FM Verification for the 21 st Century

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.

2017 ◽  
Vol 28 (10) ◽  
pp. 883-892 ◽  
Author(s):  
Samantha J. Gustafson ◽  
Todd A. Ricketts ◽  
Anne Marie Tharpe

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.


Author(s):  
Jace Wolfe ◽  
Mila Duke ◽  
Sharon Miller ◽  
Erin Schafer ◽  
Christine Jones ◽  
...  

Background: For children with hearing loss, the primary goal of hearing aids is to provide improved access to the auditory environment within the limits of hearing aid technology and the child’s auditory abilities. However, there are limited data examining aided speech recognition at very low (40 dBA) and low (50 dBA) presentation levels. Purpose: Due to the paucity of studies exploring aided speech recognition at low presentation levels for children with hearing loss, the present study aimed to 1) compare aided speech recognition at different presentation levels between groups of children with normal hearing and hearing loss, 2) explore the effects of aided pure tone average (PTA) and aided Speech Intelligibility Index (SII) on aided speech recognition at low presentation levels for children with hearing loss ranging in degree from mild to severe, and 3) evaluate the effect of increasing low-level gain on aided speech recognition of children with hearing loss. Research Design: In phase 1 of this study, a two-group, repeated-measures design was used to evaluate differences in speech recognition. In phase 2 of this study, a single-group, repeated-measures design was used to evaluate the potential benefit of additional low-level hearing aid gain for low-level aided speech recognition of children with hearing loss. Study Sample: The first phase of the study included 27 school-age children with mild to severe sensorineural hearing loss and 12 school-age children with normal hearing. The second phase included eight children with mild to moderate sensorineural hearing loss. Intervention: Prior to the study, children with hearing loss were fitted binaurally with digital hearing aids. Children in the second phase were fitted binaurally with digital study hearing aids and completed a trial period with two different gain settings: 1) gain required to match hearing aid output to prescriptive targets (i.e., primary program), and 2) a 6-dB increase in overall gain for low-level inputs relative to the primary program. In both phases of this study, real-ear verification measures were completed to ensure the hearing aid output matched prescriptive targets. Data Collection and Analysis: Phase 1 included monosyllabic word recognition and syllable-final plural recognition at three presentation levels (40, 50, and 60 dBA). Phase 2 compared speech recognition performance for the same test measures and presentation levels with two differing gain prescriptions. Results and Conclusions: In phase 1 of the study, aided speech recognition was significantly poorer in children with hearing loss at all presentation levels. Higher aided SII in the better ear (55 dB SPL input) was associated with higher CNC word recognition at a 40 dBA presentation level. In phase 2, increasing the hearing aid gain for low-level inputs provided a significant improvement in syllable-final plural recognition at very low-level inputs and resulted in a non-significant trend toward better monosyllabic word recognition at very low presentation levels. Additional research is needed to document the speech recognition difficulties children with hearing aids may experience with low-level speech in the real world as well as the potential benefit or detriment of providing additional low-level hearing aid gain


2013 ◽  
Vol 24 (09) ◽  
pp. 832-844 ◽  
Author(s):  
Andrea L. Pittman ◽  
Mollie M. Hiipakka

Background: Before advanced noise-management features can be recommended for use in children with hearing loss, evidence regarding their ability to use these features to optimize speech perception is necessary. Purpose: The purpose of this study was to examine the relation between children's preference for, and performance with, four combinations of noise-management features in noisy listening environments. Research Design: Children with hearing loss were asked to repeat short sentences presented in steady-state noise or in multitalker babble while wearing ear-level hearing aids. The aids were programmed with four memories having an orthogonal arrangement of two noise-management features. The children were also asked to indicate the hearing aid memory that they preferred in each of the listening conditions both initially and after a short period of use. Study Sample: Fifteen children between the ages of 8 and 12 yr with moderate hearing losses, bilaterally. Results: The children's preference for noise management aligned well with their performance for at least three of the four listening conditions. The configuration of noise-management features had little effect on speech perception with the exception of reduced performance for speech originating from behind the child while in a directional hearing aid setting. Additionally, the children's preference appeared to be governed by listening comfort, even under conditions for which a benefit was not expected such as the use of digital noise reduction in the multitalker babble conditions. Conclusions: The results serve as evidence in support of the use of noise-management features in grade-school children as young as 8 yr of age.


