scholarly journals Detection, Speech Recognition, Loudness, and Preference Outcomes With a Direct Drive Hearing Aid: Effects of Bandwidth

2021 ◽  
Vol 25 ◽  
pp. 233121652199913
Author(s):  
Paula Folkeard ◽  
Maaike Van Eeckhoutte ◽  
Suzanne Levy ◽  
Drew Dundas ◽  
Parvaneh Abbasalipour ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Outcome Measurement ◽  
Direct Drive ◽  
Hearing Devices ◽  
Within Subjects ◽  
Study Participants

Direct drive hearing devices, which deliver a signal directly to the middle ear by vibrating the tympanic membrane via a lens placed in contact with the umbo, are designed to provide an extension of audible bandwidth, but there are few studies of the effects of these devices on preference, speech intelligibility, and loudness. The current study is the first to compare aided speech understanding between narrow and extended bandwidth conditions for listeners with hearing loss while fitted with a direct drive hearing aid system. The study also explored the effect of bandwidth on loudness perception and investigated subjective preference for bandwidth. Fifteen adult hearing aid users with symmetrical sensorineural hearing loss participated in a prospective, within-subjects, randomized single-blind repeated-measures study. Participants wore the direct drive hearing aids for 4 to 15 weeks (average 6 weeks) prior to outcome measurement. Outcome measures were completed in various bandwidth conditions achieved by reducing the gain of the device above 5000 Hz or by filtering the stimuli. Aided detection thresholds provided evidence of amplification to 10000 Hz. A significant improvement was found in high-frequency consonant detection and recognition, as well as for speech in noise performance in the full versus narrow bandwidth conditions. Subjective loudness ratings increased with provision of the full bandwidth available; however, real-world trials showed most participants were able to wear the full bandwidth hearing aids with only small adjustments to the prescription method. The majority of participants had either no preference or a preference for the full bandwidth setting.

scholarly journals The use of speech sentence audiometry in a free sound field

2020 ◽  
Vol 5 (1) ◽  
pp. 36-39
Author(s):  
Mariya Yu. Boboshko ◽  
Irina P. Berdnikova ◽  
Natalya V. Maltzeva
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Normative Data ◽  
Hearing Aid ◽  
Sound Field ◽  
Normal Hearing ◽  
Significant Difference ◽  
Hearing Aid Benefit

Objectives -to determine the normative data of sentence speech intelligibility in a free sound field and to estimate the applicability of the Russian Matrix Sentence test (RuMatrix) for assessment of the hearing aid fitting benefit. Material and methods. 10 people with normal hearing and 28 users of hearing aids with moderate to severe sensorineural hearing loss were involved in the study. RuMatrix test both in quiet and in noise was performed in a free sound field. All patients filled in the COSI questionnaire. Results. The hearing impaired patients were divided into two subgroups: the 1st with high and the 2nd with low hearing aid benefit, according to the COSI questionnaire. In the 1st subgroup, the threshold for the sentence intelligibility in quiet was 34.9 ± 6.4 dB SPL, and in noise -3.3 ± 1.4 dB SNR, in the 2nd subgroup 41.7 ± 11.5 dB SPL and 0.15 ± 3.45 dB SNR, respectively. The significant difference between the data of both subgroups and the norm was registered (p

scholarly journals Evaluation of Hearing Aid Manufacturers' Software-Derived Fittings to DSL v5.0 Pediatric Targets

2020 ◽  
Vol 31 (05) ◽  
pp. 354-362
Author(s):  
Paula Folkeard ◽  
Marlene Bagatto ◽  
Susan Scollie
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Chart Review ◽  
Hearing Aid ◽  
Test Case ◽  
Data Collection And Analysis ◽  
Speech Intelligibility Index ◽  
Programming Software ◽  
Test Level

