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.

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…

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.

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.

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

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.

[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.

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.

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.

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.

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…

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)

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.

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

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

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.

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.

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

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

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.

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.

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.

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.

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

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.

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

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.

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

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.

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

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.

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

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.

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.

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.

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

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.

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.

Advantage of bimodal fitting in prosody perception for children using a cochlear implant and a hearing aid.

PubMed

Straatman, L V; Rietveld, A C M; Beijen, J; Mylanus, E A M; Mens, L H M

2010-10-01

Cochlear implants are largely unable to encode voice pitch information, which hampers the perception of some prosodic cues, such as intonation. This study investigated whether children with a cochlear implant in one ear were better able to detect differences in intonation when a hearing aid was added in the other ear ("bimodal fitting"). Fourteen children with normal hearing and 19 children with bimodal fitting participated in two experiments. The first experiment assessed the just noticeable difference in F0, by presenting listeners with a naturally produced bisyllabic utterance with an artificially manipulated pitch accent. The second experiment assessed the ability to distinguish between questions and affirmations in Dutch words, again by using artificial manipulation of F0. For the implanted group, performance significantly improved in each experiment when the hearing aid was added. However, even with a hearing aid, the implanted group required exaggerated F0 excursions to perceive a pitch accent and to identify a question. These exaggerated excursions are close to the maximum excursions typically used by Dutch speakers. Nevertheless, the results of this study showed that compared to the implant only condition, bimodal fitting improved the perception of intonation.

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.

Speech recognition for bilaterally asymmetric and symmetric hearing aid microphone modes in simulated classroom environments.

PubMed

Ricketts, Todd A; Picou, Erin M

2013-09-01

This study aimed to evaluate the potential utility of asymmetrical and symmetrical directional hearing aid fittings for school-age children in simulated classroom environments. This study also aimed to evaluate speech recognition performance of children with normal hearing in the same listening environments. Two groups of school-age children 11 to 17 years of age participated in this study. Twenty participants had normal hearing, and 29 participants had sensorineural hearing loss. Participants with hearing loss were fitted with behind-the-ear hearing aids with clinically appropriate venting and were tested in 3 hearing aid configurations: bilateral omnidirectional, bilateral directional, and asymmetrical directional microphones. Speech recognition testing was completed in each microphone configuration in 3 environments: Talker-Front, Talker-Back, and Question-Answer situations. During testing, the location of the speech signal changed, but participants were always seated in a noisy, moderately reverberant classroom-like room. For all conditions, results revealed expected effects of directional microphones on speech recognition performance. When the signal of interest was in front of the listener, bilateral directional microphone was best, and when the signal of interest was behind the listener, bilateral omnidirectional microphone was best. Performance with asymmetric directional microphones was between the 2 symmetrical conditions. The magnitudes of directional benefits and decrements were not significantly correlated. In comparison with their peers with normal hearing, children with hearing loss performed similarly to their peers with normal hearing when fitted with directional microphones and the speech was from the front. In contrast, children with normal hearing still outperformed children with hearing loss if the speech originated from behind, even when the children were fitted with the optimal hearing aid microphone mode for the situation. Bilateral directional microphones can be effective in improving speech recognition performance for children in the classroom, as long as child is facing the talker of interest. Bilateral directional microphones, however, can impair performance if the signal originates from behind a listener. However, these data suggest that the magnitude of decrement is not predictable from an individual's benefit. The results re-emphasize the importance of appropriate switching between microphone modes so children can take full advantage of directional benefits without being hurt by directional decrements. An asymmetric fitting limits decrements, but does not lead to maximum speech recognition scores when compared with the optimal symmetrical fitting. Therefore, the asymmetric mode may not be the best option as a default fitting for children in a classroom environment. While directional microphones improve performance for children with hearing loss, their performance in most conditions continues to be impaired relative to their normal-hearing peers, particularly when the signals of interest originate from behind or from an unpredictable location.

Self-Fitting Hearing Aids

PubMed Central

Convery, Elizabeth

2016-01-01

A self-contained, self-fitting hearing aid (SFHA) is a device that enables the user to perform both threshold measurements leading to a prescribed hearing aid setting and fine-tuning, without the need for audiological support or access to other equipment. The SFHA has been proposed as a potential solution to address unmet hearing health care in developing countries and remote locations in the developed world and is considered a means to lower cost and increase uptake of hearing aids in developed countries. This article reviews the status of the SFHA and the evidence for its feasibility and challenges and predicts where it is heading. Devices that can be considered partly or fully self-fitting without audiological support were identified in the direct-to-consumer market. None of these devices are considered self-contained as they require access to other hardware such as a proprietary interface, computer, smartphone, or tablet for manipulation. While there is evidence that self-administered fitting processes can provide valid and reliable results, their success relies on user-friendly device designs and interfaces and easy-to-interpret instructions. Until these issues have been sufficiently addressed, optional assistance with the self-fitting process and on-going use of SFHAs is recommended. Affordability and a sustainable delivery system remain additional challenges for the SFHA in developing countries. Future predictions include a growth in self-fitting products, with most future SFHAs consisting of earpieces that connect wirelessly with a smartphone and providers offering assistance through a telehealth infrastructure, and the integration of SFHAs into the traditional hearing health-care model. PMID:27072929

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

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.

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

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.

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.

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.

Auditory processing disorders and problems with hearing-aid fitting in old age.

PubMed

Antonelli, A R

1978-01-01

The hearing handicap experienced by elderly subjects depends only partially on end-organ impairment. Not only the neural unit loss along the central auditory pathways contributes to decreased speech discrimination, but also learning processes are slowed down. Diotic listening in elderly people seems to fasten learning of discrimination in critical conditions, as in the case of sensitized speech. This fact, and the binaural gain through the binaural release from masking, stress the superiority, on theoretical grounds, of binaural over monaural hearing-aid fitting.

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

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.

[Dichotic digit test. Case].

PubMed

Zenker Castro, Franz; Fernández Belda, Rafael; Barajas de Prat, José Juan

2008-12-01

In this study we present a case of a 71-year-old female patient with sensorineural hearing loss and fitted with bilateral hearing aids. The patient complained of scant benefit from the hearing aid fitting with difficulties in understanding speech with background noise. The otolaryngology examination was normal. Audiological tests revealed bilateral sensorineural hearing loss with threshold values of 51 and 50 dB HL in the right and left ear. The Dichotic Digit Test was administered in a divided attention mode and focalizing the attention to each ear. Results in this test are consistent with a Central Auditory Processing Disorder.

