Hearing Impaired Children's Preference for, and Performance with, Four Combinations of Directional Microphone and Digital Noise Reduction Technology

2013 ◽  
Vol 24 (09) ◽  
pp. 832-844 ◽  
Author(s):  
Andrea L. Pittman ◽  
Mollie M. Hiipakka

Background: Before advanced noise-management features can be recommended for use in children with hearing loss, evidence regarding their ability to use these features to optimize speech perception is necessary. Purpose: The purpose of this study was to examine the relation between children's preference for, and performance with, four combinations of noise-management features in noisy listening environments. Research Design: Children with hearing loss were asked to repeat short sentences presented in steady-state noise or in multitalker babble while wearing ear-level hearing aids. The aids were programmed with four memories having an orthogonal arrangement of two noise-management features. The children were also asked to indicate the hearing aid memory that they preferred in each of the listening conditions both initially and after a short period of use. Study Sample: Fifteen children between the ages of 8 and 12 yr with moderate hearing losses, bilaterally. Results: The children's preference for noise management aligned well with their performance for at least three of the four listening conditions. The configuration of noise-management features had little effect on speech perception with the exception of reduced performance for speech originating from behind the child while in a directional hearing aid setting. Additionally, the children's preference appeared to be governed by listening comfort, even under conditions for which a benefit was not expected such as the use of digital noise reduction in the multitalker babble conditions. Conclusions: The results serve as evidence in support of the use of noise-management features in grade-school children as young as 8 yr of age.

2016 ◽  
Vol 27 (03) ◽  
pp. 237-251 ◽  
Author(s):  
Susan Scollie ◽  
Charla Levy ◽  
Nazanin Pourmand ◽  
Parvaneh Abbasalipour ◽  
Marlene Bagatto ◽  
...  

Background: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying some technologies are not always available. One such technology is noise management in children’s hearing aids. Children are frequently in high-level and/or noisy environments, and many options for noise management exist in modern hearing aids. Verification protocols are needed to define specific test signals and levels for use in clinical practice. Purpose: This work aims to (1) describe the variation in different brands of noise reduction processors in hearing aids and the verification of these processors and (2) determine whether these differences are perceived by 13 children who have hearing loss. Finally, we aimed to develop a verification protocol for use in pediatric clinical practice. Study Sample: A set of hearing aids was tested using both clinically available test systems and a reference system, so that the impacts of noise reduction signal processing in hearing aids could be characterized for speech in a variety of background noises. A second set of hearing aids was tested across a range of audiograms and across two clinical verification systems to characterize the variance in clinical verification measurements. Finally, a set of hearing aid recordings that varied by type of noise reduction was rated for sound quality by children with hearing loss. Results: Significant variation across makes and models of hearing aids was observed in both the speed of noise reduction activation and the magnitude of noise reduction. Reference measures indicate that noise-only testing may overestimate noise reduction magnitude compared to speech-in-noise testing. Variation across clinical test signals was also observed, indicating that some test signals may be more successful than others for characterization of hearing aid noise reduction. Children provided different sound quality ratings across hearing aids, and for one hearing aid rated the sound quality as higher with the noise reduction system activated. Conclusions: Implications for clinical verification systems may be that greater standardization and the use of speech-in-noise test signals may improve the quality and consistency of noise reduction verification cross clinics. A suggested clinical protocol for verification of noise management in children’s hearing aids is suggested.


2017 ◽  
Vol 28 (05) ◽  
pp. 415-435 ◽  
Author(s):  
Jace Wolfe ◽  
Mila Duke ◽  
Erin Schafer ◽  
Christine Jones ◽  
Lori Rakita

Background: Children with hearing loss experience significant difficulty understanding speech in noisy and reverberant situations. Adaptive noise management technologies, such as fully adaptive directional microphones and digital noise reduction, have the potential to improve communication in noise for children with hearing aids. However, there are no published studies evaluating the potential benefits children receive from the use of adaptive noise management technologies in simulated real-world environments as well as in daily situations. Purpose: The objective of this study was to compare speech recognition, speech intelligibility ratings (SIRs), and sound preferences of children using hearing aids equipped with and without adaptive noise management technologies. Research Design: A single-group, repeated measures design was used to evaluate performance differences obtained in four simulated environments. In each simulated environment, participants were tested in a basic listening program with minimal noise management features, a manual program designed for that scene, and the hearing instruments’ adaptive operating system that steered hearing instrument parameterization based on the characteristics of the environment. Study Sample: Twelve children with mild to moderately severe sensorineural hearing loss. Data Collection and Analysis: Speech recognition and SIRs were evaluated in three hearing aid programs with and without noise management technologies across two different test sessions and various listening environments. Also, the participants’ perceptual hearing performance in daily real-world listening situations with two of the hearing aid programs was evaluated during a four- to six-week field trial that took place between the two laboratory sessions. Results: On average, the use of adaptive noise management technology improved sentence recognition in noise for speech presented in front of the participant but resulted in a decrement in performance for signals arriving from behind when the participant was facing forward. However, the improvement with adaptive noise management exceeded the decrement obtained when the signal arrived from behind. Most participants reported better subjective SIRs when using adaptive noise management technologies, particularly when the signal of interest arrived from in front of the listener. In addition, most participants reported a preference for the technology with an automatically switching, adaptive directional microphone and adaptive noise reduction in real-world listening situations when compared to conventional, omnidirectional microphone use with minimal noise reduction processing. Conclusions: Use of the adaptive noise management technologies evaluated in this study improves school-age children’s speech recognition in noise for signals arriving from the front. Although a small decrement in speech recognition in noise was observed for signals arriving from behind the listener, most participants reported a preference for use of noise management technology both when the signal arrived from in front and from behind the child. The results of this study suggest that adaptive noise management technologies should be considered for use with school-age children when listening in academic and social situations.