2021 ◽  
Vol 8 ◽  
pp. 205566832110215
Author(s):  
Madeline Hallewell ◽  
Davide Salanitri ◽  
Mirabelle D’Cruz ◽  
Sue Cobb ◽  
Lorenzo Picinali ◽  
...  

Introduction It is notoriously difficult to obtain a perfect fitting of hearing aids (HAs) for children as they often struggle to understand their hearing loss well enough to discuss the fitting adequately with their audiologist. Dartanan is an ‘edutainment’ game developed to help children understand the functions of their HA in different sound contexts. Dartanan also has elements of a leisure game for all children, in order to create an inclusive activity. Methods Game prototypes were evaluated during two formative evaluations and a summative evaluation. In total 106 children with and without hearing loss in Italy, Spain and the UK played Dartanan. A built-in virtual HA enabled children with hearing loss to use headphones to play. Results and conclusions: During the formative stages, feedback was discussed during focus groups on factors such as the audiological aspects, the extent to which children learned about HA functions, accessibility and usability, and this feedback was presented to the developers. After redevelopment, a summative evaluation was performed using an online survey. It was concluded that the game had met the goals of helping children understand their HA functionalities and providing an inclusive activity. User-evaluations were crucial in the development of the app into a useful and useable service.


2021 ◽  
Vol 4 (2) ◽  
pp. 45-50
Author(s):  
Ecem KARTAL ÖZCAN ◽  
Merve ÖZBAL BATUK ◽  
Şule KAYA ◽  
Gonca SENNAROĞLU

Assessment of speech perception in noise in children with hearing aids: Preliminary results* Objective: Noisy environments are a part of the daily life of children, just like adults. Children with hearing loss who wear hearing aids are more susceptible to the negative effects of noise than their normal-hearing peers. This study aims to evaluate the speech recognition in noise performance of hearing aid users and compare them with their normal-hearing peers. Material and Method: Five children aged 6-12 years with bilateral moderate to severe symmetrical sensorineural hearing loss and using bilateral behind-the-ear hearing aids were included in the study. 4 different conditions of the Turkish HINT-C were applied, and a speech recognition threshold (SRT) is determined for each condition. Results: Regardless of their age, the SRT needed by children with hearing aids to achieve equal performance with their normal-hearing peers was found to be higher for all test conditions. As seen in children with normal hearing in general, the mean noise front score of the children with hearing loss was higher than the mean noise right and noise left scores. Conclusion: The results of this study revealed that children with bilaterally symmetrical moderate to severe hearing loss achieved poor speech recognition scores in environments similar to the classroom environment, compared to their normal-hearing peers. Our results guided appropriate rehabilitation and follow-up. Keywords: noise, speech recognition in noise, hearing loss, hearing aid, pediatric audiology, HINT, HINT-C


2020 ◽  
Vol 5 (6) ◽  
pp. 1809-1812
Author(s):  
Helen Brough ◽  
Tiwaope Kachaje

Purpose Hearing loss can have a negative impact on a child's development. Hearing aids, if fitted appropriately, maintained well, and used regularly, can offer benefit to children with hearing loss. Regular reviews of hearing aid users can help to monitor a child's progress and provide timely intervention when problems arise or needs change. This study investigates the follow-up care received by children fitted with hearing aids at a clinic in Malawi. Method A clinical audit was done of the frequency of face-to-face follow-up appointments, following which all pediatric hearing aid users who had not recently received follow-up care were called to invite them for a review, and then a re-audit was conducted. Results Of the 47 children in the audit, 46 had not had a recent face-to-face follow-up appointment. Strenuous efforts were made to call those 46 children to the clinic for review: 20 caregivers agreed to bring their child for review, 10 of whom attended. It was not possible to contact 24 caregivers. Conclusions Reasons for low attendance for review at this service are not known, but may be related to the financial circumstances of the patients' families as well as difficulty in maintaining contact with families. It has not yet been possible to establish a system for routine follow-up care for pediatric hearing aid users at this well-established clinic in a low-income country.


