Acceptable Noise Level as a Predictor of Hearing Aid Use

2006 ◽  
Vol 17 (09) ◽  
pp. 626-639 ◽  
Author(s):  
Anna K. Nabelek ◽  
Melinda C. Freyaldenhoven ◽  
Joanna W. Tampas ◽  
Samuel B. Burchfield ◽  
Robert A. Muenchen
Keyword(s):  
Time Use ◽  
Hearing Aids ◽  
Noise Level ◽  
Background Noise ◽  
Hearing Aid ◽  
Full Time ◽  
Speech In Noise ◽  
Hearing Aid Use ◽  
Acceptable Noise Level ◽  
Part Time

Acceptable noise level (ANL) measures a listener's reaction to background noise while listening to speech. Relations among hearing aid use and ANL, speech in noise (SPIN) scores, and listener characteristics (age, gender, pure-tone average) were investigated in 191 listeners with hearing impairment. Listeners were assigned to one of three groups based on patterns of hearing aid use: full-time use (whenever hearing aids are needed), part-time use (occasional use), or nonuse. Results showed that SPIN scores and listener characteristics were not related to ANL or hearing aid use. However, ANLs were related to hearing aid use. Specifically, full-time hearing aid users accepted more background noise than part-time users or nonusers, yet part-time users and nonusers could not be differentiated. Thus, a prediction of hearing aid use was examined by comparing part-time users and nonusers (unsuccessful hearing aid users) with full-time users (successful hearing aid users). Regression analysis determined that unaided ANLs could predict a listener's success of hearing aids with 85% accuracy.

Toleration of Background Noises

1991 ◽  
Vol 34 (3) ◽  
pp. 679-685 ◽  
Author(s):  
Anna K. Nabelek ◽  
Frances M. Tucker ◽  
Tomasz R. Letowski
Keyword(s):  
Hearing Aids ◽  
Background Noise ◽  
Hearing Aid ◽  
Elderly Subjects ◽  
Pneumatic Drill ◽  
Full Time ◽  
Hearing Aid Use ◽  
Part Time ◽  
Speech Spectrum ◽  
Young Subjects

One of the frequently quoted reasons for the rejection of hearing aids is amplification of background noise. The relationship between hearing aid use and toleration of background noise was assessed. Four groups of elderly subjects (at least 65 years old) and one group of young subjects with normal hearing participated in the study. Each group consisted of 15 subjects. The young subjects and elderly subjects in one group with relatively good hearing were tested for comparison with the hearing-impaired subjects. Elderly subjects in the three remaining groups had acquired hearing losses and had been fitted with hearing aids. The subjects were assigned to three groups on the basis of hearing aid use: full-time users, part-time users, and nonusers. The amount of background noise tolerated when listening to speech was tested. The speech stimulus was a story read by a woman and set at an individually chosen most comfortable level. The maskers were a babble of voices, speech-spectrum noise, traffic noise, music, and the noise of a pneumatic drill. There was a significant interaction between groups and noises. The full-time users tolerated significantly higher levels of music and speech-spectrum noise than part-time users and nonusers. In addition, the full-time users, but not the part-time users, assessed themselves as less handicapped in everyday functions when they wore hearing aids than when they did not wear their hearing aids

Comparison of Speech Perception in Background Noise With Acceptance of Background Noise in Aided and Unaided Conditions

2004 ◽  
Vol 47 (5) ◽  
pp. 1001-1011 ◽  
Author(s):  
Anna K. Nabelek ◽  
Joanna W. Tampas ◽  
Samuel B. Burchfield
Keyword(s):  
Speech Perception ◽  
Hearing Aids ◽  
Noise Level ◽  
Background Noise ◽  
Hearing Aid ◽  
Test Results ◽  
Speech Perception In Noise ◽  
Speech Understanding In Noise ◽  
Hearing Aid Use ◽  
Acceptable Noise Level

