scholarly journals The Effect of Hearing Aid Technologies on Listening in an Automobile

2013 ◽  
Vol 24 (06) ◽  
pp. 474-485 ◽  
Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Ruth A. Bentler ◽  
Rachel W. Stanziola

Background: Communication while traveling in an automobile often is very difficult for hearing aid users. This is because the automobile/road noise level is usually high, and listeners/drivers often do not have access to visual cues. Since the talker of interest usually is not located in front of the listener/driver, conventional directional processing that places the directivity beam toward the listener's front may not be helpful and, in fact, could have a negative impact on speech recognition (when compared to omnidirectional processing). Recently, technologies have become available in commercial hearing aids that are designed to improve speech recognition and/or listening effort in noisy conditions where talkers are located behind or beside the listener. These technologies include (1) a directional microphone system that uses a backward-facing directivity pattern (Back-DIR processing), (2) a technology that transmits audio signals from the ear with the better signal-to-noise ratio (SNR) to the ear with the poorer SNR (Side-Transmission processing), and (3) a signal processing scheme that suppresses the noise at the ear with the poorer SNR (Side-Suppression processing). Purpose: The purpose of the current study was to determine the effect of (1) conventional directional microphones and (2) newer signal processing schemes (Back-DIR, Side-Transmission, and Side-Suppression) on listener's speech recognition performance and preference for communication in a traveling automobile. Research Design: A single-blinded, repeated-measures design was used. Study Sample: Twenty-five adults with bilateral symmetrical sensorineural hearing loss aged 44 through 84 yr participated in the study. Data Collection and Analysis: The automobile/road noise and sentences of the Connected Speech Test (CST) were recorded through hearing aids in a standard van moving at a speed of 70 mph on a paved highway. The hearing aids were programmed to omnidirectional microphone, conventional adaptive directional microphone, and the three newer schemes. CST sentences were presented from the side and back of the hearing aids, which were placed on the ears of a manikin. The recorded stimuli were presented to listeners via earphones in a sound-treated booth to assess speech recognition performance and preference with each programmed condition. Results: Compared to omnidirectional microphones, conventional adaptive directional processing had a detrimental effect on speech recognition when speech was presented from the back or side of the listener. Back-DIR and Side-Transmission processing improved speech recognition performance (relative to both omnidirectional and adaptive directional processing) when speech was from the back and side, respectively. The performance with Side-Suppression processing was better than with adaptive directional processing when speech was from the side. The participants' preferences for a given processing scheme were generally consistent with speech recognition results. Conclusions: The finding that performance with adaptive directional processing was poorer than with omnidirectional microphones demonstrates the importance of selecting the correct microphone technology for different listening situations. The results also suggest the feasibility of using hearing aid technologies to provide a better listening experience for hearing aid users in automobiles.

2010 ◽  
Vol 21 (08) ◽  
pp. 546-557 ◽  
Author(s):  
Kristi Oeding ◽  
Michael Valente ◽  
Jessica Kerckhoff

