Low-level Speech Recognition of Children with Hearing Aids

2021 ◽  
Author(s):  
Jace Wolfe ◽  
Mila Duke ◽  
Sharon Miller ◽  
Erin Schafer ◽  
Christine Jones ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Word Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Phase 1 ◽  
Second Phase ◽  
Phase 2 ◽  
Low Level ◽  
Children With Hearing Loss

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

scholarly journals Perceptual Implications of Level- and Frequency-Specific Deviations from Hearing Aid Prescription in Children

2017 ◽  
Vol 28 (09) ◽  
pp. 861-875 ◽  
Author(s):  
Ryan W. McCreery ◽  
Marc Brennan ◽  
Elizabeth A. Walker ◽  
Meredith Spratford
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Word Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Computer Assisted ◽  
Phoneme Recognition ◽  
Absolute Deviation ◽  
Children With Hearing Loss ◽  
Dependent Error

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.

An Evaluation of Several Rationales for Selecting Hearing Aid Gain

1986 ◽  
Vol 51 (3) ◽  
pp. 272-281 ◽  
Author(s):  
Larry E. Humes
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Second Phase ◽  
Selection Procedures ◽  
Relative Gain ◽  
Typical Range ◽  
Selection Of

The present study evaluates the rationales underlying several hearing aid selection procedures. The first portion of the evaluation confirms that the gain-selection rationales result in the selection of different hearing aids for a given patient. Nine different audiometric configurations representing varying degrees of fiat, sloping, and rising sensorineural hearing loss were considered. The second phase of the evaluation considered how well each procedure achieved the goal of maximizing speech recognition. This analysis made use of the Articulation Index and was applied to each of the nine audiometric configurations. The results of this analysis suggested that, given the ability to adjust the overall gain over a typical range available through most volume controls, any of the procedures could produce optimal aided speech recognition performance. The final portion of the evaluation examined the ability of each procedure to prescribe absolute gain and relative gain (frequency response) that corresponded to that preferred by hearing aid wearers. The data for preferred insertion gain came from a recent investigation by Leijon, Eriksson-Mangold, an d Beck-Karlsen (1984). The results of this evaluation suggested that some procedures prescribe gain values closer to those preferred by listeners than others. More data are needed on preferred gain values for a variety of configurations, however, before any one procedure can be recommended over another.

scholarly journals İşitme cihazı kullanan çocuklarda gürültüde konuşmayı anlama becerisinin değerlendirilmesi: Preliminer sonuçlar

2021 ◽  
Vol 4 (2) ◽  
pp. 45-50
Author(s):  
Ecem KARTAL ÖZCAN ◽  
Merve ÖZBAL BATUK ◽  
Şule KAYA ◽  
Gonca SENNAROĞLU
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Classroom Environment ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Negative Effects ◽  
The Mean ◽  
Children With Hearing Loss ◽  
Speech Recognition In Noise

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

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.

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.

scholarly journals Unilateral hearing loss and the use of hearing aid: speech recognition, benefit, self-perception of functional performance and satisfaction

Revista CEFAC ◽  
2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Lidiéli Dalla Costa ◽  
Sinéia Neujahr dos Santos ◽  
Maristela Julio Costa
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Functional Performance ◽  
Hearing Aid ◽  
Brazilian Portuguese ◽  
Unilateral Hearing Loss ◽  
Life Questionnaire ◽  
Self Perception ◽  
Sound Amplification

ABSTRACT Purpose: to investigate speech recognition in silence and in noise in subjects with unilateral hearing loss with and without hearing aids, and to analyze the benefit, self-perception of functional performance, satisfaction and the use of hearing aids in these subjects. Methods: eleven adults with unilateral, mixed and sensorineural, mild to severe hearing loss participated in this study. Speech recognition was evaluated by the Brazilian Portuguese sentences lists test; functional performance of the hearing was assessed by using the Speech Spatial and Qualities of Hearing Scale questionnaire; satisfaction was assessed by the Satisfaction with Amplification in Daily Life questionnaire, both in Brazilian Portuguese; and to assess the use of hearing aids, the patient's report was analyzed. Results: the adaptation of hearing aids provided benefits in speech recognition in all positions evaluated, both in silence and in noise. The subjects did not report major limitations in communication activities with the use of hearing aids. They were satisfied with the use of sound amplification. Most of the subjects did not use hearing aids, effectively. The discontinuity of hearing aids use can be justified by the difficulty on perceiving participation’s restriction caused by hearing loss, as well as the benefit of the hearing aid, besides the concern with batteries’ costs and aesthetic aspects. Conclusion: although showing benefits in speech recognition, in silence and in noise, and satisfaction with sound amplification, most subjects with unilateral hearing loss do not effectively use hearing aids.