2008 ◽  
Vol 18 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Leisha Eiten ◽  
Dawna Lewis

Background: For children with hearing loss, the benefits of FM systems in overcoming deleterious effects of noise, distance, and reverberation have led to recommendations for use beyond classroom settings. It is important that audiologists who recommend and fit these devices understand the rationale and procedures underlying fitting and verification. Objectives: This article reviews previousguidelines for FM verification, addresses technological advances, and introduces verification procedures appropriate for current FM and hearing-aid technology. Methods: Previous guidelines for verification of FM systems are reviewed. Those recommendations that are appropriate for current technology are addressed, as are procedures that are no longer adequate for hearing aids and FM systems utilizing more complex processing than in the past. Technological advances are discussed, and an updated approach to FM verification is proposed. Conclusions: Approaches to verification andfitting of FM systems must keep pace with advances in hearing-aid and FM technology. The transparency approach addressed in this paper is recommended for verification of FM systems coupled to hearing aids.


2017 ◽  
Vol 28 (10) ◽  
pp. 883-892 ◽  
Author(s):  
Samantha J. Gustafson ◽  
Todd A. Ricketts ◽  
Anne Marie Tharpe

Background: Consistency of hearing aid and remote microphone system use declines as school-age children with hearing loss age. One indicator of hearing aid use time is data logging, another is parent report. Recent data suggest that parents overestimate their children’s hearing aid use time relative to data logging. The potential reasons for this disparity remain unclear. Because school-age children spend the majority of their day away from their parents and with their teachers, reports from teachers might serve as a valuable and additional tool for estimating hearing aid use time and management. Purpose: This study expands previous research on factors influencing hearing aid use time in school-age children using data logging records. Discrepancies between data logging records and parent reports were explored using custom surveys designed for parents and teachers. Responses from parents and teachers were used to examine hearing aid use, remote microphone system use, and hearing aid management in school-age children. Study Sample: Thirteen children with mild-to-moderate hearing loss between the ages of 7 and 10 yr and their parents participated in this study. Teachers of ten of these children also participated. Data Collection and Analysis: Parents and teachers of children completed written surveys about each child’s hearing aid use, remote microphone system use, and hearing aid management skills. Data logs were read from hearing aids using manufacturer’s software. Multiple linear regression analysis and an intraclass correlation coefficient were used to examine factors influencing hearing aid use time and parent agreement with data logs. Parent report of hearing aid use time was compared across various activities and school and nonschool days. Survey responses from parents and teachers were compared to explore areas requiring potential improvement in audiological counseling. Results: Average daily hearing aid use time was ˜6 hr per day as recorded with data logging technology. Children exhibiting greater degrees of hearing loss and those with poorer vocabulary were more likely to use hearing aids consistently than children with less hearing loss and better vocabulary. Parents overestimated hearing aid use by ˜1 hr per day relative to data logging records. Parent-reported use of hearing aids varied across activities but not across school and nonschool days. Overall, parents and teachers showed excellent agreement on hearing aid and remote microphone system use during school instruction but poor agreement when asked about the child’s ability to manage their hearing devices independently. Conclusions: Parental reports of hearing aid use in young school-age children are largely consistent with data logging records and with teacher reports of hearing aid use in the classroom. Audiologists might find teacher reports helpful in learning more about children’s hearing aid management and remote microphone system use during their time at school. This supplementary information can serve as an additional counseling tool to facilitate discussion about remote microphone system use and hearing aid management in school-age children with hearing loss.