Background noise is a significant factor influencing hearing-aid satisfaction and is a major reason for rejection of hearing aids. Attempts have been made by previous researchers to relate the use of hearing aids to speech perception in noise (SPIN), with an expectation of improved speech perception followed by an increased acceptance of hearing aids. Unfortunately, SPIN was not related to hearing-aid use or satisfaction. A new measure of listener reaction to background noise has been proposed. The acceptable noise level (ANL), expressed in decibels, is defined as a difference between the most comfortable listening level for speech and the highest background noise level that is acceptable when listening to and following a story. The ANL measure assumes that speech understanding in noise may not be as important as is the willingness to listen in the presence of noise. It has been established that people who accept background noise have smaller ANLs and tend to be "good" users of hearing aids. Conversely, people who cannot accept background noise have larger ANLs and may only use hearing aids occasionally or reject them altogether. Because this is a new measure, it was important to determine the reliability of the ANL over time with and without hearing aids, to determine the effect of acclimatization to hearing aids, and to compare the ANL to well-established measures such as speech perception scores collected with the SPIN test. Results from 50 listeners indicate that for both good and occasional hearing aid users, the ANL is comparable in reliability to the SPIN test and that both measures do not change with acclimatization. The ANLs and SPIN scores are unrelated. Although the SPIN scores improve with amplification, the ANLs are unaffected by amplification, suggesting that the ANL is inherent to an individual and can be established prior to hearing aid fitting as a possible predictor of hearing-aid use. KEY WORDS : background noise, hearing aids, acceptable noise level, speech perception in noise

Loudness as a Cue for Acceptable Noise Levels

2014 ◽  
Vol 25 (06) ◽  
pp. 605-623 ◽  
Author(s):  
Karrie L. Recker ◽  
Martin F. McKinney ◽  
Brent W. Edwards
Keyword(s):  
Hearing Aids ◽  
Noise Level ◽  
Background Noise ◽  
Hearing Aid ◽  
Matching Task ◽  
Small Subset ◽  
Acceptable Noise Level ◽  
Matched Data ◽  
High Degree ◽  
Different Levels

Background/Purpose: The acceptable noise level (ANL) test is the only test that is known to predict success with hearing aids with a high degree of accuracy. A person’s ANL is the maximal amount of background noise that he or she is “willing to put up with” while listening to running speech. It is defined as the speech level minus the noise level, in decibels (dB). People who are willing to put up with high levels of background noise are generally successful hearing-aid wearers, whereas people who are not willing to put up with high levels of background noise are generally unsuccessful hearing-aid wearers. If it were known what cues that listeners are using to decide how much background noise they are willing to tolerate, then it might be possible to create technology that reduces these cues and improves listeners’ chances of success with hearing aids. As a first step toward this goal, this study investigated whether listeners are using loudness as a cue to determine their ANLs. Research Design and Study Sample: Twenty-one individuals with normal hearing and 21 individuals with sensorineural hearing loss participated in this study. In each group of 21 participants, 7 had a low ANL (<7 dB), 7 had a mid ANL (7–13 dB), and 7 had a high ANL (>13 dB). Data Collection/Analysis: Participants performed a modified version of the ANL in which the speech was fixed at four different levels (50, 63, 75 and 88 dBA), and participants adjusted the background noise (multitalker babble) to the maximal level at which they were willing to listen while following the speech. These results were compared with participants’ equal-loudness contours for the multitalker babble in the presence of speech. Equal-loudness contours were measured by having the participants perform a loudness-matching task in which they matched the level of the background noise (multitalker babble), played concurrently with speech, to a reference condition (also multitalker babble). During the test condition, the speech played at 50, 63, 75, or 88 dBA. All testing was performed in a sound booth with the speech and the noise presented from a loudspeaker at a 0° azimuth, 3 feet in front of the participant. Each condition was presented multiple times, and the results were averaged. Presentation order was randomized. Participants were tested unaided. Results: Participants' ANLs were compared with their equal-loudness contours for the background noise. ANLs that ran parallel to the equal-loudness contours were considered consistent with a loudness-based listening strategy. This pattern was observed for only two participants – both hearing-impaired. Conclusions: The majority of listeners showed no consistent trend between their ANLs and their loudness-matched data, suggesting that they are using cues other than loudness to determine their ANLs. ANLs were consistent with loudness-matched data for a small subset of listeners, suggesting that they may be using loudness as a cue for determining their ANLs.

Use of a Mild-Gain Hearing Aid by Middle-Age Normal-Hearing Adults Who Do and Do Not Self-Report Trouble Hearing in Background Noise

2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty
Keyword(s):  
Hearing Aids ◽  
Background Noise ◽  
Middle Age ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Self Report ◽  
Hearing Aid Use ◽  
Hearing Handicap ◽  
Before And After ◽  
Hearing Problems