Background: Patients with unilateral sensorineural hearing loss (USNHL) experience great difficulty listening to speech in noisy environments. A directional microphone (DM) could potentially improve speech recognition in this difficult listening environment. It is well known that DMs in behind-the-ear (BTE) and custom hearing aids can provide a greater signal-to-noise ratio (SNR) in comparison to an omnidirectional microphone (OM) to improve speech recognition in noise for persons with hearing impairment. Studies examining the DM in bone anchored auditory osseointegrated implants (Baha), however, have been mixed, with little to no benefit reported for the DM compared to an OM. Purpose: The primary purpose of this study was to determine if there are statistically significant differences in the mean reception threshold for sentences (RTS in dB) in noise between the OM and DM in the Baha® Divino™. The RTS of these two microphone modes was measured utilizing two loudspeaker arrays (speech from 0° and noise from 180° or a diffuse eight-loudspeaker array) and with the better ear open or closed with an earmold impression and noise attenuating earmuff. Subjective benefit was assessed using the Abbreviated Profile of Hearing Aid Benefit (APHAB) to compare unaided and aided (Divino OM and DM combined) problem scores. Research Design: A repeated measures design was utilized, with each subject counterbalanced to each of the eight treatment levels for three independent variables: (1) microphone (OM and DM), (2) loudspeaker array (180° and diffuse), and (3) better ear (open and closed). Study Sample: Sixteen subjects with USNHL currently utilizing the Baha were recruited from Washington University's Center for Advanced Medicine and the surrounding area. Data Collection and Analysis: Subjects were tested at the initial visit if they entered the study wearing the Divino or after at least four weeks of acclimatization to a loaner Divino. The RTS was determined utilizing Hearing in Noise Test (HINT) sentences in the R-Space™ system, and subjective benefit was determined utilizing the APHAB. A three-way repeated measures analysis of variance (ANOVA) and a paired samples t-test were utilized to analyze results of the HINT and APHAB, respectively. Results: Results revealed statistically significant differences within microphone (p < 0.001; directional advantage of 3.2 dB), loudspeaker array (p = 0.046; 180° advantage of 1.1 dB), and better ear conditions (p < 0.001; open ear advantage of 4.9 dB). Results from the APHAB revealed statistically and clinically significant benefit for the Divino relative to unaided on the subscales of Ease of Communication (EC) (p = 0.037), Background Noise (BN) (p < 0.001), and Reverberation (RV) (p = 0.005). Conclusions: The Divino's DM provides a statistically significant improvement in speech recognition in noise compared to the OM for subjects with USNHL. Therefore, it is recommended that audiologists consider selecting a Baha with a DM to provide improved speech recognition performance in noisy listening environments.


2003 ◽  
Vol 12 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Paula Henry ◽  
Todd Ricketts

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.


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.


2018 ◽  
Vol 27 (4) ◽  
pp. 581-593 ◽  
Author(s):  
Lisa Brody ◽  
Yu-Hsiang Wu ◽  
Elizabeth Stangl

Purpose The aim of this study was to compare the benefit of self-adjusted personal sound amplification products (PSAPs) to audiologist-fitted hearing aids based on speech recognition, listening effort, and sound quality in ecologically relevant test conditions to estimate real-world effectiveness. Method Twenty-five older adults with bilateral mild-to-moderate hearing loss completed the single-blinded, crossover study. Participants underwent aided testing using 3 PSAPs and a traditional hearing aid, as well as unaided testing. PSAPs were adjusted based on participant preference, whereas the hearing aid was configured using best-practice verification protocols. Audibility provided by the devices was quantified using the Speech Intelligibility Index (American National Standards Institute, 2012). Outcome measures assessing speech recognition, listening effort, and sound quality were administered in ecologically relevant laboratory conditions designed to represent real-world speech listening situations. Results All devices significantly improved Speech Intelligibility Index compared to unaided listening, with the hearing aid providing more audibility than all PSAPs. Results further revealed that, in general, the hearing aid improved speech recognition performance and reduced listening effort significantly more than all PSAPs. Few differences in sound quality were observed between devices. All PSAPs improved speech recognition and listening effort compared to unaided testing. Conclusions Hearing aids fitted using best-practice verification protocols were capable of providing more aided audibility, better speech recognition performance, and lower listening effort compared to the PSAPs tested in the current study. Differences in sound quality between the devices were minimal. However, because all PSAPs tested in the study significantly improved participants' speech recognition performance and reduced listening effort compared to unaided listening, PSAPs could serve as a budget-friendly option for those who cannot afford traditional amplification.


1986 ◽  
Vol 51 (3) ◽  
pp. 272-281 ◽  
Author(s):  
Larry E. Humes

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.


