The efficacy of the Prescription of Gain/Output (POGO) in fitting hearing aids to mild and moderate sensorineural hearing losses

1994 ◽  
Vol 41 (1) ◽  
Author(s):  
Sandra Thorpe ◽  
Carol Jardine
Keyword(s):  
Word Recognition ◽  
Hearing Aids ◽  
User Satisfaction ◽  
Sensorineural Hearing ◽  
Subjective Ratings ◽  
Frequency Responses ◽  
Perceived Benefit ◽  
Functional Gain ◽  
Modified Functional ◽  
Fitting Hearing Aids

This study investigated the effectiveness of the application of the Prescription of Gain/Output (POGO) in hearing aid fittings. Six subjects were tested. Each presented with binaural mild to moderate sensorineural hearing losses and were previously fitted monaurally with behind-the-ear aids using modifications of the traditional Carhart (1946) approach. Functional gain requirements stipulated by POGO were calculated from unaided thresholds and compared to actual functional gain measurements. Five subjects, whose functional gain measures were not within prescribed limits, were referred for modification of the gain and frequency responses of their hearing aids and earmoulds. Post-modified functional gain measurements were analysed. The extent to which the required functional gain measurements were met, was investigated statistically in relation to word recognition scores and subjective ratings of perceived benefit. The conclusion reached was that the application of POGO results in improved word recognition scores and self-reported user satisfaction.

Evaluation of Hardwire Personal Assistive Listening Devices

1994 ◽  
Vol 3 (2) ◽  
pp. 71-77 ◽  
Author(s):  
James J. Dempsey ◽  
Mark Ross
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Low Frequency ◽  
Sensorineural Hearing ◽  
Clinical Implications ◽  
Frequency Responses ◽  
Subjective Evaluations ◽  
Potential Benefits

A large number of personal amplifiers have recently become available commercially. These devices have not been classified as hearing aids by the FDA and are therefore not subject to the FDA rules and regulations governing the sales of hearing aid devices. In this investigation, several of these personal amplifiers were evaluated to determine potential benefits and problems for each device. The devices were evaluated electroacoustically and, also, subjectively by a group of adults with sensorineural hearing loss. The results of the electroacoustic evaluation revealed very sharply peaked frequency responses. The subjective evaluations revealed tremendous variability, with some preferences for power and low-frequency amplification. Clinical implications of these results and suggestions for further research are provided.

Severe difficulties with word recognition in noise after platinum chemotherapy in childhood, and improvements with open-fitting hearing-aids

2011 ◽  
Vol 50 (10) ◽  
pp. 642-651 ◽  
Author(s):  
Einar-Jón Einarsson ◽  
Hannes Petersen ◽  
Thomas Wiebe ◽  
Per-Anders Fransson ◽  
Måns Magnusson ◽  
...  
Keyword(s):  
Word Recognition ◽  
Hearing Aids ◽  
Open Fitting ◽  
Platinum Chemotherapy ◽  
Fitting Hearing Aids

Frequency Responses of Hearing Aids and Their Effects on the Speech Perception of Hearing-Impaired Subjects

1975 ◽  
Vol 84 (5_suppl) ◽  
pp. 5-5 ◽  
Author(s):  
David Pedeo Pascoe
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Word List ◽  
Hearing Impaired ◽  
Hearing Level ◽  
Closed Set ◽  
Frequency Responses ◽  
Significant Difference ◽  
Monosyllabic Words ◽  
Functional Gain

Eight hearing-impaired subjects were tested with a binaural master hearing aid. This aid has “on-the-head” miniature transducers and has an adjustable frequency response. Five frequency responses were used, two of them were defined by their response in a 2-cm3 coupler: 1) uniform coupler gain (UCG), and 2) 6 dB per octave rise (6 dB). The other responses were defined in terms of functional gain (difference between unaided and aided thresholds): 3) uniform functional gain (UFG); 4) uniform hearing level (UHL); and 5) a simulation of a commercial hearing aid (AS). A significant difference between coupler and functional gain was seen. Discrimination was tested with a special closed-set word list which includes fifty monosyllabic words with a high percentage of voiceless phonemes. Discrimination scores were consistently better with the UHL response. The lowest scores were obtained with the AS response. The average difference in scores between these two responses was 18.4%. Further testing replicated these results and also compared the effects of a different type of word list phonetically balanced (PB); with these lists, the above-mentioned difference in scores was smaller in quiet (5.9%) but larger in noise (20.9%).

