Comprehensive Hearing Aid Intervention at a Free Subspecialty Clinic.

PubMed

Wertz, Aileen P; Mannarelli, Gregory; Shuman, Andrew G; McKean, Erin L

2017-09-01

Providing a model of a comprehensive free audiologic program may assist other health care professionals in developing their own similar program. To describe the structure, feasibility, and outcomes of a free subspecialty clinic providing hearing aids to develop a paradigm for other programs interested in implementing similar projects. A retrospective case series was conducted from September 1, 2013, through March 31, 2016. In a partnership between a free independent clinic for indigent patients and an academic medical center, 54 indigent patients were referred to the clinic for audiograms. A total of 50 of these patients had results of audiograms available for review and were therefore included in the study; 34 of these 50 patients were determined to be eligible for hearing aid fitting based on audiometric results. Free audiometric testing, hearing aid fitting, and hearing aid donation. The number of hearing aids donated, number of eligible patients identified, number of patients fitted with hearing aids, and work effort (hours) and start-up costs associated with implementation of this program were quantified. A total of 54 patients (31 women [57.4%] and 23 men [42.6%]; median age, 61 years; range, 33-85 years) had audiograms performed, and 84 hearing aids were donated to the program. The patients were provided with free audiograms, hearing aid molds, and hearing aid programming, as well as follow-up appointments to ensure continued proper functioning of their hearing aids. Since 2013, a total of 34 patients have been determined to be eligible for the free program and were offered hearing aid services. Of these, 20 patients (59%) have been fitted or are being fitted with free hearing aids. The value of services provided is estimated to be $2260 per patient. It is feasible to provide free, comprehensive audiologic care, including hearing aids and fitting, in a well-established, free clinic model. The opportunity for indigent patients to use hearing aids at minimal personal cost is a major step forward in improving access to high-quality care.

Style preference survey: a report on the psychometric properties and a cross-validation experiment.

PubMed

Smith, Sherri L; Ricketts, Todd; McArdle, Rachel A; Chisolm, Theresa H; Alexander, Genevieve; Bratt, Gene

2013-02-01

Several self-report measures exist that target different aspects of outcomes for hearing aid use. Currently, no comprehensive questionnaire specifically assesses factors that may be important for differentiating outcomes pertaining to hearing aid style. The goal of this work was to develop the Style Preference Survey (SPS), a questionnaire aimed at outcomes associated with hearing aid style differences. Two experiments were conducted. After initial item development, Experiment 1 was conducted to refine the items and to determine its psychometric properties. Experiment 2 was designed to cross-validate the findings from the initial experiment. An observational design was used in both experiments. Participants who wore traditional, custom-fitted (TC) or open-canal (OC) style hearing aids from 3 mo to 3 yr completed the initial experiment. One-hundred and eighty-four binaural hearing aid users (120 of whom wore TC hearing aids and 64 of whom wore OC hearing aids) participated. A new sample of TC and OC users (n = 185) participated in the cross-validation experiment. Currently available self-report measures were reviewed to identify items that might differentiate between hearing aid styles, particularly preference for OC versus TC hearing aid styles. A total of 15 items were selected and modified from available self-report measures. An additional 55 items were developed through consensus of six audiologists for the initial version of the SPS. In the first experiment, the initial SPS version was mailed to 550 veterans who met the inclusion criteria. A total of 184 completed the SPS. Approximately three weeks later, a subset of participants (n = 83) completed the SPS a second time. Basic analyses were conducted to evaluate the psychometric properties of the SPS including subscale structure, internal consistency, test-retest reliability, and responsiveness. Based on the results of Experiment 1, the SPS was revised. A cross-validation experiment was then conducted using the revised version of the SPS to confirm the subscale structure, internal consistency, and responsiveness of the questionnaire in a new sample of participants. The final factor analysis led to the ultimate version of the SPS, which had a total of 35 items encompassing five subscales: (1) Feedback, (2) Occlusion/Own Voice Effects, (3) Localization, (4) Fit, Comfort, and Cosmetics, and (5) Ease of Use. The internal consistency of the total SPS (Cronbach's α = .92) and of the subscales (each Cronbach's α > .75) was high. Intraclass correlations (ICCs) showed that the test-retest reliability of the total SPS (ICC = .93) and of the subscales (each ICC > .80) also was high. TC hearing aid users had significantly poorer outcomes than OC hearing aid users on 4 of the 5 subscales, suggesting that the SPS largely is responsive to factors related to style-specific differences. The results suggest that the SPS has good psychometric properties and is a valid and reliable measure of outcomes related to style-specific, hearing aid preference. American Academy of Audiology.

Impact of Hearing Aid Technology on Outcomes in Daily Life III: Localization.

PubMed

Johnson, Jani A; Xu, Jingjing; Cox, Robyn M

Compared to basic-feature hearing aids, premium-feature hearing aids have more advanced technologies and sophisticated features. The objective of this study was to explore the difference between premium-feature and basic-feature hearing aids in horizontal sound localization in both laboratory and daily life environments. We hypothesized that premium-feature hearing aids would yield better localization performance than basic-feature hearing aids. Exemplars of premium-feature and basic-feature hearing aids from two major manufacturers were evaluated. Forty-five older adults (mean age 70.3 years) with essentially symmetrical mild to moderate sensorineural hearing loss were bilaterally fitted with each of the four pairs of hearing aids. Each pair of hearing aids was worn during a 4-week field trial and then evaluated using laboratory localization tests and a standardized questionnaire. Laboratory localization tests were conducted in a sound-treated room with a 360°, 24-loudspeaker array. Test stimuli were high frequency and low frequency filtered short sentences. The localization test in quiet was designed to assess the accuracy of front/back localization, while the localization test in noise was designed to assess the accuracy of locating sound sources throughout a 360° azimuth in the horizontal plane. Laboratory data showed that unaided localization was not significantly different from aided localization when all hearing aids were combined. Questionnaire data showed that aided localization was significantly better than unaided localization in everyday situations. Regarding the difference between premium-feature and basic-feature hearing aids, laboratory data showed that, overall, the premium-feature hearing aids yielded more accurate localization than the basic-feature hearing aids when high-frequency stimuli were used, and the listening environment was quiet. Otherwise, the premium-feature and basic-feature hearing aids yielded essentially the same performance in other laboratory tests and in daily life. The findings were consistent for both manufacturers. Laboratory tests for two of six major manufacturers showed that premium-feature hearing aids yielded better localization performance than basic-feature hearing aids in one out of four laboratory conditions. There was no difference between the two feature levels in self-reported everyday localization. Effectiveness research with different hearing aid technologies is necessary, and more research with other manufacturers' products is needed. Furthermore, these results confirm previous observations that research findings in laboratory conditions might not translate to everyday life.

Hearing aid effectiveness after aural rehabilitation - individual versus group (HEARING) trial: RCT design and baseline characteristics

PubMed Central

2009-01-01

Background Hearing impairment is the most common body system disability in veterans. In 2008, nearly 520,000 veterans had a disability for hearing loss through the Department of Veterans Affairs (VA). Changes in eligibility for hearing aid services, along with the aging population, contributed to a greater than 300% increase in the number of hearing aids dispensed from 1996 to 2006. In 2006, the VA committed to having no wait times for patient visits while providing quality clinically-appropriate care. One approach to achieving this goal is the use of group visits as an alternative to individual visits. We sought to determine: 1) if group hearing aid fitting and follow-up visits were at least as effective as individual visits, and 2) whether group visits lead to cost savings through the six month period after the hearing aid fitting. We describe the rationale, design, and characteristics of the baseline cohort of the first randomized clinical trial to study the impact of group versus individual hearing aid fitting and follow-up visits. Methods Participants were recruited from the VA Puget Sound Health Care System Audiology Clinic. Eligible patients had no previous hearing aid use and monaural or binaural air-conduction hearing aids were ordered at the evaluation visit. Participants were randomized to receive the hearing aid fitting and the hearing aid follow-up in an individual or group visit. The primary outcomes were hearing-related function, measured with the first module of the Effectiveness of Aural Rehabilitation (Inner EAR), and hearing aid adherence. We tracked the total cost of planned and unplanned audiology visits over the 6-month interval after the hearing aid fitting. Discussion A cohort of 659 participants was randomized to receive group or individual hearing aid fitting and follow-up visits. Baseline demographic and self-reported health status and hearing-related measures were evenly distributed across the treatment arms. Outcomes after the 6-month follow-up period are needed to determine if group visits were as least as good as those for individual visits and will be reported in subsequent publication. Trial Registration NCT00260663 PMID:20003515

Round Window Application of an Active Middle Ear Implant: A Comparison With Hearing Aid Usage in Japan.

PubMed

Iwasaki, Satoshi; Usami, Shin-Ichi; Takahashi, Haruo; Kanda, Yukihiko; Tono, Tetsuya; Doi, Katsumi; Kumakawa, Kozo; Gyo, Kiyofumi; Naito, Yasushi; Kanzaki, Sho; Yamanaka, Noboru; Kaga, Kimitaka

2017-07-01

To report on the safety and efficacy of an investigational active middle ear implant (AMEI) in Japan, and to compare results to preoperative results with a hearing aid. Prospective study conducted in Japan in which 23 Japanese-speaking adults suffering from conductive or mixed hearing loss received a VIBRANT SOUNDBRIDGE with implantation at the round window. Postoperative thresholds, speech perception results (word recognition scores, speech reception thresholds, signal-to-noise ratio [SNR]), and quality of life questionnaires at 20 weeks were compared with preoperative results with all patients receiving the same, best available hearing aid (HA). Statistically significant improvements in postoperative AMEI-aided thresholds (1, 2, 4, and 8 kHz) and on the speech reception thresholds and word recognition scores tests, compared with preoperative HA-aided results, were observed. On the SNR, the subjects' mean values showed statistically significant improvement, with -5.7 dB SNR for the AMEI-aided mean and -2.1 dB SNR for the preoperative HA-assisted mean. The APHAB quality of life questionnaire also showed statistically significant improvement with the AMEI. Results with the AMEI applied to the round window exceeded those of the best available hearing aid in speech perception as well as quality of life questionnaires. There were minimal adverse events or changes to patients' residual hearing.

A piezoelectric bone-conduction bending hearing actuator.

PubMed

Adamson, R B A; Bance, M; Brown, J A

2010-10-01

A prototype of a novel bone-conduction hearing actuator based on a piezoelectric bending actuator is presented. The device lies flat against the skull which would allow it to form the basis of a subcutaneous bone-anchored hearing aid. The actuator excites bending in bone through a local bending moment rather than the application of a point force as with conventional bone-anchored hearing aids. Through measurements of the cochlear velocity created by the actuator in embalmed human heads, the device is shown to exhibit high efficiency, making it a possible alternative to present-day electromagnetic bone-vibration actuators.

Candidacy for bilateral hearing aids: a retrospective multicenter study.

PubMed

Boymans, Monique; Goverts, S Theo; Kramer, Sophia E; Festen, Joost M; Dreschler, Wouter A

2009-02-01

The goal of this study was to find factors for refining candidacy criteria for bilateral hearing aid fittings. Clinical files of 1,000 consecutive hearing aid fittings were analyzed. Case history, audiometric, and rehabilitation data were collected from clinical files, and an extensive questionnaire on long-term outcome measures was conducted. After at least 2 years of hearing aid use, 505 questionnaires were returned. In order to compare differences in benefits between unilateral and bilateral fittings, two subgroups were composed in which most relevant variables (age, degree of hearing loss, and audiometric asymmetry) were matched for unilateral fittings (n=212) and bilateral fittings (n=477). The bilateral group had significantly higher benefit scores than the unilateral group for detection, speech intelligibility in reverberation, and localization, but poorer scores for comfort of loud sounds. The benefit of bilateral hearing aids was not significantly related to the level of technology of the hearing aids. The analysis of the relation between objective parameters and the subjective outcome measures showed that candidacy for a successful bilateral fitting could not be predicted from age, maximum speech intelligibility, employment, exposure to background noise, or social activities.

Information Retention and Overload in First-Time Hearing Aid Users: An Interactive Multimedia Educational Solution.

PubMed

Ferguson, Melanie; Brandreth, Marian; Brassington, William; Wharrad, Heather

2015-09-01

An educational intervention to improve knowledge of hearing aids and communication in first-time hearing aid users was assessed. This intervention was based on the concept of reusable learning objects (RLOs). A randomized controlled trial was conducted. One group received the educational intervention, and the other acted as a control group. RLOs were delivered online and through DVD for television and personal computer. Knowledge of both practical and psychosocial aspects of hearing aids and communication was assessed using a free-recall method 6 weeks postfitting. Knowledge of both practical and psychosocial issues was significantly higher in the group that received the RLOs than in the control group. Moderate to large effect sizes indicated that these differences were clinically significant. An educational intervention that supplements clinical practice results in improved knowledge in first-time hearing aid users.

Sex-specific predictors of hearing-aid use in older persons: The age, gene/environment susceptibility - Reykjavik study

PubMed Central

Fisher, Diana E.; Li, Chuan-Ming; Hoffman, Howard J.; Chiu, May S.; Themann, Christa L.; Petersen, Hannes; Jonsson, Palmi V.; Jonsson, Helgi; Jonasson, Fridbert; Sverrisdottir, Johanna Eyrun; Launer, Lenore J.; Eiriksdottir, Gudny; Gudnason, Vilmundur; Cotch, Mary Frances

2015-01-01

Objective We estimate the prevalence of hearing-aid use in Iceland and identify sex-specific factors associated with use. Design Population-based cohort study. Study sample A total of 5172 age, gene/environment susceptibility - Reykjavik study (AGES-RS) participants, aged 67 to 96 years (mean age 76.5 years), who completed air-conduction and pure-tone audiometry. Results Hearing-aid use was reported by 23.0% of men and 15.9% of women in the cohort, although among participants with at least moderate hearing loss in the better ear (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz ≥ 35 dB hearing level [HL]) it was 49.9% and did not differ by sex. Self-reported hearing loss was the strongest predictor of hearing-aid use in men [OR: 2.68 (95% CI: 1.77, 4.08)] and women [OR: 3.07 (95% CI: 1.94, 4.86)], followed by hearing loss severity based on audiometry. Having diabetes or osteoarthritis were significant positive predictors of use in men, whereas greater physical activity and unimpaired cognitive status were important in women. Conclusions Hearing-aid use was comparable in Icelandic men and women with moderate or greater hearing loss. Self-recognition of hearing loss was the factor most predictive of hearing-aid use; other influential factors differed for men and women. PMID:25816699

Longitudinal predictors of aided speech audibility in infants and children

PubMed Central

McCreery, Ryan W.; Walker, Elizabeth A.; Spratford, Meredith; Bentler, Ruth; Holte, Lenore; Roush, Patricia; Oleson, Jacob; Van Buren, John; Moeller, Mary Pat

2015-01-01

Objectives Amplification is a core component of early intervention for children who are hard of hearing (CHH), but hearing aids (HAs) have unique effects that may be independent from other components of the early intervention process, such as caregiver training or speech and language intervention. The specific effects of amplification are rarely described in studies of developmental outcomes. The primary purpose of this manuscript is to quantify aided speech audibility during the early childhood years and examine the factors that influence audibility with amplification for children in the Outcomes of Children with Hearing Loss (OCHL) study. Design Participants were 288 children with permanent hearing loss who were followed as part of the OCHL study. All of the children in this analysis had bilateral hearing loss and wore air-conduction behind-the-ear HAs. At every study visit, hearing thresholds were measured using developmentally-appropriate behavioral methods. Data were obtained for a total of 1043 audiometric evaluations across all subjects for the first four study visits. In addition, the aided audibility of speech through the HA was assessed using probe microphone measures. Hearing thresholds and aided audibility were analyzed. Repeated-measures analyses of variance were conducted to determine if patterns of thresholds and aided audibility were significantly different between ears (left vs. right) or across the first four study visits. Furthermore, a cluster analysis was performed based on the aided audibility at entry into the study, aided audibility at the child’s final visit, and change in aided audibility between these two intervals to determine if there were different patterns of longitudinal aided audibility within the sample. Results Eighty-four percent of children in the study had stable audiometric thresholds during the study, defined as threshold changes <10 dB for any single study visit. There were no significant differences in hearing thresholds, aided audibility, or deviation of the HA fitting from prescriptive targets between ears or across test intervals for the first four visits. Approximately 35% of the children in the study had aided audibility that was below the average for the normative range for the Speech Intelligibility Index (SII) based on degree of hearing loss. The cluster analysis of longitudinal aided audibility revealed three distinct groups of children: a group with consistently high aided audibility throughout the study, a group with decreasing audibility during the study, and a group with consistently low aided audibility. Conclusions The current results indicated that approximately 65% of children in the study had adequate aided audibility of speech and stable hearing during the study period. Limited audibility was associated with greater degrees of hearing loss and larger deviations from prescriptive targets. Studies of developmental outcomes will help to determine how aided audibility is necessary to affects developmental outcomes in CHH. PMID:26731156

Modeling relationships between various domains of hearing aid provision.

PubMed

Meister, Hartmut; Lausberg, Isabel; Kiessling, Jürgen; von Wedel, Hasso; Walger, Martin

2003-01-01

Various inventories have been developed to quantify the success of hearing aid provision. Though numerous parameters including initial measures (hearing disability, handicap) or 'outcome measures' (e.g. benefit, satisfaction and usage) are recorded, relationships and interactions among them are still unclear. A study applying a questionnaire addressing 11 domains relevant to amplification was conducted in order to generate different psychometric models with the AMOS software package for structural equation modeling. The models expose easily interpretable interactions and are helpful in understanding effects occurring with commonly used outcome measures: benefit reflects the difference between the aided and unaided condition but additionally comprises the importance of the hearing aid within a specific situation. Satisfaction is highly reliant on benefit. Usage is strongly dependent on the severity of hearing problems and therefore not appropriate in assessing the success of amplification. Moreover, the models help to predict the outcome of clinically used inventories (i.e. the Glasgow Hearing Aid Benefit Profile). Copyright 2003 S. Karger AG, Basel

Preference for One or Two Hearing Aids among Adult Patients

PubMed Central

Cox, Robyn M; Schwartz, Kathryn S.; Noe, Colleen M.; Alexander, Genevieve C.

2010-01-01

Objectives Most practitioners believe that use of two hearing aids is the ideal fitting for adults with bilateral symmetrical hearing loss. However, previous research has consistently shown that a substantial proportion of these patients actually prefer to use only one hearing aid. The current study explored whether this pattern of preferences is seen with technologically advanced hearing aids. In addition, a selection of variables that were available pre-fitting were used to attempt to predict which patients will prefer one hearing aid rather than two. Design The study was designed as a 12-week field trial including structured and unstructured use of one and two hearing aids. Ninety-four subjects with mild to moderate bilaterally symmetrical hearing loss were bilaterally fit with 2005-2007 era hearing aids. Potential predictors included demographic, audiometric, auditory lifestyle, personality, and binaural processing variables. After the field trial, each subject stated his/her preference for one or two hearing aids and completed three self-report outcome questionnaires for their preferred fitting. Results Previous research was confirmed with modern technology hearing aids: after the field trial 46% of the subjects preferred to use one hearing aid rather than two. Subjects who preferred two hearing aids tended to report better real-world outcomes than those who preferred one. Subjects who reported more hearing problems in daily life, who experienced more binaural loudness summation, and whose ears were more equivalent in dichotic listening were more likely to prefer to use two hearing aids. Contrary to conventional wisdom (ideas that are generally accepted as true), audiometric hearing loss and auditory lifestyle were not predictive of aiding preference. However, the best predictive approach from these data yielded accurate predictions for only two-thirds of subjects. Conclusions Evidence-based practice calls for a conscientious melding of current evidence, clinical judgment, and patient preferences. The results of this research challenge practitioners to recognize that many patients who appear to be ideal candidates for bilateral aiding will actually prefer to wear only one hearing aid. Further, at this time there is not an accurate method that will predict which patients will prefer one hearing aid rather than two. Currently, the most effective approach open to practitioners would be to conduct a candid unbiased systematic field trial allowing each patient to compare unilateral and bilateral fittings in daily life. This might necessitate more fitting sessions and could perhaps add to the practitioner's burden. This downside should be weighed against the additional patient satisfaction that can be anticipated as a result of transparency in the fitting protocol, collaboration with the patient in the treatment decisions, and the knowledge of selecting the most cost-effective patient-centered solution. PMID:20890203

Development of Bone-Conducted Ultrasonic Hearing Aid for the Profoundly Deaf: Assessments of the Modulation Type with Regard to Intelligibility and Sound Quality

NASA Astrophysics Data System (ADS)

Nakagawa, Seiji; Fujiyuki, Chika; Kagomiya, Takayuki

2012-07-01

Bone-conducted ultrasound (BCU) is perceived even by the profoundly sensorineural deaf. A novel hearing aid using the perception of amplitude-modulated BCU (BCU hearing aid: BCUHA) has been developed; however, further improvements are needed, especially in terms of articulation and sound quality. In this study, the intelligibility and sound quality of BCU speech with several types of amplitude modulation [double-sideband with transmitted carrier (DSB-TC), double-sideband with suppressed carrier (DSB-SC), and transposed modulation] were evaluated. The results showed that DSB-TC and transposed speech were more intelligible than DSB-SC speech, and transposed speech was closer than the other types of BCU speech to air-conducted speech in terms of sound quality. These results provide useful information for further development of the BCUHA.

Enjoyment of music by elderly hearing-impaired listeners.

PubMed

Leek, Marjorie R; Molis, Michelle R; Kubli, Lina R; Tufts, Jennifer B

2008-06-01

Anecdotal evidence suggests that hearing loss interferes with the enjoyment of music, although it is not known how widespread this problem currently is. To estimate the prevalence of music-listening difficulties among a group of elderly hearing aid wearers. Interview. Telephone interviews were conducted with patients who wore hearing aids. Questions regarding several aspects of music listening were included. Sixty-eight hearing-impaired people served as subjects. They had all been seen in the audiology clinic for hearing aid evaluation during the previous year. Subjects were asked questions concerning their use of hearing aids, the importance of listening to music in their lives, their habits and practices concerning music, and difficulties they experienced in listening to music. Almost 30% of the respondents reported that their hearing losses affected their enjoyment of music. About half of the respondents indicated that music was either too loud or too soft, although only about one-third reported difficulties with level contrasts within musical pieces. In contrast to a similar survey carried out 20 years ago, there were many fewer complaints about listening to music. This result may be due in large part to improvements in hearing aids, especially with regard to nonlinear compression. Although new hearing aid technologies have somewhat reduced problems of music enjoyment experienced by hearing-impaired people, audiologists should be aware that some 25-30% of patients may have difficulties with listening to music and may require extra attention to minimize those problems.

AIDS Epidemic. Hearing before the Committee on Labor and Human Resources. United States Senate, One Hundredth Congress, First Session on Reviewing Federal Efforts Being Conducted toward Combating the AIDS Epidemic.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

The text of a Senate hearing called to review federal efforts combating acquired immune deficiency syndrome (AIDS) is presented in this document. Opening statements reviewing the AIDS crisis are given by Senators Edward Kennedy and Lowell Weicker, Jr. Prepared statements are included by Senators Orrin Hatch and Ted Stevens. David Baltimore and…

Rehabilitation for disabling hearing loss: evaluating the need relative to provision of hearing aids in the public health care system.

PubMed

Hlayisi, Vera-Genevey; Ramma, Lebogang

2018-05-20

To determine the demand relative to supply of hearing rehabilitation through hearing aids for those with disabling hearing loss in a public health care setting in South Africa. Retrospective cross-sectional survey of medical records of all patients were seen at a public hospital (Polokwane Provincial Academic) during 2012-2014, was conducted. Audiological data from 3894 medical folders were accessed and reviewed; thereafter, results were analyzed using descriptive statistics. Of the 3894 medical folders reviewed, two-third (62%, n = 2402) were diagnosed with hearing loss, mostly bilaterally (81%). More than 30% of all patients diagnosed with hearing loss were ≤10 years old. Sensorineural (permanent) hearing loss was diagnosed most often (38%, n = 913) and 74% (n = 1778) of hearing losses diagnosed were of moderate or worse severity (i.e., disabling loss). Hearing aids were fitted to only 15% (n = 272) of those diagnosed with disabling hearing loss and most hearing aid fittings were to low-income adult patients (≥25 years old) with more severe-profound hearing losses. This study showed that the need for hearing aids to provide hearing rehabilitation far exceeds the supply. Therefore, a multi-pronged approach that includes increased budget allocation and exploring low-cost interventions for developing countries to meet the demand for hearing aids. Furthermore, study highlighted a high prevalence of hearing loss in those younger than 10 years of age, and thus highlights the need for early intervention as well as intensifying efforts to reduce preventable causes of hearing loss. Implications for Rehabilitation Audiologists need to advocate for an increase in budget allocation for hearing rehabilitation devices. Study indicates need to explore low-cost hearing devices/rehabilitation interventions for developing countries. Health professionals should consider preventative measures to reduce prevalence of preventable hearing loss.

Bilateral versus unilateral hearing aids for bilateral hearing impairment in adults.

PubMed

Schilder, Anne Gm; Chong, Lee Yee; Ftouh, Saoussen; Burton, Martin J

2017-12-19

Acquired hearing loss is common and its incidence increases markedly with age. In most people, 'age-related' hearing loss is sensorineural (due to the loss of cochlear hair cells) and bilateral, affecting both ears to the same degree. Hearing loss categorised as mild, moderate or severe is primarily managed with hearing aids. People with bilateral hearing loss may be offered one aid, fitted to one specific ear, or two aids fitted to both ears. There is uncertainty about the relative benefits to people with hearing loss of these different strategies. To assess the effects of bilateral versus unilateral hearing aids in adults with a bilateral hearing impairment. The Cochrane ENT Information Specialist searched the ENT Trials Register; Cochrane Register of Studies Online; PubMed; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 8 June 2017. Randomised controlled trials (RCTs) comparing the fitting of two versus one ear-level acoustic hearing aids in adults (over 18 years) with a bilateral hearing impairment, both ears being eligible for hearing aids. We used the standard methodological procedures expected by Cochrane. Our primary outcomes were patient preference for bilateral or unilateral aids, hearing-specific health-related quality of life and adverse effects (pain or discomfort in the ear, initiation or exacerbation of middle or outer ear infection). Secondary outcomes included: usage of hearing aids (as measured by, for example, data logging or battery consumption), generic health-related quality of life, listening ability and audiometric benefit measured as binaural loudness summation. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics. We included four cross-over RCTs with a total of 209 participants, ranging in age from 23 to 85 and with a preponderance of men. All the studies allowed the use of hearing aids for a total period of at least eight weeks before questions on preference were asked. All studies recruited patients with bilateral hearing loss but there was considerable variation in the types and degree of sensorineural hearing loss that the participants were experiencing.Three of the studies were published before the mid-1990s whereas the fourth study was published in 2011. Therefore, only the most recent study used hearing aids incorporating technology comparable to that currently readily available in high-income settings. Of the four studies, two were conducted in the UK in National Health Service (NHS - public sector) patients: one recruited patients from primary care with hearing loss detected by a screening programme whereas the other recruited patients who had been referred by their primary care practitioner to an otolaryngology department for hearing aids. The other two studies were conducted in the United States: one study recruited only military personnel or veterans with noise-induced hearing loss whereas about half of the participants in the other study were veterans.Only one primary outcome (patient preference) was reported in all studies. The percentage of patients who preferred bilateral hearing aids varied between studies: this was 54% (51 out of 94 participants), 39% (22 out of 56), 55% (16 out of 29) and 77% (23 out of 30), respectively. We have not combined the data from these four studies. The evidence for this outcome is of very low quality.The other outcomes of interest were not reported in the included studies. This review identified only four studies comparing the use of one hearing aid with two. The studies were small and included participants of widely varying ages. There was also considerable variation in the types and degree of sensorineural hearing loss that the participants were experiencing.For the most part, the types of hearing aid evaluated would now be regarded, in high-income settings, as 'old technology', with only one study looking at 'modern' digital aids. However, the relevance of this is uncertain, as this review did not evaluate the differences in outcomes between the different types of technology.We were unable to pool data from the four studies and the very low quality of the evidence leads us to conclude that we do not know if people with hearing loss have a preference for one aid or two. Similarly, we do not know if hearing-specific health-related quality of life, or any of our other outcomes, are better with bilateral or unilateral aids.

Software intelligent system for effective solutions for hearing impaired subjects.

PubMed

S, Rajkumar; S, Muttan; V, Sapthagirivasan; V, Jaya; S S, Vignesh

2017-01-01

The anatomy and physiology of the ear is complex in nature, which makes it a challenge for audiologists to prescribe solutions for varied hearing-impaired subjects. There is a need to increase the satisfaction level of hearing-aid users by adopting better strategies that involve modern technological advancements. To design and develop a decision support Software Intelligent System (SIS) that performs audiological investigations to assess the degree of hearing loss and to suggest appropriate hearing-aid gain values. SIS is developed based on the study conducted in the Government General Hospital, Chennai, India, between 2013 and 2015. In the study period, audiological investigations were performed on 368 subjects, using the clinical audiometer (Inventis-Piano, Italy) and the SIS. Gain suggestions were recommended for hearing-aid users (Siemens Intuis life & Intuis-SP) using standard prescriptive procedures, alterations made by the audiologists, and by the SIS. It was developed with artificial neural network-based gain predictions. Of the tested subjects, 256 were identified as hearing-impaired. The calculated sensitivity, specificity and accuracy of the computerised audiometer incorporated in the SIS are 93%, 85% and 90% respectively. Furthermore, 86% of the hearing-impaired subjects were satisfied during their first hearing-aid trial with the gain recommendations from SIS. The findings suggest that the proposed SIS could be used to perform audiological screening tests and to recommend appropriate hearing-aid gain values to the hearing-impaired subjects. This could eventually be helpful for audiologists in the areas where routine mass audiological screening and fast hearing-aid solution is required. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of Hearing Aid Technology on Outcomes in Daily Life I: the Patients’ Perspective

PubMed Central

Cox, Robyn M; Johnson, Jani A; Xu, Jingjing

2016-01-01

Objectives One of the challenges facing hearing care providers when recommending hearing aids is the choice of device technology level. Major manufacturers market families of hearing aids that are described as spanning the range from basic technology to premium technology. Premium technology hearing aids include acoustical processing capabilities (features) that are not found in basic technology instruments. These premium features are intended to yield improved hearing in daily life compared to basic-feature devices. However, independent research that establishes the incremental effectiveness of premium-feature devices compared to basic-feature devices is lacking. This research was designed to explore reported differences in hearing abilities for adults using premium-feature and basic-feature hearing aids in their daily lives. Design This was a single-blinded, repeated, crossover trial in which the participants were blinded. All procedures were carefully controlled to limit researcher bias. Forty-five participants used carefully fitted bilateral hearing aids for one month and then provided data to describe the hearing improvements or deficiencies noted in daily life. Typical participants were 70 years old with mild to moderate adult-onset hearing loss bilaterally. Each participant used 4 pairs of hearing aids: premium- and basic-feature devices from brands marketed by each of two major manufacturers. Participants were blinded about the devices they used and about the research questions. Results All of the outcomes were designed to capture the participant’s point of view about the benefits of the hearing aids. Three types of data were collected: change in hearing-related quality of life, extent of agreement with six positively worded statements about everyday hearing with the hearing aids, and reported preferences between the premium- and basic-feature devices from each brand as well as across all four research hearing aids combined. None of these measures yielded a statistically significant difference in outcomes between premium- and basic-feature devices. Participants did not report better outcomes with premium processing with any measure. Conclusions It could reasonably be asserted that the patient’s perspective is the gold standard for hearing aid effectiveness. While the acoustical processing provided by premium features can potentially improve scores on tests conducted in contrived conditions in a laboratory, or on specific items in a questionnaire, this does not ensure that the processing will be of noteworthy benefit when the hearing aid is used in the real world challenges faced by the patient. If evidence suggests the patient cannot detect that premium features yield improvements over basic features in daily life, what is the responsibility of the provider in recommending hearing aid technology level? In the current research, there was no evidence to suggest that premium-feature devices yielded better outcomes than basic-feature devices from the patient’s point of view. All of the research hearing aids were substantially, but equally, helpful. Further research is needed on this topic with other hearing aids and other manufacturers. In the meantime, providers should insist on scientifically credible independent evidence to support effectiveness claims for any hearing help devices. PMID:26881981

The value of ASSR threshold-based bilateral hearing aid fitting in children with difficult or unreliable behavioral audiometry.

PubMed

Vlastarakos, Petros V; Vasileiou, Alexandra; Nikolopoulos, Thomas P

2017-12-01

We conducted an analysis to assess the relative contribution of auditory brainstem response (ABR) testing and auditory steady-state response (ASSR) testing in providing appropriate hearing aid fitting in hearing-impaired children with difficult or unreliable behavioral audiometry. Of 150 infants and children who had been referred to us for hearing assessment as part of a neonatal hearing screening and cochlear implantation program, we identified 5 who exhibited significant discrepancies between click-ABR and ASSR testing results and difficult or unreliable behavioral audiometry. Hearing aid fitting in pediatric cochlear implant candidates for a trial period of 3 to 6 months is a common practice in many implant programs, but monitoring the progress of the amplified infants and providing appropriate hearing aid fitting can be challenging. If we accept the premise that we can assess the linguistic progress of amplified infants with an acceptable degree of certainty, the auditory behavior that we are monitoring presupposes appropriate bilateral hearing aid fitting. This may become very challenging in young children, or even in older children with difficult or unreliable behavioral audiometry results. This challenge can be addressed by using data from both ABR and ASSR testing. Fitting attempts that employ data from only ABR testing provide amplification that involves the range of spoken language but is not frequency-specific. Hearing aid fitting should also incorporate and take into account ASSR data because reliance on ABR testing alone might compromise the validity of the monitoring process. In conclusion, we believe that ASSR threshold-based bilateral hearing aid fitting is necessary to provide frequency-specific amplification of hearing and appropriate propulsion in the prelinguistic vocalizations of monitored infants.

Applications of direct-to-consumer hearing devices for adults with hearing loss: a review

PubMed Central

Manchaiah, Vinaya; Taylor, Brian; Dockens, Ashley L; Tran, Nicole R; Lane, Kayla; Castle, Mariana; Grover, Vibhu

2017-01-01

Background This systematic literature review is aimed at investigating applications of direct-to-consumer hearing devices for adults with hearing loss. This review discusses three categories of direct-to-consumer hearing devices: 1) personal sound amplification products (PSAPs), 2) direct-mail hearing aids, and 3) over-the-counter (OTC) hearing aids. Method A literature review was conducted using EBSCOhost and included the databases CINAHL, MEDLINE, and PsycINFO. After applying prior agreed inclusion and exclusion criteria, 13 reports were included in the review. Results Included studies fell into three domains: 1) electroacoustic characteristics, 2) consumer surveys, and 3) outcome evaluations. Electroacoustic characteristics of these devices vary significantly with some meeting the stringent acoustic criteria used for hearing aids, while others producing dangerous output levels (ie, over 120-dB sound pressure level). Low-end (or low-cost) devices were typically poor in acoustic quality and did not meet gain levels necessary for most adult and elderly hearing loss patterns (eg, presbycusis), especially in high frequencies. Despite direct-mail hearing aids and PSAPs being associated with lower satisfaction when compared to hearing aids purchased through hearing health care professionals, consumer surveys suggest that 5%–19% of people with hearing loss purchase hearing aids through direct-mail or online. Studies on outcome evaluation suggest positive outcomes of OTC devices in the elderly population. Of note, OTC outcomes appear better when a hearing health care professional supports these users. Conclusion While some direct-to-consumer hearing devices have the capability to produce adverse effects due to production of dangerously high sound levels and internal noise, the existing literature suggests that there are potential benefits of these devices. Research of direct-to-consumer hearing devices is limited, and current published studies are of weak quality. Much effort is needed to understand the benefits and limitations of such devices on people with hearing loss. PMID:28553093

Applications of direct-to-consumer hearing devices for adults with hearing loss: a review.

PubMed

Manchaiah, Vinaya; Taylor, Brian; Dockens, Ashley L; Tran, Nicole R; Lane, Kayla; Castle, Mariana; Grover, Vibhu

2017-01-01

This systematic literature review is aimed at investigating applications of direct-to-consumer hearing devices for adults with hearing loss. This review discusses three categories of direct-to-consumer hearing devices: 1) personal sound amplification products (PSAPs), 2) direct-mail hearing aids, and 3) over-the-counter (OTC) hearing aids. A literature review was conducted using EBSCOhost and included the databases CINAHL, MEDLINE, and PsycINFO. After applying prior agreed inclusion and exclusion criteria, 13 reports were included in the review. Included studies fell into three domains: 1) electroacoustic characteristics, 2) consumer surveys, and 3) outcome evaluations. Electroacoustic characteristics of these devices vary significantly with some meeting the stringent acoustic criteria used for hearing aids, while others producing dangerous output levels (ie, over 120-dB sound pressure level). Low-end (or low-cost) devices were typically poor in acoustic quality and did not meet gain levels necessary for most adult and elderly hearing loss patterns (eg, presbycusis), especially in high frequencies. Despite direct-mail hearing aids and PSAPs being associated with lower satisfaction when compared to hearing aids purchased through hearing health care professionals, consumer surveys suggest that 5%-19% of people with hearing loss purchase hearing aids through direct-mail or online. Studies on outcome evaluation suggest positive outcomes of OTC devices in the elderly population. Of note, OTC outcomes appear better when a hearing health care professional supports these users. While some direct-to-consumer hearing devices have the capability to produce adverse effects due to production of dangerously high sound levels and internal noise, the existing literature suggests that there are potential benefits of these devices. Research of direct-to-consumer hearing devices is limited, and current published studies are of weak quality. Much effort is needed to understand the benefits and limitations of such devices on people with hearing loss.

Audiological Evaluation for Exaggerated Hearing Level.

ERIC Educational Resources Information Center

Engelberg, Marvin W.

Described are clinical techniques and procedures useful in evaluations for exaggerated hearing levels. Discussed are considerations of the audiologist, his equipment, and erroneous findings; patient cooperation, anticipated hearing handicaps, detection of exaggeration, and order of test presentation; voluntary aid conduction audiometry,…

Round window vibroplasty: long-term results.

PubMed

Böheim, Klaus; Mlynski, Robert; Lenarz, Thomas; Schlögel, Max; Hagen, Rudolf

2012-10-01

The round window (RW) approach in the use of the Vibrant Soundbridge(®) (VSB) is a safe and effective treatment of conductive and mixed hearing losses for a period of more than 3 years of device use. To investigate the long-term safety and efficacy as well as user satisfaction of patients with conductive and mixed hearing losses implanted with the VSB using RW vibroplasty. Twelve patients with conductive and mixed hearing losses were evaluated after 40 months of daily VSB use. Safety was assessed by evaluating reports of postoperative medical and surgical complications as well as by changes in bone conduction hearing thresholds. Efficacy outcome measures included aided and unaided hearing thresholds, speech recognition in quiet and in noise and subjective benefit questionnaires. The safety results revealed no significant medical complications. One subject experienced sudden hearing loss after 18-24 months of device use, but still continues to wear the device to her satisfaction. With regard to efficacy, there were no significant changes from short- to long-term results in aided word understanding, functional gain or speech recognition threshold, suggesting that the outcomes are stable over time. Subjective questionnaires revealed either the same or better results compared with the short-term data.

The impact of self-efficacy, expectations, and readiness on hearing aid outcomes.

PubMed

Ferguson, Melanie A; Woolley, Annie; Munro, Kevin J

2016-07-01

To examine the impact of self-efficacy and expectations for hearing aids, and readiness to improve hearing, on hearing aid outcome measures in first-time adult hearing aid users Design: A prospective, single centre design. Predictor variables measured at the hearing assessment included measures of self-efficacy, expectations and readiness to improve hearing. Outcome measures obtained at six-week follow-up were the Glasgow Hearing Aid Benefit Profile and Satisfaction with Amplification in Daily Life. A sample of 30 first-time adult hearing aid users were recruited through a public-sector funded audiology clinic. When measured prior to hearing aid fitting, self-efficacy for hearing aids predicted satisfaction with hearing aids but was not related to other hearing aid outcomes. Expectations of hearing aids, in particular positive expectations, and readiness to improve hearing predicted outcomes for hearing aid satisfaction and benefit, although not hearing aid use. Hearing sensitivity was not correlated with hearing aid outcomes. These results suggest that assessment of expectations of hearing aids, and readiness to improve hearing, may be useful to help identify individuals attending audiology clinics who would most likely benefit from hearing aid provision.

Fitting recommendations and clinical benefit associated with use of the NAL-NL2 hearing-aid prescription in Nucleus cochlear implant recipients.

PubMed

English, Ruth; Plant, Kerrie; Maciejczyk, Michael; Cowan, Robert

2016-01-01

For a group of cochlear implant recipients, who use hearing aids in the contralateral ear, the benefit of NAL-NL2 relative to a recipients' own prescription was assessed. Whether there was a preferred frequency response and/or gain deviation from NAL-NL2 was then investigated. Speech recognition and self-reported ratings of benefit were examined for the recipients' own prescription compared to the NAL-NL2 prescription, in the bimodal and hearing-aid alone conditions. Paired-comparison of hearing-aid frequency response was conducted with default NAL-NL2 and two variants, a low frequency boost or cut. Using a loudness balancing procedure, the hearing-aid gain required to achieve equal loudness between the devices was measured. Sixteen adults with post-lingual hearing loss. A 22% increase in group median word score in quiet with use of NAL-NL2 in the hearing-aid alone condition. In the bimodal condition there was no improvement with NAL-NL2. Default NAL-NL2 frequency response was preferred by 67% of participants. For 56% of participants, the preferred gain to achieve loudness balance across bimodal devices was within 5-dB of prescribed values. The NAL-NL2 prescription provides a high level of clinical performance, and an acceptable frequency response and gain for most participants.

Role of hearing AIDS in tinnitus intervention: a scoping review.

PubMed

Shekhawat, Giriraj Singh; Searchfield, Grant D; Stinear, Cathy M

2013-09-01

Tinnitus can have a devastating impact on the quality of life of the sufferer. Although the mechanisms underpinning tinnitus remain uncertain, hearing loss is often associated with its onset, and hearing aids are among the most commonly used tools for its management. To conduct a scoping review to explore the role of hearing aids in tinnitus management. Scoping review based on the six-stage framework of Arksey and O'Malley (2005). Relevant studies were identified using various databases (Scopus, Google Scholar, SpringerLink, and PubMed) and hand searching of journals and a reference list of articles. Out of 277 shortlisted articles, 29 studies (18 research studies and 11 reviews) were chosen for charting of data based on their abstracts. Tinnitus assessment measures used in studies were recorded along with changes in their scores. Measures used in studies included the Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), Tinnitus Severity Index (TSI), Tinnitus Reaction Questionnaire (TRQ), German version of Tinnitus Questionnaire (TQ), Beck Depression Inventory (BDI), and visual analogue scale (VAS) of tinnitus intensity. Where possible Cohen's d effect size statistic was calculated. Although the quality of evidence for hearing aids' effect on tinnitus is not strong, the weight of evidence (17 research studies for, 1 against) suggests merit in using hearing aids for tinnitus management. The majority of studies reviewed support the use of hearing aids for tinnitus management. Clinicians should feel reassured that some evidence shows support for the use of hearing aids for treating tinnitus, but there is still a need for stronger methodology and randomized control trials. American Academy of Audiology.

NIST System for Measuring the Directivity Index of Hearing Aids under Simulated Real-Ear Conditions.

PubMed

Wagner, Randall P

2013-01-01

The directivity index is a parameter that is commonly used to characterize the performance of directional hearing aids, and is determined from the measured directional response. Since this response is different for a hearing aid worn on a person as compared to when it is in a free field, directivity index measurements of hearing aids are usually done under simulated real-ear conditions. Details are provided regarding the NIST system for measuring the hearing aid directivity index under these conditions and how this system is used to implement a standardized procedure for performing such measurements. This procedure involves a sampling method that utilizes sound source locations distributed in a semi-aligned zone array on an imaginary spherical surface surrounding a standardized acoustical test manikin. The capabilities of the system were demonstrated over the frequency range of one-third-octave bands with center frequencies from 200 Hz to 8000 Hz through NIST participation in an interlaboratory comparison. This comparison was conducted between eight different laboratories of members of Working Group S3/WG48, Hearing Aids, established by Accredited Standards Committee S3, Bioacoustics, which is administered by the Acoustical Society of America and accredited by the American National Standards Institute. Directivity measurements were made for a total of six programmed memories in two different hearing aids and for the unaided manikin with the manikin right pinna accompanying the aids. Omnidirectional, cardioid, and bidirectional response patterns were measured. Results are presented comparing the NIST data with the reference values calculated from the data reported by all participating laboratories.

NIST System for Measuring the Directivity Index of Hearing Aids under Simulated Real-Ear Conditions

PubMed Central

Wagner, Randall P

2013-01-01

The directivity index is a parameter that is commonly used to characterize the performance of directional hearing aids, and is determined from the measured directional response. Since this response is different for a hearing aid worn on a person as compared to when it is in a free field, directivity index measurements of hearing aids are usually done under simulated real-ear conditions. Details are provided regarding the NIST system for measuring the hearing aid directivity index under these conditions and how this system is used to implement a standardized procedure for performing such measurements. This procedure involves a sampling method that utilizes sound source locations distributed in a semi-aligned zone array on an imaginary spherical surface surrounding a standardized acoustical test manikin. The capabilities of the system were demonstrated over the frequency range of one-third-octave bands with center frequencies from 200 Hz to 8000 Hz through NIST participation in an interlaboratory comparison. This comparison was conducted between eight different laboratories of members of Working Group S3/WG48, Hearing Aids, established by Accredited Standards Committee S3, Bioacoustics, which is administered by the Acoustical Society of America and accredited by the American National Standards Institute. Directivity measurements were made for a total of six programmed memories in two different hearing aids and for the unaided manikin with the manikin right pinna accompanying the aids. Omnidirectional, cardioid, and bidirectional response patterns were measured. Results are presented comparing the NIST data with the reference values calculated from the data reported by all participating laboratories. PMID:26401425

Electromagnetic interference of bone-anchored hearing aids by cellular phones.

PubMed

Kompis, M; Negri, S; Häusler, R

2000-10-01

We report a case of electromagnetic interference between a bone-anchored hearing aid (BAHA) and a cellular phone. A 54-year-old women was successfully treated for severe mixed conductive and sensorineural hearing loss with a BAHA. Five years after implantation, the patient experienced a sudden feeling of dizziness, accompanied by a loud buzzing sound and by a sensation of head pressure while examining a digital mobile phone. During a subsequent experiment, the buzzing sound could be reproduced and was identified as electromagnetic interference between the BAHA and digital cellular phones. Seventeen adult BAHA users from our clinic participated in a subsequent survey. Of the 13 patients with some experience of digital cellular phones, 11 reported hearing annoying noises elicited by these devices. However, no other sensation, such as dizziness, was described. Owing to the increasing number of users of both hearing aids and cellular phones, the incidence of electromagnetic interference must be expected to increase as well. Although to date there is no evidence that such interference may be harmful or dangerous to users of conventional or bone-anchored hearing aids, unexpected interference can be a frightening experience.

Ear malformations, hearing loss and hearing rehabilitation in children with Treacher Collins syndrome.

PubMed

Rosa, Francisco; Coutinho, Miguel Bebiano; Ferreira, João Pinto; Sousa, Cecilia Almeida

2016-01-01

The aim of this study was to assess the main ear malformations, hearing loss and auditory rehabilitation in children with Treacher Collins syndrome. We performed a retrospective study of 9 children with Treacher Collins syndrome treated in a central hospital between January 2003 and January 2013. This study showed a high incidence of malformations of the outer and middle ear, such as microtia, atresia or stenosis of the external auditory canal, hypoplastic middle ear cavity, dysmorphic or missing ossicular chain. Most patients had bilateral hearing loss of moderate or high degree. In the individuals studied, there was functional improvement in patients with bone-anchored hearing aids in relation to conventional hearing aids by bone conduction. Treacher Collins syndrome is characterized by bilateral malformations of the outer and middle ear. Hearing rehabilitation in these children is of utmost importance, and bone-anchored hearing aids is the method of choice. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

The Stigma of Hearing Loss

PubMed Central

Wallhagen, Margaret I.

2010-01-01

Purpose: To explore dimensions of stigma experienced by older adults with hearing loss and those with whom they frequently communicate to target interventions promoting engagement and positive aging. Design and Methods: This longitudinal qualitative study conducted interviews over 1 year with dyads where one partner had hearing loss. Participants were naive to or had not worn hearing aids in the past year. Data were analyzed using grounded theory, constant comparative methodology. Results: Perceived stigma emerged as influencing decision-making processes at multiple points along the experiential continuum of hearing loss, such as initial acceptance of hearing loss, whether to be tested, type of hearing aid selected, and when and where hearing aids were worn. Stigma was related to 3 interrelated experiences, alterations in self-perception, ageism, and vanity and was influenced by dyadic relationships and external societal forces, such as health and hearing professionals and media. Implications: Findings are discussed in relation to theoretical perspectives regarding stigma and ageism and suggest the need to destigmatize hearing loss by promoting its assessment and treatment as well as emphasizing the importance of remaining actively engaged to support positive physical and cognitive functioning. PMID:19592638

How to Get Hearing Aids

MedlinePlus

... batteries and hearing aids away from children and pets. We recommend visiting a hearing healthcare professional on a regular basis to have your hearing aids inspected. More in Hearing Aids Hearing Loss Types of Hearing Aids Benefits and Safety Issues Hearing Aids and Cell Phones ...

Hearing in middle age: a population snapshot of 40–69 year olds in the UK

PubMed Central

Dawes, Piers; Fortnum, Heather; Moore, David R.; Emsley, Richard; Norman, Paul; Cruickshanks, Karen; Davis, Adrian; Edmondson-Jones, Mark; McCormack, Abby; Lutman, Mark; Munro, Kevin

2014-01-01

Objective To report population-based prevalence of hearing impairment based on speech recognition in noise testing in a large and inclusive sample of UK adults aged 40 to 69 years. The present study is the first to report such data. Prevalence of tinnitus and use of hearing aids is also reported. Design The research was conducted using the UK Biobank resource. The better-ear unaided speech reception threshold was measured adaptively using the Digit Triplet Test (n = 164,770). Self-report data on tinnitus, hearing aid use, noise exposure as well as demographic variables were collected. Results Overall, 10.7% of adults (95%CI 10.5–10.9%) had significant hearing impairment. Prevalence of tinnitus was 16.9% (95%CI 16.6–17.1%) and hearing aid use was 2.0% (95%CI 1.9–2.1%). Odds of hearing impairment increased with age, with a history of work- and music-related noise exposure, for lower socioeconomic background and for ethnic minority backgrounds. Males were at no higher risk of hearing impairment than females. Conclusion Around 1 in 10 adults aged 40 to 69 years have substantial hearing impairment. The reasons for excess risk of hearing impairment particularly for those from low socioeconomic and ethnic minority backgrounds require identification, as this represents a serious health inequality. The underutilization of hearing aids has altered little since the 1980s, and is a major cause for concern. PMID:24518430

Historical background of bone conduction hearing devices and bone conduction hearing aids.

PubMed

Mudry, Albert; Tjellström, Anders

2011-01-01

During the last 20 years, bone-anchored hearing aids (Baha(®)) became a familiar solution in the treatment of some types of hearing loss. The aim of this chapter is to present the different historical steps which have permitted the production of this new bone conduction hearing device. The recognition of bone conduction hearing is old and was known at least in Antiquity. During the Renaissance, Girolamo Cardano demonstrated a method by which sound may be transmitted to the ear by means of a rod or the shaft of a spear held between one's teeth: this was the beginning of teeth stimulators to improve hearing, firstly in connection with a musical instrument and then, in the second part of the 19th century, with the speaker. The development of the carbon microphone at the beginning of the 20th century allowed the construction of the bone conduction vibrator placed on the mastoid area, notably supported by eyeglasses since the 1950s. Confronted by various problems, and notably the loss of part of sound in the soft tissue of the external mastoid, the idea to implant the vibrator into the mastoid bone was developed in Göteborg, and the first Baha was implanted in 1977 by Anders Tjellström. From that date, various improvements allowed the development of the actual Baha. These different steps are presented in this study, supported by original documentation. Copyright © 2011 S. Karger AG, Basel.

Are two ears not better than one?

PubMed

McArdle, Rachel A; Killion, Mead; Mennite, Monica A; Chisolm, Theresa H

2012-03-01

The decision to fit one or two hearing aids in individuals with binaural hearing loss has been debated for years. Although some 78% of U.S. hearing aid fittings are binaural (Kochkin , 2010), Walden and Walden (2005) presented data showing that 82% (23 of 28 patients) of their sample obtained significantly better speech recognition in noise scores when wearing one hearing aid as opposed to two. To conduct two new experiments to fuel the monaural/binaural debate. The first experiment was a replication of Walden and Walden (2005), whereas the second experiment examined the use of binaural cues to improve speech recognition in noise. A repeated measures experimental design. Twenty veterans (aged 59-85 yr), with mild to moderately severe binaurally symmetrical hearing loss who wore binaural hearing aids were recruited from the Audiology Department at the Bay Pines VA Healthcare System. Experiment 1 followed the procedures of the Walden and Walden study, where signal-to-noise ratio (SNR) loss was measured using the Quick Speech-in-Noise (QuickSIN) test on participants who were aided with their current hearing aids. Signal and noise were presented in the sound booth at 0° azimuth under five test conditions: (1) right ear aided, (2) left ear aided, (3) both ears aided, (4) right ear aided, left ear plugged, and (5) unaided. The opposite ear in (1) and (2) was left open. In Experiment 2, binaural Knowles Electronics Manikin for Acoustic Research (KEMAR) manikin recordings made in Lou Malnati's pizza restaurant during a busy period provided a typical real-world noise, while prerecorded target sentences were presented through a small loudspeaker located in front of the KEMAR manikin. Subjects listened to the resulting binaural recordings through insert earphones under the following four conditions: (1) binaural, (2) diotic, (3) monaural left, and (4) monaural right. Results of repeated measures ANOVAs demonstrated that the best speech recognition in noise performance was obtained by most participants with both ears aided in Experiment 1 and in the binaural condition in Experiment 2. In both experiments, only 20% of our subjects did better in noise with a single ear, roughly similar to the earlier Jerger et al (1993) finding that 8-10% of elderly hearing aid users preferred one hearing aid. American Academy of Audiology.

A Randomized Control Trial: Supplementing Hearing Aid Use with Listening and Communication Enhancement (LACE) Auditory Training.

PubMed

Saunders, Gabrielle H; Smith, Sherri L; Chisolm, Theresa H; Frederick, Melissa T; McArdle, Rachel A; Wilson, Richard H

2016-01-01

To examine the effectiveness of the Listening and Communication Enhancement (LACE) program as a supplement to standard-of-care hearing aid intervention in a Veteran population. A multisite randomized controlled trial was conducted to compare outcomes following standard-of-care hearing aid intervention supplemented with (1) LACE training using the 10-session DVD format, (2) LACE training using the 20-session computer-based format, (3) placebo auditory training (AT) consisting of actively listening to 10 hr of digitized books on a computer, and (4) educational counseling-the control group. The study involved 3 VA sites and enrolled 279 veterans. Both new and experienced hearing aid users participated to determine if outcomes differed as a function of hearing aid user status. Data for five behavioral and two self-report measures were collected during three research visits: baseline, immediately following the intervention period, and at 6 months postintervention. The five behavioral measures were selected to determine whether the perceptual and cognitive skills targeted in LACE training generalized to untrained tasks that required similar underlying skills. The two self-report measures were completed to determine whether the training resulted in a lessening of activity limitations and participation restrictions. Outcomes were obtained from 263 participants immediately following the intervention period and from 243 participants 6 months postintervention. Analyses of covariance comparing performance on each outcome measure separately were conducted using intervention and hearing aid user status as between-subject factors, visit as a within-subject factor, and baseline performance as a covariate. No statistically significant main effects or interactions were found for the use of LACE on any outcome measure. Findings from this randomized controlled trial show that LACE training does not result in improved outcomes over standard-of-care hearing aid intervention alone. Potential benefits of AT may be different than those assessed by the performance and self-report measures utilized here. Individual differences not assessed in this study should be examined to evaluate whether AT with LACE has any benefits for particular individuals. Clinically, these findings suggest that audiologists may want to temper the expectations of their patients who embark on LACE training.

A Qualitative Case Study of Smartphone-Connected Hearing Aids: Influences on Patients, Clinicians, and Patient-Clinician Interactions.

PubMed

Ng, Stella L; Phelan, Shanon; Leonard, MaryAnn; Galster, Jason

2017-06-01

Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients' needs, and attentive to society's influence. The authors aimed to understand how new innovations influence clinician and patient experiences, through a study focusing on connected hearing aids. "Connected" refers to the wireless functional connection of hearing aids with everyday technologies like mobile phones and tablets. The authors used a qualitative collective case study methodology, borrowing from constructivist grounded theory for data collection and analysis methods. Specifically, the authors designed a collective case study of a connected hearing aid and smartphone application, composed of two cases of experience with the innovation: the case of clinician experiences, and the case of patient experiences. The qualitative sampling methods employed were case sampling, purposive within-case sampling, and theoretical sampling, and culminated in a total collective case n = 19 (clinician case n = 8; patient case n = 11). These data were triangulated with a supplementary sample of ten documents: relevant news and popular media collected during the study time frame. The authors conducted interviews with the patients and clinicians, and analyzed the interview and document data using the constant comparative method. The authors compared their two cases by looking at trends within, between, and across cases. The clinician case highlighted clinicians' heuristic-based candidacy judgments in response to the adoption of the connected hearing aids into their practice. The patient case revealed patients' perceptions of themselves as technologically competent or incompetent, and descriptions of how they learned to use the new technology. Between cases, the study found a difference in the response to how the connected hearing aid changed the clinician-patient relationship. While clinicians valued the increased time they spent "getting to know" their patients, patients experienced some frustration specific to the additional troubleshooting related to Bluetooth connectivity. Across cases, there was a resounding theme of "normalization" of hearing aids via their integration with a "normal" technology (mobile phones) and general lack of concern about privacy in relation to the smartphone application and its tracking and geotagging features. Both audiologists and patients credited the connected hearing aids with increased opportunities to participate more fully in everyday life. The introduction of smartphone-connected hearing aids influenced the identities and candidate profiles of hearing aid users, and the nature of time spent in clinical interactions, in important and interesting ways. The influence of connected hearing aids on patient experience and audiology practice calls for continued research and clinical consideration, with implications for clinical decision-making regarding hearing aid candidacy. Further study should look critically at normalization and possible unintended stigmatizing effects of making hearing aids increasingly discreet. American Academy of Audiology

DSL prescriptive targets for bone conduction devices: adaptation and comparison to clinical fittings.

PubMed

Hodgetts, William E; Scollie, Susan D

2017-07-01

To develop an algorithm that prescribes targets for bone conduction frequency response shape, compression, and output limiting, along with a clinical method that ensures accurate transforms between assessment and verification stages of the clinical workflow. Technical report of target generation and validation. We recruited 39 adult users of unilateral percutaneous bone conduction hearing aids with a range of unilateral, bilateral, mixed and conductive hearing losses across the sample. The initial algorithm over-prescribed output compared to the user's own settings in the low frequencies, but provided a good match to user settings in the high frequencies. Corrections to the targets were derived and implemented as a low-frequency cut aimed at improving acceptance of the wearer's own voice during device use. The DSL-BCD prescriptive algorithm is compatible with verification of devices and fine-tuning to target for percutaneous bone conduction hearing devices that can be coupled to a skull simulator. Further study is needed to investigate the appropriateness of this prescriptive algorithm for other input levels, and for other clinical populations including those with single-sided deafness, bilateral devices, children and users of transcutaneous bone conduction hearing aids.

Decision-making and outcomes of hearing help-seekers: A self-determination theory perspective.

PubMed

Ridgway, Jason; Hickson, Louise; Lind, Christopher

2016-07-01

To explore the explanatory power of a self-determination theory (SDT) model of health behaviour change for hearing aid adoption decisions and fitting outcomes. A quantitative approach was taken for this longitudinal cohort study. Participants completed questionnaires adapted from SDT that measured autonomous motivation, autonomy support, and perceived competence for hearing aids. Hearing aid fitting outcomes were obtained with the international outcomes inventory for hearing aids (IOI-HA). Sociodemographic and audiometric information was collected. Participants were 216 adult first-time hearing help-seekers (125 hearing aid adopters, 91 non-adopters). Regression models assessed the impact of autonomous motivation and autonomy support on hearing aid adoption and hearing aid fitting outcomes. Sociodemographic and audiometric factors were also taken into account. Autonomous motivation, but not autonomy support, was associated with increased hearing aid adoption. Autonomy support was associated with increased perceived competence for hearing aids, reduced activity limitation and increased hearing aid satisfaction. Autonomous motivation was positively associated with hearing aid satisfaction. The SDT model is potentially useful in understanding how hearing aid adoption decisions are made, and how hearing health behaviour is internalized and maintained over time. Autonomy supportive practitioners may improve outcomes by helping hearing aid adopters maintain internalized change.

Binaural Hearing Ability With Bilateral Bone Conduction Stimulation in Subjects With Normal Hearing: Implications for Bone Conduction Hearing Aids.

PubMed

Zeitooni, Mehrnaz; Mäki-Torkko, Elina; Stenfelt, Stefan

The purpose of this study is to evaluate binaural hearing ability in adults with normal hearing when bone conduction (BC) stimulation is bilaterally applied at the bone conduction hearing aid (BCHA) implant position as well as at the audiometric position on the mastoid. The results with BC stimulation are compared with bilateral air conduction (AC) stimulation through earphones. Binaural hearing ability is investigated with tests of spatial release from masking and binaural intelligibility level difference using sentence material, binaural masking level difference with tonal chirp stimulation, and precedence effect using noise stimulus. In all tests, results with bilateral BC stimulation at the BCHA position illustrate an ability to extract binaural cues similar to BC stimulation at the mastoid position. The binaural benefit is overall greater with AC stimulation than BC stimulation at both positions. The binaural benefit for BC stimulation at the mastoid and BCHA position is approximately half in terms of decibels compared with AC stimulation in the speech based tests (spatial release from masking and binaural intelligibility level difference). For binaural masking level difference, the binaural benefit for the two BC positions with chirp signal phase inversion is approximately twice the benefit with inverted phase of the noise. The precedence effect results with BC stimulation at the mastoid and BCHA position are similar for low frequency noise stimulation but differ with high-frequency noise stimulation. The results confirm that binaural hearing processing with bilateral BC stimulation at the mastoid position is also present at the BCHA implant position. This indicates the ability for binaural hearing in patients with good cochlear function when using bilateral BCHAs.

Restoration of hearing by hearing aids: conventional hearing aids – implantable hearing aids – cochlear implants – auditory brainstem implants

PubMed Central

Leuwer, R.; Müller, J.

2005-01-01

Aim of this report is to explain the current concept of hearing restoration using hearing aids. At present the main issues of conventional hearing aids are the relative benefits of analogue versus digital devices and different strategies for the improvement of hearing in noise. Implantable hearing aids provide a better sound quality and less distortion. The lack of directional microphones is the major disadvantage of the partially implantable hearing aids commercially available. Two different clinical studies about fully implantable hearing aids have been started in 2004. One of the most-promising developments seems to be the electric-acoustic stimulation. PMID:22073051

The Master Hearing Aid

PubMed Central

Curran, James R.

2013-01-01

As early as the 1930s the term Master Hearing Aid (MHA) described a device used in the fitting of hearing aids. In their original form, the MHA was a desktop system that allowed for simulated or actual adjustment of hearing aid components that resulted in a changed hearing aid response. Over the years the MHA saw many embodiments and contributed to a number of rationales for the fitting of hearing aids. During these same years, the MHA was viewed by many as an inappropriate means of demonstrating hearing aids; the audio quality of the desktop systems was often superior to the hearing aids themselves. These opinions and the evolution of the MHA have molded the modern perception of hearing aids and the techniques used in the fitting of hearing aids. This article reports on a history of the MHA and its influence on the fitting of hearing aids. PMID:23686682

Client labor: adults with hearing impairment describing their participation in their hearing help-seeking and rehabilitation.

PubMed

Knudsen, Line V; Nielsen, Claus; Kramer, Sophia E; Jones, Lesley; Laplante-Lévesque, Ariane

2013-03-01

The uptake and use of hearing aids is low compared to the prevalence of hearing impairment. People who seek help and take part in a hearing aid rehabilitation process participate actively in this process in several ways. In order to gain more knowledge on the challenges of hearing help-seeking and hearing aid use, this qualitative study sought to understand the ways that people with hearing impairment describe themselves as active participants throughout the hearing aid rehabilitation process. In this qualitative interview study we examined the hearing rehabilitation process from the perspective of the hearing impaired. In this article we describe how the qualitative interview material was interpreted by a pragmatic qualitative thematic analysis. The analysis described in this article focused on the efforts, initiatives, actions, and participation the study participants described that they had engaged in during their rehabilitation. Interviews were conducted with people with hearing impairment in Australia, Denmark, the United Kingdom, and the United States. The 34 interview participants were distributed equally between the sites, just as men and women were almost equally represented (56% women). The average age of the participants was 64. All participants had a hearing impairment in at least one ear. The participants were recruited to represent a range of experiences with hearing help-seeking and rehabilitation. With each participant one qualitative semistructured interview ranging between 1 and 2 hr was carried out. The interviews were transcribed verbatim, read through several times, and themes were identified, defined, and reviewed by an iterative process. From this thematic focus a concept called "client labor" has emerged. Client labor contains nine subthemes divided into three overarching groups: cognitive labor, emotional labor, and physical labor. The participants' experiences and meaning-making related to these conceptual types of efforts is described. The study findings have implications for the clinical encounter between people with hearing impairment and hearing health-care professionals. We suggest that a patient-centered approach that bears in mind the client's active participation could help toward improving clinical dispensing, fitting, and counseling practices with the end goal to increase hearing aid benefit and satisfaction. American Academy of Audiology.

Hearing Aid Assembly

NASA Technical Reports Server (NTRS)

Grugel, Richard N. (Inventor)

2002-01-01

Progress in hearing aids has come a long way. Yet despite such progress hearing aids are not the perfect answer to many hearing problems. Some adult ears cannot accommodate tightly fitting hearing aids. Mouth movements such as chewing, talking, and athletic or other active endeavors also lead to loosely fitting ear molds. It is well accepted that loosely fitting hearing aids are the cause of feedback noise. Since feedback noise is the most common complaint of hearing aid wearers it has been the subject of various patents. Herein a hearing aid assembly is provided eliminating feedback noise. The assembly includes the combination of a hearing aid with a headset developed to constrict feedback noise.

Item Response Theory Applied to Factors Affecting the Patient Journey Towards Hearing Rehabilitation

PubMed Central

Chenault, Michelene; Berger, Martijn; Kremer, Bernd; Anteunis, Lucien

2016-01-01

To develop a tool for use in hearing screening and to evaluate the patient journey towards hearing rehabilitation, responses to the hearing aid rehabilitation questionnaire scales aid stigma, pressure, and aid unwanted addressing respectively hearing aid stigma, experienced pressure from others; perceived hearing aid benefit were evaluated with item response theory. The sample was comprised of 212 persons aged 55 years or more; 63 were hearing aid users, 64 with and 85 persons without hearing impairment according to guidelines for hearing aid reimbursement in the Netherlands. Bias was investigated relative to hearing aid use and hearing impairment within the differential test functioning framework. Items compromising model fit or demonstrating differential item functioning were dropped. The aid stigma scale was reduced from 6 to 4, the pressure scale from 7 to 4, and the aid unwanted scale from 5 to 4 items. This procedure resulted in bias-free scales ready for screening purposes and application to further understand the help-seeking process of the hearing impaired. PMID:28028428

Analysis of Performance on Cognitive Test Measures Before, During, and After 6 Months of Hearing Aid Use: A Single-Subject Experimental Design.

PubMed

Desjardins, Jamie L

2016-06-01

The present study examined the effect of hearing aid use on cognitive test performance using a single-subject treatment design. Six participants 54 to 64 years old with sensorineural hearing loss were fitted with hearing aids. Participants used the hearing aids for approximately 8 hr each day for the duration of the study. A battery of cognitive tests was administered to participants during baseline (pre-hearing aid fitting), treatment (hearing aid use), and withdrawal (post-hearing aid use) study phases over a period of 6 months of hearing aid use. All participants showed significant improvements in performance on the cognitive test measures with hearing aid use. The most significant treatment effects were evidenced at 2 to 4 weeks of hearing aid use on the Listening Span Test and an auditory selective attention task. In many cases, cognitive performance scores returned to baseline levels after the participant stopped using the hearing aids. The findings from this study are consistent with the hypothesis that hearing aid use may improve cognitive performance by improving audibility and decreasing the cognitive load of the listening task.

Bone anchored hearing aid: an evidence-based analysis.

PubMed

2002-01-01

The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of bone-anchored hearing aid (BAHA) in improving the hearing of people with conduction or mixed hearing loss. The (BAHA) is a bone conduction hearing device that includes a titanium fixture permanently implanted into the mastoid bone of the skull and an external percutaneous sound processor. The sound processor is attached to the fixture by means of a skin penetrating abutment. Because the device bypasses the middle ear and directly stimulates the cochlea, it has been recommended for individuals with conduction hearing loss or discharging middle ear infection. The titanium implant is expected to last a lifetime while the external sound processor is expected to last 5 years. The total initial device cost is approximately $5,300 and the external sound processor costs approximately $3,500. REVIEW OF BAHA BY THE MEDICAL ADVISORY SECRETARIAT: The Medical Advisory Secretariat's review is a descriptive synthesis of findings from 36 research articles published between January 1990 and May 2002. No randomized controlled studies were found. The evidence was derived from level 4 case series with relative small sample sizes (ranging from 30-188). The majority of the studies have follow-up periods of eight years or longer. All except one study were based on monaural BAHA implant on the side with the best bone conduction threshold. Level 4 evidence showed that BAHA has been be implanted safely in adults and children with success rates of 90% or higher in most studies. No mortality or life threatening morbidity has been reported. Revision rates for tissue reduction or resiting were generally under 10% for adults but have been reported to be as high as 25% in pediatric studies. Adverse skin reaction around the skin penetration site was the most common complication reported. Most of these conditions were successfully treated with antibiotics, and only 1% to 2% required surgical revision. Less than 1% required removal of the fixture. Other complications included failure to osseointegrate and loss of fixture and/or abutment due to trauma or infection. Studies showed that BAHAs were implanted in people who have conduction or mixed hearing loss, congenital atresia or suppurative otitis media who were not candidates for surgical repair, and who cannot use conventional bone conduction hearing aids. The need for BAHA is not age- related. Objective audiometric measures and subjective patient satisfaction surveys showed that BAHA significantly improved the unaided and aided free field and sound field thresholds as well as speech discrimination in quiet and in noise for former users of conventional bone conduction hearing aids. The outcomes were ambiguous for former users of air conduction hearing aids. BAHA has been shown to reduce the frequency of ear infection and reduce the discharge particularly among patients with suppurative otitis media. Patients have reported that BAHA improved their quality of life. Reported benefits were improved speech intelligibility, better sound comfort, less pressure on the head, less skin irritation, greater cosmetic acceptance and increase in confidence. Main reported shortcomings were wind noise, feedback and difficulty in using the telephone. Experts and the BAHA manufacturer recommended that recipients of a BAHA implant be at least 5 years old. Challenges associated with the implantation of BAHA in pediatric patients include thin bone, soft bone, higher rates of fixture loss due to trauma, psychological problems, and higher revision rates due to rapid bone growth. The overall outcomes are comparable to adult BAHA. The benefits of pediatric BAHA (e.g. on speech development) appear to outweigh the disadvantages. Screening according to strict eligibility criteria, preoperative counselling, close monitoring by a physician with BAHA expertise and on-going follow-up were identified as critical factors for long-term implant survival. Examples of eligibility criteria were provided. No literature on cost-effectiveness of BAHA was found.