2017 ◽  
Vol 28 (08) ◽  
pp. 698-707
Author(s):  
Francis Kuk ◽  
Eric Seper ◽  
Chi-Chuen Lau ◽  
Petri Korhonen

AbstractThe benefits offered by noise reduction (NR) features on a hearing aid had been studied traditionally using test conditions that set the hearing aids into a stable state of performance. While adequate, this approach does not allow the differentiation of two NR algorithms that differ in their timing characteristics (i.e., activation and stabilization time).The current study investigated a new method of measuring noise tolerance (Tracking of Noise Tolerance [TNT]) as a means to differentiate hearing aid technologies. The study determined the within-session and between-session reliability of the procedure. The benefits provided by various hearing aid conditions (aided, two NR algorithms, and a directional microphone algorithm) were measured using this procedure. Performance on normal-hearing listeners was also measured for referencing.A single-blinded, repeated-measures design was used.Thirteen experienced hearing aid wearers with a bilaterally symmetrical (≤10 dB) mild-to-moderate sensorineural hearing loss participated in the study. In addition, seven normal-hearing listeners were tested in the unaided condition.Participants tracked the noise level that met the criterion of tolerable noise level (TNL) in the presence of an 85 dB SPL continuous discourse passage. The test conditions included an unaided condition and an aided condition with combinations of NR and microphone modes within the UNIQUE hearing aid (omnidirectional microphone, no NR; omnidirectional microphone, NR; directional microphone, no NR; and directional microphone, NR) and the DREAM hearing aid (omnidirectional microphone, no NR; omnidirectional microphone, NR). Each tracking trial lasted 2 min for each hearing aid condition. Normal-hearing listeners tracked in the unaided condition only. Nine of the 13 hearing-impaired listeners returned after 3 mo for retesting in the unaided and aided conditions with the UNIQUE hearing aid. The individual TNL was estimated for each participant for all test conditions. The TNT index was calculated as the difference between 85 dB SPL and the TNL.The TNT index varied from 2.2 dB in the omnidirectional microphone, no NR condition to −4.4 dB in the directional microphone, NR on condition. Normal-hearing listeners reported a TNT index of −5.7 dB using this procedure. The averaged improvement in TNT offered by the NR algorithm on the UNIQUE varied from 2.1 dB when used with a directional microphone to 3.0 dB when used with the omnidirectional microphone. The time course of the NR algorithm was different between the UNIQUE and the DREAM hearing aids, with the UNIQUE reaching a stable TNL sooner than the DREAM. The averaged improvement in TNT index from the UNIQUE directional microphone was 3.6 dB when NR was activated and 4.4 dB when NR was deactivated. Together, directional microphone and NR resulted in a total TNT improvement of 6.5 dB. The test–retest reliability of the procedure was high, with an intrasession 95% confidence interval (CI) of 2.2 dB and an intersession 95% CI of 4.2 dB.The effect of the NR and directional microphone algorithms was measured to be 2–3 and 3.6–4.4 dB, respectively, using the TNT procedure. Because of its tracking property and reliability, this procedure may hold promise in differentiating among some hearing aid features that also differ in their time course of action.


2021 ◽  
Vol 15 ◽  
Author(s):  
Jing Chen ◽  
Zhe Wang ◽  
Ruijuan Dong ◽  
Xinxing Fu ◽  
Yuan Wang ◽  
...  

Objective: This study was aimed at evaluating improvements in speech-in-noise recognition ability as measured by signal-to-noise ratio (SNR) with the use of wireless remote microphone technology. These microphones transmit digital signals via radio frequency directly to hearing aids and may be a valuable assistive listening device for the hearing-impaired population of Mandarin speakers in China.Methods: Twenty-three adults (aged 19–80 years old) and fourteen children (aged 8–17 years old) with bilateral sensorineural hearing loss were recruited. The Mandarin Hearing in Noise Test was used to test speech recognition ability in adult subjects, and the Mandarin Hearing in Noise Test for Children was used for children. The subjects’ perceived SNR was measured using sentence recognition ability at three different listening distances of 1.5, 3, and 6 m. At each distance, SNR was obtained under three device settings: hearing aid microphone alone, wireless remote microphone alone, and hearing aid microphone and wireless remote microphone simultaneously.Results: At each test distance, for both adult and pediatric groups, speech-in-noise recognition thresholds were significantly lower with the use of the wireless remote microphone in comparison with the hearing aid microphones alone (P &lt; 0.05), indicating better SNR performance with the wireless remote microphone. Moreover, when the wireless remote microphone was used, test distance had no effect on speech-in-noise recognition for either adults or children.Conclusion: Wireless remote microphone technology can significantly improve speech recognition performance in challenging listening environments for Mandarin speaking hearing aid users in China.


