Speech Recognition In Hearing Aids: Used For Assessing CI Candidacy In Tonal Language Population

2021 ◽  
Author(s):  
Yu-Lin Chang ◽  
Chia-Jou Liu ◽  
Pey-Yu Chen ◽  
Hung-Ching Lin
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Recognition Test ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Pure Tone Audiometry ◽  
Profound Hearing Loss ◽  
Tonal Language ◽  
Severe Hearing Loss

Abstract Objective: CI (cochlear implantation) candidacy is somewhat controversial in severe hearing loss among tonal mandarin-speaking patients. To assess the relationship between pure tone audiometry (PTA) and speech recognition score (SRS), with and without hearing aid amplification, among patients who did not meet the NIH criteria of CI candidacy in tonal language mandarian-speaking countries, especially those with severe hearing loss (70 dB HL < 4FPTA(0.5, 1, 2, 4 KHz) ≤ 90 dB HL) Materials and Methods: A total of 414 patients with sensorineural hearing loss with 774 ears were reviewed retrospectively in a tertiary referral center. The Mandarin Monosyllable Recognition Test (MMRT) was used to evaluate the SRS of these ears. Results: 31% (10/32) of the 32 ears with severe hearing loss, 70-90 dB HL, still showed poor speech recognition (SRS<30%) after hearing aid amplification, while 71% (46/65) of the 65 ears with profound hearing loss, > 90 dB HL, showed poor speech recognition with hearing aid amplification. Conclusions: The speech audiometry with Mandarin Monosyllable Recognition Test (MMRT) helped identify those patients whose 4FPTA< 90 dB HL fell outside the CI candidacy criteria of NIH in tonal language mandarin-speaking countries but showed significantly poor (SRS< 30%) speech recognition performance.

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 An Evaluation of Hearing Aid Beamforming Microphone Arrays in a Noisy Laboratory Setting

2019 ◽  
Vol 30 (02) ◽  
pp. 131-144 ◽  
Author(s):  
Erin M. Picou ◽  
Todd A. Ricketts
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Linear Models ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Microphone Arrays ◽  
Laboratory Setting ◽  
Subjective Ratings ◽  
Sentence Recognition

AbstractPeople with hearing loss experience difficulty understanding speech in noisy environments. Beamforming microphone arrays in hearing aids can improve the signal-to-noise ratio (SNR) and thus also speech recognition and subjective ratings. Unilateral beamformer arrays, also known as directional microphones, accomplish this improvement using two microphones in one hearing aid. Bilateral beamformer arrays, which combine information across four microphones in a bilateral fitting, further improve the SNR. Early bilateral beamformers were static with fixed attenuation patterns. Recently adaptive, bilateral beamformers have been introduced in commercial hearing aids.The purpose of this article was to evaluate the potential benefits of adaptive unilateral and bilateral beamformers for improving sentence recognition and subjective ratings in a laboratory setting. A secondary purpose was to identify potential participant factors that explain some of the variability in beamformer benefit.Participants were fitted with study hearing aids equipped with commercially available adaptive unilateral and bilateral beamformers. Participants completed sentence recognition testing in background noise using three hearing aid settings (omnidirectional, unilateral beamformer, bilateral beamformer) and two noise source configurations (surround, side). After each condition, participants made subjective ratings of their perceived work, desire to control the situation, willingness to give up, and tiredness.Eighteen adults (50–80 yr, M = 66.2, σ = 8.6) with symmetrical mild sloping to severe hearing loss participated.Sentence recognition scores and subjective ratings were analyzed separately using generalized linear models with two within-subject factors (hearing aid microphone and noise configuration). Two benefit scores were calculated: (1) unilateral beamformer benefit (relative to performance with omnidirectional) and (2) additional bilateral beamformer benefit (relative to performance with unilateral beamformer). Hierarchical multiple linear regression was used to determine if beamformer benefit was associated with participant factors (age, degree of hearing loss, unaided speech in noise ability, spatial release from masking, and performance in omnidirectional).Sentence recognition and subjective ratings of work, control, and tiredness were better with both types of beamformers relative to the omnidirectional conditions. In addition, the bilateral beamformer offered small additional improvements relative to the unilateral beamformer in terms of sentence recognition and subjective ratings of tiredness. Speech recognition performance and subjective ratings were generally independent of noise configuration. Performance in the omnidirectional setting and pure-tone average were independently related to unilateral beamformer benefits. Those with the lowest performance or the largest degree of hearing loss benefited the most. No factors were significantly related to additional bilateral beamformer benefit.Adaptive bilateral beamformers offer additional advantages over adaptive unilateral beamformers in hearing aids. The small additional advantages with the adaptive beamformer are comparable to those reported in the literature with static beamformers. Although the additional benefits are small, they positively affected subjective ratings of tiredness. These data suggest that adaptive bilateral beamformers have the potential to improve listening in difficult situations for hearing aid users. In addition, patients who struggle the most without beamforming microphones may also benefit the most from the technology.