Purpose The aim of the study was to assess how the use of a mild-gain hearing aid can affect hearing handicap, motivation, and attitudes toward hearing aids for middle-age, normal-hearing adults who do and do not self-report trouble hearing in background noise. Method A total of 20 participants (45–60 years of age) with clinically normal-hearing thresholds (< 25 dB HL) were enrolled in this study. Ten self-reported difficulty hearing in background noise, and 10 did not self-report difficulty hearing in background noise. All participants were fit with mild-gain hearing aids, bilaterally, and were asked to wear them for 2 weeks. Hearing handicap, attitudes toward hearing aids and hearing loss, and motivation to address hearing problems were evaluated before and after participants wore the hearing aids. Participants were also asked if they would consider purchasing a hearing aid before and after 2 weeks of hearing aid use. Results After wearing the hearing aids for 2 weeks, hearing handicap scores decreased for the participants who self-reported difficulty hearing in background noise. No changes in hearing handicap scores were observed for the participants who did not self-report trouble hearing in background noise. The participants who self-reported difficulty hearing in background noise also reported greater personal distress from their hearing problems, were more motivated to address their hearing problems, and had higher levels of hearing handicap compared to the participants who did not self-report trouble hearing in background noise. Only 20% (2/10) of the participants who self-reported trouble hearing in background noise reported that they would consider purchasing a hearing aid after 2 weeks of hearing aid use. Conclusions The use of mild-gain hearing aids has the potential to reduce hearing handicap for normal-hearing, middle-age adults who self-report difficulty hearing in background noise. However, this may not be the most appropriate treatment option for their current hearing problems given that only 20% of these participants would consider purchasing a hearing aid after wearing hearing aids for 2 weeks.

Intertester Reliability of the Acceptable Noise Level

2012 ◽  
Vol 23 (07) ◽  
pp. 534-541 ◽  
Author(s):  
Susan Gordon-Hickey ◽  
Elizabeth Adams ◽  
Robert Moore ◽  
Ashley Gaal ◽  
Katie Berry ◽  
...  
Keyword(s):  
Noise Level ◽  
Background Noise ◽  
Hearing Aid ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Random Order ◽  
Instruction Set ◽  
Intraclass Correlation Coefficients ◽  
Acceptable Noise Level ◽  
Quasi Experimental

Background: The acceptable noise level (ANL) serves to accurately predict the listener's likelihood of success with amplification. It has been proposed as a pre–hearing aid fitting protocol for hearing aid selection and counseling purposes. The ANL is a subjective measure of the listener's ability to accept background noise. Measurement of ANL relies on the tester and listener to follow the instructions set forth. To date, no research has explored the reliability of ANL as measured across clinicians or testers. Purpose: To examine the intertester reliability of ANL. Research Design: A descriptive quasi-experimental reliability study was completed. ANL was measured for one group of listeners by three testers. Study Sample: Three participants served as testers. Each tester was familiar with basic audiometry. Twenty-five young adults with normal hearing served as listeners. Data Collection/Analysis: Each tester was stationed in a laboratory with the needed equipment. Listeners were instructed to report to these laboratories in a random order provided by the experimenters. The testers assessed most comfortable listening level (MCL) and background noise level (BNL) for all 25 listeners. Results: Intraclass correlation coefficients were significant and revealed that MCL, BNL, and ANLs are reliable across testers. Additionally, one-way ANOVAs for MCL, BNL, and ANL were not significant. These findings indicate that MCL, BNL, and ANL do not differ significantly when measured by different testers. Conclusions: If the ANL instruction set is accurately followed, ANL can be reliably measured across testers, laboratories, and clinics. Intertester reliability of ANL allows for comparison across ANLs measured by different individuals. Findings of the present study indicate that tester reliability can be ruled out as a factor contributing to the disparity of mean ANLs reported in the literature.

scholarly journals The Relationship between Personality Type and Acceptable Noise Levels: A Pilot Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Cliff Franklin ◽  
Laura V. Johnson ◽  
Letitia White ◽  
Clay Franklin ◽  
Laura Smith-Olinde
Keyword(s):  
Big Five ◽  
Hearing Aids ◽  
Background Noise ◽  
Hearing Aid ◽  
Personality Type ◽  
Full Time ◽  
Personality Dimension ◽  
Big Five Inventory ◽  
Myers Briggs ◽  
The Relationship

Objectives. This study examined the relationship between acceptable noise level (ANL) and personality. ANL is the difference between a person’s most comfortable level for speech and the loudest level of background noise they are willing to accept while listening to speech. Design. Forty young adults with normal hearing participated. ANLs were measured and two personality tests (Big Five Inventory, Myers-Briggs Type Indicator) were administered. Results. The analysis revealed a correlation between ANL and the openness and conscientious personality dimensions from the Big Five Inventory; no correlation emerged between ANL and the Myers-Briggs personality types. Conclusions. Lower ANLs are correlated with full-time hearing aid use and the openness personality dimension; higher ANLs are correlated with part-time or hearing aid nonuse and the conscientious personality dimension. Current data suggest that those more open to new experiences may accept more noise and possibly be good hearing aid candidates, while those more conscientious may accept less noise and reject hearing aids, based on their unwillingness to accept background noise. Knowing something about a person’s personality type may help audiologists determine if their patients will likely be good candidates for hearing aids.