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.

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

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.

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

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

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.

Outcomes With a Self-Fitting Hearing Aid.

PubMed

Keidser, Gitte; Convery, Elizabeth

2018-01-01

Self-fitting hearing aids (SFHAs)-devices that enable self-directed threshold measurements leading to a prescribed hearing aid (HA) setting, and fine-tuning, without the need for professional support-are now commercially available. This study examined outcomes obtained with one commercial SFHA, the Companion (SoundWorld Solutions), when support was available from a clinical assistant during self-fitting. Participants consisted of 27 experienced and 25 new HA users who completed the self-fitting process, resulting in 38 user-driven and 14 clinician-driven fittings. Following 12 weeks' experience with the SFHAs in the field, outcomes measured included the following: coupler gain and output, HA handling and management skills, speech recognition in noise, and self-reported benefit and satisfaction. In addition, the conventionally fitted HAs of 22 of the experienced participants who had user-driven fittings were evaluated. Irrespective of HA experience, the type of fitting (user- or clinician-driven) had no significant effect on coupler gain, speech recognition scores, or self-reported benefit and satisfaction. Users selected significantly higher low-frequency gain in the SFHAs when compared with the conventionally fitted HAs. The conventionally fitted HAs were rated significantly higher for benefit and satisfaction on some subscales due to negative issues with the physical design and implementation of the SFHAs, rather than who drove the fitting process. Poorer cognitive function was associated with poorer handling and management of the SFHAs. Findings suggest that with the right design and support, SFHAs may be a viable option to improve the accessibility of hearing health care.

Satisfaction with Hearing Aids Based on Technology and Style among Hearing Impaired Persons

PubMed Central

Faraji- Khiavi, Farzad; Dashti, Rezvan; Sameni, Seyyed-Jalal; Bayat, Arash

2016-01-01

Introduction: Hearing loss is one of the most disabling impairments. Using a hearing aid as an attempt to improve the hearing problem can positively affect the quality of life for these people. This research was aimed to assess satisfaction of hearing impaired patients with their hearing aids regarding the employed technology and style. Materials and Methods: This descriptive-analytic cross-sectional research was conducted on 187 subjects with hearing loss who were using a hearing aid. The subjects were over 18 years of age and were using a hearing aid for at least 6 months. The Persian version of Satisfaction with Amplification in Daily Life (SADL) questionnaire was the instrument which was used for assessing satisfaction with the hearing aid. Cronbach’s alpha was calculated to be 0.80 for instrument reliability. Results: A significant difference was observed among satisfaction subscales’ mean scores with hearing aid technology. Also a significant difference was observed between the total satisfaction score and the hearing aid model. With respect to the analysis of satisfaction with the hearing aid and its style, cost and services was the only subscale which showed a significant difference (P=0.005). Conclusion: Respondents using hearing aids with different technology and style were estimated to be quite satisfied. Training audiologists in using more appropriate and fitting hearing aids in addition to using self-reporting questionnaires like SADL for estimating patients’ social condition and participation in their life can essentially change their disability condition and countervail their hearing loss. PMID:27738608

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.

Using the Real-Ear-to-Coupler Difference within the American Academy of Audiology Pediatric Amplification Guideline: Protocols for Applying and Predicting Earmold RECDs.

PubMed

Moodie, Sheila; Pietrobon, Jonathan; Rall, Eileen; Lindley, George; Eiten, Leisha; Gordey, Dave; Davidson, Lisa; Moodie, K Shane; Bagatto, Marlene; Haluschak, Meredith Magathan; Folkeard, Paula; Scollie, Susan

2016-03-01

Real-ear-to-coupler difference (RECD) measurements are used for the purposes of estimating degree and configuration of hearing loss (in dB SPL ear canal) and predicting hearing aid output from coupler-based measures. Accurate measurements of hearing threshold, derivation of hearing aid fitting targets, and predictions of hearing aid output in the ear canal assume consistent matching of RECD coupling procedure (i.e., foam tip or earmold) with that used during assessment and in verification of the hearing aid fitting. When there is a mismatch between these coupling procedures, errors are introduced. The goal of this study was to quantify the systematic difference in measured RECD values obtained when using a foam tip versus an earmold with various tube lengths. Assuming that systematic errors exist, the second goal was to investigate the use of a foam tip to earmold correction for the purposes of improving fitting accuracy when mismatched RECD coupling conditions occur (e.g., foam tip at assessment, earmold at verification). Eighteen adults and 17 children (age range: 3-127 mo) participated in this study. Data were obtained using simulated ears of various volumes and earmold tubing lengths and from patients using their own earmolds. Derived RECD values based on simulated ear measurements were compared with RECD values obtained for adult and pediatric ears for foam tip and earmold coupling. Results indicate that differences between foam tip and earmold RECDs are consistent across test ears for adults and children which support the development of a correction between foam tip and earmold couplings for RECDs that can be applied across individuals. The foam tip to earmold correction values developed in this study can be used to provide improved estimations of earmold RECDs. This may support better accuracy in acoustic transforms related to transforming thresholds and/or hearing aid coupler responses to ear canal sound pressure level for the purposes of fitting behind-the-ear hearing aids. American Academy of Audiology.

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…

Clinical Experience of Using Cortical Auditory Evoked Potentials in the Treatment of Infant Hearing Loss in Australia

PubMed Central

Punch, Simone; Van Dun, Bram; King, Alison; Carter, Lyndal; Pearce, Wendy

2016-01-01

This article presents the clinical protocol that is currently being used within Australian Hearing for infant hearing aid evaluation using cortical auditory evoked potentials (CAEPs). CAEP testing is performed in the free field at two stimulus levels (65 dB sound pressure level [SPL], followed by 55 or 75 dB SPL) using three brief frequency-distinct speech sounds /m/, /ɡ/, and /t/, within a standard audiological appointment of up to 90 minutes. CAEP results are used to check or guide modifications of hearing aid fittings or to confirm unaided hearing capability. A retrospective review of 83 client files evaluated whether clinical practice aligned with the clinical protocol. It showed that most children could be assessed as part of their initial fitting program when they were identified as a priority for CAEP testing. Aided CAEPs were most commonly assessed within 8 weeks of the fitting. A survey of 32 pediatric audiologists provided information about their perception of cortical testing at Australian Hearing. The results indicated that clinical CAEP testing influenced audiologists' approach to rehabilitation and was well received by parents and that they were satisfied with the technique. Three case studies were selected to illustrate how CAEP testing can be used in a clinical environment. Overall, CAEP testing has been effectively integrated into the infant fitting program. PMID:27587921

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

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.

