Using the Repeat-Recall Test to Examine Factors Affecting Context Use

2021 ◽  
Author(s):  
Francis Kuk ◽  
Christopher Slugocki ◽  
Petri Korhonen
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Speech Processing ◽  
Repeated Measures ◽  
Recall Test ◽  
Outcome Measure ◽  
Hearing Aid ◽  
Listening Effort ◽  
Double Blind ◽  
Repeated Measures Design

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.

scholarly journals An Integrative Evaluation of the Efficacy of a Directional Microphone and Noise-Reduction Algorithm under Realistic Signal-to-Noise Ratios

2020 ◽  
Vol 31 (04) ◽  
pp. 262-270
Author(s):  
Francis Kuk ◽  
Christopher Slugocki ◽  
Petri Korhonen
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Working Memory Capacity ◽  
Moderate Degree ◽  
Signal To Noise ◽  
Listening Effort ◽  
Double Blind ◽  
Repeated Measures Design

Abstract Background Many studies on the efficacy of directional microphones (DIRMs) and noise-reduction (NR) algorithms were not conducted under realistic signal-to-noise ratio (SNR) conditions. A Repeat-Recall Test (RRT) was developed previously to partially address this issue. Purpose This study evaluated whether the RRT could provide a more comprehensive understanding of the efficacy of a DIRM and NR algorithm under realistic SNRs. Possible interaction with listener working memory capacity (WMC) was assessed. Research Design This study uses a double-blind, within-subject repeated measures design. Study Sample Nineteen listeners with a moderate degree of hearing loss participated. Data Collection and Analysis The RRT was administered with participants wearing the study hearing aids (HAs) under two microphones (omnidirectional versus directional) by two NR (on versus off) conditions. Speech was presented from 0° at 75 dB SPL and a continuous noise from 180° at SNRs of 0, 5, 10, and 15 dB. The order of SNR and HA conditions was counterbalanced across listeners. Each test condition was completed twice in two 2-hour sessions separated by one month. Results The recall scores of listeners were used to group listeners into good and poor WMC groups. Analysis using linear mixed-effects models revealed significant effects of context, SNR, and microphone for all four measures (repeat, recall, listening effort, and tolerable time). NR was only significant on the listening effort scale in the DIRM mode at an SNR of 5 dB. Listeners with good WMC performed better on all measures of the RRT and benefitted more from context. Although DIRM benefitted listeners with good and poor WMC, the benefits differed by context and SNR. Conclusions The RRT confirmed the efficacy of DIRM and NR on several outcome measures under realistic SNRs. It also highlighted interactions between WMC and sentence context on feature efficacy.

An Integrative Evaluation of the Efficacy of a Directional Microphone and Noise Reduction Algorithm Under Realistic Signal-to-Noise Ratios

2019 ◽  
Author(s):  
Francis Kuk ◽  
Christopher Slugocki ◽  
Petri Korhonen
Keyword(s):  
Noise Reduction ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Moderate Degree ◽  
Signal To Noise ◽  
Listening Effort ◽  
Double Blind ◽  
Directional Microphones ◽  
Repeated Measures Design ◽  
Directional Microphone

Background: Many studies on the efficacy of directional microphones (DIRMs) and noise reduction (NR)algorithms were not conducted under realistic signal-to-noise ratio (SNR) conditions. A Repeat–RecallTest (RRT) was developed previously to partially address this issue.<br />Purpose: This study evaluated whether the RRT could provide a more comprehensive understanding ofthe efficacy of a DIRM and NR algorithm under realistic SNRs. Possible interaction with listener workingmemory capacity (WMC) was assessed.<br />Research Design: This study uses a double-blind, within-subject repeated measures design.<br />Study Sample: Nineteen listeners with a moderate degree of hearing loss participated.<br />Data Collection and Analysis: The RRT was administered with participants wearing the study hearingaids (HAs) under two microphones (omnidirectional versus directional) by two NR (on versus off) conditions.Speech was presented from 0° at 75 dB SPL and a continuous noise from 180° at SNRs of 0, 5,10, and 15 dB. The order of SNR and HA conditions was counterbalanced across listeners. Each testcondition was completed twice in two 2-hour sessions separated by one month.<br />Results: The recall scores of listeners were used to group listeners into good and poor WMC groups.Analysis using linear mixed-effects models revealed significant effects of context, SNR, and microphonefor all four measures (repeat, recall, listening effort, and tolerable time). NR was only significant on thelistening effort scale in the DIRM mode at an SNR of 5 dB. Listeners with good WMC performed better onall measures of the RRT and benefitted more from context. Although DIRM benefitted listeners with goodand poor WMC, the benefits differed by context and SNR.<br />Conclusions: The RRT confirmed the efficacy of DIRM and NR on several outcome measures underrealistic SNRs. It also highlighted interactions between WMC and sentence context on feature efficacy.<br />

scholarly journals Sentence Recognition in Noise and Perceived Benefit of Noise Reduction on the Receiver and Transmitter Sides of a BICROS Hearing Aid