Teaching severely multihandicapped students to put on their own hearing aids.

PubMed Central

Tucker, D J; Berry, G W

1980-01-01

Two experiments were conducted with six severely multihandicapped students with hearing impairments to: (a) train the six students to put on their own hearing aids independently, and (b) provide an empirical evaluation of a comprehensive instructional program for putting on a hearing aid by assessing acquisition, maintenance, and generalization of that skill across environments. All six students acquired the skill rapidly, with two students requiring remedial training on one step of the program. Because for two of the original three students the newly learned skill failed initially to generalize to other environments, a second experiment was initiated to assess generalization across environments as well as to replicate the efficiency of the acquisition program. When a variation of the multiple-probe baseline technique was used, the behavior of three additional students generalized to other settings without direct training in those settings. PMID:6444931

Factors Influencing Hearing Aid Use in the Classroom: A Pilot Study.

PubMed

Gustafson, Samantha J; Davis, Hilary; Hornsby, Benjamin W Y; Bess, Fred H

2015-12-01

This pilot study examined factors influencing classroom hearing aid use in school-age children with hearing loss. The research team visited classrooms of 38 children with mild-to-moderate hearing loss (Grades 1-7) on 2 typical school days, twice per day, to document hearing aid use. In addition, parents reported the number of hours their children used hearing aids at school. Nearly 24% of children were observed not wearing their hearing aids in the classroom on either observation day. Both grade level and degree of hearing loss appeared to affect hearing aid use. Children in Grades 5-7 and those with milder hearing losses were less likely to wear hearing aids. Overall, parents accurately reported classroom hearing aid use; however, those with children in Grades 5-7 were less accurate than those with children in earlier grades. These preliminary results suggest that children with milder hearing loss and those in Grades 5-7 are at increased risk for reduced hearing aid use in the classroom. Also, parents of school-age children in these later grades are less accurate reporters of classroom hearing aid use compared to parents of children in earlier grades.

Encoding of speech sounds at auditory brainstem level in good and poor hearing aid performers.

PubMed

Shetty, Hemanth Narayan; Puttabasappa, Manjula

Hearing aids are prescribed to alleviate loss of audibility. It has been reported that about 31% of hearing aid users reject their own hearing aid because of annoyance towards background noise. The reason for dissatisfaction can be located anywhere from the hearing aid microphone till the integrity of neurons along the auditory pathway. To measure spectra from the output of hearing aid at the ear canal level and frequency following response recorded at the auditory brainstem from individuals with hearing impairment. A total of sixty participants having moderate sensorineural hearing impairment with age range from 15 to 65 years were involved. Each participant was classified as either Good or Poor Hearing aid Performers based on acceptable noise level measure. Stimuli /da/ and /si/ were presented through loudspeaker at 65dB SPL. At the ear canal, the spectra were measured in the unaided and aided conditions. At auditory brainstem, frequency following response were recorded to the same stimuli from the participants. Spectrum measured in each condition at ear canal was same in good hearing aid performers and poor hearing aid performers. At brainstem level, better F 0 encoding; F 0 and F 1 energies were significantly higher in good hearing aid performers than in poor hearing aid performers. Though the hearing aid spectra were almost same between good hearing aid performers and poor hearing aid performers, subtle physiological variations exist at the auditory brainstem. The result of the present study suggests that neural encoding of speech sound at the brainstem level might be mediated distinctly in good hearing aid performers from that of poor hearing aid performers. Thus, it can be inferred that subtle physiological changes are evident at the auditory brainstem in a person who is willing to accept noise from those who are not willing to accept noise. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

21 CFR 874.3305 - Wireless air-conduction hearing aid.

Code of Federal Regulations, 2013 CFR

2013-04-01

...-amplifying device, intended to compensate for impaired hearing that incorporates wireless technology in its...: (1) Appropriate analysis/testing should validate electro magnetic compatibility (EMC) and safety of... technology functions; and (3) Labeling should specify appropriate instructions, warnings, and information...

Active transcutaneous bone conduction implant: audiological results in paediatric patients with bilateral microtia associated with external auditory canal atresia.

PubMed

Bravo-Torres, Sofía; Der-Mussa, Carolina; Fuentes-López, Eduardo

2018-01-01

To describe, in terms of functional gain and word recognition, the audiological results of patients under 18 years of age implanted with the active bone conduction implant, Bonebridge™. Retrospective case studies conducted by reviewing the medical records of patients receiving implants between 2014 and 2016 in the public health sector in Chile. All patients implanted with the Bonebridge were included (N = 15). Individuals who had bilateral conductive hearing loss, secondary to external ear malformations, were considered as candidates. The average hearing threshold one month after switch on was 25.2 dB (95%CI 23.5-26.9). Hearing thresholds between 0.5 and 4 kHz were better when compared with bone conduction hearing aids. Best performance was observed at 4 kHz, where improvements to hearing were observed throughout the adaptation process. There was evidence of a significant increase in the recognition of monosyllables. The Bonebridge implant showed improvements to hearing thresholds and word recognition in paediatric patients with congenital conductive hearing loss.

Hearing aid fine-tuning based on Dutch descriptions.

PubMed

Thielemans, Thijs; Pans, Donné; Chenault, Michelene; Anteunis, Lucien

2017-07-01

The aim of this study was to derive an independent fitting assistant based on expert consensus. Two questions were asked: (1) what (Dutch) terms do hearing impaired listeners use nowadays to describe their specific hearing aid fitting problems? (2) What is the expert consensus on how to resolve these complaints by adjusting hearing aid parameters? Hearing aid dispensers provided descriptors that impaired listeners use to describe their reactions to specific hearing aid fitting problems. Hearing aid fitting experts were asked "How would you adjust the hearing aid if its user reports that the aid sounds…?" with the blank filled with each of the 40 most frequently mentioned descriptors. 112 hearing aid dispensers and 15 hearing aid experts. The expert solution with the highest weight value was considered the best solution for that descriptor. Principal component analysis (PCA) was performed to identify a factor structure in fitting problems. Nine fitting problems could be identified resulting in an expert-based, hearing aid manufacturer independent, fine-tuning fitting assistant for clinical use. The construction of an expert-based, hearing aid manufacturer independent, fine-tuning fitting assistant to be used as an additional tool in the iterative fitting process is feasible.

[Digital vs. analog hearing aids for children. Is there a method for making an objective comparison possible?].

PubMed

Prinz, I; Nubel, K; Gross, M

2002-09-01

Until now, the assumed benefits of digital hearing aids are reflected only in subjective descriptions by patients with hearing aids, but cannot be documented adequately by routine diagnostic methods. Seventeen schoolchildren with moderate severe bilateral symmetrical sensorineural hearing loss were examined in a double-blinded crossover study. Differences in performance between a fully digital hearing aid (DigiFocus compact/Oticon) and an analogous digitally programmable two-channel hearing aid were evaluated. Of the 17 children, 13 choose the digital and 4 the analogous hearing aid. In contrast to the clear subjective preferences for the fully digital hearing aid, we could not obtain any significant results with routine diagnostic methods. Using the "virtual hearing aid," a subjective comparison and speech recognition performance task yielded significant differences. The virtual hearing aid proved to be suitable for a direct comparison of different hearing aids and can be used for double-blind testing in a pediatric population.

Management of Children Using Cochlear Implants and Hearing Aids.

ERIC Educational Resources Information Center

Ching, Teresa Y. C.; Psarros, Colleen; Incerti, Paula; Hill, Mandy

2001-01-01

Four case studies identify six factors affecting successful use of a hearing aid with a cochlear implant: duration of hearing aid use prior to implantation, amount of residual hearing in the non-implanted ear, educational and listening demands, cosmetic issues, hearing aid rejection, and extended period of non-use of hearing aid. (Contains…

The psychosocial impact of hearing aids in children with otitis media with effusion.

PubMed

Qureishi, A; Garas, G; Mallick, A; Parker, D

2014-11-01

In children, otitis media with effusion is treated using grommets or hearing aids. Parents considering treatment options express concerns regarding the psychosocial impact of hearing aids in terms of self-esteem and bullying. This study assessed the psychosocial impact of hearing aid use. A cross-sectional study was undertaken comparing hearing aid users to non hearing aid users with regard to their attitudes towards hearing aids. All subjects, who had been diagnosed with otitis media with effusion, were aged less than 16 years, were without disability and attended mainstream schools. A questionnaire was designed and utilised. The study comprised 47 children with hearing aids and 50 with grommets. Significant between-group differences (p < 0.05) were noted with regard to perceptions related to bullying, feelings of inadequacy and embarrassment. The overall negative perceptions of non hearing aid users were not reported by hearing aid users. Children with hearing aids do not suffer from bullying or low self-esteem to the extent perceived by parents. This information is useful for informed decisions regarding treatment of otitis media with effusion.

Students' Attitudes toward the Use of Hearing Aids in Al-Ahsa, Kingdom of Saudi Arabia

ERIC Educational Resources Information Center

Alodail, Abdullah Kholifh

2011-01-01

Hearing aid devices are worn within people's ears to help them hear the sounds around them. Teachers have to accept the use of hearing aids in the classroom as a device to assist students with hearing loss (Plumley, 2008). Further study is helpful to hearing aid research because it demonstrates the importance of hearing aid benefit awareness in…

Better together: reduced compliance after sequential versus simultaneous bilateral hearing aids fitting.

PubMed

Lavie, Limor; Banai, Karen; Attias, Joseph; Karni, Avi

2014-03-01

The purpose of this study was to determine the effects of sequential versus simultaneous bilateral hearing aids fitting on patient compliance. Thirty-six older adults with hearing impairment participated in this study. Twelve were fitted with bilateral hearing aids simultaneously. The remaining participants were fitted sequentially: One hearing aid (to the left or to the right ear) was used initially; 1 month later, the other ear was also fitted with a hearing aid for bilateral use. Self-reports on usefulness and compliance were elicited after the first and second months of hearing aid use. In addition, the number of hours the hearing aids were used was extracted from the data loggings of each device. Simultaneous fitting resulted in high levels of compliance and consistent usage throughout the study period. Sequential fitting resulted in abrupt reduction in compliance and hours of use once the second hearing aid was added, both in the clinical scoring and in the data loggings. Simultaneous fitting of bilateral hearing aids results in better compliance compared with sequential fitting. The addition of a second hearing aid after a relatively short period of monaural use may lead to inconsistent use of both hearing aids.

State of the art in perceptual design of hearing aids

NASA Astrophysics Data System (ADS)

Edwards, Brent W.; van Tasell, Dianne J.

2002-05-01

Hearing aid capabilities have increased dramatically over the past six years, in large part due to the development of small, low-power digital signal processing chips suitable for hearing aid applications. As hearing aid signal processing capabilities increase, there will be new opportunities to apply perceptually based knowledge to technological development. Most hearing loss compensation techniques in today's hearing aids are based on simple estimates of audibility and loudness. As our understanding of the psychoacoustical and physiological characteristics of sensorineural hearing loss improves, the result should be improved design of hearing aids and fitting methods. The state of the art in hearing aids will be reviewed, including form factors, user requirements, and technology that improves speech intelligibility, sound quality, and functionality. General areas of auditory perception that remain unaddressed by current hearing aid technology will be discussed.

Web-based auditory self-training system for adult and elderly users of hearing aids.

PubMed

Vitti, Simone Virginia; Blasca, Wanderléia Quinhoneiro; Sigulem, Daniel; Torres Pisa, Ivan

2015-01-01

Adults and elderly users of hearing aids suffer psychosocial reactions as a result of hearing loss. Auditory rehabilitation is typically carried out with support from a speech therapist, usually in a clinical center. For these cases, there is a lack of computer-based self-training tools for minimizing the psychosocial impact of hearing deficiency. To develop and evaluate a web-based auditory self-training system for adult and elderly users of hearing aids. Two modules were developed for the web system: an information module based on guidelines for using hearing aids; and an auditory training module presenting a sequence of training exercises for auditory abilities along the lines of the auditory skill steps within auditory processing. We built aweb system using PHP programming language and a MySQL database .from requirements surveyed through focus groups that were conducted by healthcare information technology experts. The web system was evaluated by speech therapists and hearing aid users. An initial sample of 150 patients at DSA/HRAC/USP was defined to apply the system with the inclusion criteria that: the individuals should be over the age of 25 years, presently have hearing impairment, be a hearing aid user, have a computer and have internet experience. They were divided into two groups: a control group (G1) and an experimental group (G2). These patients were evaluated clinically using the HHIE for adults and HHIA for elderly people, before and after system implementation. A third web group was formed with users who were invited through social networks for their opinions on using the system. A questionnaire evaluating hearing complaints was given to all three groups. The study hypothesis considered that G2 would present greater auditory perception, higher satisfaction and fewer complaints than G1 after the auditory training. It was expected that G3 would have fewer complaints regarding use and acceptance of the system. The web system, which was named SisTHA portal, was finalized, rated by experts and hearing aid users and approved for use. The system comprised auditory skills training along five lines: discrimination; recognition; comprehension and temporal sequencing; auditory closure; and cognitive-linguistic and communication strategies. Users needed to undergo auditory training over a minimum period of 1 month: 5 times a week for 30 minutes a day. Comparisons were made between G1 and G2 and web system use by G3. The web system developed was approved for release to hearing aid users. It is expected that the self-training will help improve effective use of hearing aids, thereby decreasing their rejection.

Hearing Aids and Hearing Impaired Students in Rural Schools.

ERIC Educational Resources Information Center

Woodford, Charles

This paper describes functions of the components of hearing aids and provides a detailed procedure to detect hearing aid dysfunctions. The most common type of hearing aids for school children are the behind the ear type. Various hearing aid components change sound into an electrical signal, which is amplified and adjusted by a volume control. The…

Autonomous motivation is associated with hearing aid adoption.

PubMed

Ridgway, Jason; Hickson, Louise; Lind, Christopher

2015-07-01

To use the self-determination theory of motivation to investigate whether different forms of motivation were associated with adults' decisions whether or not to adopt hearing aids. A quantitative approach was used in this cohort study. Participants completed the treatment self-regulation questionnaire (TSRQ), which measured autonomous and controlled motivation for hearing aid adoption. Sociodemographic data and audiometric information were also obtained. Participants were 253 adults who had sought information about their hearing but had not consulted with a hearing professional. Participants were categorized as hearing aid adopters if they had been fitted with hearing aids 4-6 months after completing the TSRQ, and as non-adopters if they had not. Multivariate logistic regression was used to examine associations between autonomous and controlled motivation, sociodemographic and audiometric variables, and hearing aid adoption (n = 160). Three factors were significantly associated with increased hearing aid adoption when the influence of other variables was accounted for: autonomous motivation, perceived hearing difficulty, and poorer hearing. Controlled motivation was not found to influence hearing aid adoption. These empirical findings that link autonomous motivation to decisions of hearing help-seekers have implications for the ways practitioners may evaluate motivation and could inform discussions with clients about hearing aid adoption.

Buying a Hearing Aid

MedlinePlus

... hearing aids? Federal regulation prohibits any hearing aid sale unless the buyer has first received a physician’s ... care of your hearing aids and other helpful strategies. How should I begin wearing the aids? Start ...

Sounds perceived as annoying by hearing-aid users in their daily soundscape.

PubMed

Skagerstrand, Åsa; Stenfelt, Stefan; Arlinger, Stig; Wikström, Joel

2014-04-01

The noises in modern soundscapes continue to increase and are a major origin for annoyance. For a hearing-impaired person, a hearing aid is often beneficial, but noise and annoying sounds can result in non-use of the hearing aid, temporary or permanently. The purpose of this study was to identify annoying sounds in a daily soundscape for hearing-aid users. A diary was used to collect data where the participants answered four questions per day about annoying sounds in the daily soundscape over a two-week period. Sixty adult hearing-aid users. Of the 60 participants 91% experienced annoying sounds daily when using hearing aids. The annoying sound mentioned by most users, was verbal human sounds, followed by other daily sound sources categorized into 17 groups such as TV/radio, vehicles, and machine tools. When the hearing-aid users were grouped in relation to age, hearing loss, gender, hearing-aid experience, and type of signal processing used in their hearing aids, small and only few significant differences were found when comparing their experience of annoying sounds. The results indicate that hearing-aid users often experience annoying sounds and improved clinical fitting routines may reduce the problem.

Factors affecting the use and perceived benefit of ITE and BTE hearing aids.

PubMed

Baumfield, A; Dillon, H

2001-08-01

The aim of the present study was to investigate factors that might affect hearing aid use, satisfaction and perceived benefit. A further aim was to look at which variables affect the choice of hearing aid, in particular, an in-the-ear (ITE) versus a behind-the-ear (BTE) device. Twenty-nine elderly hearing-impaired people with a mild-to-moderate hearing loss were fitted with both an ITE and a BTE hearing aid with similar electroacoustic performance. Both hearing aids were linear with output compression limiting and were fitted in a randomized order. After wearing each device for a six-week period, subj ets were asked to select the hearing aid they preferred. Variables significantly related to hearing aid choice, use and perceived benefit included ease of management, accuracy with which the NAL-R insertion gain target was achieved, earmould comfort and the type of hearing aid the client preferred initially.

A Historical Perspective on Digital Hearing Aids: How Digital Technology Has Changed Modern Hearing Aids

PubMed Central

Levitt, Harry

2007-01-01

This article provides the author's perspective on the development of digital hearing aids and how digital signal processing approaches have led to changes in hearing aid design. Major landmarks in the evolution of digital technology are identified, and their impact on the development of digital hearing aids is discussed. Differences between analog and digital approaches to signal processing in hearing aids are identified. PMID:17301334

Ensuring financial access to hearing AIDS for infants and young children.

PubMed

Limb, Stephanie J; McManus, Margaret A; Fox, Harriette B; White, Karl R; Forsman, Irene

2010-08-01

Many young children with permanent hearing loss do not receive hearing aids and related professional services, in part because of public and private financing limitations. In 2006 the Children's Audiology Financing Workgroup was convened by the National Center for Hearing Assessment and Management to evaluate and make recommendations about public and private financing of hearing aids and related professional services for 0- to 3-year-old children. The workgroup recommended 4 possible strategies for ensuring that all infants and young children with hearing loss have access to appropriate hearing aids and professional services: (1) clarify that the definition of assistive technology, which is a required service under Part C of the Individuals With Disabilities Education Act (IDEA), includes not only analog hearing aids but also digital hearing aids with appropriate features as needed by young children with hearing loss; (2) clarify for both state Medicaid and Children's Health Insurance Programs that digital hearing aids are almost always the medically necessary type of hearing aid required for infants and young children and should be covered under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program; (3) encourage the passage of private health insurance legislative mandates to require coverage of appropriate digital hearing aids and related professional services for infants and young children; and (4) establish hearing-aid loaner programs in every state. The costs of providing hearing aids to all 0- to 3-year old children in the United States are estimated here.

Development of a Bone-Conducted Ultrasonic Hearing Aid for the Profoundly Deaf: Evaluation of Sound Quality Using a Semantic Differential Method

NASA Astrophysics Data System (ADS)

Nakagawa, Seiji; Fujiyuki, Chika; Kagomiya, Takayuki

2013-07-01

Bone-conducted ultrasound (BCU) is perceived even by the profoundly sensorineural deaf. A novel hearing aid using the perception of amplitude-modulated BCU (BCU hearing aid: BCUHA) has been developed. However, there is room for improvement particularly in terms of sound quality. BCU speech is accompanied by a strong high-pitched tone and contain some distortion. In this study, the sound quality of BCU speech with several types of amplitude modulation [double-sideband with transmitted carrier (DSB-TC), double-sideband with suppressed carrier (DSB-SC), and transposed modulations] and air-conducted (AC) speech was quantitatively evaluated using semantic differential and factor analysis. The results showed that all the types of BCU speech had higher metallic and lower esthetic factor scores than AC speech. On the other hand, transposed speech was closer than the other types of BCU speech to AC speech generally; the transposed speech showed a higher powerfulness factor score than the other types of BCU speech and a higher esthetic factor score than DSB-SC speech. These results provide useful information for further development of the BCUHA.

Current process in hearing-aid fitting appointments: An analysis of audiologists' use of behaviour change techniques using the behaviour change technique taxonomy (v1).

PubMed

Barker, Fiona; Mackenzie, Emma; de Lusignan, Simon

2016-11-01

To observe and analyse the range and nature of behaviour change techniques (BCTs) employed by audiologists during hearing-aid fitting consultations to encourage and enable hearing-aid use. Non-participant observation and qualitative thematic analysis using the behaviour change technique taxonomy (version 1) (BCTTv1). Ten consultations across five English NHS audiology departments. Audiologists engage in behaviours to ensure the hearing-aid is fitted to prescription and is comfortable to wear. They provide information, equipment, and training in how to use a hearing-aid including changing batteries, cleaning, and maintenance. There is scope for audiologists to use additional BCTs: collaborating with patients to develop a behavioural plan for hearing-aid use that includes goal-setting, action-planning and problem-solving; involving significant others; providing information on the benefits of hearing-aid use or the consequences of non-use and giving advice about using prompts/cues for hearing-aid use. This observational study of audiologist behaviour in hearing-aid fitting consultations has identified opportunities to use additional behaviour change techniques that might encourage hearing-aid use. This information defines potential intervention targets for further research with the aim of improving hearing-aid use amongst adults with acquired hearing loss.

Hearing aids: Do they help and, if so, how does one know?

NASA Astrophysics Data System (ADS)

Humes, Larry E.

2003-04-01

For those individuals with sensorineural hearing loss, ranging from mild to severe in degree, the conventional hearing aid is the most appropriate rehabilitative device available. Despite the fact that such devices have been available commercially for over 60 years, until recently, relatively little research has been directed at evaluating the effectiveness of these rehabilitative devices. How does one evaluate the effectiveness of a hearing aid as a rehabilitative device? Should effectiveness be based on the relative improvement in communication with and without the hearing aid, typically referred to as hearing-aid benefit, the satisfaction of the consumer with the device, or simply whether and how much the hearing aid is used? How are these aspects of hearing-aid effectiveness or outcome measured? Are the measures of hearing-aid outcome related to one another? What evidence is there regarding the effectiveness of contemporary hearing aids? Recent research regarding these and other related questions will be reviewed in this presentation. [Work supported, in part, by NIA.

Predictors of Hearing-Aid Outcomes

PubMed Central

Johannesen, Peter T.; Pérez-González, Patricia; Blanco, José L.; Kalluri, Sridhar; Edwards, Brent

2017-01-01

Over 360 million people worldwide suffer from disabling hearing loss. Most of them can be treated with hearing aids. Unfortunately, performance with hearing aids and the benefit obtained from using them vary widely across users. Here, we investigate the reasons for such variability. Sixty-eight hearing-aid users or candidates were fitted bilaterally with nonlinear hearing aids using standard procedures. Treatment outcome was assessed by measuring aided speech intelligibility in a time-reversed two-talker background and self-reported improvement in hearing ability. Statistical predictive models of these outcomes were obtained using linear combinations of 19 predictors, including demographic and audiological data, indicators of cochlear mechanical dysfunction and auditory temporal processing skills, hearing-aid settings, working memory capacity, and pretreatment self-perceived hearing ability. Aided intelligibility tended to be better for younger hearing-aid users with good unaided intelligibility in quiet and with good temporal processing abilities. Intelligibility tended to improve by increasing amplification for low-intensity sounds and by using more linear amplification for high-intensity sounds. Self-reported improvement in hearing ability was hard to predict but tended to be smaller for users with better working memory capacity. Indicators of cochlear mechanical dysfunction, alone or in combination with hearing settings, did not affect outcome predictions. The results may be useful for improving hearing aids and setting patients’ expectations. PMID:28929903

Internet Competency Predicts Practical Hearing Aid Knowledge and Skills in First-Time Hearing Aid Users.

PubMed

Maidment, David; Brassington, William; Wharrad, Heather; Ferguson, Melanie

2016-10-01

The purpose of the study was to assess whether Internet competency predicted practical hearing aid knowledge and handling skills in first-time hearing aid users. The design was a prospective, randomized controlled trial of a multimedia educational intervention consisting of interactive video tutorials (or reusable learning objects [RLOs]). RLOs were delivered through DVD for TV or PC, and online. Internet competency was measured at the hearing aid fitting appointment, whereas hearing aid knowledge and practical handling skills were assessed 6 weeks postfitting. Internet competency predicted practical hearing aid knowledge and handling skills, controlling for age, hearing sensitivity, educational status, and gender for the group that received the RLOs. Internet competency was inversely related to the number of times the RLOs were watched. Associations between Internet competency and practical hearing aid knowledge, handling skills, and watching the RLOs fewer times may have arisen because of improved self-efficacy. Therefore, first-time hearing aid users who are more competent Internet users may be better equipped to apply newly learned information to effectively manage their hearing loss.

21 CFR 874.3330 - Master hearing aid.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Master hearing aid. 874.3330 Section 874.3330 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3330 Master hearing aid. (a) Identification. A master hearing aid is an electronic device intended to simulate a hearing aid during audiometric...

21 CFR 874.3330 - Master hearing aid.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Master hearing aid. 874.3330 Section 874.3330 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3330 Master hearing aid. (a) Identification. A master hearing aid is an electronic device intended to simulate a hearing aid during audiometric...

21 CFR 874.3330 - Master hearing aid.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Master hearing aid. 874.3330 Section 874.3330 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3330 Master hearing aid. (a) Identification. A master hearing aid is an electronic device intended to simulate a hearing aid during audiometric...

21 CFR 874.3330 - Master hearing aid.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Master hearing aid. 874.3330 Section 874.3330 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3330 Master hearing aid. (a) Identification. A master hearing aid is an electronic device intended to simulate a hearing aid during audiometric...

21 CFR 874.3330 - Master hearing aid.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Master hearing aid. 874.3330 Section 874.3330 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3330 Master hearing aid. (a) Identification. A master hearing aid is an electronic device intended to simulate a hearing aid during audiometric...

Does hearing aid use affect audiovisual integration in mild hearing impairment?

PubMed

Gieseler, Anja; Tahden, Maike A S; Thiel, Christiane M; Colonius, Hans

2018-04-01

There is converging evidence for altered audiovisual integration abilities in hearing-impaired individuals and those with profound hearing loss who are provided with cochlear implants, compared to normal-hearing adults. Still, little is known on the effects of hearing aid use on audiovisual integration in mild hearing loss, although this constitutes one of the most prevalent conditions in the elderly and, yet, often remains untreated in its early stages. This study investigated differences in the strength of audiovisual integration between elderly hearing aid users and those with the same degree of mild hearing loss who were not using hearing aids, the non-users, by measuring their susceptibility to the sound-induced flash illusion. We also explored the corresponding window of integration by varying the stimulus onset asynchronies. To examine general group differences that are not attributable to specific hearing aid settings but rather reflect overall changes associated with habitual hearing aid use, the group of hearing aid users was tested unaided while individually controlling for audibility. We found greater audiovisual integration together with a wider window of integration in hearing aid users compared to their age-matched untreated peers. Signal detection analyses indicate that a change in perceptual sensitivity as well as in bias may underlie the observed effects. Our results and comparisons with other studies in normal-hearing older adults suggest that both mild hearing impairment and hearing aid use seem to affect audiovisual integration, possibly in the sense that hearing aid use may reverse the effects of hearing loss on audiovisual integration. We suggest that these findings may be particularly important for auditory rehabilitation and call for a longitudinal study.

Assistive hearing technologies among students with hearing impairment: factors that promote satisfaction.

PubMed

Rekkedal, Ann Mette

2012-01-01

Hearing technology can play an essential part in the education of deaf and hard-of-hearing children in inclusive schools. Few studies have examined these children's experiences with this technology. This article explores factors pertaining to children's use of and attitudes toward hearing technologies, such as hearing aids, cochlear implants, teacher-worn microphones, and student-worn microphones. The study included 153 deaf and hard-of-hearing students. All students communicated orally and were in inclusive schools from grades 5-10. The results suggest that males view hearing technology more positively than do females. Having severe hearing loss also promoted positive attitudes toward hearing aids and cochlear implants, but not toward microphones. The students with positive self-descriptions tended to be more satisfied with hearing aids or cochlear implants than the students with negative self-descriptions. The main factors promoting the use of hearing aids were severe hearing loss, positive attitudes toward hearing aids, and the sound quality of hearing aids.

Identifying the needs of elderly, hearing-impaired persons: the importance and utility of hearing aid attributes.

PubMed

Meister, Hartmut; Lausberg, Isabel; Kiessling, Juergen; von Wedel, Hasso; Walger, Martin

2002-11-01

Older patients represent the majority of hearing-aid users. The needs of elderly, hearing-impaired subjects are not entirely identified. The present study aims to determine the importance of fundamental hearing-aid attributes and to elicit the utility of associated hypothetical hearing aids for older patients. This was achieved using a questionnaire-based conjoint analysis--a decompositional approach to preference measurement offering a realistic study design. A random sample of 200 experienced hearing-aid users participated in the study. Though three out of the six examined attributes revealed age-related dependencies, the only significant effect was found for the attribute "handling", which was considerably more important for older than younger hearing-aid users. A trend of decreasing importance of speech intelligibility in noise and increasing significance of speech in quiet was observed for subjects older than 70 years. In general, the utility of various hypothetical hearing aids was similar for older and younger subjects. Apart from the attribute "handling", older and younger subjects have comparable needs regarding hearing-aid features. On the basis of the examined attributes, there is no requirement for hearing aids designed specifically for elderly hearing-aid users, provided that ergonomic features are considered and the benefits of modern technology are made fully available for older patients.

Hearing aid and hearing assistance technology use in Aotearoa/New Zealand.

PubMed

Kelly-Campbell, Rebecca J; Lessoway, Kamea

2015-05-01

The purpose of this study was to describe factors that are related to hearing aid and hearing assistance technology ownership and use in Aotearoa/New Zealand. Adults with hearing impairment living in New Zealand were surveyed regarding health-related quality of life and device usage. Audiometric data (hearing sensitivity and speech in noise) were collected. Data were obtained from 123 adults with hearing impairment: 73 reported current hearing-aid use, 81 reported current hearing assistance technology use. In both analyses, device users had more difficulty understanding speech in background noise, had poor hearing in both their better and worse hearing ears, and perceived more consequences of hearing impairment in their everyday lives (both emotionally and socially) than non-hearing-aid users. Discriminant analyses showed that the social consequences of hearing impairment and the better ear hearing best classified hearing aid users from non-users but social consequences and worse ear hearing best classified hearing assistance technology users from non-users. Quality of life measurements and speech-in-noise assessments provide useful clinical information. Hearing-impaired adults in New Zealand who use hearing aids also tend to use hearing assistance technology, which has important clinical implications.

34 CFR 300.113 - Routine checking of hearing aids and external components of surgically implanted medical devices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Routine checking of hearing aids and external... Eligibility Other Fape Requirements § 300.113 Routine checking of hearing aids and external components of surgically implanted medical devices. (a) Hearing aids. Each public agency must ensure that hearing aids worn...

34 CFR 300.113 - Routine checking of hearing aids and external components of surgically implanted medical devices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true Routine checking of hearing aids and external components... Eligibility Other Fape Requirements § 300.113 Routine checking of hearing aids and external components of surgically implanted medical devices. (a) Hearing aids. Each public agency must ensure that hearing aids worn...

34 CFR 300.113 - Routine checking of hearing aids and external components of surgically implanted medical devices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false Routine checking of hearing aids and external... Eligibility Other Fape Requirements § 300.113 Routine checking of hearing aids and external components of surgically implanted medical devices. (a) Hearing aids. Each public agency must ensure that hearing aids worn...

Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

PubMed Central

Hrapcak, Susan; Kuper, Hannah; Bartlett, Peter; Devendra, Akash; Makawa, Atupele; Kim, Maria; Kazembe, Peter; Ahmed, Saeed

2016-01-01

Introduction With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. Methods This was a cross-sectional survey of 380 HIV-infected children aged 4–14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. Results Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2–13.0) and ear drainage (OR 6.4, 3.6–11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2–4.5) or Stage 4 (OR 6.4, 2.7–15.2) and history of malnutrition (OR 2.1, 1.3–3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child’s hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). Conclusions There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most hearing loss was conductive in nature, likely due to frequent ear infections, and many children with hearing loss qualified for hearing aids. Screening strategies need to be developed and tested since caregivers were not reliable at identifying hearing loss, and often mis-identified children with normal hearing as having hearing loss. Children with frequent ear infections, ear drainage, TB, severe HIV disease, or low BMI should receive more frequent ear assessments and hearing evaluations. PMID:27551970

A Study of the Combined Use of a Hearing Aid and Tactual Aid in an Adult with Profound Hearing Loss

ERIC Educational Resources Information Center

Reed, Charlotte M.; Delhorne, Lorraine A.

2006-01-01

This study examined the benefits of the combined used of a hearing aid and tactual aid to supplement lip-reading in the reception of speech and for the recognition of environmental sounds in an adult with profound hearing loss. Speech conditions included lip-reading alone (L), lip-reading + tactual aid (L+TA) lip-reading + hearing aid (L+HA) and…

Consensus on Hearing Aid Candidature and Fitting for Mild Hearing Loss, With and Without Tinnitus: Delphi Review

PubMed Central

Hoare, Derek J.; Nicholson, Richard; Smith, Sandra; Hall, Deborah A.

2015-01-01

Objectives: In many countries including the United Kingdom, hearing aids are a first line of audiologic intervention for many people with tinnitus and aidable hearing loss. Nevertheless, there is a lack of high quality evidence to support that they are of benefit for tinnitus, and wide variability in their use in clinical practice especially for people with mild hearing loss. The aim of this study was to identify a consensus among a sample of UK clinicians on the criteria for hearing aid candidature and clinical practice in fitting hearing aids specifically for mild hearing loss with and without tinnitus. This will allow professionals to establish clinical benchmarks and to gauge their practice with that used elsewhere. Design: The Delphi technique, a systematic methodology that seeks consensus amongst experts through consultation using a series of iterative questionnaires, was used. A three-round Delphi survey explored clinical consensus among a panel of 29 UK hearing professionals. The authors measured panel agreement on 115 statements covering: (i) general factors affecting the decision to fit hearing aids, (ii) protocol-driven factors affecting the decision to fit hearing aids, (iii) general practice, and (iv) clinical observations. Consensus was defined as a priori ≥70% agreement across the panel. Results: Consensus was reached for 58 of the 115 statements. The broad areas of consensus were around factors important to consider when fitting hearing aids; hearing aid technology/features offered; and important clinical assessment to verify hearing aid fit (agreement of 70% or more). For patients with mild hearing loss, the greatest priority was given by clinicians to patient-centered criteria for fitting hearing aids: hearing difficulties, motivation to wear hearing aids, and impact of hearing loss on quality of life (chosen as top five by at least 64% of panelists). Objective measures were given a lower priority: degree of hearing loss and shape of the audiogram (chosen as top five by less than half of panelists). Areas where consensus was not reached were related to the use of questionnaires to predict and verify hearing aid benefit for both hearing and tinnitus; audiometric criteria for fitting hearing aids; and safety of using loud sounds when verifying hearing aid fitting when the patient has tinnitus (agreement of <70%). Conclusions: The authors identified practices that are considered important when recommending or fitting hearing aid for a patient with tinnitus. More importantly perhaps, they identified practical issues where there are divided opinions. Their findings inform the design of clinical trials and open up debate on the potential impact of practice differences on patient outcomes. PMID:25587668

Hearing aid handling skills: relationship with satisfaction and benefit.

PubMed

Campos, Patrícia Danieli; Bozza, Amanda; Ferrari, Deborah Viviane

2014-01-01

To evaluate hearing aid handling skills for new and experienced users and to assess if such skills influence user's benefit and satisfaction. Seventy four participants (mean age of 70.43), experienced (n=37) or new hearing aid users (n=37) performed the tasks of "Practical Hearing Aid Skills Test" (PHAST), which were scored on a five-point Likert scale - higher scores indicate better hearing aid handling skills. Experienced users answered the International Outcome Inventory for Hearing Aids (IOI-HA) and the hearing aid benefit for handicap reduction was calculated by the hearing handicap inventory (HHIA/HHIE). Medians for PHAST total scores of 79 and 71% were obtained for experienced and new users, respectively - there were no significant difference between groups. Lower PHAST scores were observed for the tasks of volume control manipulation and telephone usage. Moderate correlations were obtained between IOI benefit and quality of life items and the PHAST scores. There was no correlation between the results of PHAST and demographic data of the participants. There was no difference in handling skills between new and experienced hearing aid users. Handling skills affected hearing aid benefit.

Modeling and Predicting Hearing Aid Outcome

PubMed Central

Humes, Larry E.

2003-01-01

Following a brief tutorial on the application of factor analysis to hearing aid outcome measures, three studies of hearing aid outcome measures in elderly adults are presented and analyzed. Two of the studies were completed at Indiana University (IU-1 and IU-2), and one was a collaborative multisite study by the Veterans Administration and the National Institute of Deafness and other Communication Disorders (NIDCD/VA). IU-1 measured hearing aid outcome in 173 elderly wearers of single-channel, linear, in-the-ear hearing aids with output-limiting compression, whereas IU-2 obtained the same extensive set of outcome measures from 53 elderly wearers of two-channel, wide-dynamic-range compression, in-the-canal hearing aids. In the NIDCD/VA study, 333 to 338 participants wore three single-channel circuits in succession, with each circuit housed within an in-the-ear shell. The three circuits included in that study and in this analysis were: (1) linear with peak clipping, (2) linear with output-limiting compression, and (3) single-channel, wide-dynamic-range compression. Evaluation of the many outcome measures completed in each study using principal components factor analysis revealed that from three (both IU studies) to five (NIDCD/VA study) principal components captured the individual differences in hearing aid outcome. This was independent of hearing aid type (in-the-ear or in-the-canal) and circuitry. Subsequent multiple regression analyses of individual differences in performance along each dimension of hearing aid outcome revealed that these individual differences could be accounted for reasonably well by various prefit variables for some dimensions of outcome, but not others. In general, measures of speech recognition performance were well accounted for by prefit measures, with the best predictors being hearing loss, cognitive performance, and age. Measures of hearing aid usage were less well accounted for by prefit measures, with the most accurate predictor of current hearing aid use being prior hearing aid use. The outcome dimension accounted for most poorly was that associated with hearing aid satisfaction, with subjective measures of aided sound quality being the best predictor of performance along this dimension of hearing aid outcome. Additional multicenter, large-scale studies are needed to develop more complete models of hearing aid outcome and to identify the variables that influence various aspects of hearing aid outcome. It is only through this additional research that it will be possible to optimize outcome for hearing aid wearers. PMID:15004647

Digital Hearing Aids From the Perspective of One Consumer/Audiologist

PubMed Central

Ross, Mark

2007-01-01

Recent developments in hearing aids are reviewed in the context of the author's personal experience as an audiologist and as a hearing aid wearer. The need for evidence of benefit specific to digital signal processing in hearing aids is stressed, as well as addressing cost-benefit ratios in view of the high cost of digital hearing aids. PMID:17301335

Music and Hearing Aids

PubMed Central

Moore, Brian C. J.

2014-01-01

The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. PMID:25361601

Music and hearing aids.

PubMed

Madsen, Sara M K; Moore, Brian C J

2014-10-31

The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. © The Author(s) 2014.

Development of a digital hearing aid to meet the Brazilian Government's Ordinance 587 (APAC).

PubMed

Penteado, Silvio Pires; Bento, Ricardo Ferreira

2010-01-01

The treatment of sensorineural hearing loss is based on hearing aids, also known as individual sound amplification devices. The hearing aids purchased by the Brazilian Government, aiming at fulfilling public policies, are based on dedicated components, which bring about benefits, but also render them expensive and may impair repair services after manufacture's warranty expires. to design digital behind-the-ear hearing aids built from standardized components coming from the very supply chain of these manufacturers. experimental. to identify the supply chain of these manufacturers, request samples and set up hearing aids in the laboratory. The developed hearing aids did not show lesser electroacoustic characteristics when compared to those acquired by the Government, also being tested by the same reference international technical standard. It is possible to develop digital behind-the-ear hearing aids based on off-the-shelf components from hearing aid manufacturers' supply chain. Their advantages include low operational costs - for acquisition (with clear advantages for the Government) and service (advantage for the patient).

Transitioning hearing aid users with severe and profound loss to a new gain/frequency response: benefit, perception, and acceptance.

PubMed

Convery, Elizabeth; Keidser, Gitte

2011-03-01

Adults with severe and profound hearing loss tend to be long-term, full-time users of amplification who are highly reliant on their hearing aids. As a result of these characteristics, they are often reluctant to update their hearing aids when new features or signal-processing algorithms become available. Due to the electroacoustic constraints of older devices, many severely and profoundly hearing-impaired adults continue to wear hearing aids that provide more low- and mid-frequency gain and less high-frequency gain than would be prescribed by the National Acoustic Laboratories' revised formula with profound correction factor (NAL-RP). To investigate the effect of a gradual change in gain/frequency response on experienced hearing-aid wearers with moderately severe to profound hearing loss. Double-blind, randomized controlled trial. Twenty-three experienced adult hearing-aid users with severe and profound hearing loss participated in the study. Participants were selected for inclusion in the study if the gain/frequency response of their own hearing aids differed significantly from their NAL-RP prescription. Participants were assigned either to a control or to an experimental group balanced for aided ear three-frequency pure-tone average (PTA) and age. Participants were fitted with Siemens Artis 2 SP behind-the-ear (BTE) hearing aids that were matched to the gain/frequency response of their own hearing aids for a 65 dB SPL input level. The experimental group progressed incrementally to their NAL-RP targets over the course of 15 wk, while the control group maintained their initial settings throughout the study. Aided speech discrimination testing, loudness scaling, and structured questionnaires were completed at 3, 6, 9, 12, and 15 wk postfitting. A paired comparison between the old and new gain/frequency responses was completed at 1 and 15 wk postfitting. Statistical analysis was conducted to examine differences between the experimental and control groups and changes in objective performance and subjective perception over time. The results of the study showed that participants in the experimental group were subjectively accepting of the changes to their amplification characteristics, as evidenced by nonsignificant changes in the ratings of device performance over time. Perception of loudness, sound quality, speech intelligibility, and own voice volume did not change significantly throughout the study. Objectively, participants in the experimental group demonstrated poorer speech discrimination performance as the study progressed, although there was no change in objective loudness perception. According to the paired comparison, there was an overall subjective preference for the original gain/frequency response among all participants, although participants in the experimental group did show an increase in preference for the NAL-RP response by the end of the study. Based on the findings of this study, we suggest that undertaking a gradual change to a new gain/frequency response with severely and profoundly hearing-impaired adults is a feasible procedure. However, we recommend that clinicians select transition candidates carefully and initiate the procedure only if there is a clinical reason for doing so. A validated prescriptive formula should be used as a transition target, and speech discrimination performance should be monitored throughout the transition. American Academy of Audiology.

Validity and reliability of in-situ air conduction thresholds measured through hearing aids coupled to closed and open instant-fit tips.

PubMed

O'Brien, Anna; Keidser, Gitte; Yeend, Ingrid; Hartley, Lisa; Dillon, Harvey

2010-12-01

Audiometric measurements through a hearing aid ('in-situ') may facilitate provision of hearing services where these are limited. This study investigated the validity and reliability of in-situ air conduction hearing thresholds measured with closed and open domes relative to thresholds measured with insert earphones, and explored sources of variability in the measures. Twenty-four adults with sensorineural hearing impairment attended two sessions in which thresholds and real-ear-to-dial-difference (REDD) values were measured. Without correction, significantly higher low-frequency thresholds in dB HL were measured in-situ than with insert earphones. Differences were due predominantly to differences in ear canal SPL, as measured with the REDD, which were attributed to leaking low-frequency energy. Test-retest data yielded higher variability with the closed dome coupling due to inconsistent seals achieved with this tip. For all three conditions, inter-participant variability in the REDD values was greater than intra-participant variability. Overall, in-situ audiometry is as valid and reliable as conventional audiometry provided appropriate REDD corrections are made and ambient sound in the test environment is controlled.

Hearing-aid tester

NASA Technical Reports Server (NTRS)

Kessinger, R.; Polhemus, J. T.; Waring, J. G.

1977-01-01

Hearing aids are automatically checked by circuit that applies half-second test signal every thirty minutes. If hearing-aid output is distorted, too small, or if battery is too low, a warning lamp is activated. Test circuit is incorporated directly into hearing-aid package.

Speech-Language Pathologists' Knowledge and Skills Regarding Hearing Aids.

ERIC Educational Resources Information Center

Woodford, Charles M.

1987-01-01

Speech-language pathologists (n=49) and speech-language pathology graduate students (n=53) were administered a written examination on hearing aids and a practical examination concerning the functioning of two types of hearing aids. The majority lacked basic knowledge and skills necessary to assist hearing-impaired students with their hearing aids.…

Some characteristics of amplified music through hearing aids.

PubMed

Chasin, Marshall; Hockley, Neil S

2014-02-01

Hearing aids are a relatively non-invasive means of reducing the negative effects of hearing loss on an individual who does not require a cochlear implant. Music amplified through hearing aids has some interesting characteristics but high fidelity is not typically one of them. This poses a serious problem for the investigator who wants to perform research on music with hearing impaired individuals who wear hearing aids. If the signal at the tympanic membrane is somewhat distorted then this has consequences for the assessment of music processing when examining both the peripheral and the central auditory system. In this review article on the subject of hearing aids and music, some of the acoustical differences between speech and music will be described. Following this, a discussion about what hearing aids do well and also less well for music as an input will be presented. Finally, some recommendations are made about what can be done for hearing-impaired individuals who wear hearing aids to listen to music. Copyright © 2013 Elsevier B.V. All rights reserved.

Treatment Efficacy: Hearing Aids in the Management of Hearing Loss in Adults.

ERIC Educational Resources Information Center

Weinstein, Barbara E.

1996-01-01

This article reviews the efficacy of hearing aids in adults with hearing impairments. Information is provided on the prevalence of hearing impairments; the daily effects of a hearing impairment; and the role of the audiologist. The effectiveness and benefits of hearing aids are reviewed, and a case study is provided. (CR)

Evaluation of Speech Intelligibility and Sound Localization Abilities with Hearing Aids Using Binaural Wireless Technology.

PubMed

Ibrahim, Iman; Parsa, Vijay; Macpherson, Ewan; Cheesman, Margaret

2013-01-02

Wireless synchronization of the digital signal processing (DSP) features between two hearing aids in a bilateral hearing aid fitting is a fairly new technology. This technology is expected to preserve the differences in time and intensity between the two ears by co-ordinating the bilateral DSP features such as multichannel compression, noise reduction, and adaptive directionality. The purpose of this study was to evaluate the benefits of wireless communication as implemented in two commercially available hearing aids. More specifically, this study measured speech intelligibility and sound localization abilities of normal hearing and hearing impaired listeners using bilateral hearing aids with wireless synchronization of multichannel Wide Dynamic Range Compression (WDRC). Twenty subjects participated; 8 had normal hearing and 12 had bilaterally symmetrical sensorineural hearing loss. Each individual completed the Hearing in Noise Test (HINT) and a sound localization test with two types of stimuli. No specific benefit from wireless WDRC synchronization was observed for the HINT; however, hearing impaired listeners had better localization with the wireless synchronization. Binaural wireless technology in hearing aids may improve localization abilities although the possible effect appears to be small at the initial fitting. With adaptation, the hearing aids with synchronized signal processing may lead to an improvement in localization and speech intelligibility. Further research is required to demonstrate the effect of adaptation to the hearing aids with synchronized signal processing on different aspects of auditory performance.

Brainstem processing following unilateral and bilateral hearing-aid amplification.

PubMed

Dawes, Piers; Munro, Kevin J; Kalluri, Sridhar; Edwards, Brent

2013-04-17

Following previous research suggesting hearing-aid experience may induce functional plasticity at the peripheral level of the auditory system, click-evoked auditory brainstem response was recorded at first fitting and 12 weeks after hearing-aid use by unilateral and bilateral hearing-aid users. A control group of experienced hearing-aid users was tested over a similar time scale. No significant alterations in auditory brainstem response latency or amplitude were identified in any group. This does not support the hypothesis of plastic changes in the peripheral auditory system induced by hearing-aid use for 12 weeks.

Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test.

PubMed

Saunders, Gabrielle H; Morse-Fortier, Charlotte; McDermott, Daniel J; Vachhani, Jay J; Grush, Leslie D; Griest, Susan; Lewis, M Samantha

2018-03-01

The ability to manage hearing aids is crucial for successful outcomes and for maintaining hearing aid use. It is therefore important to have a tool that can effectively identify which hearing aid management skills are lacking so that the audiologist can provide additional education and training on that skill. Such a tool can also provide useful quantitative data for researchers. To collect normative data (Experiment 1) and assess inter- and intrarater reliability (Experiment 2) for a hearing aid management assessment tool known as the Hearing Aid Skills and Knowledge (HASK) test. Two hundred thirty-six new hearing aid users recruited from the VA Portland Health Care System and 126 experienced hearing aid users recruited from the local Portland community participated in Experiment 1. The veteran participants were taking part in a larger hearing aid study, and the community participants were recruited at community events that took place around Portland, OR. Three clinical audiologists and two AuD students completing their fourth year externship participated in Experiment 2. In Experiment 1, HASK data were collected from the new hearing aid users at 4-8 wk and 6-8 mo after the fitting of their first pair of hearing aids, and from experienced users on a single occasion. In addition, self-reported hearing aid use, benefit, and satisfaction were assessed for all participants. The audiologists/students in Experiment 2 watched and independently scored videos of six individuals completing the HASK. Intraclass correlation coefficients (ICCs) across audiologists were computed for HASK scores. Three audiologists/students rated at least one video on two occasions to provide interrater reliability data. Mean performance on the HASK was about 70% for knowledge and 80% for skills for both the new and experienced hearing aid users. Performance did not change among the new users between the 4-8 wk and 6-8 mo administration. The specific skills lacking were associated with advanced management abilities (cleaning and troubleshooting). Experiment 2 revealed ICCs for inter- and intrarater reliability for HASK to range from 0.76 to 0.94, showing acceptable to excellent reliability. The HASK is a quick and easy test with good-to-excellent inter- and intrarater reliability. It can effectively identify which hearing aid management skills are lacking so that the audiologist can provide additional education and training on those skills. Data show performance is ∼70% for knowledge and 80% for skills and this does not change with hearing aid experience. The significant positive correlations between HASK scores and hearing aid use and satisfaction highlight the notion that ability to manage hearing aids successfully is integral to good hearing aid outcome. American Academy of Audiology

Language-specific strategy for programming hearing aids - A double-blind randomized controlled crossover study.

PubMed

Matsumoto, Nozomu; Suzuki, Nobuyoshi; Iwasaki, Satoshi; Ishikawa, Kazuha; Tsukiji, Hiroki; Higashino, Yoshie; Tabuki, Tomoko; Nakagawa, Takashi

2018-08-01

Voice-aligned compression (VAC) is a method used in Oticon's hearing aids to provide more comfortable hearing without sacrificing speech discrimination. The complex, non-linear compression curve for the VAC strategy is designed based on the frequency profile of certain spoken Western languages. We hypothesized that hearing aids could be further customized for Japanese-speaking users by modifying the compression curve using the frequency profile of spoken Japanese. A double-blind randomized controlled crossover study was performed to determine whether or not Oticon's modified amplification strategy (VAC-J) provides subjectively preferable hearing aids for Japanese-speaking hearing aid users compared to the same company's original amplification strategy (VAC). The participants were randomized to two groups. The VAC-first group received a pair of hearing aids programmed using the VAC strategy and wore them for three weeks, and then received a pair of hearing aids programmed using VAC-J strategy and wore them for three weeks. The VAC-J-first group underwent the same study, but they received hearing aids in the reverse sequence. A Speech, Spatial and Qualities (SSQ) questionnaire was administered before beginning to use the hearing aids, at the end of using the first pair of hearing aids, and at the end of using the second pair of hearing aids. Twenty-five participants that met the inclusion/exclusion criteria from January 1 to October 31, 2016, were randomized to two groups. Twenty-two participants completed the study. There were no statistically significant differences in the increment of SSQ scores between the participants when using the VAC- or the VAC-J-programmed hearing aids. However, participants preferred the VAC-J strategy to the VAC strategy at the end of the study, and this difference was statistically significant. Japanese-speaking hearing aid users preferred using hearing aids that were fitted with the VAC-J strategy. Our results show that the VAC strategy can be adjusted to the frequency profile of different languages and that participants expressed their subjective preference more clearly than was reflected in the SSQ scores. A similar language-specific strategy may improve user's satisfaction while using hearing devices, and this concept may be extended to implantable hearing devices. R000023191. Copyright © 2017 Elsevier B.V. All rights reserved.

Perception of Hearing Aid-Processed Speech in Individuals with Late-Onset Auditory Neuropathy Spectrum Disorder.

PubMed

Mathai, Jijo Pottackal; Appu, Sabarish

2015-01-01

Auditory neuropathy spectrum disorder (ANSD) is a form of sensorineural hearing loss, causing severe deficits in speech perception. The perceptual problems of individuals with ANSD were attributed to their temporal processing impairment rather than to reduced audibility. This rendered their rehabilitation difficult using hearing aids. Although hearing aids can restore audibility, compression circuits in a hearing aid might distort the temporal modulations of speech, causing poor aided performance. Therefore, hearing aid settings that preserve the temporal modulations of speech might be an effective way to improve speech perception in ANSD. The purpose of the study was to investigate the perception of hearing aid-processed speech in individuals with late-onset ANSD. A repeated measures design was used to study the effect of various compression time settings on speech perception and perceived quality. Seventeen individuals with late-onset ANSD within the age range of 20-35 yr participated in the study. The word recognition scores (WRSs) and quality judgment of phonemically balanced words, processed using four different compression settings of a hearing aid (slow, medium, fast, and linear), were evaluated. The modulation spectra of hearing aid-processed stimuli were estimated to probe the effect of amplification on the temporal envelope of speech. Repeated measures analysis of variance and post hoc Bonferroni's pairwise comparisons were used to analyze the word recognition performance and quality judgment. The comparison between unprocessed and all four hearing aid-processed stimuli showed significantly higher perception using the former stimuli. Even though perception of words processed using slow compression time settings of the hearing aids were significantly higher than the fast one, their difference was only 4%. In addition, there were no significant differences in perception between any other hearing aid-processed stimuli. Analysis of the temporal envelope of hearing aid-processed stimuli revealed minimal changes in the temporal envelope across the four hearing aid settings. In terms of quality, the highest number of individuals preferred stimuli processed using slow compression time settings. Individuals who preferred medium ones followed this. However, none of the individuals preferred fast compression time settings. Analysis of quality judgment showed that slow, medium, and linear settings presented significantly higher preference scores than the fast compression setting. Individuals with ANSD showed no marked difference in perception of speech that was processed using the four different hearing aid settings. However, significantly higher preference, in terms of quality, was found for stimuli processed using slow, medium, and linear settings over the fast one. Therefore, whenever hearing aids are recommended for ANSD, those having slow compression time settings or linear amplification may be chosen over the fast (syllabic compression) one. In addition, WRSs obtained using hearing aid-processed stimuli were remarkably poorer than unprocessed stimuli. This shows that processing of speech through hearing aids might have caused a large reduction of performance in individuals with ANSD. However, further evaluation is needed using individually programmed hearing aids rather than hearing aid-processed stimuli. American Academy of Audiology.

Lack of ear care knowledge in nursing homes.

PubMed

Solheim, Jorunn; Shiryaeva, Olga; Kvaerner, Kari J

2016-01-01

Rising life expectancy means an increase in the number of elderly people with hearing loss in the population. Many elderly people live in nursing homes, with varying care needs. A substantial proportion of these people will need help with their hearing aids and other hearing devices. The objective of the study has been to assess the knowledge, experience, skills, competence, and need for information of staff at nursing homes in relation to residents' hearing loss and hearing aids. One hundred and ninety-five employees at seven nursing homes participated in the study. The main approach was a descriptive study, using questionnaires. The main findings are that 73% of informants found that many residents need help with their hearing aids. Only one-tenth report that they know enough about the residents' hearing aids. Almost four out of five informants find that the residents become socially isolated as a result of hearing loss. Seventy-eight percent agree to some extent that more residents would benefit from hearing aids. Staff at nursing homes have insufficient knowledge about hearing loss and hearing aids. Increased focus on the elderly with hearing impairment in nursing homes is needed. Contact between nursing homes and audiological specialists should be improved to best followup hearing loss and hearing aids.

(De)stigmatizing the silent epidemic: representations of hearing loss in entertainment television.

PubMed

Foss, Katherine A

2014-01-01

The number of adolescents, young adults, and senior citizens experiencing hearing loss has significantly increased over the last 30 years. Despite this prevalence, hearing loss receives little attention in popular and political discourse, except in its connection to aging. Thus, hearing loss and the use of hearing aids have been stigmatized, discouraging adults from seeking hearing evaluation and screening, and justifying the lack of insurance coverage for hearing devices. This research explored how and why hearing loss continues to be stigmatized through a study of media messages about hearing loss. A textual analysis was conducted on 276 television episodes that involved d/Deaf characters and/or storylines about hearing loss and deafness from 1987 through 2013 (see Table 1). Only 11 fictional programs addressed the experience of hearing loss through 47 episodes, including Criminal Minds, Switched at Birth, House, M.D., and New Girl. Contrary to the assumption that hearing loss exclusively impacts older people, characters were typically young, attractive, working professionals who held prominent roles in the programs. For most characters, hearing loss developed suddenly and was restored by the end of the episode, with only four characters using hearing aids. Hearing loss was depicted as comical, embarrassing, lonely, and threatening to one's work. The scarcity of hearing loss portrayals, combined with the negative representations of hearing loss, could help explain why hearing loss continues to be stigmatized and overlooked, even though almost half of all Americans will eventually experience difficulty hearing.

[Auditory and corporal laterality, logoaudiometry, and monaural hearing aid gain].

PubMed

Benavides, Mariela; Peñaloza-López, Yolanda R; de la Sancha-Jiménez, Sabino; García Pedroza, Felipe; Gudiño, Paula K

2007-12-01

To identify the auditory or clinical test that has the best correlation with the ear in which we apply the monaural hearing aid in symmetric bilateral hearing loss. A total of 37 adult patients with symmetric bilateral hearing loss were examined regarding the correlation between the best score in speech discrimination test, corporal laterality, auditory laterality with dichotic digits in Spanish and score for filtered words with monaural hearing aid. The best correlation was obtained between auditory laterality and gain with hearing aid (0.940). The dichotic test for auditory laterality is a good tool for identifying the best ear in which to apply a monaural hearing aid. The results of this paper suggest the necessity to apply this test in patients before a hearing aid is indicated.

Hearing aid user guides: suitability for older adults.

PubMed

Caposecco, Andrea; Hickson, Louise; Meyer, Carly

2014-02-01

The aim of this study was to analyse the content, design, and readability of printed hearing aid user guides to determine their suitability for older adults, who are the main users of hearing aids. Hearing aid user guides were assessed using four readability formulae and a standardized tool to assess content and design (SAM - Suitability Assessment of Materials). A sample of 36 hearing aid user guides (four user guides from nine different hearing aid manufacturers) were analysed. Sixty nine percent of user guides were rated 'not suitable' and 31% were rated 'adequate' for their suitability. Many scored poorly for scope, vocabulary, aspects of layout and typography, and learning stimulation and motivation. The mean reading grade level for all user guides was grade 9.6 which is too high for older adults. The content, design, and readability of hearing aid user guides are not optimal for older adults and thus may serve as a barrier to successful hearing aid outcomes for this population.

Self-Assessment of Hearing and Purchase of Hearing Aids by Middle-Aged and Elderly Adults

PubMed Central

Otavio, Andressa Colares da Costa; Coradini, Patricia Pérez; Teixeira, Adriane Ribeiro

2015-01-01

Introduction Presbycusis is a consequence of aging. Prescription of hearing aids is part of the treatment, although the prevalence of use by elderly people is still small. Objective To verify whether or not self-assessment of hearing is a predictor for purchase of hearing aids. Methods Quantitative, cross-sectional, descriptive, and observational study. Participants were subjects who sought a private hearing center for selection of hearing aids. During the diagnostic interview, subjects answered the following question: “On a scale of 1 to 10, with 1 being the worst and 10 the best, how would you rate your overall hearing ability?” After that, subjects underwent audiometry, selected a hearing aid, performed a home trial, and decided whether or not to purchase the hearing aid. The variables were associated and analyzed statistically. Results The sample was comprised of 32 subjects, both men and women, with a higher number of women. Mean age was 71.41 ± 12.14 years. Self-assessment of hearing ranged from 2 to 9 points. Overall, 71.9% of the subjects purchased hearing aids. There was no association between scores in the self-assessment and the purchase of hearing aids (p = 0.263). Among those who scored between 2 and 5 points, 64.7% purchased the device; between 6 and 7 points, 76.09% purchased the device; and between 8 and 9 points, 50% purchased the device, respectively. Conclusion There is evidence that low self-assessment scores lead to the purchase of hearing aids, although no significant association was observed in the sample. PMID:26722346

Hearing aids: indications, technology, adaptation, and quality control

PubMed Central

Hoppe, Ulrich; Hesse, Gerhard

2017-01-01

Hearing loss can be caused by a number of different pathological conditions. Some of them can be successfully treated, mainly by surgery, depending on the individual’s disease process. However, the treatment of chronic sensorineural hearing loss with damaged cochlear structures usually needs hearing rehabilitation by means of technical amplification. During the last two decades tremendous improvements in hearing aid technology led to a higher quality of the hearing rehabilitation process. For example, due to sophisticated signal processing acoustic feedback could be reduced and hence open fitting options are available even for more subjects with higher degrees of hearing loss. In particular for high-frequency hearing loss, the use of open fitting is an option. Both the users’ acceptance and the perceived sound quality were significantly increased by open fittings. However, we are still faced with a low level of readiness in many hearing impaired subjects to accept acoustic amplification. Since ENT specialists play a key-role in hearing aid provision, they should promote early hearing aid rehabilitation and include this in the counselling even in subjects with mild and moderate hearing loss. Recent investigations demonstrated the benefit of early hearing aid use in this group of patients since this may help to reduce subsequent damages as auditory deprivation, social isolation, development of dementia, and cognitive decline. For subjects with tinnitus, hearing aids may also support masking by environmental sounds and enhance cortical inhibition. The present paper describes the latest developments of hearing aid technology and the current state of the art for amplification modalities. Implications for both hearing aid indication and provision are discussed. PMID:29279726

Types of Hearing Aids

MedlinePlus

... hearing impairment. Most hearing aids share several similar electronic components, including a microphone that picks up sound; ... the ear canal; and batteries that power the electronic parts. Hearing aids differ by: design technology used ...

Should children who use cochlear implants wear hearing aids in the opposite ear?

PubMed

Ching, T Y; Psarros, C; Hill, M; Dillon, H; Incerti, P

2001-10-01

The aim of this study was to investigate 1) whether a hearing aid needs to be adjusted differently depending on whether a child wears a cochlear implant or another hearing aid in the contralateral ear; 2) whether the use of a hearing aid and a cochlear implant in opposite ears leads to binaural interference; and 3) whether the use of a hearing aid and a cochlear implant in opposite ears leads to binaural benefits in speech perception, localization, and communicative functioning in real life. Sixteen children participated in this study. All children used a Nucleus 22 or Nucleus 24 cochlear implant system programmed with the SPEAK strategy in one ear. The hearing aid amplification requirements in the nonimplanted ear of these children were determined using two procedures. A paired comparison technique was used to identify the frequency response that was best for speech intelligibility in quiet, and a loudness balancing technique was used to match the loudness of speech in the ear with a hearing aid to that with a cochlear implant. Eleven of the 16 children participated in the investigation of binaural effects. Performance in speech perception, localization, and communicative functioning was assessed under four aided conditions: cochlear implant with hearing aid as worn, cochlear implant alone, hearing aid alone, and cochlear implant with hearing aid adjusted according to individual requirements. Fifteen of the 16 children whose amplification requirements were determined preferred a hearing aid frequency response that was within +/-6 dB/octave of the NAL-RP prescription. On average, the children required 6 dB more gain than prescribed to balance the loudness of the implanted ear for a speech signal presented at 65 dB SPL. For all 11 children whose performance was evaluated for investigating binaural effects, there was no indication of significantly poorer performance under bilaterally aided conditions compared with unilaterally aided conditions. On average, there were significant benefits in speech perception, localization, and aural/oral function when the children used cochlear implants with adjusted hearing aids than when they used cochlear implants alone. All individuals showed benefits in at least one of the measures. Hearing aids for children who also use cochlear implants can be selected using the NAL-RP prescription. Adjustment of hearing aid gain to match loudness in the implanted ear can facilitate integration of signals from both ears, leading to better speech perception. Given that there are binaural advantages from using cochlear implants with hearing aids in opposite ears, clinicians should advise parents and other professionals about these potential advantages, and facilitate bilateral amplification by adjusting hearing aids after stable cochlear implant MAPs are established.

Hearing-aid use and long-term health outcomes: Hearing handicap, mental health, social engagement, cognitive function, physical health, and mortality.

PubMed

Dawes, Piers; Cruickshanks, Karen J; Fischer, Mary E; Klein, Barbara E K; Klein, Ronald; Nondahl, David M

2015-01-01

To clarify the impact of hearing aids on mental health, social engagement, cognitive function, and physical health outcomes in older adults with hearing impairment. We assessed hearing handicap (hearing handicap inventory for the elderly; HHIE-S), cognition (mini mental state exam, trail making, auditory verbal learning, digit-symbol substitution, verbal fluency, incidence of cognitive impairment), physical health (SF-12 physical component, basic and instrumental activities of daily living, mortality), social engagement (hours per week spent in solitary activities), and mental health (SF-12 mental component) at baseline, five years prior to baseline, and five and 11 years after baseline. Community-dwelling older adults with hearing impairment (N = 666) from the epidemiology of hearing loss study cohort. There were no significant differences between hearing-aid users and non-users in cognitive, social engagement, or mental health outcomes at any time point. Aided HHIE-S was significantly better than unaided HHIE-S. At 11 years hearing-aid users had significantly better SF-12 physical health scores (46.2 versus 41.2; p = 0.03). There was no difference in incidence of cognitive impairment or mortality. There was no evidence that hearing aids promote cognitive function, mental health, or social engagement. Hearing aids may reduce hearing handicap and promote better physical health.

Evaluation of Speech Intelligibility and Sound Localization Abilities with Hearing Aids Using Binaural Wireless Technology

PubMed Central

Ibrahim, Iman; Parsa, Vijay; Macpherson, Ewan; Cheesman, Margaret

2012-01-01

Wireless synchronization of the digital signal processing (DSP) features between two hearing aids in a bilateral hearing aid fitting is a fairly new technology. This technology is expected to preserve the differences in time and intensity between the two ears by co-ordinating the bilateral DSP features such as multichannel compression, noise reduction, and adaptive directionality. The purpose of this study was to evaluate the benefits of wireless communication as implemented in two commercially available hearing aids. More specifically, this study measured speech intelligibility and sound localization abilities of normal hearing and hearing impaired listeners using bilateral hearing aids with wireless synchronization of multichannel Wide Dynamic Range Compression (WDRC). Twenty subjects participated; 8 had normal hearing and 12 had bilaterally symmetrical sensorineural hearing loss. Each individual completed the Hearing in Noise Test (HINT) and a sound localization test with two types of stimuli. No specific benefit from wireless WDRC synchronization was observed for the HINT; however, hearing impaired listeners had better localization with the wireless synchronization. Binaural wireless technology in hearing aids may improve localization abilities although the possible effect appears to be small at the initial fitting. With adaptation, the hearing aids with synchronized signal processing may lead to an improvement in localization and speech intelligibility. Further research is required to demonstrate the effect of adaptation to the hearing aids with synchronized signal processing on different aspects of auditory performance. PMID:26557339

Prediction of the use of conventional hearing aids in Korean adults with unilateral hearing impairment.

PubMed

Lee, Dong-Hee; Noh, Heil

2015-01-01

To determine the use of a hearing aid at six months post-fitting and to evaluate the predictors of its ongoing use in Korean adults with unilateral hearing impairment (HI). Retrospective study at a secondary referral hospital over a 15-year period. This study analysed 119 adults with unilateral HI who had been recommended for hearing amplification (55 men and 64 women, mean age, 58.0 ± 11.7 years). Six months after the fitting, all of the participants were surveyed regarding subsequent decisions and actions about obtaining hearing aids. General uptake rate for a hearing aid was 68.1% (58.0% of participants surveyed were successful users, and 10.1% were intermittent users). The most significant parameter associated with hearing-aid use was social and/or work activities (R(2) = 0.457), and the significant predictors for successful hearing-aid use were social and/or work activities and method of signal processing (discriminatory power = 56.3%). Six months post-fitting, 68.1% of Korean adults with unilateral HI who had agreed to try a hearing aid continued to use it regularly. The predictors for hearing-aid use six months post-fitting included social and/or work activities and digital signal processing.

Older people's views on what they need to successfully adjust to life with a hearing aid.