Efficacy of Hearing-Aid Based Telephone Strategies for Listeners with Moderate-to-Severe Hearing Loss

2013 ◽  
Vol 24 (01) ◽  
pp. 059-070 ◽  
Author(s):  
Erin M. Picou ◽  
Todd A. Ricketts
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Sensorineural Hearing Loss ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Sensorineural Hearing ◽  
Subjective Ratings ◽  
Severe Hearing Loss ◽  
Acoustic Coupling ◽  
Wireless Routing

Background: Understanding speech over the telephone when listening in noisy environments may present a significant challenge for listeners with moderate-to-severe hearing loss. Purpose: The purpose of this study was to compare speech recognition and subjective ratings across several hearing aid-based telephone listening strategies for individuals with moderate-to-severe sensorineural hearing loss. Research Design: Speech recognition and subjective ratings were evaluated for a simulated telephone signal. The strategies evaluated included acoustic telephone, unilateral telecoil, unilateral wireless streaming, and bilateral wireless streaming. Participants were seated in a noisy room for all evaluations. Study Sample: Eighteen adults, aged 49–88 yr, with moderate-to-severe sensorineural hearing loss participated. Data Collection and Analysis: Speech recognition scores on the Connected Speech Test were converted to rationalized arcsine units and analyzed using analysis of variance testing and Tukey post hoc analyses. Subjective ratings of ease and comfort were also analyzed in this manner. Results: Speech recognition performance was poorest with acoustic coupling to the telephone and best with bilateral wireless routing. Telecoil coupling resulted in better speech recognition performance than acoustic coupling, but was significantly poorer than bilateral wireless routing. Furthermore, unilateral wireless routing and telecoil coupling generally led to similar speech recognition performance, except in lower-level background noise conditions, for which unilateral routing resulted in better performance than the telecoil. Conclusions: For people with moderate-to-severe sensorineural hearing loss, acoustic telephone listening with a hearing aid may not lead to acceptable performance in noise. Although unilateral routing options (telecoil and wireless streaming) improved performance, speech recognition performance and subjective ratings of ease and comfort were best when bilateral wireless routing was used. These results suggest that wireless routing is a potentially beneficial telephone listening strategy for listeners with moderate-to-severe hearing loss who are fitted with limited venting if the telephone signal is routed to both ears. Unilateral wireless routing may provide similar benefits to traditional unilateral telecoil. However, the newer wireless systems may have the advantage for some listeners in that they do not include some of the positioning constraints associated with telecoil use.

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 The Characteristics of Adults with Severe Hearing Loss

2018 ◽  
Vol 29 (08) ◽  
pp. 764-779 ◽  
Author(s):  
Pamela Souza ◽  
Eric Hoover ◽  
Michael Blackburn ◽  
Frederick Gallun
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Assistive Technology ◽  
Spectral Resolution ◽  
Hearing Aids ◽  
Technology Use ◽  
Hearing Aid ◽  
Published Data ◽  
Severe Hearing Loss ◽  
Wide Range

