Do Modern Hearing Aids Meet ANSI Standards?

2016 ◽  
Vol 27 (08) ◽  
pp. 619-627 ◽  
Author(s):  
Jourdan T. Holder ◽  
Erin M. Picou ◽  
Jill M. Gruenwald ◽  
Todd A. Ricketts
Keyword(s):  
Quality Control ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Analysis Data ◽  
National Standards ◽  
Control Measures ◽  
Input Noise ◽  
Release Times ◽  
Quality Control Testing ◽  
Equivalent Input Noise

Background: The American National Standards Institute (ANSI) provides standards used to govern standardization of all hearing aids. If hearing aids do not meet specifications, there are potential negative implications for hearing aid users, professionals, and the industry. Recent literature has not investigated the proportion of new hearing aids in compliance with the ANSI specifications for quality control standards when they arrive in the clinic before dispensing. Purpose: The aims of this study were to determine the percentage of new hearing aids compliant with the relevant ANSI standard and to report trends in electroacoustic analysis data. Research Design: New hearing aids were evaluated for quality control via the ANSI S3.22-2009 standard. In addition, quality control of directional processing was also assessed. Study Sample: Seventy-three behind-the-ear hearing aids from four major manufacturers, that were purchased for clinical patients were evaluated before dispensing. Data Collection and Analysis: Audioscan Verifit (version 3.1) hearing instrument fitting system was used to complete electroacoustic analysis and directional processing evaluation of the hearing aids. Frye’s Fonix 8000 test box system (Fonix 8000) was also used to cross-check equivalent input noise (EIN) measurements. These measurements were then analyzed for trends across brands and specifications. Results: All of the hearing aids evaluated were found to be out of specification for at least one measure. EIN and attack and release times were the measures most frequently out of specification. EIN was found to be affected by test box isolation for two of the four brands tested. Systematic discrepancies accounted for ˜93% of the noncompliance issues, while unsystematic quality control issues accounted for the remaining 7%. Conclusions: The high number of systematic discrepancies between the data collected and the specifications published by the manufacturers suggests there are clear issues related to the specific protocols used for quality control testing. These issues present a significant barrier for hearing aid dispensers when attempting to accurately determine if a hearing aid is functioning appropriately. The significant number of unsystematic discrepancies supports the continued importance of quality control measures of new and repaired hearing aids to ensure that the device is functioning properly before it is dispensed and to avoid future negative implications of fitting a faulty device.

Feasibility of smartphone-based hearing-aid apps for patients with mild hearing loss: an exploratory pilot study (Preprint)

2020 ◽  
Author(s):  
Willy Nguyen ◽  
Miseung Koo ◽  
Seung Ha Oh ◽  
Jun Ho Lee ◽  
Moo Kyun Park
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Clinical Performance ◽  
Hearing Aid ◽  
National Standards ◽  
Hearing In Noise ◽  
Mild Hearing Loss ◽  
Consumer Devices ◽  
Selection Of

BACKGROUND Underuse of hearing aids is caused by several factors, including the stigma associated with hearing disability, affordability, and lack of awareness of rising hearing impairment associated with the growing population. Thus, there is a significant opportunity for the development of direct-to-consumer devices. For the past few years, smartphone-based hearing-aid apps have become more numerous and diverse, but few studies have investigated them. OBJECTIVE This study aimed to elucidate the electroacoustic characteristics and potential user benefits of a selection of currently available hearing-aid apps. METHODS We investigated the apps based on hearing-aid control standards (American National Standards Institute) using measurement procedures from previous studies. We categorized the apps and excluded those we considered inefficient. We investigated a selection of user-friendly, low-end apps, EarMachine and Sound Amplifier, with warble-tone audiometry, word recognition testing in unaided and aided conditions, and hearing-in-noise test in quiet and noise-front conditions in a group of users with mild hearing impairment (n = 7) as a pilot for a future long-term investigation. Results from the apps were compared with those of a conventional hearing aid. RESULTS Five of 14 apps were considered unusable based on low scores in several metrics, while the others varied across the range of electroacoustic measurements. The apps that we considered “high end” that provided lower processing latencies and audiogram-based fitting algorithms were superior overall. The clinical performance of the listeners tended to be better when using hearing aid, while the low end hearing-aid apps had limited benefits on the users. CONCLUSIONS Some apps showed the potential to benefit users with limited cases of minimal or mild hearing loss if the inconvenience of relatively poor electroacoustic performance did not outweigh the benefits of amplification.