scholarly journals Verification of Hearing Aids by Comparing Real Ear Measurements and Word Recognition Scores

2021 ◽  
Vol 64 (9) ◽  
pp. 619-625
Author(s):  
Taeuk Cheon ◽  
Yehree Kim ◽  
Marn Joon Park ◽  
Min Young Kwak ◽  
Chan Joo Yang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Discrimination Score ◽  
Success Rates ◽  
Speech Mapping ◽  
The Mean ◽  
Functional Gain

Background and Objectives In this study, we introduce our method of hearing aid (HA) verification using real ear measurement (REM). We verified HAs that have gone through the fitting program using speech mapping REM; we then compared the outcome with word recognition scores (WRS) to evaluate functional gain. Subjects and Method Fifty-six patients of sensorineural hearing loss (81 ears) were enrolled in the study. In REM, if the gap between the target gain of HA and real ear aided response (REAR) was less than 10 dB SPL, fitting was considered successful. In speech audiometry, unaided maximum discrimination score (PB max), unaided WRS at 65 dB HL and aided WRS at 65 dB HL were measured. By comparing PB max and aided WRS at 65 dB HL, patients were sorted into best (n=15), good (n=57), and poorly (n=9) aided groups and analyzed for the successes of fitting. Fitting was deemed unsuccessful if REAR was ≥10 dB SPL lower than the target value of HA.Results The mean aided WRS at 65 dB HL of best, good and poorly aided groups were 85.6%, 77.3%, and 54.2%, respectively. There were statistically significant differences between all groups (p=0.019, 0.001, 0.002). The success rates of HA fitting showed significant differences at 0.5, 0.75, 1, 4 kHz of 55 dB SPL (p=0.023, 0.005, 0.003, 0.014), and at 4 kHz of 65 and 75 dB SPL (p=0.004, 0.001). The high WRS group showed sufficient gain at many frequencies. Conclusion Well fitted HAs can provide sufficient increase in speech intelligibility. Using the speech mapping REM is a great method to verify fitting of HA.

scholarly journals Audiological outcomes utilizing a transcutaneous ossseointegrated implant system in pediatric patients

2019 ◽  
Vol 11 (1) ◽  
pp. 90-95
Author(s):  
Lisa Vaughan Christensen ◽  
Kristi Reed ◽  
Laura Smith Olinde
Keyword(s):  
Hearing Aids ◽  
User Satisfaction ◽  
Pediatric Patients ◽  
Medical Center ◽  
Bone Conduction ◽  
Retrospective Chart Review ◽  
System Data ◽  
Bone Conduction Hearing ◽  
Functional Gain ◽  
Baha Attract