AbstractSevere hearing loss impairs communication in a wide range of listening environments. However, we lack data as to the specific objective and subjective abilities of listeners with severe hearing loss. Insight into those abilities may inform treatment choices.The primary goal was to describe the audiometric profiles, spectral resolution ability, and objective and subjective speech perception of a sample of adult listeners with severe hearing loss, and to consider the relationships among those measures. We also considered the typical fitting received by individuals with severe loss, in terms of hearing aid style, electroacoustic characteristics, and features, as well as supplementary device use.A within-subjects design was used.Participants included 36 adults aged 54–93 yr with unilateral or bilateral severe hearing loss.Testing included a full hearing and hearing aid history; audiometric evaluation; loudness growth and dynamic range; spectral resolution; assessment of cochlear dead regions; objective and subjective assessment of speech recognition; and electroacoustic evaluation of current hearing aids. Regression models were used to analyze relationships between hearing loss, spectral resolution, and speech recognition.For speech in quiet, 60% of the variance was approximately equally accounted for by amount of hearing loss, spectral resolution, and number of dead regions. For speech in noise, only a modest proportion of performance variance was explained by amount of hearing loss. In general, participants were wearing amplification of appropriate style and technology for their hearing loss, but the extent of assistive technology use was low. Subjective communication ratings depended on the listening situation, but in general, were similar to previously published data for adults with mild-to-moderate loss who did not wear hearing aids.The present data suggest that the range of abilities of an individual can be more fully captured with comprehensive testing. Such testing also offers an opportunity for informed counseling regarding realistic expectations for hearing aid use and the availability of hearing assistive technology.

Effects of Reducing Low-Frequency Amplification on Consonant Perception in Quiet and Noise

1984 ◽  
Vol 27 (4) ◽  
pp. 483-493 ◽  
Author(s):  
Sandra Gordon-Salant
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Low Frequency ◽  
Identification Performance ◽  
Phonetic Feature ◽  
Consonant Recognition

The aim of this study was to assess the effect of low-frequency amplification on speech recognition performance by hearing-impaired listeners. Consonant identification performance by subjects with flat hearing losses and high-frequency hearing losses was assessed in three different hearing aid conditions, in quiet and noise. The experimental hearing aids all provided extra high-frequency amplification but differed in the amount of low-frequency amplification. The results showed that listeners with flat hearing losses benefited by low-frequency amplification, whereas subjects with high-frequency hearing losses exhibited deteriorating scores in conditions with greatest low-frequency amplification. Analyses of phonetic feature perception and individual consonant recognition scores revealed subtle interactions between hearing loss configuration and amplification contour.

scholarly journals Degree of Hearing Loss Affects Bilateral Hearing Aid Benefits in Ecologically Relevant Laboratory Conditions

2019 ◽  
Vol 62 (10) ◽  
pp. 3834-3850 ◽  
Author(s):  
Todd A. Ricketts ◽  
Erin M. Picou ◽  
James Shehorn ◽  
Andrew B. Dittberner
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Visual Cues ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Listening Effort ◽  
Sentence Recognition ◽  
Predictive Variables ◽  
The Relationship

Purpose Previous evidence supports benefits of bilateral hearing aids, relative to unilateral hearing aid use, in laboratory environments using audio-only (AO) stimuli and relatively simple tasks. The purpose of this study was to evaluate bilateral hearing aid benefits in ecologically relevant laboratory settings, with and without visual cues. In addition, we evaluated the relationship between bilateral benefit and clinically viable predictive variables. Method Participants included 32 adult listeners with hearing loss ranging from mild–moderate to severe–profound. Test conditions varied by hearing aid fitting type (unilateral, bilateral) and modality (AO, audiovisual). We tested participants in complex environments that evaluated the following domains: sentence recognition, word recognition, behavioral listening effort, gross localization, and subjective ratings of spatialization. Signal-to-noise ratio was adjusted to provide similar unilateral speech recognition performance in both modalities and across procedures. Results Significant and similar bilateral benefits were measured for both modalities on all tasks except listening effort, where bilateral benefits were not identified in either modality. Predictive variables were related to bilateral benefits in some conditions. With audiovisual stimuli, increasing hearing loss, unaided speech recognition in noise, and unaided subjective spatial ability were significantly correlated with increased benefits for many outcomes. With AO stimuli, these same predictive variables were not significantly correlated with outcomes. No predictive variables were correlated with bilateral benefits for sentence recognition in either modality. Conclusions Hearing aid users can expect significant bilateral hearing aid advantages for ecologically relevant, complex laboratory tests. Although future confirmatory work is necessary, these data indicate the presence of vision strengthens the relationship between bilateral benefits and degree of hearing loss.