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

Hearing aid fitting in older persons with hearing impairment: the influence of cognitive function, age, and hearing loss on hearing aid benefit.

PubMed

Meister, Hartmut; Rählmann, Sebastian; Walger, Martin; Margolf-Hackl, Sabine; Kießling, Jürgen

2015-01-01

To examine the association of cognitive function, age, and hearing loss with clinically assessed hearing aid benefit in older hearing-impaired persons. Hearing aid benefit was assessed using objective measures regarding speech recognition in quiet and noisy environments as well as a subjective measure reflecting everyday situations captured using a standardized questionnaire. A broad range of general cognitive functions such as attention, memory, and intelligence were determined using different neuropsychological tests. Linear regression analyses were conducted with the outcome of the neuropsychological tests as well as age and hearing loss as independent variables and the benefit measures as dependent variables. Thirty experienced older hearing aid users with typical age-related hearing impairment participated. Most of the benefit measures revealed that the participants obtained significant improvement with their hearing aids. Regression models showed a significant relationship between a fluid intelligence measure and objective hearing aid benefit. When individual hearing thresholds were considered as an additional independent variable, hearing loss was the only significant contributor to the benefit models. Lower cognitive capacity - as determined by the fluid intelligence measure - was significantly associated with greater hearing loss. Subjective benefit could not be predicted by any of the variables considered. The present study does not give evidence that hearing aid benefit is critically associated with cognitive function in experienced hearing aid users. However, it was found that lower fluid intelligence scores were related to higher hearing thresholds. Since greater hearing loss was associated with a greater objective benefit, these results strongly support the advice of using hearing aids regardless of age and cognitive function to counter hearing loss and the adverse effects of age-related hearing impairment. Still, individual cognitive capacity might be relevant for hearing aid benefit during an initial phase of hearing aid provision if acclimatization has not yet taken place.

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.

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…

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

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

Auditory Processing Disorders

MedlinePlus

... Loss Hearing Loss in Seniors Hearing Aids General Information Types Features Fittings Assistive Listening & Alerting Devices Cochlear Implants Aural Rehabilitation Auditory Processing Disorders (APDs) Common Conditions Dizziness Tinnitus Who Are ...

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.

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.

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.

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

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.

The relationship between obligatory cortical auditory evoked potentials (CAEPs) and functional measures in young infants.

PubMed

Golding, Maryanne; Pearce, Wendy; Seymour, John; Cooper, Alison; Ching, Teresa; Dillon, Harvey

2007-02-01

Finding ways to evaluate the success of hearing aid fittings in young infants has increased in importance with the implementation of hearing screening programs. Cortical auditory evoked potentials (CAEP) can be recorded in infants and provides evidence for speech detection at the cortical level. The validity of this technique as a tool of hearing aid evaluation needs, however, to be demonstrated. The present study examined the relationship between the presence/absence of CAEPs to speech stimuli and the outcomes of a parental questionnaire in young infants who were fitted with hearing aids. The presence/absence of responses was determined by an experienced examiner as well as by a statistical measure, Hotelling's T(2). A statistically significant correlation between CAEPs and questionnaire scores was found using the examiner's grading (rs = 0.45) and using the statistical grading (rs = 0.41), and there was reasonably good agreement between traditional response detection methods and the statistical analysis.

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.

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

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.

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

Effect of occlusion, directionality and age on horizontal localization

NASA Astrophysics Data System (ADS)

Alworth, Lynzee Nicole

Localization acuity of a given listener is dependent upon the ability discriminate between interaural time and level disparities. Interaural time differences are encoded by low frequency information whereas interaural level differences are encoded by high frequency information. Much research has examined effects of hearing aid microphone technologies and occlusion separately and prior studies have not evaluated age as a factor in localization acuity. Open-fit hearing instruments provide new earmold technologies and varying microphone capabilities; however, these instruments have yet to be evaluated with regard to horizontal localization acuity. Thus, the purpose of this study is to examine the effects of microphone configuration, type of dome in open-fit hearing instruments, and age on the horizontal localization ability of a given listener. Thirty adults participated in this study and were grouped based upon hearing sensitivity and age (young normal hearing, >50 years normal hearing, >50 hearing impaired). Each normal hearing participant completed one localization experiment (unaided/unamplified) where they listened to the stimulus "Baseball" and selected the point of origin. Hearing impaired listeners were fit with the same two receiver-in-the-ear hearing aids and same dome types, thus controlling for microphone technologies, type of dome, and fitting between trials. Hearing impaired listeners completed a total of 7 localization experiments (unaided/unamplified; open dome: omnidirectional, adaptive directional, fixed directional; micromold: omnidirectional, adaptive directional, fixed directional). Overall, results of this study indicate that age significantly affects horizontal localization ability as younger adult listeners with normal hearing made significantly fewer localization errors than older adult listeners with normal hearing. Also, results revealed a significant difference in performance between dome type; however, upon further examination was not significant. Therefore, results examining type of dome should be viewed with caution. Results examining microphone configuration and microphone configuration by dome type were not significant. Moreover, results evaluating performance relative to unaided (unamplified) were not significant. Taken together, these results suggest open-fit hearing instruments, regardless of microphone or dome type, do not degrade horizontal localization acuity within a given listener relative to their 'older aged' normal hearing counterparts in quiet environments.

CONQUERING CHILDHOOD DEAFNESS, A NEW TECHNIQUE FOR OVERCOMING HEARING PROBLEMS IN INFANTS AND CHILDREN.