2013 ◽  
Vol 24 (10) ◽  
pp. 980-991 ◽  
Author(s):  
Kristi Oeding ◽  
Michael Valente
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Background Noise ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Directional Microphones ◽  
Sentence Recognition ◽  
Clinically Significant ◽  
The Impact

Background: In the past, bilateral contralateral routing of signals (BICROS) amplification incorporated omnidirectional microphones on the transmitter and receiver sides and some models utilized noise reduction (NR) on the receiver side. Little research has examined the performance of BICROS amplification in background noise. However, previous studies examining contralateral routing of signals (CROS) amplification have reported that the presence of background noise on the transmitter side negatively affected speech recognition. Recently, NR was introduced as a feature on the receiver and transmitter sides of BICROS amplification, which has the potential to decrease the impact of noise on the wanted speech signal by decreasing unwanted noise directed to the transmitter side. Purpose: The primary goal of this study was to examine differences in the reception threshold for sentences (RTS in dB) using the Hearing in Noise Test (HINT) in a diffuse listening environment between unaided and three aided BICROS conditions (no NR, mild NR, and maximum NR) in the Tandem 16 BICROS. A secondary goal was to examine real-world subjective impressions of the Tandem 16 BICROS compared to unaided. Research Design: A randomized block repeated measures single blind design was used to assess differences between no NR, mild NR, and maximum NR listening conditions. Study Sample: Twenty-one adult participants with asymmetric sensorineural hearing loss (ASNHL) and experience with BICROS amplification were recruited from Washington University in St. Louis School of Medicine. Data Collection and Analysis: Participants were fit with the National Acoustic Laboratories’ Nonlinear version 1 prescriptive target (NAL-NL1) with the Tandem 16 BICROS at the initial visit and then verified using real-ear insertion gain (REIG) measures. Participants acclimatized to the Tandem 16 BICROS for 4 wk before returning for final testing. Participants were tested utilizing HINT sentences examining differences in RTS between unaided and three aided listening conditions. Subjective benefit was determined via the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire between the Tandem 16 BICROS and unaided. A repeated measures analysis of variance (ANOVA) was utilized to analyze the results of the HINT and APHAB. Results: Results revealed no significant differences in the RTS between unaided, no NR, mild NR, and maximum NR. Subjective impressions using the APHAB revealed statistically and clinically significant benefit with the Tandem 16 BICROS compared to unaided for the Ease of Communication (EC), Background Noise (BN), and Reverberation (RV) subscales. Conclusions: The RTS was not significantly different between unaided, no NR, mild NR, and maximum NR. None of the three aided listening conditions were significantly different from unaided performance as has been reported for previous studies examining CROS hearing aids. Further, based on comments from participants and previous research studies with conventional hearing aids, manufacturers of BICROS amplification should consider incorporating directional microphones and independent volume controls on the receiver and transmitter sides to potentially provide further improvement in signal-to-noise ratio (SNR) for patients with ASNHL.

The Effects of Noise Reduction Technologies on the Acceptance of Background Noise

2013 ◽  
Vol 24 (08) ◽  
pp. 649-659 ◽  
Author(s):  
Kristy Jones Lowery ◽  
Patrick N. Plyler
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Background Noise ◽  
Negative Effects ◽  
Directional Microphones ◽  
Repeated Measures Design ◽  
Noise Type ◽  
Data Collection And Analysis ◽  
Speech Spectrum