2017 ◽  
Vol 26 (3S) ◽  
pp. 451-461 ◽  
Author(s):  
Nikolai Bisgaard ◽  
Stefan Ruf

Purpose The purpose of this study was to analyze data from the EuroTrak surveys performed from 2009 to 2015 in Germany, France, and the United Kingdom to identify factors that could account for the growth in hearing aid sales over that period. Method Data of 132,028 people—approximately 15,000 for each of the 3 countries at 3-year intervals—were collected using a questionnaire. The sample in each country was weighted using the respective country age–gender populations to get balanced results. Furthermore, 11,867 persons with self-reported hearing impairment filled in a comprehensive questionnaire on hearing status and related matters; 4,631 were hearing aid owners. Data were pooled over the 3 countries for each of the years 2009, 2012, and 2015 and analyzed for developments over the 6-year period. In certain cases, data were pooled across countries and years. The analysis focused on hearing loss prevalence, hearing aid adoption rates, satisfaction with hearing aids, and benefits of hearing aid use. Results Hearing loss prevalence was stable over the period around 10%—slightly higher for men than for women. Hearing aid adoption overall increased from 33% to 37%, and bilateral use increased from 55% to 69%. Intervals between hearing aid renewals decreased. These factors contribute to increased hearing aid sales. Bilateral users are more satisfied with the hearing aid product features (76%) and performance (72%) and use their hearing aids 9.1 hr per day, compared with unilateral users where the corresponding numbers are 71%, 67%, and 7.8 hr, respectively. Satisfaction with hearing aid product features and performance in general is slightly increasing; hearing aid users are 14.5% less exhausted at the end of the day compared with nonusers with similar hearing loss and exhibit less depressive and forgetfulness symptoms. Conclusions The prevalence of self-reported hearing loss is 10.6% and stable, and hearing aid adoption has increased, particularly of bilateral fittings that are more satisfactory and exhibit higher daily use patterns. Higher uptake of hearing aids contributes to growing hearing aid sales.


Author(s):  
Jace Wolfe ◽  
Mila Duke ◽  
Sharon Miller ◽  
Erin Schafer ◽  
Christine Jones ◽  
...  

Background: For children with hearing loss, the primary goal of hearing aids is to provide improved access to the auditory environment within the limits of hearing aid technology and the child’s auditory abilities. However, there are limited data examining aided speech recognition at very low (40 dBA) and low (50 dBA) presentation levels. Purpose: Due to the paucity of studies exploring aided speech recognition at low presentation levels for children with hearing loss, the present study aimed to 1) compare aided speech recognition at different presentation levels between groups of children with normal hearing and hearing loss, 2) explore the effects of aided pure tone average (PTA) and aided Speech Intelligibility Index (SII) on aided speech recognition at low presentation levels for children with hearing loss ranging in degree from mild to severe, and 3) evaluate the effect of increasing low-level gain on aided speech recognition of children with hearing loss. Research Design: In phase 1 of this study, a two-group, repeated-measures design was used to evaluate differences in speech recognition. In phase 2 of this study, a single-group, repeated-measures design was used to evaluate the potential benefit of additional low-level hearing aid gain for low-level aided speech recognition of children with hearing loss. Study Sample: The first phase of the study included 27 school-age children with mild to severe sensorineural hearing loss and 12 school-age children with normal hearing. The second phase included eight children with mild to moderate sensorineural hearing loss. Intervention: Prior to the study, children with hearing loss were fitted binaurally with digital hearing aids. Children in the second phase were fitted binaurally with digital study hearing aids and completed a trial period with two different gain settings: 1) gain required to match hearing aid output to prescriptive targets (i.e., primary program), and 2) a 6-dB increase in overall gain for low-level inputs relative to the primary program. In both phases of this study, real-ear verification measures were completed to ensure the hearing aid output matched prescriptive targets. Data Collection and Analysis: Phase 1 included monosyllabic word recognition and syllable-final plural recognition at three presentation levels (40, 50, and 60 dBA). Phase 2 compared speech recognition performance for the same test measures and presentation levels with two differing gain prescriptions. Results and Conclusions: In phase 1 of the study, aided speech recognition was significantly poorer in children with hearing loss at all presentation levels. Higher aided SII in the better ear (55 dB SPL input) was associated with higher CNC word recognition at a 40 dBA presentation level. In phase 2, increasing the hearing aid gain for low-level inputs provided a significant improvement in syllable-final plural recognition at very low-level inputs and resulted in a non-significant trend toward better monosyllabic word recognition at very low presentation levels. Additional research is needed to document the speech recognition difficulties children with hearing aids may experience with low-level speech in the real world as well as the potential benefit or detriment of providing additional low-level hearing aid gain


2017 ◽  
Vol 28 (09) ◽  
pp. 810-822 ◽  
Author(s):  
Benjamin J. Kirby ◽  
Judy G. Kopun ◽  
Meredith Spratford ◽  
Clairissa M. Mollak ◽  
Marc A. Brennan ◽  
...  