ERIC Educational Resources Information Center

GRIFFITHS, CIWA

A TECHNIQUE FOR OVERCOMING HEARING PROBLEMS IN INFANTS AND CHILDREN IS DESCRIBED IN THIS BOOK WHICH ALSO REPORTS ON 10 YEARS OF HEAR (HEARING EDUCATION THROUGH AUDITORY RESEARCH) FOUNDATION ACHIEVEMENTS. ANY CHILD IS ELIGIBLE FOR AUDIOMETRIC EVALUATION AND/OR THERAPY AT THE FOUNDATION, WHICH ROUTINELY FITS CHILDREN WITH BINAURAL AIDS. EXPLANATIONS…

A comparison between the first-fit settings of two multichannel digital signal-processing strategies: music quality ratings and speech-in-noise scores.

PubMed

Higgins, Paul; Searchfield, Grant; Coad, Gavin

2012-06-01

The aim of this study was to determine which level-dependent hearing aid digital signal-processing strategy (DSP) participants preferred when listening to music and/or performing a speech-in-noise task. Two receiver-in-the-ear hearing aids were compared: one using 32-channel adaptive dynamic range optimization (ADRO) and the other wide dynamic range compression (WDRC) incorporating dual fast (4 channel) and slow (15 channel) processing. The manufacturers' first-fit settings based on participants' audiograms were used in both cases. Results were obtained from 18 participants on a quick speech-in-noise (QuickSIN; Killion, Niquette, Gudmundsen, Revit, & Banerjee, 2004) task and for 3 music listening conditions (classical, jazz, and rock). Participants preferred the quality of music and performed better at the QuickSIN task using the hearing aids with ADRO processing. A potential reason for the better performance of the ADRO hearing aids was less fluctuation in output with change in sound dynamics. ADRO processing has advantages for both music quality and speech recognition in noise over the multichannel WDRC processing that was used in the study. Further evaluations of which DSP aspects contribute to listener preference are required.

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.

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.

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

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.

Methods and Applications of the Audibility Index in Hearing Aid Selection and Fitting

PubMed Central

Amlani, Amyn M.; Punch, Jerry L.; Ching, Teresa Y. C.

2002-01-01

During the first half of the 20th century, communications engineers at Bell Telephone Laboratories developed the articulation model for predicting speech intelligibility transmitted through different telecommunication devices under varying electroacoustic conditions. The profession of audiology adopted this model and its quantitative aspects, known as the Articulation Index and Speech Intelligibility Index, and applied these indices to the prediction of unaided and aided speech intelligibility in hearing-impaired listeners. Over time, the calculation methods of these indices—referred to collectively in this paper as the Audibility Index—have been continually refined and simplified for clinical use. This article provides (1) an overview of the basic principles and the calculation methods of the Audibility Index, the Speech Transmission Index and related indices, as well as the Speech Recognition Sensitivity Model, (2) a review of the literature on using the Audibility Index to predict speech intelligibility of hearing-impaired listeners, (3) a review of the literature on the applicability of the Audibility Index to the selection and fitting of hearing aids, and (4) a discussion of future scientific needs and clinical applications of the Audibility Index. PMID:25425917

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.

Factors Affecting Psychosocial and Motor Development in 3-Year-Old Children Who Are Deaf or Hard of Hearing

PubMed Central

Leigh, Greg; Ching, Teresa Y. C.; Crowe, Kathryn; Cupples, Linda; Marnane, Vivienne; Seeto, Mark

2015-01-01

Previous research has shown an association between children’s development of psychosocial and motor skills. This study evaluated the development of these skills in 301 three-year-old deaf and hard of hearing children (M: 37.8 months) and considered a range of possible predictors including gender, birth weight, age at first fitting with hearing devices, hearing device used, presence of additional disabilities, severity of hearing loss, maternal education, socio-economic status (SES), language ability, and communication mode. Caregivers reported on children’s development using the Child Development Inventory (CDI). On average, both psychosocial and motor development quotients were within the typical range for hearing children, with large individual differences. There was a positive correlation between language ability and both social and motor development, and also between social and motor development. Age at first fitting of hearing aids (as an indicator of age at identification of hearing loss), SES, degree of hearing loss, and maternal education were not significant predictors of social skill or motor development, whereas presence of additional disabilities and birth weight were. Girls performed better than boys on all but the Gross Motor subscale of the CDI. Children with hearing aids tended to perform better than those with cochlear implants on the Gross Motor subscale. PMID:26209447

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.

Achieving effective hearing aid fitting within one month after identification of childhood permanent hearing impairment.

PubMed

Bastanza, G; Gallus, R; De Carlini, M; Picciotti, P M; Muzzi, E; Ciciriello, E; Orzan, E; Conti, G

2016-02-01

Diagnosis of child permanent hearing impairment (PHI) can be made with extreme timeliness compared to the past thanks to improvements in PHI identification through newborn hearing screening programmes. It now becomes essential to provide an effective amplification as quickly as possible in order to restore auditory function and favour speech and language development. The early fitting of hearing aids and possible later cochlear implantation indeed prompts the development of central auditory pathways, connections with secondary sensory brain areas, as well as with motor and articulatory cortex. The aim of this paper is to report the results of a strategic analysis that involves identification of strengths, weaknesses, opportunities and threats regarding the process of achieving early amplification in all cases of significant childhood PHI. The analysis is focused on the Italian situation and is part of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children". © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

Perception of Consonants in Reverberation and Noise by Adults Fitted with Bimodal Devices

ERIC Educational Resources Information Center

Mason, Michelle; Kokkinakis, Kostas

2014-01-01

Purpose: The purpose of this study was to evaluate the contribution of a contralateral hearing aid to the perception of consonants, in terms of voicing, manner, and place-of-articulation cues in reverberation and noise by adult cochlear implantees aided by bimodal fittings. Method: Eight postlingually deafened adult cochlear implant (CI) listeners…

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.