Abstract Background Hearing aid prescriptive methods are a commonly recommended component of evidence-based preferred practice guidelines and are often implemented in the hearing aid programming software. Previous studies evaluating hearing aid manufacturers' software-derived fittings to prescriptions have shown significant deviations from targets. However, few such studies examined the accuracy of software-derived fittings for the Desired Sensation Level (DSL) v5.0 prescription. Purpose The purpose of this study was to evaluate the accuracy of software-derived fittings to the DSL v5.0 prescription, across a range of hearing aid brands, audiograms, and test levels. Research Design This study is a prospective chart review with simulated cases. Data Collection and Analysis A set of software-derived fittings were created for a six-month-old test case, across audiograms ranging from mild to profound. The aided output from each fitting was verified in the test box at 55-, 65-, 75-, and 90-dB SPL, and compared with DSL v5.0 child targets. The deviations from target across frequencies 250-6000 Hz were calculated, together with the root-mean-square error (RMSE) from target. The aided Speech Intelligibility Index (SII) values generated for the speech passages at 55- and 65-dB SPL were compared with published norms. Study Sample Thirteen behind-the-ear style hearing aids from eight manufacturers were tested. Results The amount of deviation per frequency was dependent on the test level and degree of hearing loss. Most software-derived fittings for mild-to-moderately severe hearing losses fell within ± 5 dB of the target for most frequencies. RMSE results revealed more than 84% of those hearing aid fittings for the mild-to-moderate hearing losses were within 5 dB at all test levels. Fittings for severe to profound hearing losses had the greatest deviation from target and RMSE. Aided SII values for the mild-to-moderate audiograms fell within the normative range for DSL pediatric fittings, although they fell within the lower portion of the distribution. For more severe losses, SII values for some hearing aids fell below the normative range. Conclusions In this study, use of the software-derived manufacturers' fittings based on the DSL v5.0 pediatric targets set most hearing aids within a clinically acceptable range around the prescribed target, particularly for mild-to-moderate hearing losses. However, it is likely that clinician adjustment based on verification of hearing aid output would be required to optimize the fit to target, maximize aided SII, and ensure appropriate audibility across all degrees of hearing loss.

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.

scholarly journals Changes in Psychosocial Measures After a 6-Week Field Trial

2017 ◽  
Vol 26 (2) ◽  
pp. 119-128 ◽  
Author(s):  
Jamie L. Desjardins ◽  
Karen A. Doherty
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Field Trial ◽  
Hearing Aid ◽  
Control Group ◽  
Psychosocial Consequences ◽  
Hearing Handicap ◽  
Bilateral Sensorineural Hearing Loss ◽  
Study Participants ◽  
Positive Effect

PurposeThe purpose of this study was to assess the extent to which intervention with hearing aids, namely, a 6-week hearing aid field trial, can minimize the psychosocial consequences of hearing loss in adults who have previously not sought treatment for their hearing loss.MethodTwenty-four adults with mild to moderate bilateral sensorineural hearing loss, who had never worn hearing aids or sought help for their hearing loss, participated in this study. Participants were fitted with receiver-in-canal hearing aids, bilaterally, and wore them for 6 weeks. Participants completed subjective measures of hearing handicap and attitudes about hearing loss and hearing aids before, during, and after the hearing aid trial. A control group of age-matched participants followed the same experimental protocol, except they were not fitted with hearing aids.ResultsUsing hearing aids for 6 weeks significantly reduced participants' perceived stigma of hearing aids, personal distress and inadequacy due to hearing difficulties, and hearing handicap.ConclusionsA hearing aid trial can have a positive effect on a person's attitudes toward wearing hearing aids and decrease hearing handicap.

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.

scholarly journals The Effects of Manufacturer’s Prefit and Real-Ear Fitting on the Predicted Speech Perception of Children with Severe to Profound Hearing Loss

2019 ◽  
Vol 30 (05) ◽  
pp. 346-356 ◽  
Author(s):  
Tian Kar Quar ◽  
Cila Umat ◽  
Yong Yee Chew
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
High Input ◽  
Profound Hearing Loss ◽  
High Frequency Region ◽  
Cross Sectional ◽  
Significant Difference