Uses and Abuses of Hearing Aids

1980 ◽  
Vol 89 (5_suppl) ◽  
pp. 70-73 ◽  
Author(s):  
James E. Peck
Keyword(s):  
Time Use ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Maximum Benefit ◽  
Part Time ◽  
Binaural Listening ◽  
Unrealistic Expectations

The view is expressed that many hearing-impaired individuals are not deriving maximum benefit from amplification or are not using amplification at all because of failure of professionals to keep in mind certain uses and abuses. Some of the specific uses are for minimal and profound hearing losses, adaptation with special earmold modifications, chronic or recurrent conductive losses, part-time use, and binaural listening. Some specific abuses include: unrealistic expectations, overlooking the role of motivation, pressuring persons to try/wear amplification, overamplification, Y cord, inappropriate binaural fittings, and failure to alternate a hearing aid between ears in symmetrical hearing losses.

scholarly journals Effects of an Intervention Designed to Increase Toddlers' Hearing Aid Use

2019 ◽  
Vol 25 (1) ◽  
pp. 55-67 ◽  
Author(s):  
Sophie E Ambrose ◽  
Margo Appenzeller ◽  
Sarah Al-Salim ◽  
Ann P Kaiser
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Single Case ◽  
Full Time ◽  
Data Logging ◽  
Short Term ◽  
Baseline Design ◽  
Early Intervention Services ◽  
Hearing Aid Use ◽  
Hearing Devices

Abstract The purpose of this study was to examine the effectiveness of Ears On, an intervention designed to increase toddlers’ use of hearing devices. A single-case, multiple-baseline design across participants was used with three parent–child dyads who demonstrated low hearing aid use despite enrollment in traditional early intervention services. Data logging technology was used to objectively measure hearing aid use. A functional relationship was identified between participation in the intervention and the number of hours children utilized their hearing aids. Two dyads met the criterion set for completing the intervention: an average of 8 hr of daily hearing aid use. One dyad did not reach this criterion but did meet the parent’s goal of full-time use in the child’s educational setting. For all dyads, increases in use were maintained 1 month after completion of the intervention. Findings support use of this short-term, intensive, individualized intervention to improve hearing aid use for toddlers with hearing loss.

scholarly journals The Effect of Digital Noise Reduction on Annoyance and Speech Perception in Low and High Acceptable Noise Level Groups

2019 ◽  
Vol 23 (04) ◽  
pp. e433-e439
Author(s):  
Hemanth Narayan Shetty ◽  
Navya Bilijagalemole Nanjundaswamy
Keyword(s):  
Speech Perception ◽  
Noise Reduction ◽  
Hearing Aids ◽  
Noise Level ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Strong Negative Correlation ◽  
Acceptable Noise Level ◽  
Group A ◽  
Hearing Aid Benefit

Introduction Studies have reported that although speech perception in noise was unaltered with and without digital noise reduction (DNR), the annoyance toward noise measured by acceptable noise level (ANL) was significantly improved by DNR with the range between 2.5 and 4.5 dB. It is unclear whether a similar improvement would be observed in those individuals who have an ANL ≥ 14 dB (predictive of poor hearing aid user) often rejects their aid because of annoyance toward noise. Objectives (a) To determine the effect of activation of DNR on the improvement in the aided ANL from low- and high-ANL groups; and (b) to predict the change in ANL when DNR was activated. Method Ten bilateral mild to severe sloping sensorineural hearing loss (SNHL) participants in each of the low- and high-ANL groups were involved. These participants were bilaterally fitted with receiver in canal (RIC) hearing aids (Oticon, Smorum, Egedal, Denmark) with a DNR processor. Both SNR-50% (Signal to noise ratio (in dB) required to achieve 50 % speech recognition) and ANL were assessed in DNR-on and DNR-off listening conditions. Results Digital noise reduction has no effect on SNR-50 in each group. The annoyance level was significantly reduced in the DNR-on than DNR-off condition in the low-ANL group. In the high-ANL group, a strong negative correlation was observed between the ANL in DNR off and a change in ANL after DNR was employed in the hearing aid (benefit). The benefit of DNR on annoyance can be effectively predicted by baseline-aided ANL by linear regression. Conclusion Digital noise reduction reduced the annoyance level in the high-ANL group, and the amount of improvement was related to the baseline-aided ANL value.

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