Background: Directional microphones (D-Mics) and digital noise reduction (DNR) algorithms are used in hearing aids to reduce the negative effects of background noise on performance. Directional microphones attenuate sounds arriving from anywhere other than the front of the listener while DNR attenuates sounds with physical characteristics of noise. Although both noise reduction technologies are currently available in hearing aids, it is unclear if the use of these technologies in isolation or together affects acceptance of noise and/or preference for the end user when used in various types of background noise. Purpose: The purpose of the research was to determine the effects of D-Mic, DNR, or the combination of D-Mic and DNR on acceptance of noise and preference when listening in various types of background noise. Research Design: An experimental study in which subjects were exposed to a repeated measures design was utilized. Study Sample: Thirty adult listeners with mild sloping to moderately severe sensorineural hearing loss participated (mean age 67 yr). Data Collection and Analysis: Acceptable noise levels (ANLs) were obtained using no noise reduction technologies, D-Mic only, DNR only, and the combination of the two technologies (Combo) for three different background noises (single-talker speech, speech-shaped noise, and multitalker babble) for each listener. In addition, preference rankings of the noise reduction technologies were obtained within each background noise (1 = best, 3 = worst). Results: ANL values were significantly better for each noise reduction technology than baseline; and benefit increased significantly from DNR to D-Mic to Combo. Listeners with higher (worse) baseline ANLs received more benefit from noise reduction technologies than listeners with lower (better) baseline ANLs. Neither ANL values nor ANL benefit values were significantly affected by background noise type; however, ANL benefit with D-Mic and Combo was similar when speech-like noise was present while ANL benefit was greatest for Combo when speech spectrum noise was present. Listeners preferred the hearing aid settings that resulted in the best ANL value. Conclusion: Noise reduction technologies improved ANL for each noise type, and the amount of improvement was related to the baseline ANL value. Improving an ANL with noise reduction technologies is noticeable to listeners, at least when examined in this laboratory setting, and listeners prefer noise reduction technologies that improved their ability to accept noise.

Effects of a Transient Noise Reduction Algorithm on Speech Understanding, Subjective Preference, and Preferred Gain

2013 ◽  
Vol 24 (09) ◽  
pp. 845-858 ◽  
Author(s):  
Petri Korhonen ◽  
Francis Kuk ◽  
Chi Lau ◽  
Denise Keenan ◽  
Jennifer Schumacher ◽  
...  
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Speech Intelligibility ◽  
Repeated Measures Design ◽  
Subjective Preference ◽  
Listening Environments ◽  
Speech Identification ◽  
Noise Reduction Algorithm ◽  
Phoneme Identification

Background: Today's compression hearing aids with noise reduction systems may not manage transient noises effectively because of the short duration of these sounds compared to the onset times of the compressors and/or noise reduction algorithms. Purpose: The current study was designed to evaluate the effect of a transient noise reduction (TNR) algorithm on listening comfort, speech intelligibility in quiet, and preferred wearer gain in the presence of transients. Research Design: A single-blinded, repeated-measures design was used. Study Sample: Thirteen experienced hearing aid users with bilaterally symmetrical (≤7.5 dB) sensorineural hearing loss participated in the study. Results: Speech identification in quiet (no transient noise) was identical between the TNR On and the TNR Off conditions. The participants showed subjective preference for the TNR algorithm when “comfortable listening” was used as the criterion. Participants preferred less gain than the default prescription in the presence of transient noise sounds. However, the preferred gain was 2.9 dB higher when the TNR was activated than when it was deactivated. This translated to 12.1% improvement in phoneme identification over the TNR Off condition for soft speech. Conclusions: This study demonstrated that the use of the TNR algorithm would not negatively affect speech identification. The results also suggested that this algorithm may improve listening comfort in the presence of transient noise sounds and ensure consistent use of prescribed gain. Such an algorithm may ensure more consistent audibility across listening environments.

Evaluation of a Wind Noise Attenuation Algorithm on Subjective Annoyance and Speech-in-Wind Performance

2017 ◽  
Vol 28 (01) ◽  
pp. 046-057 ◽  
Author(s):  
Petri Korhonen ◽  
Francis Kuk ◽  
Eric Seper ◽  
Martin Mørkebjerg ◽  
Majken Roikjer
Keyword(s):  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Real Life ◽  
Subjective Rating ◽  
Noise Attenuation ◽  
Wind Noise ◽  
Wind Speeds ◽  
Repeated Measures Design ◽  
Phoneme Identification

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.

Chosen Listening Levels for Music With and Without the Use of Hearing Aids

2016 ◽  
Vol 25 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Naomi B. H. Croghan ◽  
Anne M. Swanberg ◽  
Melinda C. Anderson ◽  
Kathryn H. Arehart
Keyword(s):  
Tympanic Membrane ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Rock Music ◽  
Classical Music ◽  
Hearing Aid ◽  
Intersubject Variability ◽  
Repeated Measures Design ◽  
Recorded Music ◽  
Listening Levels

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.