scholarly journals Evidence of Acclimatization in Persons with Severe-to-Profound Hearing Loss

2003 ◽  
Vol 14 (02) ◽  
pp. 084-099 ◽  
Author(s):  
Francis K. Kuk ◽  
Lisa Potts ◽  
Michael Valente ◽  
Lidia Lee ◽  
Jay Picirrillo
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Profound Hearing Loss ◽  
Secondary Purpose ◽  
Objective Performance ◽  
Recognition Testing ◽  
The One ◽  
Better Than

The present study examined the phenomenon of acclimatization in persons with a severe-to-profound hearing loss. A secondary purpose was to examine the efficacy of a digital nonlinear power hearing aid that has a low compression threshold with expansion for this population. Twenty experienced hearing aid users wore the study hearing aids for three months and their performance with the study hearing aids was evaluated at the initial fitting, one month, and three months after the initial fitting. Performance of their current hearing aids was also evaluated at the initial fitting. Speech recognition testing was conducted at input levels of 50 dB SPL and 65 dB SPL in quiet, and 75 dB SPL in noise at a +10 SNR. Questionnaires were used to measure subjective performance at each evaluation interval. The results showed improvement in speech recognition score at the one-month evaluation over the initial evaluation. No significant improvement was seen at the three-month evaluation from the one-month visit. In addition, subjective and objective performance of the study hearing aids was significantly better than the participants' own hearing aids at all evaluation intervals. These results provided evidence of acclimatization in persons with a severe-to-profound hearing loss and reinforced the precaution that any trial of amplification, especially from linear to nonlinear mode, should consider this phenomenon.

The Effects of Changes in Head Angle on Auditory and Visual Input for Omnidirectional and Directional Microphone Hearing Aids

2003 ◽  
Vol 12 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Paula Henry ◽  
Todd Ricketts
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Visual Cues ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Binaural Hearing ◽  
Increase Signal Intensity ◽  
Visual Mode

Improving the signal-to-noise ratio (SNR) for individuals with hearing loss who are listening to speech in noise provides an obvious benefit. Although binaural hearing provides the greatest advantage over monaural hearing in noise, some individuals with symmetrical hearing loss choose to wear only one hearing aid. The present study tested the hypothesis that individuals with symmetrical hearing loss fit with one hearing aid would demonstrate improved speech recognition in background noise with increases in head turn. Fourteen individuals were fit monaurally with a Starkey Gemini in-the-ear (ITE) hearing aid with directional and omnidirectional microphone modes. Speech recognition performance in noise was tested using the audiovisual version of the Connected Speech Test (CST v.3). The test was administered in auditory-only conditions as well as with the addition of visual cues for each of three head angles: 0°, 20°, and 40°. Results indicated improvement in speech recognition performance with changes in head angle for the auditory-only presentation mode at the 20° and 40° head angles when compared to 0°. Improvement in speech recognition performance for the auditory + visual mode was noted for the 20° head angle when compared to 0°. Additionally, a decrement in speech recognition performance for the auditory + visual mode was noted for the 40° head angle when compared to 0°. These results support a speech recognition advantage for listeners fit with one ITE hearing aid listening in a close listener-to-speaker distance when they turn their head slightly in order to increase signal intensity.

scholarly journals Hearing Aid Treatment for Patients with Mixed Hearing Loss. Part II: Speech Recognition in Comparison to Direct Acoustic Cochlear Stimulation

2020 ◽  
Vol 25 (3) ◽  
pp. 133-142
Author(s):  
Nina Wardenga ◽  
Ad F.M. Snik ◽  
Eugen Kludt ◽  
Bernd Waldmann ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Middle Ear ◽  
Hearing Aids ◽  
Dynamic Range ◽  
Hearing Aid ◽  
Middle Ear Surgery ◽  
Promising Alternative ◽  
Mixed Hearing Loss ◽  
Technical Specifications