AbstractSloping hearing loss imposes limits on audibility for high-frequency sounds in many hearing aid users. Signal processing algorithms that shift high-frequency sounds to lower frequencies have been introduced in hearing aids to address this challenge by improving audibility of high-frequency sounds.This study examined speech perception performance, listening effort, and subjective sound quality ratings with conventional hearing aid processing and a new frequency-lowering signal processing strategy called frequency composition (FC) in adults and children.Participants wore the study hearing aids in two signal processing conditions (conventional processing versus FC) at an initial laboratory visit and subsequently at home during two approximately six-week long trials, with the order of conditions counterbalanced across individuals in a double-blind paradigm.Children (N = 12, 7 females, mean age in years = 12.0, SD = 3.0) and adults (N = 12, 6 females, mean age in years = 56.2, SD = 17.6) with bilateral sensorineural hearing loss who were full-time hearing aid users.Individual performance with each type of processing was assessed using speech perception tasks, a measure of listening effort, and subjective sound quality surveys at an initial visit. At the conclusion of each subsequent at-home trial, participants were retested in the laboratory. Linear mixed effects analyses were completed for each outcome measure with signal processing condition, age group, visit (prehome versus posthome trial), and measures of aided audibility as predictors.Overall, there were few significant differences in speech perception, listening effort, or subjective sound quality between FC and conventional processing, effects of listener age, or longitudinal changes in performance. Listeners preferred FC to conventional processing on one of six subjective sound quality metrics. Better speech perception performance was consistently related to higher aided audibility.These results indicate that when high-frequency speech sounds are made audible with conventional processing, speech recognition ability and listening effort are similar between conventional processing and FC. Despite the lack of benefit to speech perception, some listeners still preferred FC, suggesting that qualitative measures should be considered when evaluating candidacy for this signal processing strategy.


2015 ◽  
Vol 20 (01) ◽  
pp. 034-038 ◽  
Author(s):  
Maria Mondelli ◽  
Thais Mariano ◽  
Heitor Honório ◽  
Rubens Brito

Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria) associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden) and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.


2021 ◽  
Vol 8 ◽  
pp. 205566832110215
Author(s):  
Madeline Hallewell ◽  
Davide Salanitri ◽  
Mirabelle D’Cruz ◽  
Sue Cobb ◽  
Lorenzo Picinali ◽  
...  

Introduction It is notoriously difficult to obtain a perfect fitting of hearing aids (HAs) for children as they often struggle to understand their hearing loss well enough to discuss the fitting adequately with their audiologist. Dartanan is an ‘edutainment’ game developed to help children understand the functions of their HA in different sound contexts. Dartanan also has elements of a leisure game for all children, in order to create an inclusive activity. Methods Game prototypes were evaluated during two formative evaluations and a summative evaluation. In total 106 children with and without hearing loss in Italy, Spain and the UK played Dartanan. A built-in virtual HA enabled children with hearing loss to use headphones to play. Results and conclusions: During the formative stages, feedback was discussed during focus groups on factors such as the audiological aspects, the extent to which children learned about HA functions, accessibility and usability, and this feedback was presented to the developers. After redevelopment, a summative evaluation was performed using an online survey. It was concluded that the game had met the goals of helping children understand their HA functionalities and providing an inclusive activity. User-evaluations were crucial in the development of the app into a useful and useable service.


2021 ◽  
Vol 4 (2) ◽  
pp. 45-50
Author(s):  
Ecem KARTAL ÖZCAN ◽  
Merve ÖZBAL BATUK ◽  
Şule KAYA ◽  
Gonca SENNAROĞLU

Assessment of speech perception in noise in children with hearing aids: Preliminary results* Objective: Noisy environments are a part of the daily life of children, just like adults. Children with hearing loss who wear hearing aids are more susceptible to the negative effects of noise than their normal-hearing peers. This study aims to evaluate the speech recognition in noise performance of hearing aid users and compare them with their normal-hearing peers. Material and Method: Five children aged 6-12 years with bilateral moderate to severe symmetrical sensorineural hearing loss and using bilateral behind-the-ear hearing aids were included in the study. 4 different conditions of the Turkish HINT-C were applied, and a speech recognition threshold (SRT) is determined for each condition. Results: Regardless of their age, the SRT needed by children with hearing aids to achieve equal performance with their normal-hearing peers was found to be higher for all test conditions. As seen in children with normal hearing in general, the mean noise front score of the children with hearing loss was higher than the mean noise right and noise left scores. Conclusion: The results of this study revealed that children with bilaterally symmetrical moderate to severe hearing loss achieved poor speech recognition scores in environments similar to the classroom environment, compared to their normal-hearing peers. Our results guided appropriate rehabilitation and follow-up. Keywords: noise, speech recognition in noise, hearing loss, hearing aid, pediatric audiology, HINT, HINT-C


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