Background: Percutaneous bone conduction hearing aids have proven to be audiometrically successful, but too often result in soft tissue issues at the abutment site. To counter this possibility, a magnetized, transcutaneous bone conduction hearing aid has been developed, the Baha Attract®. However, only limited research exists to demonstrate efficacy and verification measures of the Baha Attract® System. Purpose: The purpose of this study was to evaluate audiologic outcomes when using the Baha Attract® magnetic osseointegrated system in pediatric patients by measuring functional gain and post-implant user satisfaction with the Children’s Home Inventory for Listening Difficulties (CHILD) scale. Research design: The authors used a retrospective chart review of pediatric patients implanted with the Attract® System from 2014 to 2017 at Cook Children's Medical Center located in Fort Worth, Texas. Study sample: One ear of fourteen pediatric patients aged 5 to 18 years with bilateral or unilateral conductive hearing loss implanted unilaterally (13 children) or bilaterally (1 child, 1 ear randomly chosen for inclusion) with the Cochlear Baha Attract® System. Data collection and analysis: Aided and unaided thresholds were collected for 14 patients. Effective gain testing occurred approximately three months after the initial fitting appointment. Additionally, results of the CHILD survey were collected from seven of these children. A 2-factor analysis of variance test was used to examine the audiometric data, descriptive statistics were employed for the CHILD scores and correlations were run between CHILD scores and 1) overall functional gain, 2) frequency-specific functional gain and 3) age. Results: Participants in this study showed a statistically significant improvement in bone conduction thresholds at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz when using the Baha Attract® System compared to the unaided condition. CHILD survey results showed a mean score of 6.5 and median score of 7 on a scale of 8. Correlation R values ranged from 0.14 to 0.79. Conclusion: For these children with conductive losses, a transcutaneous, magnetic osseointegrated hearing implant is a viable treatment option that provides significant audiometric functional gain. The CHILD results suggest that the children positively benefit from the implant, and that the perceived benefit may increase with age.

Evaluation of Extended-Wear Hearing Technology for Children with Hearing Loss

2015 ◽  
Vol 26 (07) ◽  
pp. 615-631 ◽  
Author(s):  
Jace Wolfe ◽  
Erin Schafer ◽  
Natalie Martella ◽  
Mila Morais ◽  
Misty Mann
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Sensorineural Hearing ◽  
Older Children ◽  
Sentence Recognition ◽  
Hearing Instruments ◽  
Loudness Scaling ◽  
Children With Hearing Loss

Background: Research shows that many older children and teenagers who have mild to moderately severe sensorineural hearing loss do not use their hearing instruments during all waking hours. A variety of reasons may contribute toward this problem, including concerns about cosmetics associated with hearing aid use and the inconvenience of daily maintenance associated with hearing instruments. Extended-wear hearing instruments are inserted into the wearer’s ear canal by an audiologist and are essentially invisible to outside observers. Purpose: The goal of this study was to evaluate the potential benefits and limitations associated with use of extended-wear hearing instruments in a group of children with hearing loss. Research Design: A two-way repeated measures design was used to examine performance differences obtained with the participants’ daily-wear hearing instruments versus that obtained with extended-wear hearing instruments. Study Sample: Sixteen children, ages 10–17 yr old, with sensorineural hearing loss ranging from mild to moderately severe. Data Collection and Analysis: Probe microphone measures were completed to evaluate the aided output of device. Behavioral test measures included word recognition in quiet, sentence recognition in noise, aided warble-tone thresholds, and psychophysical loudness scaling. Questionnaires were also administered to evaluate subjective performance with each hearing technology. Results: Data logging suggested that many participants were not using their daily-wear hearing instruments during all waking hours (mean use was less than 6 h/day). Real ear probe microphone measurements indicated that a closer fit to the Desired Sensation Level Version 5 prescriptive targets was achieved with the children’s daily-wear instruments when compared to the extended-wear instruments. There was no statistically significant difference in monosyllabic word recognition at 50 or 60 dBA obtained with the two hearing technologies. Sentence recognition in noise obtained with use of the extended-wear devices was, however, significantly better than what was obtained with the daily-wear hearing aids. Aided warble-tone thresholds indicated significantly better audibility for low-level sounds with use of the daily-wear hearing technology, but loudness scaling results produced mixed results. Specifically, the participants generally reported greater loudness perception with use of their daily-wear hearing aids at 2000 Hz, but use of the extended-wear hearing technology provided greater loudness perception at 4000 Hz. Finally, the participants reported higher levels of subjective performance with use of the extended-wear hearing instruments. Conclusions: Although some measures suggested that daily-wear hearing instruments provided better audibility than the extended-wear hearing devices, word recognition in quiet was similar with use of the two technologies, and sentence recognition in noise was better with the extended-wear hearing technology. In addition, the participants in this study reported better subjective benefit associated with the use of extended-wear hearing technology. Collectively, the results of this study suggest that extended-wear hearing technology is a viable option for older children and teenagers with mild to moderately severe hearing loss.