PubMed

Kelly, Timothy B; Tolson, Debbie; Day, Tracy; McColgan, Gillian; Kroll, Thilo; Maclaren, William

2013-05-01

This article reports a study exploring what older people believe would enable them to adjust to and gain maximum benefit from wearing a hearing aid. A mixed methods approach was employed during 2006 involving interviews with key stakeholders, a survey across three Scottish health board areas and focus groups. Nine key stakeholders from six national and local organisations were interviewed about the needs of older people being fitted with hearing aids. In total, 240 older people belonging to three different types of hearing impaired older people were surveyed: long-term users of hearing aids, new hearing aid users, and those on a waiting list from urban and rural areas (response rate = 24%). A series of eight follow-up focus groups with 31 audiology patients was held. Health professionals appeared to neglect appropriate provision of information and overly rely on technological interventions. Of 154 older people already fitted with hearing aids, only 52% of hearing aid users reported receiving enough practical help post fitting and only 41% reported receiving enough support. Approximately 40% reported not feeling confident in the use of their aids or their controls. Older people wanted more information than they received both before and after hearing aid fitting. Information provision and attention to the psychosocial aspects of care are key to enabling older people to adjust and optimise hearing aid benefit. © 2013 Blackwell Publishing Ltd.

The Effects of Unilateral Adaptation of Hearing Aids on Symptoms of Depression and Social Activity Constraints of Elderly

PubMed Central

Santos, Fernanda Dutra dos; Teixeira, Adriane Ribeiro

2014-01-01

Introduction Hearing loss is one of the most common problems in the elderly population. Besides compromising oral communication, it directly affects social relations and prevents elderly patients from living actively in society, possibly leading to the onset of depression or other conditions. Objective To analyze the effects of unilateral adaptation of hearing aids on symptoms of depression and the social activity constraints of elderly subjects with hearing impairment. Methods The sample consisted of elderly subjects with hearing loss who did not use hearing aids. Data were collected in two phases. Initially, all participants underwent an audiological assessment and answered the Hearing Handicap Inventory for Elderly (summarized version) and the Geriatric Depression Scale. All subjects participated in the selection and hearing aid adaptation processes and became monaural hearing aid users. After 30 days of hearing aid use, they were assessed with the same instruments. The results of the questionnaires before and after hearing aid adaptation were compared. Results The sample consisted of 13 individuals, between 60 and 90 years old (mean 72.85 ± 11.05 years). Data analysis showed that there was significant improvement in social activity constraints (p < 0.001) and in symptoms of depression (p = 0.031). Conclusion Results show that, in the sample studied, unilateral hearing aid adaptation reduced social activity constraints and depression symptoms. PMID:26157497

The Effects of Unilateral Adaptation of Hearing Aids on Symptoms of Depression and Social Activity Constraints of Elderly.

PubMed

Santos, Fernanda Dutra Dos; Teixeira, Adriane Ribeiro

2015-07-01

Introduction Hearing loss is one of the most common problems in the elderly population. Besides compromising oral communication, it directly affects social relations and prevents elderly patients from living actively in society, possibly leading to the onset of depression or other conditions. Objective To analyze the effects of unilateral adaptation of hearing aids on symptoms of depression and the social activity constraints of elderly subjects with hearing impairment. Methods The sample consisted of elderly subjects with hearing loss who did not use hearing aids. Data were collected in two phases. Initially, all participants underwent an audiological assessment and answered the Hearing Handicap Inventory for Elderly (summarized version) and the Geriatric Depression Scale. All subjects participated in the selection and hearing aid adaptation processes and became monaural hearing aid users. After 30 days of hearing aid use, they were assessed with the same instruments. The results of the questionnaires before and after hearing aid adaptation were compared. Results The sample consisted of 13 individuals, between 60 and 90 years old (mean 72.85 ± 11.05 years). Data analysis showed that there was significant improvement in social activity constraints (p < 0.001) and in symptoms of depression (p = 0.031). Conclusion Results show that, in the sample studied, unilateral hearing aid adaptation reduced social activity constraints and depression symptoms.

Evaluating a smartphone digits-in-noise test as part of the audiometric test battery.

PubMed

Potgieter, Jenni-Mari; Swanepoel, De Wet; Smits, Cas

2018-05-21

 Speech-in-noise tests have become a valuable part of the audiometric test battery providing an indication of a listener's ability to function in background noise. A simple digits-in-noise (DIN) test could be valuable to support diagnostic hearing assessments, hearing aid fittings and counselling for both paediatric and adult populations. Objective: The objective of this study was to evaluate the South African English smartphone DIN test's performance as part of the audiometric test battery. Design: This descriptive study evaluated 109 adult subjects (43 male and 66 female subjects) with and without sensorineural hearing loss by comparing pure-tone air conduction thresholds, speech recognition monaural performance scores (SRS dB) and the DIN speech reception threshold (SRT). An additional nine adult hearing aid users (four male and five female subjects) were included in a subset to determine aided and unaided DIN SRTs. Results: The DIN SRT is strongly associated with the best ear 4 frequency pure-tone average (4FPTA) (rs = 0.81) and maximum SRS dB (r = 0.72). The DIN test had high sensitivity and specificity to identify abnormal pure-tone (0.88 and 0.88, respectively) and SRS dB (0.76 and 0.88, respectively) results. There was a mean signal-to-noise ratio (SNR) improvement in the aided condition that demonstrated an overall benefit of 0.84 SNR dB. Conclusion: The DIN SRT was significantly correlated with the best ear 4FPTA and maximum SRS dB. The DIN SRT provides a useful measure of speech recognition in noise that can evaluate hearing aid fittings, manage counselling and hearing expectations.

Speech perception benefits of FM and infrared devices to children with hearing aids in a typical classroom.

PubMed

Anderson, Karen L; Goldstein, Howard

2004-04-01

Children typically learn in classroom environments that have background noise and reverberation that interfere with accurate speech perception. Amplification technology can enhance the speech perception of students who are hard of hearing. This study used a single-subject alternating treatments design to compare the speech recognition abilities of children who are, hard of hearing when they were using hearing aids with each of three frequency modulated (FM) or infrared devices. Eight 9-12-year-olds with mild to severe hearing loss repeated Hearing in Noise Test (HINT) sentence lists under controlled conditions in a typical kindergarten classroom with a background noise level of +10 dB signal-to-noise (S/N) ratio and 1.1 s reverberation time. Participants listened to HINT lists using hearing aids alone and hearing aids in combination with three types of S/N-enhancing devices that are currently used in mainstream classrooms: (a) FM systems linked to personal hearing aids, (b) infrared sound field systems with speakers placed throughout the classroom, and (c) desktop personal sound field FM systems. The infrared ceiling sound field system did not provide benefit beyond that provided by hearing aids alone. Desktop and personal FM systems in combination with personal hearing aids provided substantial improvements in speech recognition. This information can assist in making S/N-enhancing device decisions for students using hearing aids. In a reverberant and noisy classroom setting, classroom sound field devices are not beneficial to speech perception for students with hearing aids, whereas either personal FM or desktop sound field systems provide listening benefits.

Pediatric hearing aid use: parent-reported challenges.

PubMed

Muñoz, Karen; Olson, Whitney A; Twohig, Michael P; Preston, Elizabeth; Blaiser, Kristina; White, Karl R

2015-01-01

The aim of this study was to investigate parent-reported challenges related to hearing aid management and parental psychosocial characteristics during the first 3 years of the child's life. Using a cross-sectional survey design, surveys were distributed to parents of children with hearing loss via state Early Intervention programs in Utah and Indiana. Packets contained one family demographic form and two sets of three questionnaires to obtain responses from mothers and fathers separately: the Parent Hearing Aid Management Inventory explored parent access to information, parent confidence in performing skills, expectations, communication with the audiologist, and hearing aid use challenges. The Acceptance and Action Questionnaire measured psychological flexibility, experiential avoidance, and internal thought processes that can affect problem-solving ability and decrease an individual's ability to take value-based actions. The Patient Health Questionnaire identified symptoms of depression. Thirty-seven families completed questionnaires (35 mothers and 20 fathers). Most responses were parents of toddlers (M = 22 months) who had been wearing binaural hearing aids for an average of 15 months. Both mothers and fathers reported that even though the amount of information they received was overwhelming, most (84%) preferred to have all the information at the beginning, rather than to receive it over an extended time period. Parents reported an array of challenges related to hearing aid management, with the majority related to daily management, hearing aid use, and emotional adjustment. Sixty-six percent of parents reported an audiologist taught them how to complete a listening check using a stethoscope, however, only one-third reported doing a daily hearing aid listening check. Both mothers and fathers reported a wide range of variability in their confidence in performing activities related to hearing aid management, and most reported minimal confidence in their ability to troubleshoot hearing aid problems. More than half of the parents reported child behavior and activities, such as playing outside, as a major hearing aid use challenge. Parents reported hearing aids were worn all waking hours by 35% of children and less than 5 hr/day by 31%. Almost half of the parents (47%) did not feel that they had enough time to talk about their emotions when speaking with their audiologist(s), 69% reported the audiologist did not help them know what to expect related to emotions about their child's hearing loss, and 22% reported symptoms of depression. Parents reported an array of challenges, even after their child had been wearing hearing aids for a prolonged time, revealing critical implications for how to provide audiological care. Audiologists have an important role in partnering with parents to identify and jointly problem-solving challenges related to their child's hearing aid use. Supporting parents includes not only addressing technical aspects of hearing testing and hearing aid function but also addressing parent thoughts, feelings, and emotions.

Hearing rehabilitation in Treacher Collins Syndrome with bone anchored hearing aid

PubMed Central

Polanski, José Fernando; Plawiak, Anna Clara; Ribas, Angela

2015-01-01

Objective: To describe a case of hearing rehabilitation with bone anchored hearing aid in a patient with Treacher Collins syndrome. Case description: 3 years old patient, male, with Treacher Collins syndrome and severe complications due to the syndrome, mostly related to the upper airway and hearing. He had bilateral atresia of external auditory canals, and malformation of the pinna. The initial hearing rehabilitation was with bone vibration arch, but there was poor acceptance due the discomfort caused by skull compression. It was prescribed a model of bone-anchored hearing aid, in soft band format. The results were evaluated through behavioral hearing tests and questionnaires Meaningful Use of Speech Scale (MUSS) and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS). Comments: The patient had a higher acceptance of the bone-anchored hearing aid compared to the traditional bone vibration arch. Audiological tests and the speech and auditory skills assessments also showed better communication and hearing outcomes. The bone-anchored hearing aid is a good option in hearing rehabilitation in this syndrome. PMID:26298651

Exploration of a physiologically-inspired hearing-aid algorithm using a computer model mimicking impaired hearing.

PubMed

Jürgens, Tim; Clark, Nicholas R; Lecluyse, Wendy; Meddis, Ray

2016-01-01

To use a computer model of impaired hearing to explore the effects of a physiologically-inspired hearing-aid algorithm on a range of psychoacoustic measures. A computer model of a hypothetical impaired listener's hearing was constructed by adjusting parameters of a computer model of normal hearing. Absolute thresholds, estimates of compression, and frequency selectivity (summarized to a hearing profile) were assessed using this model with and without pre-processing the stimuli by a hearing-aid algorithm. The influence of different settings of the algorithm on the impaired profile was investigated. To validate the model predictions, the effect of the algorithm on hearing profiles of human impaired listeners was measured. A computer model simulating impaired hearing (total absence of basilar membrane compression) was used, and three hearing-impaired listeners participated. The hearing profiles of the model and the listeners showed substantial changes when the test stimuli were pre-processed by the hearing-aid algorithm. These changes consisted of lower absolute thresholds, steeper temporal masking curves, and sharper psychophysical tuning curves. The hearing-aid algorithm affected the impaired hearing profile of the model to approximate a normal hearing profile. Qualitatively similar results were found with the impaired listeners' hearing profiles.

Hearing aid malfunction detection system

NASA Technical Reports Server (NTRS)

Kessinger, R. L. (Inventor)

1977-01-01

A malfunction detection system for detecting malfunctions in electrical signal processing circuits is disclosed. Malfunctions of a hearing aid in the form of frequency distortion and/or inadequate amplification by the hearing aid amplifier, as well as weakening of the hearing aid power supply are detectable. A test signal is generated and a timed switching circuit periodically applies the test signal to the input of the hearing aid amplifier in place of the input signal from the microphone. The resulting amplifier output is compared with the input test signal used as a reference signal. The hearing aid battery voltage is also periodically compared to a reference voltage. Deviations from the references beyond preset limits cause a warning system to operate.

Otologic manifestations of Larsen syndrome.

PubMed

Marques, Letícia Helena de Sousa; Martins, Daniela Vieira; Juares, Gabriel Liria; Lorenzetti, Fábio Tadeu Moura; Monsanto, Rafael da Costa

2017-10-01

To describe and discuss otologic manifestations of Larsen syndrome, based on a case report and a systematic review of the literature. We performed a PubMED database search, and we selected studies reporting otolaryngologic manifestations secondary to Larsen syndrome. The selected articles were read in full, and three researchers independently extracted data from the studies. In parallel, we report the case of a 14-year-old patient who had hearing loss secondary to Larsen syndrome. Fifteen studies met our selection criteria. Seven studies reported hearing loss in patients with Larsen syndrome (4 had conductive hearing loss and 3 had mixed hearing loss). The conductive hearing loss may be secondary to ossicular malformations and/or middle ear effusions. Other causes for conductive hearing loss are mesenchymal remnants in the middle ear, Eustachian tube dysfunction, and cleft palate. Surgical management of the hearing loss is possible in selected cases, although the surgical and anesthetic risks should be considered. Hearing aids seem to be safe and effective treatment options for the hearing loss secondary to Larsen syndrome. Although rare, patients with Larsen syndrome may have hearing loss. The most frequent type of deficit is conductive, either secondary to malformation of the ossicles or middle ear effusion. Possible surgical correction of these abnormalities should be weighed against the anesthetic risks of these patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Working Memory, Sleep, and Hearing Problems in Patients with Tinnitus and Hearing Loss Fitted with Hearing Aids.

PubMed

Zarenoe, Reza; Hällgren, Mathias; Andersson, Gerhard; Ledin, Torbjörn

2017-02-01

Tinnitus is a common condition and there is a need to evaluate effects of tinnitus management in relation to moderating factors such as degree of hearing loss. As it is possible that tinnitus influences concentration, and thus is likely to disturb cognitive processing, the role of cognitive functioning also needs to be investigated. To compare a group of patients with sensorineural hearing loss and tinnitus to a control group with only sensorineural hearing loss (and no tinnitus). To investigate working memory, sleep, and hearing problems measured before and after hearing rehabilitation. A prospective study. The sample consisted of 100 patients, 50 with hearing loss and tinnitus, and 50 controls with hearing loss but no tinnitus. All patients were between 40 and 82 yr old and had a pure-tone average (PTA; average of 0.5, 1, 2, and 4 kHz) <70 dB HL. Patients were tested before and after rehabilitation with hearing aids with regard to their working memory capacity, sleep quality, hearing problems, speech recognition, and tinnitus annoyance. Eight patients dropped out of the study. Thus, a total of 92 patients were included for analysis, with 46 in each group. As a consequence of unplanned age and PTA differences between the groups, an age-matched subsample (n = 30 + 30) was selected for further analysis. Tests including the Reading Span, Hearing-in-Noise Test (HINT), Tinnitus Handicap Inventory (THI), Hearing Handicap Inventory for the Elderly (HHIE), and Pittsburgh Sleep Quality Index (PSQI) were administered before and after hearing aid rehabilitation. There were no between-group differences at baseline in the full sample (n = 92), with the exception of the THI (p < 0.001) and the PSQI (p < 0.002), on which the hearing loss and tinnitus group had significantly higher scores. Pre/post changes were significant for both groups on the Reading Span, and HHIE. However, these improvements were significantly larger for the patients in the hearing loss and tinnitus group on the Reading Span test (p < 0.001) and the PSQI (p < 0.001). Patients with tinnitus and hearing loss also exhibited significantly improved THI scores at follow-up, compared to baseline (p < 0.001). We conducted the same analyses for the age-matched subsample (n = 30 + 30). For the baseline data, only the THI (p < 0.001) and the PSQI (p < 0.015) difference remained significant. With regard to the pre/post changes, we found the same differences in improvement in Reading Span (p < 0.001) and the PSQI (p < 0.015) as in the full sample. Patients with tinnitus benefited from hearing aid rehabilitation. The observed differences in cognitive function were unexpected, and there were larger score improvements on the Reading Span test in the hearing loss and tinnitus group than in the hearing loss group. Patients with tinnitus and hearing loss may receive extra benefit in terms of cognitive function following hearing aid rehabilitation. American Academy of Audiology

Qualitative interviews on the beliefs and feelings of adults towards their ownership, but non-use of hearing aids.

PubMed

Linssen, Anouk M; Joore, Manuela A; Minten, Rianne K H; van Leeuwen, Yvonne D; Anteunis, Lucien J C

2013-10-01

Up to a quarter of the adults who own hearing aids never use them. To provide these 'non-users' with the best help, hearing care professionals need to have an in-depth understanding of the non-users' beliefs and feelings with regard to the non-use. This qualitative study explored these beliefs and feelings in order to increase our understanding of hearing aid non-users. Individual face-to-face semi-structured interviews were completed. Eleven hearing aid owners (aged 54-80 years) who reported that they never or hardly ever used their hearing aids. The participants expressed a variety of feelings towards their non-use, including indifference, self-annoyance, frustration, powerlessness, shame, and guilt. Their feelings were related to beliefs about: (1) the severity of their hearing handicap with and without hearing aids, (2) whom or what was responsible for the non-use, and (3) the attitudes of significant others towards the non-use. Hearing-aid non-users differ in their beliefs and feelings towards the non-use. A patient-centred approach is needed.

21 CFR 874.3320 - Group hearing aid or group auditory trainer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Group hearing aid or group auditory trainer. 874... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3320 Group hearing aid or group auditory trainer. (a) Identification. A group hearing aid or group auditory trainer...

21 CFR 874.3320 - Group hearing aid or group auditory trainer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Group hearing aid or group auditory trainer. 874... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3320 Group hearing aid or group auditory trainer. (a) Identification. A group hearing aid or group auditory trainer...

21 CFR 874.3320 - Group hearing aid or group auditory trainer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Group hearing aid or group auditory trainer. 874... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3320 Group hearing aid or group auditory trainer. (a) Identification. A group hearing aid or group auditory trainer...

21 CFR 874.3320 - Group hearing aid or group auditory trainer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Group hearing aid or group auditory trainer. 874... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3320 Group hearing aid or group auditory trainer. (a) Identification. A group hearing aid or group auditory trainer...

Hearing aid use and long-term health outcomes: hearing handicap, mental health, social engagement, cognitive function, physical health and mortality

PubMed Central

Dawes, Piers; Cruickshanks, Karen J.; Fischer, Mary E.; Klein, Barbara E.K.; Klein, Ronald; Nondahl, David M.

2016-01-01

Objective To clarify the impact of hearing aids on mental health, social engagement, cognitive function, and physical health outcomes in older adults with hearing impairment. Design We assessed hearing handicap (Hearing Handicap Inventory for the Elderly; HHIE-S), cognition (Mini Mental State Exam, Trail Making, Auditory Verbal Learning, Digit-Symbol Substitution, Verbal Fluency, incidence of cognitive impairment), physical health (SF-12 physical component, basic and instrumental activities of daily living, mortality), social engagement (hours per week spent in solitary activities) and mental health (SF-12 mental component) at baseline, 5 years prior to baseline, and 5 and 11 years after baseline. Study sample Community-dwelling older adults with hearing impairment (N=666) from the Epidemiology of Hearing Loss Study cohort. Results There were no significant differences between hearing aid users and non-users in cognitive, social engagement or mental health outcomes at any time point. Aided HHIE-S was significantly better than unaided HHIE-S. At 11 years hearing aid users had significantly better SF-12 physical health scores (46.2 versus 41.2; p=0.03). There was no difference in incidence of cognitive impairment or mortality. Conclusion There was no evidence that hearing aids promote cognitive function, mental health, or social engagement. Hearing aids may reduce hearing handicap and promote better physical health. PMID:26140300

Use of the Aided Articulation Index (AAI) in the Evaluation of Hearing-Aid Fitting for Hearing-Impaired Children.

ERIC Educational Resources Information Center

Nakagawa, Tatsuo

1996-01-01

Examined the effectiveness of the Aided Articulation Index (AAI) in the evaluation of the fitting of hearing aids, using a sample of hearing-impaired children in a kindergarten and primary school for the deaf in Japan. Found that AAI decreased with hearing threshold level and an AAI of 0.3 is necessary for children to function effectively with…

Cortical Auditory Evoked Potentials Reveal Changes in Audibility with Nonlinear Frequency Compression in Hearing Aids for Children: Clinical Implications

PubMed Central

Ching, Teresa Y. C.; Zhang, Vicky W.; Hou, Sanna; Van Buynder, Patricia

2016-01-01

Hearing loss in children is detected soon after birth via newborn hearing screening. Procedures for early hearing assessment and hearing aid fitting are well established, but methods for evaluating the effectiveness of amplification for young children are limited. One promising approach to validating hearing aid fittings is to measure cortical auditory evoked potentials (CAEPs). This article provides first a brief overview of reports on the use of CAEPs for evaluation of hearing aids. Second, a study that measured CAEPs to evaluate nonlinear frequency compression (NLFC) in hearing aids for 27 children (between 6.1 and 16.8 years old) who have mild to severe hearing loss is reported. There was no significant difference in aided sensation level or the detection of CAEPs for /g/ between NLFC on and off conditions. The activation of NLFC was associated with a significant increase in aided sensation levels for /t/ and /s/. It also was associated with an increase in detection of CAEPs for /t/ and /s/. The findings support the use of CAEPs for checking audibility provided by hearing aids. Based on the current data, a clinical protocol for using CAEPs to validate audibility with amplification is presented. PMID:27587920

Dynamic relation between working memory capacity and speech recognition in noise during the first 6 months of hearing aid use.

PubMed

Ng, Elaine H N; Classon, Elisabet; Larsby, Birgitta; Arlinger, Stig; Lunner, Thomas; Rudner, Mary; Rönnberg, Jerker

2014-11-23

The present study aimed to investigate the changing relationship between aided speech recognition and cognitive function during the first 6 months of hearing aid use. Twenty-seven first-time hearing aid users with symmetrical mild to moderate sensorineural hearing loss were recruited. Aided speech recognition thresholds in noise were obtained in the hearing aid fitting session as well as at 3 and 6 months postfitting. Cognitive abilities were assessed using a reading span test, which is a measure of working memory capacity, and a cognitive test battery. Results showed a significant correlation between reading span and speech reception threshold during the hearing aid fitting session. This relation was significantly weakened over the first 6 months of hearing aid use. Multiple regression analysis showed that reading span was the main predictor of speech recognition thresholds in noise when hearing aids were first fitted, but that the pure-tone average hearing threshold was the main predictor 6 months later. One way of explaining the results is that working memory capacity plays a more important role in speech recognition in noise initially rather than after 6 months of use. We propose that new hearing aid users engage working memory capacity to recognize unfamiliar processed speech signals because the phonological form of these signals cannot be automatically matched to phonological representations in long-term memory. As familiarization proceeds, the mismatch effect is alleviated, and the engagement of working memory capacity is reduced. © The Author(s) 2014.

Effects of venting on wind noise levels measured at the eardrum.

PubMed

Chung, King

2013-01-01

Wind noise can be a nuisance to hearing aid users. With the advent of sophisticated feedback reduction algorithms, people with higher degrees of hearing loss are fit with larger vents than previously allowed, and more people with lesser degrees of hearing loss are fit with open hearing aids. The purpose of this study was to examine the effects of venting on wind noise levels in the ear canal for hearing aids with omnidirectional and directional microphones. Two behind-the-ear hearing aids were programmed when they were worn on a Knowles Electronics Manikin for Acoustic Research. The hearing aid worn on the right ear was programmed to the omnidirectional microphone mode and the one on the left to the directional microphone mode. The hearing aids were adjusted to linear amplification with flat frequency response in an anechoic chamber. Gains below 10 dB were used to avoid output limiting of wind noise levels at low input levels. Wind noise samples were recorded at the eardrum location in a wind tunnel at wind velocities ranging from a gentle to a strong breeze. The hearing aids were coupled to #13 tubings (i.e., open vent), or conventional skeleton earmolds with no vent, pressure vents, or 3mm vents. Polar and spectral characteristics of wind noise were analyzed off-line using MatLab programs. Wind noise levels in the ear canals were mostly predicted by vent-induced frequency response changes in the conventional earmold conditions for both omnidirectional and directional hearing aids. The open vent condition, however, yielded the lowest levels, which could not be entirely predicted by the frequency response changes of the hearing aids. This indicated that a wind-related vent effect permitted an additional amount of sound reduction in the ear canal, which could not be explained by known vent effects. For the microphone location, form factor, and gain settings tested, open fit hearing aids yielded lower noise levels at the eardrum location than conventional behind-the-ear hearing aids.

Alternatives in Aural Rehabilitation: Provider Training of Nonaudiologists in the Delivery of Hearing-Aid Supportive Services to Older Persons with Hearing Loss.

ERIC Educational Resources Information Center

Patterson, Karen; Dancer, Jess

1987-01-01

Describes program in which American Speech-Language-Hearing Association certified audiologists train protocol providers to assist older hearing-aid users in adjusting to using hearing aids on a daily basis. Training emphasizes empathy, effective communication skills, knowledge of the interaction of aging and hearing loss, phases outlined in…

Health behavior theories as predictors of hearing-aid uptake and outcomes.

PubMed

Saunders, Gabrielle H; Frederick, Melissa T; Silverman, ShienPei C; Nielsen, Claus; Laplante-Lévesque, Ariane

2016-07-01

To understand hearing behaviors of adults seeking help for the first time through the application of two models of health behavior change: the transtheoretical model and the health belief model. The relationships between attitudes and beliefs were examined relative to hearing-aid uptake and outcomes six months later. One hundred and sixty adults completed the University of Rhode Island change assessment (targeting the transtheoretical model), and the hearing beliefs questionnaire (targeting the health belief model), as well as the hearing handicap inventory and the psychosocial impact of hearing loss scale, within two months of an initial hearing assessment. Six months later, participants completed these same questionnaires, while those who had taken up hearing aids also completed hearing-aid outcome questionnaires. (1) Attitudes and beliefs were associated with future hearing-aid uptake, and were effective at modeling this behavior; (2) attitudes and beliefs changed following behavior change, and (3) attitudes and beliefs following behavior change were better predictors of hearing-aid outcomes than pre-behavior change attitudes and beliefs. A counseling-based intervention targeting the attitudes and beliefs assessed by the transtheoretical model and the health belief model has the potential to increase uptake of hearing health care.

Considerations in the Development of a Sound Tolerance Interview and Questionnaire Instrument

PubMed Central

Sherlock, LaGuinn P.; Formby, Craig

2017-01-01

Most clinicians approach the objective fitting of hearing aids with three goals in mind: audibility, comfort, and tolerance. When these three amplification goals have been met, the hearing aid user is more likely to adapt to and perceive benefit from hearing aid use. However, problems related to the loudness of sounds and reduced sound tolerance, which may or may not be reported by the aided user, can adversely impact adaptation to amplification and the individual's quality of life. Although there are several standardized questionnaires available to evaluate hearing aid benefit and satisfaction, there is no standardized questionnaire or interview tool for evaluating reduced sound tolerance and the related impact on hearing aid use. We describe a 36-item tool, the Sound Tolerance Questionnaire (STQ), consisting of six sections, including experience with hearing aids, sound sensitivity/intolerance, medical and noise exposure histories, coexisting tinnitus problems, and a final question to differentiate the primary and secondary problems related to sound intolerance, tinnitus, and hearing loss. In its current format as a research tool, the STQ was sensitive in pinpointing vague sound tolerance complaints not reported by the study participants in eligibility screening by Formby et al. A refined version of the STQ, the Sound Tolerance Interview and Questionnaire Instrument (STIQI), structured as a two-part tool, is presented in the appendix for prospective clinical use. The STIQI has potential utility to delineate factors contributing to loudness complaints and/or reduced sound tolerance in individuals considering hearing aid use, as well as those who have been unsuccessful hearing aid users secondary to loudness complaints or sound intolerance. The STIQI, when validated and refined, also may hold promise for predicting hearing aid benefit and/or assessing treatment-related change over time of hearing aid use or interventions designed to remediate problems of loudness and/or sound intolerance among hearing aid candidates or users. PMID:28286364

Detecting components of hearing aid fitting using a self-assessment-inventory.

PubMed

Meister, Hartmut; Lausberg, Isabel; Kiessling, Juergen; von Wedel, Hasso; Walger, Martin

2005-07-01

The evaluation of hearing-aid fitting includes numerous assessments such as electro- and psychoacoustic tests. The subjective estimation of the hearing aid user can be elicited with self-assessment inventories encompassing various parameters, e.g., benefit, satisfaction and usage. A questionnaire comprising 11 domains (disability, handicap, frequency and significance of the listening situation, importance of the hearing aid, expectation, demand, aided performance, benefit, satisfaction and usage) within three different conditions (speech in quiet and in noise and listening to sounds) was used to detect components underlying hearing aid fitting. The data show a three-factor structure (situation-, restriction- and aid-related variables) independent from the conditions. Usage depends on all of the three factors. Disability and handicap reveal the highest values for speech in noise, whereas the aid-related factor shows the lowest values for this condition. Global satisfaction with the hearing aid is significantly correlated with the aid-related factor, but independent from the restriction of hearing. The aid-related factor is positively influenced by the amount of social activity because more active persons report higher benefit and satisfaction for all listening conditions. Age does not exhibit a significant relationship to one of the components. Basically, all correlation coefficients are only intermediate, revealing that inter-individual differences of the patients are rather high. The data indicate that extra-audiological factors might also play an important role in the success of hearing aid fitting.

Effect of hearing aids on auditory function in infants with perinatal brain injury and severe hearing loss.

PubMed

Moreno-Aguirre, Alma Janeth; Santiago-Rodríguez, Efraín; Harmony, Thalía; Fernández-Bouzas, Antonio

2012-01-01

Approximately 2-4% of newborns with perinatal risk factors present with hearing loss. Our aim was to analyze the effect of hearing aid use on auditory function evaluated based on otoacoustic emissions (OAEs), auditory brain responses (ABRs) and auditory steady state responses (ASSRs) in infants with perinatal brain injury and profound hearing loss. A prospective, longitudinal study of auditory function in infants with profound hearing loss. Right side hearing before and after hearing aid use was compared with left side hearing (not stimulated and used as control). All infants were subjected to OAE, ABR and ASSR evaluations before and after hearing aid use. The average ABR threshold decreased from 90.0 to 80.0 dB (p = 0.003) after six months of hearing aid use. In the left ear, which was used as a control, the ABR threshold decreased from 94.6 to 87.6 dB, which was not significant (p>0.05). In addition, the ASSR threshold in the 4000-Hz frequency decreased from 89 dB to 72 dB (p = 0.013) after six months of right ear hearing aid use; the other frequencies in the right ear and all frequencies in the left ear did not show significant differences in any of the measured parameters (p>0.05). OAEs were absent in the baseline test and showed no changes after hearing aid use in the right ear (p>0.05). This study provides evidence that early hearing aid use decreases the hearing threshold in ABR and ASSR assessments with no functional modifications in the auditory receptor, as evaluated by OAEs.

Effect of Hearing Aids on Auditory Function in Infants with Perinatal Brain Injury and Severe Hearing Loss

PubMed Central

Moreno-Aguirre, Alma Janeth; Santiago-Rodríguez, Efraín; Harmony, Thalía; Fernández-Bouzas, Antonio

2012-01-01

Background Approximately 2–4% of newborns with perinatal risk factors present with hearing loss. Our aim was to analyze the effect of hearing aid use on auditory function evaluated based on otoacoustic emissions (OAEs), auditory brain responses (ABRs) and auditory steady state responses (ASSRs) in infants with perinatal brain injury and profound hearing loss. Methodology/Principal Findings A prospective, longitudinal study of auditory function in infants with profound hearing loss. Right side hearing before and after hearing aid use was compared with left side hearing (not stimulated and used as control). All infants were subjected to OAE, ABR and ASSR evaluations before and after hearing aid use. The average ABR threshold decreased from 90.0 to 80.0 dB (p = 0.003) after six months of hearing aid use. In the left ear, which was used as a control, the ABR threshold decreased from 94.6 to 87.6 dB, which was not significant (p>0.05). In addition, the ASSR threshold in the 4000-Hz frequency decreased from 89 dB to 72 dB (p = 0.013) after six months of right ear hearing aid use; the other frequencies in the right ear and all frequencies in the left ear did not show significant differences in any of the measured parameters (p>0.05). OAEs were absent in the baseline test and showed no changes after hearing aid use in the right ear (p>0.05). Conclusions/Significance This study provides evidence that early hearing aid use decreases the hearing threshold in ABR and ASSR assessments with no functional modifications in the auditory receptor, as evaluated by OAEs. PMID:22808289

Benefits of Localization and Speech Perception with Multiple Noise Sources in Listeners with a Short-electrode Cochlear Implant

PubMed Central

Dunn, Camille C.; Perreau, Ann; Gantz, Bruce; Tyler, Richard

2009-01-01

Background Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. Purpose The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech in noise test with spatially-separate noise sources. Research Design Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all eleven subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Conclusion Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise. PMID:20085199

Benefits of localization and speech perception with multiple noise sources in listeners with a short-electrode cochlear implant.

PubMed

Dunn, Camille C; Perreau, Ann; Gantz, Bruce; Tyler, Richard S

2010-01-01

Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech-in-noise test with spatially separate noise sources. Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all 11 subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise.

Identifying congenital hearing impairment. Personal experience based on selective hearing screening.

PubMed

Molini, E; Ricci, G; Baroni, S; Ciorba, A; Bellocci, A; Simoncelli, C

2004-06-01

If all degrees of permanent uni- or bilateral hypoacusis are taken into consideration, hearing impairment is the most common congenital disease. Early detection of permanent infantile hearing impairment has become extremely important in preventive medicine, since steps can be taken with hearing aids and rehabilitation to ensure better development of language and higher cognitive functions. Aim of this study is to provide a critical review of the time of diagnosis of hypoacusis at our audiology laboratory, where two methods were used to screen hearing of children with/without risk indicators. Results of approximately 10 years' work were re-examined during which time outpatient screening was conducted on children referred by colleagues in neonatology and paediatrics. All were carriers of congenital risk indicators associated with sensorineural and/or conductive hearing loss, based on the Joint Committee on Infant Hearing findings, or were suspected of being hypoacusic even if they had no known congenital risk factors. Hearing screening was conducted in hospital on newborns with no risk factors, within the first few days of birth. Results of the present study showed that when selective hearing screening was performed, the mean age of high-risk patients diagnosed with hypoacusis was slightly higher than that in international guidelines. Moreover, these patients represent approximately half the hypoacusic population identified in the study period. The other half of congenital hypoacusic subjects identified had no risk indicators and there was a significant delay in diagnosis due to later manifestation of symptoms indicating hypoacusis, and thus, in turn, delayed referral for hearing tests. In contrast, subjects without risk indicators who underwent in-hospital hearing screening and proved to be hypoacusic, were diagnosed early. In our experience, however, universal screening has considerable disadvantages, such as difficulty in covering the entire population, difficulty in follow-up after discharge from hospital, and last, but by no means least, significant organisational and professional commitments, making it impossible to perform in all hospitals. In order to ensure effective hearing screening for congenital hearing loss and, thus permit prompt identification of hypoacusic children, use of hearing aids and rehabilitation screening should incorporate two aspects. First, selection should be compulsory, thereby reducing waiting time between collecting case histories and performing outpatient tests; second, hospital screening of children without risk factors should be performed whenever possible. Integrating these two aspects would make it possible to approach the "utopia" of universal hearing screening.

Teachers' Perceptions of Adolescent Girls Who Wear Hearing Aids.

ERIC Educational Resources Information Center

Cox, Linda R.; And Others

1989-01-01

Females, aged 10-14, were photographed wearing a body aid, a postauricular aid, or no hearing aid. Ratings by 60 college education majors indicated that subjects pictured wearing a hearing aid were rated lower on achievement but higher on factors of appearance, personality, and assertiveness than subjects without the aid. (Author/JDD)

21 CFR 801.420 - Hearing aid devices; professional and patient labeling.

Code of Federal Regulations, 2014 CFR

2014-04-01

... damage the hearing aid, such as dropping, immersing, or exposing the hearing aid to excessive heat. (vii... strongly discouraged. children with hearing loss In addition to seeing a physician for a medical evaluation, a child with a hearing loss should be directed to an audiologist for evaluation and rehabilitation...

Dichotic Hearing in Elderly Hearing Aid Users Who Choose to Use a Single-Ear Device

PubMed Central

Ribas, Angela; Mafra, Nicoli; Marques, Jair; Mottecy, Carla; Silvestre, Renata; Kozlowski, Lorena

2014-01-01

Introduction Elderly individuals with bilateral hearing loss often do not use hearing aids in both ears. Because of this, dichotic tests to assess hearing in this group may help identify peculiar degenerative processes of aging and hearing aid selection. Objective To evaluate dichotic hearing for a group of elderly hearing aid users who did not adapt to using binaural devices and to verify the correlation between ear dominance and the side chosen to use the device. Methods A cross-sectional descriptive study involving 30 subjects from 60 to 81 years old, of both genders, with an indication for bilateral hearing aids for over 6 months, but using only a single device. Medical history, pure tone audiometry, and dichotic listening tests were all completed. Results All subjects (100%) of the sample failed the dichotic digit test; 94% of the sample preferred to use the device in one ear because bilateral use bothered them and affected speech understanding. In 6%, the concern was aesthetics. In the dichotic digit test, there was significant predominance of the right ear over the left, and there was a significant correlation between the dominant side with the ear chosen by the participant for use of the hearing aid. Conclusion In elderly subjects with bilateral hearing loss who have chosen to use only one hearing aid, there is dominance of the right ear over the left in dichotic listening tasks. There is a correlation between the dominant ear and the ear chosen for hearing aid fitting. PMID:25992120

[Subsidized project of hearing aid purchase for mild-moderate hearing impaired children in Akita prefecture].

PubMed

Sato, Teruyuki; Nakazawa, Misao; Takahashi, Shin; Ishikawa, Kazuo

2013-06-01

The dissemination of newborn hearing screening has detected children with mild-moderate hearing impairment at an early age. However, there is no nation-wide welfare system for children with mild-moderate hearing impairment in Japan. Under these kinds of social conditions, a subsidized project of hearing aid purchase for mild-moderate hearing impaired children has come into force from April 2010 in Akita prefecture. All 18 candidates who applied for this project were subsidized in Akita prefecture. Eighteen children purchased their hearing aids using this subsidy. The feature of this project was that every child could have access to subsidies as long as their doctor recognized the effectiveness of hearing aids because children with hearing impairment need to learn language. They contacted the hospital, prefectural government and institutes related to hearing loss before this project come into force. We recognized parents who are raising a child with mild-moderate hearing impairment have high interest in this project. Hearing aids can represent a considerable expense for young parents who are raising a child. We encountered some children who had to give up the idea of hearing aids due to their parents' economic circumstances before this project become effective. These situations were completely avoided after this project came into being. This administrative purpose was of demonstrated value in children with mild-moderate hearing impairment.

Directivity and noise reduction in hearing aids: speech perception and benefit.

PubMed

Quintino, Camila Angélica; Mondelli, Maria Fernanda Capoani Garcia; Ferrari, Déborah Viviane

2010-01-01

Hearing aid. To compare the performance, benefit and satisfaction of users of ITE, CIC and BTE digital hearing aid with noise reduction and omnidirectional and directional microphones. 34 users of hearing aid were evaluated by means of speech perception in noise tests and APHAB and IOI self assessment questionnaires. Prospective study. Better results were obtained by users of ITE, CIC and directional hearing aids, however, no statistical significance was found between the groups. Directivity improved speech perception in noise and benefit in daily life situations.

Speech perception in noise in unilateral hearing loss.

PubMed

Mondelli, Maria Fernanda Capoani Garcia; Dos Santos, Marina de Marchi; José, Maria Renata

2016-01-01

Unilateral hearing loss is characterized by a decrease of hearing in one ear only. In the presence of ambient noise, individuals with unilateral hearing loss are faced with greater difficulties understanding speech than normal listeners. To evaluate the speech perception of individuals with unilateral hearing loss in speech perception with and without competitive noise, before and after the hearing aid fitting process. The study included 30 adults of both genders diagnosed with moderate or severe sensorineural unilateral hearing loss using the Hearing In Noise Test - Hearing In Noise Test-Brazil, in the following scenarios: silence, frontal noise, noise to the right, and noise to the left, before and after the hearing aid fitting process. The study participants had a mean age of 41.9 years and most of them presented right unilateral hearing loss. In all cases evaluated with Hearing In Noise Test, a better performance in speech perception was observed with the use of hearing aids. Using the Hearing In Noise Test-Brazil test evaluation, individuals with unilateral hearing loss demonstrated better performance in speech perception when using hearing aids, both in silence and in situations with a competing noise, with use of hearing aids. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Probe Microphone Measurements: 20 Years of Progress

PubMed Central

Mueller, H. Gustav

2001-01-01

Probe-microphone testing was conducted in the laboratory as early as the 1940s (e.g., the classic work of Wiener and Ross, reported in 1946), however, it was not until the late 1970s that a “dispenser friendly” system was available for testing hearing aids in the real ear. In this case, the term “dispenser friendly,” is used somewhat loosely. The 1970s equipment that I'm referring to was first described in a paper that was presented by Earl Harford, Ph.D. in September of 1979 at the International Ear Clinics' Symposium in Minneapolis. At this meeting, Earl reported on his clinical experiences of testing hearing aids in the real ear using a miniature (by 1979 standards) Knowles microphone. The microphone was coupled to an interfacing impedance matching system (developed by David Preves, Ph.D., who at the time worked at Starkey Laboratories) which could be used with existing hearing aid analyzer systems (see Harford, 1980 for review of this early work). Unlike today's probe tube microphone systems, this early method of clinical real-ear measurement involved putting the entire microphone (about 4mm by 5mm by 2mm) in the ear canal down by the eardrum of the patient. If you think cerumen is a problem with probe-mic measurements today, you should have seen the condition of this microphone after a day's work! While this early instrumentation was a bit cumbersome, we quickly learned the advantages that probe-microphone measures provided in the fitting of hearing aids. We frequently ran into calibration and equalization problems, not to mention a yelp or two from the patient, but the resulting information was worth the trouble. Help soon arrived. In the early 1980s, the first computerized probe-tube microphone system, the Rastronics CCI-10 (developed in Denmark by Steen Rasmussen), entered the U.S. market (Nielsen and Rasmussen, 1984). This system had a silicone tube attached to the microphone (the transmission of sound through this tube was part of the calibration process), which eliminated the need to place the microphone itself in the ear canal. By early 1985, three or four different manufactures had introduced this new type of computerized probe-microphone equipment, and this hearing aid verification procedure became part of the standard protocol for many audiology clinics. At his time, the POGO (Prescription Of Gain and Output) and Libby 1/3 prescriptive fitting methods were at the peak of their popularity, and a revised NAL (National Acoustic Laboratories) procedure was just being introduced. All three of these methods were based on functional gain, but insertion gain easily could be substituted, and therefore, manufacturers included calculation of these prescriptive targets as part of the probe-microphone equipment software. Audiologists, frustrated with the tedious and unreliable functional gain procedure they had been using, soon developed a fascination with matching real-ear results to prescriptive targets on a computer monitor. In some ways, not a lot has changed since those early days of probe-microphone measurements. Most people who use this equipment simply run a gain curve for a couple inputs and see if it's close to prescriptive target—something that could be accomplished using the equipment from 1985. Contrary to the predictions of many, probe-mic measures have not become the “standard hearing aid verification procedure.” (Mueller and Strouse, 1995). There also has been little or no increase in the use of this equipment in recent years. In 1998, I reported on a survey that was conducted by The Hearing Journal regarding the use of probe-microphone measures (Mueller, 1998). We first looked at what percent of people dispensing hearing aids own (or have immediate access to) probe-microphone equipment. Our results showed that 23% of hearing instrument specialists and 75% of audiologists have this equipment. Among audiologists, ownership varied among work settings: 91% for hospitals/clinics, 73% for audiologists working for physicians, and 69% for audiologists in private practice. But more importantly, and a bit puzzling, was the finding that showed that nearly one half of the people who fit hearing aids and have access to this equipment, seldom or never use it. I doubt that the use rate of probe-microphone equipment has changed much in the last three years, and if anything, I suspect it has gone down. Why do I say that? As programmable hearing aids have become the standard fitting in many clinics, it is tempting to become enamoured with the simulated gain curves on the fitting screen, somehow believing that this is what really is happening in the real ear. Additionally, some dispensers have been told that you can't do reliable probe-mic testing with modern hearing aids—this of course is not true, and we'll address this issue in the Frequently Asked Questions portion of this paper. The infrequent use of probe-mic testing among dispensers is discouraging, and let's hope that probe-mic equipment does not suffer the fate of the rowing machine stored in your garage. A lot has changed over the years with the equipment itself, and there are also expanded clinical applications and procedures. We have new manufacturers, procedures, acronyms and noises. We have test procedures that allow us to accurately predict the output of a hearing aid in an infant's ear. We now have digital hearing aids, which provide us the opportunity to conduct real-ear measures of the effects of digital noise reduction, speech enhancement, adaptive feedback, expansion, and all the other features. Directional microphone hearing aids have grown in popularity and what better way to assess the real-ear directivity than with probe-mic measures? The array of assistive listening devices has expanded, and so has the role of the real-ear assessment of these products. And finally, with today's PC -based systems, we can program our hearing aids and simultaneously observe the resulting real-ear effects on the same fitting screen, or even conduct an automated target fitting using earcanal monitoring of the output. There have been a lot of changes, and we'll talk about all of them in this issue of Trends. PMID:25425897

[Effect of rehabilitation for prelingual deaf children who use cochlear implants in conjunction with hearing aids in the opposite ears].

PubMed

Tian, Yanjing; Zhou, Huifang; Zhang, Jing; Yang, Dong; Xu, Yi; Guo, Yuxi

2012-10-01

To compare the effect of rehabilitation of prelingual deaf children who used a cochlear implant (CI) in one ear and a hearing aids in the opposite ear while the hearing level of the opposite ears are different. Hearing ability, language ability and learning ability was included in the content. The aim of this research is to investigate better style of rehabilitation, and to offer the best help to the prelingual deaf children. Accord ing to the hearing level of the ear opposite to the one wearing a cochlear implant and whether the opposite ear wear a hearing aid or not, 30 prelingual deaf children were divided into three groups, including cochlear implant with opposite severe hearing loss and hearing aid ear (CI+SHA), cochlear implant with opposite profound hearing loss and hearing aid ear (CI+PHA), cochlear implant only (CI). The effect of rehabilitation was assessed in six different times (3,6,9,12,15 and 18 months after the cochlear implants and hearing aids began to work). The longer time the rehabilitation spends, the better the hearing ability,language ability and the learning ability were. The hearing ability of CI+SHA was better than those of CI+PHA (P<0.05) and CI (P<0.05). The language ability and learning ability of CI-SHA was nearly equal to those of the other two groups. The prelingual deaf children should take much more time on rehabilitation. The effect of rehabilitation for prelingual deaf children who used cochlear implant in one ear and hearing aid in the other depend on the residual hearing level of the other ear. If a prelingual deaf children still has any residual hearing level in the ear opposite to the cochlear implant ear, it is better for him/her to wear a hearing aid in the ear.

Acclimatization in first-time hearing aid users using three different fitting protocols.

PubMed

Reber, Monika Bertges; Kompis, Martin

2005-12-01

To study auditory acclimatization and outcome in first time hearing aid users fitted with state of the art hearing aids as a function of different hearing aid fitting protocols. Twenty-eight adult subjects participated in the study. Each subject was assigned to one of three study groups (named audiologist driven, AD; patient driven, PD; set-to-target, STT according to the fitting protocol used) and fitted with digital hearing aids (Bernafon Symbio). Speech recognition scores were measured in aided and unaided conditions over a 6-month period. Five subjects (three from the PD-group, two from the STT group) decided to withdraw from the study during the 6-month-study period, leaving a total of 23 complete data sets for analysis. Aided speech understanding increased significantly over this time period in all three groups. However, average hearing aid insertion gain changes were small over the same period. There were no statistically significant differences in aided or unaided speech recognition scores between the three groups after 2 weeks or after 6 months. On average, twice as many fine tunings of the hearing aids were requested by the patients in the AD and the STT group than in the PD group and subjects in the AD and STT group used their hearing aids approximately twice as much as subjects in the PD group. The substantial increase in speech intelligibility without significant changes of the insertion gain of the hearing aids over a 6-month period in all three groups suggests a significant acclimatization effect. Although the speech recognition with hearing aids did not differ significantly among the three study groups after 6 months, the lower average wearing time and the higher number of withdrawals from the study in the PD group suggest that the patients' needs are not adequately met. In terms of aided speech recognition scores and hearing aid wearing time the STT group and the AD group were very similar. However, comments of the patients and the higher rate of withdrawals in the STT group suggest an over-all advantage for the AD fitting protocol.

Development of Improved Software Intelligent System for Audiological Solutions.

PubMed

Rajkumar, S; Muttan, S; Sapthagirivasan, V; Jaya, V; Vignesh, S S

2018-06-02

Of late, there has been an increase in hearing impairment cases and to provide the most advantageous solutions to them is an uphill task for audiologists. Significant difficulty faced by the audiologists is in effective programming of hearing aids to provide enhanced satisfaction to the users. The main aim of our study was to develop a software intelligent system (SIS): (i) to perform the required audiological investigations for finding the degree and type of hearing loss, and (ii) to suggest appropriate values of hearing aid parameters for enhancing the speech intelligibility and the satisfaction level among the hearing aid users. In this paper, we present a Neuro-Fuzzy based SIS to automatically predict and suggest the hearing-aid parameters such as gain values, compression ratio and threshold knee point, which are needed to be fixed for different octave frequencies of sound inputs during the hearing-aid trial. The test signals for audiological investigations are generated through the standard hardware present in a personal computer system and with the aid of a software algorithm. The proposed system was validated with 243 subjects' data collected at the Government General Hospital, Chennai, India. The calculated sensitivity, specificity and accuracy of the proposed audiometer incorporated in the SIS were 98.6%, 96.4 and 98.2%, respectively, by comparing its interpretations with those of the 'gold standard' audiometers. Furthermore, 91% (221 of 243) of the hearing impaired subjects attained satisfaction in the first hearing aid trials itself with the gain values as recommended by the improved SIS. The proposed system reduced around 75% of the 'trial and error' time spent by audiologists for enhancing satisfactory usage of the hearing aid. Hence, the proposed SIS could be used to find the degree and type of hearing loss and to recommend hearing aid parameters to provide optimal solutions to the hearing aid users.

Measuring listening effort: driving simulator vs. simple dual-task paradigm

PubMed Central

Wu, Yu-Hsiang; Aksan, Nazan; Rizzo, Matthew; Stangl, Elizabeth; Zhang, Xuyang; Bentler, Ruth

2014-01-01

Objectives The dual-task paradigm has been widely used to measure listening effort. The primary objectives of the study were to (1) investigate the effect of hearing aid amplification and a hearing aid directional technology on listening effort measured by a complicated, more real world dual-task paradigm, and (2) compare the results obtained with this paradigm to a simpler laboratory-style dual-task paradigm. Design The listening effort of adults with hearing impairment was measured using two dual-task paradigms, wherein participants performed a speech recognition task simultaneously with either a driving task in a simulator or a visual reaction-time task in a sound-treated booth. The speech materials and road noises for the speech recognition task were recorded in a van traveling on the highway in three hearing aid conditions: unaided, aided with omni directional processing (OMNI), and aided with directional processing (DIR). The change in the driving task or the visual reaction-time task performance across the conditions quantified the change in listening effort. Results Compared to the driving-only condition, driving performance declined significantly with the addition of the speech recognition task. Although the speech recognition score was higher in the OMNI and DIR conditions than in the unaided condition, driving performance was similar across these three conditions, suggesting that listening effort was not affected by amplification and directional processing. Results from the simple dual-task paradigm showed a similar trend: hearing aid technologies improved speech recognition performance, but did not affect performance in the visual reaction-time task (i.e., reduce listening effort). The correlation between listening effort measured using the driving paradigm and the visual reaction-time task paradigm was significant. The finding showing that our older (56 to 85 years old) participants’ better speech recognition performance did not result in reduced listening effort was not consistent with literature that evaluated younger (approximately 20 years old), normal hearing adults. Because of this, a follow-up study was conducted. In the follow-up study, the visual reaction-time dual-task experiment using the same speech materials and road noises was repeated on younger adults with normal hearing. Contrary to findings with older participants, the results indicated that the directional technology significantly improved performance in both speech recognition and visual reaction-time tasks. Conclusions Adding a speech listening task to driving undermined driving performance. Hearing aid technologies significantly improved speech recognition while driving, but did not significantly reduce listening effort. Listening effort measured by dual-task experiments using a simulated real-world driving task and a conventional laboratory-style task was generally consistent. For a given listening environment, the benefit of hearing aid technologies on listening effort measured from younger adults with normal hearing may not be fully translated to older listeners with hearing impairment. PMID:25083599

Advantages of binaural amplification to acceptable noise level of directional hearing aid users.

PubMed

Kim, Ja-Hee; Lee, Jae Hee; Lee, Ho-Ki

2014-06-01

The goal of the present study was to examine whether Acceptable Noise Levels (ANLs) would be lower (greater acceptance of noise) in binaural listening than in monaural listening condition and also whether meaningfulness of background speech noise would affect ANLs for directional microphone hearing aid users. In addition, any relationships between the individual binaural benefits on ANLs and the individuals' demographic information were investigated. Fourteen hearing aid users (mean age, 64 years) participated for experimental testing. For the ANL calculation, listeners' most comfortable listening levels and background noise level were measured. Using Korean ANL material, ANLs of all participants were evaluated under monaural and binaural amplification with a counterbalanced order. The ANLs were also compared across five types of competing speech noises, consisting of 1- through 8-talker background speech maskers. Seven young normal-hearing listeners (mean age, 27 years) participated for the same measurements as a pilot testing. The results demonstrated that directional hearing aid users accepted more noise (lower ANLs) with binaural amplification than with monaural amplification, regardless of the type of competing speech. When the background speech noise became more meaningful, hearing-impaired listeners accepted less amount of noise (higher ANLs), revealing that ANL is dependent on the intelligibility of the competing speech. The individuals' binaural advantages in ANLs were significantly greater for the listeners with longer experience of hearing aids, yet not related to their age or hearing thresholds. Binaural directional microphone processing allowed hearing aid users to accept a greater amount of background noise, which may in turn improve listeners' hearing aid success. Informational masking substantially influenced background noise acceptance. Given a significant association between ANLs and duration of hearing aid usage, ANL measurement can be useful for clinical counseling of binaural hearing aid candidates or unsuccessful users.

Effectiveness of an online SUpport PRogramme (SUPR) for older hearing aid users: study protocol for a cluster randomised controlled trial

PubMed Central

Meijerink, Janine FJ; Pronk, Marieke; Paulissen, Bernadette; Witte, Birgit I; van der Wouden, Bregje; Jansen, Vera; Kramer, Sophia E

2017-01-01

Background An educational SUpport PRogramme called SUPR has been developed for hearing aid users (HAUs) and their communication partners (CPs) offering care beyond hearing aid fitting. SUPR teaches its users communication strategies, hearing aid handling skills and personal adjustment to hearing impairment. Methods/design Using a cluster randomised controlled trial design, 70 Dutch hearing aid dispenser practices were randomised into hearing aid fitting (care as usual, 34 practices) and hearing aid fitting including SUPR (36 practices). The aim was to recruit a total of 569 older (aged 50+ years) first-time (n=258) and experienced (n=311) HAUs and their CPs. SUPR consists of a Practical Support Booklet and online material offered via email over a period of 6–7 months. The booklet provides practical information on hearing aids, advice on communication strategies and home exercises. The online material consists of educational videos on hearing aid functionality and usage, communication strategies and peer testimonials. Finally, noncommittal email contact with the dispenser is offered. Every HAU is asked to assign a CP who is advised to be involved intensively. Effect measurements for HAUs and their CPs will occur at baseline and at 6, 12 and 18 months follow-up via online questionnaires. The primary outcomes for HAUs will be the use of communication strategies as measured by the subscales of the Communication Profile for the Hearing Impaired. A process evaluation will be performed. Ethics and dissemination The study was approved by the Dutch Institutional Review Board of the VU Medical University Center Amsterdam. This intervention could contribute to lowering the hearing impairment burden in our ageing society. The results will be disseminated through peer-reviewed publications and scientific conferences. Trial registration number ISRCTN77340339; Pre-results. PMID:28634259

New Perspectives on Assessing Amplification Effects

PubMed Central

Souza, Pamela E.; Tremblay, Kelly L.

2006-01-01

Clinicians have long been aware of the range of performance variability with hearing aids. Despite improvements in technology, there remain many instances of well-selected and appropriately fitted hearing aids whereby the user reports minimal improvement in speech understanding. This review presents a multistage framework for understanding how a hearing aid affects performance. Six stages are considered: (1) acoustic content of the signal, (2) modification of the signal by the hearing aid, (3) interaction between sound at the output of the hearing aid and the listener's ear, (4) integrity of the auditory system, (5) coding of available acoustic cues by the listener's auditory system, and (6) correct identification of the speech sound. Within this framework, this review describes methodology and research on 2 new assessment techniques: acoustic analysis of speech measured at the output of the hearing aid and auditory evoked potentials recorded while the listener wears hearing aids. Acoustic analysis topics include the relationship between conventional probe microphone tests and probe microphone measurements using speech, appropriate procedures for such tests, and assessment of signal-processing effects on speech acoustics and recognition. Auditory evoked potential topics include an overview of physiologic measures of speech processing and the effect of hearing loss and hearing aids on cortical auditory evoked potential measurements in response to speech. Finally, the clinical utility of these procedures is discussed. PMID:16959734

Factors Influencing Hearing Aid Use in the Classroom: A Pilot Study

ERIC Educational Resources Information Center

Gustafson, Samantha J.; Davis, Hilary; Hornsby, Benjamin W. Y.; Bess, Fred H.

2015-01-01

Purpose: This pilot study examined factors influencing classroom hearing aid use in school-age children with hearing loss. Method: The research team visited classrooms of 38 children with mild-to-moderate hearing loss (Grades 1-7) on 2 typical school days, twice per day, to document hearing aid use. In addition, parents reported the number of…

Factors Influencing Help Seeking, Hearing Aid Uptake, Hearing Aid Use and Satisfaction With Hearing Aids: A Review of the Literature

PubMed Central

Knudsen, Line Vestergaard; Öberg, Marie; Nielsen, Claus; Naylor, Graham; Kramer, Sophia E.

2010-01-01

Objectives: This descriptive summary of the literature provides an overview of the available studies (published between January 1980 and January 2009) on correlates of help-seeking behavior for hearing loss, hearing-aid uptake, hearing-aid use, and satisfaction with the device. Methods: Publications were identified by structured searches in Pubmed and Cinahl and by inspecting the reference lists of relevant articles. The articles covered different stages that a person with hearing impairment may go through: prior to hearing aid fitting, the period covering the fitting and the period post hearing aid fitting. Inclusion of articles occurred according to strict inclusion and exclusion criteria. Data were extracted by two independent researchers. Thirty-nine papers were included that identified 31 factors examined in relation to the four outcome measures. These covered personal factors (e.g., source of motivation, expectation, attitude), demographic factors (e.g., age, gender) and external factors (e.g., cost, counseling). Only two studies covered the actual fitting process. There was only one factor positively affecting all four outcome variables. This was self-reported hearing disability. The vast majority of studies showed no relationship of age and gender with any of the outcome domains. Discussion and conclusion: Whereas research of the last 28 years yielded valuable information regarding relevant and irrelevant factors in hearing aid health care, there are still many relevant issues that have never been investigated in controlled studies. These are discussed. PMID:21109549

[APHAB scores for individual assessment of the benefit of hearing aid fitting].

PubMed

Löhler, J; Wollenberg, B; Schönweiler, R

2017-11-01

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire measures subjective hearing impairment on four different subscales pertaining to different listening situations. Using a very large patient cohort, this study aims to show how answers are distributed within the four subscales before and after hearing aid fitting, and what benefit the patients experience. The results are discussed on the basis of the available literature. Between April 2013 and March 2016, 35,000 APHAB questionnaires from nine German statutory health insurance providers were evaluated. The average values before and after hearing aid fitting, as well as the benefit, were determined for all four APHAB subscales and analyzed graphically. The results of the subjective evaluation of hearing impairment before and after hearing aid fitting and the resultant benefit were plotted by percentile distribution graphs and boxplots. The data were analyzed statistically. There was no overlap of the interquartile ranges before and after hearing aid fitting in any of the APHAB subscales. In three scales (EC, BN and RV), the median improvement after hearing aid fitting was nearly 30 percentage points. In the AV subscale, this value was slightly negative. The percentile distribution graphs used in this study allow individual evaluation of subjective hearing impairment before and after hearing aid fitting, as well as of the resultant benefit, on the background of a huge database. Additionally, it is demonstrated why presentation as boxplots and the average benefit values calculated from these is problematic.

Effects of hearing aids on cognitive functions and depressive signs in elderly people.

PubMed

Acar, Baran; Yurekli, Muge Fethiye; Babademez, Mehmet Ali; Karabulut, Hayriye; Karasen, Rıza Murat

2011-01-01

With the physical, emotional and cognitive effects of senility, elderly people, especially those with impaired hearing, need rehabilitation for improving their life conditions. Hearing aids are frequently used to improve their daily life communications and activities. The aim of this study was to report the cognitive and psychological benefits of using hearing aids by the elderly people, over the age of 65. This was a prospective, single-arm interventional study in 34 elderly subjects with hearing impairment who answered the geriatric depression scale-short form (GDS) questionnaire and the mini mental state examination (MMSE) test, prior to, and 3 months following the use of hearing aid, after obtaining the patients' consent to participate in study. Patients with evidence of focal neurological loss with clinical examination, a confusional state, sudden hear loss and severe tinnitus were not included in the study. Scores of the effects of hearing aids on mood and cognitive functions were compared for each subject, before and after, and between males and females. After 3 months of using a hearing aid, all patients showed a significant improvement of the psychosocial and cognitive conditions, and all of them showed betterment of their problems, i.e., the social communication and exchanging information. In conclusion, for the elderly people with the effects of hearing aids in presbycusis and due to the significant improvement in psychological state and mental functions, using and being adaptable to hearing aids is a good solution. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Effect of a Bluetooth-implemented hearing aid on speech recognition performance: subjective and objective measurement.

PubMed

Kim, Min-Beom; Chung, Won-Ho; Choi, Jeesun; Hong, Sung Hwa; Cho, Yang-Sun; Park, Gyuseok; Lee, Sangmin

2014-06-01

The object was to evaluate speech perception improvement through Bluetooth-implemented hearing aids in hearing-impaired adults. Thirty subjects with bilateral symmetric moderate sensorineural hearing loss participated in this study. A Bluetooth-implemented hearing aid was fitted unilaterally in all study subjects. Objective speech recognition score and subjective satisfaction were measured with a Bluetooth-implemented hearing aid to replace the acoustic connection from either a cellular phone or a loudspeaker system. In each system, participants were assigned to 4 conditions: wireless speech signal transmission into hearing aid (wireless mode) in quiet or noisy environment and conventional speech signal transmission using external microphone of hearing aid (conventional mode) in quiet or noisy environment. Also, participants completed questionnaires to investigate subjective satisfaction. Both cellular phone and loudspeaker system situation, participants showed improvements in sentence and word recognition scores with wireless mode compared to conventional mode in both quiet and noise conditions (P < .001). Participants also reported subjective improvements, including better sound quality, less noise interference, and better accuracy naturalness, when using the wireless mode (P < .001). Bluetooth-implemented hearing aids helped to improve subjective and objective speech recognition performances in quiet and noisy environments during the use of electronic audio devices.

Evaluation of a Modified User Guide for Hearing Aid Management.

PubMed

Caposecco, Andrea; Hickson, Louise; Meyer, Carly; Khan, Asaduzzaman

2016-01-01

This study investigated if a hearing aid user guide modified using best practice principles for health literacy resulted in superior ability to perform hearing aid management tasks, compared with the user guide in the original form. This research utilized a two-arm study design to compare the original manufacturer's user guide with a modified user guide for the same hearing aid--an Oticon Acto behind-the-ear aid with an open dome. The modified user guide had a lower reading grade level (4.2 versus 10.5), used a larger font size, included more graphics, and had less technical information. Eighty-nine adults ages 55 years and over were included in the study; none had experience with hearing aid use or management. Participants were randomly assigned either the modified guide (n = 47) or the original guide (n = 42). All participants were administered the Hearing Aid Management test, designed for this study, which assessed their ability to perform seven management tasks (e.g., change battery) with their assigned user guide. The regression analysis indicated that the type of user guide was significantly associated with performance on the Hearing Aid Management test, adjusting for 11 potential covariates. In addition, participants assigned the modified guide required significantly fewer prompts to perform tasks and were significantly more likely to perform four of the seven tasks without the need for prompts. The median time taken by those assigned the modified guide was also significantly shorter for three of the tasks. Other variables associated with performance on the Hearing Aid Management test were health literacy level, finger dexterity, and age. Findings indicate that the need to design hearing aid user guides in line with best practice principles of health literacy as a means of facilitating improved hearing aid management in older adults.

The evidence base for the application of contralateral bone anchored hearing aids in acquired unilateral sensorineural hearing loss in adults.

PubMed

Baguley, D M; Bird, J; Humphriss, R L; Prevost, A T

2006-02-01

. Acquired unilateral sensorineural hearing loss reduces the ability to localize sounds and to discriminate in background noise. . Four controlled trials attempt to determine the benefit of contralateral bone anchored hearing aids over contralateral routing of signal (CROS) hearing aids and over the unaided condition. All found no significant improvement in auditory localization with either aid. Speech discrimination in noise and subjective questionnaire measures of auditory abilities showed an advantage for bone anchored hearing aid (BAHA) > CROS > unaided conditions. . All four studies have material shortfalls: (i) the BAHA was always trialled after the CROS aid; (ii) CROS aids were only trialled for 4 weeks; (iii) none used any measure of hearing handicap when selecting subjects; (iv) two studies have a bias in terms of patient selection; (v) all studies were underpowered (vi) double reporting of patients occurred. . There is a paucity of evidence to support the efficacy of BAHA in the treatment of acquired unilateral sensorineural hearing loss. Clinicians should proceed with caution and perhaps await a larger randomized trial. . It is perhaps only appropriate to insert a BAHA peg at the time of vestibular schwanoma tumour excision in patients with good preoperative hearing, as their hearing handicap increases most.

Age-related hearing difficulties. I. Hearing impairment, disability, and handicap--a controlled study.

PubMed

Salomon, G; Vesterager, V; Jagd, M

1988-01-01

The study compares the audiological profile of a group of first-time applicants for hearing aids, a group of re-applicants and a group of non-complainers, aged 70-75 years (n = 71). In spite of overlap in range, a significant difference in thresholds and discrimination was found. The lip-reading capacity was well preserved in the elderly, but showed a significant correlation to the general health condition. The audiological benefit of hearing-aids did not increase with early fitting. General satisfaction with life was independent of satisfaction with hearing; two thirds of the patients were satisfied with their aids and used them regularly. The rest were dissatisfied and used them less than once a week. The aids were most systematically used to watch TV. Pure-tone average and handicap scaling were compared as guidelines for hearing-aid fitting. The most powerful tool to identify those in need of hearing-aids was handicap scaling based on interviews concerning self-assessed hearing difficulties.

Audiologist-patient communication profiles in hearing rehabilitation appointments.

PubMed

Meyer, Carly; Barr, Caitlin; Khan, Asaduzzaman; Hickson, Louise

2017-08-01

To profile the communication between audiologists and patients in initial appointments on a biomedical-psychosocial continuum; and explore the associations between these profiles and 1) characteristics of the appointment and 2) patients' decisions to pursue hearing aids. Sixty-three initial hearing assessment appointments were filmed and audiologist-patient communication was coded using the Roter Interaction Analysis System. A hierarchical cluster analysis was conducted to profile audiologist-patient communication, after which regression modelling and Chi-squared analyses were conducted. Two distinct audiologist-patient communication profiles were identified during both the history taking phase (46=biopsychosocial profile, 15=psychosocial profile) and diagnosis and management planning phase (45=expanded biomedical profile, 11=narrowly biomedical profile). Longer appointments were significantly more likely to be associated with an expanded biomedical interaction during the diagnosis and management planning phase. No significant associations were found between audiologist-patient communication profile and patients' decisions to pursue hearing aids. Initial audiology consultations appear to remain clinician-centred. Three quarters of appointments began with a biopsychosocial interaction; however, 80% ended with an expanded biomedical interaction. Findings suggest that audiologists could consider modifying their communication in initial appointments to more holistically address the needs of patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Challenges in fitting a hearing aid to a severely collapsed ear canal and mixed hearing loss.

PubMed

Oeding, Kristi; Valente, Michael; Chole, Richard

2012-04-01

Collapsed ear canals typically occur when an outside force, such as a headset for audiometric testing, is present. However, when a collapsed ear canal occurs without external pressure, this creates a challenge not only for performing audiometric testing but also for coupling a hearing aid to the ear canal. This case report highlights the challenges associated with fitting a hearing aid on a patient with a severe anterior-posterior collapsed ear canal with a mixed hearing loss. A 67-yr-old female originally presented to Washington University in St. Louis School of Medicine in 1996 with a long-standing history of bilateral otosclerosis. She had chronic ear infections in the right ear and a severely collapsed ear canal in the left ear and was fit with a bone anchored hearing aid (BAHA®) on the right side in 2003. However, benefit from the BAHA started to decrease due to changes in hearing, and a different hearing solution was needed. It was proposed that a hearing aid be fit to her collapsed left ear canal; however, trying to couple a hearing aid to the collapsed ear canal required unique noncustom earmold solutions. This case study highlights some of the obstacles and potential solutions for coupling a hearing aid to a severely collapsed ear canal. American Academy of Audiology.

Hearing aid patients in private practice and public health (Veterans Affairs) clinics: are they different?