Comparison of Onset and Steady-State Responses of Hearing Aids

1987 ◽  
Vol 30 (1) ◽  
pp. 130-136 ◽  
Author(s):  
Michael P. Gorga ◽  
Kathryn A. Beauchaine ◽  
Jan K. Reiland
Keyword(s):  
Steady State ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Reference Conditions ◽  
Tone Burst ◽  
Input Output ◽  
Release Times ◽  
Steady State Responses ◽  
State Responses ◽  
Onset Responses

Input-output (I/O) functions of hearing aids were measured in response to a 2000-Hz tone burst, having 0.5 ms rise/fall time and 10 ms duration. I/O functions, measured with a hearing-aid analyzer, served as reference conditions. Heating-aid outputs at onset and during the steady-state portion of the waveform differed; these differences often depended upon stimulus rate. The relation between onset and steady-state estimates of output were not always predictable from hearing-aid attack and release times. These findings indicate that the steady-state output limitation characteristics of hearing aids cannot be estimated from their onset responses. In turn, this suggests that ABR measurements may not provide accurate estimates of the compressive characteristics of hearing aids.

Interactions of Hearing Aid Compression Release Time and Fitting Formula: Effects on Speech Acoustics

2003 ◽  
Vol 14 (02) ◽  
pp. 059-071 ◽  
Author(s):  
John C. Ellison ◽  
Frances P. Harris ◽  
Thomas Muller
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Release Time ◽  
Digital Instrument ◽  
Speech Acoustics ◽  
Release Times ◽  
Rms Amplitude ◽  
Fitting Hearing Aids ◽  
Composite Signal

The effects of the interaction of compression release time and prescribed gain on running speech processed through a hearing aid on KEMAR was investigated. A digital instrument was programmed to fit a mild to moderate sloping hearing loss using probe microphone measures to reach targets prescribed by NAL-NL1, DSL I/O, FIG.6 or ASA2p with release times of 40 and 640 ms for each condition. Recordings were made through KEMAR and analyzed to determine the long-term-average-speech spectra, consonant-to-vowel ratios and the RMS amplitude of 32 phonemic units. Aided and unaided results were compared. Within each prescriptive formula, changes in release time affected all of the speech measures subsequent to programming the instrument to a static-composite signal. The short release-time condition produced the greatest alteration to the speech signal. Release time may need consideration when fitting hearing aids to target gain prescriptions.

scholarly journals Over-the-Counter Hearing Aids: A Lost Decade for Change

2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Zoe Yee Ting Chan ◽  
Bradley McPherson
Keyword(s):  
Hearing Aids ◽  
Control Function ◽  
Low Cost ◽  
Low Frequency ◽  
Volume Control ◽  
Elderly Persons ◽  
Over The Counter ◽  
Input Noise ◽  
Irregular Frequency ◽  
Equivalent Input Noise

Background. Hearing aids sold directly to consumers in retail stores or through the internet, without individual prescription by audiological professionals, are termed over-the-counter (OTC) devices. This study aimed to determine whether there was any change in the electroacoustic characteristics of OTC devices compared to research carried out a decade earlier. The previous results indicated that most OTC devices were low-frequency-emphasis devices and were unsuitable for elderly people with presbycusis, who were likely to be the major consumers of these products.Methods. Ten OTC devices were selected and their electroacoustic performance was measured. Appropriate clients for the OTC devices were derived, using four linear prescription formulae, and OTC suitability for elderly persons with presbycusis was investigated.Results. OTC electroacoustic characteristics were similar to those in the earlier study. Most OTC devices were not acoustically appropriate for potential consumers with presbycusis. Although several of the devices could match prescriptive targets for individuals with presbycusis, their poor electroacoustic performance—including ineffective volume control function, high equivalent input noise, and irregular frequency response—may override their potential benefit.Conclusion. The low-cost OTC devices were generally not suitable for the main consumers of these products, and there has been little improvement in the appropriateness of these devices over the past decade.

Electroacoustic Performance of Direct-Input Hearing Aids with FM Amplification Systems

1990 ◽  
Vol 21 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Linda M. Thibodeau
Keyword(s):  
Hearing Aids ◽  
Sound Pressure ◽  
Harmonic Distortion ◽  
Pressure Level ◽  
Volume Control ◽  
High Frequencies ◽  
Input Noise ◽  
Practical Information ◽  
Direct Input ◽  
Equivalent Input Noise

The purpose of this paper was to provide audiologists practical information regarding the use of direct-input hearing aids with FM systems. The degree to which the electroacoustic characteristics of direct-input hearing aids were preserved when used with two different personal FM systems was evaluated. Although there were limited changes in saturation sound pressure level and harmonic distortion, there was an increase in equivalent-input noise and full-on-gain. The frequency response curve of the aid + FM condition relative to the aid alone differed in the high frequencies for the two FM systems. Aids with equivalent gain values had varying amounts of gain when tested with the FM systems set at a constant volume control setting. This variability in the electroacoustic response of a given aid when coupled to a personal FM system suggests that one may not assume characteristics of the hearing aid are maintained when it is used with an FM system.