Background: The conventional therapy for severe mixed hearing loss is middle ear surgery combined with a power hearing aid. However, a substantial group of patients with severe mixed hearing loss cannot be treated adequately with today’s state-of-the-art (SOTA) power hearing aids, as predicted by the accompanying part I of this publication, where we compared the available maximum power output (MPO) and gain from technical specifications to requirements for optimum benefit using a common fitting rule. Here, we intended to validate the theoretical assumptions from part I experimentally in a mixed hearing loss cohort fitted with SOTA power hearing aids. Additionally, we compared the results with an implantable hearing device that circumvents the impaired middle ear, directly stimulating the cochlea, as this might be a better option. Objectives: Speech recognition outcomes obtained from patients with severe mixed hearing loss supplied acutely with a SOTA hearing aid were studied to validate the outcome predictions as described in part I. Further, the results obtained with hearing aids were compared to those in direct acoustic cochlear implant (DACI) users. Materials and Methods: Twenty patients (37 ears with mixed hearing loss) were provided and fitted with a SOTA power hearing aid. Before and after an acclimatization period of at least 4 weeks, word recognition scores (WRS) in quiet and in noise were studied, as well as the speech reception threshold in noise (SRT). The outcomes were compared retrospectively to a second group of 45 patients (47 ears) using the DACI device. Based on the severity of the mixed hearing loss and the available gain and MPO of the SOTA hearing aid, the hearing aid and DACI users were subdivided into groups with prediction of sufficient, partially insufficient, or very insufficient hearing aid performance. Results: The patients with predicted adequate SOTA hearing aid performance indeed showed the best WRS in quiet and in noise when compared to patients with predicted inferior outcomes. Insufficient hearing aid performance at one or more frequencies led to a gradual decrease in hearing aid benefit, validating the criteria used here and in the accompanying paper. All DACI patients showed outcomes at the same level as the adequate hearing aid performance group, being significantly better than those of the groups with inadequate hearing aid performance. Whereas WRS in quiet and noise were sensitive to insufficient gain or output, showing significant differences between the SOTA hearing aid and DACI groups, the SRT in noise was less sensitive. Conclusions: Limitations of outcomes in mixed hearing loss individuals due to insufficient hearing aid performance can be accurately predicted by applying a commonly used fitting rule and the 35-dB dynamic range rule on the hearing aid specifications. Evidently, when outcomes in patients with mixed hearing loss using the most powerful hearing aids are insufficient, bypassing the middle ear with a powerful active middle ear implant or direct acoustic implant can be a promising alternative treatment.

Are Two Ears Not Better Than One?

2012 ◽  
Vol 23 (03) ◽  
pp. 171-181 ◽  
Author(s):  
Rachel A. McArdle ◽  
Mead Killion ◽  
Monica A. Mennite ◽  
Theresa H. Chisolm
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Analysis Experiment ◽  
Insert Earphones ◽  
Speech Recognition In Noise

Background: The decision to fit one or two hearing aids in individuals with binaural hearing loss has been debated for years. Although some 78% of U.S. hearing aid fittings are binaural (Kochkin , 2010), Walden and Walden (2005) presented data showing that 82% (23 of 28 patients) of their sample obtained significantly better speech recognition in noise scores when wearing one hearing aid as opposed to two. Purpose: To conduct two new experiments to fuel the monaural/binaural debate. The first experiment was a replication of Walden and Walden (2005), whereas the second experiment examined the use of binaural cues to improve speech recognition in noise. Research Design: A repeated measures experimental design. Study Sample: Twenty veterans (aged 59–85 yr), with mild to moderately severe binaurally symmetrical hearing loss who wore binaural hearing aids were recruited from the Audiology Department at the Bay Pines VA Healthcare System. Data Collection and Analysis: Experiment 1 followed the procedures of the Walden and Walden study, where signal-to-noise ratio (SNR) loss was measured using the Quick Speech-in-Noise (QuickSIN) test on participants who were aided with their current hearing aids. Signal and noise were presented in the sound booth at 0° azimuth under five test conditions: (1) right ear aided, (2) left ear aided, (3) both ears aided, (4) right ear aided, left ear plugged, and (5) unaided. The opposite ear in (1) and (2) was left open. In Experiment 2, binaural Knowles Electronics Manikin for Acoustic Research (KEMAR) manikin recordings made in Lou Malnati's pizza restaurant during a busy period provided a typical real-world noise, while prerecorded target sentences were presented through a small loudspeaker located in front of the KEMAR manikin. Subjects listened to the resulting binaural recordings through insert earphones under the following four conditions: (1) binaural, (2) diotic, (3) monaural left, and (4) monaural right. Results: Results of repeated measures ANOVAs demonstrated that the best speech recognition in noise performance was obtained by most participants with both ears aided in Experiment 1 and in the binaural condition in Experiment 2. Conclusions: In both experiments, only 20% of our subjects did better in noise with a single ear, roughly similar to the earlier Jerger et al (1993) finding that 8–10% of elderly hearing aid users preferred one hearing aid.

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