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

Effects of Age on Auditory and Cognitive Processing: Implications for Hearing Aid Fitting and Audiologic Rehabilitation

PubMed Central

Pichora-Fuller, M. Kathleen; Singh, Gurjit

2006-01-01

Recent advances in research and clinical practice concerning aging and auditory communication have been driven by questions about age-related differences in peripheral hearing, central auditory processing, and cognitive processing. A “site-of-lesion” view based on anatomic levels inspired research to test competing hypotheses about the contributions of changes at these three levels of the nervous system. A “processing” view based on psychologic functions inspired research to test alternative hypotheses about how lower-level sensory processes and higher-level cognitive processes interact. In the present paper, we suggest that these two views can begin to be unified following the example set by the cognitive neuroscience of aging. The early pioneers of audiology anticipated such a unified view, but today, advances in science and technology make it both possible and necessary. Specifically, we argue that a synthesis of new knowledge concerning the functional neuroscience of auditory cognition is necessary to inform the design and fitting of digital signal processing in “intelligent” hearing devices, as well as to inform best practices for resituating hearing aid fitting in a broader context of audiologic rehabilitation. Long-standing approaches to rehabilitative audiology should be revitalized to emphasize the important role that training and therapy play in promoting compensatory brain reorganization as older adults acclimatize to new technologies. The purpose of the present paper is to provide an integrated framework for understanding how auditory and cognitive processing interact when older adults listen, comprehend, and communicate in realistic situations, to review relevant models and findings, and to suggest how new knowledge about age-related changes in audition and cognition may influence future developments in hearing aid fitting and audiologic rehabilitation. PMID:16528429

Outcomes of Early- and Late-identified Children at 3 Years of Age: Findings from a Prospective Population-based Study

PubMed Central

Ching, Teresa Y.C.; Dillon, Harvey; Marnane, Vivienne; Hou, Sanna; Day, Julia; Seeto, Mark; Crowe, Kathryn; Street, Laura; Thomson, Jessica; Van Buynder, Patricia; Zhang, Vicky; Wong, Angela; Burns, Lauren; Flynn, Christopher; Cupples, Linda; Cowan, Robert S.C.; Leigh, Greg; Sjahalam-King, Jessica; Yeh, Angel

2013-01-01

Objectives To address the question of whether, on a population level, early detection and amplification improve outcomes of children with hearing impairment. Design All families of children who were born between 2002 and 2007, and who presented for hearing services below 3 years of age at Australian Hearing pediatric centers in New South Wales, Victoria and Southern Queensland were invited to participate in a prospective study on outcomes. Children’s speech, language, functional and social outcomes were assessed at 3 years of age, using a battery of age-appropriate tests. Demographic information relating to the child, family, and educational intervention was solicited through the use of custom-designed questionnaires. Audiological data were collected from the national database of Australian Hearing and records held at educational intervention agencies for children. Regression analysis was used to investigate the effects of each of 15 predictor variables, including age of amplification, on outcomes. Results Four hundred and fifty-one children enrolled in the study, 56% of whom received their first hearing-aid fitting before 6 months of age. Based on clinical records, 44 children (10%) were diagnosed with auditory neuropathy spectrum disorder. There were 107 children (24%) reported to have additional disabilities. At 3 years of age, 317 children (70%) were hearing-aid users and 134 children (30%) used cochlear implants. Based on parent reports, about 71% used an aural/oral mode of communication, and about 79% used English as the spoken language at home. Children’s performance scores on standardized tests administered at 3 years of age were used in a factor analysis to derive a global development factor score. On average, the global score of hearing-impaired children was more than one standard deviation (SD) below the mean of normal-hearing children at the same age. Regression analysis revealed that five factors, including female gender, absence of additional disabilities, less severe hearing loss, higher maternal education; and for children with cochlear implants, earlier age of switch-on; were associated with better outcomes at the 5% significance level. Whereas the effect of age of hearing aid fitting on child outcomes was weak, a younger age at cochlear implant switch-on was significantly associated with better outcomes for children with cochlear implants at 3 years of age. Conclusions Fifty-six percent of the 451 children were fitted with hearing aids before 6 months of age. At 3 years of age, 134 children used cochlear implants and the remaining children used hearing aids. On average, outcomes were well below population norms. Significant predictors of child outcomes include: presence/absence of additional disabilities, severity of hearing loss, gender, maternal education; together with age of switch-on for children with cochlear implants. PMID:23462376

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.

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.

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.

The effect of multi-channel wide dynamic range compression, noise reduction, and the directional microphone on horizontal localization performance in hearing aid wearers.

PubMed

Keidser, Gitte; Rohrseitz, Kristin; Dillon, Harvey; Hamacher, Volkmar; Carter, Lyndal; Rass, Uwe; Convery, Elizabeth

2006-10-01

This study examined the effect that signal processing strategies used in modern hearing aids, such as multi-channel WDRC, noise reduction, and directional microphones have on interaural difference cues and horizontal localization performance relative to linear, time-invariant amplification. Twelve participants were bilaterally fitted with BTE devices. Horizontal localization testing using a 360 degrees loudspeaker array and broadband pulsed pink noise was performed two weeks, and two months, post-fitting. The effect of noise reduction was measured with a constant noise present at 80 degrees azimuth. Data were analysed independently in the left/right and front/back dimension and showed that of the three signal processing strategies, directional microphones had the most significant effect on horizontal localization performance and over time. Specifically, a cardioid microphone could decrease front/back errors over time, whereas left/right errors increased when different microphones were fitted to left and right ears. Front/back confusions were generally prominent. Objective measurements of interaural differences on KEMAR explained significant shifts in left/right errors. In conclusion, there is scope for improving the sense of localization in hearing aid users.

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

Using Speech Recall in Hearing Aid Fitting and Outcome Evaluation Under Ecological Test Conditions.

PubMed

Lunner, Thomas; Rudner, Mary; Rosenbom, Tove; Ågren, Jessica; Ng, Elaine Hoi Ning

2016-01-01

In adaptive Speech Reception Threshold (SRT) tests used in the audiological clinic, speech is presented at signal to noise ratios (SNRs) that are lower than those generally encountered in real-life communication situations. At higher, ecologically valid SNRs, however, SRTs are insensitive to changes in hearing aid signal processing that may be of benefit to listeners who are hard of hearing. Previous studies conducted in Swedish using the Sentence-final Word Identification and Recall test (SWIR) have indicated that at such SNRs, the ability to recall spoken words may be a more informative measure. In the present study, a Danish version of SWIR, known as the Sentence-final Word Identification and Recall Test in a New Language (SWIRL) was introduced and evaluated in two experiments. The objective of experiment 1 was to determine if the Swedish results demonstrating benefit from noise reduction signal processing for hearing aid wearers could be replicated in 25 Danish participants with mild to moderate symmetrical sensorineural hearing loss. The objective of experiment 2 was to compare direct-drive and skin-drive transmission in 16 Danish users of bone-anchored hearing aids with conductive hearing loss or mixed sensorineural and conductive hearing loss. In experiment 1, performance on SWIRL improved when hearing aid noise reduction was used, replicating the Swedish results and generalizing them across languages. In experiment 2, performance on SWIRL was better for direct-drive compared with skin-drive transmission conditions. These findings indicate that spoken word recall can be used to identify benefits from hearing aid signal processing at ecologically valid, positive SNRs where SRTs are insensitive.