PubMed

Cox, Robyn M; Alexander, Genevieve C; Gray, Ginger A

2005-12-01

In hearing aid research, it is commonplace to combine data across subjects whose hearing aids were provided in different service delivery models. There is reason to question whether these types of patients are always similar enough to justify this practice. To explore this matter, this investigation evaluated similarities and differences in self-report data obtained from hearing aid patients derived from public health (Veterans Affairs, VA) and private practice (PP) settings. The study was a multisite, cross-sectional survey in which 230 hearing aid patients from VA and PP audiology clinic settings provided self-report data on a collection of questionnaires both before and after the hearing aid fitting. Subjects were all older adults with mild to moderately severe hearing loss. About half of them had previous experience wearing hearing aids. All subjects were fitted with wide-dynamic-range-compression instruments and received similar treatment protocols. Numerous statistically significant differences were observed between the VA and PP subject groups. Before the fitting, VA patients reported higher expectations from the hearing aids and more severe unaided problems compared with PP patients with similar audiograms. Three wks after the fitting, VA patients reported more satisfaction with their hearing aids. On some measures VA patients reported more benefit, but different measures of benefit did not give completely consistent results. Both groups reported using the hearing aids an average of approximately 8 hrs per day. VA patients reported age-normal physical and mental health, but PP patients tended to report better than typical health for their age group. These data indicate that hearing aid patients seen in the VA public health hearing services are systematically different in self-report domains from those seen in private practice services. It is therefore risky to casually combine data from these two types of subjects or to generalize research results from one group to the other. Further, compared with PP patients, VA patients consistently reported more favorable hearing aid fitting outcomes. Additional study is indicated to explore the determinants of this result and its generalizability to other public health service delivery systems such as those in other countries. Moreover, efforts should be made to assess the potential for transferring positive elements from the VA system to the PP service delivery system, if possible.

Cortical Auditory Evoked Potentials in (Un)aided Normal-Hearing and Hearing-Impaired Adults

PubMed Central

Van Dun, Bram; Kania, Anna; Dillon, Harvey

2016-01-01

Cortical auditory evoked potentials (CAEPs) are influenced by the characteristics of the stimulus, including level and hearing aid gain. Previous studies have measured CAEPs aided and unaided in individuals with normal hearing. There is a significant difference between providing amplification to a person with normal hearing and a person with hearing loss. This study investigated this difference and the effects of stimulus signal-to-noise ratio (SNR) and audibility on the CAEP amplitude in a population with hearing loss. Twelve normal-hearing participants and 12 participants with a hearing loss participated in this study. Three speech sounds—/m/, /g/, and /t/—were presented in the free field. Unaided stimuli were presented at 55, 65, and 75 dB sound pressure level (SPL) and aided stimuli at 55 dB SPL with three different gains in steps of 10 dB. CAEPs were recorded and their amplitudes analyzed. Stimulus SNRs and audibility were determined. No significant effect of stimulus level or hearing aid gain was found in normal hearers. Conversely, a significant effect was found in hearing-impaired individuals. Audibility of the signal, which in some cases is determined by the signal level relative to threshold and in other cases by the SNR, is the dominant factor explaining changes in CAEP amplitude. CAEPs can potentially be used to assess the effects of hearing aid gain in hearing-impaired users. PMID:27587919

Music preferences with hearing aids: effects of signal properties, compression settings, and listener characteristics.

PubMed

Croghan, Naomi B H; Arehart, Kathryn H; Kates, James M

2014-01-01

Current knowledge of how to design and fit hearing aids to optimize music listening is limited. Many hearing-aid users listen to recorded music, which often undergoes compression limiting (CL) in the music industry. Therefore, hearing-aid users may experience twofold effects of compression when listening to recorded music: music-industry CL and hearing-aid wide dynamic-range compression (WDRC). The goal of this study was to examine the roles of input-signal properties, hearing-aid processing, and individual variability in the perception of recorded music, with a focus on the effects of dynamic-range compression. A group of 18 experienced hearing-aid users made paired-comparison preference judgments for classical and rock music samples using simulated hearing aids. Music samples were either unprocessed before hearing-aid input or had different levels of music-industry CL. Hearing-aid conditions included linear gain and individually fitted WDRC. Combinations of four WDRC parameters were included: fast release time (50 msec), slow release time (1,000 msec), three channels, and 18 channels. Listeners also completed several psychophysical tasks. Acoustic analyses showed that CL and WDRC reduced temporal envelope contrasts, changed amplitude distributions across the acoustic spectrum, and smoothed the peaks of the modulation spectrum. Listener judgments revealed that fast WDRC was least preferred for both genres of music. For classical music, linear processing and slow WDRC were equally preferred, and the main effect of number of channels was not significant. For rock music, linear processing was preferred over slow WDRC, and three channels were preferred to 18 channels. Heavy CL was least preferred for classical music, but the amount of CL did not change the patterns of WDRC preferences for either genre. Auditory filter bandwidth as estimated from psychophysical tuning curves was associated with variability in listeners' preferences for classical music. Fast, multichannel WDRC often leads to poor music quality, whereas linear processing or slow WDRC are generally preferred. Furthermore, the effect of WDRC is more important for music preferences than music-industry CL applied to signals before the hearing-aid input stage. Variability in hearing-aid users' perceptions of music quality may be partially explained by frequency resolution abilities.

Cochlear implantation in adults with asymmetric hearing loss.

PubMed

Firszt, Jill B; Holden, Laura K; Reeder, Ruth M; Cowdrey, Lisa; King, Sarah

2012-01-01

Bilateral severe to profound sensorineural hearing loss is a standard criterion for cochlear implantation. Increasingly, patients are implanted in one ear and continue to use a hearing aid in the nonimplanted ear to improve abilities such as sound localization and speech understanding in noise. Patients with severe to profound hearing loss in one ear and a more moderate hearing loss in the other ear (i.e., asymmetric hearing) are not typically considered candidates for cochlear implantation. Amplification in the poorer ear is often unsuccessful because of limited benefit, restricting the patient to unilateral listening from the better ear alone. The purpose of this study was to determine whether patients with asymmetric hearing loss could benefit from cochlear implantation in the poorer ear with continued use of a hearing aid in the better ear. Ten adults with asymmetric hearing between ears participated. In the poorer ear, all participants met cochlear implant candidacy guidelines; seven had postlingual onset, and three had pre/perilingual onset of severe to profound hearing loss. All had open-set speech recognition in the better-hearing ear. Assessment measures included word and sentence recognition in quiet, sentence recognition in fixed noise (four-talker babble) and in diffuse restaurant noise using an adaptive procedure, localization of word stimuli, and a hearing handicap scale. Participants were evaluated preimplant with hearing aids and postimplant with the implant alone, the hearing aid alone in the better ear, and bimodally (the implant and hearing aid in combination). Postlingual participants were evaluated at 6 mo postimplant, and pre/perilingual participants were evaluated at 6 and 12 mo postimplant. Data analysis compared the following results: (1) the poorer-hearing ear preimplant (with hearing aid) and postimplant (with cochlear implant); (2) the device(s) used for everyday listening pre- and postimplant; and (3) the hearing aid-alone and bimodal listening conditions postimplant. The postlingual participants showed significant improvements in speech recognition after 6 mo cochlear implant use in the poorer ear. Five postlingual participants had a bimodal advantage over the hearing aid-alone condition on at least one test measure. On average, the postlingual participants had significantly improved localization with bimodal input compared with the hearing aid-alone. Only one pre/perilingual participant had open-set speech recognition with the cochlear implant. This participant had better hearing than the other two pre/perilingual participants in both the poorer and better ear. Localization abilities were not significantly different between the bimodal and hearing aid-alone conditions for the pre/perilingual participants. Mean hearing handicap ratings improved postimplant for all participants indicating perceived benefit in everyday life with the addition of the cochlear implant. Patients with asymmetric hearing loss who are not typical cochlear implant candidates can benefit from using a cochlear implant in the poorer ear with continued use of a hearing aid in the better ear. For this group of 10, the 7 postlingually deafened participants showed greater benefits with the cochlear implant than the pre/perilingual participants; however, further study is needed to determine maximum benefit for those with early onset of hearing loss.

Cochlear Implantation in Adults with Asymmetric Hearing Loss

PubMed Central

Firszt, Jill B.; Holden, Laura K.; Reeder, Ruth M.; Cowdrey, Lisa; King, Sarah

2012-01-01

Objective Bilateral severe-to-profound sensorineural hearing loss is a standard criterion for cochlear implantation. Increasingly, patients are implanted in one ear and continue to use a hearing aid in the non-implanted ear to improve abilities such as sound localization and speech understanding in noise. Patients with severe-to-profound hearing loss in one ear and a more moderate hearing loss in the other ear (i.e., asymmetric hearing) are not typically considered candidates for cochlear implantation. Amplification in the poorer ear is often unsuccessful due to limited benefit, restricting the patient to unilateral listening from the better ear alone. The purpose of this study was to determine if patients with asymmetric hearing loss could benefit from cochlear implantation in the poorer ear with continued use of a hearing aid in the better ear. Design Ten adults with asymmetric hearing between ears participated. In the poorer ear, all participants met cochlear implant candidacy guidelines; seven had postlingual onset and three had pre/perilingual onset of severe-to-profound hearing loss. All had open-set speech recognition in the better hearing ear. Assessment measures included word and sentence recognition in quiet, sentence recognition in fixed noise (four-talker babble) and in diffuse restaurant noise using an adaptive procedure, localization of word stimuli and a hearing handicap scale. Participants were evaluated pre-implant with hearing aids and post-implant with the implant alone, the hearing aid alone in the better ear and bimodally (the implant and hearing aid in combination). Postlingual participants were evaluated at six months post-implant and pre/perilingual participants were evaluated at six and 12 months post-implant. Data analysis compared results 1) of the poorer hearing ear pre-implant (with hearing aid) and post-implant (with cochlear implant), 2) with the device(s) used for everyday listening pre- and post-implant and, 3) between the hearing aid-alone and bimodal listening conditions post-implant. Results The postlingual participants showed significant improvements in speech recognition after six months cochlear implant use in the poorer ear. Five postlingual participants had a bimodal advantage over the hearing aid-alone condition on at least one test measure. On average, the postlingual participants had significantly improved localization with bimodal input compared to the hearing aid-alone. Only one pre/perilingual participant had open-set speech recognition with the cochlear implant. This participant had better hearing than the other two pre/perilingual participants in both the poorer and better ear. Localization abilities were not significantly different between the bimodal and hearing aid-alone conditions for the pre/perilingual participants. Mean hearing handicap ratings improved post-implant for all participants indicating perceived benefit in everyday life with the addition of the cochlear implant. Conclusions Patients with asymmetric hearing loss who are not typical cochlear implant candidates can benefit from using a cochlear implant in the poorer ear with continued use of a hearing aid in the better ear. For this group of ten, the seven postlingually deafened participants showed greater benefits with the cochlear implant than the pre/perilingual participants; however, further study is needed to determine maximum benefit for those with early onset of hearing loss. PMID:22441359

Initial experience with the Sophono Alpha 1 osseointegrated implant.

PubMed

Escorihuela-García, Vicente; Llópez-Carratalá, Ignacio; Pitarch-Ribas, Ignacia; Latorre-Monteagudo, Emilia; Marco-Algarra, Jaime

2014-01-01

In the last several years, bone anchored hearing aids have proven to be useful in treating conductive and mixed unilateral or bilateral hearing loss, as well as for sensorineural unilateral hearing loss. The Sophono Alpha 1 model has the advantage of not requiring an abutment, with it being coupled by magnetism instead. We report the cases of 3 infants with congenital malformations of external and middle ear. Audiometry showed conductive hearing loss. All 3 patients were implanted with Alpha 1 model (Sophono). Patients evolved satisfactorily. After 30 days we applied the processor and the control audiometry showed a marked improvement of hearing thresholds, although without a complete closure of the gap. With minimal care, the skin over the implant remained in excellent condition, with a very satisfactory cosmetic outcome. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

Tactile Aid Usage with Young Hearing-Impaired Children.

ERIC Educational Resources Information Center

Proctor, Adele

Five hearing impaired children (2 to 4 years old) were followed longitudinally while using a single channel, vibrotactile aid as a supplement to hearing aids. Standardized language tests (including the Scales of Early Communication Skills for Hearing Impaired Children, the Test for Auditory Comprehension of Language, and the Test for Auditory…

Determining the importance of fundamental hearing aid attributes.

PubMed

Meister, Hartmut; Lausberg, Isabel; Kiessling, Juergen; Walger, Martin; von Wedel, Hasso

2002-07-01

To determine the importance of fundamental hearing aid attributes and to elicit measures of satisfaction and dissatisfaction. A prospective study based on a survey using a decompositional approach of preference measurement (conjoint analysis). Ear, nose, and throat university hospitals in Cologne and Giessen; various branches of hearing aid dispensers. A random sample of 175 experienced hearing aid users aged 20 to 91 years (mean age, 61 yr) recruited at two different sites. Relative importance of different hearing aid attributes, satisfaction and dissatisfaction with hearing aid attributes. Of the six fundamental hearing aid attributes assessed by the hearing aid users, the two features concerning speech perception attained the highest relative importance (25% speech in quiet, 27% speech in noise). The remaining four attributes (sound quality, handling, feedback, localization) had significantly lower values in a narrow range of 10 to 12%. Comparison of different subgroups of hearing aid wearers based on sociodemographic and user-specific data revealed a large interindividual scatter of the preferences for the attributes. A similar examination with 25 clinicians revealed overestimation of the importance of the attributes commonly associated with problems. Moreover, examination of satisfaction showed that speech in noise was the most frequent source of dissatisfaction (30% of all statements), whereas the subjects were satisfied with speech in quiet. The results emphasize the high importance of attributes related to speech perception. Speech discrimination in noise was the most important but also the most frequent source of negative statements. This attribute will be the outstanding parameter of future developments. Appropriate handling becomes an important factor for elderly subjects. However, because of the large interindividual scatter of data, the preferences of different hearing aid users were hardly predictable, giving evidence of multifactorial influences.

[Progressive noise induced hearing loss caused by hearing AIDS, a dilemma for the worker and the expert alike].

PubMed

Feldmann, H

2001-12-01

Investigating cases of noise induced hearing loss the expert is often confronted with the situation that the hearing loss is progressive although the noise exposure has been reduced to almost non-damaging levels. Other causes such as age, hereditary deafness, head injuries, blasts, internal diseases can be excluded. Hearing aids as sources of damaging noise? By consulting the protocol of the hearing-aid acoustician and by own examinations the expert should obtain the following data: loudness level that yields best discrimination score of speech; level of discomfort for tones and speech, discrimination score that is achieved under free field condition with a speech level of 65 dB, using the hearing aids. Furthermore he should explore the circumstances under which the hearing aids are used: how many hours per day, at what occasions etc.? It is likely that in using the hearing aids they are adjusted to emit an intensity level identical to the one yielding the optimal discrimination score. If this e. g. is 100 dB and the hearing aids are used for 2 hours per day this would be equivalent to an exposure to industrial noise of 94 dB (A) for 8 hours daily without ear protection. Among all individuals working under industrial noise exposure today only about 1 - 2 % having unusually vulnerable inner ears will suffer a noise induced hearing loss. On the other hand workers in industrial noise are accustomed to loud noise levels, usually have a raised threshold of discomfort and therefore are likely to adjust their hearing aids to such high intensities. The expert will have to decide whether in an individual case the industrial noise exposure or the use of the hearing aids is the dominant risk for further damage. The consequences in respect to the regulations of the workers' health insurance are discussed.

The hearing aid effect in 2013.

PubMed

Rauterkus, Erik P; Palmer, Catherine V

2014-10-01

The hearing aid effect is the term used to describe the assignment of negative attributes to individuals using hearing aids. The effect was first empirically identified in 1977 when it was reported that adults rating young children with and without hearing aids assigned negative attributes to the children depicted with hearing aids. Investigations in the 1980s and 1990s reported mixed results related to the extent of the hearing aid effect but continued to identify, on average, some negative attributes assigned to individuals wearing hearing aids. The specific aim of this research was to investigate whether the hearing aid effect has diminished in the past several decades by replicating the methods of previous studies for testing the hearing aid effect while using updated devices. Five device configurations were rated across eight attributes. RESULTS for each attribute were considered separately. A total of 24 adults judged pictures of young men wearing various ear level technologies across 8 attributes on a 7-point Likert scale. Five young men between ages 15 and 17 yr were photographed wearing each of five device configurations including (1) a standard-sized behind-the-ear (BTE) hearing aid coupled to an earmold with #13 tubing, (2) a mini-BTE hearing aid with a slim tube open-fit configuration, (3) a completely-in-the-canal hearing aid that could not be seen because of its location in the ear canal, (4) an earbud, and (5) a Bluetooth receiver. The 24 raters saw pictures of each of the 5 young men with each wearing one of the 5 devices so that devices and young men were never judged twice by the same observer. All judgments of each device, regardless of the young man modeling the device, were combined in the data analysis. The effect of device types on judgments was tested using a one-way between-participant analysis of variance. There was a significant difference on the judgment of age and trustworthiness level among the five devices. However, our post hoc analysis revealed that only two significant effects were present. People wearing a completely-in-the-canal aid (nothing visible in the ear) were rated significantly older than people wearing an earbud, and people wearing the standard-size BTE with earmold were rated significantly more trustworthy than people who wore the Bluetooth device. It was hypothesized that the hearing aid effect would be diminished in 2013 compared with data reported in the past. This proved to be the case, as no hearing aid condition was rated as more negative than any of the non-hearing aid device conditions. In fact, models wearing the standard-size BTE with earmold were rated as more trustworthy than models wearing the Bluetooth device. The standard-sized BTE with earmold condition is the configuration that can be directly compared with previous research because similar devices were used in those studies. These results indicate that the hearing aid effect has diminished, if not completely disappeared, in the 21st century. American Academy of Audiology.

Exploring the influence of culture on hearing help-seeking and hearing-aid uptake.

PubMed

Zhao, Fei; Manchaiah, Vinaya; St Claire, Lindsay; Danermark, Berth; Jones, Lesley; Brandreth, Marian; Krishna, Rajalakshmi; Goodwin, Robin

2015-07-01

The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. Information on audiological services in different countries and 'theories related to cross-culture' is presented, followed by a general discussion. Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.

Interventions following hearing screening in adults: a systematic descriptive review.

PubMed

Pronk, Marieke; Kramer, Sophia E; Davis, Adrian C; Stephens, Dafydd; Smith, Pauline A; Thodi, Chryssoula; Anteunis, Lucien J C; Parazzini, Marta; Grandori, Ferdinando

2011-09-01

Adult hearing screening may be a solution to the under-diagnosis and under-treatment of hearing loss in adults. Limited use and satisfaction with hearing aids indicate that consideration of alternative interventions following hearing screening may be needed. The primary aim of this study is to provide an overview of all intervention types that have been offered to adult (≥ 18 years) screen-failures. Systematic literature review. Articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, private libraries, and through reference checking. Of the initial 3027 papers obtained from the searches, a total of 37 were found to be eligible. The great majority of the screening programmes (i.e. 26) referred screen-failures to a hearing specialist without further rehabilitation being specified. Most of the others (i.e. seven) led to the provision of hearing aids. Four studies offered alternative interventions comprising communication programme elements (e.g. speechreading, hearing tactics) or advice on environmental aids. Interventions following hearing screening generally comprised referral to a hearing specialist or hearing aid rehabilitation. Some programmes offered alternative rehabilitation options. These may be valuable as an addition to or replacement of hearing aid rehabilitation. It is recommended that this be addressed in future research.

Quality standards for bone conduction implants.

PubMed

Gavilan, Javier; Adunka, Oliver; Agrawal, Sumit; Atlas, Marcus; Baumgartner, Wolf-Dieter; Brill, Stefan; Bruce, Iain; Buchman, Craig; Caversaccio, Marco; De Bodt, Marc T; Dillon, Meg; Godey, Benoit; Green, Kevin; Gstoettner, Wolfgang; Hagen, Rudolf; Hagr, Abdulrahman; Han, Demin; Kameswaran, Mohan; Karltorp, Eva; Kompis, Martin; Kuzovkov, Vlad; Lassaletta, Luis; Li, Yongxin; Lorens, Artur; Martin, Jane; Manoj, Manikoth; Mertens, Griet; Mlynski, Robert; Mueller, Joachim; O'Driscoll, Martin; Parnes, Lorne; Pulibalathingal, Sasidharan; Radeloff, Andreas; Raine, Christopher H; Rajan, Gunesh; Rajeswaran, Ranjith; Schmutzhard, Joachim; Skarzynski, Henryk; Skarzynski, Piotr; Sprinzl, Georg; Staecker, Hinrich; Stephan, Kurt; Sugarova, Serafima; Tavora, Dayse; Usami, Shin-Ichi; Yanov, Yuri; Zernotti, Mario; Zorowka, Patrick; de Heyning, Paul Van

2015-01-01

Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program. To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines. Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure, clinical management, transfer of care and patient complaints.

Hearing Aids and Room Acoustics: an Entrepreneurial Physics Project

NASA Astrophysics Data System (ADS)

Caner, Edward

2002-10-01

We present an acoustics-based physics entrepreneurship project that identifies problems associated with hearing aids and listening environments such as restaurants and churches. The proposed company "Earcrafters" deals with the alarmingly low market penetration of hearing aids--especially amongst baby boomers--in two key ways: 1) Offering hearing instruments that "sound better" by way of improved frequency response throughout the audio spectrum and 2) applying marketing forces to effectively change the public perception that hearing aids are bulky and tinny-sounding. In contrast, the proposed company "US Sound" recognizes low hearing aid market penetration as a trend that will continue. The company is developing efficient methods to improve the acoustical environment of public areas such as restaurants and churches in order to fill the demand of baby boomers with hearing impairment--a number that has reached staggering proportions.

Struggling to Hear? Tiny Devices Can Keep You Connected

MedlinePlus

... features. For example, some can connect to your mobile phone, TV, and other devices using Bluetooth technology. That ... Loss? Hearing Aids Hearing Loss and Hearing Aid Use (Infographic) Assistive Devices for People with Hearing, Voice, ...

Longitudinal Relationship Between Hearing Aid Use and Cognitive Function in Older Americans.

PubMed

Maharani, Asri; Dawes, Piers; Nazroo, James; Tampubolon, Gindo; Pendleton, Neil

2018-04-10

To test whether hearing aid use alters cognitive trajectories in older adults. US population-based longitudinal cohort study SETTING: Data were drawn from the Health and Retirement Study (HRS), which measured cognitive performance repeatedly every 2 years over 18 years (1996-2014). Adults aged 50 and older who who took part in a minimum of 3 waves of the HRS and used hearing aids for the first time between Waves 4 and 11 (N=2,040). Cognitive outcomes were based on episodic memory scores determined according to the sum of immediate and delayed recall of 10 words. Hearing aid use was positively associated with episodic memory scores (β=1.53, p<.001). Decline in episodic memory scores was slower after (β=-0.02, p<.001) than before using hearing aids (β=-0.1, p<.001). These results were robust to adjustment for multiple confounders and to attrition, as accounted for using a joint model. Hearing aids may have a mitigating effect on trajectories of cognitive decline in later life. Providing hearing aids or other rehabilitative services for hearing impairment much earlier in the course of hearing impairment may stem the worldwide rise of dementia. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Frequency-Shift Hearing Aid

NASA Technical Reports Server (NTRS)

Weinstein, Leonard M.

1994-01-01

Proposed hearing aid maps spectrum of speech into band of lower frequencies at which ear remains sensitive. By redirecting normal speech frequencies into frequency band from 100 to 1,500 Hz, hearing aid allows people to understand normal conversation, including telephone calls. Principle operation of hearing aid adapted to other uses such as, clearing up noisy telephone or radio communication. In addition, loud-speakers more easily understood in presence of high background noise.

The influence of non-linear frequency compression on the perception of music by adults with a moderate to sever hearing loss: subjective impressions.

PubMed

Uys, Marinda; Pottas, Lidia; Vinck, Bart; van Dijk, Catherine

2012-12-01

To date, the main direction in frequency-lowering hearing aid studies has been in relation to speech perception abilities. With improvements in hearing aid technology, interest in musical perception as a dimension that could improve hearing aid users' quality of life has grown. The purpose of this study was to determine the influence of non-linear frequency compression (NFC) on hearing aid users' subjective impressions of listening to music. DESIGN & SAMPLE: A survey research design was implemented to elicit participants' (N=40) subjective impressions of musical stimuli with and without NFC. The use of NFC significantly improved hearing aid users' perception of the musical qualities of overall fidelity, tinniness and reverberance. Although participants preferred to listen to the loudness, fullness, crispness, naturalness and pleasantness of music with the use of NFC, these benefits were not significant. The use of NFC can increase hearing aid users' enjoyment and appreciation of music. Given that a relatively large percentage of hearing aid users express a loss of enjoyment of music, audiologists should not ignore the possible benefits of NFC, especially if one takes into account that previous research indicates speech perception benefits with this technology.

Socioeconomic differences in hearing among middle-aged and older adults: cross-sectional analyses using the Health Survey for England

PubMed Central

Scholes, Shaun; Biddulph, Jane; Davis, Adrian; Mindell, Jennifer S.

2018-01-01

Background Hearing loss impacts on cognitive, social and physical functioning. Both hearing loss and hearing aid use vary across population subgroups. We examined whether hearing loss, and reported current hearing aid use among persons with hearing loss, were associated with different markers of socioeconomic status (SES) in a nationally representative sample of community-dwelling middle-aged and older adults. Methods Hearing was measured using an audiometric screening device in the Health Survey for England 2014 (3292 participants aged 45 years and over). Hearing loss was defined as >35 dB HL at 3.0 kHz in the better-hearing ear. Using sex-specific logistic regression modelling, we evaluated the associations between SES and hearing after adjustment for potential confounders. Results 26% of men and 20% of women aged 45 years and over had hearing loss. Hearing loss was higher among men in the lowest SES groups. For example, the multivariable-adjusted odds of hearing loss were almost two times as high for those in the lowest versus the highest income tertile (OR 1.77, 95% CI 1.15 to 2.74). Among those with hearing loss, 30% of men and 27% of women were currently using a hearing aid. Compared with men in the highest income tertile, the multivariable-adjusted odds of using a hearing aid nowadays were lower for men in the middle (OR 0.50, 95% CI 0.25 to 0.99) and the lowest (OR 0.47, 95% CI 0.23 to 0.97) income tertiles. Associations between SES and hearing were weaker or null among women. Conclusions While the burden of hearing loss fell highest among men in the lowest SES groups, current hearing aid use was demonstrably lower. Initiatives to detect hearing loss early and increase the uptake and the use of hearing aids may provide substantial public health benefits and reduce socioeconomic inequalities in health. PMID:29391384

Improvement in word recognition score with level is associated with hearing aid ownership among patients with hearing loss.

PubMed

Halpin, Chris; Rauch, Steven D

2012-01-01

Market surveys consistently show that only 22% of those with hearing loss own hearing aids. This is often ascribed to cosmetics, but is it possible that patients apply a different auditory criterion than do audiologists and manufacturers? We tabulated hearing aid ownership in a survey of 1000 consecutive patients. We separated hearing loss cases, with one cohort in which word recognition in quiet could improve with gain (vs. 40 dB HL) and another without such improvement but nonetheless with audiometric thresholds within the manufacturer's fitting ranges. Overall, we found that exactly 22% of hearing loss patients in this sample owned hearing aids; the same finding has been reported in many previous, well-accepted surveys. However, while all patients in the two cohorts experienced difficulty in noise, patients in the cohort without word recognition improvement were found to own hearing aids at a rate of 0.3%, while those patients whose word recognition could increase with level were found to own hearing aids at a rate of 50%. Results also coherently fit a logistic model where shift of the word recognition performance curve by level corresponded to the likelihood of ownership. In addition to the common attribution of low hearing aid usage to patient denial, cosmetic issues, price, or social stigma, these results provide one alternative explanation based on measurable improvement in word recognition performance. Copyright © 2011 S. Karger AG, Basel.

Psychosocial health of cochlear implant users compared to that of adults with and without hearing aids: Results of a nationwide cohort study.

PubMed

Bosdriesz, J R; Stam, M; Smits, C; Kramer, S E

2018-06-01

This study aimed to examine the psychosocial health status of adult cochlear implant (CI) users, compared to that of hearing aid (HA) users, hearing-impaired adults without hearing aids and normally hearing adults. Cross-sectional observational study, using both self-reported survey data and a speech-in-noise test. Data as collected within the Netherlands Longitudinal Study on Hearing (NL-SH) between September 2011 and June 2016 were used. Data from 1254 Dutch adults (aged 23-74), selected in a convenience sample design, were included for analyses. Psychosocial health measures included emotional and social loneliness, anxiety, depression, distress and somatisation. Psychosocial health, hearing status, use of hearing technology and covariates were measured by self-report; hearing ability was assessed through an online digit triplet speech-in-noise test. After adjusting for the degree of hearing impairment, HA users (N = 418) and hearing-impaired adults (N = 247) had significantly worse scores on emotional loneliness than CI users (N = 37). HA users had significantly higher anxiety scores than CI users in some analyses. Non-significant differences were found between normally hearing (N = 552) and CI users for all psychosocial outcomes. Psychosocial health of CI users is not worse than that of hearing-impaired adults with or without hearing aids. CI users' level of emotional loneliness is even lower than that of their hearing-impaired peers using hearing aids. A possible explanation is that CI patients receive more professional and family support, and guidance along their patient journey than adults who are fitted with hearing aids. © 2017 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd.

21 CFR 874.3310 - Hearing aid calibrator and analysis system.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hearing aid calibrator and analysis system. 874.3310 Section 874.3310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... aid calibrator and analysis system. (a) Identification. A hearing aid calibrator and analysis system...

21 CFR 874.3310 - Hearing aid calibrator and analysis system.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hearing aid calibrator and analysis system. 874.3310 Section 874.3310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... aid calibrator and analysis system. (a) Identification. A hearing aid calibrator and analysis system...

21 CFR 874.3310 - Hearing aid calibrator and analysis system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hearing aid calibrator and analysis system. 874.3310 Section 874.3310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... aid calibrator and analysis system. (a) Identification. A hearing aid calibrator and analysis system...

21 CFR 874.3310 - Hearing aid calibrator and analysis system.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hearing aid calibrator and analysis system. 874.3310 Section 874.3310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... aid calibrator and analysis system. (a) Identification. A hearing aid calibrator and analysis system...

21 CFR 874.3310 - Hearing aid calibrator and analysis system.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hearing aid calibrator and analysis system. 874.3310 Section 874.3310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... aid calibrator and analysis system. (a) Identification. A hearing aid calibrator and analysis system...

Prevalence and associated factors of hearing aid use among older adults in Chile.

PubMed

Fuentes-López, Eduardo; Fuente, Adrian; Cardemil, Felipe; Valdivia, Gonzalo; Albala, Cecilia

2017-11-01

The aim of this study was to determine the prevalence of use of hearing aids by older adults in Chile and the influence of some variables such as education level, income level and geographic area of residence on the prevalence of hearing aids. A national cross-sectional survey which was carried out in 2009. A representative sample of 4766 Chilean older adults aged 60 years and above. The percentage of older adults in Chile who self-reported hearing problems and used hearing aids was 8.9%. Such prevalence increased for adults living in urban areas and for those who knew about the new Chilean programme of universal access to health services (AUGE). For older adults who did not know about this programme, significant associations between the use of hearing aids and the variables of age, geographic area of residence, and income level were found. People's knowledge about AUGE programme may positively influence the use of hearing aids, although a direct effect cannot be attributed.

The floating mass transducer at the round window: direct transmission or bone conduction?

PubMed

Arnold, Andreas; Kompis, Martin; Candreia, Claudia; Pfiffner, Flurin; Häusler, Rudolf; Stieger, Christof

2010-05-01

The round window placement of a floating mass transducer (FMT) is a new approach for coupling an implantable hearing system to the cochlea. We evaluated the vibration transfer to the cochlear fluids of an FMT placed at the round window (rwFMT) with special attention to the role of bone conduction. A posterior tympanotomy was performed on eleven ears of seven human whole head specimens. Several rwFMT setups were examined using laser Doppler vibrometry measurements at the stapes and the promontory. In three ears, the vibrations of a bone anchored hearing aid (BAHA) and an FMT fixed to the promontory (pFMT) were compared to explore the role of bone conduction. Vibration transmission to the measuring point at the stapes was best when the rwFMT was perpendicularly placed in the round window and underlayed with connective tissue. Fixation of the rwFMT to the round window exhibited significantly lower vibration transmission. Although measurable, bone conduction from the pFMT was much lower than that of the BAHA. Our results suggest that the rwFMT does not act as a small bone anchored hearing aid, but instead, acts as a direct vibratory stimulator of the round window membrane. Copyright (c) 2009 Elsevier B.V. All rights reserved.

Hearing and Underwater Noise Exposure

DTIC Science & Technology

1985-08-27

Ordnance Laboratory, White Oak, Silver Springs, Md. Corso, J. F. (1963) Bone-conduction thresholds for sonic and ultrasonic frequencies. J. Acoust...Soc. Am. 35, 1738-1743. Corso, J. F., & Levine, M. (1965a) Sonic and Ultrasonic equal loudness contours. J. Exp. Psychol. 70, 412-416. Corso, J...KEY WORDS (Continue on reverse aide II neceaaary and identity by block number) Hearing, Deafness, Sonar, Noise, Sound, Ultrasound, Infra -sound

A Randomized Controlled Trial to Evaluate the Benefits of a Multimedia Educational Program for First-Time Hearing Aid Users.

PubMed

Ferguson, Melanie; Brandreth, Marian; Brassington, William; Leighton, Paul; Wharrad, Heather

2016-01-01

The aims of this study were to (1) develop a series of short interactive videos (or reusable learning objects [RLOs]) covering a broad range of practical and psychosocial issues relevant to the auditory rehabilitation for first-time hearing aid users; (2) establish the accessibility, take-up, acceptability and adherence of the RLOs; and (3) assess the benefits and cost-effectiveness of the RLOs. The study was a single-center, prospective, randomized controlled trial with two arms. The intervention group (RLO+, n = 103) received the RLOs plus standard clinical service including hearing aid(s) and counseling, and the waitlist control group (RLO-, n = 100) received standard clinical service only. The effectiveness of the RLOs was assessed 6-weeks posthearing aid fitting. Seven RLOs (total duration 1 hr) were developed using a participatory, community of practice approach involving hearing aid users and audiologists. RLOs included video clips, illustrations, animations, photos, sounds and testimonials, and all were subtitled. RLOs were delivered through DVD for TV (50.6%) and PC (15.2%), or via the internet (32.9%). RLO take-up was 78%. Adherence overall was at least 67%, and 97% in those who attended the 6-week follow-up. Half the participants watched the RLOs two or more times, suggesting self-management of their hearing loss, hearing aids, and communication. The RLOs were rated as highly useful and the majority of participants agreed the RLOs were enjoyable, improved their confidence and were preferable to written information. Postfitting, there was no significant between-group difference in the primary outcome measure, overall hearing aid use. However, there was significantly greater hearing aid use in the RLO+ group for suboptimal users. Furthermore, the RLO+ group had significantly better knowledge of practical and psychosocial issues, and significantly better practical hearing aid skills than the RLO- group. The RLOs were shown to be beneficial to first-time hearing aid users across a range of quantitative and qualitative measures. This study provides evidence to suggest that the RLOs may provide valuable learning and educational support for first-time hearing aid users and could be used to supplement clinical rehabilitation practice.

Recognition and localization of speech by adult cochlear implant recipients wearing a digital hearing aid in the nonimplanted ear (bimodal hearing).

PubMed

Potts, Lisa G; Skinner, Margaret W; Litovsky, Ruth A; Strube, Michael J; Kuk, Francis

2009-06-01

The use of bilateral amplification is now common clinical practice for hearing aid users but not for cochlear implant recipients. In the past, most cochlear implant recipients were implanted in one ear and wore only a monaural cochlear implant processor. There has been recent interest in benefits arising from bilateral stimulation that may be present for cochlear implant recipients. One option for bilateral stimulation is the use of a cochlear implant in one ear and a hearing aid in the opposite nonimplanted ear (bimodal hearing). This study evaluated the effect of wearing a cochlear implant in one ear and a digital hearing aid in the opposite ear on speech recognition and localization. A repeated-measures correlational study was completed. Nineteen adult Cochlear Nucleus 24 implant recipients participated in the study. The participants were fit with a Widex Senso Vita 38 hearing aid to achieve maximum audibility and comfort within their dynamic range. Soundfield thresholds, loudness growth, speech recognition, localization, and subjective questionnaires were obtained six-eight weeks after the hearing aid fitting. Testing was completed in three conditions: hearing aid only, cochlear implant only, and cochlear implant and hearing aid (bimodal). All tests were repeated four weeks after the first test session. Repeated-measures analysis of variance was used to analyze the data. Significant effects were further examined using pairwise comparison of means or in the case of continuous moderators, regression analyses. The speech-recognition and localization tasks were unique, in that a speech stimulus presented from a variety of roaming azimuths (140 degree loudspeaker array) was used. Performance in the bimodal condition was significantly better for speech recognition and localization compared to the cochlear implant-only and hearing aid-only conditions. Performance was also different between these conditions when the location (i.e., side of the loudspeaker array that presented the word) was analyzed. In the bimodal condition, the speech-recognition and localization tasks were equal regardless of which side of the loudspeaker array presented the word, while performance was significantly poorer for the monaural conditions (hearing aid only and cochlear implant only) when the words were presented on the side with no stimulation. Binaural loudness summation of 1-3 dB was seen in soundfield thresholds and loudness growth in the bimodal condition. Measures of the audibility of sound with the hearing aid, including unaided thresholds, soundfield thresholds, and the Speech Intelligibility Index, were significant moderators of speech recognition and localization. Based on the questionnaire responses, participants showed a strong preference for bimodal stimulation. These findings suggest that a well-fit digital hearing aid worn in conjunction with a cochlear implant is beneficial to speech recognition and localization. The dynamic test procedures used in this study illustrate the importance of bilateral hearing for locating, identifying, and switching attention between multiple speakers. It is recommended that unilateral cochlear implant recipients, with measurable unaided hearing thresholds, be fit with a hearing aid.

Effectiveness of an online SUpport PRogramme (SUPR) for older hearing aid users: study protocol for a cluster randomised controlled trial.

PubMed

Meijerink, Janine Fj; Pronk, Marieke; Paulissen, Bernadette; Witte, Birgit I; Wouden, Bregje van der; Jansen, Vera; Kramer, Sophia E

2017-06-20

An educational SUpport PRogramme called SUPR has been developed for hearing aid users (HAUs) and their communication partners (CPs) offering care beyond hearing aid fitting. SUPR teaches its users communication strategies, hearing aid handling skills and personal adjustment to hearing impairment. Using a cluster randomised controlled trial design, 70 Dutch hearing aid dispenser practices were randomised into hearing aid fitting (care as usual, 34 practices) and hearing aid fitting including SUPR (36 practices). The aim was to recruit a total of 569 older (aged 50+ years) first-time (n=258) and experienced (n=311) HAUs and their CPs. SUPR consists of a Practical Support Booklet and online material offered via email over a period of 6-7 months. The booklet provides practical information on hearing aids, advice on communication strategies and home exercises. The online material consists of educational videos on hearing aid functionality and usage, communication strategies and peer testimonials. Finally, noncommittal email contact with the dispenser is offered. Every HAU is asked to assign a CP who is advised to be involved intensively. Effect measurements for HAUs and their CPs will occur at baseline and at 6, 12 and 18 months follow-up via online questionnaires. The primary outcomes for HAUs will be the use of communication strategies as measured by the subscales of the Communication Profile for the Hearing Impaired. A process evaluation will be performed. The study was approved by the Dutch Institutional Review Board of the VU Medical University Center Amsterdam. This intervention could contribute to lowering the hearing impairment burden in our ageing society. The results will be disseminated through peer-reviewed publications and scientific conferences. ISRCTN77340339; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Motivational engagement in first-time hearing aid users: A feasibility study.

PubMed

Ferguson, Melanie; Maidment, David; Russell, Naomi; Gregory, Melanie; Nicholson, Richard

2016-07-01

To assess (1) the feasibility of incorporating the Ida Institute's Motivation Tools into a UK audiology service, (2) the potential benefits of motivational engagement in first-time hearing aid users, and (3) predictors of hearing aid and general health outcome measures. A feasibility study using a single-centre, prospective, quasi-randomized controlled design with two arms. The Ida Institute's Motivation Tools formed the basis for motivational engagement. First-time hearing aid users were recruited at the initial hearing assessment appointment. The intervention arm underwent motivational engagement (M+, n = 32), and a control arm (M-, n = 36) received standard care only. The M+ group showed greater self-efficacy, reduced anxiety, and greater engagement with the audiologist at assessment and fitting appointments. However, there were no significant between-group differences 10-weeks post-fitting. Hearing-related communication scores predicted anxiety, and social isolation scores predicted depression for the M+ group. Readiness to address hearing difficulties predicted hearing aid outcomes for the M- group. Hearing sensitivity was not a predictor of outcomes. There were some positive results from motivational engagement early in the patient journey. Future research should consider using qualitative methods to explore whether there are longer-term benefits of motivational engagement in hearing aid users.

Target-matched insertion gain derived from three different hearing aid selection procedures.

PubMed

Punch, J L; Shovels, A H; Dickinson, W W; Calder, J H; Snead, C

1995-11-01

Three hearing aid selection procedures were compared to determine if any one was superior in producing prescribed real-ear insertion gain. For each of three subject groups, 12 in-the-ear style hearing aids with Class D circuitry and similar dispenser controls were ordered from one of three manufacturers. Subject groups were classified based on the type of information included on the hearing aid order form: (1) the subject's audiogram, (2) a three-part matrix specifying the desired maximum output, full-on gain, and frequency response slope of the hearing aid, or (3) the desired 2-cc coupler full-in grain of the hearing aid, based on real-ear coupler difference (RECD) measurements. Following electroacoustic adjustments aimed at approximating a commonly used target insertion gain formula, results revealed no significant differences among any of the three selection procedures with respect to obtaining acceptable insertion gain values.

The importance of creating a social business to produce low-cost hearing aids.

PubMed

Caccamo, Samantha; Voloshchenko, Anastasia; Dankyi, Nana Yaa

2014-09-01

The World Health Organization (WHO) estimates that about 280 million people worldwide have a bilateral hearing loss, mostly living in poor countries. Hearing loss causes heavy social burdens on individuals, families, communities and countries. However, due to the lack of accessibility and affordability, the vast majority of people in the world who need hearing aids do not have access to them. Low-income countries are thus pulled into a disability/poverty spiral. From this standpoint, the production of available, accessible and affordable hearing aids for the poorest populations of our planet should be one of the main issues in global hearing healthcare. Designing and producing a brand new low-cost hearing aid is the most effective option. Involving a large producer of hearing aids in the creation of a social business to solve the problem of access to affordable hearing aids is an essential step to reduce hearing disability on a large scale globally. Today's technology allows for the creation of a "minimal design" product that does not exceed $100-$150, that can be further lowered when purchased in large quantities and dispensed with alternative models. It is conceivable that by making a sustainable social business, the low cost product could be sold with a cross-subsidy model in order to recover the overhead costs. Social business is an economic model that has the potential to produce and distribute affordable hearing aids in low- and middle-income countries. Rehabilitation of hearing impaired children will be carried out in partnership with Sahic (Society of Assistance to Hearing Impaired Children) in Dhaka, Bangladesh and the ENT Department of Ospedale Burlo di Trieste, Dr. Eva Orzan.

Factors influencing speech perception in noise for 5-year-old children using hearing aids or cochlear implants.

PubMed

Ching, Teresa Yc; Zhang, Vicky W; Flynn, Christopher; Burns, Lauren; Button, Laura; Hou, Sanna; McGhie, Karen; Van Buynder, Patricia

2017-07-07

We investigated the factors influencing speech perception in babble for 5-year-old children with hearing loss who were using hearing aids (HAs) or cochlear implants (CIs). Speech reception thresholds (SRTs) for 50% correct identification were measured in two conditions - speech collocated with babble, and speech with spatially separated babble. The difference in SRTs between the two conditions give a measure of binaural unmasking, commonly known as spatial release from masking (SRM). Multiple linear regression analyses were conducted to examine the influence of a range of demographic factors on outcomes. Participants were 252 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. Children using HAs or CIs required a better signal-to-noise ratio to achieve the same level of performance as their normal-hearing peers but demonstrated SRM of a similar magnitude. For children using HAs, speech perception was significantly influenced by cognitive and language abilities. For children using CIs, age at CI activation and language ability were significant predictors of speech perception outcomes. Speech perception in children with hearing loss can be enhanced by improving their language abilities. Early age at cochlear implantation was also associated with better outcomes.

Hearing Aid Tester

NASA Technical Reports Server (NTRS)

1978-01-01

Hearing aids often develop malfunctions that are not detected by the wearer. This is particularly true when the wearers are school-age children. Studies of selected groups showed that from 30 to more than 50 percent of school children were not getting adequate benefit from their hearing aids because of unrecognized malfunctions, usually low or dead batteries. This can be serious because hearing impairment retards a child's educational progress. NASA technology incorporated in the Hearing Aid Malfunction Detection Unit (HAMDU), the device pictured, is expected to provide an effective countermeasure to the childrens' hearing aid problem. A patent license has been awarded to a minority-owned firm, Hopkins International Company, a subsidiary of H. H. Aerospace Design Co., Inc., Elmford, New York. The company plans early commercial availability of its version of the device.

Factors that influence intent to adopt a hearing aid among older people in Italy.

PubMed

Cobelli, Nicola; Gill, Liz; Cassia, Fabio; Ugolini, Marta

2014-11-01

Hearing loss is one of the most prevalent health impairments associated with ageing in developed countries, and it can result in social, emotional and communication dysfunction. Hearing loss in Italy is increasing, yet, despite the availability of free hearing aids and access to qualified community-based health professionals specialising in audiology services, their uptake remains low (about 15%-20%). This paper presents an investigation of the possible reasons why older people in Italy resist adopting a hearing aid. We used the literature to identify factors influencing people with hearing loss's decision-making, and drew on the theory of reasoned action to create an explanatory model. To test our hypotheses, we applied a cross-sectional design. We developed a questionnaire including 13 items related to adopting a hearing aid. Health professionals identified 400 persons aged 60-90 who were candidates for a free hearing aid. Those willing to participate were sent a copy of the questionnaire and telephoned between August and September 2009; a total of 243 responded (response rate of 60.8%). Linear regression analysis highlighted that a person's intention to adopt a hearing aid was positively related to their attitude towards its adoption, but negatively linked to their perceived subjective norms. It was found that trust in the health professional does not moderate the relationship between a person's attitude and their intention to adopt a hearing aid, but trust mitigates the relationship between a person's perceived subjective norms and their intentions. These findings underline the importance of the potential role that the healthcare professional could play in reducing the uncertainty created by external social pressures. For this purpose, stronger collaboration between the various health professionals involved in hearing aid provision, from diagnosis to fitting, is recommended. © 2014 John Wiley & Sons Ltd.

Benefits of active middle ear implants in mixed hearing loss: Stapes versus round window.

PubMed

Lee, Jeon Mi; Jung, Jinsei; Moon, In Seok; Kim, Sung Huhn; Choi, Jae Young

2017-06-01

We compared the audiologic benefits of active middle ear implants with those of passive middle ear implants with hearing aids in mixed hearing loss, and also compared the outcomes of stapes vibroplasty with those of round window vibroplasty. Retrospective chart review. Thirty-four patients with mixed hearing loss due to chronic otitis media were treated with a middle ear implant. Of these, 15 were treated with a passive middle ear implant (conventional ossiculoplasty with a partial ossicular replacement prosthesis), nine with an active middle ear implant coupling to the stapes, and 10 with an active middle ear implant coupling to the round window. Patients underwent pure-tone/free-field audiograms and speech discrimination tests before surgery and 6 months after surgery, and the results of these tests were compared. The active middle ear implant resulted in better outcomes than the passive middle ear implant with hearing aids at mid to high frequencies (P < .05). Patients who received either a stapes vibroplasty or a round window vibroplasty showed comparable hearing gain except at 8,000 Hz (48.9 dB vs. 31.0 dB, P < .05). Patients who received a stapes vibroplasty showed an improvement even in bone conduction at 1,000 Hz and 2,000 Hz (both P < .05). Active middle ear implantation could be a better option than treatment with passive middle ear implants with hearing aids for achieving rehabilitation in patients with mixed hearing loss. Vibroplasty via either oval window or round window stimulation shares similar good results. 4 Laryngoscope, 127:1435-1441, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Remote hearing aid fitting: Tele-audiology in the context of Brazilian Public Policy

PubMed Central

Penteado, Silvio Pires; Ramos, Sueli de Lima; Battistella, Linamara Rizzo; Marone, Silvio Antonio Monteiro; Bento, Ricardo Ferreira

2012-01-01

Summary Introduction: Currently, the Brazilian government has certificated nearly 140 specialized centers in hearing aid fittings through the Brazilian National Health System (SUS). Remote fitting through the Internet can allow a broader and more efficient coverage with a higher likelihood of success for patients covered by the SUS, as they can receive fittings from their own homes instead of going to the few and distant specialized centers. Aim: To describe a case of remote fitting between 2 cities, with revision of the literature. Method: Computer gears, a universal interface, and hearing aids were used. Case study: An audiologist located in a specialized center introduced a new hearing aid and its fitting procedure to a remote center (200 km away). The specialized center helped the remote center in fitting a hearing aid in 2 patients, and performed fitting in one of its own patients. The whole process was done through the Internet with audio and video in real time. Results: Three patients were fitted remotely. Three audiologists were remotely trained on how to fit the hearing aids. Conclusions: Remote fitting of hearing aids is possible through the Internet, as well as further supplying technical training to a remote center about the fitting procedures. Such a technological approach can help the government advance public policies on hearing rehabilitation, as patients can be motivated about maintaining their use of hearing aids with the option to ask for help in the comfort of their own homes. PMID:25991960

The benefits of using bluetooth accessories with hearing aids.

PubMed

Smith, Pauline; Davis, Adrian

2014-10-01

To investigate the benefits in reported outcomes after providing bluetooth accessories for established hearing aid users. Prospective observational study using validated quantitative outcome measures and detailed patient narrative before and two months after patients were provided with bluetooth accessories. Twelve patients with bilateral NHS hearing aids participated. They had a wide range of ages and hearing loss. After two months, 10 patients reported substantial additional benefit and kept the accessories; two returned them for various reasons. Statistically significant changes were seen in two validated outcome measures: the Glasgow Hearing Aid Benefit Profile and the International Outcome Inventory - Hearing Aids, but not in the Speech, Spatial and Qualities of Hearing Scale. Two notable benefits were reported: some described hearing the emotion and mood in a voice for the first time; others were amazed to report an improved ability to hear film or to hold conversations over the telephone. The provision of bluetooth accessories can give additional reported benefit for some patients - we need better knowledge about who benefits, and whether further support/training to individuals would make a difference.

Consensus statements on the BAHA system: where do we stand at present?

PubMed

Snik, Ad F M; Mylanus, Emmanuel A M; Proops, David W; Wolfaardt, John F; Hodgetts, William E; Somers, Thomas; Niparko, John K; Wazen, Jack J; Sterkers, Olivier; Cremers, Cor W R J; Tjellström, Anders

2005-12-01

After more than 25 years of clinical experience, the BAHA (bone-anchored hearing aid) system is a well-established treatment for hearing-impaired patients with conductive or mixed hearing loss. Owing to its success, the use of the BAHA system has spread and the indications for application have gradually become broader. New indications, as well as clinical applications, were discussed during scientific roundtable meetings in 2004 by experts in the field, and the outcomes of these discussions are presented in the form of statements. The issues that were discussed concerned BAHA surgery, the fitting range of the BAHA system, the BAHA system compared to conventional devices, bilateral application, the BAHA system in children, the BAHA system in patients with single-sided deafness, and, finally, the BAHA system in patients with unilateral conductive hearing loss.

Effectiveness of alternative listening devices to conventional hearing aids for adults with hearing loss: a systematic review protocol.

PubMed

Maidment, David W; Barker, Alex B; Xia, Jun; Ferguson, Melanie A

2016-10-27

Hearing loss is a major public health concern, affecting over 11 million people in the UK. While hearing aids are the most common clinical intervention for hearing loss, the majority of people that would benefit from using hearing aids do not take them up. Recent technological advances have led to a rapid increase of alternative listening devices to conventional hearing aids. These include hearing aids that can be customised using a smartphone, smartphone-based 'hearing aid' apps, personal sound amplification products and wireless hearing products. However, no systematic review has been published evaluating whether alternative listening devices are an effective management strategy for people with hearing loss. The objective of this systematic review is to assess whether alternative listening devices are an effective intervention for adults with hearing loss. Methods are reported according to the Preferred Reporting Items for Systematic reviews and Meta-analyses Protocols (PRISMA-P) 2015 checklist. Retrospective or prospective studies, randomised controlled trials, non-randomised controlled trials, and before-after comparison studies will be eligible for inclusion. We will include studies with adult participants (≥18 years) with a mild or moderate hearing loss. The intervention should be an alternative listening device to a conventional hearing aid (comparison). Studies will be restricted to outcomes associated with the consequences of hearing loss. We will search relevant databases to identify published, completed but unpublished and ongoing trials. The overall quality of included evidence will be evaluated using the GRADE system, and meta-analysis performed if appropriate. No ethical issues are foreseen. The findings will be reported at national and international conferences, primarily audiology, and ear, nose and throat, and in a peer-reviewed journal using the PRISMA guidelines. PROSPERO CRD4201502958. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evaluating the physical fit of receiver-in-the-ear hearing aids in infants.

PubMed

Caporali, Sueli Aparecida; Schmidt, Erik; Eriksson, Asa; Sköld, Birgitta; Popecki, Barbara; Larsson, Josefina; Auriemmo, Jane

2013-03-01

In spite of early identification and intervention efforts achieved by Early Hearing Detection and Intervention (EHDI) programs, many infants with hearing loss experience delays in early vocabulary development in comparison to peers with normal hearing (Mayne, Yoshinaga-Itano, Sedey, 2000a; Mayne, Yoshinaga-Itano, Sedey, Carey, 2000b; Moeller et al, 2007a, 2007b). One of the several factors that may contribute to individual differences in outcomes is inconsistent hearing aid use in this age group. This may be associated with the physical fit when using traditional behind-the-ear (BTE) hearing aids, since they are relatively large in comparison with the small and soft ear of an infant. Receiver-in-the-ear (RITE) hearing aids may be advantageous for use in pediatric fittings, since they are very tiny and lightweight and therefore sit comfortably on a small soft ear. To evaluate the use of a RITE hearing aid with an instant ear-tip especially developed for infants in terms of physical fit, stability, safety, and security of the device, as well as the use of retention tools (remedies for keeping the hearing aid securely on the ear) with this age group. A longitudinal study with hearing impaired infants fitted with RITE hearing aids was performed. Eighteen infants with mild to moderate/severe hearing loss participated in the study. The age range was 2-36 mo. Sixteen infants had worn hearing aids prior to their participation in the study. Each hearing impaired infant was fitted with the RITE hearing aid and an instant ear-tip, the size of which was chosen by the audiologist. The infants used the device for a period of 2-5 mo. Audiologists and parents completed questionnaires at every visit (5-7 visits in total). Responses were obtained using a category rating scale (Stevens, 1975) from 0 to 10. The data were analyzed using descriptive statistics and nonparametric statistics. Sixteen of the 18 children completed the study. At the end of the study, 11 of the 16 children were using the instant ear-tip, whereas five children were fitted with the receiver mounted in a custom earmold. The audiologists rated the RITE solution to provide a safe, stable, and secure fit. The general trend was that ratings improved over time. At the final follow-up session, all median ratings were between 8 and 10. Based on the positive results obtained in the study, the use of an appropriately designed RITE hearing aid is recommended for infants. American Academy of Audiology.

Wind noise in hearing aids with directional and omnidirectional microphones: polar characteristics of behind-the-ear hearing aids.

PubMed

Chung, King; Mongeau, Luc; McKibben, Nicholas

2009-04-01

Wind noise can be a significant problem for hearing instrument users. This study examined the polar characteristics of flow noise at outputs of two behind-the-ear digital hearing aids, and a microphone mounted on the surface of a cylinder at flow velocities ranging from a gentle breeze (4.5 m/s) to a strong gale (22.5 m/s) . The hearing aids were programed in an anechoic chamber, and tested in a quiet wind tunnel for flow noise recordings. Flow noise levels were estimated by normalizing the overall gain of the hearing aids to 0 dB. The results indicated that the two hearing aids had similar flow noise characteristics: The noise level was generally the lowest when the microphone faced upstream, higher when the microphone faced downstream, and the highest for frontal and rearward incidence angles. Directional microphones often generated higher flow noise level than omnidirectional microphones but they could reduce far-field background noise, resulting in a lower ambient noise level than omnidirectional microphones. Data for the academic microphone- on-cylinder configuration suggested that both turbulence and flow impingement might have contributed to the generation of flow noise in the hearing aids. Clinical and engineering design applications are discussed.

Investigating the Impact of Hearing Aid Use and Auditory Training on Cognition, Depressive Symptoms, and Social Interaction in Adults With Hearing Loss: Protocol for a Crossover Trial

PubMed Central

Meyer, Denny; Blamey, Peter J; Pipingas, Andrew; Bhar, Sunil

2018-01-01

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. Trial Registration ClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B). PMID:29572201

Investigating the Impact of Hearing Aid Use and Auditory Training on Cognition, Depressive Symptoms, and Social Interaction in Adults With Hearing Loss: Protocol for a Crossover Trial.

PubMed

Nkyekyer, Joanna; Meyer, Denny; Blamey, Peter J; Pipingas, Andrew; Bhar, Sunil

2018-03-23

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. 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. 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. Data analysis is currently under way and the first results are expected to be submitted for publication in June 2018. Results from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials. ClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B). ©Joanna Nkyekyer, Denny Meyer, Peter J Blamey, Andrew Pipingas, Sunil Bhar. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 23.03.2018.

Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.

PubMed

Poost-Foroosh, Laya; Jennings, Mary Beth; Cheesman, Margaret F

2015-03-01

Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology-related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. A cross-sectional approach was used to obtain online and paper-based concept ratings. Participants were 43 adults (age range, 45-85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated "the importance of each of the statements in a person's decision to purchase a hearing aid" on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. There was a significant difference in the mean ratings for clients and clinicians for the concepts understanding and meeting client needs, conveying device information by clinician, supporting choices and shared decision making, and factors in client readiness. Three concepts-understanding and meeting client needs, conveying device information by clinician, and supporting choices and shared decision making-were rated as more important by clients than by clinicians. One concept (ie, factors in client readiness) was rated as more important by clinicians than by clients. The concepts rated as most important by clients and clinicians are consistent with components of several existing models of client-centered and patient-centered care. These concepts reflect the clients' perception of the importance of their involvement in the decision-making process. A preliminary model of client-centered care within the hearing aid uptake process and implications for clinical audiology are described. American Academy of Audiology.

The effect of hearing aid signal-processing schemes on acceptable noise levels: perception and prediction.

PubMed

Wu, Yu-Hsiang; Stangl, Elizabeth

2013-01-01

The acceptable noise level (ANL) test determines the maximum noise level that an individual is willing to accept while listening to speech. The first objective of the present study was to systematically investigate the effect of wide dynamic range compression processing (WDRC), and its combined effect with digital noise reduction (DNR) and directional processing (DIR), on ANL. Because ANL represents the lowest signal-to-noise ratio (SNR) that a listener is willing to accept, the second objective was to examine whether the hearing aid output SNR could predict aided ANL across different combinations of hearing aid signal-processing schemes. Twenty-five adults with sensorineural hearing loss participated in the study. ANL was measured monaurally in two unaided and seven aided conditions, in which the status of the hearing aid processing schemes (enabled or disabled) and the location of noise (front or rear) were manipulated. The hearing aid output SNR was measured for each listener in each condition using a phase-inversion technique. The aided ANL was predicted by unaided ANL and hearing aid output SNR, under the assumption that the lowest acceptable SNR at the listener's eardrum is a constant across different ANL test conditions. Study results revealed that, on average, WDRC increased (worsened) ANL by 1.5 dB, while DNR and DIR decreased (improved) ANL by 1.1 and 2.8 dB, respectively. Because the effects of WDRC and DNR on ANL were opposite in direction but similar in magnitude, the ANL of linear/DNR-off was not significantly different from that of WDRC/DNR-on. The results further indicated that the pattern of ANL change across different aided conditions was consistent with the pattern of hearing aid output SNR change created by processing schemes. Compared with linear processing, WDRC creates a noisier sound image and makes listeners less willing to accept noise. However, this negative effect on noise acceptance can be offset by DNR, regardless of microphone mode. The hearing aid output SNR derived using the phase-inversion technique can predict aided ANL across different combinations of signal-processing schemes. These results suggest a close relationship between aided ANL, signal-processing scheme, and hearing aid output SNR.

Development of a multimedia educational programme for first-time hearing aid users: a participatory design.

PubMed

Ferguson, Melanie; Leighton, Paul; Brandreth, Marian; Wharrad, Heather

2018-05-02

To develop content for a series of interactive video tutorials (or reusable learning objects, RLOs) for first-time adult hearing aid users, to enhance knowledge of hearing aids and communication. RLO content was based on an electronically-delivered Delphi review, workshops, and iterative peer-review and feedback using a mixed-methods participatory approach. An expert panel of 33 hearing healthcare professionals, and workshops involving 32 hearing aid users and 11 audiologists. This ensured that social, emotional and practical experiences of the end-user alongside clinical validity were captured. Content for evidence-based, self-contained RLOs based on pedagogical principles was developed for delivery via DVD for television, PC or internet. Content was developed based on Delphi review statements about essential information that reached consensus (≥90%), visual representations of relevant concepts relating to hearing aids and communication, and iterative peer-review and feedback of content. This participatory approach recognises and involves key stakeholders in the design process to create content for a user-friendly multimedia educational intervention, to supplement the clinical management of first-time hearing aid users. We propose participatory methodologies are used in the development of content for e-learning interventions in hearing-related research and clinical practice.

Use of technological aids and interpretation services among children and adults with hearing loss.

PubMed

Dammeyer, Jesper; Lehane, Christine; Marschark, Marc

2017-10-01

The technological development of communication aids for people with hearing loss has progressed rapidly over the last decades. Quality has improved and the number of different types of aids has increased. However, few studies have examined the prevalence of technology use and interpreting services use among people with hearing loss as they relate to demographic characteristics of this population. This study reports from national surveys of children and adults with hearing loss. Use of hearing aids, cochlear implants, other aids and interpreting services were analysed with regard to gender, age, degree of hearing loss, mode of communication, having an additional disability, level of educational achievement among adults, and whether or not children lived together with both of their parents. 269 children (0-15 years of age) and 839 adults (16-65 years of age). Differences in technology and service use were associated with age, degree of hearing loss, and mode of communication among children and adults, and gender and level of educational achievement among adults. Individual and social factors have an impact on technological hearing aid and interpreter use. More research about individual differences and clinical implications of support services is needed.

Hearing AIDS and music.

PubMed

Chasin, Marshall; Russo, Frank A

2004-01-01

Historically, the primary concern for hearing aid design and fitting is optimization for speech inputs. However, increasingly other types of inputs are being investigated and this is certainly the case for music. Whether the hearing aid wearer is a musician or merely someone who likes to listen to music, the electronic and electro-acoustic parameters described can be optimized for music as well as for speech. That is, a hearing aid optimally set for music can be optimally set for speech, even though the converse is not necessarily true. Similarities and differences between speech and music as inputs to a hearing aid are described. Many of these lead to the specification of a set of optimal electro-acoustic characteristics. Parameters such as the peak input-limiting level, compression issues-both compression ratio and knee-points-and number of channels all can deleteriously affect music perception through hearing aids. In other cases, it is not clear how to set other parameters such as noise reduction and feedback control mechanisms. Regardless of the existence of a "music program,'' unless the various electro-acoustic parameters are available in a hearing aid, music fidelity will almost always be less than optimal. There are many unanswered questions and hypotheses in this area. Future research by engineers, researchers, clinicians, and musicians will aid in the clarification of these questions and their ultimate solutions.

Clinical assessment of ossicular mobility by a ceramic vibrator designed for implantable hearing aids.

PubMed

Gyo, K; Yanagihara, N

1986-01-01

Ossicular mobility was assessed by direct coupling of a piezoelectric ceramic vibrator to the ossicles during middle ear surgery. The sites excited were body of the incus, head of the stapes, and footplate of the stapes through a hydroxyapatite ceramic strut. The threshold of the vibratory hearing was determined by the patient's response as a minimum audition, and the vibration threshold was obtained by subtracting the preoperative bone conduction threshold from the vibratory hearing threshold. The results were analyzed by the state of hearing after the operation, which revealed that a patient with a good vibration threshold during the operation had a tendency to get good postoperative hearing. This may mean that postoperative hearing can be predicted to some extent during the operation by the measurement of ossicular mobility.

Satisfaction of Elderly Hearing Aid Users

PubMed Central

Kozlowski, Lorena; Ribas, Angela; Almeida, Gleide; Luz, Idalina

2016-01-01

Introduction The impact of auditory sensory deprivation in the life of an individual is enormous because it not only affects one's ability to properly understand auditory information, but also the way people relate to their environment and their culture. The monitoring of adult and elderly subjects with hearing loss is intended to minimize the difficulties and handicaps that occur as a consequence of this pathology. Objective To evaluate the level of user satisfaction with hearing aids. Methods A clinical and experimental study involving 91 elderly hearing aid users. We used the questionnaire Satisfaction with Amplification in Daily Life to determine the degree of the satisfaction provided by hearing aids. We evaluated mean global score, subscales, as well as the variables time to use, age, and degree of hearing loss. Results Mean global score was 4.73, the score for Positive Effects 5.45, Negative Factors 3.2, demonstrating that they were satisfied; Services and Costs 5.98: very satisfied ; 3.65 Personal Image: dissatisfied. We observed statistically significant difference for the time of hearing aid use, age, and degree of hearing loss. Conclusion The SADL is a tool, simple and easy to apply and in this study we can demonstrate the high degree of satisfaction with the hearing aids by the majority of the sample collected, increasing with time of use and a greater degree of hearing loss. PMID:28050214

47 CFR 68.4 - Hearing aid-compatible telephones.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Hearing aid-compatible telephones. 68.4 Section 68.4 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK General § 68.4 Hearing aid-compatible...

47 CFR 68.4 - Hearing aid-compatible telephones.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Hearing aid-compatible telephones. 68.4 Section 68.4 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK General § 68.4 Hearing aid-compatible...

Hearing Aid Fitting in Infants.

ERIC Educational Resources Information Center

Hoover, Brenda M.

2000-01-01

This article examines the latest technological advances in hearing aids and explores the available research to help families and professionals make informed decisions when fitting amplification devices on infants and young children. Diagnostic procedures, evaluation techniques, hearing aid selection, circuit and advanced technology options, and…

Tolerable hearing-aid delays: IV. effects on subjective disturbance during speech production by hearing-impaired subjects.

PubMed

Stone, Michael A; Moore, Brian C J

2005-04-01

We assessed the effects of time delay in a hearing aid on subjective disturbance and reading rates while the user of the aid was speaking, using hearing-impaired subjects and real-time processing. The time delay was constant across frequency. A digital signal processor was programmed as a four-channel, fast-acting, wide-dynamic-range compression hearing aid. One of four delays could be selected on the aid to produce a total delay of 13, 21, 30, or 40 msec between microphone and receiver. Twenty-five subjects, mostly with near-symmetric hearing impairment of cochlear origin, were fitted bilaterally with behind-the-ear aids connected to the processor. The aids were programmed with insertion gains prescribed by the CAMEQ loudness equalization procedure for each subject and ear. Subjects were asked to read aloud from scripts: speech production rates were measured and subjective ratings of the disturbance of the delay were obtained. Subjects required some training to recognize the effects of the delay to rate it consistently. Subjective disturbance increased progressively with increasing delay and was a nonmonotonic function of low-frequency hearing loss. Subjects with mild or severe low-frequency hearing loss were generally less disturbed by the delay than those with moderate loss. Disturbance ratings tended to decrease over successive tests. Word production rates were not significantly affected by delay over the range of delays tested. The results follow a pattern similar to those presented in , obtained using a simulation of hearing loss and normally hearing subjects, except for the nonmonotonic variation of disturbance with low-frequency hearing loss. We hypothesize that disturbance is maximal when the levels in the ear canal of the low-frequency components are similar for the unaided and aided sounds. A rating of 3, which is probably just acceptable, was obtained for delays ranging from 14 to 30 msec, depending on the hearing loss. Some acclimatization to the subjective disturbance occurred over a time scale of about 1 hour.

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

PubMed

Einarsson, Einar-Jón; Petersen, Hannes; Wiebe, Thomas; Fransson, Per-Anders; Magnusson, Måns; Moëll, Christian

2011-10-01

To investigate word recognition in noise in subjects treated in childhood with chemotherapy, study benefits of open-fitting hearing-aids for word recognition, and investigate whether self-reported hearing-handicap corresponded to subjects' word recognition ability. Subjects diagnosed with cancer and treated with platinum-based chemotherapy in childhood underwent audiometric evaluations. Fifteen subjects (eight females and seven males) fulfilled the criteria set for the study, and four of those received customized open-fitting hearing-aids. Subjects with cisplatin-induced ototoxicity had severe difficulties recognizing words in noise, and scored as low as 54% below reference scores standardized for age and degree of hearing loss. Hearing-impaired subjects' self-reported hearing-handicap correlated significantly with word recognition in a quiet environment but not in noise. Word recognition in noise improved markedly (up to 46%) with hearing-aids, and the self-reported hearing-handicap and disability score were reduced by more than 50%. This study demonstrates the importance of testing word recognition in noise in subjects treated with platinum-based chemotherapy in childhood, and to use specific custom-made questionnaires to evaluate the experienced hearing-handicap. Open-fitting hearing-aids are a good alternative for subjects suffering from poor word recognition in noise.

Hearing aid fitting for visual and hearing impaired patients with Usher syndrome type IIa.

PubMed

Hartel, B P; Agterberg, M J H; Snik, A F; Kunst, H P M; van Opstal, A J; Bosman, A J; Pennings, R J E

2017-08-01

Usher syndrome is the leading cause of hereditary deaf-blindness. Most patients with Usher syndrome type IIa start using hearing aids from a young age. A serious complaint refers to interference between sound localisation abilities and adaptive sound processing (compression), as present in today's hearing aids. The aim of this study was to investigate the effect of advanced signal processing on binaural hearing, including sound localisation. In this prospective study, patients were fitted with hearing aids with a nonlinear (compression) and linear amplification programs. Data logging was used to objectively evaluate the use of either program. Performance was evaluated with a speech-in-noise test, a sound localisation test and two questionnaires focussing on self-reported benefit. Data logging confirmed that the reported use of hearing aids was high. The linear program was used significantly more often (average use: 77%) than the nonlinear program (average use: 17%). The results for speech intelligibility in noise and sound localisation did not show a significant difference between type of amplification. However, the self-reported outcomes showed higher scores on 'ease of communication' and overall benefit, and significant lower scores on disability for the new hearing aids when compared to their previous hearing aids with compression amplification. Patients with Usher syndrome type IIa prefer a linear amplification over nonlinear amplification when fitted with novel hearing aids. Apart from a significantly higher logged use, no difference in speech in noise and sound localisation was observed between linear and nonlinear amplification with the currently used tests. Further research is needed to evaluate the reasons behind the preference for the linear settings. © 2016 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd.