The Effect of a High Upper Input Limiting Level on Word Recognition in Noise, Sound Quality Preferences, and Subjective Ratings of Real-World Performance

2015 ◽  
Vol 26 (06) ◽  
pp. 547-562
Author(s):  
Kristi Oeding ◽  
Michael Valente
Keyword(s):  
Word Recognition ◽  
Hearing Aids ◽  
Real World ◽  
Repeated Measures ◽  
Dynamic Range ◽  
Sound Quality ◽  
Subjective Ratings ◽  
Analog To Digital ◽  
Significant Difference ◽  
Listening Environments

Background: One important factor that plays a role in front-end processing is the analog-to-digital converter within current hearing aids. The average input dynamic range of hearing aids is 96 dB SPL with an upper input limiting level (UILL) of 95–105 dB SPL. The UILL of standard hearing aids could distort loud signals, such as loud speech or music, which have root-mean-square values of 90 and 105 dB SPL with crest factors of 12 dB SPL to 14–20 dB SPL, respectively. This indicates that these loud sounds could create a distorted signal for patients when the input limiting level is reached. Purpose: To examine if significant differences in word recognition in noise, sound quality preferences, and subjective ratings of real-world performance exist between conventional and high UILL hearing aids. Research Design: Words in noise and sound quality preferences were assessed using recordings on a Knowles Electronic Manikin for Acoustic Research with conventional and high UILL hearing aids, different microphone modes, and listening conditions. Participants wore the hearing aids for 2 mo and completed questionnaires on subjective performance. Study Sample: Ten adults with bilateral slight to moderately severe sensorineural hearing loss were recruited. Results: A four-factor repeated-measures analysis of variance (ANOVA) revealed significant differences between the conventional and high UILL across microphone modes and listening conditions for words in noise [F (2, 18) = 6.0; p < 0.05]. A three-factor repeated-measures ANOVA for sound quality preferences revealed a significant difference only for presentation level [F (1, 9) = 81.0; p < 0.001]. A one-factor ANOVA did not reveal significant differences between the conventional and high UILL on subjective ratings of real-world performance. Conclusions: Word recognition and sound quality preferences revealed significant differences between the conventional and high UILL; however, there were no differences in subjective ratings of real-world performance. One participant preferred the conventional UILL, two the high UILL, and seven thought performance was equal, which may be due to the listening environments participants encountered, as evidenced by datalogging.

Frequency Responses of Hearing Aids and Their Effects on the Speech Perception of Hearing-Impaired Subjects

1975 ◽  
Vol 84 (23_suppl) ◽  
pp. 3-40 ◽  
Author(s):  
David Pedro Pascoe
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Word List ◽  
Hearing Impaired ◽  
Hearing Level ◽  
Closed Set ◽  
Frequency Responses ◽  
Significant Difference ◽  
Monosyllabic Words ◽  
Functional Gain

Eight hearing-impaired subjects were tested with a binaural master hearing aid. This aid has “on-the-head” miniature transducers and has an adjustable frequency response. Five frequency responses were used, two of them were defined by their response in a 2-cm3 coupler: 1) uniform coupler gain (UCG), and 2) 6 dB per octave rise (6 dB). The other responses were defined in terms of functional gain (difference between unaided and aided thresholds): 3) uniform functional gain (UFG); 4) uniform hearing level (UHL); and 5) a simulation of a commercial hearing aid (AS). A significant difference between coupler and functional gain was seen. Discrimination was tested with a special closed-set word list which includes fifty monosyllabic words with a high percentage of voiceless phonemes. Discrimination scores were consistently better with the UHL response. The lowest scores were obtained with the AS response. The average difference in scores between these two responses was 18.4%. Further testing replicated these results and also compared the effects of a different type of word list phonetically balanced (PB); with these lists, die above-mentioned difference in scores was smaller in quiet (5.9%) but larger in noise (20.9%).

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

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