2016 ◽  
Vol 27 (03) ◽  
pp. 188-203 ◽  
Author(s):  
Marlene Bagatto ◽  
Sheila Moodie ◽  
Christine Brown ◽  
April Malandrino ◽  
Frances Richert ◽  
...  

Background: Guidelines and protocols for pediatric hearing aid fitting are necessary to meet the goals of Early Hearing Detection and Intervention (EHDI) programs. The American Academy of Audiology published an update to their Pediatric Amplification Guideline in 2013. Ontario's Infant Hearing Program (IHP) offers specific protocols that aim to fulfill recommended guidelines. It has recently been updated to align with the American Academy of Audiology Guideline and other evidence. Purpose: A summary of the updates to the Ontario IHP’s Amplification Protocol is described. In addition, data illustrating hearing-related outcomes of the program are offered. Research Design: The updated Ontario protocol is based on evidence, wherever possible. Where research is not yet available, clinical decision support has been described in a systematic way. Outcomes of the Ontario IHP were obtained through a longitudinal clinical observation study. Study Sample: One hundred and fifteen children with hearing loss, who wore hearing aids, were included in the outcome analyses (mean = 28.6 mo; range = 1.3–115.3 mo). Hearing losses ranged from mild to profound, unilateral or bilateral sensorineural (pure-tone average = 52.3 dB HL). They were recruited from four IHP clinics within Ontario. Children with complexities in addition to hearing loss were included. Intervention: The children were fitted with hearing aids following Ontario's Amplification Protocol. Data Collection and Analyses: During routine clinical appointments, IHP Audiologists administered questionnaires to the parents of their pediatric patients using a systematic outcome measurement protocol (University of Western Ontario Pediatric Audiological Monitoring Protocol). Hearing aid fitting details (e.g., speech intelligibility index) were also gathered to describe the quality of the hearing aid fittings in relation to the functional outcomes. Regression analyses were conducted to characterize scores on the questionnaires and the impact of important variables. Children with complexities were analyzed separately from those who were typically developing. Results: Important updates to Ontario's Amplification Protocol offer new details about candidacy considerations as well as technical updates. Outcomes from the IHP reveal protocol elements can be executed clinically and when they are, typically developing children who wear hearing aids are meeting auditory development and performance milestones. Conclusions: Updates to Ontario's Amplification Protocol are necessary to support the evolution of EHDI programs and the evidence which sustains them. With advances in technology and additional research, pediatric hearing aid fitting will continue to progress and support systematic measurement of outcomes for children who wear hearing aids. The application of state-of-the-art hearing aid fitting practices to the pediatric population within EHDI programs supports good outcomes for infants and children with hearing loss.


2017 ◽  
Vol 28 (09) ◽  
pp. 861-875 ◽  
Author(s):  
Ryan W. McCreery ◽  
Marc Brennan ◽  
Elizabeth A. Walker ◽  
Meredith Spratford