Working Memory Capacity May Influence Perceived Effort during Aided Speech Recognition in Noise

2012 ◽  
Vol 23 (08) ◽  
pp. 577-589 ◽  
Author(s):  
Mary Rudner ◽  
Thomas Lunner ◽  
Thomas Behrens ◽  
Elisabet Sundewall Thorén ◽  
Jerker Rönnberg
Keyword(s):  
Working Memory ◽  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Cognitive Capacity ◽  
Subjective Ratings ◽  
Perceived Effort ◽  
Noise Type ◽  
Speech Recognition In Noise

Background: Recently there has been interest in using subjective ratings as a measure of perceived effort during speech recognition in noise. Perceived effort may be an indicator of cognitive load. Thus, subjective effort ratings during speech recognition in noise may covary both with signal-to-noise ratio (SNR) and individual cognitive capacity. Purpose: The present study investigated the relation between subjective ratings of the effort involved in listening to speech in noise, speech recognition performance, and individual working memory (WM) capacity in hearing impaired hearing aid users. Research Design: In two experiments, participants with hearing loss rated perceived effort during aided speech perception in noise. Noise type and SNR were manipulated in both experiments, and in the second experiment hearing aid compression release settings were also manipulated. Speech recognition performance was measured along with WM capacity. Study Sample: There were 46 participants in all with bilateral mild to moderate sloping hearing loss. In Experiment 1 there were 16 native Danish speakers (eight women and eight men) with a mean age of 63.5 yr (SD = 12.1) and average pure tone (PT) threshold of 47. 6 dB (SD = 9.8). In Experiment 2 there were 30 native Swedish speakers (19 women and 11 men) with a mean age of 70 yr (SD = 7.8) and average PT threshold of 45.8 dB (SD = 6.6). Data Collection and Analysis: A visual analog scale (VAS) was used for effort rating in both experiments. In Experiment 1, effort was rated at individually adapted SNRs while in Experiment 2 it was rated at fixed SNRs. Speech recognition in noise performance was measured using adaptive procedures in both experiments with Dantale II sentences in Experiment 1 and Hagerman sentences in Experiment 2. WM capacity was measured using a letter-monitoring task in Experiment 1 and the reading span task in Experiment 2. Results: In both experiments, there was a strong and significant relation between rated effort and SNR that was independent of individual WM capacity, whereas the relation between rated effort and noise type seemed to be influenced by individual WM capacity. Experiment 2 showed that hearing aid compression setting influenced rated effort. Conclusions: Subjective ratings of the effort involved in speech recognition in noise reflect SNRs, and individual cognitive capacity seems to influence relative rating of noise type.

scholarly journals The Physiologic and Psychophysical Consequences of Severe-to-Profound Hearing Loss

2018 ◽  
Vol 39 (04) ◽  
pp. 349-363 ◽  
Author(s):  
Eric Hoover ◽  
Pamela Souza
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Treatment Options ◽  
Sufficient Information ◽  
Noisy Environments ◽  
Cochlear Function ◽  
Profound Hearing Loss ◽  
Sound Perception ◽  
Severe Hearing Loss ◽  
Tuning Curves

AbstractSubstantial loss of cochlear function is required to elevate pure-tone thresholds to the severe hearing loss range; yet, individuals with severe or profound hearing loss continue to rely on hearing for communication. Despite the impairment, sufficient information is encoded at the periphery to make acoustic hearing a viable option. However, the probability of significant cochlear and/or neural damage associated with the loss has consequences for sound perception and speech recognition. These consequences include degraded frequency selectivity, which can be assessed with tests including psychoacoustic tuning curves and broadband rippled stimuli. Because speech recognition depends on the ability to resolve frequency detail, a listener with severe hearing loss is likely to have impaired communication in both quiet and noisy environments. However, the extent of the impairment varies widely among individuals. A better understanding of the fundamental abilities of listeners with severe and profound hearing loss and the consequences of those abilities for communication can support directed treatment options in this population.

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