Comparison of In-the-Ear and Over-the-Ear Hearing Aid Fittings

1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Comparative Evaluation ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
The Difference ◽  
Functional Gain ◽  
The Relationship

A custom in-the-ear (ITE) hearing aid fitting was compared to two over-the-ear (OTE) hearing aid fittings for each of 9 subjects with mild to moderately severe hearing losses. Speech intelligibility via the three instruments was compared using the Speech Intelligibility Rating (SIR) test. The relationship between functional gain and coupler gain was compared for the ITE and the higher rated OTE instruments. The difference in input received at the microphone locations of the two types of hearing aids was measured for 10 different subjects and compared to the functional gain data. It was concluded that (a) for persons with mild to moderately severe hearing losses, appropriately adjusted custom ITE fittings typically yield speech intelligibility that is equal to the better OTE fitting identified in a comparative evaluation; and (b) gain prescriptions for ITE hearing aids should be adjusted to account for the high-frequency emphasis associated with in-the-concha microphone placement.

Review of Recent Research on the Selection of Frequency-Gain Characteristics for Hearing Aids

1980 ◽  
Vol 89 (5_suppl) ◽  
pp. 79-83
Author(s):  
Richard Lippmann
Keyword(s):  
Hearing Aids ◽  
Speech Intelligibility ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Linear Amplification ◽  
Percentage Points ◽  
Gain Characteristic ◽  
The Relationship ◽  
Fitting Hearing Aids ◽  
Selection Of

Following the Harvard master hearing aid study in 1947 there was little research on linear amplification. Recently, however, there have been a number of studies designed to determine the relationship between the frequency-gain characteristic of a hearing aid and speech intelligibility for persons with sensorineural hearing loss. These studies have demonstrated that a frequency-gain characteristic that rises at a rate of 6 dB/octave, as suggested by the Harvard study, is not optimal. They have also demonstrated that high-frequency emphasis of 10–40 dB above 500–1000 Hz is beneficial. Most importantly, they have demonstrated that hearing aids as they are presently being fit do not provide maximum speech intelligibility. Percent word correct scores obtained with the best frequency-gain characteristics tested in various studies have been found to be 9 to 19 percentage points higher than scores obtained with commercial aids owned by subjects. This increase in scores is equivalent to an increase in signal-to-noise ratio of 10 to 20 dB. This is a significant increase which could allow impaired listeners to communicate in many situations where they presently cannot. These results demonstrate the need for further research on linear amplification aimed at developing practical suggestions for fitting hearing aids.

Predicted Gain and Functional Gain With Transcranial Routing of Signal Completely-in-the-Canal Hearing Aids

2003 ◽  
Vol 12 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Marc A. Fagelson ◽  
Colleen M. Noe ◽  
Owen D. Murnane ◽  
Jennifer S. Blevins
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Mechanical Vibration ◽  
Signal Frequency ◽  
Unilateral Hearing Loss ◽  
External Canal ◽  
The Difference ◽  
Acoustic Output ◽  
Functional Gain

Transcranial routing of signal (TCROS) was accomplished using completely-in-the-canal (CIC) hearing aids in 5 profoundly unilaterally hearing-impaired individuals. The functional gain realized by the participants far exceeded the gain predicted by measuring the acoustic output and real ear aided response of the hearing aids. The difference between predicted and functional gain increased with signal frequency and was attributed at least in part to mechanical vibration of the hearing aid in the external canal. Implications for fitting unilateral hearing loss using TCROS amplifying systems are discussed.

Initial-Fit Approach Versus Verified Prescription: Comparing Self-Perceived Hearing Aid Benefit

2012 ◽  
Vol 23 (10) ◽  
pp. 768-778 ◽  
Author(s):  
Harvey B. Abrams ◽  
Theresa H. Chisolm ◽  
Megan McManus ◽  
Rachel McArdle
Keyword(s):  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
Fitting Method ◽  
Repeated Measures Analysis ◽  
Perceived Benefit ◽  
Eta Squared ◽  
The Difference ◽  
Hearing Aid Benefit