The Otolaryngologist and the Hearing Aid Delivery System: Current Federal Regulations

1978 ◽  
Vol 86 (4_suppl) ◽  
pp. ORL-559-ORL-562
Author(s):  
Francis I. Catlin
Keyword(s):  
Hearing Aids ◽  
Federal Trade Commission ◽  
Hearing Aid ◽  
National Standards ◽  
Personal Beliefs ◽  
Best Interest ◽  
Medical Evaluation ◽  
Prospective Buyer ◽  
The Right ◽  
Community Facilities

New proposed rules and regulations concerning trade practices for the hearing aid industry have been developed in response to political pressures from Congress and consumer groups. Revisions to the trade regulations proposed by the Federal Trade Commission (FTC) include (1) more stringent limitations in advertising, (2) written permission to sell a hearing aid at home or in the buyer's place of business, and (3) the right of a buyer to cancel a hearing aid sale, rental, or lease within 30 days. Testimony on hearings regarding this rule are being reviewed by the FTC presiding officer. Food and Drug Administration national standards for the labeling and sale of hearing aids became effective Aug 15, 1977. A medical evaluation by a licensed physician is required before a hearing aid may be sold. Fully informed adults may request a waiver of this requirement for religious or personal beliefs, but a medical evaluation is mandatory for persons under 18 years of age. A User Instructional Brochure, which lists several conditions for which medical advice is advised, must be reviewed with the prospective buyer. In the recognition that some physicians may be dispensers of hearing aids, the Judicial Council of the American Medical Association has recommended that a physician may dispense hearing aids if it is in the best interest of the patient, but that a physician should not be encouraged to retail hearing aids in his office if other adequate community facilities exist.

Effects of Acoustical Stimuli Delivered through Hearing Aids on Tinnitus

2010 ◽  
Vol 21 (07) ◽  
pp. 461-473 ◽  
Author(s):  
Robert W. Sweetow ◽  
Jennifer Henderson Sabes
Keyword(s):  
Hearing Aids ◽  
Repeated Measures ◽  
Field Trial ◽  
Dynamic Range ◽  
Hearing Aid ◽  
Analysis Data ◽  
Acoustic Stimuli ◽  
Signed Rank ◽  
Management Procedures ◽  
Clinically Significant

Background: The use of acoustic signals to mask, mix with, or ease the distress associated with tinnitus has been clinically employed for decades. It has been proposed that expanding acoustic options for tinnitus sufferers due to personal preferences is desirable. Fractal tones incorporate many useful characteristics of music while avoiding certain features that could be distracting to some individuals. Purpose: To assess the effects on relaxation, tinnitus annoyance, tinnitus handicap, and tinnitus reaction from the use of a hearing aid that incorporates combinations of amplification, fractal tones, and white noise. Research Design: Participants listened to experimental hearing aids containing several acoustic options and were asked to rate the signals in terms of their effect on relaxation and tinnitus annoyance. They subsequently wore the hearing aids for 6 mo and completed tinnitus handicap and reaction scales. Study Sample: Fourteen hearing-impaired adults with primary complaints of subjective tinnitus. Intervention: Participants were tested wearing hearing aids containing several programs including amplification only, fractal tones only, and a combination of amplification, noise, and/or fractal tones. The fractal tones (now commercially available as the “Zen” feature) were generated by the Widex Mind hearing aid. Rating procedures were conducted in the laboratory, and tinnitus reaction and handicap were assessed during and following a 6 mo field trial. Data Collection and Analysis: Data were collected at the initial visit, one week, 1 mo, 3 mo, and 6 mo. Nonparametric statistics included Wilcoxon matched-pairs signed-rank, χ2, and repeated-measures analyses of variance. Results: Thirteen of 14 participants reported that their tinnitus annoyance, as measured by the Tinnitus Annoyance Scale, was reduced for at least one of the amplified conditions (with or without fractal tones or noise), relative to the unaided condition. Nine assigned a lower tinnitus annoyance rating when listening to fractal tones alone versus the amplification-alone condition. There was a range of preferences observed for fractal settings, with most participants preferring fractals with a slow or medium tempo and restricted dynamic range. The majority (86%) indicated that it was easier to relax while listening to fractal signals. Participants had preferences for certain programs and fractal characteristics. Although seven participants rated the noise-only condition as providing the least tinnitus annoyance, only two opted to have noise only as a program during the field trial, and none selected the noise-only condition as the preferred setting. Furthermore, while all four of the experienced hearing aid users selected noise as producing the least annoying tinnitus in the laboratory, only one selected it for field wear. Tinnitus Handicap Inventory and Tinnitus Reaction Questionnaire scores were improved over the course of the 6 mo trial, with clinically significant improvements occurring for over half of the participants on at least one of the measures. Conclusions: The results suggest that use of acoustic stimuli, particularly fractal tones, delivered though hearing aids can provide amplification while allowing for relief for some tinnitus sufferers. It is important to recognize, however, that tinnitus management procedures need to be supplemented with appropriate counseling.