AbstractThe purpose of providing amplification for children with hearing loss is to make speech audible across a range of frequencies and intensities. Children with hearing aids (HAs) that closely approximate prescriptive targets have better audibility than peers with HA output below prescriptive targets. Poor aided audibility puts children with hearing loss at risk for delays in communication, social, and academic development.The goals of this study were to determine how well HAs match prescriptive targets across ranges of frequency and intensity of speech and to determine how level- and frequency-dependent deviations from prescriptive target affect speech recognition in quiet and in background noise.One-hundred sixty-six children with permanent mild to severe hearing loss who were between 6 months and 8 years of age and who wore HAs participated in the study.Hearing aid verification and speech recognition data were collected as part of a longitudinal study of communication development in children with HAs. Hearing aid output at levels of soft and average speech and maximum power output were compared with each child’s prescriptive targets. The deviations from prescriptive target were quantified based on the root-mean-square (RMS) error and absolute deviation from target for octave frequencies. Children were classified into groups based on the number of level-dependent deviations from prescriptive target. Frequency-specific deviations from prescriptive target and sensation levels (SLs) were used to estimate the proximity of fittings across the frequency range. Lexical Neighborhood Test (LNT) word recognition in quiet and Computer-Assisted Speech Perception Assessment (CASPA) phoneme recognition in noise were compared across level-dependent error groups and as a function of SL at 4 kHz.Children who had deviations from prescriptive target at all three input levels had poorer LNT word recognition in quiet than children who had fittings that matched prescriptive target within 5 dB RMS at all three input levels. Children with lower 4 kHz SLs through their HAs had poorer LNT recognition in quiet and CASPA phoneme recognition in noise than children with higher aided SLs.Children with HAs fitted to provide audibility for speech across a range of inputs and frequencies had better speech recognition outcomes than peers with HAs that were not optimally fitted to prescriptive targets.


2015 ◽  
Vol 24 (4) ◽  
pp. 563-568 ◽  
Author(s):  
Samantha J. Gustafson ◽  
Hilary Davis ◽  
Benjamin W. Y. Hornsby ◽  
Fred H. Bess

PurposeThis pilot study examined factors influencing classroom hearing aid use in school-age children with hearing loss.MethodThe research team visited classrooms of 38 children with mild-to-moderate hearing loss (Grades 1–7) on 2 typical school days, twice per day, to document hearing aid use. In addition, parents reported the number of hours their children used hearing aids at school.ResultsNearly 24% of children were observed not wearing their hearing aids in the classroom on either observation day. Both grade level and degree of hearing loss appeared to affect hearing aid use. Children in Grades 5–7 and those with milder hearing losses were less likely to wear hearing aids. Overall, parents accurately reported classroom hearing aid use; however, those with children in Grades 5–7 were less accurate than those with children in earlier grades.ConclusionsThese preliminary results suggest that children with milder hearing loss and those in Grades 5–7 are at increased risk for reduced hearing aid use in the classroom. Also, parents of school-age children in these later grades are less accurate reporters of classroom hearing aid use compared to parents of children in earlier grades.


2020 ◽  
Vol 51 (1) ◽  
pp. 55-67 ◽  
Author(s):  
Ryan W. McCreery ◽  
Elizabeth A. Walker ◽  
Derek J. Stiles ◽  
Meredith Spratford ◽  
Jacob J. Oleson ◽  
...  

Purpose Because of uncertainty about the level of hearing where hearing aids should be provided to children, the goal of the current study was to develop audibility-based hearing aid candidacy criteria based on the relationship between unaided hearing and language outcomes in a group of children with hearing loss who did not wear hearing aids. Method Unaided hearing and language outcomes were examined for 52 children with mild-to-severe hearing losses. A group of 52 children with typical hearing matched for age, nonverbal intelligence, and socioeconomic status was included as a comparison group representing the range of optimal language outcomes. Two audibility-based criteria were considered: (a) the level of unaided hearing where unaided children with hearing loss fell below the median for children with typical hearing and (b) the level of unaided hearing where the slope of language outcomes changed significantly based on an iterative, piecewise regression modeling approach. Results The level of unaided audibility for children with hearing loss that was associated with differences in language development from children with typical hearing or based on the modeling approach varied across outcomes and criteria but converged at an unaided speech intelligibility index of 80. Conclusions Children with hearing loss who have unaided speech intelligibility index values less than 80 may be at risk for delays in language development without hearing aids. The unaided speech intelligibility index potentially could be used as a clinical criterion for hearing aid fitting candidacy for children with hearing loss.


Sign in / Sign up

Export Citation Format

Share Document