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

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.

2012 ◽  
Vol 23 (08) ◽  
pp. 577-589 ◽  
Author(s):  
Mary Rudner ◽  
Thomas Lunner ◽  
Thomas Behrens ◽  
Elisabet Sundewall Thorén ◽  
Jerker Rönnberg

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.


2019 ◽  
Vol 30 (02) ◽  
pp. 131-144 ◽  
Author(s):  
Erin M. Picou ◽  
Todd A. Ricketts

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.


1982 ◽  
Vol 47 (2) ◽  
pp. 114-123 ◽  
Author(s):  
Donald D. Dirks ◽  
Donald E. Morgan ◽  
Judy R. Dubno

This paper describes the results of two experiments in which speech recognition performance was determined for listeners with sensorineural hearing loss, while listening in babble. Adaptive strategies were used in both experiments to measure the signal-to-babble ratio required to achieve a preselected level of performance at several speech presentation levels encountered in normal conversation or when listening through an amplifier system. The results suggest that the proposed adaptive strategy may provide a practical method by which the relative effects of competition on speech recognition may be quantified in an individual listener.


1990 ◽  
Vol 33 (4) ◽  
pp. 726-735 ◽  
Author(s):  
Larry E. Humes ◽  
Lisa Roberts

The role that sensorineural hearing loss plays in the speech-recognition difficulties of the hearing-impaired elderly is examined. One approach to this issue was to make between-group comparisons of performance for three groups of subjects: (a) young normal-hearing adults; (b) elderly hearing-impaired adults; and (c) young normal-hearing adults with simulated sensorineural hearing loss equivalent to that of the elderly subjects produced by a spectrally shaped masking noise. Another approach to this issue employed correlational analyses to examine the relation between audibility and speech recognition within the group of elderly hearing-impaired subjects. An additional approach was pursued in which an acoustical index incorporating adjustments for threshold elevation was used to examine the role audibility played in the speech-recognition performance of the hearing-impaired elderly. A wide range of listening conditions was sampled in this experiment. The conclusion was that the primary determiner of speech-recognition performance in the elderly hearing-impaired subjects was their threshold elevation.


2021 ◽  
Author(s):  
Yu-Lin Chang ◽  
Chia-Jou Liu ◽  
Pey-Yu Chen ◽  
Hung-Ching Lin

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.


2010 ◽  
Vol 2 (2) ◽  
pp. 143-149
Author(s):  
Ashutosh G Pusalkar

Abstract Till about 15 years ago, the only choice of hearing improvement for moderate sensorineural hearing loss with severe speech discrimination defect was a hearing aid. It was only after Mr. Geoff Ball, an electronic engineer who was suffering from a similar defect, started thinking of an alternative to the conventional hearing aid that the Vibrant Soundbridge came into existence, and with the passage of time the indications for the use of the same have increased.


2017 ◽  
Author(s):  
Joanna Nkyekyer ◽  
Denny Meyer ◽  
Peter J Blamey ◽  
Andrew Pipingas ◽  
Sunil Bhar

BACKGROUND Sensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training—formal listening activities designed to optimize speech perception—are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss. OBJECTIVE This study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own. METHODS This is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for either the first 3 or last 3 months of the 6-month auditory training program. Each participant will be tested at baseline, 3, and 6 months using a neuropsychological battery of computer-based cognitive assessments, together with a depression symptom instrument and a social interaction measure. The primary outcome will be cognitive performance with regard to spatial working memory. Secondary outcome measures include other cognition performance measures, depressive symptoms, social interaction, and hearing satisfaction. RESULTS Data analysis is currently under way and the first results are expected to be submitted for publication in June 2018. CONCLUSIONS Results from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials. CLINICALTRIAL ClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B).


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