Recording and Classification of the Acoustic Environment of Hearing Aid Users

2008 ◽  
Vol 19 (04) ◽  
pp. 348-370 ◽  
Author(s):  
Kirsten Carola Wagener ◽  
Martin Hansen ◽  
Carl Ludvigsen
Keyword(s):  
Hearing Aids ◽  
Acoustic Analysis ◽  
Hearing Aid ◽  
Analysis Data ◽  
Acoustic Characteristics ◽  
Acoustic Environment ◽  
Subjective Assessments ◽  
The Individual ◽  
Hearing Aid Benefit

This article investigates the different acoustic signals that hearing aid users are exposed to in their everyday environment. Binaural microphone signals from recording positions close to the microphone locations of behind-the-ear hearing aids were recorded by 20 hearing aid users during daily life. The recorded signals were acoustically analyzed with regard to narrow-band short-term level distributions. The subjects also performed subjective assessments of their own recordings in the laboratory using several questions from the Glasgow Hearing Aid Benefit Profile (GHABP) questionnaire. Both the questionnaire and the acoustic analysis data show that the importance, problems, and hearing aid benefit as well as the acoustic characteristics of the individual situations vary a lot across subjects. Therefore, in addition to a nonlinear hearing aid fitting, further signal classification and signal/situation-adaptive features are highly desirable inside modern hearing aids. These should be compatible with the variability of the individual sound environments of hearing-impaired listeners. Este artículo investiga las diferentes señales acústicas a las que están expuestos los usuarios de auxiliares auditivos en sus ambientes cotidianos. Se registraron señales biauriculares de micrófono desde posiciones de registro cercanas a la localización de los micrófonos de auxiliares auditivos retroauriculares, en 20 usuarios de auxiliares auditivos durante su vida diaria. Las señales registradas fueron analizadas acústicamente con relación a las distribuciones de niveles de banda estrecha a corto plazo. Los sujetos también realizaron evaluaciones subjetivas de sus propios registros en el laboratorio usando varias preguntas del cuestionario Perfil de Glasgow de Beneficio del Auxiliar Auditivo (GHABP). Tanto el cuestionario como los datos del análisis acústico mostraron que la importancia, los problemas, y el beneficio del auxiliar auditivo, así como las características acústicas de las situaciones individuales variaban mucho entre los sujetos. Por lo tanto, además de la adaptación no lineal de los auxiliares auditivos, es deseable la existencia de clasificaciones adicionales de la señal, y de rasgos adaptativos de señal y de situación, dentro de los auxiliares auditivos modernos. Estos deberían ser compatibles con la gran variabilidad de los ambientes sonoros individuales de los sujetos con trastornos auditivos.

scholarly journals High-Frequency Audibility: The Effects of Audiometric Configuration, Stimulus Type, and Device

2015 ◽  
Vol 26 (02) ◽  
pp. 128-137 ◽  
Author(s):  
Chelsea Kimlinger ◽  
Ryan McCreery ◽  
Dawna Lewis
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Broadband Noise ◽  
National Standards ◽  
Upper Limit ◽  
Average Maximum ◽  
Audible Frequency ◽  
Speech Spectrum

