme identification performance was measured using Widex Office of Clinical Amplification Nonsense Syllable Test presented at 60, 65, 70, and 75 dB SPL from 270° in the presence of wind originating from 0° at a speed of 5 m/sec.The subjective annoyance from wind noise was reduced for wind originating from 0° at wind speeds from 4 to 7 m/sec. The largest improvement in phoneme identification with the WNA algorithm was 48.2% when speech was presented from 270° at 65 dB SPL and the wind originated from 0° azimuth at 5 m/sec.The WNA algorithm used in this study reduced subjective annoyance for wind speeds ranging from 4 to 7 m/sec. The algorithm was effective in improving speech identification in the presence of wind originating from 0° at 5 m/sec. These results suggest that the WNA algorithm used in the current study could expand the range of real-life situations where a hearing-impaired person can use the hearing aid optimally.


2016 ◽  
Vol 25 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Naomi B. H. Croghan ◽  
Anne M. Swanberg ◽  
Melinda C. Anderson ◽  
Kathryn H. Arehart

Purpose The objective of this study was to describe chosen listening levels (CLLs) for recorded music for listeners with hearing loss in aided and unaided conditions. Method The study used a within-subject, repeated-measures design with 13 adult hearing-aid users. The music included rock and classical samples with different amounts of audio-industry compression limiting. CLL measurements were taken at ear level (i.e., at input to the hearing aid) and at the tympanic membrane. Results For aided listening, average CLLs were 69.3 dBA at the input to the hearing aid and 80.3 dBA at the tympanic membrane. For unaided listening, average CLLs were 76.9 dBA at the entrance to the ear canal and 77.1 dBA at the tympanic membrane. Although wide intersubject variability was observed, CLLs were not associated with audiometric thresholds. CLLs for rock music were higher than for classical music at the tympanic membrane, but no differences were observed between genres for ear-level CLLs. The amount of audio-industry compression had no significant effect on CLLs. Conclusion By describing the levels of recorded music chosen by hearing-aid users, this study provides a basis for ecologically valid testing conditions in clinical and laboratory settings.


2011 ◽  
Vol 22 (09) ◽  
pp. 612-622 ◽  
Author(s):  
Susan Scollie ◽  
Marlene Bagatto ◽  
Sheila Moodie ◽  
Jeff Crukley

Background: Measurement of the real ear response of a fitted hearing aid allows matching of the frequency response to prescriptive targets, as well as comparison of the response to both threshold and loudness discomfort level (LDL). These processes are recommended procedures for hearing aid fittings. The real ear aided response (REAR) is often predicted based on the coupler response of the device, the real-ear-to-coupler difference (RECD), and the microphone location effect (MLE). Individualized measurement of the RECD tends to increase the accuracy of this prediction. A commercial hearing aid has been developed that measures the individual RECD and incorporates the data into the software-assisted fitting process. Purpose: This study evaluated the test-retest reliability and predictive validity of this particular method for measuring the RECD. Research Design: A repeated measures design was used to evaluate differences between subsequent measures of the RECD in the same ear, and prediction differences associated with using the RECD (and other information) to predict the REAR. Study Sample: Fifteen ears, on a convenience sample of ten adults (45–86 yr) and five children (6–15 yr) were tested. All participants were hearing aid users. Data Collection and Analysis: Predicted and measured REARs were collected using normal clinical procedures, on an Audioscan Verifit VF-1 for two test signals/levels. Reliability, mean differences between predicted and measured REARs, and 95% confidence intervals of the prediction accuracy are reported. Results: The RECD procedure had test-retest reliability within 2.5 dB for 14 out of 15 ears between 500 and 4000 Hz, and had predictive accuracy within 5 dB between 500 and 4000 Hz for 14 out of 15 ears. However, errors associated with earhook misalignment were discovered. Also, the RECD values measured using this hearing-aid-specific procedure differ somewhat from the normative data available from insert earphone RECDs. Conclusions: This procedure, when measured according to recommendations, provides a reasonably accurate prediction of the REAR. Functionally, this procedure does not replace the range of measures offered by modern real ear measurement systems. However, given the inaccuracy of software-assisted fittings without a measure of individual ear canal acoustics, use of this procedure may have the potential to improve the accuracy of fittings versus fittings completed without real ear measurement.