Background: Despite evidence suggesting inaccuracy in the default fittings provided by hearing aid manufacturers, the use of probe-microphone measures for the verification of fitting accuracy is routinely used by fewer than half of practicing audiologists. Purpose: The present study examined whether self-perception of hearing aid benefit, as measured through the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox and Alexander, 1995), differed as a function of hearing aid fitting method, specifically, manufacturer's initial-fit approach versus a verified prescription. The prescriptive fit began at NAL-NL1 targets, with adjustments based on participant request. Each of the two fittings included probe-microphone measurement. Research Design: A counterbalanced, cross-over, repeated-measures, single-blinded design was utilized to address the research objectives. Study Sample: Twenty-two experienced hearing aid users from the general Bay Pines VA Healthcare System audiology clinic population were randomized into one of two intervention groups. Intervention: At the first visit, half of the participants were fit with new hearing aids via the manufacturer's initial fit while the second half were fit to a verified prescription using probe-microphone measurement. After a wear period of 4–6 wk, the participants' hearing aids were refit via the alternate method and worn for an additional 4–6 wk. Participants were blinded to the method of fitting by utilizing probe-microphone measures with both approaches. Data Collection and Analysis: The APHAB was administered at baseline and at the end of each intervention trial. At the end of the second trial period, the participants were asked to identify which hearing aid fitting was “preferred.” The APHAB data were subjected to a general linear model repeated-measures analysis of variance. Results: For the three APHAB communication subscales (i.e., Ease of Communication, Reverberation, and Background Noise) mean scores obtained with the verified prescription were higher than those obtained with the initial-fit approach, indicating greater benefit with the former. The main effect of hearing aid fitting method was statistically significant [F (1, 21) = 4.69, p = 0.042] and accounted for 18% of the variance in the data (partial eta squared = 0.183). Although the mean benefit score for the APHAB Aversiveness subscale was also better (i.e., lower) for the verified prescription than the initial-fit approach, the difference was not statistically significant. Of the 22 participants, 7 preferred their hearing aids programmed to initial-fit settings and 15 preferred their hearing aids programmed to the verified prescription. Conclusions: The data support the conclusion that hearing aids fit to experienced hearing aid wearers using a verified prescription are more likely to yield better self-perceived benefit as measured by the APHAB than if fit using the manufacturer's initial-fit approach.

The Intelligibility of Speech by Hearing Aids on Inductance Loop and Microphone Modes of Signal Reception

1970 ◽  
Vol 13 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Steven W. Vargo ◽  
Glenn Taylor ◽  
J. Curtis Tannahill ◽  
Sally A. Plummer
Keyword(s):  
Data Analysis ◽  
Hearing Aids ◽  
Comparative Evaluation ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
The Other ◽  
Measure Data ◽  
Criterion Measure ◽  
Inductance Coil ◽  
Intelligible Speech

A comparative evaluation was done on the speech intelligibility of two hearing aids, one with an inductance loop and the other with a conventional body unit. Each aid received and reproduced 50 monosyllables (CID W 22) on both inductance coil and microphone input modes. The resultant 200 words were tape-recorded from the output of a 2cc coupler and then evaluated by 196 students. Words correctly written served as the criterion measure. Data analysis revealed significantly more intelligible speech for the conventional hearing aid for both inductance coil and microphone inputs. Further, the loop hearing aid was significantly less intelligible on its inductance coil setting than on microphone reception.

Coupling of FM Systems to Individuals With Unilateral Hearing Loss

1992 ◽  
Vol 35 (1) ◽  
pp. 201-207 ◽  
Author(s):  
Judy G. Kopun ◽  
Patricia G. Stelmachowicz ◽  
Edward Carney ◽  
Laura Schulte
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Ear Canal ◽  
Hearing Sensitivity ◽  
Adults And Children ◽  
Significant Attenuation ◽  
The Difference ◽  
Delivery Options ◽  
Speech Information ◽  
The Relationship

This study examined the attenuation characteristics of five FM system sound delivery options for a group of 10 adults and 15 children (5–13 years). Sound delivery options included a tube-fitting, lightweight headphones, a CROS earmold with tubing, a CROS earmold with a snap-ring, and a standard snap-ring earmold with a vent. Attenuation was defined as the difference between probe-tube microphone measures of the ear canal resonance and the SPL in the ear canal with each sound delivery option in place. A statistically significant but clinically inconsequential difference in attenuation for the CROS earmold with tubing was noted between adults and children. No significant differences in attenuation for any of the other sound delivery options were noted between adults and children. An investigation of the relationship between magnitude of attenuation and percentage of the ear canal occluded suggests that degree of occlusion is a major factor in determining degree of attenuation provided by a particular sound delivery option. Results also indicate that significant attenuation of high-frequency signals can occur with earmolds commonly considered nonoccluding. Caution should be used in fitting hearing aids or FM systems to individuals with normal high-frequency hearing sensitivity to prevent attenuation of unamplified high-frequency speech information.

Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss

2018 ◽  
Vol 29 (03) ◽  
pp. 243-254 ◽  
Author(s):  
Angeline Seeto ◽  
Grant D. Searchfield
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Sound Quality ◽  
Significant Benefit ◽  
Band Frequency ◽  
Significant Difference ◽  
Moderate Hearing Loss