Background: For the last decade, the importance of providing amplification up to 9–10 kHz has been supported by multiple studies involving children and adults. The extent to which a listener with hearing loss can benefit from bandwidth expansion is dependent on the audibility of high-frequency cues. The American National Standards Institute (ANSI) devised a standard method for measuring and reporting hearing aid bandwidth for quality-control purposes. However, ANSI bandwidth measurements were never intended to reflect the true frequency range that is audible for a speech stimulus for a person with hearing loss. Purpose: The purpose of this study was to (1) determine the maximum audible frequency of conventional hearing aids using a speech signal as the input through the hearing aid microphone for different degrees of hearing loss, (2) examine how the maximum audible frequency changes when the input stimulus is presented through hearing assistance technology (HAT) systems with cross-coupling of manufacturers' transmitters and receivers, and (3) evaluate how the maximum audible frequency compares with the upper limit of the ANSI bandwidth measure. Research Design: Eight behind-the-ear hearing aids from five hearing aid manufacturers were selected based on a range of ANSI bandwidth upper frequency limits. Three audiometric configurations with varied degrees of high-frequency hearing loss were programmed into each hearing aid. Hearing aid responses were measured with the International Speech Test Signal (ISTS), broadband noise, and a short speech token (/asa/) as stimuli presented through a loudspeaker. HAT devices from three manufacturers were used to create five HAT scenarios. These instruments were coupled to the hearing aid programmed for the audiogram that provided the highest maximum audible frequency in the hearing aid analysis. The response from each HAT scenario was obtained using the same three stimuli as during the hearing aid analysis. Study Sample: All measurements were collected in an audiometric sound booth on a Knowles Electronic Manikin for Acoustic Research (KEMAR). Data Collection and Analysis: A custom computer program was used to record responses from KEMAR. Maximum audible frequency was defined as the highest point where the Long-Term Average Speech Spectrum (LTASS) intersected the audiogram. Results: The average maximum audible frequency measured through KEMAR ranged from 3.5 kHz to beyond 8 kHz and varied significantly across devices, audiograms, and stimuli. The specified upper limit of the ANSI bandwidth was not predictive of the maximum audible frequency across conditions. For most HAT systems, the maximum audible frequency for the hearing aid plus HAT condition was equivalent to the hearing aid for the same measurement configuration. In some cases, however, the HAT system imposed a lower maximum audible frequency than the hearing aid–only condition. Conclusions: The maximum audible frequency of behind-the-ear hearing aids is dependent on the degree of hearing loss, amplification device, and stimulus input. Estimating the maximum audible frequency by estimating the frequency where the speech spectrum intersects the audiogram in the high frequencies can assist clinicians in making decisions about which device or configuration of devices provides the greatest access to high-frequency information, as well as whether frequency-lowering technology should be used.

Influence of audibility and distortion on the recognition of reverberant speech for children and adults with hearing aid amplification

2021 ◽  
Author(s):  
Marc Brennan ◽  
Ryan Mccreery ◽  
John Massey
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Nonsense Syllable ◽  
Hearing Aid ◽  
Release Time ◽  
Spectral Distortion ◽  
Release Times ◽  
Negative Effect ◽  
Amplitude Compression ◽  
Adults And Children

Background: Adults and children with sensorineural hearing loss (SNHL) have trouble understanding speech in rooms with reverberation when using hearing aid amplification. While the use of amplitude compression signal processing in hearing aids may contribute to this difficulty, there is conflicting evidence on the effects of amplitude compression settings on speech recognition. Less clear is the effect of a fast release time for adults and children with SNHL when using compression ratios derived from a prescriptive procedure. Purpose: To determine whether release time impacts speech recognition in reverberation for children and adults with SNHL and to determine if these effects of release time and reverberation can be predicted using indices of audibility or temporal and spectral distortion. Research Design: A quasi-experimental cohort study. Participants used a hearing aid simulator set to the Desired Sensation Level algorithm m[i/o] for three different amplitude compression release times. Reverberation was simulated using three different reverberation times. Participants: Participants were 20 children and 16 adults with SNHL. Data Collection and Analyses: Participants were seated in a sound-attenuating booth and then nonsense syllable recognition was measured. Predictions of speech recognition were made using indices of audibility, temporal distortion, and spectral distortion and the effects of release time and reverberation were analyzed using linear mixed models. Results: While nonsense syllable recognition decreased in reverberation; release time did not significantly affect nonsense syllable recognition. Participants with lower audibility were more susceptible to the negative effect of reverberation on nonsense syllable recognition. Conclusions: We have extended previous work on the effects of reverberation on aided speech recognition to children with SNHL. Variations in release time did not impact the understanding of speech. An index of audibility best predicted nonsense syllable recognition in reverberation and, clinically, these results suggest that patients with less audibility are more susceptible to nonsense syllable recognition in reverberation.

Sign in / Sign up

Export Citation Format

Share Document