Data mining of audiology patient records: factors influencing the choice of hearing aid type

PubMed Central

2012-01-01

Background This paper describes the analysis of a database of over 180,000 patient records, collected from over 23,000 patients, by the hearing aid clinic at James Cook University Hospital in Middlesbrough, UK. These records consist of audiograms (graphs of the faintest sounds audible to the patient at six different pitches), categorical data (such as age, gender, diagnosis and hearing aid type) and brief free text notes made by the technicians. This data is mined to determine which factors contribute to the decision to fit a BTE (worn behind the ear) hearing aid as opposed to an ITE (worn in the ear) hearing aid. Methods From PCA (principal component analysis) four main audiogram types are determined, and are related to the type of hearing aid chosen. The effects of age, gender, diagnosis, masker, mould and individual audiogram frequencies are combined into a single model by means of logistic regression. Some significant keywords are also discovered in the free text fields by using the chi-squared (χ2) test, which can also be used in the model. The final model can act a decision support tool to help decide whether an individual patient should be offered a BTE or an ITE hearing aid. Results The final model was tested using 5-fold cross validation, and was able to replicate the decisions of audiologists whether to fit an ITE or a BTE hearing aid with precision in the range 0.79 to 0.87. Conclusions A decision support system was produced to predict the type of hearing aid which should be prescribed, with an explanation facility explaining how that decision was arrived at. This system should prove useful in providing a "second opinion" for audiologists. PMID:22595091

Gaze Patterns in Auditory-Visual Perception of Emotion by Children with Hearing Aids and Hearing Children

PubMed Central

Wang, Yifang; Zhou, Wei; Cheng, Yanhong; Bian, Xiaoying

2017-01-01

This study investigated eye-movement patterns during emotion perception for children with hearing aids and hearing children. Seventy-eight participants aged from 3 to 7 were asked to watch videos with a facial expression followed by an oral statement, and these two cues were either congruent or incongruent in emotional valence. Results showed that while hearing children paid more attention to the upper part of the face, children with hearing aids paid more attention to the lower part of the face after the oral statement was presented, especially for the neutral facial expression/neutral oral statement condition. These results suggest that children with hearing aids have an altered eye contact pattern with others and a difficulty in matching visual and voice cues in emotion perception. The negative cause and effect of these gaze patterns should be avoided in earlier rehabilitation for hearing-impaired children with assistive devices. PMID:29312104

The Experience of Pleasure before and after Hearing Rehabilitation

ERIC Educational Resources Information Center

Rey, Gwladys

2010-01-01

Hearing loss may lead to major changes in the social and emotional aspects of daily life. This follow-up study investigated the effect of hearing-aid use on emotional experience in adults with hearing impairment. Thirteen individuals with impaired hearing were tested before and after 6 months of hearing-aid use, and were compared with 19…

A Randomized Controlled Trial to Evaluate the Benefits of a Multimedia Educational Program for First-Time Hearing Aid Users

PubMed Central

Brandreth, Marian; Brassington, William; Leighton, Paul; Wharrad, Heather

2016-01-01

Objectives: The aims of this study were to (1) develop a series of short interactive videos (or reusable learning objects [RLOs]) covering a broad range of practical and psychosocial issues relevant to the auditory rehabilitation for first-time hearing aid users; (2) establish the accessibility, take-up, acceptability and adherence of the RLOs; and (3) assess the benefits and cost-effectiveness of the RLOs. Design: The study was a single-center, prospective, randomized controlled trial with two arms. The intervention group (RLO+, n = 103) received the RLOs plus standard clinical service including hearing aid(s) and counseling, and the waitlist control group (RLO−, n = 100) received standard clinical service only. The effectiveness of the RLOs was assessed 6-weeks posthearing aid fitting. Seven RLOs (total duration 1 hr) were developed using a participatory, community of practice approach involving hearing aid users and audiologists. RLOs included video clips, illustrations, animations, photos, sounds and testimonials, and all were subtitled. RLOs were delivered through DVD for TV (50.6%) and PC (15.2%), or via the internet (32.9%). Results: RLO take-up was 78%. Adherence overall was at least 67%, and 97% in those who attended the 6-week follow-up. Half the participants watched the RLOs two or more times, suggesting self-management of their hearing loss, hearing aids, and communication. The RLOs were rated as highly useful and the majority of participants agreed the RLOs were enjoyable, improved their confidence and were preferable to written information. Postfitting, there was no significant between-group difference in the primary outcome measure, overall hearing aid use. However, there was significantly greater hearing aid use in the RLO+ group for suboptimal users. Furthermore, the RLO+ group had significantly better knowledge of practical and psychosocial issues, and significantly better practical hearing aid skills than the RLO− group. Conclusions: The RLOs were shown to be beneficial to first-time hearing aid users across a range of quantitative and qualitative measures. This study provides evidence to suggest that the RLOs may provide valuable learning and educational support for first-time hearing aid users and could be used to supplement clinical rehabilitation practice. PMID:26565785

Evaluation of Extended-wear Hearing Aid Technology for Operational Military Use

DTIC Science & Technology

2017-07-01

for a transparent hearing protection device that could protect the hearing of normal-hearing listeners without degrading auditory situational...method, suggest that continuous noise protection is also comparable to conventional earplug devices. Behavioral testing on listeners with normal...associated with the extended-wear hearing aid could be adapted to provide long-term hearing protection for listeners with normal hearing with minimal

The influence of hearing aids on the speech and language development of children with hearing loss.

PubMed

Tomblin, J Bruce; Oleson, Jacob J; Ambrose, Sophie E; Walker, Elizabeth; Moeller, Mary Pat

2014-05-01

IMPORTANCE Hearing loss (HL) in children can be deleterious to their speech and language development. The standard of practice has been early provision of hearing aids (HAs) to moderate these effects; however, there have been few empirical studies evaluating the effectiveness of this practice on speech and language development among children with mild-to-severe HL. OBJECTIVE To investigate the contributions of aided hearing and duration of HA use to speech and language outcomes in children with mild-to-severe HL. DESIGN, SETTING, AND PARTICIPANTS An observational cross-sectional design was used to examine the association of aided hearing levels and length of HA use with levels of speech and language outcomes. One hundred eighty 3- and 5-year-old children with HL were recruited through records of Universal Newborn Hearing Screening and referrals from clinical service providers in the general community in 6 US states. INTERVENTIONS All but 4 children had been fitted with HAs, and measures of aided hearing and the duration of HA use were obtained. MAIN OUTCOMES AND MEASURES Standardized measures of speech and language ability were obtained. RESULTS Measures of the gain in hearing ability for speech provided by the HA were significantly correlated with levels of speech (ρ179 = 0.20; P = .008) and language: ρ155 = 0.21; P = .01) ability. These correlations were indicative of modest levels of association between aided hearing and speech and language outcomes. These benefits were found for children with mild and moderate-to-severe HL. In addition, the amount of benefit from aided hearing interacted with the duration of HA experience (Speech: F4,161 = 4.98; P < .001; Language: F4,138 = 2.91; P < .02). Longer duration of HA experience was most beneficial for children who had the best aided hearing. CONCLUSIONS AND RELEVANCE The degree of improved hearing provided by HAs was associated with better speech and language development in children. In addition, the duration of HA experience interacted with the aided hearing to influence outcomes. These results provide support for the provision of well-fitted HAs to children with HL. In particular, the findings support early HA fitting and HA provision to children with mild HL.

[Rehabilitative measures in hearing-impaired children].

PubMed

von Wedel, H; von Wedel, U C; Zorowka, P

1991-12-01

On the basis of certain fundamental data on the maturation processes of the central auditory pathways in early childhood the importance of early intervention with hearing aids is discussed and emphasized. Pathological hearing, that is acoustical deprivation in early childhood will influence the maturation process. Very often speech development is delayed if diagnosis and therapy or rehabilitation are not early enough. Anamnesis, early diagnosis and clinical differential diagnosis are required before a hearing aid can be fitted. Selection criteria and adjustment parameters are discussed, showing that the hearing aid fitting procedure must be embedded in a complex matrix of requirements related to the development of speech as well as to the cognitive, emotional and social development of the child. As a rule, finding and preparing the "best" hearing aids (binaural fitting is obligatory) for a child is a long and often difficult process, which can only be performed by specialists who are pedo-audiologists. After the binaural fitting of hearing aids an intensive hearing and speech education in close cooperation between parents, pedo-audiologist and teacher must support the whole development of the child.

Application of the Consumer Decision-Making Model to Hearing Aid Adoption in First-Time Users

PubMed Central

Amlani, Amyn M.

2016-01-01

Since 1980, hearing aid adoption rates have remained essentially the same, increasing at a rate equal to the organic growth of the population. Researchers have used theoretical models from psychology and sociology to determine those factors or constructs that lead to the adoption of hearing aids by first-time impaired listeners entering the market. In this article, a theoretical model, the Consumer Decision-Making Model (CDM), premised on the neobehavioral approach that considers an individual's psychological and cognitive emphasis toward a product or service, is described. Three theoretical models (i.e., transtheoretical, social model of disability, Health Belief Model), and their relevant findings to the hearing aid market, are initially described. The CDM is then presented, along with supporting evidence of the model's various factors from the hearing aid literature. Future applications of the CDM to hearing health care also are discussed. PMID:27516718

Application of the Consumer Decision-Making Model to Hearing Aid Adoption in First-Time Users.

PubMed

Amlani, Amyn M

2016-05-01

Since 1980, hearing aid adoption rates have remained essentially the same, increasing at a rate equal to the organic growth of the population. Researchers have used theoretical models from psychology and sociology to determine those factors or constructs that lead to the adoption of hearing aids by first-time impaired listeners entering the market. In this article, a theoretical model, the Consumer Decision-Making Model (CDM), premised on the neobehavioral approach that considers an individual's psychological and cognitive emphasis toward a product or service, is described. Three theoretical models (i.e., transtheoretical, social model of disability, Health Belief Model), and their relevant findings to the hearing aid market, are initially described. The CDM is then presented, along with supporting evidence of the model's various factors from the hearing aid literature. Future applications of the CDM to hearing health care also are discussed.

Loudness judgment procedures for evaluating hearing aid preselection decisions for severely and profoundly hearing-impaired listeners.

PubMed

Gottermeier, L; De Filippo, C L; Block, M G

1991-08-01

Hearing aid fitting involves a two-phase process of preselection and evaluation (Seewald RC and Ross M. Amplification for the Hearing Impaired 1988:213-271). The purpose of the present study was to examine alternative procedures that clinicians might use in the evaluation phase to verify the adequacy of hearing aid preselection decisions for severely and profoundly hearing-impaired listeners. Bekesy tracking, loudness rating, and conventional bracketing procedures were used to determine threshold, most comfortable listening level, and uncomfortable listening level for 10 hearing-impaired young adults. Stimuli were pulsed pure tones of 500, 1000, and 2000 Hz and filtered words. Means and standard deviations of most comfortable listening levels and uncomfortable listening levels derived from loudness judgments of the 10 subjects showed only nominal differences across procedures. However, correlation analysis (Pearson r) indicated that individuals responded to the three procedures in varying ways, producing different loudness judgments and overall dynamic ranges. Thus, test procedure may influence the clinician's final evaluation of a preselected hearing aid. Initial work suggests that closed-set response categories such as loudness rating can limit measurement variability and potentially guide the clinician's evaluation of hearing aid preselection decisions.

Hearing Impairments. Tech Use Guide: Using Computer Technology.

ERIC Educational Resources Information Center

Council for Exceptional Children, Reston, VA. Center for Special Education Technology.

One of nine brief guides for special educators on using computer technology, this guide focuses on advances in electronic aids, computers, telecommunications, and videodiscs to assist students with hearing impairments. Electronic aids include hearing aids, telephone devices for the deaf, teletypes, closed captioning systems for television, and…

Open fitting: performance verification of receiver in the ear and receiver in the aid.

PubMed

Mondelli, Maria Fernanda Capoani Garcia; Garcia, Tatiana Manfrini; Hashimoto, Fabiana Midori Tokuhara; Rocha, Andressa Vital

2015-01-01

To verify the receiver in the ear and receiver in the aid adaptations by measuring in situ the speech perception and users' level of satisfaction. The study was approved by the research ethics committee (Process: 027/2011). Twenty subjects older than 18 years with audiological diagnosis of mild and moderate bilateral descending sensorineural hearing loss were evaluated. The subjects were divided into two groups, where G1 (group 1) was fitted with open-fit hearing aids with the built-in receiver unit (receiver in the ear) and G2 (group 2) was fitted with open-fit hearing aids with RITE. A probe microphone measurement was performed to check the gain and output provided by the amplification and for assessment of speech perception with Hearing in Noise Test with and without hearing aids. After a period of six weeks of use without interruption, the subjects returned for follow-up and answered the Satisfaction with Amplification in Daily Life questionnaire, and were again subjected to Hearing in Noise Test. Both groups presented better test results for speech recognition in the presence of noise. Groups 1 and 2 were satisfied with the use of hearing aids and improved speech recognition in silent and noisy situations with hearing aids. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Understanding history, philanthropy and the role of WHO in provision of assistive technologies for hearing loss.

PubMed

Chadha, Shelly; Moussy, Francis; Friede, Martin Howell

2014-09-01

Philanthropy continues to play an important role in provision of hearing devices and is often the only alternative for the majority of those in need of these devices. While this leads to improved access to services it may also create unsustainable service delivery models. Over the past decade, World Health Organization (WHO) has been making consistent efforts towards promoting accessibility and affordability of high-quality hearing devices, especially in Low- and Middle-Income Countries (LMIC). WHO developed and updated the "Guidelines for Hearing Aids and Services in Developing Countries", in 2004. In 2006, WHO supported the establishment of "World Wide (WW) Hearing", to promote hearing aid access across the globe. In the past year, WHO has renewed these efforts. As the first step and following a consultation on promoting access to hearing devices, WHO has developed a preferred product profile in order to facilitate the development and access of appropriate and affordable hearing aids for developing countries. The Convention on the Rights of Persons with Disabilities (article 32), calls for international collaboration to promote access to assistive technology including hearing devices. A coordinated global effort is required to promote availability and affordability of high-quality hearing devices. Such an undertaking requires the cooperation of all stakeholders: WHO, Member States, Non-Governmental Organizations (NGOs), philanthropists, manufacturers and users, to fulfill the international obligation and bring about a change in the quality of life of millions of people with hearing loss. Development of preferred product profile for hearing aids in LMICs can improve development and provision of high-quality, affordable hearing devices. Investment made by the recipients, such as partial financial contribution towards the cost of device or through purchase of ear mould or batteries, leads to a greater sense of responsibility towards the device and its maintenance. Low level of awareness about hearing loss and the potential benefits of hearing aids contribute to the underutilization of hearing aids.

Comparing NAL-NL1 and DSL v5 in Hearing Aids Fit to Children with Severe or Profound Hearing Loss: Goodness of Fit-to-Targets, Impacts on Predicted Loudness and Speech Intelligibility.

PubMed

Ching, Teresa Y C; Quar, Tian Kar; Johnson, Earl E; Newall, Philip; Sharma, Mridula

2015-03-01

An important goal of providing amplification to children with hearing loss is to ensure that hearing aids are adjusted to match targets of prescriptive procedures as closely as possible. The Desired Sensation Level (DSL) v5 and the National Acoustic Laboratories' prescription for nonlinear hearing aids, version 1 (NAL-NL1) procedures are widely used in fitting hearing aids to children. Little is known about hearing aid fitting outcomes for children with severe or profound hearing loss. The purpose of this study was to investigate the prescribed and measured gain of hearing aids fit according to the NAL-NL1 and the DSL v5 procedure for children with moderately severe to profound hearing loss; and to examine the impact of choice of prescription on predicted speech intelligibility and loudness. Participants were fit with Phonak Naida V SP hearing aids according to the NAL-NL1 and DSL v5 procedures. The Speech Intelligibility Index (SII) and estimated loudness were calculated using published models. The sample consisted of 16 children (30 ears) aged between 7 and 17 yr old. The measured hearing aid gains were compared with the prescribed gains at 50 (low), 65 (medium), and 80 dB SPL (high) input levels. The goodness of fit-to-targets was quantified by calculating the average root-mean-square (RMS) error of the measured gain compared with prescriptive gain targets for 0.5, 1, 2, and 4 kHz. The significance of difference between prescriptions for hearing aid gains, SII, and loudness was examined by performing analyses of variance. Correlation analyses were used to examine the relationship between measures. The DSL v5 prescribed significantly higher overall gain than the NAL-NL1 procedure for the same audiograms. For low and medium input levels, the hearing aids of all children fit with NAL-NL1 were within 5 dB RMS of prescribed targets, but 33% (10 ears) deviated from the DSL v5 targets by more than 5 dB RMS on average. For high input level, the hearing aid fittings of 60% and 43% of ears deviated by more than 5 dB RMS from targets of NAL-NL1 and DSL v5, respectively. Greater deviations from targets were associated with more severe hearing loss. On average, the SII was higher for DSL v5 than for NAL-NL1 at low input level. No significant difference in SII was found between prescriptions at medium or high input level, despite greater loudness for DSL v5 than for NAL-NL1. Although targets between 0.25 and 2 kHz were well matched for both prescriptions in commercial hearing aids, gain targets at 4 kHz were matched for NAL-NL1 only. Although the two prescriptions differ markedly in estimated loudness, they resulted in comparable predicted speech intelligibility for medium and high input levels. American Academy of Audiology.

Recognition and Localization of Speech by Adult Cochlear Implant Recipients Wearing a Digital Hearing Aid in the Nonimplanted Ear (Bimodal Hearing)

PubMed Central

Potts, Lisa G.; Skinner, Margaret W.; Litovsky, Ruth A.; Strube, Michael J; Kuk, Francis

2010-01-01

Background The use of bilateral amplification is now common clinical practice for hearing aid users but not for cochlear implant recipients. In the past, most cochlear implant recipients were implanted in one ear and wore only a monaural cochlear implant processor. There has been recent interest in benefits arising from bilateral stimulation that may be present for cochlear implant recipients. One option for bilateral stimulation is the use of a cochlear implant in one ear and a hearing aid in the opposite nonimplanted ear (bimodal hearing). Purpose This study evaluated the effect of wearing a cochlear implant in one ear and a digital hearing aid in the opposite ear on speech recognition and localization. Research Design A repeated-measures correlational study was completed. Study Sample Nineteen adult Cochlear Nucleus 24 implant recipients participated in the study. Intervention The participants were fit with a Widex Senso Vita 38 hearing aid to achieve maximum audibility and comfort within their dynamic range. Data Collection and Analysis Soundfield thresholds, loudness growth, speech recognition, localization, and subjective questionnaires were obtained six–eight weeks after the hearing aid fitting. Testing was completed in three conditions: hearing aid only, cochlear implant only, and cochlear implant and hearing aid (bimodal). All tests were repeated four weeks after the first test session. Repeated-measures analysis of variance was used to analyze the data. Significant effects were further examined using pairwise comparison of means or in the case of continuous moderators, regression analyses. The speech-recognition and localization tasks were unique, in that a speech stimulus presented from a variety of roaming azimuths (140 degree loudspeaker array) was used. Results Performance in the bimodal condition was significantly better for speech recognition and localization compared to the cochlear implant–only and hearing aid–only conditions. Performance was also different between these conditions when the location (i.e., side of the loudspeaker array that presented the word) was analyzed. In the bimodal condition, the speech-recognition and localization tasks were equal regardless of which side of the loudspeaker array presented the word, while performance was significantly poorer for the monaural conditions (hearing aid only and cochlear implant only) when the words were presented on the side with no stimulation. Binaural loudness summation of 1–3 dB was seen in soundfield thresholds and loudness growth in the bimodal condition. Measures of the audibility of sound with the hearing aid, including unaided thresholds, soundfield thresholds, and the Speech Intelligibility Index, were significant moderators of speech recognition and localization. Based on the questionnaire responses, participants showed a strong preference for bimodal stimulation. Conclusions These findings suggest that a well-fit digital hearing aid worn in conjunction with a cochlear implant is beneficial to speech recognition and localization. The dynamic test procedures used in this study illustrate the importance of bilateral hearing for locating, identifying, and switching attention between multiple speakers. It is recommended that unilateral cochlear implant recipients, with measurable unaided hearing thresholds, be fit with a hearing aid. PMID:19594084

A "Goldilocks" Approach to Hearing Aid Self-Fitting: Ear-Canal Output and Speech Intelligibility Index.

PubMed

Mackersie, Carol; Boothroyd, Arthur; Lithgow, Alexandra

2018-06-11

The objective was to determine self-adjusted output response and speech intelligibility index (SII) in individuals with mild to moderate hearing loss and to measure the effects of prior hearing aid experience. Thirteen hearing aid users and 13 nonusers, with similar group-mean pure-tone thresholds, listened to prerecorded and preprocessed sentences spoken by a man. Starting with a generic level and spectrum, participants adjusted (1) overall level, (2) high-frequency boost, and (3) low-frequency cut. Participants took a speech perception test after an initial adjustment before making a final adjustment. The three self-selected parameters, along with individual thresholds and real-ear-to-coupler differences, were used to compute output levels and SIIs for the starting and two self-adjusted conditions. The values were compared with an NAL second nonlinear threshold-based prescription (NAL-NL2) and, for the hearing aid users, performance of their existing hearing aids. All participants were able to complete the self-adjustment process. The generic starting condition provided outputs (between 2 and 8 kHz) and SIIs that were significantly below those prescribed by NAL-NL2. Both groups increased SII to values that were not significantly different from prescription. The hearing aid users, but not the nonusers, increased high-frequency output and SII significantly after taking the speech perception test. Seventeen of the 26 participants (65%) met an SII criterion of 60% under the generic starting condition. The proportion increased to 23 out of 26 (88%) after the final self-adjustment. Of the 13 hearing aid users, 8 (62%) met the 60% criterion with their existing hearing aids. With the final self-adjustment, 12 out of 13 (92%) met this criterion. The findings support the conclusion that user self-adjustment of basic amplification characteristics can be both feasible and effective with or without prior hearing aid experience.

Centre-level variation in outcomes and treatment for otitis media with effusion and hearing loss and the association of hearing loss with developmental outcomes at ages 5 and 7 years in children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 2.

PubMed

Hall, A; Wills, A K; Mahmoud, O; Sell, D; Waylen, A; Grewal, S; Sandy, J R; Ness, A R

2017-06-01

To explore centre-level variation in otitis media with effusion (OME), hearing loss and treatments in children in Cleft Care UK (CCUK) and to examine the association between OME, hearing loss and developmental outcomes at 5 and 7 years. Two hundred and sixty-eight 5-year-old British children with non-syndromic unilateral cleft lip and palate (UCLP) recruited to CCUK. Children had air and bone conduction audiometry at age 5. Information on grommet and hearing aid treatment was obtained from parental questionnaire and medical notes. Hearing loss at age 5 was defined as >20 dB in the better ear and history of OME and hearing loss was determined from past treatment. Children with sensorineural hearing loss were excluded. Associations were examined with speech, behaviour and self-confidence at age 5 and educational attainment at age 7. Centre variation was examined using hierarchical models and associations between hearing variables and developmental outcomes were examined using logistic regression. There was centre-level variation in early grommet placement (variance partition coefficient (VPC) 18%, P=.001) and fitting of hearing aids (VPC 8%, P=.03). A history of OME and hearing loss was associated with poor intelligibility of speech (adjusted odds ratio=2.87, 95% CI 1.42-5.77) and aspects of educational attainment. Hearing loss is an important determinant of poor speech and treatment variation across centres suggest management of OME and hearing loss could be improved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Hearing Function in Patients Living with HIV/AIDS

PubMed Central

Luque, Amneris E.; Orlando, Mark S.; Leong, U-Cheng; Allen, Paul D.; Guido, Joseph J.; Yang, Hongmei; Wu, Hulin

2014-01-01

Background During the earlier years of the HIV/AIDS epidemic, initial reports described sensorineural hearing loss in up to 49% of individuals with HIV/AIDS. During those years, patients commonly progressed to advanced stages of HIV disease, and frequently had neurological complications. However, the abnormalities on pure-tone audiometry and brainstem evoked responses outlined in small studies were not always consistently correlated with advanced stages of HIV/AIDS. Moreover, these studies could not exclude the confounding effect of concurrent opportunistic infections and syphilis. Additional reports also have indicated that some antiretroviral (ARV) medications may be ototoxic, thus it has been difficult to make conclusions regarding the cause of changes in hearing function in HIV-infected patients. More recently, accelerated aging has been suggested as a potential explanation for the disproportionate increase in complications of aging described in many HIV-infected patients, hence accelerated aging associated hearing loss may also be playing a role in these patients. Methods We conducted a large cross-sectional analysis of hearing function in over 300 patients with HIV-1 infection and in 137 HIV-uninfected controls. HIV-infected participants and HIV-uninfected controls underwent a two-hour battery of hearing tests including the Hearing Handicap Inventory, standard audiometric pure-tone air and bone conduction testing, tympanometric testing and speech reception and discrimination testing. Results Three-way ANOVA and logistic regression analysis of 278 eligible HIV-infected subjects stratified by disease stage in early HIV disease (n= 127) and late HIV disease (n=148) and 120 eligible HIV-uninfected controls revealed no statistical significant differences among the three study groups in either overall 4-PTA or hearing loss prevalence in either ear. Three-way ANOVA showed significant differences in word recognition scores (WRS) in the right ear among groups; a significant group effect on tympanogram static admittance in both ears, and a significant group effect on tympanic gradient in the right ear. There was significantly larger admittance and gradient in controls as compared to the HIV-infected group at late stage of disease. Hearing loss in the HIV-infected groups was associated with increased age and was similar to that described in the literature for the general population. Three-way ANOVA analysis also indicated significantly greater pure tone thresholds (worse hearing) at low frequencies in HIV patients in the late stage of disease compared with HIV-uninfected controls. This difference was also found by semi-parametric mixed effects (SPME) models. Conclusions Despite reports of “premature” or “accelerated” aging in HIV-infected subjects, we found no evidence of hearing loss occurring at an earlier age in HIV-infected patients compared to HIV-uninfected controls. Similar to what is described in the general population; the probability of hearing loss increased with age in the HIV-infected subjects and was more common in patients over 60 years of age. Interestingly, HIV-infected subjects had worse hearing at lower frequencies and have significant differences in tympanometry compared to HIV-uninfected controls; these findings deserve further study. PMID:25127320

Hearing function in patients living with HIV/AIDS.

PubMed

Luque, Amneris E; Orlando, Mark S; Leong, U-Cheng; Allen, Paul D; Guido, Joseph J; Yang, Hongmei; Wu, Hulin

2014-01-01

During the earlier years of the HIV/AIDS epidemic, initial reports described sensorineural hearing loss in up to 49% of individuals with HIV/AIDS. During those years, patients commonly progressed to advanced stages of HIV disease and frequently had neurological complications. However, the abnormalities on pure-tone audiometry and brainstem-evoked responses outlined in small studies were not always consistently correlated with advanced stages of HIV/AIDS. Moreover, these studies could not exclude the confounding effect of concurrent opportunistic infections and syphilis. Additional reports also have indicated that some antiretroviral medications may be ototoxic; thus, it has been difficult to make conclusions regarding the cause of changes in hearing function in HIV-infected patients. More recently, accelerated aging has been suggested as a potential explanation for the disproportionate increase in complications of aging described in many HIV-infected patients; hence, accelerated aging-associated hearing loss may also be playing a role in these patients. We conducted a large cross-sectional analysis of hearing function in over 300 patients with HIV-1 infection and in 137 HIV-uninfected controls. HIV-infected participants and HIV-uninfected controls underwent a 2-hr battery of hearing tests including the Hearing Handicap Inventory, standard audiometric pure-tone air and bone conduction testing, tympanometric testing, and speech reception and discrimination testing. Three-way analysis of variance (ANOVA) and logistic regression analysis of 278 eligible HIV-infected subjects stratified by disease stage in early HIV disease (n = 127) and late HIV disease (n = 148) and 120 eligible HIV-uninfected controls revealed no statistically significant differences among the three study groups in either overall 4-frequency pure-tone average (4-PTA) or hearing loss prevalence in either ear. Three-way ANOVA showed significant differences in word recognition scores in the right ear among groups, a significant group effect on tympanogram static admittance in both ears and a significant group effect on tympanic gradient in the right ear. There was significantly larger admittance and gradient in controls as compared to the HIV-infected group at late stage of disease. Hearing loss in the HIV-infected groups was associated with increased age and was similar to that described in the literature for the general population. Three-way ANOVA analysis also indicated significantly greater pure-tone thresholds (worse hearing) at low frequencies in HIV patients in the late stage of disease compared with HIV-uninfected controls. This difference was also found by semi-parametric mixed effects models. Despite reports of "premature" or "accelerated" aging in HIV-infected subjects, we found no evidence of hearing loss occurring at an earlier age in HIV-infected patients compared to HIV-uninfected controls. Similar to what is described in the general population, the probability of hearing loss increased with age in the HIV-infected subjects and was more common in patients over 60 years of age. Interestingly, HIV-infected subjects had worse hearing at lower frequencies and have significant differences in tympanometry compared to HIV-uninfected controls; these findings deserve further study.

Hearing Aids and Music

PubMed Central

Chasin, Marshall; Russo, Frank A.

2004-01-01

Historically, the primary concern for hearing aid design and fitting is optimization for speech inputs. However, increasingly other types of inputs are being investigated and this is certainly the case for music. Whether the hearing aid wearer is a musician or merely someone who likes to listen to music, the electronic and electro-acoustic parameters described can be optimized for music as well as for speech. That is, a hearing aid optimally set for music can be optimally set for speech, even though the converse is not necessarily true. Similarities and differences between speech and music as inputs to a hearing aid are described. Many of these lead to the specification of a set of optimal electro-acoustic characteristics. Parameters such as the peak input-limiting level, compression issues—both compression ratio and knee-points—and number of channels all can deleteriously affect music perception through hearing aids. In other cases, it is not clear how to set other parameters such as noise reduction and feedback control mechanisms. Regardless of the existence of a “music program,” unless the various electro-acoustic parameters are available in a hearing aid, music fidelity will almost always be less than optimal. There are many unanswered questions and hypotheses in this area. Future research by engineers, researchers, clinicians, and musicians will aid in the clarification of these questions and their ultimate solutions. PMID:15497032

21 CFR 801.420 - Hearing aid devices; professional and patient labeling.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING Special Requirements for Specific Devices § 801.420 Hearing aid devices; professional and patient labeling. (a) Definitions for the purposes of this section... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hearing aid devices; professional and patient...

21 CFR 801.420 - Hearing aid devices; professional and patient labeling.

Code of Federal Regulations, 2011 CFR

2011-04-01

... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES LABELING Special Requirements for Specific Devices § 801.420 Hearing aid devices; professional and patient labeling. (a) Definitions for the purposes of this section... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hearing aid devices; professional and patient...

The Problem of Feedback in Hearing Aids.

ERIC Educational Resources Information Center

Kates, James M.

1991-01-01

This paper discusses the problem of feedback in hearing aids and offers examples based on a computer simulation of hearing aid behavior. The available technology for dealing with feedback is reviewed, and the new digital signal-processing approaches which may finally solve the feedback problem are described. (Author/DB)

78 FR 66940 - Regulatory Requirements for Hearing Aid Devices and Personal Sound Amplification Products; Draft...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-D-1295] Regulatory Requirements for Hearing Aid Devices and Personal Sound Amplification Products; Draft Guidance for... draft guidance entitled ``Regulatory Requirements for Hearing Aid Devices and Personal Sound...

Solar recharging system for hearing aid cells.

PubMed

Gòmez Estancona, N; Tena, A G; Torca, J; Urruticoechea, L; Muñiz, L; Aristimuño, D; Unanue, J M; Torca, J; Urruticoechea, A

1994-09-01

We present a solar recharging system for nickel-cadmium cells of interest in areas where batteries for hearing aids are difficult to obtain. The charger has sun cells at the top. Luminous energy is converted into electrical energy, during the day and also at night if there is moonlight. The cost of the charger and hearing aid is very low at 35 US$. The use of solar recharging for hearing aids would be useful in alleviating the problems of deafness in parts of developing countries where there is no electricity.

Designing of a Digital Behind-the-Ear Hearing Aid to Meet the World Health Organization Requirements

PubMed Central

Bento, Ricardo Ferreira; Penteado, Silvio Pires

2010-01-01

Hearing loss is a common health issue that affects nearly 10% of the world population as indicated by many international studies. The hearing impaired typically experience more frustration, anxiety, irritability, depression, and disorientation than those with normal hearing levels. The standard rehabilitation tool for hearing impairment is an electronic hearing aid whose main components are transducers (microphone and receiver) and a digital signal processor. These electronic components are manufactured by supply chain rather than by hearing aid manufacturers. Manufacturers can use custom-designed components or generic off-the-shelf components. These electronic components are available as application-specific or off-the-shelf products, with the former designed for a specific manufacturer and the latter for a generic approach. The choice of custom or generic components will affect the product specifications, pricing, manufacturing, life cycle, and marketing strategies of the product. The World Health Organization is interested in making available to developing countries hearing aids that are inexpensive to purchase and maintain. The hearing aid presented in this article was developed with these specifications in mind together with additional contemporary features such as four channels with wide dynamic range compression, an adjustable compression rate for each channel, four comfort programs, an adaptive feedback manager, and full volume control. This digital hearing aid is fitted using a personal computer with minimal hardware requirements in intuitive three-step fitting software. A trimmer-adjusted version can be developed where human and material resources are scarce. PMID:20724354

Designing of a digital behind-the-ear hearing aid to meet the World Health Organization requirements.

PubMed

Bento, Ricardo Ferreira; Penteado, Silvio Pires

2010-06-01

Hearing loss is a common health issue that affects nearly 10% of the world population as indicated by many international studies. The hearing impaired typically experience more frustration, anxiety, irritability, depression, and disorientation than those with normal hearing levels. The standard rehabilitation tool for hearing impairment is an electronic hearing aid whose main components are transducers (microphone and receiver) and a digital signal processor. These electronic components are manufactured by supply chain rather than by hearing aid manufacturers. Manufacturers can use custom-designed components or generic off-the-shelf components. These electronic components are available as application-specific or off-the-shelf products, with the former designed for a specific manufacturer and the latter for a generic approach. The choice of custom or generic components will affect the product specifications, pricing, manufacturing, life cycle, and marketing strategies of the product. The World Health Organization is interested in making available to developing countries hearing aids that are inexpensive to purchase and maintain. The hearing aid presented in this article was developed with these specifications in mind together with additional contemporary features such as four channels with wide dynamic range compression, an adjustable compression rate for each channel, four comfort programs, an adaptive feedback manager, and full volume control. This digital hearing aid is fitted using a personal computer with minimal hardware requirements in intuitive three-step fitting software. A trimmer-adjusted version can be developed where human and material resources are scarce.

Acceptable noise level (ANL) with Danish and non-semantic speech materials in adult hearing-aid users.

PubMed

Olsen, Steen Østergaard; Lantz, Johannes; Nielsen, Lars Holme; Brännström, K Jonas

2012-09-01

The acceptable noise level (ANL) test is used for quantification of the amount of background noise subjects accept when listening to speech. This study investigates Danish hearing-aid users' ANL performance using Danish and non-semantic speech signals, the repeatability of ANL, and the association between ANL and outcome of the international outcome inventory for hearing aids (IOI-HA). ANL was measured in three conditions in both ears at two test sessions. Subjects completed the IOI-HA and the ANL questionnaire. Sixty-three Danish hearing-aid users; fifty-seven subjects were full time users and 6 were part time/non users of hearing aids according to the ANL questionnaire. ANLs were similar to results with American English speech material. The coefficient of repeatability (CR) was 6.5-8.8 dB. IOI-HA scores were not associated to ANL. Danish and non-semantic ANL versions yield results similar to the American English version. The magnitude of the CR indicates that ANL with Danish and non-semantic speech materials is not suitable for prediction of individual patterns of future hearing-aid use or evaluation of individual benefit from hearing-aid features. The ANL with Danish and non-semantic speech materials is not related to IOI-HA outcome.

An Overview of the Major Phenomena of the Localization of Sound Sources by Normal-Hearing, Hearing-Impaired, and Aided Listeners

PubMed Central

2014-01-01

Localizing a sound source requires the auditory system to determine its direction and its distance. In general, hearing-impaired listeners do less well in experiments measuring localization performance than normal-hearing listeners, and hearing aids often exacerbate matters. This article summarizes the major experimental effects in direction (and its underlying cues of interaural time differences and interaural level differences) and distance for normal-hearing, hearing-impaired, and aided listeners. Front/back errors and the importance of self-motion are noted. The influence of vision on the localization of real-world sounds is emphasized, such as through the ventriloquist effect or the intriguing link between spatial hearing and visual attention. PMID:25492094

Localization and interaural time difference (ITD) thresholds for cochlear implant recipients with preserved acoustic hearing in the implanted ear

PubMed Central

Gifford, René H.; Grantham, D. Wesley; Sheffield, Sterling W.; Davis, Timothy J.; Dwyer, Robert; Dorman, Michael F.

2014-01-01

The purpose of this study was to investigate horizontal plane localization and interaural time difference (ITD) thresholds for 14 adult cochlear implant recipients with hearing preservation in the implanted ear. Localization to broadband noise was assessed in an anechoic chamber with a 33-loudspeaker array extending from −90 to +90°. Three listening conditions were tested including bilateral hearing aids, bimodal (implant + contralateral hearing aid) and best aided (implant + bilateral hearing aids). ITD thresholds were assessed, under headphones, for low-frequency stimuli including a 250-Hz tone and bandpass noise (100–900 Hz). Localization, in overall rms error, was significantly poorer in the bimodal condition (mean: 60.2°) as compared to both bilateral hearing aids (mean: 46.1°) and the best-aided condition (mean: 43.4°). ITD thresholds were assessed for the same 14 adult implant recipients as well as 5 normal-hearing adults. ITD thresholds were highly variable across the implant recipients ranging from the range of normal to ITDs not present in real-world listening environments (range: 43 to over 1600 μs). ITD thresholds were significantly correlated with localization, the degree of interaural asymmetry in low-frequency hearing, and the degree of hearing preservation related benefit in the speech reception threshold (SRT). These data suggest that implant recipients with hearing preservation in the implanted ear have access to binaural cues and that the sensitivity to ITDs is significantly correlated with localization and degree of preserved hearing in the implanted ear. PMID:24607490

Localization and interaural time difference (ITD) thresholds for cochlear implant recipients with preserved acoustic hearing in the implanted ear.

PubMed

Gifford, René H; Grantham, D Wesley; Sheffield, Sterling W; Davis, Timothy J; Dwyer, Robert; Dorman, Michael F

2014-06-01

The purpose of this study was to investigate horizontal plane localization and interaural time difference (ITD) thresholds for 14 adult cochlear implant recipients with hearing preservation in the implanted ear. Localization to broadband noise was assessed in an anechoic chamber with a 33-loudspeaker array extending from -90 to +90°. Three listening conditions were tested including bilateral hearing aids, bimodal (implant + contralateral hearing aid) and best aided (implant + bilateral hearing aids). ITD thresholds were assessed, under headphones, for low-frequency stimuli including a 250-Hz tone and bandpass noise (100-900 Hz). Localization, in overall rms error, was significantly poorer in the bimodal condition (mean: 60.2°) as compared to both bilateral hearing aids (mean: 46.1°) and the best-aided condition (mean: 43.4°). ITD thresholds were assessed for the same 14 adult implant recipients as well as 5 normal-hearing adults. ITD thresholds were highly variable across the implant recipients ranging from the range of normal to ITDs not present in real-world listening environments (range: 43 to over 1600 μs). ITD thresholds were significantly correlated with localization, the degree of interaural asymmetry in low-frequency hearing, and the degree of hearing preservation related benefit in the speech reception threshold (SRT). These data suggest that implant recipients with hearing preservation in the implanted ear have access to binaural cues and that the sensitivity to ITDs is significantly correlated with localization and degree of preserved hearing in the implanted ear. Copyright © 2014. Published by Elsevier B.V.

Challenges and Recent Developments in Hearing Aids: Part II. Feedback and Occlusion Effect Reduction Strategies, Laser Shell Manufacturing Processes, and Other Signal Processing Technologies

PubMed Central

Chung, King

2004-01-01

This is the second part of a review on the challenges and recent developments in hearing aids. Feedback and the occlusion effect pose great challenges in hearing aid design and usage. Yet, conventional solutions to feedback and the occlusion effect often create a dilemma: the solution to one often leads to the other. This review discusses the advanced signal processing strategies to reduce feedback and some new approaches to reduce the occlusion effect. Specifically, the causes of three types of feedback (acoustic, mechanical, and electromagnetic) are discussed. The strategies currently used to reduce acoustic feedback (i.e., adaptive feedback reduction algorithms using adaptive gain reduction, notch filtering, and phase cancellation strategies) and the design of new receivers that are built to reduce mechanical and electromagnetic feedback are explained. In addition, various new strategies (i.e., redesigned sound delivery devices and receiver-in-the-ear-canal hearing aid configuration) to reduce the occlusion effect are reviewed. Many manufacturers have recently adopted laser shell-manufacturing technologies to overcome problems associated with manufacturing custom hearing aid shells. The mechanisms of selected laser sintering and stereo lithographic apparatus and the properties of custom shells produced by these two processes are reviewed. Further, various new developments in hearing aid transducers, telecoils, channel-free amplification, open-platform programming options, rechargeable hearing aids, ear-level frequency modulated (FM) receivers, wireless Bluetooth FM systems, and wireless programming options are briefly explained and discussed. Finally, the applications of advanced hearing aid technologies to enhance other devices such as cochlear implants, hearing protectors, and cellular phones are discussed. PMID:15735871

Effectiveness of alternative listening devices to conventional hearing aids for adults with hearing loss: a systematic review protocol

PubMed Central

Barker, Alex B; Xia, Jun

2016-01-01

Introduction Hearing loss is a major public health concern, affecting over 11 million people in the UK. While hearing aids are the most common clinical intervention for hearing loss, the majority of people that would benefit from using hearing aids do not take them up. Recent technological advances have led to a rapid increase of alternative listening devices to conventional hearing aids. These include hearing aids that can be customised using a smartphone, smartphone-based ‘hearing aid’ apps, personal sound amplification products and wireless hearing products. However, no systematic review has been published evaluating whether alternative listening devices are an effective management strategy for people with hearing loss. Methods and analysis The objective of this systematic review is to assess whether alternative listening devices are an effective intervention for adults with hearing loss. Methods are reported according to the Preferred Reporting Items for Systematic reviews and Meta-analyses Protocols (PRISMA-P) 2015 checklist. Retrospective or prospective studies, randomised controlled trials, non-randomised controlled trials, and before-after comparison studies will be eligible for inclusion. We will include studies with adult participants (≥18 years) with a mild or moderate hearing loss. The intervention should be an alternative listening device to a conventional hearing aid (comparison). Studies will be restricted to outcomes associated with the consequences of hearing loss. We will search relevant databases to identify published, completed but unpublished and ongoing trials. The overall quality of included evidence will be evaluated using the GRADE system, and meta-analysis performed if appropriate. Ethics and dissemination No ethical issues are foreseen. The findings will be reported at national and international conferences, primarily audiology, and ear, nose and throat, and in a peer-reviewed journal using the PRISMA guidelines. Review registration number PROSPERO CRD4201502958. PMID:27789514

Opening the Market for Lower Cost Hearing Aids: Regulatory Change Can Improve the Health of Older Americans.

PubMed

Blustein, Jan; Weinstein, Barbara E

2016-06-01

Hearing loss is a leading cause of disability among older people. Yet only one in seven US adults who could benefit from a hearing aid uses one. This fraction has not increased over the past 30 years, nor have hearing aid prices dropped, despite trends of steady improvements and price reductions in the consumer electronics industry. The President's Council on Science and Technology has proposed changes in the regulation of hearing aids, including the creation of a "basic" low-cost over-the-counter category of devices. We discuss the potential to reduce disability as well as to improve public health, stakeholder responses to the president's council's proposal, and public health efforts to further mitigate the burden of disability stemming from age-related hearing loss.

76 FR 34845 - Medical Devices; Ear, Nose, and Throat Devices; Classification of the Wireless Air-Conduction...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... control by other users with a similar medical device. Exposure to non-ionizing radiation Wireless... Administration (FDA) is classifying the wireless air-conduction hearing aid into class II (special controls). The Agency is classifying the device into class II (special controls) in order to provide a reasonable...

Pilot Study to Evaluate Hearing Aid Service Delivery Model and Measure Benefit Using Self-Report Outcome Measures Using Community Hearing Workers in a Developing Country

PubMed Central

Emerson, Lingamdenne Paul; Job, Anand; Abraham, Vinod

2013-01-01

Hearing loss is a major handicap in developing countries with paucity of trained audiologists and limited resources. In this pilot study trained community health workers were used to provide comprehensive hearing aid services in the community. One hundred and eleven patients were fitted with semi-digital hearing aid and were evaluated over a period of six months. They were assessed using self-report outcome measure APHAB. Results show that trained CHWs are effective in detecting disabling hearing loss and in providing HAs. APHAB can identify and pick up significant improvements in communication in daily activities and provides a realistic expectation of the benefits of a hearing aid. The model of using trained CHWs to provide rehabilitative services in audiology along with self-report outcome measures can be replicated in other developing countries. PMID:23724277

Effects of noise and working memory capacity on memory processing of speech for hearing-aid users.

PubMed

Ng, Elaine Hoi Ning; Rudner, Mary; Lunner, Thomas; Pedersen, Michael Syskind; Rönnberg, Jerker

2013-07-01

It has been shown that noise reduction algorithms can reduce the negative effects of noise on memory processing in persons with normal hearing. The objective of the present study was to investigate whether a similar effect can be obtained for persons with hearing impairment and whether such an effect is dependent on individual differences in working memory capacity. A sentence-final word identification and recall (SWIR) test was conducted in two noise backgrounds with and without noise reduction as well as in quiet. Working memory capacity was measured using a reading span (RS) test. Twenty-six experienced hearing-aid users with moderate to moderately severe sensorineural hearing loss. Noise impaired recall performance. Competing speech disrupted memory performance more than speech-shaped noise. For late list items the disruptive effect of the competing speech background was virtually cancelled out by noise reduction for persons with high working memory capacity. Noise reduction can reduce the adverse effect of noise on memory for speech for persons with good working memory capacity. We argue that the mechanism behind this is faster word identification that enhances encoding into working memory.

Pragmatic Abilities of Children with Hearing Loss Using Cochlear Implants or Hearing Aids Compared to Hearing Children

ERIC Educational Resources Information Center

Most, Tova; Shina-August, Ella; Meilijson, Sara

2010-01-01

This study characterized the profile of pragmatic abilities among 24 children with hearing loss (HL) aged 6.3-9.4 years, 13 using hearing aids (HAs) and 11 using cochlear implants (CIs), in comparison to those of 13 hearing children with similar chronological and language ages. All the children with HL used spoken language, attended regular…

Hearing aids for nursing home residents: current policy and future needs.

PubMed

Cohen-Mansfield, Jiska; Infeld, Donna Lind

2006-11-01

Hearing aids are crucial for people with hearing loss, especially dementia patients in nursing homes. However, the actual use of hearing aids in this population is very low. A major barrier to use is the cost. This paper examines the issue in terms of current financial coverage available through federal and state systems as well as private insurance. We discuss the applicability of the Americans with Disabilities Act (ADA) and other federal laws to this problem. There is a need for future policy development to improve both the quality of hearing aids and the financial mechanisms that will allow nursing home residents to use them. Plans to move the policy agenda forward are suggested.

Successful bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

PubMed

Coutinho, M B; Marques, C; Mendes, G J; Gonçalves, C

2015-11-01

To report a case of successful bone-anchored hearing aid implantation in an adult patient with type III osteogenesis imperfecta, which is commonly regarded as a contraindication to this procedure. A 45-year-old man with type III osteogenesis imperfecta presented with mixed hearing loss. There was a mild sensorineural component in both ears, with an air-bone gap between 45 and 50 dB HL. He was implanted with a bone-anchored hearing aid. The audiological outcome was good, with no complications and good implant stability (as measured by resonance frequency analysis). To our knowledge, this is the first recorded case of bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

The Future of Hearing Aid Technology

PubMed Central

Edwards, Brent

2007-01-01

Hearing aids have advanced significantly over the past decade, primarily due to the maturing of digital technology. The next decade should see an even greater number of innovations to hearing aid technology, and this article attempts to predict in which areas the new developments will occur. Both incremental and radical innovations in digital hearing aids will be driven by research advances in the following fields: (1) wireless technology, (2) digital chip technology, (3) hearing science, and (4) cognitive science. The opportunities and limitations for each of these areas will be discussed. Additionally, emerging trends such as connectivity and individualization will also drive new technology, and these are discussed within the context of the areas given here. PMID:17301336

What Factors Are Associated with Autonomous and Controlled Motivation for Hearing Help-Seekers?

PubMed

Ridgway, Jason; Hickson, Louise; Lind, Christopher

Hearing impairment is prevalent in older adults. Motivation is important in people's choice to seek help for their hearing and whether to adopt or not adopt hearing aids. To investigate associations between sociodemographic and audiometric characteristics and autonomous and controlled motivation among a sample of hearing help-seekers. A quantitative approach was taken for this cross-sectional cohort study. A total of 253 adult first-time hearing help-seekers were recruited to the study. Participants provided sociodemographic information and completed questionnaires adapted from self-determination theory that measured autonomous motivation (motivation that originates from within the self and is aligned with personal values and beliefs) and controlled motivation (motivation that stems from external pressures such as rewards or punishment, or conflicted inner feelings such as guilt or shame). Participants with higher autonomous motivation scores were younger, wanted hearing aids more, and reported greater hearing difficulty in everyday life than those with lower scores. Participants with higher controlled motivation scores were more often referred to the service by others and wanted hearing aids more than those with lower controlled motivation scores. Controlled motivation scores were not associated with perceptions of hearing difficulty in everyday life. Relationships among motivation and sociodemographic factors highlight the importance of characterizing autonomous and controlled motivation in first-time hearing help-seekers. Attention to personal characteristics in order to understand motivational processes involved in rehabilitation decisions such as hearing aid adoption may aid in consultations. American Academy of Audiology

The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial.

PubMed

Humes, Larry E; Rogers, Sara E; Quigley, Tera M; Main, Anna K; Kinney, Dana L; Herring, Christine

2017-03-01

The objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models. The design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups. Older adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic. Participants were adults, ages 55-79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention. All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model. Primary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained. Per-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However, CD group had a significantly (p < .05) lower satisfaction and percentage (CD: 55%; AB: 81%; P: 36%) likely to purchase hearing aids after the trial. Hearing aids are efficacious in older adults for both AB and CD service-delivery models. CD model of OTC service delivery yielded only slightly poorer outcomes than the AB model. Efficacious OTC models may increase accessibility and affordability of hearing aids for millions of older adults. Purchase price had no effect on outcomes, but a high percentage of those who rejected hearing aids paid the typical price (85%). Clinicaltrials.gov: NCT01788432; https://clinicaltrials.gov/ct2/show/NCT01788423.

Use of Hearing Aids and Functional Capacity in Middle-Aged and Elderly Individuals

PubMed Central

Carioli, Juliana; Teixeira, Adriane Ribeiro

2014-01-01

Introduction Hearing loss is among the sensory changes strongly associated with loss of functional capacity. Objective It aims to determine whether the use of hearing aid contributes to the improvement of instrumental activities of daily living (IADL) for middle aged and elderly hearing-impaired individuals. Methods This is a descriptive, longitudinal, and interventional study. We evaluated 17 subjects, 13 (76.5%) female, aged between 58 and 96 years old (mean 77.1 ± 10.4 years). All were new users of hearing aids. Evaluation included social history, pure tone audiometry, and scale of IADL developed by Lawton and Brody. The subjects were presented daily life situations and were expected to respond if they could do them without assistance (3 points), partially assisted (2 points) or if they were unable to perform them (1 point). IADL was applied before the use of hearing aids adaptation and after a three- and six-month period of use. Results Data analysis revealed that before the use of hearing aids the average score obtained by the subjects was 22.94 ± 4.04 points. Three months after beginning the use the average score was 23.29 ± 4.12 and after six months the average score was 23.71 ± 3.69 points. Statistical analysis revealed a significant difference between scores obtained before the use of hearing aids and six months post-fitting (p = 0.015*) Conclusion The use of hearing aids among the subjects evaluated promoted positive changes in performing IADL, especially to using the telephone. PMID:25992101

The University of Western Ontario Pediatric Audiological Monitoring Protocol (UWO PedAMP)

PubMed Central

Moodie, Sheila T.; Malandrino, April C.; Richert, Frances M.; Clench, Debbie A.; Scollie, Susan D.

2011-01-01

This study proposed and evaluated a guideline for outcome evaluation for infants and children with hearing loss who wear hearing aids. The University of Western Ontario Pediatric Audiological Monitoring Protocol (UWO PedAMP) was developed following a critical review of pediatric outcome evaluation tools and was systematically examined by the Network of Pediatric Audiologists of Canada. It consists of tools to gather clinical process outcomes as well as functional caregiver reports. The UWO PedAMP was administered to a clinical population of infants and children with hearing aids. Sixty-eight children were administered the functional outcome evaluation tools (i.e., caregiver reports) a total of 133 times. Clinical process outcomes of hearing aid verification (e.g., real-ear-to-coupler difference) revealed typical aided audibility (e.g., Speech Intelligibility Index). Results for the LittlEARS® questionnaire revealed that typically developing children with hearing loss who wear hearing aids are meeting auditory development milestones. Children with mild to moderate comorbidities displayed typical auditory development during the 1st year of life after which development began to decline. Children with complex factors related to hearing aid use had lower scores on the LittlEARS, but auditory development was in parallel to norms. Parents’ Evaluation of Aural/Oral Performance (PEACH) results indicated no age effect on scoring for children above 2 years of age; however, the effect of degree of hearing loss was significant. This work provides clinicians with a systematic, evidence-based outcome evaluation protocol to implement as part of a complete pediatric hearing aid fitting. PMID:22194316

Beyond the hearing aid: Assistive listening devices

NASA Astrophysics Data System (ADS)

Holmes, Alice E.

2003-04-01

Persons with hearing loss can obtain great benefit from hearing aids but there are many situations that traditional amplification devices will not provide enough help to ensure optimal communication. Assistive listening and signaling devices are designed to improve the communication of the hearing impaired in instances where traditional hearing aids are not sufficient. These devices are designed to help with problems created by listening in noise or against a competing message, improve distance listening, facilitate group conversation (help with problems created by rapidly changing speakers), and allow independence from friends and family. With the passage of the Americans with Disabilities Act in 1990, assistive listening devices (ALDs) are becoming more accessible to the public with hearing loss. Employers and public facilities must provide auxiliary aids and services when necessary to ensure effective communication for persons who are deaf or hard of hearing. However many professionals and persons with hearing loss are unaware of the various types and availability of ALDs. An overview of ALDs along with a discussion of their advantages and disadvantages will be given.

Coping together with hearing loss: a qualitative meta-synthesis of the psychosocial experiences of people with hearing loss and their communication partners.

PubMed

Barker, Alex B; Leighton, Paul; Ferguson, Melanie A

2017-05-01

To examine the psychosocial experiences of hearing loss from the perspectives of both the person with hearing loss and their communication partner. A meta-synthesis of the qualitative literature. From 880 records, 12 qualitative papers met the inclusion criteria, (i) adults with hearing loss, communication partners, or both, and (ii) explored psychosocial issues. Four themes related to the psychosocial experience of hearing loss were found, (i) the effect of the hearing loss, (ii) the response to hearing aids, (iii) stigma and identity, and (iv) coping strategies. Hearing loss affected both people with hearing loss and communication partners. Hearing aids resulted in positive effects, however, these were often outnumbered by negative effects. Non-use of hearing aids was often influenced by stigma. Coping strategies used were related to how the person with hearing loss perceived their self and how the communication partner perceived the relationship. Aligned coping strategies appeared to have a positive effect. Hearing loss affects both people with hearing loss and their communication partners. Aligned coping strategies can facilitate adjustment to hearing loss.

Perception of Suprasegmental Features of Speech by Children with Cochlear Implants and Children with Hearing Aids

ERIC Educational Resources Information Center

Most, Tova; Peled, Miriam

2007-01-01

This study assessed perception of suprasegmental features of speech by 30 prelingual children with sensorineural hearing loss. Ten children had cochlear implants (CIs), and 20 children wore hearing aids (HA): 10 with severe hearing loss and 10 with profound hearing loss. Perception of intonation, syllable stress, word emphasis, and word pattern…

Acoustical and Perceptual Comparison of Noise Reduction and Compression in Hearing Aids

ERIC Educational Resources Information Center

Brons, Inge; Houben, Rolph; Dreschler, Wouter A.

2015-01-01

Purpose: Noise reduction and dynamic-range compression are generally applied together in hearing aids but may have opposite effects on amplification. This study evaluated the acoustical and perceptual effects of separate and combined processing of noise reduction and compression. Design: Recordings of the output of 4 hearing aids for speech in…

Candidacy for Bilateral Hearing Aids: A Retrospective Multicenter Study

ERIC Educational Resources Information Center

Boymans, Monique; Goverts, S. Theo; Kramer, Sophia E.; Festen, Joost M.; Dreschler, Wouter A.

2009-01-01

Purpose: The goal of this study was to find factors for refining candidacy criteria for bilateral hearing aid fittings. Clinical files of 1,000 consecutive hearing aid fittings were analyzed. Method: Case history, audiometric, and rehabilitation data were collected from clinical files, and an extensive questionnaire on long-term outcome measures…

Electroacoustic Evaluation of Frequency-Modulated Receivers Interfaced with Personal Hearing Aids

ERIC Educational Resources Information Center

Schafer, Erin C.; Thibodeau, Linda M.; Whalen, Holly S.; Overson, Gary J.

2007-01-01

Purpose: The purpose of this study was to compare the electroacoustic outputs of frequency-modulated (FM) systems coupled to hearing aids. Method: Electroacoustic performance of FM systems coupled to hearing aids was determined for 3 FM receivers: body-worn with neck loop, ear-level nonprogrammable, and ear-level programmable. Systems were…

Vocabulary Facilitates Speech Perception in Children with Hearing Aids

ERIC Educational Resources Information Center

Klein, Kelsey E.; Walker, Elizabeth A.; Kirby, Benjamin; McCreery, Ryan W.

2017-01-01

Purpose: We examined the effects of vocabulary, lexical characteristics (age of acquisition and phonotactic probability), and auditory access (aided audibility and daily hearing aid [HA] use) on speech perception skills in children with HAs. Method: Participants included 24 children with HAs and 25 children with normal hearing (NH), ages 5-12…

Self-demodulation of amplitude-modulated signal components in amplitude-modulated bone-conducted ultrasonic hearing

NASA Astrophysics Data System (ADS)

Ito, Kazuhito; Nakagawa, Seiji

2015-07-01

A novel hearing aid system utilizing amplitude-modulated bone-conducted ultrasound (AM-BCU) is being developed for use by profoundly deaf people. However, there is a lack of research on the acoustic aspects of AM-BCU hearing. In this study, acoustic fields in the ear canal under AM-BCU stimulation were examined with respect to the self-demodulation effect of amplitude-modulated signal components generated in the ear canal. We found self-demodulated signals with an audible sound pressure level related to the amplitude-modulated signal components of bone-conducted ultrasonic stimulation. In addition, the increases in the self-demodulated signal levels at low frequencies in the ear canal after occluding the ear canal opening, i.e., the positive occlusion effect, indicate the existence of a pathway by which the self-demodulated signals pass through the aural cartilage and soft tissue, and radiate into the ear canal.

Hearing and hearing loss: Causes, effects, and treatments

NASA Astrophysics Data System (ADS)

Schmiedt, Richard A.

2003-04-01

Hearing loss can have multiple causes. The outer and middle ears are conductive pathways for acoustic energy to the inner ear (cochlea) and help shape our spectral sensitivity. Conductive hearing loss is mechanical in nature such that the energy transfer to the cochlea is impeded, often from eardrum perforations or middle ear fluid buildup. Beyond the middle ear, the cochlea comprises three interdependent systems necessary for normal hearing. The first is that of basilar-membrane micromechanics including the outer hair cells. This system forms the basis of the cochlear amplifier and is the most vulnerable to noise and drug exposure. The second system comprises the ion pumps in the lateral wall tissues of the cochlea. These highly metabolic cells provide energy to the cochlear amplifier in the form of electrochemical potentials. This second system is particularly vulnerable to the effects of aging. The third system comprises the inner hair cells and their associated sensory nerve fibers. This system is the transduction stage, changing mechanical vibrations to nerve impulses. New treatments for hearing loss are on the horizon; however, at present the best strategy is avoidance of cochlear trauma and the proper use of hearing aids. [Work supported by NIA and MUSC.

Tolerable hearing aid delays. V. Estimation of limits for open canal fittings.

PubMed

Stone, Michael A; Moore, Brian C J; Meisenbacher, Katrin; Derleth, Ralph P

2008-08-01

Open canal fittings are a popular alternative to close-fitting earmolds for use with patients whose low-frequency hearing is near normal. Open canal fittings reduce the occlusion effect but also provide little attenuation of external air-borne sounds. The wearer therefore receives a mixture of air-borne sound and amplified but delayed sound through the hearing aid. To explore systematically the effect of the mixing, we simulated with varying degrees of complexity the effects of both a hearing loss and a high-quality hearing aid programmed to compensate for that loss, and used normal-hearing participants to assess the processing. The off-line processing was intended to simulate the percept of listening to the speech of a single (external) talker. The effect of introducing a delay on a subjective measure of speech quality (disturbance rating on a scale from 1 to 7, 7 being maximal disturbance) was assessed using both a constant gain and a gain that varied across frequency. In three experiments we assessed the effects of different amounts of delay, maximum aid gain and rate of change of gain with frequency. The simulated hearing aids were chosen to be appropriate for typical mild to moderate high-frequency losses starting at 1 or 2 kHz. Two of the experiments used simulations of linear hearing aids, whereas the third used fast-acting multichannel wide-dynamic-range compression and a simulation of loudness recruitment. In one experiment, a condition was included in which spectral ripples produced by comb-filtering were partially removed using a digital filter. For linear hearing aids, disturbance increased progressively with increasing delay and with decreasing rate of change of gain; the effect of amount of gain was small when the gain varied across frequency. The effect of reducing spectral ripples was also small. When the simulation of dynamic processes was included (experiment 3), the pattern with delay remained similar, but disturbance increased with increasing gain. It is argued that this is mainly due to disturbance increasing with increasing simulated hearing loss, probably because of the dynamic processing involved in the hearing aid and recruitment simulation. A disturbance rating of 3 may be considered as just acceptable. This rating was reached for delays of about 5 and 6 msec, for simulated hearing losses starting at 2 and 1 kHz, respectively. The perceptual effect of reducing the spectral ripples produced by comb-filtering was small; the effect was greatest when the hearing aid gain was small and when the hearing loss started at a low frequency.

38 CFR 17.149 - Sensori-neural aids.

Code of Federal Regulations, 2010 CFR

2010-07-01

... attendance or by reason of being permanently housebound; (6) Those who have a visual or hearing impairment... normally occurring visual or hearing impairments; and (8) Those visually or hearing impaired so severely... frequency ranges which contribute to a loss of communication ability; however, hearing aids are to be...

The impact of hearing aids and age-related hearing loss on auditory plasticity across three months - An electrical neuroimaging study.

PubMed

Giroud, Nathalie; Lemke, Ulrike; Reich, Philip; Matthes, Katarina L; Meyer, Martin

2017-09-01

The present study investigates behavioral and electrophysiological auditory and cognitive-related plasticity in three groups of healthy older adults (60-77 years). Group 1 was moderately hearing-impaired, experienced hearing aid users, and fitted with new hearing aids using non-linear frequency compression (NLFC on); Group 2, also moderately hearing-impaired, used the same type of hearing aids but NLFC was switched off during the entire period of study duration (NLFC off); Group 3 represented individuals with age-appropriate hearing (NHO) as controls, who were not different in IQ, gender, or age from Group 1 and 2. At five measurement time points (M1-M5) across three months, a series of active oddball tasks were administered while EEG was recorded. The stimuli comprised syllables consisting of naturally high-pitched fricatives (/sh/, /s/, and /f/), which are hard to distinguish for individuals with presbycusis. By applying a data-driven microstate approach to obtain global field power (GFP) as a measure of processing effort, the modulations of perceptual (P50, N1, P2) and cognitive-related (N2b, P3b) auditory evoked potentials were calculated and subsequently related to behavioral changes (accuracy and reaction time) across time. All groups improved their performance across time, but NHO showed consistently higher accuracy and faster reaction times than the hearing-impaired groups, especially under difficult conditions. Electrophysiological results complemented this finding by demonstrating longer latencies in the P50 and the N1 peak in hearing aid users. Furthermore, the GFP of cognitive-related evoked potentials decreased from M1 to M2 in the NHO group, while a comparable decrease in the hearing-impaired group was only evident at M5. After twelve weeks of hearing aid use of eight hours each day, we found a significantly lower GFP in the P3b of the group with NLFC on as compared to the group with NLFC off. These findings suggest higher processing effort, as evidenced by higher GFP, in hearing-impaired individuals when compared to those with normal hearing, although the hearing-impaired show a decrease of processing effort after repeated stimulus exposure. In addition, our findings indicate that the acclimatization to a new hearing aid algorithm may take several weeks. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Opening the Market for Lower Cost Hearing Aids: Regulatory Change Can Improve the Health of Older Americans

PubMed Central

Weinstein, Barbara E.

2016-01-01

Hearing loss is a leading cause of disability among older people. Yet only one in seven US adults who could benefit from a hearing aid uses one. This fraction has not increased over the past 30 years, nor have hearing aid prices dropped, despite trends of steady improvements and price reductions in the consumer electronics industry. The President’s Council on Science and Technology has proposed changes in the regulation of hearing aids, including the creation of a “basic” low-cost over-the-counter category of devices. We discuss the potential to reduce disability as well as to improve public health, stakeholder responses to the president’s council’s proposal, and public health efforts to further mitigate the burden of disability stemming from age-related hearing loss. PMID:27077339

Results with cochlear implantation in adults with speech recognition scores exceeding current criteria.

PubMed

Amoodi, Hosam A; Mick, Paul T; Shipp, David B; Friesen, Lendra M; Nedzelski, Julian M; Chen, Joseph M; Lin, Vincent Y W

2012-01-01

The primary purpose of this study was to evaluate a group of postlingually deafened adults, whose aided speech recognition exceeded commonly accepted candidacy criteria for implantation. The study aimed to define performance and qualitative outcomes of cochlear implants in these individuals compared with their optimally fitted hearing aid(s). Retrospective case series. Tertiary referral center. All postlingually deafened subjects (N = 27), who were unsuccessful hearing aid users implanted between 2000 and 2010 with a preimplantation Hearing in Noise Test (HINT) score of 60% or more were included. We compared patients' preoperative performance (HINT score) with hearing aids to postoperative performance with the cochlear implant after 12 months of device use. In addition, the Hearing Handicap Inventory questionnaire was used to quantify the hearing-related handicap change perceived after the implantation. The study group demonstrated significant postoperative improvement on all outcome measures; most notably, the mean HINT score improved from 68.4% (standard deviation, 8.3) to 91.9% (standard deviation, 9.7). Additionally, there was a significant improvement in hearing-related handicap perceived by all patients. The envelope of implantation candidacy criteria continues to expand as shown by this study's cohort. Patient satisfaction and speech recognition results are very encouraging in support of treating those who currently perform at a level above the conventional candidacy threshold but struggle with optimally fitted hearing aids.

Hearing Aid-Induced Plasticity in the Auditory System of Older Adults: Evidence from Speech Perception

ERIC Educational Resources Information Center

Lavie, Limor; Banai, Karen; Karni, Avi; Attias, Joseph

2015-01-01

Purpose: We tested whether using hearing aids can improve unaided performance in speech perception tasks in older adults with hearing impairment. Method: Unaided performance was evaluated in dichotic listening and speech-­in-­noise tests in 47 older adults with hearing impairment; 36 participants in 3 study groups were tested before hearing aid…

Effects of reverberation and noise on speech intelligibility in normal-hearing and aided hearing-impaired listeners.

PubMed

Xia, Jing; Xu, Buye; Pentony, Shareka; Xu, Jingjing; Swaminathan, Jayaganesh

2018-03-01

Many hearing-aid wearers have difficulties understanding speech in reverberant noisy environments. This study evaluated the effects of reverberation and noise on speech recognition in normal-hearing listeners and hearing-impaired listeners wearing hearing aids. Sixteen typical acoustic scenes with different amounts of reverberation and various types of noise maskers were simulated using a loudspeaker array in an anechoic chamber. Results showed that, across all listening conditions, speech intelligibility of aided hearing-impaired listeners was poorer than normal-hearing counterparts. Once corrected for ceiling effects, the differences in the effects of reverberation on speech intelligibility between the two groups were much smaller. This suggests that, at least, part of the difference in susceptibility to reverberation between normal-hearing and hearing-impaired listeners was due to ceiling effects. Across both groups, a complex interaction between the noise characteristics and reverberation was observed on the speech intelligibility scores. Further fine-grained analyses of the perception of consonants showed that, for both listener groups, final consonants were more susceptible to reverberation than initial consonants. However, differences in the perception of specific consonant features were observed between the groups.

[Prevalence of hearing loss in Northern and Southern Germany. German version].

PubMed

von Gablenz, P; Hoffmann, E; Holube, I

2017-08-01

The HÖRSTAT study conducted in Northwest Germany yielded hearing impairment in approximately 16% of adults according to the World Health Organization (WHO) criterion. However, the robustness of extrapolations on a national level might be questioned, as the epidemiological data were collected on a regional level. Independently from HÖRSTAT, the "Hearing in Germany" study examined adult hearing in Aalen, a town located in Southwest Germany. Both cross-sectional studies were based on stratified random samples from the general population. Pure-tone average at 0.5, 1, 2, and 4 kHz (PTA4), the prevalence of hearing impairment (WHO criterion: PTA4 in the better ear >25 dB HL), and hearing aid provision were compared. Data from the Aalen study and HÖRSTAT were pooled (n = 3105) to extrapolate the prevalence and degree of hearing impairment for the years 2015, 2020, and 2025. Both studies show very similar results for PTA4. Weighted for official population statistics, the prevalence of hearing impairment according to the WHO criterion is 16.2% among adults, affecting 11.1 million persons in Germany. Due to demographic changes, the prevalence is expected to increase in the medium term by around 1% per 5‑year period. With a similar degree of hearing loss, hearing aid provision differs from place to place. Adjusted for gender and age to the European Standard Population (ESP), the prevalence of hearing impairment observed both in HÖRSTAT and the Aalen sample is considerably lower than reported for international studies. Since the analysis refers to cross-sectional data only, possible cohort effects are not considered in the prevalence projection.