1967 ◽  
Vol 10 (2) ◽  
pp. 377-383 ◽  
Author(s):  
Roger N. Kasten ◽  
Stephen H. Lotterman ◽  
Sally G. Revoile

Full-on gain versus frequency response curves were obtained from ten different hearing aid models using 15 samples of each model. A mean curve and the range of responses from 20 discrete frequency points were plotted for each model along with the manufacturer’s published curve at full-on gain values. While about half of the models tested showed good intragroup consistency, the variability of gain characteristics for the remaining models was large. The mean gain versus frequency curves of the sample aids differed from those published by the manufacrurer for about half of the models tested.


2013 ◽  
Vol 24 (08) ◽  
pp. 660-670 ◽  
Author(s):  
Kristi Oeding ◽  
Michael Valente

Background: SoundTracker is an algorithm in Widex's Compass fitting software that could potentially be used to estimate a patient's aided sensation level (SL). SoundTracker's accuracy of estimating a patient's SL has never been verified in comparison to SL measured with commercially available real-ear analyzers. Purpose: Determine whether statistically significant differences are present between the estimated SL of the Widex SoundTracker software application and the measured SL of the Audioscan Verifit and Frye 6500 real-ear analyzers at 500, 1000, 2000, and 4000 Hz. Research Design: This study used a randomized repeated measures design to determine differences in SL between SoundTracker and the Verifit and 6500. Study Sample: Ten subjects (N = 20 ears) were recruited who were experienced users of behind-the-ear hearing aids with conventional vented earmolds and had bilateral sensorineural hearing loss that was >30 dB HL below 1000 Hz and ≤70 dB HL to 4000 Hz. Data Collection and Analysis: Real-ear in-situ thresholds (dB sound pressure level [SPL]) and real-ear aided responses (REAR; dB SPL) were measured at 500, 1000, 2000, and 4000 Hz to determine differences in SL between SoundTracker, Verifit, and 6500. A three-factor repeated measures analysis of variance (ANOVA) was utilized to determine differences between method (real-ear analyzers and SoundTracker), analyzer (Verifit and 6500), and frequency (500, 1000, 2000, and 4000 Hz). Results: Mean differences in measured SL for the Verifit and 6500 were ≤2 dB when compared to the estimated SL using SoundTracker. A statistically significant difference in SL was present between the Verifit and SoundTracker at 2000 Hz (p < 0.01), but no significant differences were present at 500, 1000, and 4000 Hz. A statistically significant difference in SL was present between the 6500 and SoundTracker at 4000 Hz (p < 0.01), but no significant differences were present at 500, 1000, and 2000 Hz. Mean differences in measured SL between the real-ear analyzers (difference of SoundTracker SL minus Verifit SL compared to the difference of SoundTracker SL minus 6500 SL) were ≤2 dB with a statistically significant difference present at 2000 Hz (p < 0.01), but no statistically significant differences were present at 500, 1000, or 4000 Hz. Conclusions: Nearly 85% of the differences between the estimated SoundTracker SL and the measured SLs of the Verifit and 6500 were ≤2 dB. Despite some limitations of this study, SoundTracker could be useful as a counseling tool to illustrate to patients which sounds are audible or inaudible when unaided and aided.