Effect of Maximum Power Output and Noise Reduction on Speech Recognition in Noise

2011 ◽  
Vol 22 (05) ◽  
pp. 265-273 ◽  
Author(s):  
Francis Kuk ◽  
Heidi Peeters ◽  
Chi Lau ◽  
Petri Korhonen
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Power Output ◽  
Noise Level ◽  
Repeated Measures ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Maximum Power ◽  
Maximum Power Output ◽  
Bonferroni Adjustment

Background: The maximum power output (MPO) of a hearing aid was typically discussed in the context of avoiding loudness discomfort. However, an MPO that is too low, as in the cases to avoid discomfort for people with a severe loudness tolerance problem and hearing losses that exceed the fitting range of the hearing aids, could negatively affect sound quality and speech intelligibility in noise. Purpose: The current study was designed to demonstrate the degradation in speech intelligibility in noise on the HINT (Hearing in Noise Test) when the MPO of the wearers' hearing aids was lowered by 10 dB from the default. The interactions with noise reduction (NR) algorithms (classic [NR-classic] and Speech Enhancer [NR-SE]) were also examined. Research Design: A single-blinded, factorial repeated-measures design was used to study the effect of noise input level (68 dBC, 75 dBC), MPO setting (default and default-10), and NR algorithm (off, classic, SE) on HINT performance. Study Sample: Eleven adults with a severe sensorineural hearing loss participated. Intervention: Participants were fit with the Widex m4-19 behind-the-ear hearing aids binaurally in the default frequency response and MPO settings. The hearing aids were adjusted to six MPO (default, default-10) by NR (off, classic, SE conditions). Testing was completed within one 2 hr session. Data Collection and Analysis: The RTS (reception threshold for speech) for 50% correct on the HINT was measured in each of the six hearing aid conditions at two input levels (68 and 75 dBC) with speech and noise stimuli presented from the front. Repeated-measures ANOVAs were conducted using SPSS software to examine significant differences. Results: A repeated-measures ANOVA showed that noise level was not significant while NR algorithm and MPO were significant. The interaction between noise level and NR algorithm was also significant. Post hoc analysis with Bonferroni adjustment for the effect of NR algorithm showed that performance with NR-off was significantly poorer than performance with NR-classic and NR-SE (p < 0.05). However, NR-classic and NR-SE were not significantly different from each other (p > 0.05). Conclusions: An MPO that was 10 dB lower than the default could negatively affect the signal-to-noise ratio (SNR) of the listening environment. However, NR could compensate for the degradation in SNR.

The Effects of Hearing Aid Directional Microphone and Noise Reduction Processing on Listening Effort in Older Adults with Hearing Loss

2016 ◽  
Vol 27 (01) ◽  
pp. 029-041 ◽  
Author(s):  
Jamie L. Desjardins
Keyword(s):  
Hearing Loss ◽  
Cognitive Load ◽  
Noise Reduction ◽  
Cognitive Processing ◽  
Hearing Aids ◽  
Background Noise ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Listening Effort ◽  
Directional Microphone

Background: Older listeners with hearing loss may exert more cognitive resources to maintain a level of listening performance similar to that of younger listeners with normal hearing. Unfortunately, this increase in cognitive load, which is often conceptualized as increased listening effort, may come at the cost of cognitive processing resources that might otherwise be available for other tasks. Purpose: The purpose of this study was to evaluate the independent and combined effects of a hearing aid directional microphone and a noise reduction (NR) algorithm on reducing the listening effort older listeners with hearing loss expend on a speech-in-noise task. Research Design: Participants were fitted with study worn commercially available behind-the-ear hearing aids. Listening effort on a sentence recognition in noise task was measured using an objective auditory–visual dual-task paradigm. The primary task required participants to repeat sentences presented in quiet and in a four-talker babble. The secondary task was a digital visual pursuit rotor-tracking test, for which participants were instructed to use a computer mouse to track a moving target around an ellipse that was displayed on a computer screen. Each of the two tasks was presented separately and concurrently at a fixed overall speech recognition performance level of 50% correct with and without the directional microphone and/or the NR algorithm activated in the hearing aids. In addition, participants reported how effortful it was to listen to the sentences in quiet and in background noise in the different hearing aid listening conditions. Study Sample: Fifteen older listeners with mild sloping to severe sensorineural hearing loss participated in this study. Results: Listening effort in background noise was significantly reduced with the directional microphones activated in the hearing aids. However, there was no significant change in listening effort with the hearing aid NR algorithm compared to no noise processing. Correlation analysis between objective and self-reported ratings of listening effort showed no significant relation. Conclusions: Directional microphone processing effectively reduced the cognitive load of listening to speech in background noise. This is significant because it is likely that listeners with hearing impairment will frequently encounter noisy speech in their everyday communications.

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
Keyword(s):  
Frequency Response ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Mixed Model ◽  
Hearing Aid ◽  
Primary Concern ◽  
The Real ◽  
Repeated Measures Design ◽  
Significant Difference ◽  
The Mean

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.

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