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.

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.

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.

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

Predictors of Early Reading Skill in 5-Year-Old Children With Hearing Loss Who Use Spoken Language

PubMed Central

Ching, Teresa Y.C.; Crowe, Kathryn; Day, Julia; Seeto, Mark

2013-01-01

This research investigated the concurrent association between early reading skills and phonological awareness (PA), print knowledge, language, cognitive, and demographic variables in 101 5-year-old children with prelingual hearing losses ranging from mild to profound who communicated primarily using spoken language. All participants were fitted with hearing aids (n = 71) or cochlear implants (n = 30). They completed standardized assessments of PA, receptive vocabulary, letter knowledge, word and non-word reading, passage comprehension, math reasoning, and nonverbal cognitive ability. Multiple regressions revealed that PA (assessed using judgments of similarity based on words’ initial or final sounds) made a significant, independent contribution to children’s early reading ability (for both letters and words/non-words) after controlling for variation in receptive vocabulary, nonverbal cognitive ability, and a range of demographic variables (including gender, degree of hearing loss, communication mode, type of sensory device, age at fitting of sensory devices, and level of maternal education). Importantly, the relationship between PA and reading was specific to reading and did not generalize to another academic ability, math reasoning. Additional multiple regressions showed that letter knowledge (names or sounds) was superior in children whose mothers had undertaken post-secondary education, and that better receptive vocabulary was associated with less severe hearing loss, use of a cochlear implant, and earlier age at implant switch-on. Earlier fitting of hearing aids or cochlear implants was not, however, significantly associated with better PA or reading outcomes in this cohort of children, most of whom were fitted with sensory devices before 3 years of age. PMID:24563553

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.

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 SKI*HI Model: Programming for Hearing Impaired Infants through Home Intervention, Home Visit Curriculum. Fourth Edition.

ERIC Educational Resources Information Center

Clark, Thomas C.; Watkins, Susan

The manual describes the SKI*HI Model, a comprehensive approach to identification and home intervention treatment of hearing impaired children and their families. The model features home programing in four basic areas: the home hearing aid program (nine lessons which facilitate the proper fit and acceptance of amplification by the child), home…

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

Bulletin of Prosthetics Research. Rehabilitative Engineering Research and Development, Volume 18, Number 2, Fall 1981,

DTIC Science & Technology

1981-01-01

of 140 beats per minute Upper limb prosthetic terminal devices have remained un- could either crutch walk at 60 meters per minute or run at 134...Responses During Binaural Stimulation, TN. Decker and S.W. Howe; J. Functional Effectiveness of a Myo-Electric Prosthesis Compared Acoust. Soc. Amer., 69(4...were whether the aid(s) should be fitted monaurally, binaurally or fitted with hearing aids. Of these, roughly 9,000 were CROS. About 95 percent of

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

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.

Long-term tinnitus suppression with linear octave frequency transposition hearing AIDS.

PubMed

Peltier, Elisabeth; Peltier, Cedric; Tahar, Stephanie; Alliot-Lugaz, Evelyne; Cazals, Yves

2012-01-01

Over the last three years of hearing aid dispensing, it was observed that among 74 subjects fitted with a linear octave frequency transposition (LOFT) hearing aid, 60 reported partial or complete tinnitus suppression during day and night, an effect still lasting after several months or years of daily use. We report in more details on 38 subjects from whom we obtained quantified measures of tinnitus suppression through visual analog scaling and several additional psychoacoustic and audiometric measures. The long-term suppression seems independent of subject age, and of duration and subjective localization of tinnitus. A small but significant correlation was found with audiogram losses but not with high frequency loss slope. Long-term tinnitus suppression was observed for different etiologies, but with a low success rate for sudden deafness. It should be noted that a majority of subjects (23) had a history of noise exposure. Tinnitus suppression started after a few days of LOFT hearing aid use and reached a maximum after a few weeks of daily use. For nine subjects different amounts of frequency shifting were tried and found more or less successful for long-term tinnitus suppression, no correlation was found with tinnitus pitch. When the use of the LOFT hearing aid was stopped tinnitus reappeared within a day, and after re-using the LOFT aid it disappeared again within a day. For about one third of the 38 subjects a classical amplification or a non linear frequency compression aid was also tried, and no such tinnitus suppression was observed. Besides improvements in audiometric sensitivity to high frequencies and in speech discrimination scores, LOFT can be considered as a remarkable opportunity to suppress tinnitus over a long time scale. From a pathophysiological viewpoint these observations seem to fit with a possible re-attribution of activity to previously deprived cerebral areas corresponding to high frequency coding.

Amplification, Technology, and Cochlear Implants for Infants.

ERIC Educational Resources Information Center

Adam, Arlie J.

1993-01-01

Early amplification is crucial to efficient habilitation and development of oral communication skills in hearing-impaired infants. Initial evaluation and fitting of amplification is a joint effort by the audiologist, therapist, and parents, whether the child uses traditional hearing aids or cochlear implants, and should be supplemented by a…

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.

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.

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

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

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.

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options.