The Effects of Hearing Aid Directional Microphone and Noise Reduction Processing on Listening Effort in Older Adults with Hearing Loss.

PubMed

Desjardins, Jamie L

2016-01-01

Older listeners with hearing loss may exert more cognitive resources to maintain a level of listening performance similar to that of younger listeners with normal hearing. Unfortunately, this increase in cognitive load, which is often conceptualized as increased listening effort, may come at the cost of cognitive processing resources that might otherwise be available for other tasks. The purpose of this study was to evaluate the independent and combined effects of a hearing aid directional microphone and a noise reduction (NR) algorithm on reducing the listening effort older listeners with hearing loss expend on a speech-in-noise task. Participants were fitted with study worn commercially available behind-the-ear hearing aids. Listening effort on a sentence recognition in noise task was measured using an objective auditory-visual dual-task paradigm. The primary task required participants to repeat sentences presented in quiet and in a four-talker babble. The secondary task was a digital visual pursuit rotor-tracking test, for which participants were instructed to use a computer mouse to track a moving target around an ellipse that was displayed on a computer screen. Each of the two tasks was presented separately and concurrently at a fixed overall speech recognition performance level of 50% correct with and without the directional microphone and/or the NR algorithm activated in the hearing aids. In addition, participants reported how effortful it was to listen to the sentences in quiet and in background noise in the different hearing aid listening conditions. Fifteen older listeners with mild sloping to severe sensorineural hearing loss participated in this study. Listening effort in background noise was significantly reduced with the directional microphones activated in the hearing aids. However, there was no significant change in listening effort with the hearing aid NR algorithm compared to no noise processing. Correlation analysis between objective and self-reported ratings of listening effort showed no significant relation. Directional microphone processing effectively reduced the cognitive load of listening to speech in background noise. This is significant because it is likely that listeners with hearing impairment will frequently encounter noisy speech in their everyday communications. American Academy of Audiology.

75 FR 63764 - Hearing Aid Compatibility Proceeding; Request That Comments Address Effects of New Legislation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-18

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 20 [DA 10-1936; WT Docket No. 07-250] Hearing Aid... Telecommunications Bureau requests that the comments in the pending Hearing Aid Compatibility proceeding address the effects of the Twenty-First Century Communications and Video Accessibility Act of 2010, if any, on the...

Development of a Self-Report Tool to Evaluate Hearing Aid Outcomes among Chinese Speakers

ERIC Educational Resources Information Center

Wong, Lena L. N.; Hang, Na

2014-01-01

Purpose: This article reports on the development of a self-report tool--the Chinese Hearing Aid Outcomes Questionnaire (CHAOQ)--to evaluate hearing aid outcomes among Chinese speakers. Method: There were 4 phases to construct the CHAOQ and evaluate its psychometric properties. First, items were selected to evaluate a range of culturally relevant…

Preliminary support for a brief psychological intervention to improve first-time hearing aid use among adults.

PubMed

Armitage, Christopher J; Lees, Deborah; Lewis, Kathryn; Munro, Kevin J

2017-11-01

Suboptimal hearing aid use extorts significant social, health, and economic costs. The aims of this study were to (1) test the novel hypothesis that the threat associated with being diagnosed with hearing loss could be ameliorated with a self-affirmation manipulation and (2) gauge the feasibility of deploying the manipulation in routine clinical practice. Parallel groups randomized controlled trial with 10-week follow-up. Fifty people, newly prescribed with a hearing aid, completed either a questionnaire that included a brief self-affirming exercise or an identical questionnaire with no self-affirming exercise. The main outcome measure was derived from data logging automatically stored by the hearing aid. Perceived threat ('anxiety about ageing'), behavioural intention, and self-efficacy were measured as potential mediators. Objectively measured hours of daily hearing aid use were marginally higher in the intervention group compared with the control group (between-group difference = 1.94 hr, 95%CI = -1.24, 5.12, d = 0.43). At follow-up, participants in the intervention group were significantly less anxious about ageing and more accepting of older people than were participants in the control group (between-group difference = 0.75, 95%CI = 0.26, 1.22, d = 0.87). There was no statistically significant effect of the intervention on behavioural intention or self-efficacy. Although not statistically significant, the magnitude of the effect of the intervention on hearing aid use (d = 0.43) suggests that it would be worthwhile working towards a fully powered randomized controlled trial. The ability to reduce anxieties about ageing with this brief intervention could have far-reaching benefits for multiple patient and general population groups. Statement of contribution What is already known on this subject? Hearing impairment is more disabling than diabetes, yet hearing aid use is suboptimal. Anxieties about ageing may undermine hearing aid use. What does this study add? The study tests a brief theory-based psychological intervention to reduce anxiety about ageing and promote hearing aid use. Results show that the brief psychological intervention reduced anxiety and marginally increased objective hearing aid use. Further work is required to identify other situations in which anxieties about ageing undermine behaviour change efforts. The very brief, flexible nature of the intervention means it could be adapted and deployed in numerous other health care settings. © 2017 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Cognitive hearing aids? Insights and possibilities

NASA Astrophysics Data System (ADS)

Petersen, Eline Borch; Lunner, Thomas

2015-12-01

The working memory plays an important role in successfully overcoming adverse listening conditions and should consequently be considered when designing and testing hearing aids. A number of studies have established the relationship between hearing in noise and working memory involvement, but with the Sentence-final Word Identification and Recall (SWIRL) test, it is possible to show that working memory is also involved in listening under favorable conditions and that noise reduction has a positive influence in situation with very little noise. Although the capacity of the working memory is a finite individual size, its involvement can differ with fatigue and other factors and individualization of hearing aids should take this into account to obtain the best performance. A way of individually adapting hearing aids is based on changes in the electrical activity of the brain (EEG). Here we present the possibilities that arise from using EEG and show that ear-mounted electrodes is able to record useful EEG that can be explored for individualization of hearing aids. Such an adaptation could be done based on changes in the electrical activity of the brain (EEG). Here we present the possibilities that arise from using EEG and show that ear-mounted electrodes is able to record useful EEG that can be explored for individualization of hearing aids.

Factors in Client–Clinician Interaction That Influence Hearing Aid Adoption

PubMed Central

Jennings, Mary Beth; Shaw, Lynn; Meston, Christine N.; Cheesman, Margaret F.

2011-01-01

The influence of client–clinician interactions has not been emphasized in hearing health care, despite the extensive evidence of the impact of the provider–patient interaction on health outcomes. The purpose of this study was to identify factors in the client–clinician interaction that may influence hearing aid adoption. Thirteen adults who had received a hearing aid recommendation within the previous 3 months and 10 audiologists participated in a study to generate, sort, and rate the importance of factors in client–clinician interaction that may influence the hearing aid purchase decision. A concept mapping approach was used to define meaningful clusters of factors. Quantitative analysis and qualitative interpretation of the statements resulted in eight concepts. The concepts in order of their importance are (a) Ensuring client comfort, (b) Understanding and meeting client needs, (c) Client-centered traits and actions, (d) Acknowledging client as an individual, (e) Imposing undue pressure and discomfort, (f) Conveying device information by clinician, (g) Supporting choices and shared decision making, and (h) Factors in client readiness. Two overarching themes of client-centered interaction and client empowerment were identified. Results highlight the influence of the client–clinician interaction in hearing aid adoption and suggest the possibility of improving hearing aid adoption by empowering clients through a client-centered interaction. PMID:22155784

Evaluation of auditory functions for Royal Canadian Mounted Police officers.

PubMed

Vaillancourt, Véronique; Laroche, Chantal; Giguère, Christian; Beaulieu, Marc-André; Legault, Jean-Pierre

2011-06-01

Auditory fitness for duty (AFFD) testing is an important element in an assessment of workers' ability to perform job tasks safely and effectively. Functional hearing is particularly critical to job performance in law enforcement. Most often, assessment is based on pure-tone detection thresholds; however, its validity can be questioned and challenged in court. In an attempt to move beyond the pure-tone audiogram, some organizations like the Royal Canadian Mounted Police (RCMP) are incorporating additional testing to supplement audiometric data in their AFFD protocols, such as measurements of speech recognition in quiet and/or in noise, and sound localization. This article reports on the assessment of RCMP officers wearing hearing aids in speech recognition and sound localization tasks. The purpose was to quantify individual performance in different domains of hearing identified as necessary components of fitness for duty, and to document the type of hearing aids prescribed in the field and their benefit for functional hearing. The data are to help RCMP in making more informed decisions regarding AFFD in officers wearing hearing aids. The proposed new AFFD protocol included unaided and aided measures of speech recognition in quiet and in noise using the Hearing in Noise Test (HINT) and sound localization in the left/right (L/R) and front/back (F/B) horizontal planes. Sixty-four officers were identified and selected by the RCMP to take part in this study on the basis of hearing thresholds exceeding current audiometrically based criteria. This article reports the results of 57 officers wearing hearing aids. Based on individual results, 49% of officers were reclassified from nonoperational status to operational with limitations on fine hearing duties, given their unaided and/or aided performance. Group data revealed that hearing aids (1) improved speech recognition thresholds on the HINT, the effects being most prominent in Quiet and in conditions of spatial separation between target and noise (Noise Right and Noise Left) and least considerable in Noise Front; (2) neither significantly improved nor impeded L/R localization; and (3) substantially increased F/B errors in localization in a number of cases. Additional analyses also pointed to the poor ability of threshold data to predict functional abilities for speech in noise (r² = 0.26 to 0.33) and sound localization (r² = 0.03 to 0.28). Only speech in quiet (r² = 0.68 to 0.85) is predicted adequately from threshold data. Combined with previous findings, results indicate that the use of hearing aids can considerably affect F/B localization abilities in a number of individuals. Moreover, speech understanding in noise and sound localization abilities were poorly predicted from pure-tone thresholds, demonstrating the need to specifically test these abilities, both unaided and aided, when assessing AFFD. Finally, further work is needed to develop empirically based hearing criteria for the RCMP and identify best practices in hearing aid fittings for optimal functional hearing abilities. American Academy of Audiology.

The Potential Role of the cABR in Assessment and Management of Hearing Impairment

PubMed Central

Anderson, Samira; Kraus, Nina

2013-01-01

Hearing aid technology has improved dramatically in the last decade, especially in the ability to adaptively respond to dynamic aspects of background noise. Despite these advancements, however, hearing aid users continue to report difficulty hearing in background noise and having trouble adjusting to amplified sound quality. These difficulties may arise in part from current approaches to hearing aid fittings, which largely focus on increased audibility and management of environmental noise. These approaches do not take into account the fact that sound is processed all along the auditory system from the cochlea to the auditory cortex. Older adults represent the largest group of hearing aid wearers; yet older adults are known to have deficits in temporal resolution in the central auditory system. Here we review evidence that supports the use of the auditory brainstem response to complex sounds (cABR) in the assessment of hearing-in-noise difficulties and auditory training efficacy in older adults. PMID:23431313

The Role of Audiologic Evaluation in Progressive Audiologic Tinnitus Management

PubMed Central

Henry, James A.; Zaugg, Tara L.; Myers, Paula J.; Schechter, Martin A.

2008-01-01

Progressive Audiologic Tinnitus Management (PATM) is based on the premise that tinnitus is managed most efficiently using a hierarchy of clinical services that address different levels of need. PATM includes five levels of management: (a) triage; (b) audiologic evaluation; (c) group education; (d) tinnitus evaluation; and (e) individualized management. This article provides an overview of PATM and focuses on the procedures that make up the Level 2 Audiologic Evaluation. The evaluation is conducted to assess the potential need for medical, audiologic (hearing loss, tinnitus, hyperacusis), and/or mental health services. The Tinnitus Handicap Inventory, Hearing Handicap Inventory, and Tinnitus and Hearing Survey are used to differentiate effects of tinnitus and hearing loss. If indicated, patients are interviewed with the Tinnitus-Impact Screening Interview. Patients requiring amplification receive hearing aids. Often, management of hearing loss at Level 2 addresses any problems that were attributed to the tinnitus, which obviates further tinnitus-specific intervention. PMID:18628281

Prevalence and degree of hearing loss among males in Beaver Dam cohort: comparison of veterans and nonveterans.

PubMed

Wilson, Richard H; Noe, Colleen M; Cruickshanks, Karen J; Wiley, Terry L; Nondahl, David M

2010-01-01

The Epidemiology of Hearing Loss Study (EHLS) conducted in Beaver Dam, Wisconsin, was a population-based study that focused on the prevalence of hearing loss among 3,753 participants between 1993 and 1995. This article reports the results of several auditory measures from 999 veteran and 590 nonveteran males 48 to 92 years of age included in the EHLS. The auditory measures included pure tone thresholds, tympanometry and acoustic reflexes, word recognition in quiet and in competing message, and the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) version. Hearing loss in the auditory domains of pure tone thresholds, word recognition in quiet, and word recognition in competing message increased with age but were not significantly different for the veterans and nonveterans. No significant differences were found between participant groups on the HHIE-S; however, regarding hearing aid usage, mixed differences were found.

The Neural Representation of Consonant-Vowel Transitions in Adults Who Wear Hearing Aids

PubMed Central

Tremblay, Kelly L.; Kalstein, Laura; Billings, Cuttis J.; Souza, Pamela E.

2006-01-01

Hearing aids help compensate for disorders of the ear by amplifying sound; however, their effectiveness also depends on the central auditory system's ability to represent and integrate spectral and temporal information delivered by the hearing aid. The authors report that the neural detection of time-varying acoustic cues contained in speech can be recorded in adult hearing aid users using the acoustic change complex (ACC). Seven adults (50–76 years) with mild to severe sensorineural hearing participated in the study. When presented with 2 identifiable consonant-vowel (CV) syllables (“shee” and “see”), the neural detection of CV transitions (as indicated by the presence of a P1-N1-P2 response) was different for each speech sound. More specifically, the latency of the evoked neural response coincided in time with the onset of the vowel, similar to the latency patterns the authors previously reported in normal-hearing listeners. PMID:16959736

Chosen Listening Levels for Music With and Without the Use of Hearing Aids.

PubMed

Croghan, Naomi B H; Swanberg, Anne M; Anderson, Melinda C; Arehart, Kathryn H

2016-09-01

The objective of this study was to describe chosen listening levels (CLLs) for recorded music for listeners with hearing loss in aided and unaided conditions. The study used a within-subject, repeated-measures design with 13 adult hearing-aid users. The music included rock and classical samples with different amounts of audio-industry compression limiting. CLL measurements were taken at ear level (i.e., at input to the hearing aid) and at the tympanic membrane. For aided listening, average CLLs were 69.3 dBA at the input to the hearing aid and 80.3 dBA at the tympanic membrane. For unaided listening, average CLLs were 76.9 dBA at the entrance to the ear canal and 77.1 dBA at the tympanic membrane. Although wide intersubject variability was observed, CLLs were not associated with audiometric thresholds. CLLs for rock music were higher than for classical music at the tympanic membrane, but no differences were observed between genres for ear-level CLLs. The amount of audio-industry compression had no significant effect on CLLs. By describing the levels of recorded music chosen by hearing-aid users, this study provides a basis for ecologically valid testing conditions in clinical and laboratory settings.

The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial

PubMed Central

Rogers, Sara E.; Quigley, Tera M.; Main, Anna K.; Kinney, Dana L.; Herring, Christine

2017-01-01

Objectives The objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models. Design The design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups. Setting Older adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic. Participants Participants were adults, ages 55–79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention. Intervention(s) All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model. Primary and Secondary Outcome Measures Primary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained. Results Per-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However, CD group had a significantly (p < .05) lower satisfaction and percentage (CD: 55%; AB: 81%; P: 36%) likely to purchase hearing aids after the trial. Conclusions Hearing aids are efficacious in older adults for both AB and CD service-delivery models. CD model of OTC service delivery yielded only slightly poorer outcomes than the AB model. Efficacious OTC models may increase accessibility and affordability of hearing aids for millions of older adults. Purchase price had no effect on outcomes, but a high percentage of those who rejected hearing aids paid the typical price (85%). Trial Registration Clinicaltrials.gov: NCT01788432; https://clinicaltrials.gov/ct2/show/NCT01788423 Supplemental Materials https://doi.org/10.23641/asha.5382499 PMID:28252160

Hearing loss is negatively related to episodic and semantic long-term memory but not to short-term memory.

PubMed

Rönnberg, Jerker; Danielsson, Henrik; Rudner, Mary; Arlinger, Stig; Sternäng, Ola; Wahlin, Ake; Nilsson, Lars-Göran

2011-04-01

To test the relationship between degree of hearing loss and different memory systems in hearing aid users. Structural equation modeling (SEM) was used to study the relationship between auditory and visual acuity and different cognitive and memory functions in an age-hetereogenous subsample of 160 hearing aid users without dementia, drawn from the Swedish prospective cohort aging study known as Betula (L.-G. Nilsson et al., 1997). Hearing loss was selectively and negatively related to episodic and semantic long-term memory (LTM) but not short-term memory (STM) performance. This held true for both ears, even when age was accounted for. Visual acuity alone, or in combination with auditory acuity, did not contribute to any acceptable SEM solution. The overall relationships between hearing loss and memory systems were predicted by the ease of language understanding model (J. Rönnberg, 2003), but the exact mechanisms of episodic memory decline in hearing aid users (i.e., mismatch/disuse, attentional resources, or information degradation) remain open for further experiments. The hearing aid industry should strive to design signal processing algorithms that are cognition friendly.

A crossover trial comparing wide dynamic range compression and frequency compression in hearing aids for tinnitus therapy.

PubMed

Hodgson, Shirley-Anne; Herdering, Regina; Singh Shekhawat, Giriraj; Searchfield, Grant D

2017-01-01

It has been suggested that frequency lowering may be a superior tinnitus reducing digital signal processing (DSP) strategy in hearing aids than conventional amplification. A crossover trial was undertaken to determine if frequency compression (FC) was superior to wide dynamic range compression (WDRC) in reducing tinnitus. A 6-8-week crossover trial of two digital signal-processing techniques (WDRC and 2 WDRC with FC) was undertaken in 16 persons with high-frequency sensorineural hearing loss and chronic tinnitus. WDRC resulted in larger improvements in Tinnitus Functional Index and rating scale scores than WDRC with FC. The tinnitus improvements obtained with both processing types appear to be due to reduced hearing handicap and possibly decreased tinnitus audibility. Hearing aids are useful assistive devices in the rehabilitation of tinnitus. FC was very successful in a few individuals but was not superior to WDRC across the sample. It is recommended that WDRC remain as the default first choice tinnitus hearing aid processing strategy for tinnitus. FC should be considered as one of the many other options for selection based on individual hearing needs. Implications of Rehabilitation Hearing aids can significantly reduce the effects of tinnitus after 6-8 weeks of use. Addition of frequency compression digital signal processing does not appear superior to standard amplitude compression alone. Improvements in tinnitus were correlated with reductions in hearing handicap.

Concerns regarding Direct-to-Consumer Hearing Aid Purchasing

ERIC Educational Resources Information Center

Kimball, Suzanne H.

2010-01-01

An individual over age 18 can purchase a hearing aid online or through mail order if they sign a waiver declining a medical evaluation, while those under 18 are required to be seen by a physician to obtain medical consent. However, in many states there is nothing to prevent a parent or caregiver from purchasing hearing aids for their child from a…

Benefit of Wearing a Hearing Aid on the Unimplanted Ear in Adult Users of a Cochlear Implant

ERIC Educational Resources Information Center

Dunn, Camille C.; Tyler, Richard S.; Witt, Shelley A.

2005-01-01

The purpose of this investigation was to document performance of participants wearing a cochlear implant and hearing aid in opposite ears on speech-perception and localization tests. Twelve individuals who wore a cochlear implant and a hearing aid on contralateral ears were tested on their abilities to understand words in quiet and sentences in…

[Handling skills and utilization of hearing aids].

PubMed

Gimsing, S

1995-12-11

Seven hundred and fifty adult patients possessing hearing aids were interviewed with regard to utilization and handling skills. Although 71% were full-time users and 18% were part-time users, only 32% could handle their aids competently. Inhabitants of the county's major town clearly managed their aids better than residents of the remainder of the catchment area, despite the fact that 85% of the former group never sought counselling by hearing therapists. It is concluded that not only the traditional audiology professions, but also staff from other branches of the health and social services should participate more actively in the care of the hearing impaired.

Spatial separation benefit for unaided and aided listening

PubMed Central

Ahlstrom, Jayne B.; Horwitz, Amy R.; Dubno, Judy R.

2013-01-01

Consonant recognition in noise was measured at a fixed signal-to-noise ratio as a function of low-pass-cutoff frequency and noise location in older adults fit with bilateral hearing aids. To quantify age-related differences, spatial benefit was assessed in younger and older adults with normal hearing. Spatial benefit was similar for all groups suggesting that older adults used interaural difference cues to improve speech recognition in noise equivalently to younger adults. Although amplification was sufficient to increase high-frequency audibility with spatial separation, hearing-aid benefit was minimal, suggesting that factors beyond simple audibility may be responsible for limited hearing-aid benefit. PMID:24121648

Intelligent hearing aids: the next revolution.

PubMed

Tao Zhang; Mustiere, Fred; Micheyl, Christophe

2016-08-01

The first revolution in hearing aids came from nonlinear amplification, which allows better compensation for both soft and loud sounds. The second revolution stemmed from the introduction of digital signal processing, which allows better programmability and more sophisticated algorithms. The third revolution in hearing aids is wireless, which allows seamless connectivity between a pair of hearing aids and with more and more external devices. Each revolution has fundamentally transformed hearing aids and pushed the entire industry forward significantly. Machine learning has received significant attention in recent years and has been applied in many other industries, e.g., robotics, speech recognition, genetics, and crowdsourcing. We argue that the next revolution in hearing aids is machine intelligence. In fact, this revolution is already quietly happening. We will review the development in at least three major areas: applications of machine learning in speech enhancement; applications of machine learning in individualization and customization of signal processing algorithms; applications of machine learning in improving the efficiency and effectiveness of clinical tests. With the advent of the internet of things, the above developments will accelerate. This revolution will bring patient satisfactions to a new level that has never been seen before.

Access to aidable residual hearing in adult candidates for cochlear implantation in the UK.

PubMed

Fielden, Claire A; Hampton, Rosa; Smith, Sandra; Kitterick, Pádraig T

2016-04-01

Guidance from the National Institute for Health and Care Excellence (NICE) permits candidates to receive a cochlear implant provided they only hear sounds louder than 90 dB HL at 2 and 4 kHz. In some patients, their level of residual hearing may be sufficient to warrant the use of a hearing aid in their non-implanted ear. A survey of unilaterally implanted adults indicated that those implanted since the publication of NICE guidance were almost seven times more likely to use a hearing aid than those implanted prior to this. If contralateral hearing aid use provides additional benefits over implant use alone, it may be appropriate to consider the capacity to use residual hearing following implantation when determining candidacy.

Consumer preferences for hearing aid attributes: a comparison of rating and conjoint analysis methods.

PubMed

Bridges, John F P; Lataille, Angela T; Buttorff, Christine; White, Sharon; Niparko, John K

2012-03-01

Low utilization of hearing aids has drawn increased attention to the study of consumer preferences using both simple ratings (e.g., Likert scale) and conjoint analyses, but these two approaches often produce inconsistent results. The study aims to directly compare Likert scales and conjoint analysis in identifying important attributes associated with hearing aids among those with hearing loss. Seven attributes of hearing aids were identified through qualitative research: performance in quiet settings, comfort, feedback, frequency of battery replacement, purchase price, water and sweat resistance, and performance in noisy settings. The preferences of 75 outpatients with hearing loss were measured with both a 5-point Likert scale and with 8 paired-comparison conjoint tasks (the latter being analyzed using OLS [ordinary least squares] and logistic regression). Results were compared by examining implied willingness-to-pay and Pearson's Rho. A total of 56 respondents (75%) provided complete responses. Two thirds of respondents were male, most had sensorineural hearing loss, and most were older than 50; 44% of respondents had never used a hearing aid. Both methods identified improved performance in noisy settings as the most valued attribute. Respondents were twice as likely to buy a hearing aid with better functionality in noisy environments (p < .001), and willingness to pay for this attribute ranged from US$2674 on the Likert to US$9000 in the conjoint analysis. The authors find a high level of concordance between the methods-a result that is in stark contrast with previous research. The authors conclude that their result stems from constraining the levels on the Likert scale.

Consumer Preferences for Hearing Aid Attributes

PubMed Central

Lataille, Angela T.; Buttorff, Christine; White, Sharon; Niparko, John K.

2012-01-01

Low utilization of hearing aids has drawn increased attention to the study of consumer preferences using both simple ratings (e.g., Likert scale) and conjoint analyses, but these two approaches often produce inconsistent results. The study aims to directly compare Likert scales and conjoint analysis in identifying important attributes associated with hearing aids among those with hearing loss. Seven attributes of hearing aids were identified through qualitative research: performance in quiet settings, comfort, feedback, frequency of battery replacement, purchase price, water and sweat resistance, and performance in noisy settings. The preferences of 75 outpatients with hearing loss were measured with both a 5-point Likert scale and with 8 paired-comparison conjoint tasks (the latter being analyzed using OLS [ordinary least squares] and logistic regression). Results were compared by examining implied willingness-to-pay and Pearson’s Rho. A total of 56 respondents (75%) provided complete responses. Two thirds of respondents were male, most had sensorineural hearing loss, and most were older than 50; 44% of respondents had never used a hearing aid. Both methods identified improved performance in noisy settings as the most valued attribute. Respondents were twice as likely to buy a hearing aid with better functionality in noisy environments (p < .001), and willingness to pay for this attribute ranged from US$2674 on the Likert to US$9000 in the conjoint analysis. The authors find a high level of concordance between the methods—a result that is in stark contrast with previous research. The authors conclude that their result stems from constraining the levels on the Likert scale. PMID:22514094

Laryngeal Aerodynamics in Children with Hearing Impairment versus Age and Height Matched Normal Hearing Peers.

PubMed

Das, Barshapriya; Chatterjee, Indranil; Kumar, Suman

2013-01-01

Lack of proper auditory feedback in hearing-impaired subjects results in functional voice disorder. It is directly related to discoordination of intrinsic and extrinsic laryngeal muscles and disturbed contraction and relaxation of antagonistic muscles. A total of twenty children in the age range of 5-10 years were considered for the study. They were divided into two groups: normal hearing children and hearing aid user children. Results showed a significant difference in the vital capacity, maximum sustained phonation, and fast adduction abduction rate having equal variance for normal and hearing aid user children, respectively, but no significant difference was found in the peak flow value with being statistically significant. A reduced vital capacity in hearing aid user children suggests a limited use of the lung volume for speech production. It may be inferred from the study that the hearing aid user children have poor vocal proficiency which is reflected in their voice. The use of voicing component in hearing impaired subjects is seen due to improper auditory feedback. It was found that there was a significant difference in the vital capacity, maximum sustained phonation (MSP), and fast adduction abduction rate and no significant difference in the peak flow.

The Speech Intelligibility Index and the pure-tone average as predictors of lexical ability in children fit with hearing AIDS.

PubMed

Stiles, Derek J; Bentler, Ruth A; McGregor, Karla K

2012-06-01

To determine whether a clinically obtainable measure of audibility, the aided Speech Intelligibility Index (SII; American National Standards Institute, 2007), is more sensitive than the pure-tone average (PTA) at predicting the lexical abilities of children who wear hearing aids (CHA). School-age CHA and age-matched children with normal hearing (CNH) repeated words and nonwords, learned novel words, and completed a standardized receptive vocabulary test. Analyses of covariance allowed comparison of the 2 groups. For CHA, regression analyses determined whether SII held predictive value over and beyond PTA. CHA demonstrated poorer performance than CNH on tests of word and nonword repetition and receptive vocabulary. Groups did not differ on word learning. Aided SII was a stronger predictor of word and nonword repetition and receptive vocabulary than PTA. After accounting for PTA, aided SII remained a significant predictor of nonword repetition and receptive vocabulary. Despite wearing hearing aids, CHA performed more poorly on 3 of 4 lexical measures. Individual differences among CHA were predicted by aided SII. Unlike PTA, aided SII incorporates hearing aid amplification characteristics and speech-frequency weightings and may provide a more valid estimate of the child's access to and ability to learn from auditory input in real-world environments.

Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial.

PubMed

Kitterick, Pádraig T; O'Donoghue, Gerard M; Edmondson-Jones, Mark; Marshall, Andrew; Jeffs, Ellen; Craddock, Louise; Riley, Alison; Green, Kevin; O'Driscoll, Martin; Jiang, Dan; Nunn, Terry; Saeed, Shakeel; Aleksy, Wanda; Seeber, Bernhard U

2014-01-01

Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on hearing- and health-related quality of life. This multi-centre trial was designed to provide evidence for the efficacy of cochlear implantation compared to the contra-lateral routing of signals. A purpose-built sound presentation system and established measurement techniques will provide reliable and precise measures of binaural hearing. Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739 (05/JUL/2013).

Anatomy of the Human Ear/Questions to Ask your Hearing Professional

MedlinePlus

... disorders A severe blow to the head Loud noise Assistive Devices Hearing Aids —Small electronic devices worn ... or without hearing aids to overcome distance, background noise, or poor room acoustics. An example is a ...

[Auditory function in children with Brachmann-de Lange syndrom].

PubMed

Kozłowski, Jacek; Wierzba, Jolanta; Narozny, Waldemar; Balcerska, Anna; Stankiewicz, Czesław; Kuczkowski, Jerzy

2006-01-01

The aim of the research work is the evaluation of auditory function in children with rare, genetically determined Brachmann-de Lange syndrome. Test material came from 18 children (7 girls and 11 boys) between 11 months and 18 years of age with Brachmann-de Lange syndrome who have been diagnosed and treated at ENT Department and Department of Paediatrics, Haematology, Oncology and Endocrinology Medical University of Gdansk with support of Cornelia de Lange Association - Poland. In all children examinations of brainstem auditory evoked potential have been carried out as well as tympanometric examination in case of finding hearing loss. All these examinations were carried out in ENT Department of Medical University of Gdansk, using Racia-Alvar Centor C apparatus and Madsen-Zodiak 901. 9 (50%) of patients demonstrated hearing loss. In 3 (16.7%) cases the conduction hearing loss was connected with the chronic diseases of middle ear which required medical treatment. In remaining 6 (33.3%) cases due to sensorineural hearing loss children had hearing aids applied and underwent rehabilitation. The results indicate that all children with Brachmann-de Lange syndrome should undergo examinations of brainstem auditory evoked potential. It enables to detect hypoacusis and initiate proper treatment. Lack of the opportunity of having a hearing aid applied and further rehabilitation deepens the social isolation of the little patients and inhibits their natural progress in communication. In such cases mental retardation may subsequently occur.

Satisfaction with hearing aids: a consumer research perspective.

PubMed

Wong, Lena L N; Hickson, Louise; McPherson, Bradley

2009-01-01

This research aimed at describing satisfaction with hearing aids from the perspective of the client as a consumer. A disconfirmation-expectancy model, derived from consumer research, was evaluated. This model posits that pre-fitting expectations, post-fitting performance, and the experience of how performance compares to expectations (disconfirmation), contribute to satisfaction. Positive disconfirmation occurs when performance is better than original expectations and is associated with higher satisfaction. Negative disconfirmation is when performance is poorer than expectations and is associated with dissatisfaction. New hearing aid users in Hong Kong (N=42) were tested with a newly developed self-report measure (PHACS: profile of hearing aid consumer satisfaction) that included items focused on hearing ability, problems, cost, and service. Pre-fitting expectations and post-fitting performance, disconfirmation, and satisfaction were measured. Results showed that expectations were generally not related to satisfaction, that disconfirmation was correlated with many aspects of satisfaction, and that performance was most strongly related to satisfaction. The implications of the findings are that hearing aid performance is the most important element for determining satisfaction; however disconfirmation should not be overlooked.

French-Canadian translation and validation of four questionnaires assessing hearing impairment and handicap.

PubMed

Vincent, Claude; Gagné, Jean-Pierre; Leroux, Tony; Clothier, Audrey; Larivière, Marianne; Dumont, Frédéric S; Gendron, Martine

2017-04-01

Questionnaires evaluating hearing impairment are available in English but there is a need for French standardised questionnaires for researchers as well as for audiologists and other clinicians. The objective of this study is to describe the translation and validation of four questionnaires that assess different aspects of hearing impairment and handicap among elders with hearing loss, by comparing the main score and psychometric evaluation of original and French-Canadian (FC) versions of the World Health Organization Disability Assessment Scale II (WHO-DAS II), the Screening Test for Hearing Problems (STHP), the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA). Vallerand method: translation and back-translation by two translators, revision by a committee of experts and pre-tested with five bilingual older participants. Participants (n = 29) were 65 years of age or older including 21 with hearing aids. The psychometric properties (internal consistency, temporal stability after four weeks) indicate good reliability for most of the translated questionnaires and their subscales, especially the WHO-DAS II. The translations in FC of two hearing loss and two hearing aid questionnaires were validated. It is recommended to pursue the demonstration for temporal stability for the STHP.

High-frequency amplification and sound quality in listeners with normal through moderate hearing loss.

PubMed

Ricketts, Todd A; Dittberner, Andrew B; Johnson, Earl E

2008-02-01

One factor that has been shown to greatly affect sound quality is audible bandwidth. Provision of gain for frequencies above 4-6 kHz has not generally been supported for groups of hearing aid wearers. The purpose of this study was to determine if preference for bandwidth extension in hearing aid processed sounds was related to the magnitude of hearing loss in individual listeners. Ten participants with normal hearing and 20 participants with mild-to-moderate hearing loss completed the study. Signals were processed using hearing aid-style compression algorithms and filtered using two cutoff frequencies, 5.5 and 9 kHz, which were selected to represent bandwidths that are achievable in modern hearing aids. Round-robin paired comparisons based on the criteria of preferred sound quality were made for 2 different monaurally presented brief sound segments, including music and a movie. Results revealed that preference for either the wider or narrower bandwidth (9- or 5.5-kHz cutoff frequency, respectively) was correlated with the slope of hearing loss from 4 to 12 kHz, with steep threshold slopes associated with preference for narrower bandwidths. Consistent preference for wider bandwidth is present in some listeners with mild-to-moderate hearing loss.

Hearing disability in people aged 50-65: effectiveness and acceptability of rehabilitative intervention.

PubMed Central

Stephens, S D; Callaghan, D E; Hogan, S; Meredith, R; Rayment, A; Davis, A C

1990-01-01

OBJECTIVE--To determine the best means of detecting hearing disability in subjects aged 50-65 and whether rehabilitative intervention is acceptable in this age group. DESIGN--Questionnaire survey of patients on general practice age-sex registers. Two types of questionnaire were used, one being based on the closed set approach of the Institute of Hearing Research questionnaire, which had been used in a pilot study, and the other being a simplified version of this questionnaire developed by the Welsh Hearing Institute and based on open set questions. Questionnaires were sent up to three times, and any patients who had not responded two months after the last posting were personally contacted. SETTING--Two general practices in Glyncorrwg and Blaengwynfi in the Afan valley, West Glamorgan. PATIENTS--271 Patients in Glyncorrwg (136 men, 135 women) and 333 patients in Blaengwynfi (173 men, 160 women) aged 50-65. INTERVENTIONS--All patients indicating hearing disability in answering the questionnaires were invited to attend for a evaluative session in their village. After audiometric testing advice and arrangements for fitting a hearing aid were offered as appropriate. MAIN OUTCOME MEASURES--Response rates and prevalence of hearing disability before intervention and of possession of hearing aids before and after intervention. RESULTS--After three postings and personal contact the response rate was 98% (266/271) in Glyncorrwg, where the complex questionnaire was used, and 97% (322/333) in Blaengwynfi. The prevalence of hearing disability was respectively 53% (141/266) and 46% (148/322) and the prevalence of owning a hearing aid 7% (19/266) and 8% (24/322). After intervention the possession of hearing aids rose to 24% (64/266) in Glyncorrwg and 22% (71/322) in Blaengwynfi; six months later the aids were being used regularly. A direct comparison of the two questionnaires in 69 subjects from Blaengwynfi showed no significant differences in the amount of disability detected by each one. The first posting of questionnaires detected 65% (189/289) of the hearing disability in the two villages or 78% (72/92) of those prepared to accept hearing aids for the first time; 96% (88/92) of those who accepted hearing aids were detected by two postings. CONCLUSIONS--Simple questionnaires are effective in detecting hearing disabilities in people aged 50-65, and intervention was acceptable in many of those who reported having difficulties in hearing. The response rates from successive postings suggest that two postings are sufficient in terms of the return in detecting those who will accept intervention. PMID:2107929

Consensus Statement of the Indian Academy of Pediatrics on Newborn Hearing Screening.

PubMed

Paul, Abraham; Prasad, Chhaya; Kamath, S S; Dalwai, Samir; C Nair, M K; Pagarkar, Waheeda

2017-08-15

Hearing impairment is one of the most critical sensory impairments with significant social and psychological consequences. Evidence-based, standardized national guidelines are needed for professionals to screen for hearing impairment during the neonatal period. The meeting on formulation of national consensus guidelines on developmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015. The invited experts included Pediatricians, Developmental Pediatricians, Pediatric Neurologists and Clinical Psychologists. The participants framed guidelines after extensive discussions. To provide guidelines on newborn hearing screening in India. The first screening should be conducted before the neonate's discharge from the hospital - if it 'fails', then it should be repeated after four weeks, or at first immunization visit. If it 'fails' again, then Auditory Brainstem Response (ABR) audiometry should be conducted. All babies admitted to intensive care unit should be screened via ABR. All babies with abnormal ABR should undergo detailed evaluation, hearing aid fitting and auditory rehabilitation, before six months of age. The goal is to screen newborn babies before one month of age, diagnose hearing loss before three months of age and start intervention before six months of age.

Speech Perception for Adults Who Use Hearing Aids in Conjunction with Cochlear Implants in Opposite Ears

ERIC Educational Resources Information Center

Mok, Mansze; Grayden, David; Dowell, Richard C.; Lawrence, David

2006-01-01

This study aimed to (a) investigate the effect of using a hearing aid in conjunction with a cochlear implant in opposite ears on speech perception in quiet and in noise, (b) identify the speech information obtained from a hearing aid that is additive to the information obtained from a cochlear implant, and (c) explore the relationship between…

Restaurant noise, hearing loss, and hearing aids.

PubMed Central

Lebo, C P; Smith, M F; Mosher, E R; Jelonek, S J; Schwind, D R; Decker, K E; Krusemark, H J; Kurz, P L

1994-01-01

Our multidisciplinary team obtained noise data in 27 San Francisco Bay Area restaurants. These data included typical minimum, peak, and average sound pressure levels; digital tape recordings; subjective noise ratings; and on-site unaided and aided speech discrimination tests. We report the details and implications of these noise measurements and provide basic information on selecting hearing aids and suggestions for coping with restaurant noise. Images PMID:7941506

Speech perception and quality of life of open-fit hearing aid users

PubMed Central

GARCIA, Tatiana Manfrini; JACOB, Regina Tangerino de Souza; MONDELLI, Maria Fernanda Capoani Garcia

2016-01-01

ABSTRACT Objective To relate the performance of individuals with hearing loss at high frequencies in speech perception with the quality of life before and after the fitting of an open-fit hearing aid (HA). Methods The WHOQOL-BREF had been used before the fitting and 90 days after the use of HA. The Hearing in Noise Test (HINT) had been conducted in two phases: (1) at the time of fitting without an HA (situation A) and with an HA (situation B); (2) with an HA 90 days after fitting (situation C). Study Sample Thirty subjects with sensorineural hearing loss at high frequencies. Results By using an analysis of variance and the Tukey’s test comparing the three HINT situations in quiet and noisy environments, an improvement has been observed after the HA fitting. The results of the WHOQOL-BREF have showed an improvement in the quality of life after the HA fitting (paired t-test). The relationship between speech perception and quality of life before the HA fitting indicated a significant relationship between speech recognition in noisy environments and in the domain of social relations after the HA fitting (Pearson’s correlation coefficient). Conclusions The auditory stimulation has improved speech perception and the quality of life of individuals. PMID:27383708

Improving Hearing Aid Self-Efficacy and Utility Through Revising a Hearing Aid User Guide: A Pilot Study.

PubMed

McMullan, Alexandra; Kelly-Campbell, Rebecca J; Wise, Kim

2018-03-08

This pilot study aimed to investigate whether revising a hearing aid user guide (HAUG) is associated with improved hearing aid self-efficacy and utility performance. In Part 1, an HAUG was evaluated using the Suitability Assessment of Material (SAM) and readability formulas (Flesch Reading Ease [Flesch, 1943], Flesch-Kincaid Readability Formula [Kincaid, Fishburne, Rogers, & Chissom, 1957], and Simple Measure of Gobbledygook [McLaughlin, 1969]). The HAUG was revised using results from the SAM and best practice guidelines. The revision included generating a video. In Part 2, 30 adults with hearing impairment were randomly assigned to use either the original guide (N = 15) or the revised guide and video (N = 15) to perform a utility task. Participants' self-efficacy was measured using the Basic and Advanced Handling subscales of the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids questionnaire. SAM and readability were compared between the original and revised guides (Doak, Doak, & Root, 1996). SAM and readability were improved following the revision. Participants in the revised guide group performed significantly better on the utility task and on the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids subscales than participants in the original guide group. These results are encouraging as they indicate that there is scope to influence self-efficacy and utility performance through the use of appropriate HAUGs.

Simulation of bone-conducted sound transmission in a three-dimensional finite-element model of a human skull

NASA Astrophysics Data System (ADS)

Chang, You; Kim, Namkeun; Stenfelt, Stefan

2015-12-01

Bone conduction (BC) is the transmission of sound to the inner ear through the bones of the skull. This type of transmission is used in humans fitted with BC hearing aids as well as to classify between conductive and sensorineural hearing losses. The objective of the present study is to develop a finite-element (FE) model of the human skull based on cryosectional images of a female cadaver head in order to gain better understanding of the sound transmission. Further, the BC behavior was validated in terms of sound transmission against experimental data published in the literature. Results showed the responses of the simulated skull FE model were consistent with the experimentally reported data.

Pinnaplasty: reshaping ears to improve hearing aid retention.

PubMed

Gault, David; Grob, Marion; Odili, Joy

2007-01-01

The hearing aid is extremely important to the deaf. A small number have difficulty in retaining the device because the ear is prominent or cup-shaped. This report describes 11 children whose ear shape was modified to improve hearing aid retention and one adult in whom an over set back ear was released to allow fitment of a postaural device. In eight of the 11 children treated, conservative measures such as double-sided tape and retention bands (Huggies) had been tried previously without success. The creation of an antihelical fold in a misshapen ear lacking such a fold provides a reinforcing strut which is useful to support a hearing aid. In patients whose ear had been excessively tethered by previous surgery, projection was restored by inserting a cartilage block behind the ear. In one child with ears tethered by previous surgery, costal cartilage was used not only to release both ears, but also to reconstruct a new helical rim on one side. Surgery enabled a normal postaural hearing aid to be worn in 17 of the 19 ears treated. The two failures deserve special mention. In one patient with a unilateral deformity and severe mental retardation, the dressings were pulled off immediately after surgery. In another patient with a bilateral problem, the appearance and hearing aid retention was improved, but there was not enough room in the postauricular sulcus on one side for the battery component to fit comfortably and an in-the-ear device is now used on that side. Pinnaplasty is a helpful strategy to improve hearing aid retention. Care must be taken not to overdo the set back so that enough room is left to retain the hearing device.

5 CFR 2416.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Assistant Attorney General, Civil Rights Division, United States Department of Justice. Auxiliary aids means... recordings, and other similar services and devices. Auxiliary aids useful for persons with impaired hearing include telephone handset amplifiers, telephones compatible with hearing aids, telecommunication devices...

The benefits of hearing aids and closed captioning for television viewing by older adults with hearing loss.

PubMed

Gordon-Salant, Sandra; Callahan, Julia S

2009-08-01

Although watching television is a common leisure activity of older adults, the ability to understand televised speech may be compromised by age-related hearing loss. Two potential assistive devices for improving television viewing are hearing aids (HAs) and closed captioning (CC), but their use and benefit by older adults with hearing loss are unknown. The primary purpose of this initial investigation was to determine if older hearing-impaired adults show improvements in understanding televised speech with the use of these two assistive devices (HAs and CC) compared with conditions without these devices. A secondary purpose was to examine the frequency of HA and CC use among a sample of older HA wearers. The investigation entailed a randomized, repeated-measures design of 15 older adults (59 to 82 yr) with bilateral sensorineural hearing losses who wore HAs. Participants viewed three types of televised programs (news, drama, and game show) that were each edited into lists of speech segments and provided an identification response. Each participant was tested in four conditions: baseline (no HA or CC), HA only, CC only, and HA + CC. Also, pilot testing with young normal-hearing listeners was conducted to establish list equivalence and stimulus intelligibility with a control group. All testing was conducted in a quiet room to simulate a living room, using a 20 in flat screen television. Questionnaires were also administered to participants to determine the frequency of HA and CC use while watching television. A significant effect of viewing condition was observed for all programs. Participants exhibited significantly better speech recognition scores in conditions with CC than those without CC (p < 0.01). Use of personal HAs did not significantly improve recognition of televised speech compared with the unaided condition. The condition effect was similar across the three different programs. Most of the participants (73%) regularly wore their HAs while watching television; very few of them (13%) had ever used CC. On average, use of CC while watching television dramatically improved speech understanding by a sample of older hearing-impaired adults compared with conditions without CC, including when HAs were worn.

Exploring an educational assessment tool to measure registered nurses' knowledge of hearing impairment and effective communication strategies: A USA study.

PubMed

Ruesch, Amy L

2018-01-01

Poor communication between the Registered Nurse and a hearing impaired patient can affect quality of care and health outcomes. Communication skills training programs for healthcare providers are needed to improve patient centered care. A descriptive research study, using a knowledge assessment tool developed and validated by the researcher, was conducted on 339 Registered Nurses to identify knowledge deficits to be addressed in a communication skills training program being designed. The educational tool measured the Registered Nurses' knowledge across four areas - hearing impairment, hearing aids, communication strategies, and regulations regarding access to care for a person with a hearing disability. Knowledge deficits were detected in all four areas. Using this educational assessment tool may enable nurse educators to tailor communication skills training programs to specifically address the gaps identified regarding hearing impairment and how to effectively communicate with the hearing impaired patient. Post training program, nurse educators can use the tool to evaluate effectiveness. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Effect of Adaptive Nonlinear Frequency Compression on Phoneme Perception.

PubMed

Glista, Danielle; Hawkins, Marianne; Bohnert, Andrea; Rehmann, Julia; Wolfe, Jace; Scollie, Susan

2017-12-12

This study implemented a fitting method, developed for use with frequency lowering hearing aids, across multiple testing sites, participants, and hearing aid conditions to evaluate speech perception with a novel type of frequency lowering. A total of 8 participants, including children and young adults, participated in real-world hearing aid trials. A blinded crossover design, including posttrial withdrawal testing, was used to assess aided phoneme perception. The hearing aid conditions included adaptive nonlinear frequency compression (NFC), static NFC, and conventional processing. Enabling either adaptive NFC or static NFC improved group-level detection and recognition results for some high-frequency phonemes, when compared with conventional processing. Mean results for the distinction component of the Phoneme Perception Test (Schmitt, Winkler, Boretzki, & Holube, 2016) were similar to those obtained with conventional processing. Findings suggest that both types of NFC tested in this study provided a similar amount of speech perception benefit, when compared with group-level performance with conventional hearing aid technology. Individual-level results are presented with discussion around patterns of results that differ from the group average.

47 CFR 68.414 - Hearing aid-compatibility: Enforcement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Hearing aid-compatibility: Enforcement. 68.414 Section 68.414 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint Procedures § 68.414 Hearing...

47 CFR 68.414 - Hearing aid-compatibility: Enforcement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Hearing aid-compatibility: Enforcement. 68.414 Section 68.414 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint Procedures § 68.414 Hearing...

A Hearing Aid Primer 1

ERIC Educational Resources Information Center

Yetter, Carol J.

2009-01-01

This hearing aid primer is designed to define the differences among the three levels of hearing instrument technology: conventional analog circuit technology (most basic), digitally programmable/analog circuit technology (moderately advanced), and fully digital technology (most advanced). Both moderate and advanced technologies mean that hearing…

A comparison of CIC and BTE hearing aids for three-dimensional localization of speech.

PubMed

Best, Virginia; Kalluri, Sridhar; McLachlan, Sara; Valentine, Susie; Edwards, Brent; Carlile, Simon

2010-10-01

Three-dimensional sound localization of speech in anechoic space was examined for eleven listeners with sensorineural hearing loss. The listeners were fitted bilaterally with CIC and BTE hearing aids having similar bandwidth capabilities. The goal was to determine whether differences in microphone placement for these two styles (CICs at the ear canal entrance; BTEs above the pinna) would influence the availability of pinna-related spectral cues and hence localization performance. While lateral and polar angle localization was unaffected by the hearing aid style, the rate of front-back reversals was lower with CICs. This pattern persisted after listeners accommodated to each set of aids for a six week period, although the overall rate of reversals declined. Performance on all measures in all conditions was considerably poorer than in a control group of listeners with normal hearing.

Neurodynamic evaluation of hearing aid features using EEG correlates of listening effort.

PubMed

Bernarding, Corinna; Strauss, Daniel J; Hannemann, Ronny; Seidler, Harald; Corona-Strauss, Farah I

2017-06-01

In this study, we propose a novel estimate of listening effort using electroencephalographic data. This method is a translation of our past findings, gained from the evoked electroencephalographic activity, to the oscillatory EEG activity. To test this technique, electroencephalographic data from experienced hearing aid users with moderate hearing loss were recorded, wearing hearing aids. The investigated hearing aid settings were: a directional microphone combined with a noise reduction algorithm in a medium and a strong setting, the noise reduction setting turned off, and a setting using omnidirectional microphones without any noise reduction. The results suggest that the electroencephalographic estimate of listening effort seems to be a useful tool to map the exerted effort of the participants. In addition, the results indicate that a directional processing mode can reduce the listening effort in multitalker listening situations.

Reading skills in Persian deaf children with cochlear implants and hearing aids.

PubMed

Rezaei, Mohammad; Rashedi, Vahid; Morasae, Esmaeil Khedmati

2016-10-01

Reading skills are necessary for educational development in children. Many studies have shown that children with hearing loss often experience delays in reading. This study aimed to examine reading skills of Persian deaf children with cochlear implant and hearing aid and compare them with normal hearing counterparts. The sample consisted of 72 s and third grade Persian-speaking children aged 8-12 years. They were divided into three equal groups including 24 children with cochlear implant (CI), 24 children with hearing aid (HA), and 24 children with normal hearing (NH). Reading performance of participants was evaluated by the "Nama" reading test. "Nama" provides normative data for hearing and deaf children and consists of 10 subtests and the sum of the scores is regarded as reading performance score. Results of ANOVA on reading test showed that NH children had significantly better reading performance than deaf children with CI and HA in both grades (P < 0.001). Post-hoc analysis, using Tukey test, indicated that there was no significant difference between HA and CI groups in terms of non-word reading, word reading, and word comprehension skills (respectively, P = 0.976, P = 0.988, P = 0.998). Considering the findings, cochlear implantation is not significantly more effective than hearing aid for improvement of reading abilities. It is clear that even with considerable advances in hearing aid technology, many deaf children continue to find literacy a challenging struggle. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Hearing aid and cochlear implant use in children with hearing loss at three years of age: Predictors of use and predictors of changes in use

PubMed Central

Marnane, Vivienne; Ching, Teresa YC

2015-01-01

Objective To examine usage patterns of hearing aids and cochlear implants in children up to three years of age, how usage changes longitudinally, and factors associated with device usage. Design Parent report and Parent’s Evaluation of Aural/oral performance of Children (PEACH) data were obtained at six and twelve months after hearing-aid fitting or cochlear implant switch-on, and again at three years of age. The effect of device use on auditory functional performance was investigated using the PEACH questionnaire. Study sample Four hundred and thirteen participants from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study were included for analysis. Result For users of hearing aids, higher usage at three years was associated with higher maternal education, and more severe hearing loss. For users of cochlear implants, higher usage was associated with higher maternal education and the absence of additional disabilities. Higher PEACH scores was associated with higher usage scores. After allowing for the effects of demographic characteristics, device use was not a significant predictor of functional performance. Conclusions Sixty-two percent of children achieved consistent use (>75% of waking hours) within the first year of receiving a hearing aid or a cochlear implant, and 71% by three years of age. PMID:25816866

Implementation and Evaluation of Computer-Aided Mandarin Phonemes Training System for Hearing-Impaired Students

ERIC Educational Resources Information Center

Yang, Hui-Jen; Lay, Yun-Long

2005-01-01

A computer-aided Mandarin phonemes training (CAMPT) system was developed and evaluated for training hearing-impaired students in their pronunciation of Mandarin phonemes. Deaf or hearing-impaired people have difficulty hearing their own voice, hence most of them cannot learn how to speak. Phonemes are the basis for learning to read and speak in…

Language Outcomes in Children Who Are Deaf and Hard of Hearing: The Role of Language Ability before Hearing Aid Intervention

ERIC Educational Resources Information Center

Daub, Olivia; Bagatto, Marlene P.; Johnson, Andrew M.; Cardy, Janis Oram

2017-01-01

Purpose: Early auditory experiences are fundamental in infant language acquisition. Research consistently demonstrates the benefits of early intervention (i.e., hearing aids) to language outcomes in children who are deaf and hard of hearing. The nature of these benefits and their relation with prefitting development are, however, not well…

Hearing Loss Is Negatively Related to Episodic and Semantic Long-Term Memory but Not to Short-Term Memory

ERIC Educational Resources Information Center

Ronnberg, Jerker; Danielsson, Henrik; Rudner, Mary; Arlinger, Stig; Sternang, Ola; Wahlin, Ake; Nilsson, Lars-Goran

2011-01-01

Purpose: To test the relationship between degree of hearing loss and different memory systems in hearing aid users. Method: Structural equation modeling (SEM) was used to study the relationship between auditory and visual acuity and different cognitive and memory functions in an age-hetereogenous subsample of 160 hearing aid users without…

Contribution of a Contralateral Hearing Aid to Perception of Consonant Voicing, Intonation, and Emotional State in Adult Cochlear Implantees

ERIC Educational Resources Information Center

Most, Tova; Gaon-Sivan, Gal; Shpak, Talma; Luntz, Michal

2012-01-01

Binaural hearing in cochlear implant (CI) users can be achieved either by bilateral implantation or bimodally with a contralateral hearing aid (HA). Binaural-bimodal hearing has the advantage of complementing the high-frequency electric information from the CI by low-frequency acoustic information from the HA. We examined the contribution of a…

Predictors of Entering a Hearing Aid Evaluation Period: A Prospective Study in Older Hearing-Help Seekers

PubMed Central

Deeg, Dorly J.H.; Versfeld, Niek J.; Heymans, Martijn W.; Naylor, Graham; Kramer, Sophia E.

2017-01-01

This study aimed to determine the predictors of entering a hearing aid evaluation period (HAEP) using a prospective design drawing on the health belief model and the transtheoretical model. In total, 377 older persons who presented with hearing problems to an Ear, Nose, and Throat specialist (n = 110) or a hearing aid dispenser (n = 267) filled in a baseline questionnaire. After 4 months, it was determined via a telephone interview whether or not participants had decided to enter a HAEP. Multivariable logistic regression analyses were applied to determine which baseline variables predicted HAEP status. A priori, candidate predictors were divided into ‘likely’ and ‘novel’ predictors based on the literature. The following variables turned out to be significant predictors: more expected hearing aid benefits, greater social pressure, and greater self-reported hearing disability. In addition, greater hearing loss severity and stigma were predictors in women but not in men. Of note, the predictive effect of self-reported hearing disability was modified by readiness such that with higher readiness, the positive predictive effect became stronger. None of the ‘novel’ predictors added significant predictive value. The results support the notion that predictors of hearing aid uptake are also predictive of entering a HAEP. This study shows that some of these predictors appear to be gender specific or are dependent on a person’s readiness for change. After assuring the external validity of the predictors, an important next step would be to develop prediction rules for use in clinical practice, so that older persons’ hearing help-seeking journey can be facilitated. PMID:29237333

Promoting vision and hearing aids use in an intensive care unit.

PubMed

Zhou, Qiaoling; Faure Walker, Nicholas

2015-01-01

Vision and hearing impairments have long been recognised as modifiable risk factors for delirium.[1,2,3] Delirium in critically ill patients is a frequent complication (reported as high as 60% to 80% of intensive care patients), and is associated with a three-fold increase in mortality and prolonged hospital stay.[1] Guidelines by the UK Clinical Pharmacy Association recommend minimising risk factors to prevent delirium, rather than to treat it with pharmacological agents which may themselves cause delirium.[4] To address risk factors is a measure of multi-system management, such as sleep-wake cycle correction, orientation and use of vision and hearing aids, etc.[5] We designed an audit to survey the prevalence and availability of vision and hearing aids use in the intensive care unit (ICU) of one university hospital. The baseline data demonstrated a high level of prevalence and low level of availability of vision /hearing aid use. We implemented changes to the ICU Innovian assessment system, which serves to remind nursing staff performing daily checks on delirium reduction measures. This has improved practice in promoting vision and hearing aids use in ICU as shown by re-audit at six month. Further amendments to the Innovian risk assessments have increased the rate of assessment to 100% and vision aid use to near 100%.

Relationship between acceptance of background noise and hearing aid use

NASA Astrophysics Data System (ADS)

Nabelek, Anna K.; Burchfield, Samuel B.; Webster, Joanna D.

2003-04-01

Background noise produces complaints among hearing-aid users, however speech-perception-in-noise does not predict hearing-aid use. It is possible that hearing-aid users are complaining about the presence of background noise and not about speech perception. To test this possibility, acceptance of background noise is being investigated as a predictor of hearing-aid use. Acceptance of background noise is determined by having subjects select their most comfortable listening level (MCL) for a story. Next, speech-babble is added and the subjects select the maximum background noise level (BNL) which is acceptable while listening to and following the story. The difference between the MCL and the BNL is the acceptable noise level (ANL), all in dB. ANLs are being compared with hearing-aid use, subjective impressions of benefit (APHAB), speech perception in background noise (SPIN) scores, and audiometric data. Individuals who accept higher levels of background noise are more successful users than individuals who accept less background noise. Mean ANLs are 7.3 dB for full-time users (N=21), 12.6 dB for part-time users (N=44), and 13.8 dB for rejecters (N=17). ANLs are not related to APHAB, SPIN, or audiometric data. Results for about 120 subjects will be reported. [Work supported by NIDCD (NIH) RO1 DC 05018.

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

PubMed

Wolfe, Jace; Schafer, Erin; Martella, Natalie; Morais, Mila; Mann, Misty

2015-01-01

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. 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. 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. Sixteen children, ages 10-17 yr old, with sensorineural hearing loss ranging from mild to moderately severe. 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. 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. 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. American Academy of Audiology.

[Hearing aids at the International Center of Auditory rehabilitation in Abidjan: Prosthetics gains and satisfaction in patients].

PubMed

Mobio, M N A; Ilé, S; Yavo, N; Koffi-Aka, V; Kouassi-Ndjeundo, J; Tea, B

To evaluate patients wearing hearing aid at the International Center of Auditory Correction in Abidjan. It is a descriptif and transversal study from 07/01/99 to 06/30/10. We have included the files of patients completely filled. We have stu­died the indications, prosthetics gains and the satisfaction after hearing aid. We have achieved 536 files. The ave­rage was 36 years. The indications have been in 76.1% cases of sensorineural hearing loss. The hearing loss has been associa­ted in 13.2% cases to language disorder. For all patient we have noticed bilateral hearing loss in 496 cases (92.5%). The behind the ear aids have been chosen in 69% cases. The type was analogical or digital respectively in 65% and 35% des cas. The prosthetic pure tonal gain was more than 30 dB in 66.8% cases and the prosthetic speech reception threshold gain more than 30 dB in 55.3% cases. The patients have been respectively satisfied less satisfacted, no satisfacted in 68.47%, 22.76% and 8.7% cases. The hearing aids have improved the audition in most of the indications. The proportion of patients satisfied was proportionally equivalent to the audiometric results.

Technology transfer of hearing aids to low and middle income countries: policy and market factors.

PubMed

Seelman, Katherine D; Werner, Roye

2014-09-01

The competitive market advantages of industry and the balancing force of international governmental organizations (IGOs) are examined to identify market and policy in support of sustainable technology transfer of hearing aids to low and middle income countries. A second purpose is to examine the usefulness of findings for other assistive technologies (AT). Searches of electronic databases, IGO documents, industry reports and journals were supplemented by informal discussions with industry and IGO staff and audiologists. The value chain is used to examine the competitive advantage of industry and the balancing tools of certain IGOs. Both industry and IGOs engage in intellectual property (IP) and competition activities and are active in each segment of the hearing aid value chain. Their market and policy objectives and strategies are different. IGOs serve as balancing forces for the competitive advantages of industry. The hearing aid market configuration and hearing aid fitting process are not representative of other AT products but IP, trade and competition policy tools used by IGOs and governments are relevant to other AT. The value chain is a useful tool to identify the location of price mark-ups and the influence of actors. Market factors and reimbursement and subsidization policies drive hearing aid innovation. UN-related international government organization activities are responsive to the needs of disability populations who cannot afford assistive technology. Policy tools used by international governmental organizations are applicable across assistive technology. A partnership model is important to distribution of hearing aids to low and middle income countries.

Fitting of hearing aids with different technical parameters to a patient with dead regions

NASA Astrophysics Data System (ADS)

Hojan-Jezierska, Dorota; Skrodzka, Ewa

2009-01-01

The purpose of the study was to determine an optimal hearing aid fitting procedure for a patient with well diagnosed high-frequency ‘dead regions’ in both cochleas. The patient reported non-symmetrical hearing problems of sensorineural origin. For binaural amplification two similar independent hearing aids were used as well as a pair of dependent devices with an ear-to-ear function. Two fitting methods were used: DSLi/o and NAL-NL1, and four different strategies of fitting were tested: the initial fitting based on the DSLi/o or NAL-NL1 method with necessary loudness corrections, the second fitting taking into account all the available functions of hearing instruments, the third fitting (based on the second one) but with significantly reduced amplification well above one octave of frequency inside dead region, and the final fitting with significantly reduced gain slightly below one octave inside dead regions. The results of hearing aids fitting were assessed using an APHAB procedure.

Management of Hearing Aid Assembly by Urban-Dwelling Hearing-Impaired Adults in a Developed Country

PubMed Central

Keidser, Gitte; Hartley, Lisa; Caposecco, Andrea; Hickson, Louise; Meyer, Carly

2011-01-01

A self-fitting hearing aid, designed to be assembled and programmed without audiological or computer support, could bring amplification to millions of people in developing countries, who remain unaided due to the lack of a local, professional, audiological infrastructure. The ability to assemble and insert a hearing aid is fundamental to the successful use of a self-fitting device. In this study, the management of such tasks was investigated. Eighty older, urban-dwelling, hearing-impaired adults in a developed country were asked to follow a set of written, illustrated instructions to assemble two slim-fit behind-the-ear hearing aids. Participants were allowed to access assistance with the task from an accompanying partner. A range of personal and audiometric variables was measured through the use of structured questionnaires and standardized tests of health literacy, cognitive function, and manual dexterity. The results showed that 99% of participants were able to complete the hearing aid assembly task, either on their own or with assistance. Health literacy, or the ability to read and understand health-related text, and gender most strongly influenced participants’ ability to complete the assembly task independently and accurately. Higher levels of health literacy were associated with an increased likelihood of independent and successful task completion. Male participants were more likely to complete the task on their own, while female participants were more likely to assemble the device without errors. The results of this study will inform future work regarding development of educational material for the self-fitting hearing aid as well as candidacy for such a device. PMID:22200734

Sociodemographic correlates of hearing loss and hearing aid use in Hispanic adults.

PubMed

Lee, D J; Gómez-Marín, O; Lee, H M

1996-07-01

We examined sociodemographic correlates of hearing loss and hearing aid use in adult Hispanics using data from the Hispanic Health and Nutrition Examination Survey. After adjustment for age and gender, odds ratios (ORs) of hearing impairment for non-married vs married participants were 1.6 [95% confidence interval (CI) = 1.0-2.5] for Mexican-Americans and 2.2 (95% CI = 1.2-4.2) for Puerto Ricans. ORs ranged from 1.6 to 3.2 for unemployed vs employed, and from 1.7 to 2.1 for uninsured vs insured Hispanics. For Mexican-Americans, the OR of hearing aid use for those living below vs above the poverty line was 9.1 (95% CI = 1.1-100.0). These results are consistent with those reported for other ethnic groups.

Innovative technology in hearing instruments: matching needs in the developing world.

PubMed

McPherson, Bradley

2011-12-01

Hearing instrument technology research is almost entirely focused on the projected needs of the consumer market in the developed world. However, two thirds of the world's population with hearing impairment live in developing countries and this proportion will increase in future, given present demographic trends. In developing regions, amplification and other hearing health needs may differ from those in industrialized nations, for cultural, health, or economic reasons. World Health Organization estimates indicate that at present only a small percentage of individuals in developing countries who are in need of amplification have access to hearing aid provision. New technologies, such as trainable hearing aids, advanced noise reduction algorithms, feedback reduction circuitry, nano coatings for hearing aid components, and innovative power options, may offer considerable potential benefits, both for individuals with hearing impairment in developing countries and for those who provide hearing health care services in these regions. This article considers the possible supporting role of innovative hearing instrument technologies in the provision of affordable hearing health care services in developing countries and highlights the need for research that considers the requirements of the majority of the world population in need of hearing instrument provision.

Clinical implications of word recognition differences in earphone and aided conditions

PubMed Central

McRackan, Theodore R.; Ahlstrom, Jayne B.; Clinkscales, William B.; Meyer, Ted A.; Dubno, Judy R

2017-01-01

Objective To compare word recognition scores for adults with hearing loss measured using earphones and in the sound field without and with hearing aids (HA) Study design Independent review of pre-surgical audiological data from an active middle ear implant (MEI) FDA clinical trial Setting Multicenter prospective FDA clinical trial Patients Ninety-four adult HA users Interventions/Main outcomes measured Pre-operative earphone, unaided and aided pure tone thresholds, word recognition scores, and speech intelligibility index. Results We performed an independent review of pre-surgical audiological data from a MEI FDA trial and compared unaided and aided word recognition scores with participants’ HAs fit according to the NAL-R algorithm. For 52 participants (55.3%), differences in scores between earphone and aided conditions were >10%; for 33 participants (35.1%), earphone scores were higher by 10% or more than aided scores. These participants had significantly higher pure tone thresholds at 250 Hz, 500 Hz, and 1000 Hz), higher pure tone averages, higher speech recognition thresholds, (and higher earphone speech levels (p=0.002). No significant correlation was observed between word recognition scores measured with earphones and with hearing aids (r=.14; p=0.16), whereas a moderately high positive correlation was observed between unaided and aided word recognition (r=0.68; p<0.001). Conclusion Results of the these analyses do not support the common clinical practice of using word recognition scores measured with earphones to predict aided word recognition or hearing aid benefit. Rather, these results provide evidence supporting the measurement of aided word recognition in patients who are considering hearing aids. PMID:27631832

Oral Language Comprehension Using Hearing Aids and Tactile Aids: Three Case Studies.

ERIC Educational Resources Information Center

Proctor, Adele

1990-01-01

Three prelinguistic, profoundly deaf children (aged three to four) used a wearable, single channel, vibrotactile communication aid in conjunction with hearing aids during individual speech and language therapy at school. Subjects exhibited a faster than average rate of learning to understand spoken language after the onset of vibrotactile…

Hearing aid-compatible mobile handsets, petition of American National Standards Committee C63 (EMC) ANSO ASC C63 (TM). Final rule.

PubMed

2008-05-07

The Federal Communications Commission (Commission) adopts various proposals to amend its hearing aid compatibility policies and requirements pertaining to wireless services, including modifications and other requirements along the framework proposed in a consensus plan (Joint Consensus Plan) developed jointly by industry and representatives for the deaf and hard of hearing community. The Commission anticipates that these rule changes, taken together and largely supported by manufacturers, service providers, and consumers with hearing loss, will meet statutory obligations to ensure reasonable access to telephone service by persons with impaired hearing. These requirements are intended to benefit wireless users in the deaf and hard of hearing community, including the most disadvantaged who are more likely to rely on telecoil-equipped hearing aids, as well as to ensure that these consumers have a variety of handsets available to them, including handsets with innovative features.

Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial

PubMed Central

2014-01-01

Background Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. Methods/Design The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on hearing- and health-related quality of life. Discussion This multi-centre trial was designed to provide evidence for the efficacy of cochlear implantation compared to the contra-lateral routing of signals. A purpose-built sound presentation system and established measurement techniques will provide reliable and precise measures of binaural hearing. Trial registration Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739 (05/JUL/2013) PMID:25152694

75 FR 54546 - Amendment of the Commission's Rules Governing Hearing Aid-Compatible Mobile Handsets

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... revisions to the Commission's wireless hearing aid compatibility rules. The Commission initiates this proceeding to ensure that consumers with hearing loss are able to access wireless communications services.... FOR FURTHER INFORMATION CONTACT: John Borkowski, Wireless Telecommunications Bureau, (202) 418-0626, e...

AIDS Federal Policy Act of 1987. Hearings on S. 1575: To Amend the Public Health Service Act To Establish a Grant Program To Provide for Counseling and Testing Services Relating to Acquired Immune Deficiency Syndrome and To Establish Certain Prohibitions for the Purpose of Protecting Individuals with Acquired Immune Deficiency Syndrome or Related Conditions. Committee on Labor and Human Resources. United States Senate, One Hundredth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

This document presents the text from two Senate hearings on the AIDS Federal Policy Act of 1987 which concerns voluntary testing for AIDS virus, education and counseling to stop the spread of AIDS (Acquired Immune Deficiency Syndrome), and confidentiality and discrimination against AIDS victims. In the first hearing, opening statements are…

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

PubMed

Franklin, Cliff; Johnson, Laura V; White, Letitia; Franklin, Clay; Smith-Olinde, Laura

2013-01-01

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.