AbstractThe use of probe microphone measures in hearing aid verification is often neglected or not fully used by practitioners. Some practitioners rely on simulated gain and output provided by manufacturer's fitting software to verify hearing aids.This study aims to evaluate the effectiveness of manufacturer’s prefit procedure in matching the prescribed real-ear targets. It also aims to study its correlated impact on the predicted speech perception in children with severe and profound hearing loss.This cross-sectional experiment was carried out by measuring the output of hearing aids based on prefit versus real-ear at low-, moderate-, and high-input levels. The predicted speech perception for different hearing aid fittings was determined based on the Speech Intelligibility Index (SII).Sixteen children (28 ears) aged between 4 and 7 yr, with severe to profound sensorineural hearing loss took part in the study.Two different types of hearing aids (Phonak and Unitron) were programmed based on their respective manufacturers’ Desired Sensation Levels (DSL) v5 Child procedure. The hearing aids were then verified using coupler-based measurements and individual real-ear-to-coupler differences. The prefit outputs were compared with the DSL v5 Child–prescribed outputs at low-, moderate-, and high-input levels. The hearing aids were then adjusted to closely match the prescribed output. The SIIs were calculated for the fittings before and after adjustment.Sixty four percent of fittings that were based on the prefit procedure achieved the optimal fit-to-targets, with less than 5-dB RMS deviations from the DSL v5 Child targets. After adjusting the hearing aids to attempt to meet the DSL v5 Child targets, 75% of the ears tested achieved the optimal fit-to-targets. On average, hearing aid outputs generated by the manufacturer’s prefit procedure had good and reasonable agreement with the DSL v5 Child–prescribed outputs at low- and mid-frequencies. Nonetheless, at 4000 Hz, the hearing aid output mostly fell below the DSL v5 Child–prescribed outputs. This was still the case even after the hearing aid was adjusted to attempt to match with the targets. At low input level, some prefit outputs were found to be higher than the prescribed outputs. The deviations of prefit outputs from the prescribed outputs were dependent on the type of hearing aid and input levels. There was no significant difference between the SII calculated for fittings based on the prefit and adjusted fit.Prefit procedure tends to produce outputs that were below the DSL v5 Child–prescribed outputs, with the largest mean difference at 4000 Hz. Even though the hearing aid gains were adjusted to attempt to match with the targets, the outputs were still below the targets. The limitations of hearing aids to match the DSL v5 Child targets at high-frequency region have resulted in no improvement in the children’s predicted speech perception.

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.

Fit-to-Targets and Aided Speech Intelligibility Index Values for Hearing Aids Fitted to the DSL v5-Adult Prescription

2020 ◽  
Author(s):  
Andre Dao ◽  
Paula Folkeard ◽  
Sandra Baker ◽  
John Pumford ◽  
Susan Scollie
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Mean Squared Error ◽  
Hearing Aid ◽  
Hearing Level ◽  
Average Deviation ◽  
Absolute Deviation ◽  
Low Frequencies ◽  
Speech Intelligibility Index

Abstract Background Matching hearing aid output levels to prescribed targets is a component of preferred practice, yet recent normative data on appropriateness of fittings are lacking. Verification measures that assess closeness of fit-to-target include raw deviations from target, root-mean-squared-error (RMSE) deviations from target, and aided Speech Intelligibility Index (SII) values. Establishing normative ranges for these measures may help hearing professionals determine whether a patient's fit-to-targets and/or aided speech audibility is typical for his or her degree of hearing loss. Purpose This article aims to characterize the range of fit-to-target and the range of aided SII associated with hearing aid fittings using the Desired Sensation Level version 5.0 (DSL v5-adult) prescription with adults, considering also hearing aid style, venting, and audiometric characteristics. Research design A descriptive and correlational study of data collected from a retrospective chart review. Results Hearing aid fittings to 281 ears were compiled. The four-frequency average deviation from target (RMSE) was within ± 5 dB of target in 77% of fittings for mid-level speech. Deviation from targets increased with hearing loss, particularly when the loss is greater than 85 dB hearing level or if the loss was steeply sloping. Venting increased the deviation from targets in the low frequencies. Aided SII values strongly correlated with the participants' hearing thresholds. Clinical ranges for RMSE and aided SII were developed for characterization of fitting outcomes. Conclusion Fitting to DSL v5-adult targets was observed within ± 5 dB absolute deviation, or within 5 dB RMSE, on average for typical adult hearing aid fittings. Confidence intervals for deviation from target and aided SII are proposed.

Comparison of Some Speech Intelligibility Tests in the Evaluation of Hearing Aid Performance

1966 ◽  
Vol 9 (2) ◽  
pp. 253-258 ◽  
Author(s):  
James Jerger ◽  
Carolyn Malmquist ◽  
Charles Speaks
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Harmonic Distortion ◽  
Test Results ◽  
Monosyllabic Word ◽  
Word Test ◽  
Intelligibility Test ◽  
Sentence Intelligibility

A sentence intelligibility test and three monosyllabic word intelligibility tests, recorded through three hearing aids, were presented to 36 subjects with diverse types of hearing loss. Although hearing aids were rank ordered meaningfully on the sentence intelligibility test-in inverse proportion to the harmonic distortion-performance differences were not systematically reflected in the monosyllabic word test results.

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.

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