PubMed

Gordon, Karen; Henkin, Yael; Kral, Andrej

2015-07-01

Deafness affects ∼2 in 1000 children and is one of the most common congenital impairments. Permanent hearing loss can be treated by fitting hearing aids. More severe to profound deafness is an indication for cochlear implantation. Although newborn hearing screening programs have increased the identification of asymmetric hearing loss, parents and caregivers of children with single-sided deafness are often hesitant to pursue therapy for the deaf ear. Delayed intervention has consequences for recovery of hearing. It has long been reported that asymmetric hearing loss/single-sided deafness compromises speech and language development and educational outcomes in children. Recent studies in animal models of deafness and in children consistently show evidence of an "aural preference syndrome" in which single-sided deafness in early childhood reorganizes the developing auditory pathways toward the hearing ear, with weaker central representation of the deaf ear. Delayed therapy consequently compromises benefit for the deaf ear, with slow rates of improvement measured over time. Therefore, asymmetric hearing needs early identification and intervention. Providing early effective stimulation in both ears through appropriate fitting of auditory prostheses, including hearing aids and cochlear implants, within a sensitive period in development has a cardinal role for securing the function of the impaired ear and for restoring binaural/spatial hearing. The impacts of asymmetric hearing loss on the developing auditory system and on spoken language development have often been underestimated. Thus, the traditional minimalist approach to clinical management aimed at 1 functional ear should be modified on the basis of current evidence. Copyright © 2015 by the American Academy of Pediatrics.

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

Monitoring the efficiency of hearing aid fitting in the aged by the Social Hearing Handicap Index.

PubMed

von Wedel, H; von Wedel, U C; Streppel, M

1990-01-01

The unsatisfactory results obtained from tone and speech audiometric studies in identifying the effects of hearing disability, in particular the psychosocial factors, prompted us to adopt a psychological test to determine the "social hearing ability". The test consists of 20 questions which all relate to "social hearing ability" in urban society. Ten questions concern hearing ability in situations where background noise plays either a negligible role or none at all. The remaining 10 questions concern selectivity ability, that is hearing with additional background noise. The evaluation of the questionnaire results in a classification of the so-called Social Hearing Handicap Index (SHHI) in percentages together with a breakdown of the deafness components and the selectivity components into percentages. This differentiation provides additional information about the demands placed on the hearing ability of humans in quiet or noisy surroundings. The information obtained from the test enables longitudinal studies on the course of a hearing disability or the effectivity of a particular therapy, e.g. hearing aid, to be carried out in the elderly.

Subjective hearing-related quality-of-life is a major factor in the decision to continue using hearing aids among older persons.

PubMed

Maeda, Yukihide; Sugaya, Akiko; Nagayasu, Rie; Nakagawa, Atsuko; Nishizaki, Kazunori

2016-09-01

Audiological parameters alone do not determine the choice to use hearing aids (HA). Subjective hearing-related QoL is a major factor that determines whether or not an older person will continue to wear HA. This study aimed to identify which audiological parameters and quality-of-life (QoL) measures determine whether or not older persons will continue wearing HA. Charts of 157 patients aged ≥65 years who attended the HA service unit at the Otolaryngology Department were retrospectively reviewed. After HA fitting and a trial, the patients were divided into groups, depending upon whether or not they wanted to continue wearing the HA (users, 58.2%; non-users, 41.8%) and then audiological parameters were compared between them. At least 4 months after the HA fitting, the self-reported QoL questionnaire, Hearing Handicap Inventory for the Elderly (HHIE), was mailed to all 157 patients and HHIE scores were compared between HA users and non-users. Speech discrimination score and dynamic range did not significantly differ between HA users and non-users. A difference in the average hearing threshold was marginally significant. The response rate to the HHIE was 65.2%. Total HHIE and emotional scores were higher (more impaired) among HA users than non-users.

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.

[Norrie-Wardburg syndrome].

PubMed

Skevas, A; Kastanioudakis, I; Daniilidis, B; Exarchakos, G

1992-10-01

We describe a case of a 25-year old patient with typical Norrie-Warburg Syndrome. From the first year of his life he was found to be blind, with bilateral sensorineural loss of hearing. Audiological examination showed symmetrical moderate bilateral sensorineural hearing loss. His hearing loss was refractory to treatment for the last eight years. Because of timely diagnosis of hearing loss and timely fitting of a hearing aid, the patient could study at school and graduate from university education. Disease carriers who are clinically healthy can be identified only via chromosome analysis.

Vocabulary and Working Memory in Children Fit with Hearing Aids

ERIC Educational Resources Information Center

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

2012-01-01

Purpose: To determine whether children with mild-to-moderately severe sensorineural hearing loss (CHL) present with disturbances in working memory and whether these disturbances relate to the size of their receptive vocabularies. Method: Children 6 to 9 years of age participated. Aspects of working memory were tapped by articulation rate, forward…

Approaches to Selection and Fitting of Amplification for Infants and Toddlers.

ERIC Educational Resources Information Center

Beauchaine, Kathryn L.

This paper addresses three areas related to amplification for infants and toddlers with hearing impairments: (1) identification issues as they relate to early amplification; (2) selection of amplification; and (3) assessment of aided function. Identification issues discussed include the goal of early identification of hearing loss and the impact…

Autism and peripheral hearing loss: a systematic review.

PubMed

Beers, Alison N; McBoyle, Melanie; Kakande, Emily; Dar Santos, Rachelle C; Kozak, Frederick K

2014-01-01

To systematically review the literature describing the relationship between autism spectrum disorder (ASD) and peripheral hearing loss including literature recommendations for audiological assessment and auditory habilitation in cases where peripheral hearing loss and ASD coexist. Published studies indexed in MEDLINE (1948-2011). The search strategy identified 595 potential studies. After a review of the titles, 115 abstracts were reviewed and 39 articles were retrieved and assessed independently by at least two authors for possible inclusion. 22 articles pertained to children with ASD and peripheral hearing loss, hearing assessment in children with ASD, audiological habilitation for children with ASD or hyper-responsiveness in children with ASD. 17 further studies were garnered from the reference section of the 22 papers. Controversy exists in the literature regarding prevalence of hearing impairment among individuals with ASD. In cases where ASD and hearing impairment co-exist, diagnosis of one condition often leads to a delay in diagnosing the other. Audiological assessment can be difficult in children with ASD and test-retest reliability of behavioural thresholds can be poor. In cases where hearing impairment exists and hearing aids or cochlear implantation are recommended, devices are often fit with special considerations for the child with ASD. Hyper-responsiveness to auditory stimuli may be displayed by individuals with ASD. Evidence or the suspicion of hyper-responsiveness may be taken into consideration when fitting amplification and planning behavioural intervention. Prevalence rates of hearing impairment among individuals with ASD continue to be debated. At present there is no conclusive evidence that children with ASD are at increased risk of peripheral hearing loss. A complete audiological assessment is recommended in all cases where ASD is suspected so as not to delay the diagnosis of hearing impairment in the event that hearing loss and ASD co-exist. Objective assessment measures should be used to confirm behavioural testing in order to ensure reliability of audiological test results. Fitting of hearing aids or cochlear implantation are not contraindicated when hearing loss is present in children with ASD; however, success with these devices can be variable. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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.