2010 ◽  
Vol 20 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Susan Scollie

This article describes the general goals for applying the principles of evidence-based practice to clinical decision making, as applied to the selection of hearing aid signal processing for children with hearing loss. Two scenarios are considered: the case of using directional microphone hearing aids and the use of frequency lowering signal processing for mild to moderate losses. Neither situation is as simple as it seems. The evidence for each is reviewed, and questions to ask when applying each for individual children are presented, with discussion of advantages and disadvantages.


1984 ◽  
Vol 27 (4) ◽  
pp. 483-493 ◽  
Author(s):  
Sandra Gordon-Salant

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.


2007 ◽  
Vol 18 (04) ◽  
pp. 292-303
Author(s):  
Janet E. Shanks ◽  
Richard H. Wilson ◽  
Patricia Stelmachowicz ◽  
Gene W. Bratt ◽  
David W. Williams

Larson et al (2000) reported the findings of a multicenter, NIDCD/VA clinical trial that compared hearing aid performance for three output limiting circuits in 360 adults with symmetrical sensorineural hearing loss. The current study was undertaken to examine long-term hearing aid benefit in this same group of participants following five to six years of hearing aid use. The speech-recognition portion of the follow-up study enrolled 108 participants from the original study, 85% of whom were current hearing aid users and 15% of whom had not worn hearing aids during the past month (nonusers). Recognition performance in sound field on the NU-6 (quiet at 62 dB SPL) and the CST (quiet at 74 dB SPL and with -3 and 3 dB signal-to-babble ratios [S/B] at 62 and 74 dB SPL) was measured unaided and aided whenever possible. Speech-recognition abilities decreased significantly since the original study. Speech-recognition decrements were observed regardless of the speech materials (NU-6 and CST), test condition (quiet and noise), S/B (-3 and 3 dB), or stimulus level (62 and 74 dB SPL). Despite decreases in speech recognition, hearing aid benefit remained largely unchanged since the original study; aided performance exceeded unaided performance regardless of presentation level or noise condition. As in the original study, the relations among stimulus level, S/B, and speech-recognition performance were complex. Larson y col. (2000) reportaron los hallazgos de un estudio clínicos multicéntrico del NIDCD/VA que comparó el desempeño en el uso de auxiliares auditivos (AA) con tres circuitos de limitación de la salida, en 360 adultos con pérdida auditiva sensorineural simétrica. El estudio actual fue conducido para examinar el beneficio a largo plazo del AA en el mismo grupo de participantes, luego de cinco a seis años de utilización del AA. La porción de reconocimiento de lenguaje del estudio de seguimiento involucró a 108 participantes del estudio original, 85% de los cuáles eran actuales usuarios de AA y 15% que no habían usado AA durante el mes anterior (no usuarios). El desempeño en reconocimiento del lenguaje en campo sonoro con el NU-6 (en silencio a 62 dB SPL) y con el CST (en silencio a 74 dB SPL, y con tasas de señal/balbuceo de -3 y +3 dB [S&B] a 62 y 74 dB SPL), fue medido con y sin amplificación cuando resultó posible. Las habilidades de reconocimiento del lenguaje habían disminuido significativamente desde el estudio original. Se observó reducción en el reconocimiento del lenguaje independientemente del material logoaudiométrico (NU-6 y CST), las condiciones de la prueba (en silencio o en ruido), S/B (-3 y +3 dB), o la intensidad del estímulo (62 y 74 dB SPL). A pesar de la disminución en el reconocimiento del lenguaje, el beneficio del AA permaneció sin cambios en relación al estudio original; el desempeño con amplificación superó el desempeño sin amplificación sin importar la intensidad de la presentación o las condiciones de ruido. Al igual que en el estudio original, las relaciones entre el nivel de estímulo, la S/B y el desempeño en el reconocimiento de lenguaje fueron complejas.


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