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

PubMed Central

Franklin, Cliff; Johnson, Laura V.; Franklin, Clay

2013-01-01

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. PMID:24349796

Handicap versus impairment: an important distinction.

PubMed

Weinstein, B E; Richards, A M; Montano, J

1995-05-01

In this era of spiraling health care costs, audiologists are being held accountable for the rehabilitative interventions that they are uniquely qualified to deliver. Accountability data in the rehabilitative arena should address the efficacy of short- and long-term treatment. If a treatment such as a hearing aid is dispensed for the purpose of reducing the communicative and psychosocial handicap associated with hearing loss, efficacy data should demonstrate whether such a goal has been attained. Increased attention has been focused on the value of self-assessment questionnaires as instruments that are predictive of candidacy for hearing aids, intent to purchase hearing aids, and outcomes with a given hearing aid treatment. Case studies demonstrate the advantage of engaging the client in the rehabilitative process through the use of responses to self-assessment questionnaires. It is evident that the client's appraisal of the handicapping effect of a given impairment is associated with treatment efficacy.

Performance analysis of ten brands of batteries for hearing aids

PubMed Central

Penteado, Silvio Pires; Bento, Ricardo Ferreira

2013-01-01

Summary Introduction: Comparison of the performance of hearing instrument batteries from various manufacturers can enable otologists, audiologists, or final consumers to select the best products, maximizing the use of these materials. Aim: To analyze the performance of ten brands of batteries for hearing aids available in the Brazilian marketplace. Methods: Hearing aid batteries in four sizes were acquired from ten manufacturers and subjected to the same test conditions in an acoustic laboratory. Results: The results obtained in the laboratory contrasted with the values reported by manufacturers highlighted significant discrepancies, besides the fact that certain brands in certain sizes perform better on some tests, but does not indicate which brand is the best in all sizes. Conclusions: It was possible to investigate the performance of ten brands of hearing aid batteries and describe the procedures to be followed for leakage, accidental intake, and disposal. PMID:25992026

Small-Group Phonological Awareness Training for Pre-Kindergarten Children with Hearing Loss Who Wear Cochlear Implants and/or Hearing Aids

ERIC Educational Resources Information Center

Werfel, Krystal L.; Douglas, Michael; Ackal, Leigh

2016-01-01

This case report details a year-long phonological awareness (PA) intervention for pre-kindergarten children with hearing loss (CHL) who use listening and spoken language. All children wore cochlear implants and/or hearing aids. Intervention occurred for 15 min/day, 4 days per week across the pre-kindergarten school year and was delivered by…

Auditory, Visual, and Auditory-Visual Speech Perception by Individuals with Cochlear Implants versus Individuals with Hearing Aids

ERIC Educational Resources Information Center

Most, Tova; Rothem, Hilla; Luntz, Michal

2009-01-01

The researchers evaluated the contribution of cochlear implants (CIs) to speech perception by a sample of prelingually deaf individuals implanted after age 8 years. This group was compared with a group with profound hearing impairment (HA-P), and with a group with severe hearing impairment (HA-S), both of which used hearing aids. Words and…

The Influence of Hearing Aid Use on Outcomes of Children with Mild Hearing Loss

ERIC Educational Resources Information Center

Walker, Elizabeth A.; Holte, Lenore; McCreery, Ryan W.; Spratford, Meredith; Page, Thomas; Moeller, Mary Pat

2015-01-01

Purpose: This study examined the effects of consistent hearing aid (HA) use on outcomes in children with mild hearing loss (HL). Method: Five- or 7-year-old children with mild HL were separated into 3 groups on the basis of patterns of daily HA use. Using analyses of variance, we compared outcomes between groups on speech and language tests and a…

Sensitivity in Interactions between Hearing Mothers and their Toddlers with Hearing Loss: The Effect of Cochlear Implantation

ERIC Educational Resources Information Center

Bakar, Zaharah Abu; Brown, P. Margaret; Remine, Maria D.

2010-01-01

This study investigated the potential effects of cochlear implantation and age at implantation on maternal interactional sensitivity. Three groups of dyads were studied at two points over 1 year. The hearing aid (HA) group wore hearing aids throughout the study, the early cochlear implanted (ECI) group were implanted prior to 22 months of age, and…

AIDS and Young Children: Emerging Issues. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, One Hundredth Congress, First Session. Hearing Held in Berkeley, California.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

This field hearing in Berkeley, California examined: (1) the increasing incidence of babies born with, or at risk of contracting, Acquired Immune Deficiency Syndrome (AIDS); (2) the ability of health and social service systems to care for AIDS-infected infants and children and their families; and (3) prevention efforts to reduce the spread of…

Addressing Intersections in HIV/AIDS and Mental Health: The Role of Organizations for d/Deaf and Hard of Hearing Individuals in South Africa

ERIC Educational Resources Information Center

Mall, Sumaya; Swartz, Leslie

2011-01-01

Like South Africans generally, d/Deaf and hard of hearing South Africans are at risk of HIV/AIDS and mental disorders resulting from barriers to communication and care. In interviews and a focus group, members of South African organizations for d/Deaf and hard of hearing individuals all gave priority to HIV/AIDS education and prevention, citing…

The Effect of Functional Hearing and Hearing Aid Usage on Verbal Reasoning in a Large Community-Dwelling Population.

PubMed

Keidser, Gitte; Rudner, Mary; Seeto, Mark; Hygge, Staffan; Rönnberg, Jerker

2016-01-01

Verbal reasoning performance is an indicator of the ability to think constructively in everyday life and relies on both crystallized and fluid intelligence. This study aimed to determine the effect of functional hearing on verbal reasoning when controlling for age, gender, and education. In addition, the study investigated whether hearing aid usage mitigated the effect and examined different routes from hearing to verbal reasoning. Cross-sectional data on 40- to 70-year-old community-dwelling participants from the UK Biobank resource were accessed. Data consisted of behavioral and subjective measures of functional hearing, assessments of numerical and linguistic verbal reasoning, measures of executive function, and demographic and lifestyle information. Data on 119,093 participants who had completed hearing and verbal reasoning tests were submitted to multiple regression analyses, and data on 61,688 of these participants, who had completed additional cognitive tests and provided relevant lifestyle information, were submitted to structural equation modeling. Poorer performance on the behavioral measure of functional hearing was significantly associated with poorer verbal reasoning in both the numerical and linguistic domains (p < 0.001). There was no association between the subjective measure of functional hearing and verbal reasoning. Functional hearing significantly interacted with education (p < 0.002), showing a trend for functional hearing to have a greater impact on verbal reasoning among those with a higher level of formal education. Among those with poor hearing, hearing aid usage had a significant positive, but not necessarily causal, effect on both numerical and linguistic verbal reasoning (p < 0.005). The estimated effect of hearing aid usage was less than the effect of poor functional hearing. Structural equation modeling analyses confirmed that controlling for education reduced the effect of functional hearing on verbal reasoning and showed that controlling for executive function eliminated the effect. However, when computer usage was controlled for, the eliminating effect of executive function was weakened. Poor functional hearing was associated with poor verbal reasoning in a 40- to 70-year-old community-dwelling population after controlling for age, gender, and education. The effect of functional hearing on verbal reasoning was significantly reduced among hearing aid users and completely overcome by good executive function skills, which may be enhanced by playing computer games.

Speech Intelligibility of Profoundly Deaf Pediatric Hearing Aid Users.

ERIC Educational Resources Information Center

Svirsky, Mario A.; Chin, Steven B.; Miyamoto, Richard T.; Sloan, Robert B.; Caldwell, Matthew D.

2000-01-01

A study examined the speech intelligibility of children (ages 1-15) with deafness who use hearing aids. Data revealed a strong significant trend toward higher intelligibility for children with more residual hearing, and a significant trend toward higher intelligibility for users of oral communication than those using total communication. (Contains…

Research on Frequency Transposition for Hearing Aids. Final Report.

ERIC Educational Resources Information Center

Gengel, Roy W.; Pickett, J. M.

Reported were studies measuring residual auditory capacities of deaf persons and investigating hearing aids which transpose speech to lower frequencies where deaf persons may have better hearing. Studies on temporal and frequency discrimination indicated that the duration of a signal may have a differential effect on its detectability by…

75 FR 54508 - Amendment of the Commission's Rules Governing Hearing Aid-Compatible Mobile Handsets

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... (FCC) adopts final rules governing wireless hearing aid compatibility that are intended to ensure that consumers with hearing loss are able to access wireless communications services through a wide selection of... Borkowski, Wireless Telecommunications Bureau, (202) 418-0626, e-mail [email protected] . For...

Socio-demographic characteristics, lifestyle factors and burden of morbidity associated with self-reported hearing and vision impairments in older British community-dwelling men: a cross-sectional study.

PubMed

Liljas, A E M; Wannamethee, S G; Whincup, P H; Papacosta, O; Walters, K; Iliffe, S; Lennon, L T; Carvalho, L A; Ramsay, S E

2016-06-01

Hearing and vision problems are common in older adults. We investigated the association of self-reported sensory impairment with lifestyle factors, chronic conditions, physical functioning, quality of life and social interaction. A population-based cross-sectional study of participants of the British Regional Heart Study aged 63-85 years. A total of 3981 men (82% response rate) provided data. Twenty-seven per cent (n = 1074) reported hearing impairment including being able to hear with aid (n = 482), being unable to hear (no aid) (n = 424) and being unable to hear despite aid (n = 168). Three per cent (n = 124) reported vision impairment. Not being able to hear, irrespective of use of hearing aid, was associated with poor quality of life, poor social interaction and poor physical functioning. Men who could not hear despite hearing aid were more likely to report coronary heart disease (CHD) [age-adjusted odds ratios (ORs) 1.89 (95% confidence interval 1.36-2.63)]. Vision impairment was associated with symptoms of CHD including breathlessness [OR 2.06 (1.38-3.06)] and chest pain [OR 1.58 (1.07-2.35)]. Vision impairment was also associated with poor quality of life, poor social interaction and poor physical functioning. Sensory impairment is associated with poor physical functioning, poor health and poor social interaction in older men. Further research is warranted on pathways underlying these associations. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Monitoring auditory cortical plasticity in hearing aid users with long latency auditory evoked potentials: a longitudinal study.

PubMed

Leite, Renata Aparecida; Magliaro, Fernanda Cristina Leite; Raimundo, Jeziela Cristina; Bento, Ricardo Ferreira; Matas, Carla Gentile

2018-02-19

The objective of this study was to compare long-latency auditory evoked potentials before and after hearing aid fittings in children with sensorineural hearing loss compared with age-matched children with normal hearing. Thirty-two subjects of both genders aged 7 to 12 years participated in this study and were divided into two groups as follows: 14 children with normal hearing were assigned to the control group (mean age 9 years and 8 months), and 18 children with mild to moderate symmetrical bilateral sensorineural hearing loss were assigned to the study group (mean age 9 years and 2 months). The children underwent tympanometry, pure tone and speech audiometry and long-latency auditory evoked potential testing with speech and tone burst stimuli. The groups were assessed at three time points. The study group had a lower percentage of positive responses, lower P1-N1 and P2-N2 amplitudes (speech and tone burst), and increased latencies for the P1 and P300 components following the tone burst stimuli. They also showed improvements in long-latency auditory evoked potentials (with regard to both the amplitude and presence of responses) after hearing aid use. Alterations in the central auditory pathways can be identified using P1-N1 and P2-N2 amplitude components, and the presence of these components increases after a short period of auditory stimulation (hearing aid use). These findings emphasize the importance of using these amplitude components to monitor the neuroplasticity of the central auditory nervous system in hearing aid users.

Monitoring auditory cortical plasticity in hearing aid users with long latency auditory evoked potentials: a longitudinal study

PubMed Central

Leite, Renata Aparecida; Magliaro, Fernanda Cristina Leite; Raimundo, Jeziela Cristina; Bento, Ricardo Ferreira; Matas, Carla Gentile

2018-01-01

OBJECTIVE: The objective of this study was to compare long-latency auditory evoked potentials before and after hearing aid fittings in children with sensorineural hearing loss compared with age-matched children with normal hearing. METHODS: Thirty-two subjects of both genders aged 7 to 12 years participated in this study and were divided into two groups as follows: 14 children with normal hearing were assigned to the control group (mean age 9 years and 8 months), and 18 children with mild to moderate symmetrical bilateral sensorineural hearing loss were assigned to the study group (mean age 9 years and 2 months). The children underwent tympanometry, pure tone and speech audiometry and long-latency auditory evoked potential testing with speech and tone burst stimuli. The groups were assessed at three time points. RESULTS: The study group had a lower percentage of positive responses, lower P1-N1 and P2-N2 amplitudes (speech and tone burst), and increased latencies for the P1 and P300 components following the tone burst stimuli. They also showed improvements in long-latency auditory evoked potentials (with regard to both the amplitude and presence of responses) after hearing aid use. CONCLUSIONS: Alterations in the central auditory pathways can be identified using P1-N1 and P2-N2 amplitude components, and the presence of these components increases after a short period of auditory stimulation (hearing aid use). These findings emphasize the importance of using these amplitude components to monitor the neuroplasticity of the central auditory nervous system in hearing aid users. PMID:29466495

Hearing loss and speech perception in noise difficulties in Fanconi anemia.

PubMed

Verheij, Emmy; Oomen, Karin P Q; Smetsers, Stephanie E; van Zanten, Gijsbert A; Speleman, Lucienne

2017-10-01

Fanconi anemia is a hereditary chromosomal instability disorder. Hearing loss and ear abnormalities are among the many manifestations reported in this disorder. In addition, Fanconi anemia patients often complain about hearing difficulties in situations with background noise (speech perception in noise difficulties). Our study aimed to describe the prevalence of hearing loss and speech perception in noise difficulties in Dutch Fanconi anemia patients. Retrospective chart review. A retrospective chart review was conducted at a Dutch tertiary care center. All patients with Fanconi anemia at clinical follow-up in our hospital were included. Medical files were reviewed to collect data on hearing loss and speech perception in noise difficulties. In total, 49 Fanconi anemia patients were included. Audiograms were available in 29 patients and showed hearing loss in 16 patients (55%). Conductive hearing loss was present in 24.1%, sensorineural in 20.7%, and mixed in 10.3%. A speech in noise test was performed in 17 patients; speech perception in noise was subnormal in nine patients (52.9%) and abnormal in two patients (11.7%). Hearing loss and speech perception in noise abnormalities are common in Fanconi anemia. Therefore, pure tone audiograms and speech in noise tests should be performed, preferably already at a young age, because hearing aids or assistive listening devices could be very valuable in developing language and communication skills. 4. Laryngoscope, 127:2358-2361, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Phonological Awareness at 5 years of age in Children who use Hearing Aids or Cochlear Implants

PubMed Central

Ching, Teresa Y.C.; Cupples, Linda

2015-01-01

Children with hearing loss typically underachieve in reading, possibly as a result of their underdeveloped phonological skills. This study addressed the questions of whether the development of phonological awareness (PA) is influenced by 1) the degree of hearing loss; and 2) whether performance of children with severe-profound hearing loss differed according to the hearing devices used. Drawing on data collected as part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI, www.outcomes.nal.gov.au) study, the authors found that sound-matching scores of children with hearing loss ranging from mild to profound degrees were, on average, within the normal range. The degree of hearing loss did not have a significant impact on scores, but there was a non-significant tendency for the proportion of children who achieved zero scores to increase with increase in hearing loss. For children with severe hearing loss, there was no significant group difference in scores among children who used bilateral hearing aids, bimodal fitting (a cochlear implant and a hearing aid in contralateral ears), and bilateral cochlear implants. Although there is a need for further prospective research, professionals have an important role in targeting PA skills for rehabilitation of young children with hearing loss. PMID:26929789

The effect of frequency-dependent microphone directionality on horizontal localization performance in hearing-aid users.

PubMed

Keidser, Gitte; O'Brien, Anna; Hain, Jens-Uwe; McLelland, Margot; Yeend, Ingrid

2009-11-01

Frequency-dependent microphone directionality alters the spectral shape of sound as a function of arrival azimuth. The influence of this on horizontal-plane localization performance was investigated. Using a 360 degrees loudspeaker array and five stimuli with different spectral characteristics, localization performance was measured on 21 hearing-impaired listeners when wearing no hearing aids and aided with no directionality, partial (from 1 and 2 kHz) directionality, and full directionality. The test schemes were also evaluated in everyday life. Without hearing aids, localization accuracy was significantly poorer than normative data. Due to inaudibility of high-frequency energy, front/back reversals were prominent. Front/back reversals remained prominent when aided with omnidirectional microphones. For stimuli with low-frequency emphasis, directionality had no further effect on localization. For stimuli with sufficient mid- and high-frequency information, full directionality had a small positive effect on front/back localization but a negative effect on left/right localization. Partial directionality further improved front/back localization and had no significant effect on left/right localization. The field test revealed no significant effects. The alternative spectral cues provided by frequency-dependent directionality improve front/back localization in hearing-aid users.

Behavioral assessment of adaptive feedback equalization in a digital hearing aid.

PubMed

French-St George, M; Wood, D J; Engebretson, A M

1993-01-01

An evaluation was made of the efficacy of a digital feedback equalization algorithm employed by the Central Institute for the Deaf Wearable Adaptive Digital Hearing Aid. Three questions were addressed: 1) Does acoustic feedback limit gain adjustments made by hearing aid users? 2) Does feedback equalization permit users with hearing-impairment to select more gain without feedback? and, 3) If more gain is used when feedback equalization is active, does word identification performance improve? Nine subjects with hearing impairment participated in the study. Results suggest that listeners with hearing impairment are indeed limited by acoustic feedback when listening to soft speech (55 dB A) in quiet. The average listener used an additional 4 dB gain when feedback equalization was active. This additional gain resulted in an average 10 rationalized arcsine units (RAU) improvement in word identification score.

Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss.

PubMed

Seeto, Angeline; Searchfield, Grant D

2018-03-01

Advances in digital signal processing have made it possible to provide a wide-band frequency response with smooth, precise spectral shaping. Several manufacturers have introduced hearing aids that are claimed to provide gain for frequencies up to 10-12 kHz. However, there is currently limited evidence and very few independent studies evaluating the performance of the extended bandwidth hearing aids that have recently become available. This study investigated an extended bandwidth hearing aid using measures of speech intelligibility and sound quality to find out whether there was a significant benefit of extended bandwidth amplification over standard amplification. Repeated measures study designed to examine the efficacy of extended bandwidth amplification compared to standard bandwidth amplification. Sixteen adult participants with mild-to-moderate sensorineural hearing loss. Participants were bilaterally fit with a pair of Widex Mind 440 behind-the-ear hearing aids programmed with a standard bandwidth fitting and an extended bandwidth fitting; the latter provided gain up to 10 kHz. For each fitting, and an unaided condition, participants completed two speech measures of aided benefit, the Quick Speech-in-Noise test (QuickSIN™) and the Phonak Phoneme Perception Test (PPT; high-frequency perception in quiet), and a measure of sound quality rating. There were no significant differences found between unaided and aided conditions for QuickSIN™ scores. For the PPT, there were statistically significantly lower (improved) detection thresholds at high frequencies (6 and 9 kHz) with the extended bandwidth fitting. Although not statistically significant, participants were able to distinguish between 6 and 9 kHz 50% better with extended bandwidth. No significant difference was found in ability to recognize phonemes in quiet between the unaided and aided conditions when phonemes only contained frequency content <6 kHz. However significant benefit was found with the extended bandwidth fitting for recognition of 9-kHz phonemes. No significant difference in sound quality preference was found between the standard bandwidth and extended bandwidth fittings. This study demonstrated that a pair of currently available extended bandwidth hearing aids was technically capable of delivering high-frequency amplification that was both audible and useable to listeners with mild-to-moderate hearing loss. This amplification was of acceptable sound quality. Further research, particularly field trials, is required to ascertain the real-world benefit of high-frequency amplification. American Academy of Audiology

Evaluation of the International Outcome Inventory for Hearing Aids in a veteran sample.

PubMed

Smith, Sherri L; Noe, Colleen M; Alexander, Genevieve C

2009-06-01

The International Outcome Inventory for Hearing Aids (IOI-HA) was developed as a global hearing aid outcome measure targeting seven outcome domains. The published norms were based on a private-pay sample who were fitted with analog hearing aids. The purpose of this study was to evaluate the psychometric properties of the IOI-HA and to establish normative data in a veteran sample. Survey. The participants were 131 male veterans (mean age of 74.3 years, SD = 7.4) who were issued hearing aids with digital signal processing (DSP). Hearing aids with DSP that were fitted bilaterally between 2005 and 2007. Veterans were mailed two copies of the IOI-HA. The participants were instructed to complete the first copy of the questionnaire immediately and the second copy in two weeks. The completed questionnaires were mailed to the laboratory. The psychometric properties of the questionnaire were evaluated. As suggested by Cox and colleagues, the participants were divided into two categories based on their unaided subjective hearing difficulty. The two categories were (1) those with less hearing difficulty (none-to-moderate category) and (2) those who report more hearing difficulty (moderately severe+ category). The norms from the current veteran sample then were compared to the original, published sample. For each hearing difficulty category, the critical difference values were calculated for each item and for the total score. A factor analysis showed that the IOI-HA in the veteran sample had the identical subscale structure as reported in the original sample. For the total scale, the internal consistency was good (Chronbach's alpha = 0.83), and the test-retest reliability was high (lambda = 0.94). Group and individual norms were developed for both hearing difficulty categories in the veteran sample. For each IOI-HA item, the critical difference scores were < 1.0. This finding suggests that for any item on the IOI-HA, there is a 95 percent chance that an observed change of one response unit between two test sessions reflects a true change in outcome for a given domain. The results of this study confirmed that the psychometric properties of the IOI-HA questionnaire are strong and are essentially the same for the veteran sample and the original private-pay sample. The veteran norms, however, produced higher outcomes than those established originally, possibly because of differences in the population samples and/or hearing aid technology. Clinical and research applications of the current findings are presented. Based on the results from the current study, the norms established here should replace the original norms for use in veterans with current hearing aid technology.

[The Influence of Hearing Loss Represented by Standard Audiogram Types to Unaided APHAB Scores].

PubMed

Löhler, J; Akcicek, B; Kappe, T; Wollenberg, B; Schlattmann, P; Schönweiler, R

2016-08-01

Questionnaires as the APHAB (Abbreviated Profile of Hearing Aid Benefit) are besides pure-tone and speech-audiometry the third method of diagnostics in audiology. Up to now there has been no research on the influence of individual hearing loss, represented by standard audiograms, on the scores of the unaided APHAB (APHABu) done with a big number of subjects. This study will investigate whether there does exist such a relationship or not. A total of 2 745 records provided by a database were analysed. First, the subjects' audiograms (air conduction) were allocated to 7 standardised audiogram types. By using a multivariant mixed linear model a potential connection was examined between these standard audiograms and particular APHABu scores for its four subscales: EC - ease of communication, BN - background noise, RV - reverberation, AV - aversiveness of sounds. There was no evidence for a dependency between any type of hearing loss dependence and unaided APHAB-scores. The values on the EC-scale vary between 49.8 and 58.0, on the BN-scale between 45.3 and 46.6, on the RV-scale between 44.4 and 52.4, and on the AV-scale between 47.6 and 50.1. This result confirms earlier studies with other questionnaires. Therefore, the APHABu can be used as an initial instrument for the diagnostics of individual hearing loss independently on whether hearing aids will be fitted subsequently or not. © Georg Thieme Verlag KG Stuttgart · New York.

Customized acoustic transform functions and their accuracy at predicting real-ear hearing aid performance.

PubMed

Munro, K J; Hatton, N

2000-02-01

The purpose of the study was to evaluate the validity of predicting the real-ear aided response by adding customized acoustic transform functions to the performance of a hearing aid in a 2-cc coupler. The real-ear hearing aid response, the real-ear-to-coupler difference (RECD/HA2), and field to behind-the-ear microphone transfer functions were measured in both ears of 24 normally hearing subjects using probe-tube microphone equipment. The RECD/HA2 transform function was obtained using both insert earphones and with the hearing aid/ pressure comparison method. An RECD/HA2 transfer function was also obtained with a customized earmold, ER-3A foam tip, and an oto-admittance tip. Validity estimates were calculated as the difference between the derived and measured real-ear response. The derived response was generally within 5 dB of the measured real-ear response when it incorporated an RECD/HA2 transform function obtained with a customized earmold for the specific ear in question. Discrepancies increased when the RECD/HA2 transfer function was obtained from the same subject but the opposite ear. There were significant differences between the RECD/HA2 transform function obtained with customized and temporary earmolds. As a result, the derived response incorporating these transforms differed significantly from the measured real-ear response obtained with the customized earmold. The insert earphone and the hearing aid RECD/HA2 transfer function were equally valid. The derived response may be used as a substitute for in situ hearing aid response procedures when it incorporates acoustic transform functions obtained with a customized earmold from the specific ear in question.

Hearing Loss in Osteogenesis Imperfecta: Characteristics and Treatment Considerations

PubMed Central

Pillion, Joseph P.; Vernick, David; Shapiro, Jay

2011-01-01

Osteogenesis imperfecta (OI) is the most common heritable disorder of connective tissue. It is associated with fractures following relatively minor injury, blue sclerae, dentinogenesis imperfecta, increased joint mobility, short stature, and hearing loss. Structures in the otic capsule and inner ear share in the histologic features common to other skeletal tissues. OI is due to mutations involving several genes, the most commonly involved are the COL1A1 or COL1A2 genes which are responsible for the synthesis of the proalpha-1 and proalpha-2 polypeptide chains that form the type I collagen triple helix. A genotype/phenotype relationship to hearing loss has not been established in OI. Hearing loss is commonly found in OI with prevalence rates ranging from 50 to 92% in some studies. Hearing loss in OI may be conductive, mixed, or sensorineural and is more common by the second or third decade. Treatment options such as hearing aids, stapes surgery, and cochlear implants are discussed. PMID:22567374

Visual Cues Contribute Differentially to Audiovisual Perception of Consonants and Vowels in Improving Recognition and Reducing Cognitive Demands in Listeners with Hearing Impairment Using Hearing Aids

ERIC Educational Resources Information Center

Moradi, Shahram; Lidestam, Bjorn; Danielsson, Henrik; Ng, Elaine Hoi Ning; Ronnberg, Jerker

2017-01-01

Purpose: We sought to examine the contribution of visual cues in audiovisual identification of consonants and vowels--in terms of isolation points (the shortest time required for correct identification of a speech stimulus), accuracy, and cognitive demands--in listeners with hearing impairment using hearing aids. Method: The study comprised 199…

Detection Rates of Cortical Auditory Evoked Potentials at Different Sensation Levels in Infants with Sensory/Neural Hearing Loss and Auditory Neuropathy Spectrum Disorder

PubMed Central

Gardner-Berry, Kirsty; Chang, Hsiuwen; Ching, Teresa Y. C.; Hou, Sanna

2016-01-01

With the introduction of newborn hearing screening, infants are being diagnosed with hearing loss during the first few months of life. For infants with a sensory/neural hearing loss (SNHL), the audiogram can be estimated objectively using auditory brainstem response (ABR) testing and hearing aids prescribed accordingly. However, for infants with auditory neuropathy spectrum disorder (ANSD) due to the abnormal/absent ABR waveforms, alternative measures of auditory function are needed to assess the need for amplification and evaluate whether aided benefit has been achieved. Cortical auditory evoked potentials (CAEPs) are used to assess aided benefit in infants with hearing loss; however, there is insufficient information regarding the relationship between stimulus audibility and CAEP detection rates. It is also not clear whether CAEP detection rates differ between infants with SNHL and infants with ANSD. This study involved retrospective collection of CAEP, hearing threshold, and hearing aid gain data to investigate the relationship between stimulus audibility and CAEP detection rates. The results demonstrate that increases in stimulus audibility result in an increase in detection rate. For the same range of sensation levels, there was no difference in the detection rates between infants with SNHL and ANSD. PMID:27587922

Impact of unilateral conductive hearing loss due to aural atresia on academic performance in children.

PubMed

Kesser, Bradley W; Krook, Kaelyn; Gray, Lincoln C

2013-09-01

This study evaluates the effect of unilateral conductive hearing loss secondary to aural atresia on elementary school children's academic performance. Case control survey and review of audiometric data. One hundred thirty-two surveys were mailed to families of children with aural atresia, and 48 surveys were sent to families of children with unilateral sensorineural hearing loss (SNHL) to identify rates of grade retention, use of any resource, and behavioral problems. Audiometric data of the cohort were tabulated. Of the 40 atresia patients, none repeated a grade, but 65% needed some resources: 12.5% currently use a hearing aid, 32.5% use(d) a frequency-modulated system in school, 47.5% had an Individualized Education Plan, and 45% utilized speech therapy. Compared to the unilateral SNHL group and a cohort of children with unilateral SNHL in an earlier study, children with unilateral atresia were less likely to repeat a grade. Children in both unilateral atresia and SNHL groups were more likely to utilize some resource in the academic setting compared to the unilateral SNHL children in the prior study. Unilateral conductive hearing loss due to aural atresia has an impact on academic performance in children, although not as profound when compared to children with unilateral SNHL. The majority of these children with unilateral atresia utilize resources in the school setting. Parents, educators, and health care professionals should be aware of the impact of unilateral conductive hearing loss and offer appropriate habilitative services. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Cognitive Processing Speed, Working Memory, and the Intelligibility of Hearing Aid-Processed Speech in Persons with Hearing Impairment

PubMed Central

Yumba, Wycliffe Kabaywe

2017-01-01

Previous studies have demonstrated that successful listening with advanced signal processing in digital hearing aids is associated with individual cognitive capacity, particularly working memory capacity (WMC). This study aimed to examine the relationship between cognitive abilities (cognitive processing speed and WMC) and individual listeners’ responses to digital signal processing settings in adverse listening conditions. A total of 194 native Swedish speakers (83 women and 111 men), aged 33–80 years (mean = 60.75 years, SD = 8.89), with bilateral, symmetrical mild to moderate sensorineural hearing loss who had completed a lexical decision speed test (measuring cognitive processing speed) and semantic word-pair span test (SWPST, capturing WMC) participated in this study. The Hagerman test (capturing speech recognition in noise) was conducted using an experimental hearing aid with three digital signal processing settings: (1) linear amplification without noise reduction (NoP), (2) linear amplification with noise reduction (NR), and (3) non-linear amplification without NR (“fast-acting compression”). The results showed that cognitive processing speed was a better predictor of speech intelligibility in noise, regardless of the types of signal processing algorithms used. That is, there was a stronger association between cognitive processing speed and NR outcomes and fast-acting compression outcomes (in steady state noise). We observed a weaker relationship between working memory and NR, but WMC did not relate to fast-acting compression. WMC was a relatively weaker predictor of speech intelligibility in noise. These findings might have been different if the participants had been provided with training and or allowed to acclimatize to binary masking noise reduction or fast-acting compression. PMID:28861009

47 CFR 68.316 - Hearing aid compatibility: Technical requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... provided fortuitously rather than by design. More recently, special handset designs, e.g., blue grommet... were conducted to demonstrate the acceptability of such designs. It is anticipated that there will be an increase in the number of new handset designs in the future. A standard definition of the magnetic...

Hearing Aid Satisfaction: What Does Research from the Past 20 Years Say?

PubMed Central

Wong, Lena L. N.; Hickson, Louise; McPherson, Bradley

2003-01-01

Hearing aid satisfaction is a pleasurable emotional experience as an outcome of an evaluation of performance. Many tools have been designed to measure the degree of satisfaction overall, or along the dimensions of cost, appearance, acoustic benefit, comfort, and service. Various studies have used these tools to examine the relationships between satisfaction and other factors. Findings are not always consistent across studies, but in general, hearing aid satisfaction has been found to be related to experience, expectation, personality and attitude, usage, type of hearing aids, sound quality, listening situations, and problems in hearing aid use. Inconsistent findings across studies and difficulties in evaluating the underlying relationships are probably caused by problems with the tools (eg, lack of validity) and the methods used to evaluate relationships (eg, correlation analyses evaluate association and not causal effect). Whether satisfaction changes over time and how service satisfaction contributes to device satisfaction are unclear. It is hoped that this review will help readers understand current satisfaction measures, how various factors affect satisfaction, and how the way satisfaction is measured may be improved to yield more reliable and valid data. PMID:15004650

Personality and the subjective assessment of hearing aids.

PubMed

Cox, R M; Alexander, G C; Gray, G

1999-01-01

Relatively little is known about the influence of patients' personality features on the responses they make to self-assessment items used to measure the outcome of a hearing aid fitting. If the personality of the hearing aid wearer has a significant influence on self-report outcome data, it would be important to explore the relevant personality variables and to be cognizant of their effects when using subjective outcome data to justify decisions about clinical services or other matters. This investigation explored the relationship between several personality attributes and responses to the Abbreviated Profile of Hearing Aid Benefit (APHAB). It found that more extroverted patients tend to report more hearing aid benefit in all speech communication situations. In addition, patients with a more external locus of control tend to have more negative reactions to loud environmental sounds, both with and without amplification. Anxiety also played a small additional role in determining APHAB responses. Although personality variables were found to explain a relatively small amount of the variance in APHAB responses (usually around 10%), these outcomes should alert practitioners and researchers to the potential effects of personality variables in all self-report data.

Social representation of hearing aids: cross-cultural study in India, Iran, Portugal, and the United Kingdom.

PubMed

Manchaiah, Vinaya; Danermark, Berth; Vinay; Ahmadi, Tayebeh; Tomé, David; Krishna, Rajalakshmi; Germundsson, Per

2015-01-01

The current study was aimed at understanding the social representation of hearing aids in India, Iran, Portugal, and the United Kingdom. We also compared these results to explore the cross-cultural differences and similarities among these countries. The study involved a cross-sectional design, and the data were collected from four different countries using the snowball sampling method. Data were analyzed using a content analysis to identify the most-similar categories of responses reported, a co-occurrences analysis to see which of these categories are reported commonly, and a chi-square analysis to study if there was any association between positive, neutral, and negative connotations among participants in different countries. The current study revealed four different social representations of hearing aids from India, Iran, Portugal, and the United Kingdom, and also a global index. The study results provide very useful insights into how hearing aids are represented in the society. These findings may have important implications for public education and also for manufacturers from the viewpoint of designing and marketing hearing aids in different countries.

Paediatric hearing aid management: a demonstration project for using virtual visits to enhance parent support.

PubMed

Muñoz, Karen; Kibbe, Kristin; Preston, Elizabeth; Caballero, Ana; Nelson, Lauri; White, Karl; Twohig, Michael

2017-02-01

The purpose of this study was to explore the use of virtual visits to monitor hearing aid use with data logging measurements and provide parent support for hearing aid management. A 6-month longitudinal case study design was used. Four families and two providers participated. Average hours of daily hearing aid use increased 3.5 h from the beginning to the end of the study period. Prior to receiving virtual visits, the parents and the clinicians generally indicated they were hopeful about the benefits of virtual visits including the frequency and convenience of the appointments but had some concerns about technical difficulties. These concerns diminished at the conclusion of the study. Virtual visits provided benefits to families including flexibility and timely access to support. The ability to collect data logging information more frequently was important for effective problem-solving to increase hearing aid use. Both parents and clinicians were accepting of tele-support. Parents and professionals would benefit from technology that allows them to access data logging information more easily and frequently.

Social representation of hearing aids: cross-cultural study in India, Iran, Portugal, and the United Kingdom

PubMed Central

Manchaiah, Vinaya; Danermark, Berth; Vinay; Ahmadi, Tayebeh; Tomé, David; Krishna, Rajalakshmi; Germundsson, Per

2015-01-01

Background The current study was aimed at understanding the social representation of hearing aids in India, Iran, Portugal, and the United Kingdom. We also compared these results to explore the cross-cultural differences and similarities among these countries. Methods The study involved a cross-sectional design, and the data were collected from four different countries using the snowball sampling method. Data were analyzed using a content analysis to identify the most-similar categories of responses reported, a co-occurrences analysis to see which of these categories are reported commonly, and a chi-square analysis to study if there was any association between positive, neutral, and negative connotations among participants in different countries. Results The current study revealed four different social representations of hearing aids from India, Iran, Portugal, and the United Kingdom, and also a global index. Conclusion The study results provide very useful insights into how hearing aids are represented in the society. These findings may have important implications for public education and also for manufacturers from the viewpoint of designing and marketing hearing aids in different countries. PMID:26504376

Electromagnetic semi-implantable hearing device: phase I. Clinical trials.

PubMed

McGee, T M; Kartush, J M; Heide, J C; Bojrab, D I; Clemis, J D; Kulick, K C

1991-04-01

Conventional hearing aids have improved significantly in recent years; however, amplification of sound within the external auditory canal creates a number of intrinsic problems, including acoustic feedback and the need for a tight ear mold to increase usable gain. Nonacoustic alternatives which could obviate these encumbrances have not become practical due to inefficient coupling (piezoelectric techniques) or unfeasible power requirements (electromagnetic techniques). Recent technical advances, however, prompted a major clinical investigation of a new electromagnetic, semi-implantable hearing device. This study presents the details of clinical phase I, in which an electromagnetic driver was coupled with a target magnet temporarily affixed onto the lateral surface of the malleus of six hearing aid users with sensorineural losses. The results indicate that the electromagnetic hearing device provides sufficient gain and output characteristics to benefit individuals with sensorineural hearing loss. Significant improvements compared to conventional hearing aids were noted in pure-tone testing and, to a lesser degree, in speech discrimination. Subjective responses were quite favorable, indicating that the electromagnetic hearing device 1. produces no acoustic feedback; 2. works well in noisy environments; and 3. provides a more quiet, natural sound than patients' conventional hearing aids. These favorable results led to phase II of the project, in which patients with surgically amendable mixed hearing losses were implanted with the target magnet incorporated within a hydroxyapatite ossicular prosthesis. The results of this second-stage investigation were also encouraging and will be reported separately.

Hearing Aid Selection and Evaluation for Pre-school Children.

ERIC Educational Resources Information Center

Tachiiri, Hajime

1996-01-01

Focuses upon the selection and fitting of hearing aids for young children in Japan. Explains fitting methods and their evaluation. Suggests that although most of the schools for the deaf are making serious efforts to establish binaural fitting and use of residual hearing, lack of professional training hinders those efforts. (AA)

The Performance-Perceptual Test (PPT) and its relationship to aided reported handicap and hearing aid satisfaction.

PubMed

Saunders, Gabrielle H; Forsline, Anna

2006-06-01

Results of objective clinical tests (e.g., measures of speech understanding in noise) often conflict with subjective reports of hearing aid benefit and satisfaction. The Performance-Perceptual Test (PPT) is an outcome measure in which objective and subjective evaluations are made by using the same test materials, testing format, and unit of measurement (signal-to-noise ratio, S/N), permitting a direct comparison between measured and perceived ability to hear. Two variables are measured: a Performance Speech Reception Threshold in Noise (SRTN) for 50% correct performance and a Perceptual SRTN, which is the S/N at which listeners perceive that they can understand the speech material. A third variable is computed: the Performance-Perceptual Discrepancy (PPDIS); it is the difference between the Performance and Perceptual SRTNs and measures the extent to which listeners "misjudge" their hearing ability. Saunders et al. in 2004 examined the relation between PPT scores and unaided hearing handicap. In this publication, the relations between the PPT, residual aided handicap, and hearing aid satisfaction are described. Ninety-four individuals between the ages of 47 and 86 yr participated. All had symmetrical sensorineural hearing loss and had worn binaural hearing aids for at least 6 wk before participating. All subjects underwent routine audiological examination and completed the PPT, the Hearing Handicap Inventory for the Elderly/Adults (HHIE/A), and the Satisfaction for Amplification in Daily Life questionnaire. Sixty-five subjects attended one research visit for participation in this study, and 29 attended a second visit to complete the PPT a second time. Performance and Perceptual SRTN and PPDIS scores were normally distributed and showed excellent test-retest reliability. Aided SRTNs were significantly better than unaided SRTNs; aided and unaided PPDIS values did not differ. Stepwise multiple linear regression showed that the PPDIS, the Performance SRTN, and age were significant predictors of scores on the HHIE/A such that greater reported handicap is associated with underestimating hearing ability, poorer aided ability to understand speech in noise, and being younger. Scores on the Satisfaction with Amplification in Daily Life were not well explained by the PPT, age, or audiometric thresholds. When individuals were grouped by their HHIE/A scores, it was seen that individuals who report more handicap than expected based on their audiometric thresholds, have a more negative PPDIS, i.e., underestimate their hearing ability, relative to individuals who report expected handicap, who in turn have a more negative PPDIS than individuals who report less handicap than expected. No such patterns were apparent for the Performance SRTN. The study showed the PPT to be a reliable outcome measure that can provide more information than a performance measure and/or a questionnaire measure alone, in that the PPDIS can provide the clinician with an explanation for discrepant objective and subjective reports of hearing difficulties. The finding that self-reported handicap is affected independently by both actual ability to hear and the (mis)perception of ability to hear underscores the difficulty clinicians encounter when trying to interpret outcomes questionnaires. We suggest that this variable should be measured and taken into account when interpreting questionnaires and counseling patients.

[Principles of energy sources of totally implantable hearing aids for inner ear hearing loss].

PubMed

Baumann, J W; Leysieffer, H

1998-02-01

A fully implantable hearing aid consists of a sound receptor (microphone), an electronic amplifier including active audio-signal processing, an electromechanical transducer (actuator) for stimulating the ear by vibration, and an energy source. The energy source may be either a primary cell or a rechargeable (secondary) cell. As the energy requirements of an implantable hearing aid are dependent on the operating principle of the actuator, the operating principles of electromagnetic and piezoelectric transducers were examined with respect to their relative power consumption. The analysis showed that the energy requirements of an implantable hearing aid are significantly increased when an electromagnetic transducer is used. The power consumption of a piezoelectric transducer was found to be less than that of the electronic components alone. The energy needed to run a fully implantable hearing aid under these conditions would be 38 mWH per day. Primary cells cannot provide the energy needed for a minimum operation time of 5 years (70 WH), and therefore rechargeable cells must be used. A theoretical appraisal was carried out on nickel-cadmium, nickel-metal hydride, and lithium-ion cells to determine their suitability as well as to assess the risks associated with their use in an implant. Safety measures were drawn up from the results. Ni-MH cells were found to be the most suitable for use as an energy source for implantable hearing-aids because they are more robust than Li ion cells and their storage capacity is double that of Ni-Cd cells of similar size.

Implantable digital hearing aid

NASA Technical Reports Server (NTRS)

Kissiah, A. M., Jr.

1979-01-01

Hearing aid converts analog output of microphone into digital pulses in about 10 channels of audiofrequencies. Each pulse band could be directly connected to portion of auditory nerve most sensitive to that range.

Clinical evaluation of an over-the-counter hearing aid (TEO First®) in elderly patients suffering of mild to moderate hearing loss.

PubMed

Sacco, Guillaume; Gonfrier, Sébastien; Teboul, Bernard; Gahide, Ivan; Prate, Fredéric; Demory-Zory, Mathilde; Turpin, Jean-Michel; Vuagnoux, Claire; Genovese, Philippe; Schneider, Stéphane; Guérin, Olivier; Guevara, Nicolas

2016-07-09

Presbycusis has a direct influence on autonomy of the elderly but hearing aids lack of affordability. Moreover a recent review demonstrate that electroacoustic characteristics of OTC hearing aids were generally not suitable for the elderly people. In our study, we assessed the clinical value of a new over-the-counter (OTC) hearing aid device (TEO First®) in the elderly. This prospective monocentric open label study included patients over 60 years of age with a mild to moderate presbycusis. Patients were assessed with acceptable noise level test (ANL), pure tone (PTA) and speech (SA) audiometry in silent and noisy environment, with and without TEO First®. A Glasgow Hearing Aid Benefit Profile, acceptability and satisfaction surveys were completed after one month of using the device. Thirty one patients were included. There was an improvement of hearing with TEO First® in silence (SA: +39.2 %, p < 0.01; PTA: -9.04 dB, p < 0.01) or in noise (SA +47.7 %, p < 0.01; PTA: -5.23 dB, p < 0.05). After one month of use of the device, quality of life has improved with regards to the following parameters: decrease of perceived hearing difficulties during conversation without background noise (-9.6 % p = 0.018), in conversation with several people (-16.2 % p = 0.0076), decrease of negative emotions while watching TV (-18.5 % p = 0.011), during conversation without background noise (-16.5 % p = 0.0024), during conversation in noisy background (-17.1 % p = 0.027) and during conversation with several people (-20 % p = 0.014). The acceptability of the device was low to moderate. TEO First® is an effective OTC hearing aid that improves the patient's quality of life. Current Controlled Trials NCT01815788.

Insertion depth impacts speech perception and hearing preservation for lateral wall electrodes.

PubMed

O'Connell, Brendan P; Hunter, Jacob B; Haynes, David S; Holder, Jourdan T; Dedmon, Matt M; Noble, Jack H; Dawant, Benoit M; Wanna, George B

2017-10-01

1) Examine angular insertion depths (AID) and scalar location of Med-El (GmbH Innsbruck, Austria) electrodes; and 2) determine the relationship between AID and audiologic outcomes controlling for scalar position. Retrospective review. Postlingually deafened adults undergoing cochlear implantation with Flex 24, Flex 28, and Standard electrode arrays (Med-El) were identified. Patients with preoperative and postoperative computed tomography scans were included so that electrode location and AID could be determined. Outcome measures were 1) speech perception in the cochlear implant (CI)-only condition, and 2) short-term hearing preservation. Forty-eight implants were included; all electrodes (48 of 48) were positioned entirely within the scala tympani. The median AID was 408° (interquartile [IQ] range 373°-449°) for Flex 24, 575° (IQ range 465°-584°) for Flex 28, and 584° (IQ range 368°-643°) for Standard electrodes (Med-El). The mean postoperative CNC score was 43.7% ± 21.9. A positive correlation was observed between greater AID and better CNC performance (r = 0.48, P < 0.001). Excluding patients with postoperative residual hearing, a strong correlation between AID and CNC persisted (r = 0.57, P < 0.001). In patients with preoperative residual hearing, mean low-frequency pure-tone average (PTA) shift was 27 dB ± 14. A correlation between AID and low-frequency PTA shift at activation was noted (r = 0.41, P = 0.04). Favorable rates of scala tympani insertion (100%) were observed. In the CI-only condition, a direct correlation between greater AID and CNC score was noted regardless of postoperative hearing status. Deeper insertions were, however, associated with worse short-term hearing preservation. When patients without postoperative residual hearing were analyzed independently, the relationship between greater insertion depth and better performance was strengthened. 4. Laryngoscope, 127:2352-2357, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Whither High Technology?

ERIC Educational Resources Information Center

Levitt, Harry

1991-01-01

This article briefly describes sensory aids for individuals with hearing impairments, such as the visible speech translator, the cochlear implant, and the digital hearing aid, and identifies common trends. The article stresses factors affecting the development of sensory aids in the past and how these factors are likely to influence the future.…

Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

PubMed

Park, Marn Joon; Lee, Jae Ryung; Yang, Chan Joo; Yoo, Myung Hoon; Jin, In Suk; Choi, Chi Ho; Park, Hong Ju

2016-11-01

Transcutaneous devices have a disadvantage, the dampening effect by soft tissue between the bone and devices. We investigated hearing outcomes with percutaneous and transcutaneous devices using test-bands in an induced unilateral conductive hearing loss. Comparison of hearing outcomes of two devices in the same individuals. The right ear was plugged in 30 subjects and a test-band with devices (Cochlear™ Baha® BP110 Power and Sophono® Alpha-2 MPO™) was applied on the right mastoid tip with the left ear masked. Sound-field thresholds, speech recognition thresholds (SRTs), and word recognition scores (WRSs) were compared. Aided thresholds of Sophono were significantly better than those of Baha at most frequencies. Sophono WRSs (86 ± 12%) at 40 dB SPL and SRTs (14 ± 5 dB HL) were significantly better than those (73 ± 24% and 23 ± 8 dB HL) of Baha. However, Sophono WRSs (98 ± 3%) at 60 dB SPL did not differ from Baha WRSs (95 ± 12%). Amplifications of the current transcutaneous device were not inferior to those of percutaneous devices with a test-band in subjects with normal bone-conduction thresholds. Since the percutaneous devices can increase the gain when fixed to the skull by eliminating the dampening effect, both devices are expected to provide sufficient hearing amplification.

Objective and perceptual comparisons of two bluetooth hearing aid assistive devices.

PubMed

Clark, Jackie L; Pustejovsky, Carmen; Vanneste, Sven

2017-08-01

With the advent of Bluetooth technology, many of the assistive listening devices for hearing have become manufacturer specific, with little objective information about the performance provided. Thirty native English-speaking adults (mean age 29.8) with normal hearing were tested pseudo-randomly with two major hearing aid manufacturers' proprietary Bluetooth connectivity devices paired to the accompanying manufacturer's specific hearing aids. Sentence recognition performance was objectively measured for each system with signals transmitted via a land-line to the same iPhone in two conditions. There was a significant effect of participant's performance according to listening condition. There was no significant effect between device manufacturers according to listening condition, but there was a significant effect in participant's perception of "quality of sound". Despite differences in signal transmission for each devise, when worn by participants both the systems performed equally. In fact, participants expressed personal preferences for specific technology that was largely due to their perceived quality of sound while listening to recorded signals. While further research is necessary to investigate other measures of benefit for Bluetooth connectivity devices, preliminary data suggest that in order to ensure comfort and compatibility, not only should objective measures of the patient benefit be completed, but also assessing the patient's perception of benefit is equally important. Implications for Rehabilitation All professionals who work with individuals with hearing loss, become aware of the differences in the multiple choices for assistive technology readily available for hearing loss. With the ever growing dispensing of Bluetooth connectivity devices coupled to hearing aids, there is an increased burden to determine whether performance differences could exist between manufacturers. There is a growing need to investigate other measures of benefit for Bluetooth hearing aid connectivity devices that not only include objective measures, but also patient perception of benefit.

Neural Correlates of Selective Attention With Hearing Aid Use Followed by ReadMyQuips Auditory Training Program.

PubMed

Rao, Aparna; Rishiq, Dania; Yu, Luodi; Zhang, Yang; Abrams, Harvey

The objectives of this study were to investigate the effects of hearing aid use and the effectiveness of ReadMyQuips (RMQ), an auditory training program, on speech perception performance and auditory selective attention using electrophysiological measures. RMQ is an audiovisual training program designed to improve speech perception in everyday noisy listening environments. Participants were adults with mild to moderate hearing loss who were first-time hearing aid users. After 4 weeks of hearing aid use, the experimental group completed RMQ training in 4 weeks, and the control group received listening practice on audiobooks during the same period. Cortical late event-related potentials (ERPs) and the Hearing in Noise Test (HINT) were administered at prefitting, pretraining, and post-training to assess effects of hearing aid use and RMQ training. An oddball paradigm allowed tracking of changes in P3a and P3b ERPs to distractors and targets, respectively. Behavioral measures were also obtained while ERPs were recorded from participants. After 4 weeks of hearing aid use but before auditory training, HINT results did not show a statistically significant change, but there was a significant P3a reduction. This reduction in P3a was correlated with improvement in d prime (d') in the selective attention task. Increased P3b amplitudes were also correlated with improvement in d' in the selective attention task. After training, this correlation between P3b and d' remained in the experimental group, but not in the control group. Similarly, HINT testing showed improved speech perception post training only in the experimental group. The criterion calculated in the auditory selective attention task showed a reduction only in the experimental group after training. ERP measures in the auditory selective attention task did not show any changes related to training. Hearing aid use was associated with a decrement in involuntary attention switch to distractors in the auditory selective attention task. RMQ training led to gains in speech perception in noise and improved listener confidence in the auditory selective attention task.

Test-retest reliability of probe-microphone verification in children fitted with open and closed hearing aid tips.

PubMed

Kim, Hannah; Ricketts, Todd A

2013-01-01

To investigate the test-retest reliability of real-ear aided response (REAR) measures in open and closed hearing aid fittings in children using appropriate probe-microphone calibration techniques (stored equalization for open fittings and concurrent equalization for closed fittings). Probe-microphone measurements were completed for two mini-behind-the-ear (BTE) hearing aids which were coupled to the ear using open and closed eartips via thin (0.9 mm) tubing. Before probe-microphone testing, the gain of each of the test hearing aids was programmed using an artificial ear simulator (IEC 711) and a Knowles Electronic Manikin for Acoustic Research to match the National Acoustic Laboratories-Non-Linear, version 1 targets for one of two separate hearing loss configurations using an Audioscan Verifit. No further adjustments were made, and the same amplifier gain was used within each hearing aid across both eartip configurations and all participants. Probe-microphone testing included real-ear occluded response (REOR) and REAR measures using the Verifit's standard speech signal (the carrot passage) presented at 65 dB sound pressure level (SPL). Two repeated probe-microphone measures were made for each participant with the probe-tube and hearing aid removed and repositioned between each trial in order to assess intrasubject measurement variability. These procedures were repeated using both open and closed domes. Thirty-two children, ages ranging from 4 to 14 yr. The test-retest standard deviations for open and closed measures did not exceed 4 dB at any frequency. There was also no significant difference between the open (stored equalization) and closed (concurrent equalization) methods. Reliability was particularly similar in the high frequencies and was also quite similar to that reported in previous research. There was no correlation between reliability and age, suggesting high reliability across all ages evaluated. The findings from this study suggest that reliable probe-microphone measurements are obtainable on children 4 yr and older for both traditional unvented and open-canal hearing aid fittings. These data suggest that clinicians should not avoid fitting open technology to children as young as 4 y because of concerns regarding the reliability of verification techniques. American Academy of Audiology.

Stethoscopes with hearing aid use: Case studies

PubMed Central

Jacob, Regina Tangerino de Souza; Zambonato, Ticiana Cristina de Souza; Mondelli, Maria Fernanda Capoani Garcia

2013-01-01

Summary Introduction: Description for using stethoscopes adapted to hearing aids. Aim: To describe the adaptation of HAs to stethoscopes used by 2 students in the health field with bilateral hearing impairment. Case reports: Two subjects with hearing loss had their stethoscopes coupled to HAs because of the individual requirements of their professions (healthcare) to perform auscultation. Conclusion: The improvement was measured in situ, and satisfaction was evaluated using a subjective questionnaire. The use of a stethoscope coupled to an HA allowed students with hearing loss to perform auscultation. PMID:25992000

Developing an appropriate digital hearing aid for low-resource countries: a case study.

PubMed

Israsena, P; Isaradisaikul, S; Noymai, A; Boonyanukul, S; Hemakom, A; Chinnarat, C; Navacharoen, N; Lekagul, S

2013-01-01

This paper reviews the development process and discusses the key findings which resulted from our multidisciplinary research team's effort to develop an alternative digital hearing suitable for low-resource countries such as Thailand. A cost-effective, fully programmable digital hearing aid, with its specifications benchmarking against WHO's recommendations, was systematically designed, engineered, and tested. Clinically it had undergone a full clinical trial that employed the outcome measurement protocol adopted from the APHAB, the first time implemented in Thai language. Results indicated that using the hearing aid improves user's satisfaction in terms of ease of communication, background noises, and reverberation, with clear benefit after 3 and 6 months, confirming its efficacy. In terms of engineering, the hearing aid also proved to be robust, passing all the designated tests. As the technology has successfully been transferred to a local company for the production phase, we also discuss other challenges that may arise before the device can be introduced into the market.

An Evaluation of Frequency Transposition for Hearing-Impaired School-Age Children

ERIC Educational Resources Information Center

Smith, Jenny; Dann, Marilyn; Brown, P. Margaret

2009-01-01

A key objective when fitting hearing aids to children is to maximize the audibility of high frequency speech cues which are critical in the understanding of spoken English. Recent advances in digital signal processing have enabled the development of hearing aids which offer linear frequency transposition as a new way of accessing these important…

Hearing Aids: Expectations and Satisfaction of People with an Intellectual Disability, a Descriptive Pilot Study

ERIC Educational Resources Information Center

Meuwese-Jongejeugd, A.; Verschuure, H.; Evenhuis, H. M.

2007-01-01

Background: In spite of an increased risk of hearing impairment in persons with an intellectual disability (ID), rehabilitation with hearing aids often fails. We performed a descriptive pilot study with the following study questions: (1) Do comparable elements as in the general population contribute to expectations of and satisfaction with hearing…

Smartphone-Based System for Learning and Inferring Hearing Aid Settings.

PubMed

Aldaz, Gabriel; Puria, Sunil; Leifer, Larry J

2016-10-01

Previous research has shown that hearing aid wearers can successfully self-train their instruments' gain-frequency response and compression parameters in everyday situations. Combining hearing aids with a smartphone introduces additional computing power, memory, and a graphical user interface that may enable greater setting personalization. To explore the benefits of self-training with a smartphone-based hearing system, a parameter space was chosen with four possible combinations of microphone mode (omnidirectional and directional) and noise reduction state (active and off). The baseline for comparison was the "untrained system," that is, the manufacturer's algorithm for automatically selecting microphone mode and noise reduction state based on acoustic environment. The "trained system" first learned each individual's preferences, self-entered via a smartphone in real-world situations, to build a trained model. The system then predicted the optimal setting (among available choices) using an inference engine, which considered the trained model and current context (e.g., sound environment, location, and time). To develop a smartphone-based prototype hearing system that can be trained to learn preferred user settings. Determine whether user study participants showed a preference for trained over untrained system settings. An experimental within-participants study. Participants used a prototype hearing system-comprising two hearing aids, Android smartphone, and body-worn gateway device-for ∼6 weeks. Sixteen adults with mild-to-moderate sensorineural hearing loss (HL) (ten males, six females; mean age = 55.5 yr). Fifteen had ≥6 mo of experience wearing hearing aids, and 14 had previous experience using smartphones. Participants were fitted and instructed to perform daily comparisons of settings ("listening evaluations") through a smartphone-based software application called Hearing Aid Learning and Inference Controller (HALIC). In the four-week-long training phase, HALIC recorded individual listening preferences along with sensor data from the smartphone-including environmental sound classification, sound level, and location-to build trained models. In the subsequent two-week-long validation phase, participants performed blinded listening evaluations comparing settings predicted by the trained system ("trained settings") to those suggested by the hearing aids' untrained system ("untrained settings"). We analyzed data collected on the smartphone and hearing aids during the study. We also obtained audiometric and demographic information. Overall, the 15 participants with valid data significantly preferred trained settings to untrained settings (paired-samples t test). Seven participants had a significant preference for trained settings, while one had a significant preference for untrained settings (binomial test). The remaining seven participants had nonsignificant preferences. Pooling data across participants, the proportion of times that each setting was chosen in a given environmental sound class was on average very similar. However, breaking down the data by participant revealed strong and idiosyncratic individual preferences. Fourteen participants reported positive feelings of clarity, competence, and mastery when training via HALIC. The obtained data, as well as subjective participant feedback, indicate that smartphones could become viable tools to train hearing aids. Individuals who are tech savvy and have milder HL seem well suited to take advantages of the benefits offered by training with a smartphone. American Academy of Audiology

47 CFR 20.19 - Hearing aid-compatible mobile handsets.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and Hearing Aids,” ANSI C63.19-2006 (June 12, 2006), Institute of Electrical and Electronics Engineers... and Electronics Engineers, Inc., publisher. These incorporations by reference were approved by the...

Hearing loss and the central auditory system: Implications for hearing aids

NASA Astrophysics Data System (ADS)

Frisina, Robert D.

2003-04-01

Hearing loss can result from disorders or damage to the ear (peripheral auditory system) or the brain (central auditory system). Here, the basic structure and function of the central auditory system will be highlighted as relevant to cases of permanent hearing loss where assistive devices (hearing aids) are called for. The parts of the brain used for hearing are altered in two basic ways in instances of hearing loss: (1) Damage to the ear can reduce the number and nature of input channels that the brainstem receives from the ear, causing plasticity of the central auditory system. This plasticity may partially compensate for the peripheral loss, or add new abnormalities such as distorted speech processing or tinnitus. (2) In some situations, damage to the brain can occur independently of the ear, as may occur in cases of head trauma, tumors or aging. Implications of deficits to the central auditory system for speech perception in noise, hearing aid use and future innovative circuit designs will be provided to set the stage for subsequent presentations in this special educational session. [Work supported by NIA-NIH Grant P01 AG09524 and the International Center for Hearing & Speech Research, Rochester, NY.

Speech Understanding with a New Implant Technology: A Comparative Study with a New Nonskin Penetrating Baha System

PubMed Central

Caversaccio, Marco

2014-01-01

Objective. To compare hearing and speech understanding between a new, nonskin penetrating Baha system (Baha Attract) to the current Baha system using a skin-penetrating abutment. Methods. Hearing and speech understanding were measured in 16 experienced Baha users. The transmission path via the abutment was compared to a simulated Baha Attract transmission path by attaching the implantable magnet to the abutment and then by adding a sample of artificial skin and the external parts of the Baha Attract system. Four different measurements were performed: bone conduction thresholds directly through the sound processor (BC Direct), aided sound field thresholds, aided speech understanding in quiet, and aided speech understanding in noise. Results. The simulated Baha Attract transmission path introduced an attenuation starting from approximately 5 dB at 1000 Hz, increasing to 20–25 dB above 6000 Hz. However, aided sound field threshold shows smaller differences and aided speech understanding in quiet and in noise does not differ significantly between the two transmission paths. Conclusion. The Baha Attract system transmission path introduces predominately high frequency attenuation. This attenuation can be partially compensated by adequate fitting of the speech processor. No significant decrease in speech understanding in either quiet or in noise was found. PMID:25140314

Applying the COM-B behaviour model and behaviour change wheel to develop an intervention to improve hearing-aid use in adult auditory rehabilitation.

PubMed

Barker, Fiona; Atkins, Lou; de Lusignan, Simon

2016-07-01

To introduce a psychological model of behaviour; the COM-B model and describe how this has been used in combination with the behaviour change wheel (BCW) in developing an intervention which aims to promote regular, long-term use of hearing aids by adults with acquired hearing loss. Qualitative structured interview study using the COM-B model to identify the determinants of behavioural planning on the part of audiologists; a potentially important factor in encouraging long-term hearing-aid use. Ten audiologists drawn from a random sample of five English audiology departments. The analysis suggests that behavioural planning might be more likely to occur if audiologists' psychological capability, physical and social opportunity, and reflective and automatic motivation were addressed. This analysis forms the basis of an intervention design, using the BCW, to encourage behavioural planning by audiologists and subsequent hearing-aid use by people with hearing loss. The COM-B model and BCW can be applied successfully in the context of audiology to analyse the behaviour of both people with hearing loss and professionals working with them, supplying information that is being used in intervention design. The effectiveness of the intervention will be tested in a clinical trial.

Wind noise in hearing aids: I. Effect of wide dynamic range compression and modulation-based noise reduction.

PubMed

Chung, King

2012-01-01

The objectives of this study were: (1) to examine the effect of wide dynamic range compression (WDRC) and modulation-based noise reduction (NR) algorithms on wind noise levels at the hearing aid output; and (2) to derive effective strategies for clinicians and engineers to reduce wind noise in hearing aids. Three digital hearing aids were fitted to KEMAR. The noise output was recorded at flow velocities of 0, 4.5, 9.0, and 13.5 m/s in a wind tunnel as the KEMAR head was turned from 0° to 360°. Flow noise levels were compared between the 1:1 linear and 3:1 WDRC conditions, and between NR-activated and NR-deactivated conditions when the hearing aid was programmed to the directional and omnidirectional modes. The results showed that: (1) WDRC increased low-level noise and reduced high-level noise; and (2) different noise reduction algorithms provided different amounts of wind noise reduction in different microphone modes, frequency regions, flow velocities, and head angles. Wind noise can be reduced by decreasing the gain for low-level inputs, increasing the compression ratio for high-level inputs, and activating modulation-based noise reduction algorithms.

Hearing Aids: How to Choose the Right One

MedlinePlus

... and all are powered with a hearing aid battery. Small microphones collect sounds from the environment. A ... to pick up wind noise Uses very small batteries, which have shorter life and can be difficult ...

Monaural or binaural sound deprivation in postlingual hearing loss: Cochlear implant in the worse ear.

PubMed

Canale, Andrea; Dalmasso, Giulia; Dagna, Federico; Lacilla, Michelangelo; Montuschi, Carla; Rosa, Rosalba Di; Albera, Roberto

2016-08-01

To determine whether speech recognition scores (SRS) differ between adults with long-term auditory deprivation in the implanted ear and adults who received cochlear implant (CI) in the nonsound-deprived ear, either for hearing aid-assisted or due to rapidly deteriorating hearing loss. Retrospective study. Speech recognition scores at evaluations (3 and 14 months postimplantation) conducted with CI alone at 60-dB sound pressure level intensity were compared in 15 patients (4 with bilateral severe hearing loss; 11 with asymmetric hearing loss, 7 of which had contralateral hearing aid), all with long-term auditory deprivation (mean duration 16.9 years) (group A), and in 15 other patients with postlingual hearing loss (10 symmetric, 5 asymmetric with bimodal stimulation) (controls, group B). Comparison of mean percentage of correctly recognized words on speech audiometry at 3 and 14 months showed improvement within each group (P < 0.05). Between-group comparison showed no significant difference at 3 (P = 0.17) or 14 months (P = 0.46). Comparison of SRSs in group A (bimodal stimulation [n = 7] and binaural sound deprivation [n = 4]) versus group B showed no significant differences at 3 (bimodal stimulation P = 0.16; binaural sound deprivation P = 0.19) or 14 months (bimodal stimulation P = 0.14; binaural sound deprivation P = 0.82). Speech recognition scores in monaural and binaural sound-deprived ears did not significantly differ from ears with unilateral cochlear implantation in nonsound-deprived ears when tested with CI alone. Improvement in the implanted worse ear indicates that it could be a potential candidate ear for cochlear implantation even when sound deprived. 4. Laryngoscope, 126:1905-1910, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Speech Intelligibility in Persian Hearing Impaired Children with Cochlear Implants and Hearing Aids.

PubMed

Rezaei, Mohammad; Emadi, Maryam; Zamani, Peyman; Farahani, Farhad; Lotfi, Gohar

2017-04-01

The aim of present study is to evaluate and compare speech intelligibility in hearing impaired children with cochlear implants (CI) and hearing aid (HA) users and children with normal hearing (NH). The sample consisted of 45 Persian-speaking children aged 3 to 5-years-old. They were divided into three groups, and each group had 15, children, children with CI and children using hearing aids in Hamadan. Participants was evaluated by the test of speech intelligibility level. Results of ANOVA on speech intelligibility test showed that NH children had significantly better reading performance than hearing impaired children with CI and HA. Post-hoc analysis, using Scheffe test, indicated that the mean score of speech intelligibility of normal children was higher than the HA and CI groups; but the difference was not significant between mean of speech intelligibility in children with hearing loss that use cochlear implant and those using HA. It is clear that even with remarkabkle advances in HA technology, many hearing impaired children continue to find speech production a challenging problem. Given that speech intelligibility is a key element in proper communication and social interaction, consequently, educational and rehabilitation programs are essential to improve speech intelligibility of children with hearing loss.

Categorical loudness scaling and equal-loudness contours in listeners with normal hearing and hearing loss

PubMed Central

Rasetshwane, Daniel M.; Trevino, Andrea C.; Gombert, Jessa N.; Liebig-Trehearn, Lauren; Kopun, Judy G.; Jesteadt, Walt; Neely, Stephen T.; Gorga, Michael P.

2015-01-01

This study describes procedures for constructing equal-loudness contours (ELCs) in units of phons from categorical loudness scaling (CLS) data and characterizes the impact of hearing loss on these estimates of loudness. Additionally, this study developed a metric, level-dependent loudness loss, which uses CLS data to specify the deviation from normal loudness perception at various loudness levels and as function of frequency for an individual listener with hearing loss. CLS measurements were made in 87 participants with hearing loss and 61 participants with normal hearing. An assessment of the reliability of CLS measurements was conducted on a subset of the data. CLS measurements were reliable. There was a systematic increase in the slope of the low-level segment of the CLS functions with increase in the degree of hearing loss. ELCs derived from CLS measurements were similar to standardized ELCs (International Organization for Standardization, ISO 226:2003). The presence of hearing loss decreased the vertical spacing of the ELCs, reflecting loudness recruitment and reduced cochlear compression. Representing CLS data in phons may lead to wider acceptance of CLS measurements. Like the audiogram that specifies hearing loss at threshold, level-dependent loudness loss describes deficit for suprathreshold sounds. Such information may have implications for the fitting of hearing aids. PMID:25920842

Equivalent Noise Dose Obtained through Hearing Aids in the Classrooms of Hearing-Impaired Children.

ERIC Educational Resources Information Center

Wilde, Ronald A.

1990-01-01

A commercial noise dose meter was used to estimate the equivalent noise dose received through high-gain hearing aids worn in four classrooms in a school for deaf children. There were no significant differences among nominal saturation sound pressure level (SSPL) settings, and all SSPL settings produced very high equivalent noise doses. (Author/JDD)

HIV/AIDS Knowledge and Health-Related Attitudes and Behaviors among Deaf and Hearing Adolescents in Southern Brazil

ERIC Educational Resources Information Center

Bisol, Claudia Alquati; Sperb, Tania Mara; Brewer, Toye H.; Kato, Sergio Kakuta; Shor-Posner, Gail

2008-01-01

HIV/AIDS knowledge and health-related attitudes and behaviors among deaf and hearing adolescents in southern Brazil are described. Forty-two deaf students attending a special nonresidential public school for the deaf and 50 hearing students attending a regular public school, ages 15-21 years, answered a computer-assisted questionnaire. (There was…

Perception of Suprasegmental Speech Features via Bimodal Stimulation: Cochlear Implant on One Ear and Hearing Aid on the Other

ERIC Educational Resources Information Center

Most, Tova; Harel, Tamar; Shpak, Talma; Luntz, Michal

2011-01-01

Purpose: The purpose of the study was to evaluate the contribution of acoustic hearing to the perception of suprasegmental features by adults who use a cochlear implant (CI) and a hearing aid (HA) in opposite ears. Method: 23 adults participated in this study. Perception of suprasegmental features--intonation, syllable stress, and word…

Personal Style and Hearing Aid Fitting

PubMed Central

Traynor, Robert M.; Holmes, Alice E.