AbstractAdvances in digital signal processing have made it possible to provide a wide-band frequency response with smooth, precise spectral shaping. Several manufacturers have introduced hearing aids that are claimed to provide gain for frequencies up to 10–12 kHz. However, there is currently limited evidence and very few independent studies evaluating the performance of the extended bandwidth hearing aids that have recently become available.This study investigated an extended bandwidth hearing aid using measures of speech intelligibility and sound quality to find out whether there was a significant benefit of extended bandwidth amplification over standard amplification.Repeated measures study designed to examine the efficacy of extended bandwidth amplification compared to standard bandwidth amplification.Sixteen adult participants with mild-to-moderate sensorineural hearing loss.Participants were bilaterally fit with a pair of Widex Mind 440 behind-the-ear hearing aids programmed with a standard bandwidth fitting and an extended bandwidth fitting; the latter provided gain up to 10 kHz.For each fitting, and an unaided condition, participants completed two speech measures of aided benefit, the Quick Speech-in-Noise test (QuickSIN™) and the Phonak Phoneme Perception Test (PPT; high-frequency perception in quiet), and a measure of sound quality rating.There were no significant differences found between unaided and aided conditions for QuickSIN™ scores. For the PPT, there were statistically significantly lower (improved) detection thresholds at high frequencies (6 and 9 kHz) with the extended bandwidth fitting. Although not statistically significant, participants were able to distinguish between 6 and 9 kHz 50% better with extended bandwidth. No significant difference was found in ability to recognize phonemes in quiet between the unaided and aided conditions when phonemes only contained frequency content <6 kHz. However significant benefit was found with the extended bandwidth fitting for recognition of 9-kHz phonemes. No significant difference in sound quality preference was found between the standard bandwidth and extended bandwidth fittings.This study demonstrated that a pair of currently available extended bandwidth hearing aids was technically capable of delivering high-frequency amplification that was both audible and useable to listeners with mild-to-moderate hearing loss. This amplification was of acceptable sound quality. Further research, particularly field trials, is required to ascertain the real-world benefit of high-frequency amplification.

scholarly journals Audibility-Based Hearing Aid Fitting Criteria for Children With Mild Bilateral Hearing Loss

2020 ◽  
Vol 51 (1) ◽  
pp. 55-67 ◽  
Author(s):  
Ryan W. McCreery ◽  
Elizabeth A. Walker ◽  
Derek J. Stiles ◽  
Meredith Spratford ◽  
Jacob J. Oleson ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Language Development ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Language Outcomes ◽  
Hearing Aid Fitting ◽  
Modeling Approach ◽  
Speech Intelligibility Index ◽  
Children With Hearing Loss

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.

scholarly journals Perceived Sound Quality Dimensions Influencing Frequency-Gain Shaping Preferences for Hearing Aid-Amplified Speech and Music

2021 ◽  
Vol 25 ◽  
pp. 233121652198990 ◽  
Author(s):  
Jonathan M. Vaisberg ◽  
Steve Beaulac ◽  
Danielle Glista ◽  
Ewan A. Macpherson ◽  
Susan D. Scollie
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Speech Intelligibility ◽  
Classical Music ◽  
Paired Comparison ◽  
Hearing Aid ◽  
Low Frequency ◽  
Sound Quality ◽  
Pop Music ◽  
Frequency Bands

Hearing aids are typically fitted using speech-based prescriptive formulae to make speech more intelligible. Individual preferences may vary from these prescriptions and may also vary with signal type. It is important to consider what motivates listener preferences and how those preferences can inform hearing aid processing so that assistive listening devices can best be tailored for hearing aid users. Therefore, this study explored preferred frequency-gain shaping relative to prescribed gain for speech and music samples. Preferred gain was determined for 22 listeners with mild sloping to moderately severe hearing loss relative to individually prescribed amplification while listening to samples of male speech, female speech, pop music, and classical music across low-, mid-, and high-frequency bands. Samples were amplified using a fast-acting compression hearing aid simulator. Preferences were determined using an adaptive paired comparison procedure. Listeners then rated speech and music samples processed using prescribed and preferred shaping across different sound quality descriptors. On average, low-frequency gain was significantly increased relative to the prescription for all stimuli and most substantially for pop and classical music. High-frequency gain was decreased significantly for pop music and male speech. Gain adjustments, particularly in the mid- and high-frequency bands, varied considerably between listeners. Music preferences were driven by changes in perceived fullness and sharpness, whereas speech preferences were driven by changes in perceived intelligibility and loudness. The results generally support the use of prescribed amplification to optimize speech intelligibility and alternative amplification for music listening for most listeners.

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.

Evaluation of Special Hearing Aids for Deaf Children

1971 ◽  
Vol 36 (4) ◽  
pp. 527-537 ◽  
Author(s):  
Norman P. Erber
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Low Frequency ◽  
Acoustic Stimulation ◽  
Deaf Children ◽  
Frequency Range ◽  
Frequency Limit ◽  
Unpublished Studies ◽  
Published Research

Two types of special hearing aid have been developed recently to improve the reception of speech by profoundly deaf children. In a different way, each special system provides greater low-frequency acoustic stimulation to deaf ears than does a conventional hearing aid. One of the devices extends the low-frequency limit of amplification; the other shifts high-frequency energy to a lower frequency range. In general, previous evaluations of these special hearing aids have obtained inconsistent or inconclusive results. This paper reviews most of the published research on the use of special hearing aids by deaf children, summarizes several unpublished studies, and suggests a set of guidelines for future evaluations of special and conventional amplification systems.

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