Author(s):  
Francis Kuk ◽  
Christopher Slugocki ◽  
Petri Korhonen

Abstract Background The effect of context on speech processing has been studied using different speech materials and response criteria. The Repeat-Recall Test (RRT) evaluates listener performance using high context (HC) and low context (LC) sentences; this may offer another platform for studying context use (CU). Objective This article aims to evaluate if the RRT may be used to study how different signal-to-noise ratios (SNRs), hearing aid technologies (directional microphone and noise reduction), and listener working memory capacities (WMCs) interact to affect CU on the different measures of the RRT. Design Double-blind, within-subject repeated measures design. Study Sample Nineteen listeners with a mild-to-moderately severe hearing loss. Data Collection The RRT was administered with participants wearing the study hearing aids under two microphone (omnidirectional vs. directional) by two noise reduction (on vs. off) conditions. Speech was presented from 0 degree at 75 dB sound pressure level and a continuous speech-shaped noise from 180 degrees at SNRs of 0, 5, 10, and 15 dB. The order of SNR and hearing aid conditions was counterbalanced across listeners. Each test condition was completed twice in two 2-hour sessions separated by 1 month. Results CU was calculated as the difference between HC and LC sentence scores for each outcome measure (i.e., repeat, recall, listening effort, and tolerable time). For all outcome measures, repeated measures analyses of variance revealed that CU was significantly affected by the SNR of the test conditions. For repeat, recall, and listening effort measures, these effects were qualified by significant two-way interactions between SNR and microphone mode. In addition, the WMC group significantly affected CU during recall and rating of listening effort, the latter of which was qualified by an interaction between the WMC group and SNR. Listener WMC affected CU on estimates of tolerable time as qualified by significant two-way interactions between SNR and microphone mode. Conclusion The study supports use of the RRT as a tool for measuring how listeners use sentence context to aid in speech processing. The degree to which context influenced scores on each outcome measure of the RRT was found to depend on complex interactions between the SNR of the listening environment, hearing aid features, and the WMC of the listeners.


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 


Author(s):  
Golnaz Moradipour ◽  
Ahmadreza Nazeri ◽  
Hamid Jalilvand ◽  
Seyed Mehdi Tabatabaee

Background and Aim: One of the chronic hea­lth problems of the elderly is presbycusis, and one of the most important age-related changes in central auditory processing is dichotic listening deficit. The purpose of this study was to investi­gate the effects of using hearing aids on dichotic listening performance of the elderly with hearing loss by dichotic tests. Methods: In this cross-sectional study, randomi­zed dichotic digit test (RDDT) and dichotic auditory verbal memory test (DAVMT) were performed on 20 seniors with hearing loss (8 male, 12 female) aged 65−80 years. They were divided into two groups of test (with hearing aid, n = 10) and control (without hearing aid, n = 10). They were tested before and two months after the use of hearing aid and the results were analyzed using t-test for two independent variables. Results: There was a significant difference in the total DAVMT score in control group before and after the intervention (p < 0.001) and not in test group, but in terms of right and left ear DAVMT and RDDT scores, showed no significant diffe­rence in any groups. Moreover, there was no sig­nificant difference in the mean DAVMT score of the right ear and the mean RDDT score between groups, but in terms of the total DAVMT score, a significant difference between two groups was reported (p = 0.003). Conclusion: It can be said that the DAVMT has the ability to show adverse effects of hearing loss on recognition function and memory of the elde­rly.   Keywords: Randomized dichotic digit test; dichotic auditory verbal memory test; hearing aid; presbycusis


2021 ◽  
Author(s):  
Maryam Barani ◽  
Laleh Hassani ◽  
Amin Ghanbarnejad ◽  
Mohammad Ali Molavi

Abstract Background Self-efficacy, as one of the concepts of empowerment model, plays a role in increasing the caring behavior. Accordingly, the present study aimed to evaluate the effect of educational intervention based on self-efficacy theory on the caring behavior of mothers having children with cancer. Methods This before-after clinical trial study was conducted on all mothers (N = 86) of children with cancer undergoing chemotherapy who referred to Bandar Abbas Children's Hospital. All mothers participate in four educational intervention sessions. The Shearer's self-efficacy questionnaire and "mothers caring behavior scale" were completed at the 1rst and 3rd and 6th months after intervention. Descriptive statistics, paired t-test, analysis of variance (ANOVA) with repeated measures and a linear mixed model were used to assess the effect of time and self-efficacy on the caring behavior adjusting for family size, mother’s age, mother’s job, mother’s education, and chemo-therapy session. Results The results indicated a significant difference in the mean score of mothers' self-efficacy after intervention (P < 0.001). Besides, the two-way self-efficacy score of the first and second follow-ups was p = 0.096. Furthermore, the mean score of caring behavior before and after the intervention indicated a significant difference (P < 0.001). Conclusion The results of the present study indicated that an educational program for mothers increased their caring behavior and self-efficacy with the increase of self-efficacy, mothers' caring behavior was promoted. Authorities and practitioners are suggested to pay more attention to designing educational programs based on health models and theories.


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