2002-01-01

Why do I have to drag information out of some patients? Why is another patient so talkative? Why didn't this patient like the XYZ 2002 digital hearing aid when she had the same degree, type, and configuration of hearing impairment as the patient I successfully fit last month? Could the answer be as basic as a difference in personality? PMID:25425907

Biologically inspired binaural hearing aid algorithms: Design principles and effectiveness

NASA Astrophysics Data System (ADS)

Feng, Albert

2002-05-01

Despite rapid advances in the sophistication of hearing aid technology and microelectronics, listening in noise remains problematic for people with hearing impairment. To solve this problem two algorithms were designed for use in binaural hearing aid systems. The signal processing strategies are based on principles in auditory physiology and psychophysics: (a) the location/extraction (L/E) binaural computational scheme determines the directions of source locations and cancels noise by applying a simple subtraction method over every frequency band; and (b) the frequency-domain minimum-variance (FMV) scheme extracts a target sound from a known direction amidst multiple interfering sound sources. Both algorithms were evaluated using standard metrics such as signal-to-noise-ratio gain and articulation index. Results were compared with those from conventional adaptive beam-forming algorithms. In free-field tests with multiple interfering sound sources our algorithms performed better than conventional algorithms. Preliminary intelligibility and speech reception results in multitalker environments showed gains for every listener with normal or impaired hearing when the signals were processed in real time with the FMV binaural hearing aid algorithm. [Work supported by NIH-NIDCD Grant No. R21DC04840 and the Beckman Institute.

Multichannel loudness compensation method based on segmented sound pressure level for digital hearing aids

NASA Astrophysics Data System (ADS)

Liang, Ruiyu; Xi, Ji; Bao, Yongqiang

2017-07-01

To improve the performance of gain compensation based on three-segment sound pressure level (SPL) in hearing aids, an improved multichannel loudness compensation method based on eight-segment SPL was proposed. Firstly, the uniform cosine modulated filter bank was designed. Then, the adjacent channels which have low or gradual slopes were adaptively merged to obtain the corresponding non-uniform cosine modulated filter according to the audiogram of hearing impaired persons. Secondly, the input speech was decomposed into sub-band signals and the SPL of every sub-band signal was computed. Meanwhile, the audible SPL range from 0 dB SPL to 120 dB SPL was equally divided into eight segments. Based on these segments, a different prescription formula was designed to compute more detailed gain to compensate according to the audiogram and the computed SPL. Finally, the enhanced signal was synthesized. Objective experiments showed the decomposed signals after cosine modulated filter bank have little distortion. Objective experiments showed that the hearing aids speech perception index (HASPI) and hearing aids speech quality index (HASQI) increased 0.083 and 0.082 on average, respectively. Subjective experiments showed the proposed algorithm can effectively improve the speech recognition of six hearing impaired persons.

Telecoil-mode hearing aid compatibility performance requirements for wireless and cordless handsets: magnetic signal levels.

PubMed

Julstrom, Stephen; Kozma-Spytek, Linda; Isabelle, Scott

2011-09-01

In the development of the requirements for telecoil-compatible magnetic signal sources for wireless and cordless telephones to be specified in the American National Standards Institute (ANSI) C63.19 and ANSI/Telecommunications Industry Association-1083 compatibility standards, it became evident that additional data concerning in-the-field telecoil use and subjective preferences were needed. Primarily, the magnetic signal levels and, secondarily, the field orientations required for effective and comfortable telecoil use with wireless and cordless handsets needed further characterization. (A companion article addresses user signal-to-noise needs and preferences.) Test subjects used their own hearing aids, which were addressed with both a controlled acoustic speech source and a controlled magnetic speech source. Each subject's hearing aid was first measured to find the telecoil's magnetic field orientation for maximum response, and an appropriate large magnetic head-worn coil was selected to apply the magnetic signal. Subjects could control the strength of the magnetic signal, first to match the loudness of a reference acoustic signal and then to find their Most Comfortable Level (MCL). The subjective judgments were compared against objective in-ear probe tube level measurements. The 57 test subjects covered an age range of 22 to 79 yr, with a self-reported hearing loss duration of 12 to 72 yr. All had telecoils that they used for at least some telecommunications needs. The self-reported degree of hearing loss ranged from moderate to profound. A total of 69 hearing aids were surveyed for their telecoil orientation. A guided intake questionnaire yielded general background information for each subject. A custom-built test jig enabled hearing aid telecoil orientation within the aid to be determined. By comparing this observation with the in-use hearing aid position, the in-use orientation for each telecoil was determined. A custom-built test control box fed by prepared speech recordings from computer files enabled the tester to switch between acoustic and magnetic speech signals and to read and record the subject's selected magnetic level settings. The overwhelming majority of behind-the-ear aids tested exhibited in-use telecoil orientations that were substantially vertical. An insufficient number of participants used in-the-ear aids to be able to draw general conclusions concerning the telecoil orientations of this style aid. The subjects showed a generally consistent preference for telecoil speech levels that subjectively matched the level that they heard from 65 dB SPL acoustic speech. The magnetic level needed to achieve their MCL, however, varied over a 30 dB range. Producing the necessary magnetic field strengths from a wireless or cordless telephone's handset in an in-use vertical orientation is vital for compatibility with the vast majority of behind-the-ear aids. Due to the very wide range of preferred magnetic signal levels shown, only indirect conclusions can be drawn concerning required signal levels. The strong preference for a 65 dB SPL equivalent level can be combined with established standards addressing hearing aid performance to derive reasonable source level requirements. Greater consistency between in-the-field hearing aid telecoil and microphone sensitivity adjustments could yield improved results for some users. American Academy of Audiology.

Auditory training and challenges associated with participation and compliance.

PubMed

Sweetow, Robert W; Sabes, Jennifer Henderson

2010-10-01

When individuals have hearing loss, physiological changes in their brain interact with relearning of sound patterns. Some individuals utilize compensatory strategies that may result in successful hearing aid use. Others, however, are not so fortunate. Modern hearing aids can provide audibility but may not rectify spectral and temporal resolution, susceptibility to noise interference, or degradation of cognitive skills, such as declining auditory memory and slower speed of processing associated with aging. Frequently, these deficits are not identified during a typical "hearing aid evaluation." Aural rehabilitation has long been advocated to enhance communication but has not been considered time or cost-effective. Home-based, interactive adaptive computer therapy programs are available that are designed to engage the adult hearing-impaired listener in the hearing aid fitting process, provide listening strategies, build confidence, and address cognitive changes. Despite the availability of these programs, many patients and professionals are reluctant to engage in and complete therapy. The purposes of this article are to discuss the need for identifying auditory and nonauditory factors that may adversely affect the overall audiological rehabilitation process, to discuss important features that should be incorporated into training, and to examine reasons for the lack of compliance with therapeutic options. Possible solutions to maximizing compliance are explored. Only a small portion of audiologists (fewer than 10%) offer auditory training to patients with hearing impairment, even though auditory training appears to lower the rate of hearing aid returns for credit. Patients to whom auditory training programs are recommended often do not complete the training, however. Compliance for a cohort of home-based auditory therapy trainees was less than 30%. Activities to increase patient compliance to auditory training protocols are proposed. American Academy of Audiology.

Theory-of-mind development in oral deaf children with cochlear implants or conventional hearing aids.

PubMed

Peterson, Candida C

2004-09-01

In the context of the established finding that theory-of-mind (ToM) growth is seriously delayed in late-signing deaf children, and some evidence of equivalent delays in those learning speech with conventional hearing aids, this study's novel contribution was to explore ToM development in deaf children with cochlear implants. Implants can substantially boost auditory acuity and rates of language growth. Despite the implant, there are often problems socialising with hearing peers and some language difficulties, lending special theoretical interest to the present comparative design. A total of 52 children aged 4 to 12 years took a battery of false belief tests of ToM. There were 26 oral deaf children, half with implants and half with hearing aids, evenly divided between oral-only versus sign-plus-oral schools. Comparison groups of age-matched high-functioning children with autism and younger hearing children were also included. No significant ToM differences emerged between deaf children with implants and those with hearing aids, nor between those in oral-only versus sign-plus-oral schools. Nor did the deaf children perform any better on the ToM tasks than their age peers with autism. Hearing preschoolers scored significantly higher than all other groups. For the deaf and the autistic children, as well as the preschoolers, rate of language development and verbal maturity significantly predicted variability in ToM, over and above chronological age. The finding that deaf children with cochlear implants are as delayed in ToM development as children with autism and their deaf peers with hearing aids or late sign language highlights the likely significance of peer interaction and early fluent communication with peers and family, whether in sign or in speech, in order to optimally facilitate the growth of social cognition and language.

Testing a Method for Quantifying the Output of Implantable Middle Ear Hearing Devices

PubMed Central

Rosowski, J.J.; Chien, W.; Ravicz, M.E.; Merchant, S.N.

2008-01-01

This report describes tests of a standard practice for quantifying the performance of implantable middle ear hearing devices (also known as implantable hearing aids). The standard and these tests were initiated by the Food and Drug Administration of the United States Government. The tests involved measurements on two hearing devices, one commercially available and the other home built, that were implanted into ears removed from human cadavers. The tests were conducted to investigate the utility of the practice and its outcome measures: the equivalent ear canal sound pressure transfer function that relates electrically driven middle ear velocities to the equivalent sound pressure needed to produce those velocities, and the maximum effective ear canal sound pressure. The practice calls for measurements in cadaveric ears in order to account for the varied anatomy and function of different human middle ears. PMID:17406105

47 CFR 20.19 - Hearing aid-compatible mobile handsets.

Code of Federal Regulations, 2011 CFR

2011-10-01

... handsets that incorporate a Wi-Fi air interface and that were obtained by the service provider before March... the handset has not been rated for hearing aid compatibility with respect to Wi-Fi operation. (3...

Left-right and front-back spatial hearing with multiple directional microphone configurations in modern hearing aids.

PubMed

Carette, Evelyne; Van den Bogaert, Tim; Laureyns, Mark; Wouters, Jan

2014-10-01

Several studies have demonstrated negative effects of directional microphone configurations on left-right and front-back (FB) sound localization. New processing schemes, such as frequency-dependent directionality and front focus with wireless ear-to-ear communication in recent, commercial hearing aids may preserve the binaural cues necessary for left-right localization and may introduce useful spectral cues necessary for FB disambiguation. In this study, two hearing aids with different processing schemes, which were both designed to preserve the ability to localize sounds in the horizontal plane (left-right and FB), were compared. We compared horizontal (left-right and FB) sound localization performance of hearing aid users fitted with two types of behind-the-ear (BTE) devices. The first type of BTE device had four different programs that provided (1) no directionality, (2-3) symmetric frequency-dependent directionality, and (4) an asymmetric configuration. The second pair of BTE devices was evaluated in its omnidirectional setting. This setting automatically activates a soft forward-oriented directional scheme that mimics the pinna effect. Also, wireless communication between the hearing aids was present in this configuration (5). A broadband stimulus was used as a target signal. The directional hearing abilities of the listeners were also evaluated without hearing aids as a reference. A total of 12 listeners with moderate to severe hearing loss participated in this study. All were experienced hearing-aid users. As a reference, 11 listeners with normal hearing participated. The participants were positioned in a 13-speaker array (left-right, -90°/+90°) or 7-speaker array (FB, 0-180°) and were asked to report the number of the loudspeaker located the closest to where the sound was perceived. The root mean square error was calculated for the left-right experiment, and the percentage of FB errors was used as a FB performance measure. RESULTS were analyzed with repeated-measures analysis of variance. For the left-right localization task, no significant differences could be proven between the unaided condition and both partial directional schemes and the omnidirectional scheme. The soft forward-oriented system and the asymmetric system did show a detrimental effect compared with the unaided condition. On average, localization was worst when users used the asymmetric condition. Analysis of the results of the FB experiment showed good performance, similar to unaided, with both the partial directional systems and the asymmetric configuration. Significantly worse performance was found with the omnidirectional and the omnidirectional soft forward-oriented BTE systems compared with the other hearing-aid systems. Bilaterally fitted partial directional systems preserve (part of) the binaural cues necessary for left-right localization and introduce, preserve, or enhance useful spectral cues that allow FB disambiguation. Omnidirectional systems, although good for left-right localization, do not provide the user with enough spectral information for an optimal FB localization performance. American Academy of Audiology.

37 CFR 41.47 - Oral hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... on and call the Board's attention to a recent court or Board opinion which could have an effect on the manner in which the appeal is decided. (k) Visual aids. Visual aids may be used at an oral hearing... copy of each visual aid (photograph in the case of an artifact, a model or an exhibit) for each judge...

Discrepancy between self-assessed hearing status and measured audiometric evaluation

PubMed Central

Kim, So Young; Kim, Hyung-Jong; Kim, Min-Su; Park, Bumjung; Kim, Jin-Hwan

2017-01-01

Objective The purpose of this study was to examine the difference between self-reported hearing status and hearing impairment assessed using conventional audiometry. The associated factors were examined when a concordance between self-reported hearing and audiometric measures was lacking. Methods In total, 19,642 individuals ≥20 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2009 through 2012 were enrolled. Pure-tone hearing threshold audiometry (PTA) was measured and classified into three levels: <25 dB (normal hearing); ≥25 dB <40 dB (mild hearing impairment); and ≥40 dB (moderate-to-severe hearing impairment). The self-reported hearing loss was categorized into 3 categories. The participants were categorized into three groups: the concordance (matched between self-reported hearing loss and audiometric PTA), overestimation (higher self-reported hearing loss compared to audiometric PTA), and underestimation groups (lower self-reported hearing loss compared to audiometric PTA). The associations of age, sex, education level, stress level, anxiety/depression, tympanic membrane (TM) status, hearing aid use, and tinnitus with the discrepancy between the hearing self-reported hearing loss and audiometric pure tone threshold results were analyzed using multinomial logistic regression analysis with complex sampling. Results Overall, 80.1%, 7.1%, and 12.8% of the participants were assigned to the concordance, overestimation, and underestimation groups, respectively. Older age (adjusted odds ratios [AORs] = 1.28 [95% confidence interval = 1.19–1.37] and 2.80 [2.62–2.99] for the overestimation and the underestimation groups, respectively), abnormal TM (2.17 [1.46–3.23] and 1.59 [1.17–2.15]), and tinnitus (2.44 [2.10–2.83] and 1.61 [1.38–1.87]) were positively correlated with both the overestimation and underestimation groups. Compared with specialized workers, service workers, manual workers, and the unemployed were more likely to be in the overestimation group (1.48 [1.11–1.98], 1.39 [1.04–1.86], and 1.50 [1.18–1.90], respectively), and service workers were more likely to be in the underestimation group (AOR = 1.42 [1.01–1.99]). Higher education level (0.77 [0.59–1.01] and 0.43 [0.33–0.57]) and hearing aid use (0.36 [0.17–0.77] and 0.23 [0.13–0.43]) were negatively associated with being in the underestimation group (0.43 [0.37–0.50]). Compared with males, females were less likely to be assigned to the underestimation group (0.43 [0.37–0.50]). Stress (1.98 [1.32–2.98]) and anxiety/depression (1.30 [1.06–1.59]) were associated with overestimation group. Conclusion Older age, lower education level, occupation, abnormal TM, non-hearing aid use, and tinnitus were related to both overestimation and underestimation groups. Male gender was related to underestimation, and stress and anxiety/depression were correlated with overestimation group. An understanding of these factors associated with the self-reported hearing loss will be instrumental to identifying and managing hearing-impaired individuals. PMID:28792529

Discrepancy between self-assessed hearing status and measured audiometric evaluation.

PubMed

Kim, So Young; Kim, Hyung-Jong; Kim, Min-Su; Park, Bumjung; Kim, Jin-Hwan; Choi, Hyo Geun

2017-01-01

The purpose of this study was to examine the difference between self-reported hearing status and hearing impairment assessed using conventional audiometry. The associated factors were examined when a concordance between self-reported hearing and audiometric measures was lacking. In total, 19,642 individuals ≥20 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2009 through 2012 were enrolled. Pure-tone hearing threshold audiometry (PTA) was measured and classified into three levels: <25 dB (normal hearing); ≥25 dB <40 dB (mild hearing impairment); and ≥40 dB (moderate-to-severe hearing impairment). The self-reported hearing loss was categorized into 3 categories. The participants were categorized into three groups: the concordance (matched between self-reported hearing loss and audiometric PTA), overestimation (higher self-reported hearing loss compared to audiometric PTA), and underestimation groups (lower self-reported hearing loss compared to audiometric PTA). The associations of age, sex, education level, stress level, anxiety/depression, tympanic membrane (TM) status, hearing aid use, and tinnitus with the discrepancy between the hearing self-reported hearing loss and audiometric pure tone threshold results were analyzed using multinomial logistic regression analysis with complex sampling. Overall, 80.1%, 7.1%, and 12.8% of the participants were assigned to the concordance, overestimation, and underestimation groups, respectively. Older age (adjusted odds ratios [AORs] = 1.28 [95% confidence interval = 1.19-1.37] and 2.80 [2.62-2.99] for the overestimation and the underestimation groups, respectively), abnormal TM (2.17 [1.46-3.23] and 1.59 [1.17-2.15]), and tinnitus (2.44 [2.10-2.83] and 1.61 [1.38-1.87]) were positively correlated with both the overestimation and underestimation groups. Compared with specialized workers, service workers, manual workers, and the unemployed were more likely to be in the overestimation group (1.48 [1.11-1.98], 1.39 [1.04-1.86], and 1.50 [1.18-1.90], respectively), and service workers were more likely to be in the underestimation group (AOR = 1.42 [1.01-1.99]). Higher education level (0.77 [0.59-1.01] and 0.43 [0.33-0.57]) and hearing aid use (0.36 [0.17-0.77] and 0.23 [0.13-0.43]) were negatively associated with being in the underestimation group (0.43 [0.37-0.50]). Compared with males, females were less likely to be assigned to the underestimation group (0.43 [0.37-0.50]). Stress (1.98 [1.32-2.98]) and anxiety/depression (1.30 [1.06-1.59]) were associated with overestimation group. Older age, lower education level, occupation, abnormal TM, non-hearing aid use, and tinnitus were related to both overestimation and underestimation groups. Male gender was related to underestimation, and stress and anxiety/depression were correlated with overestimation group. An understanding of these factors associated with the self-reported hearing loss will be instrumental to identifying and managing hearing-impaired individuals.

A case discussion on presbyacusis.

PubMed

Angadi, Savita S; Kotrannavar, Vijaykumar S

2013-01-01

Presbyacusis is one among the many socio-medical problems, which is considered as a hidden disability. The hearing impairment in elderly people is described as presbyacusis. Hearing problem among elderly people is a major issue and a person with hearing loss may be unable to hear doorbells and alarms, to respond while talking with anyone, etc. All this can make them feel frustrated, lonely, and depressed. It is the third most common chronic condition after arthritis and hypertensive diseases among elders. Hearing loss can be improved by using the hearing aids. Hearing aids work well for some while for others; it may not be a perfect solution due to many reasons such as some people do not buy aids that meet their needs, incorrect amplification adjustments, low custom design, etc. In classics of Ayurveda this ailment has been described as karnabaadhirya under the heading of ear diseases. Karnapurana (Instillation of medicated oil into the external auditory canal) is one of the major treatments for ear diseases explained in classics. Clinical observation has shown its effectiveness in the management of presbyacusis. A case report of 75-year-old male who presented with complaints of reduced hearing and tinnitus in both ears has been presented here.

A case discussion on presbyacusis

PubMed Central

Angadi, Savita S.; Kotrannavar, Vijaykumar S.

2013-01-01

Presbyacusis is one among the many socio-medical problems, which is considered as a hidden disability. The hearing impairment in elderly people is described as presbyacusis. Hearing problem among elderly people is a major issue and a person with hearing loss may be unable to hear doorbells and alarms, to respond while talking with anyone, etc. All this can make them feel frustrated, lonely, and depressed. It is the third most common chronic condition after arthritis and hypertensive diseases among elders. Hearing loss can be improved by using the hearing aids. Hearing aids work well for some while for others; it may not be a perfect solution due to many reasons such as some people do not buy aids that meet their needs, incorrect amplification adjustments, low custom design, etc. In classics of Ayurveda this ailment has been described as karnabaadhirya under the heading of ear diseases. Karnapurana (Instillation of medicated oil into the external auditory canal) is one of the major treatments for ear diseases explained in classics. Clinical observation has shown its effectiveness in the management of presbyacusis. A case report of 75-year-old male who presented with complaints of reduced hearing and tinnitus in both ears has been presented here. PMID:23741163

Early onset hearing loss in autosomal recessive hypophosphatemic rickets caused by loss of function mutation in ENPP1.

PubMed

Steichen-Gersdorf, Elisabeth; Lorenz-Depiereux, Bettina; Strom, Tim Matthias; Shaw, Nicholas J

2015-07-01

Autosomal recessive hypophosphatemic rickets 2 (ARHR2) is a rare form of renal tubular phosphate wasting disorder. Loss of function mutations of the ecto-nucleotide pyrophosphatase/pyrophosphodiesterase 1 gene (ENPP1) causes a wide spectrum of phenotypes, ranging from lethal generalized arterial calcification of infancy to hypophosphatemic rickets with hypertension. Hearing loss was not previously thought to be one of the features of the disease entities and was merely regarded as a complication rather than a part of the disease. We report two children who presented in mid to late childhood with progressive varus deformity of their legs due to hypophosphatemic rickets caused by mutations in the ENPP1 gene. Both children had evidence of progressive hearing loss requiring the use of hearing aids. This report of two unrelated infants with compound heterozygous mutations in ENPP1 and previously published cases confirms that mild to moderate hearing loss is frequently associated with ARHR2. Early onset conductive hearing loss may further distinguish the autosomal recessive ENPP1 related type from other types of hypophosphatemia.

Implications of High-Frequency Cochlear Dead Regions for Fitting Hearing Aids to Adults with Mild to Moderately-Severe Hearing Loss

PubMed Central

Cox, Robyn M.; Johnson, Jani A.; Alexander, Genevieve C.

2012-01-01

Short Summary It has been suggested that existence of high-frequency cochlear dead regions (DRs) has implications for hearing aid fitting, and that the optimal amount of high-frequency gain is reduced for these patients. This investigation used laboratory and field measurements to examine the effectiveness of reduced high-frequency gain in typical hearing aid users with high-frequency DRs. Both types of data revealed that speech understanding was better with the evidence-based prescription than with reduced high-frequency gain, and that this was seen for listeners with and without DRs. Nevertheless, subjects did not always prefer the amplification condition that produced better speech understanding. PMID:22555183

A tool for hearing aid and cochlear implant users to judge the usability of cellular telephones in field conditions

NASA Astrophysics Data System (ADS)

Deer, Maria Soledad

The auditory experience of using a hearing aid or a cochlear implant simultaneously with a cell phone is driven by a number of factors. These factors are: radiofrequency and baseband interference, speech intelligibility, sound quality, handset design, volume control and signal strength. The purpose of this study was to develop a tool to be used by hearing aid and cochlear implant users in retail stores as they try cell phones before buying them. This tool is meant to be an efficient, practical and systematic consumer selection tool that will capture and document information on all the domains that play a role in the auditory experience of using a cell phone with a hearing aid or cochlear implant. The development of this consumer tool involved three steps as follows: preparation, verification and measurement of success according to a predefined criterion. First, the consumer tool, consisting of a comparison chart and speech material, was prepared. Second, the consumer tool was evaluated by groups of subjects in a two-step verification process. Phase I was conducted in a controlled setting and it was followed by Phase II which took place in real world (field) conditions. In order to perform a systematic evaluation of the consumer tool two questionnaires were developed: one questionnaire for each phase. Both questionnaires involved five quantitative variables scored with the use of ratings scales. These ratings were averaged yielding an Overall Consumer Performance Score. A qualitative performance category corresponding to the Mean Opinion Score (MOS) was allocated to each final score within a scale ranging from 1 to 5 (where 5 = excellent and 1 = bad). Finally, the consumer tool development was determined to be successful if at least 80% of the participants in verification Phase II rated the comparison chart as excellent or good according to the qualitative MOS score. The results for verification Phase II (field conditions) indicated that the Overall Consumer Performance score for 92% of the subjects (11/12) was 3.7 and above corresponding to Good and Excellent MOS qualitative categories. It was concluded that this is a practical and efficient tool for hearing aid/cochlear implant users as they approach a cell phone selection process.

Dual Language versus English-Only Support for Bilingual Children with Hearing Loss Who Use Cochlear Implants and Hearing Aids

ERIC Educational Resources Information Center

Bunta, Ferenc; Douglas, Michael; Dickson, Hanna; Cantu, Amy; Wickesberg, Jennifer; Gifford, René H.

2016-01-01

Background: There is a critical need to understand better speech and language development in bilingual children learning two spoken languages who use cochlear implants (CIs) and hearing aids (HAs). The paucity of knowledge in this area poses a significant barrier to providing maximal communicative outcomes to a growing number of children who have…

High-Frequency Amplification and Sound Quality in Listeners with Normal through Moderate Hearing Loss

ERIC Educational Resources Information Center

Ricketts, Todd A.; Dittberner, Andrew B.; Johnson, Earl E.

2008-01-01

Purpose: One factor that has been shown to greatly affect sound quality is audible bandwidth. Provision of gain for frequencies above 4-6 kHz has not generally been supported for groups of hearing aid wearers. The purpose of this study was to determine if preference for bandwidth extension in hearing aid processed sounds was related to the…

A self-fitting hearing aid: need and concept.

PubMed

Convery, Elizabeth; Keidser, Gitte; Dillon, Harvey; Hartley, Lisa

2011-12-01

The need for reliable access to hearing health care services is growing globally, particularly in developing countries and in remotely located, underserved regions in many parts of the developed world. Individuals with hearing loss in these areas are at a significant disadvantage due to the scarcity of local hearing health care professionals and the high cost of hearing aids. Current approaches to making hearing rehabilitation services more readily available to underserved populations include teleaudiology and the provision of amplification devices outside of the traditional provider-client relationship. Both strategies require access to such resources as dedicated equipment and/or specially trained staff. Another possible strategy is a self-fitting hearing aid, a personal amplification device that is equipped with an onboard tone generator to enable user-controlled, automated, in situ audiometry; an onboard prescription to determine the initial hearing aid settings; and a trainable algorithm to enable user-controlled fine-tuning. The device is thus assembled, fitted, and managed by the user without the need for audiological or computer support. This article details the self-fitting concept and its potential application in both developing and developed countries. Potential advantages and disadvantages of such a device are discussed, and considerations for further investigations into the concept are presented. Overall, the concept is considered technologically viable with the main challenges anticipated to be development of clear, simple user instructions and a delivery model that ensures reliable supplies of instant-fit ear tips and batteries.

A Self-Fitting Hearing Aid

PubMed Central

Keidser, Gitte; Dillon, Harvey; Hartley, Lisa

2011-01-01

The need for reliable access to hearing health care services is growing globally, particularly in developing countries and in remotely located, underserved regions in many parts of the developed world. Individuals with hearing loss in these areas are at a significant disadvantage due to the scarcity of local hearing health care professionals and the high cost of hearing aids. Current approaches to making hearing rehabilitation services more readily available to underserved populations include teleaudiology and the provision of amplification devices outside of the traditional provider-client relationship. Both strategies require access to such resources as dedicated equipment and/or specially trained staff. Another possible strategy is a self-fitting hearing aid, a personal amplification device that is equipped with an onboard tone generator to enable user-controlled, automated, in situ audiometry; an onboard prescription to determine the initial hearing aid settings; and a trainable algorithm to enable user-controlled fine-tuning. The device is thus assembled, fitted, and managed by the user without the need for audiological or computer support. This article details the self-fitting concept and its potential application in both developing and developed countries. Potential advantages and disadvantages of such a device are discussed, and considerations for further investigations into the concept are presented. Overall, the concept is considered technologically viable with the main challenges anticipated to be development of clear, simple user instructions and a delivery model that ensures reliable supplies of instant-fit ear tips and batteries. PMID:22143873

The Benefit of Remote Microphones Using Four Wireless Protocols.

PubMed

Rodemerk, Krishna S; Galster, Jason A

2015-09-01

Many studies have reported the speech recognition benefits of a personal remote microphone system when used by adult listeners with hearing loss. The advance of wireless technology has allowed for many wireless audio transmission protocols. Some of these protocols interface with commercially available hearing aids. As a result, commercial remote microphone systems use a variety of different protocols for wireless audio transmission. It is not known how these systems compare, with regard to adult speech recognition in noise. The primary goal of this investigation was to determine the speech recognition benefits of four different commercially available remote microphone systems, each with a different wireless audio transmission protocol. A repeated-measures design was used in this study. Sixteen adults, ages 52 to 81 yr, with mild to severe sensorineural hearing loss participated in this study. Participants were fit with three different sets of bilateral hearing aids and four commercially available remote microphone systems (FM, 900 MHz, 2.4 GHz, and Bluetooth(®) paired with near-field magnetic induction). Speech recognition scores were measured by an adaptive version of the Hearing in Noise Test (HINT). The participants were seated both 6 and 12' away from the talker loudspeaker. Participants repeated HINT sentences with and without hearing aids and with four commercially available remote microphone systems in both seated positions with and without contributions from the hearing aid or environmental microphone (24 total conditions). The HINT SNR-50, or the signal-to-noise ratio required for correct repetition of 50% of the sentences, was recorded for all conditions. A one-way repeated measures analysis of variance was used to determine statistical significance of microphone condition. The results of this study revealed that use of the remote microphone systems statistically improved speech recognition in noise relative to unaided and hearing aid-only conditions across all four wireless transmission protocols at 6 and 12' away from the talker. Participants showed a significant improvement in speech recognition in noise when comparing four remote microphone systems with different wireless transmission methods to hearing aids alone. American Academy of Audiology.

Survey of Current Practice in the Fitting and Fine-Tuning of Common Signal-Processing Features in Hearing Aids for Adults.

PubMed

Anderson, Melinda C; Arehart, Kathryn H; Souza, Pamela E

2018-02-01

Current guidelines for adult hearing aid fittings recommend the use of a prescriptive fitting rationale with real-ear verification that considers the audiogram for the determination of frequency-specific gain and ratios for wide dynamic range compression. However, the guidelines lack recommendations for how other common signal-processing features (e.g., noise reduction, frequency lowering, directional microphones) should be considered during the provision of hearing aid fittings and fine-tunings for adult patients. The purpose of this survey was to identify how audiologists make clinical decisions regarding common signal-processing features for hearing aid provision in adults. An online survey was sent to audiologists across the United States. The 22 survey questions addressed four primary topics including demographics of the responding audiologists, factors affecting selection of hearing aid devices, the approaches used in the fitting of signal-processing features, and the strategies used in the fine-tuning of these features. A total of 251 audiologists who provide hearing aid fittings to adults completed the electronically distributed survey. The respondents worked in a variety of settings including private practice, physician offices, university clinics, and hospitals/medical centers. Data analysis was based on a qualitative analysis of the question responses. The survey results for each of the four topic areas (demographics, device selection, hearing aid fitting, and hearing aid fine-tuning) are summarized descriptively. Survey responses indicate that audiologists vary in the procedures they use in fitting and fine-tuning based on the specific feature, such that the approaches used for the fitting of frequency-specific gain differ from other types of features (i.e., compression time constants, frequency lowering parameters, noise reduction strength, directional microphones, feedback management). Audiologists commonly rely on prescriptive fitting formulas and probe microphone measures for the fitting of frequency-specific gain and rely on manufacturers' default settings and recommendations for both the initial fitting and the fine-tuning of signal-processing features other than frequency-specific gain. The survey results are consistent with a lack of published protocols and guidelines for fitting and adjusting signal-processing features beyond frequency-specific gain. To streamline current practice, a transparent evidence-based tool that enables clinicians to prescribe the setting of other features from individual patient characteristics would be desirable. American Academy of Audiology

Smartphone-Based System for Learning and Inferring Hearing Aid Settings

PubMed Central

Aldaz, Gabriel; Puria, Sunil; Leifer, Larry J.

2017-01-01

Background Previous research has shown that hearing aid wearers can successfully self-train their instruments’ gain-frequency response and compression parameters in everyday situations. Combining hearing aids with a smartphone introduces additional computing power, memory, and a graphical user interface that may enable greater setting personalization. To explore the benefits of self-training with a smartphone-based hearing system, a parameter space was chosen with four possible combinations of microphone mode (omnidirectional and directional) and noise reduction state (active and off). The baseline for comparison was the “untrained system,” that is, the manufacturer’s algorithm for automatically selecting microphone mode and noise reduction state based on acoustic environment. The “trained system” first learned each individual’s preferences, self-entered via a smartphone in real-world situations, to build a trained model. The system then predicted the optimal setting (among available choices) using an inference engine, which considered the trained model and current context (e.g., sound environment, location, and time). Purpose To develop a smartphone-based prototype hearing system that can be trained to learn preferred user settings. Determine whether user study participants showed a preference for trained over untrained system settings. Research Design An experimental within-participants study. Participants used a prototype hearing system—comprising two hearing aids, Android smartphone, and body-worn gateway device—for ~6 weeks. Study Sample Sixteen adults with mild-to-moderate sensorineural hearing loss (HL) (ten males, six females; mean age = 55.5 yr). Fifteen had ≥6 mo of experience wearing hearing aids, and 14 had previous experience using smartphones. Intervention Participants were fitted and instructed to perform daily comparisons of settings (“listening evaluations”) through a smartphone-based software application called Hearing Aid Learning and Inference Controller (HALIC). In the four-week-long training phase, HALIC recorded individual listening preferences along with sensor data from the smartphone—including environmental sound classification, sound level, and location—to build trained models. In the subsequent two-week-long validation phase, participants performed blinded listening evaluations comparing settings predicted by the trained system (“trained settings”) to those suggested by the hearing aids’ untrained system (“untrained settings”). Data Collection and Analysis We analyzed data collected on the smartphone and hearing aids during the study. We also obtained audiometric and demographic information. Results Overall, the 15 participants with valid data significantly preferred trained settings to untrained settings (paired-samples t test). Seven participants had a significant preference for trained settings, while one had a significant preference for untrained settings (binomial test). The remaining seven participants had nonsignificant preferences. Pooling data across participants, the proportion of times that each setting was chosen in a given environmental sound class was on average very similar. However, breaking down the data by participant revealed strong and idiosyncratic individual preferences. Fourteen participants reported positive feelings of clarity, competence, and mastery when training via HALIC. Conclusions The obtained data, as well as subjective participant feedback, indicate that smartphones could become viable tools to train hearing aids. Individuals who are tech savvy and have milder HL seem well suited to take advantages of the benefits offered by training with a smartphone. PMID:27718350

Other Products and Devices to Improve Hearing

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... and Consumer Devices Consumer Products Hearing Aids Other Products and Devices to Improve Hearing Share Tweet Linkedin ... no hearing in one ear. Personal Sound Amplification Products Personal Sound Amplification Products (PSAPs), or sound amplifiers, ...

Hearing handicap, rather than measured hearing impairment, predicts poorer quality of life over 10 years in older adults.

PubMed

Gopinath, Bamini; Schneider, Julie; Hickson, Louise; McMahon, Catherine M; Burlutsky, George; Leeder, Stephen R; Mitchell, Paul

2012-06-01

We aimed to determine the prospective association between measured hearing impairment, self-reported hearing handicap and hearing aid use with quality of life. 829 Blue Mountains Hearing Study participants (≥ 55 years) were examined between 1997-1999 and 2007-2009. The shortened version of the hearing handicap inventory was administered. Hearing levels were measured using pure-tone audiometry. Quality of life was assessed using the 36-Item Short-Form Survey (SF-36); higher scores reflect better quality of life. Hearing impairment at baseline compared with no impairment was associated with lower mean SF-36 mental composite score 10 years later (multivariable-adjusted p=0.03). Physical composite score and mean scores for seven of the eight SF-36 domains after 10-year follow-up were significantly lower among participants who self-reported hearing handicap at baseline. Differences in the adjusted means between participants with and without hearing handicap ranged from 2.7 (physical composite score) to 10.4 units ('role limitations due to physical problems' domain). Individuals who developed incident hearing impairment compared to those who did not, had adjusted mean scores 9.5- and 7.7-units lower in the 'role limitation due to physical problems', and 'bodily pain' domains, respectively, at the 10-year follow-up. Hearing aid users versus non-users at baseline showed a 1.82-point (p=0.03) and 3.32-point (p=0.01) increase in SF-36 mental composite score and mental health domain over the 10-year follow-up, respectively. Older adults with self-perceived hearing handicap constitute a potential risk group for overall deterioration in quality of life, while hearing aid use could help improve the well-being of hearing impaired adults. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Self-reported Hearing Trouble in Adults Aged 18 and Over: United States, 2014.

PubMed

Zelaya, Carla E; Lucas, Jacqueline W; Hoffman, Howard J

2015-09-01

Age is typically the most significant determinant of hearing loss (5,6). Among U.S. adults in 2014, self-reported hearing loss was most prevalent among adults aged 70 and over (43.2%), compared with adults aged 40-69 (19.0%) and aged 18-39 (5.5%). Age-related hearing loss is often overlooked due to its deceptively slow progression, lack of attention from providers, and public acceptance as a condition that is perceived to be a "normal" consequence of aging (7). Among U.S. adults aged 70 and over who had any trouble hearing, 56.8% had seen a doctor or other health care professional about their hearing or ear problems in the past 5 years, but only 42.0% had ever used a hearing aid. Younger adults (aged 18-39) who had any trouble hearing were even less likely to have seen a doctor or used a hearing aid, but they were more likely to have used other assistive technology because of their hearing compared with adults aged 40-69 or 70 and over. Among U.S. adults who had any trouble hearing without a hearing aid, 1.7% were deaf, but the majority (62.6%) had mild hearing loss (defined as "a little trouble hearing"). Men were more likely than women to have self-reported trouble hearing, a sex disparity that has been documented globally among all age groups (8). Men were also more likely than women to state they had moderate trouble hearing. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Feasibility of ecological momentary assessment of hearing difficulties encountered by hearing aid users

PubMed Central

Galvez, Gino; Turbin, Mitchel B.; Thielman, Emily J.; Istvan, Joseph A.; Andrews, Judy A.; Henry, James A.

2012-01-01

Objectives Measurement of outcomes has become increasingly important to assess the benefit of audiologic rehabilitation, including hearing aids, in adults. Data from questionnaires, however, are based on retrospective recall of events and experiences, and often can be inaccurate. Questionnaires also do not capture the daily variation that typically occurs in relevant events and experiences. Clinical researchers in a variety of fields have turned to a methodology known as ecological momentary assessment (EMA) to assess quotidian experiences associated with health problems. The objective of this study was to determine the feasibility of using EMA to obtain real-time responses from hearing aid users describing their experiences with challenging hearing situations. Design This study required three phases: (1) develop EMA methodology to assess hearing difficulties experienced by hearing aid users; (2) utilize focus groups to refine the methodology; and (3) test the methodology with 24 hearing aid users. Phase 3 participants carried a personal digital assistant (PDA) 12 hr per day for 2 wk. The PDA alerted participants to respond to questions four times a day. Each assessment started with a question to determine if a hearing problem was experienced since the last alert. If “yes,” then up to 23 questions (depending on contingent response branching) obtained details about the situation. If “no,” then up to 11 questions obtained information that would help to explain why hearing was not a problem. Each participant completed the Hearing Handicap Inventory for the Elderly (HHIE) both before and after the 2-wk EMA testing period to evaluate for “reactivity” (exacerbation of self-perceived hearing problems that could result from the repeated assessments). Results Participants responded to the alerts with a 77% compliance rate, providing a total of 991 completed momentary assessments (mean = 43.1 per participant). A substantial amount of data was obtained with the methodology. Notably, participants reported a “hearing problem situation since the last alert” 37.6% of the time (372 responses). The most common problem situation involved “face-to-face conversation” (53.8% of the time). The next most common problem situation was “telephone conversation” (17.2%) followed by “TV, radio, iPod, etc.” (15.3%), “environmental sounds” (9.7%), and “movies, lecture, etc.” (4.0%). Comparison of pre- and post-EMA mean HHIE scores revealed no significant difference (p>.05), indicating that reactivity did not occur for this group. It should be noted, however, that 37.5% of participants reported a greater sense of awareness regarding their hearing loss and use of hearing aids. Conclusions Results showed participants were compliant, gave positive feedback, and did not demonstrate reactivity based on pre- and post-HHIE scores. We conclude that EMA methodology is feasible with patients who use hearing aids and could potentially inform hearing healthcare (HHC) services. The next step is to develop and evaluate EMA protocols that provide detailed daily patient information to audiologists at each stage of HHC. The advantages of such an approach would be to obtain real-life outcome measures, and to determine within- and between-day variability in outcomes and associated factors. Such information currently is not available from patients who seek and use HHC services. PMID:22531573

Feasibility of ecological momentary assessment of hearing difficulties encountered by hearing aid users.

PubMed

Galvez, Gino; Turbin, Mitchel B; Thielman, Emily J; Istvan, Joseph A; Andrews, Judy A; Henry, James A

2012-01-01

Measurement of outcomes has become increasingly important to assess the benefit of audiologic rehabilitation, including hearing aids, in adults. Data from questionnaires, however, are based on retrospective recall of events and experiences, and often can be inaccurate. Questionnaires also do not capture the daily variation that typically occurs in relevant events and experiences. Clinical researchers in a variety of fields have turned to a methodology known as ecological momentary assessment (EMA) to assess quotidian experiences associated with health problems. The objective of this study was to determine the feasibility of using EMA to obtain real-time responses from hearing aid users describing their experiences with challenging hearing situations. This study required three phases: (1) develop EMA methodology to assess hearing difficulties experienced by hearing aid users; (2) make use of focus groups to refine the methodology; and (3) test the methodology with 24 hearing aid users. Phase 3 participants carried a personal digital assistant 12 hr per day for 2 weeks. The personal digital assistant alerted participants to respond to questions four times a day. Each assessment started with a question to determine whether a hearing problem was experienced since the last alert. If "yes," then up to 23 questions (depending on contingent response branching) obtained details about the situation. If "no," then up to 11 questions obtained information that would help to explain why hearing was not a problem. Each participant completed the Hearing Handicap Inventory for the Elderly (HHIE) both before and after the 2-week EMA testing period to evaluate for "reactivity" (exacerbation of self-perceived hearing problems that could result from the repeated assessments). Participants responded to the alerts with a 77% compliance rate, providing a total of 991 completed momentary assessments (mean = 43.1 per participant). A substantial amount of data were obtained with the methodology. It is important to note that participants reported a "hearing problem situation since the last alert" 37.6% of the time (372 responses). The most common problem situation involved "face-to-face conversation" (53.8% of the time). The next most common problem situation was "telephone conversation" (17.2%) followed by "TV, radio, iPod, etc." (15.3%), "environmental sounds" (9.7%), and "movies, lecture, etc." (4.0%). Comparison of pre- and post-EMA mean HHIE scores revealed no significant difference (p > 0.05), indicating that reactivity did not occur for this group. It should be noted, however, that 37.5% of participants reported a greater sense of awareness regarding their hearing loss and use of hearing aids. Results showed participants were compliant, gave positive feedback, and did not demonstrate reactivity based on pre- and post-HHIE scores. We conclude that EMA methodology is feasible with patients who use hearing aids and could potentially inform hearing healthcare (HHC) services. The next step is to develop and evaluate EMA protocols that provide detailed daily patient information to audiologists at each stage of HHC. The advantages of such an approach would be to obtain real-life outcome measures, and to determine within- and between-day variability in outcomes and associated factors. Such information at present is not available from patients who seek and use HHC services.

Paired comparisons of nonlinear frequency compression, extended bandwidth, and restricted bandwidth hearing-aid processing for children and adults with hearing loss

PubMed Central

Brennan, Marc A.; McCreery, Ryan; Kopun, Judy; Hoover, Brenda; Alexander, Joshua; Lewis, Dawna; Stelmachowicz, Patricia G.

2014-01-01

Background Preference for speech and music processed with nonlinear frequency compression and two controls (restricted and extended bandwidth hearing-aid processing) was examined in adults and children with hearing loss. Purpose Determine if stimulus type (music, sentences), age (children, adults) and degree of hearing loss influence listener preference for nonlinear frequency compression, restricted bandwidth and extended bandwidth. Research Design Within-subject, quasi-experimental study. Using a round-robin procedure, participants listened to amplified stimuli that were 1) frequency-lowered using nonlinear frequency compression, 2) low-pass filtered at 5 kHz to simulate the restricted bandwidth of conventional hearing aid processing, or 3) low-pass filtered at 11 kHz to simulate extended bandwidth amplification. The examiner and participants were blinded to the type of processing. Using a two-alternative forced-choice task, participants selected the preferred music or sentence passage. Study Sample Sixteen children (8–16 years) and 16 adults (19–65 years) with mild-to-severe sensorineural hearing loss. Intervention All subjects listened to speech and music processed using a hearing-aid simulator fit to the Desired Sensation Level algorithm v.5.0a (Scollie et al, 2005). Results Children and adults did not differ in their preferences. For speech, participants preferred extended bandwidth to both nonlinear frequency compression and restricted bandwidth. Participants also preferred nonlinear frequency compression to restricted bandwidth. Preference was not related to degree of hearing loss. For music, listeners did not show a preference. However, participants with greater hearing loss preferred nonlinear frequency compression to restricted bandwidth more than participants with less hearing loss. Conversely, participants with greater hearing loss were less likely to prefer extended bandwidth to restricted bandwidth. Conclusion Both age groups preferred access to high frequency sounds, as demonstrated by their preference for either the extended bandwidth or nonlinear frequency compression conditions over the restricted bandwidth condition. Preference for extended bandwidth can be limited for those with greater degrees of hearing loss, but participants with greater hearing loss may be more likely to prefer nonlinear frequency compression. Further investigation using participants with more severe hearing loss may be warranted. PMID:25514451

Hearing gain with a BAHA test-band in patients with single-sided deafness.

PubMed

Kim, Do-Youn; Kim, Tae Su; Shim, Byoung Soo; Jin, In Suk; Ahn, Joong Ho; Chung, Jong Woo; Yoon, Tae Hyun; Park, Hong Ju

2014-01-01

It is assumed that preoperative use of a bone-anchored hearing aid (BAHA) test-band will give a patient lower gain compared to real post-operative gain because of the reduction of energy through the scalp when using a test-band. Hearing gains using a BAHA test-band were analyzed in patients with unilateral hearing loss. Nineteen patients with unilateral sensorineural hearing loss were enrolled. A test-band, which was connected to BAHA Intenso with full-on gain, was put on the mastoid. Conventional air-conduction (AC) pure-tone averages (PTAs) and sound-field PTAs and speech reception thresholds (SRTs) were obtained in conditions A (the better ear naked), B (the better ear plugged), and C (the better ear plugged with a test-band on the poorer mastoid). Air-conduction PTAs of the poorer and better ears were 91 ± 19 and 18 ± 8 dB HL. Sound-field PTAs in condition B were higher than those in condition A (54 vs. 26 dB HL), which means that earplugs can block the sound grossly up to 54 dB HL through the better ears. The aided PTAs (24 ± 6 dB HL) in condition C were similar to those of the better ears in condition A (26±9 dB HL), though condition C showed higher thresholds at 500 Hz and lower thresholds at 1 and 2kHz when compared to condition A. The hearing thresholds using a test-band were similar to the published results of BAHA users with the volume to most comfortable level (MCL). Our findings showed that a BAHA test-band on the poorer ear could transmit sound to the cochlea as much as the better ears can hear. The increased functional gain at 1 and 2kHz reflects the technical characteristics of BAHA processor. The reduction of energy through the scalp when using a test-band seems to be offset by the difference of output by setting the volume to full-on gain and using a high-powered speech processor. Preoperative hearing gains using a test-band with full-on gain seems to be similar to the post-operative gains of BAHA users with the volume to MCL. © 2013.

Phonological Awareness in Deaf Children Who Use Cochlear Implants

ERIC Educational Resources Information Center

James, Deborah; Rajput, Kaukab; Brown, Tracey; Sirimanna, Tony; Brinton, Julie; Goswami, Usha

2005-01-01

A short-term longitudinal study was conducted to investigate possible benefits of cochlear implant (CI) use on the development of phonological awareness in deaf children. Nineteen CI users were tested on 2 occasions. Two groups of deaf children using hearing aids were tested once: 11 profoundly deaf and 10 severely deaf children. A battery of…

The Speech Intelligibility Index and the Pure-Tone Average as Predictors of Lexical Ability in Children Fit with Hearing Aids

ERIC Educational Resources Information Center

Stiles, Derek J.; Bentler, Ruth A.; McGregor, Karla K.

2012-01-01

Purpose: To determine whether a clinically obtainable measure of audibility, the aided Speech Intelligibility Index (SII; American National Standards Institute, 2007), is more sensitive than the pure-tone average (PTA) at predicting the lexical abilities of children who wear hearing aids (CHA). Method: School-age CHA and age-matched children with…

Ensuring Access to Higher Education: Simplifying Federal Student Aid for Today's College Student. Hearing of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Thirteenth Congress, First Session on Examining Ensuring Access to Higher Education, Focusing on Simplifying Federal Student Aid for Today's College Student (November 14, 2013). Senate Hearing 113-819

ERIC Educational Resources Information Center

US Senate, 2016

2016-01-01

This hearing is the third in a series examining critical issues in postsecondary education as the committee looks to reauthorize the Higher Education Act. The topic discussed is of paramount importance and is arguably the bedrock of Federal higher education policy, that is, the Federal financial aid programs and their effectiveness in providing…

PubMed Central

PALUDETTI, G.; CONTI, G.; DI NARDO, W.; DE CORSO, E.; ROLESI, R.; PICCIOTTI, P.M.; FETONI, A.R.

2012-01-01

SUMMARY Hearing loss is one of the most common disabilities and has lifelong consequences for affected children and their families. Both conductive and sensorineural hearing loss (SNHL) may be caused by a wide variety of congenital and acquired factors. Its early detection, together with appropriate intervention, is critical to speech, language and cognitive development in hearing-impaired children. In the last two decades, the application of universal neonatal hearing screening has improved identification of hearing loss early in life and facilitates early intervention. Developments in molecular medicine, genetics and neuroscience have improved the aetiological classification of hearing loss. Once deafness is established, a systematic approach to determining the cause is best undertaken within a dedicated multidisciplinary setting. This review addresses the innovative evidences on aetiology and management of deafness in children, including universal neonatal screening, advances in genetic diagnosis and the contribution of neuroimaging. Finally, therapy remains a major challenge in management of paediatric SNHL. Current approaches are represented by hearing aids and cochlear implants. However, recent advances in basic medicine which are identifying the mechanisms of cochlear damage and defective genes causing deafness, may represent the basis for novel therapeutic targets including implantable devices, auditory brainstem implants and cell therapy. PMID:23349554

Subjective and Objective Effects of Fast and Slow Compression on the Perception of Reverberant Speech in Listeners with Hearing Loss

ERIC Educational Resources Information Center

Shi, Lu-Feng; Doherty, Karen A.

2008-01-01

Purpose: The purpose of the current study was to assess the effect of fast and slow attack/release times (ATs/RTs) on aided perception of reverberant speech in quiet. Method: Thirty listeners with mild-to-moderate sensorineural hearing loss were tested monaurally with a commercial hearing aid programmed in 3 AT/RT settings: linear, fast (AT = 9…

The role of volunteer support in the community for adults with hearing loss and hearing aids.

PubMed

Pryce, Helen; Hall, Amanda; Gooberman-Hill, Rachael

2015-08-01

To explore interactions between audiology patients and volunteers, to describe encounters and define the role of volunteers. Qualitative ethnographic and interview study of volunteer-patient interactions. Ten volunteer participants from two volunteer schemes in South West England were observed and interviewed. Three patient participants were interviewed. Analysis of observational data showed that volunteers provided support relating to local services and hearing aids, but did not engage in discussions about hearing loss. Interviews with volunteers identified gaps in audiology provision, including accessible services and clear information and highlighted a need for more support from audiology services to enable them to fulfil their role. Volunteer interactions with patients mimicked a clinician-patient encounter and volunteers employed strategies and behaviours used by professional audiologists. Audiology volunteers could provide an accessible bridge between health services and the community but their care is limited to focus on hearing aids. Volunteers enable patients to use hearing aids appropriately and are a core element of current care arrangements. However, volunteers express a need for adequate support from audiology services. Volunteers have the potential to increase service capacity and to bridge the gaps between community and audiology healthcare services. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

A Trainable Hearing Aid Algorithm Reflecting Individual Preferences for Degree of Noise-Suppression, Input Sound Level, and Listening Situation.

PubMed

Yoon, Sung Hoon; Nam, Kyoung Won; Yook, Sunhyun; Cho, Baek Hwan; Jang, Dong Pyo; Hong, Sung Hwa; Kim, In Young

2017-03-01

In an effort to improve hearing aid users' satisfaction, recent studies on trainable hearing aids have attempted to implement one or two environmental factors into training. However, it would be more beneficial to train the device based on the owner's personal preferences in a more expanded environmental acoustic conditions. Our study aimed at developing a trainable hearing aid algorithm that can reflect the user's individual preferences in a more extensive environmental acoustic conditions (ambient sound level, listening situation, and degree of noise suppression) and evaluated the perceptual benefit of the proposed algorithm. Ten normal hearing subjects participated in this study. Each subjects trained the algorithm to their personal preference and the trained data was used to record test sounds in three different settings to be utilized to evaluate the perceptual benefit of the proposed algorithm by performing the Comparison Mean Opinion Score test. Statistical analysis revealed that of the 10 subjects, four showed significant differences in amplification constant settings between the noise-only and speech-in-noise situation ( P <0.05) and one subject also showed significant difference between the speech-only and speech-in-noise situation ( P <0.05). Additionally, every subject preferred different β settings for beamforming in all different input sound levels. The positive findings from this study suggested that the proposed algorithm has potential to improve hearing aid users' personal satisfaction under various ambient situations.

The factors associated with a self-perceived hearing handicap in elderly people with hearing impairment--results from a community-based study.

PubMed

Chang, Hsin-Pin; Ho, Chin-Yu; Chou, Pesus

2009-10-01

Elderly persons with a physiologic hearing deficit (hearing impairment) are not necessarily socially or emotionally disturbed by the deficit in everyday life (hearing handicap). The self-perception of a hearing handicap in elderly people is a key element in seeking consultation for a hearing impairment or using hearing aids. Thus, it is important to determine the factors associated with the self-perception of a hearing handicap. The aims of the present study were to report the relation between a hearing impairment and the self-perception of a hearing handicap, and the factors associated with a self-perceived hearing handicap among a group of randomly recruited, community-dwelling elderly persons, aged 65 yr and older, in Taipei, Taiwan. A cross-sectional survey of community-dwelling elderly persons aged 65 yr and older (N = 1220) participating in an annual general purpose geriatric health examination in 2005 in Taipei. Pure-tone audiometry and a questionnaire including the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) were administered, after obtaining the subject's consent to participate in the study. Demographic information, lifestyle, self-report health status, and biochemical data were also collected. There was a moderate association (gamma(s) = 0.52) between hearing impairment and self-perceived handicap. Only 21.4% of the study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL, N = 555) perceived themselves as hearing-handicapped (HHIE-S total score >or=10). Besides hearing level, marital status (widowed) and self-perceived general health (bad or neutral) were factors that are significantly associated with a self-perceived hearing handicap among elderly subjects with moderate to profound hearing impairment. For study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL), 5.0% of those with HHIE-S <10 and 45.4% of those with HHIE-S >or=10 used or felt that they required hearing aids (chi2 test, p < 0.001). These data suggested that a self-perceived hearing handicap (HHIE-S >or=10) is an important indicator for referral of elderly persons for hearing-aid fitting. Our study findings, consistent with those of previous studies, demonstrated that not all elderly persons with impaired hearing function (hearing impairment) perceived a hearing deficit socially or emotionally in everyday life (hearing handicap). Marital status (widowed) and bad/neutral general health were nonaudiologically associated factors with a hearing handicap in the present study. Further, those with a self-perceived hearing handicap reported a higher rate of the use of, or requirement for, hearing aids. Because hearing deterioration is a common biologic process of aging, the results of this study can be used to identify the groups among elderly people with a greater need for hearing screening and hearing rehabilitation services.

Assembly and insertion of a self-fitting hearing aid: design of effective instruction materials.

PubMed

Caposecco, Andrea; Hickson, Louise; Meyer, Carly

2011-12-01

A self-fitting hearing aid has been proposed as a viable option to meet the need for rehabilitation in areas where audiology services are unreliable. A successful outcome with a self-fitting hearing aid pivots in part on the clarity of the instructions accompanying the device. The aims of this article are (a) to review the literature to determine features that should be incorporated into written health-care materials and factors to consider in the design process when developing written instructions for a target audience of older adults and (b) to apply this information to the development of a set of written instructions as the first step in self-fitting of a hearing aid, assembling four parts and inserting the aid into the ear. The method involved a literature review of published peer reviewed research. The literature revealed four steps in the development of written health-care materials: planning, design, assessment of suitability, and pilot testing. Best practice design principles for each step were applied in the development of instructions for how to assemble and insert a hearing aid. Separate booklets were developed for the left and right aids and the content of each consisted of simple line drawings accompanied by captions. The reading level was Grade 3.5 equivalent and the Flesch Reading Ease Score was 91.1 indicating that the materials were "very easy" to read. It is essential to follow best practice design principles when developing written health-care materials to motivate the reader, maximize comprehension, and increase the likelihood of successful application of the content.

Assembly and Insertion of a Self-Fitting Hearing Aid

PubMed Central

Hickson, Louise; Meyer, Carly

2011-01-01

A self-fitting hearing aid has been proposed as a viable option to meet the need for rehabilitation in areas where audiology services are unreliable. A successful outcome with a self-fitting hearing aid pivots in part on the clarity of the instructions accompanying the device. The aims of this article are (a) to review the literature to determine features that should be incorporated into written health-care materials and factors to consider in the design process when developing written instructions for a target audience of older adults and (b) to apply this information to the development of a set of written instructions as the first step in self-fitting of a hearing aid, assembling four parts and inserting the aid into the ear. The method involved a literature review of published peer reviewed research. The literature revealed four steps in the development of written health-care materials: planning, design, assessment of suitability, and pilot testing. Best practice design principles for each step were applied in the development of instructions for how to assemble and insert a hearing aid. Separate booklets were developed for the left and right aids and the content of each consisted of simple line drawings accompanied by captions. The reading level was Grade 3.5 equivalent and the Flesch Reading Ease Score was 91.1 indicating that the materials were “very easy” to read. It is essential to follow best practice design principles when developing written health-care materials to motivate the reader, maximize comprehension, and increase the likelihood of successful application of the content. PMID:22389434

Assistive Hearing Technologies among Students with Hearing Impairment: Factors that Promote Satisfaction

ERIC Educational Resources Information Center

Rekkedal, Ann Mette

2012-01-01

Hearing technology can play an essential part in the education of deaf and hard-of-hearing children in inclusive schools. Few studies have examined these children's experiences with this technology. This article explores factors pertaining to children's use of and attitudes toward hearing technologies, such as hearing aids, cochlear implants,…

Effects of Compression on Speech Acoustics, Intelligibility, and Sound Quality

PubMed Central

Souza, Pamela E.

2002-01-01

The topic of compression has been discussed quite extensively in the last 20 years (eg, Braida et al., 1982; Dillon, 1996, 2000; Dreschler, 1992; Hickson, 1994; Kuk, 2000 and 2002; Kuk and Ludvigsen, 1999; Moore, 1990; Van Tasell, 1993; Venema, 2000; Verschuure et al., 1996; Walker and Dillon, 1982). However, the latest comprehensive update by this journal was published in 1996 (Kuk, 1996). Since that time, use of compression hearing aids has increased dramatically, from half of hearing aids dispensed only 5 years ago to four out of five hearing aids dispensed today (Strom, 2002b). Most of today's digital and digitally programmable hearing aids are compression devices (Strom, 2002a). It is probable that within a few years, very few patients will be fit with linear hearing aids. Furthermore, compression has increased in complexity, with greater numbers of parameters under the clinician's control. Ideally, these changes will translate to greater flexibility and precision in fitting and selection. However, they also increase the need for information about the effects of compression amplification on speech perception and speech quality. As evidenced by the large number of sessions at professional conferences on fitting compression hearing aids, clinicians continue to have questions about compression technology and when and how it should be used. How does compression work? Who are the best candidates for this technology? How should adjustable parameters be set to provide optimal speech recognition? What effect will compression have on speech quality? These and other questions continue to drive our interest in this technology. This article reviews the effects of compression on the speech signal and the implications for speech intelligibility, quality, and design of clinical procedures. PMID:25425919

Condom Advertising and AIDS. Hearing before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce. House of Representatives, One Hundredth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Energy and Commerce.

This document present witnesses' testimonies from the Congressional hearing called to examine condom advertising and Acquired Immune Deficiency Syndrome (AIDS). Opening statements are included by Congressmen Henry Waxman, William Dannemeyer, and Jim Bates. C. Everett Koop, United States Surgeon General, and Gary Noble, AIDS coordinator for the…

AIDS and Teenagers: Emerging Issues. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, One Hundredth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

This document presents testimonies from the Congressional hearing examining the Acquired Immunodeficiency Syndrome (AIDS) crisis and its impact on teenagers. Opening remarks from Representatives George Miller, Dan Coats, Ted Weiss, Ron Packard, and J. Roy Rowland stress the importance of determining how to protect adolescents from AIDS. C. Everett…

Rurality and determinants of hearing healthcare in adult hearing aid recipients.

PubMed

Chan, Stephen; Hixon, Brian; Adkins, Margaret; Shinn, Jennifer B; Bush, Matthew L

2017-10-01

The objective of this study was to compare the timing of hearing aid (HA) acquisition between adults in rural and urban communities. We hypothesized that time of acquisition of HA after onset of hearing loss is greater in rural adults compared with urban adults. Secondary objectives included assessment of socioeconomic/educational status and impact of hearing loss and hearing rehabilitation of urban and rural HA recipients. Cross-sectional questionnaire survey. We assessed demographics, timing of HA fitting from onset of hearing loss, and impact of hearing impairment in 336 adult HA recipients (273 urban, 63 rural) from a tertiary referral center. Amplification benefit was assessed using the International Outcome Inventory for Hearing Aids (IOI). The time to HA acquisition was greater for rural participants compared to urban participants (19.1 vs. 25.7 years, P = 0.024) for those with untreated hearing loss for at least 8 years. Age at hearing loss onset was correlated with time to HA acquisition (P = -0.54, P < 0.001). Rural HA participants experienced longer commutes to hearing specialists (68 vs. 32 minutes, P < 0.001), were less likely to achieve a degree beyond high school (P < 0.001), and were more likely to possess Medicaid coverage (P = 0.012) compared to urban participants. Hearing impairment caused job performance difficulty in 60% of all participants. Rural adults are at risk for delayed HA acquisition, which may be related to distance to hearing specialists. Further research is indicated to investigate barriers to care and expand access for vulnerable populations. 4. Laryngoscope, 127:2362-2367, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Audiovisual spoken word recognition as a clinical criterion for sensory aids efficiency in Persian-language children with hearing loss.

PubMed

Oryadi-Zanjani, Mohammad Majid; Vahab, Maryam; Bazrafkan, Mozhdeh; Haghjoo, Asghar

2015-12-01

The aim of this study was to examine the role of audiovisual speech recognition as a clinical criterion of cochlear implant or hearing aid efficiency in Persian-language children with severe-to-profound hearing loss. This research was administered as a cross-sectional study. The sample size was 60 Persian 5-7 year old children. The assessment tool was one of subtests of Persian version of the Test of Language Development-Primary 3. The study included two experiments: auditory-only and audiovisual presentation conditions. The test was a closed-set including 30 words which were orally presented by a speech-language pathologist. The scores of audiovisual word perception were significantly higher than auditory-only condition in the children with normal hearing (P<0.01) and cochlear implant (P<0.05); however, in the children with hearing aid, there was no significant difference between word perception score in auditory-only and audiovisual presentation conditions (P>0.05). The audiovisual spoken word recognition can be applied as a clinical criterion to assess the children with severe to profound hearing loss in order to find whether cochlear implant or hearing aid has been efficient for them or not; i.e. if a child with hearing impairment who using CI or HA can obtain higher scores in audiovisual spoken word recognition than auditory-only condition, his/her auditory skills have appropriately developed due to effective CI or HA as one of the main factors of auditory habilitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Does hearing in response to soft-tissue stimulation involve skull vibrations? A within-subject comparison between skull vibration magnitudes and hearing thresholds.

PubMed

Chordekar, Shai; Perez, Ronen; Adelman, Cahtia; Sohmer, Haim; Kishon-Rabin, Liat

2018-04-03

Hearing can be elicited in response to bone as well as soft-tissue stimulation. However, the underlying mechanism of soft-tissue stimulation is under debate. It has been hypothesized that if skull vibrations were the underlying mechanism of hearing in response to soft-tissue stimulation, then skull vibrations would be associated with hearing thresholds. However, if skull vibrations were not associated with hearing thresholds, an alternative mechanism is involved. In the present study, both skull vibrations and hearing thresholds were assessed in the same participants in response to bone (mastoid) and soft-tissue (neck) stimulation. The experimental group included five hearing-impaired adults in whom a bone-anchored hearing aid was implanted due to conductive or mixed hearing loss. Because the implant is exposed above the skin and has become an integral part of the temporal bone, vibration of the implant represented skull vibrations. To ensure that middle-ear pathologies of the experimental group did not affect overall results, hearing thresholds were also obtained in 10 participants with normal hearing in response to stimulation at the same sites. We found that the magnitude of the bone vibrations initiated by the stimulation at the two sites (neck and mastoid) detected by the laser Doppler vibrometer on the bone-anchored implant were linearly related to stimulus intensity. It was therefore possible to extrapolate the vibration magnitudes at low-intensity stimulation, where poor signal-to-noise ratio limited actual recordings. It was found that the vibration magnitude differences (between soft-tissue and bone stimulation) were not different than the hearing threshold differences at the tested frequencies. Results of the present study suggest that bone vibration magnitude differences can adequately explain hearing threshold differences and are likely to be responsible for the hearing sensation. Thus, the present results support the idea that bone and soft-tissue conduction could share the same underlying mechanism, namely the induction of bone vibrations. Studies with the present methodology should be continued in future work in order to obtain further insight into the underlying mechanism of activation of the hearing system. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of multichannel wide dynamic range compression and ChannelFree processing in open canal hearing instruments.

PubMed

Plyler, Patrick N; Reber, Monika Bertges; Kovach, Amanda; Galloway, Elisabeth; Humphrey, Elizabeth

2013-02-01

Multichannel wide dynamic range compression (WDRC) and ChannelFree processing have similar goals yet differ significantly in terms of signal processing. Multichannel WDRC devices divide the input signal into separate frequency bands; a separate level is determined within each frequency band; and compression in each band is based on the level within each band. ChannelFree processing detects the wideband level, and gain adjustments are based on the wideband signal level and adjusted up to 20,000 times per second. Although both signal processing strategies are currently available in hearing aids, it is unclear if differences in these signal processing strategies affect the performance and/or preference of the end user. The purpose of the research was to determine the effects of multichannel wide dynamic range compression and ChannelFree processing on performance and/or preference of listeners using open-canal hearing instruments. An experimental study in which subjects were exposed to a repeated measures design was utilized. Fourteen adult listeners with mild sloping to moderately severe sensorineural hearing loss participated (mean age 67 yr). Participants completed two 5 wk trial periods for each signal processing strategy. Probe microphone, behavioral and subjective measures were conducted unaided and aided at the end of each trial period. Behavioral and subjective results for both signal processing strategies were significantly better than unaided results; however, behavioral and subjective results were not significantly different between the signal processing strategies. Multichannel WDRC and ChannelFree processing are both effective signal processing strategies that provide significant benefit for hearing instrument users. Overall preference between the strategies may be related to the degree of hearing loss of the user, high-frequency in-situ levels, and/or acceptance of background noise. American Academy of Audiology.

The performance-perceptual test and its relationship to unaided reported handicap.

PubMed

Saunders, Gabrielle H; Forsline, Anna; Fausti, Stephen A

2004-04-01

Measurement of hearing aid outcomes is necessary for demonstration of treatment efficacy, third-party payment, and cost-benefit analysis. Outcomes are usually measured with hearing-related questionnaires and/or tests of speech recognition. However, results from these two types of test often conflict. In this paper, we provide data from a new test measure, known as the Performance-Perceptual Test (PPT), in which subjective and performance aspects of hearing in noise are measured using the same test materials and procedures. A Performance Speech Reception Threshold (SRTN) and a Perceptual SRTN are measured using the Hearing In Noise Test materials and adaptive procedure. A third variable, the discrepancy between these two SRTNs, is also computed. It measures the accuracy with which subjects assess their own hearing ability and is referred to as the Performance-Perceptual Discrepancy (PPDIS). One hundred seven subjects between 24 and 83 yr of age took part. Thirty-three subjects had normal hearing, while the remaining seventy-four had symmetrical sensorineural hearing loss. Of the subjects with impaired hearing, 24 wore hearing aids and 50 did not. All subjects underwent routine audiological examination and completed the PPT and the Hearing Handicap Inventory for the Elderly/Adults on two occasions, between 1 and 2 wk apart. The PPT was conducted for unaided listening with the masker level set to 50, 65, and 80 dB SPL. PPT data show that the subjects with normal hearing have significantly better Performance and Perceptual SRTNs at each test level than the subjects with impaired hearing but that PPDIS values do not differ between the groups. Test-retest reliability for the PPT is excellent (r-values > 0.93 for all conditions). Stepwise multiple regression analysis showed that the Performance SRTN, the PPDIS, and age explain 40% of the variance in reported handicap (Hearing Handicap Inventory for the Elderly/Adults scores). More specifically, poorer performance, underestimation of hearing ability and younger age result in greater reported handicap, and vice versa. Reported handicap consists of a performance component and a (mis)perception component, as measured by the Performance SRTN and the PPDIS respectively. The PPT should thus prove to be a valuable tool for better understanding why some individuals complain of hearing difficulties but have only a mild hearing loss or conversely report few difficulties in the presence of substantial impairment. The measure would thus seem to provide both an explanation and a counseling tool for patients for whom there is a mismatch between reported and measured hearing difficulties.

47 CFR 68.415 - Hearing aid-compatibility and volume control informal complaints.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Hearing aid-compatibility and volume control informal complaints. 68.415 Section 68.415 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint...

47 CFR 68.415 - Hearing aid-compatibility and volume control informal complaints.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Hearing aid-compatibility and volume control informal complaints. 68.415 Section 68.415 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint...

77 FR 41919 - Hearing Aid Compatibility Technical Standard

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

.... SUMMARY: The Wireless Telecommunications Bureau and the Office of Engineering and Technology (Bureaus) adopt the 2011 ANSI Standard for evaluating the hearing aid compatibility of wireless phones. The Bureaus take this action to ensure that a selection of digital wireless handset models is available to...