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.

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

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.

Activity limitation and participation restriction in adults seeking hearing aid fitting and rehabilitation.

PubMed

Helvik, Anne-Sofie; Jacobsen, Geir; Wennberg, Siri; Arnesen, Haakon; Ringdahl, Anders; Hallberg, Lillemor R-M

2006-03-15

We first aimed to describe demographic and audiological characteristics of adults referred to a university hospital for hearing aid (HA) fitting and rehabilitation. Our second aim was to employ an inventory that assesses life consequences of hearing impairment (HI) in terms of perceived activity limitation and participation restriction for the first time in a Norwegian adult outpatient population. A third aim was to study life consequences by audiological and demographic characteristics. During one year consecutive patients (n = 343) were requested to answer the Hearing Disability and Handicap Scale (HDHS) assessing activity limitation and participation restriction in relation to an audiological examination and medical consultation. The mean threshold of hearing (MTH) was ascertained by pure tone thresholds at 0.5 - 1 - 2 - 4 kHz in the better ear. Activity limitation and participation restriction were both higher for HA experienced than HA naïve subjects ( p < 0.01). In a multivariable model, the explained adjusted variance of activity limitation (R2) was 43.4% with MTH, perceived duration, and severity of hearing problems as predictor variables. Correspondingly, the explained adjusted variance of participation restriction was 28.4% for a model with MTH, age, gender and perceived severity of hearing problems as predictors. As a standard supplement to audiometric tests, HDHS may be successfully applied as a clinical tool among similar hearing impaired outpatients in order to assess activity limitation and participation restriction as part of audiological rehabilitation.

[Effect of sound amplification on parent's communicative modalities].

PubMed

Couto, Maria Inês Vieira; Lichtig, Ida

2007-01-01

auditory rehabilitation in deaf children users of sign language. to verify the effects of sound amplification on parent's communicative modalities when interacting with their deaf children. participants were twelve deaf children, aged 50 to 80 months and their hearing parents. Children had severe or profound hearing loss in their better ear and were fitted with hearing aids in both ears. Children communicated preferably through sign language. The cause-effect relation between the children's auditory skills profile (insertion gain, functional gain and The Meaningful Auditory Integration Scale--MAIS) and the communicative modalities (auditive-oral, visuo-spacial, bimodal) used by parents was analyzed. Communicative modalities were compared in two different experimental situations during a structured interaction between parents and children, i.e. when children were not fitted with their hearing aids (Situation 1) and when children were fitted with them (Situation 2). Data was analyzed using descriptive statistics. the profile of the deaf children's auditory skills demonstrated to be lower than 53% (unsatisfactory). Parents used predominately the bimodal modality to gain children's attention, to transmit and to end tasks. A slight positive effect of sound amplification on the communicative modalities was observed, once parents presented more turn-takings during communication when using the auditory-oral modality in Situation 2. hearing parents tend to use more turn-takings during communication in the auditory-oral modality to gain children's attention, to transmit and to end tasks, since they observe an improvement in the auditory skills of their children.

Two Ears and Two (or More?) Devices: A Pediatric Case Study of Bilateral Profound Hearing Loss

PubMed Central

Uchanski, Rosalie M.; Davidson, Lisa S.; Quadrizius, Sharon; Reeder, Ruth; Cadieux, Jamie; Kettel, Jerrica; Chole, Richard A.

2009-01-01

Advances in technology and expanding candidacy guidelines have motivated many clinics to consider children with precipitously sloping high-frequency hearing loss as candidates for cochlear implants (CIs). A case study is presented of a pediatric CI patient whose hearing thresholds were preserved within 10 dB of preimplant levels (125–750 Hz) after receiving a fully inserted 31.5-mm electrode array at one ear. The primary goal of this study was to explore the possible benefit of using both a hearing aid (HA) and a CI at one ear while using a HA at the opposite ear. The authors find that although the use of bilateral hearing aids with a CI may only provide a slight benefit, careful attention must be paid to the coordinated fitting of devices, especially at the ear with two devices. PMID:19447765

Two ears and two (or more?) devices: a pediatric case study of bilateral profound hearing loss.

PubMed

Uchanski, Rosalie M; Davidson, Lisa S; Quadrizius, Sharon; Reeder, Ruth; Cadieux, Jamie; Kettel, Jerrica; Chole, Richard A

2009-06-01

Advances in technology and expanding candidacy guidelines have motivated many clinics to consider children with precipitously sloping high-frequency hearing loss as candidates for cochlear implants (CIs). A case study is presented of a pediatric CI patient whose hearing thresholds were preserved within 10 dB of preimplant levels (125-750 Hz) after receiving a fully inserted 31.5-mm electrode array at one ear. The primary goal of this study was to explore the possible benefit of using both a hearing aid (HA) and a CI at one ear while using a HA at the opposite ear. The authors find that although the use of bilateral hearing aids with a CI may only provide a slight benefit, careful attention must be paid to the coordinated fitting of devices, especially at the ear with two devices.

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 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

Directional hearing aid using hybrid adaptive beamformer (HAB) and binaural ITE array

NASA Astrophysics Data System (ADS)

Shaw, Scott T.; Larow, Andy J.; Gibian, Gary L.; Sherlock, Laguinn P.; Schulein, Robert

2002-05-01

A directional hearing aid algorithm called the Hybrid Adaptive Beamformer (HAB), developed for NIH/NIA, can be applied to many different microphone array configurations. In this project the HAB algorithm was applied to a new array employing in-the-ear microphones at each ear (HAB-ITE), to see if previous HAB performance could be achieved with a more cosmetically acceptable package. With diotic output, the average benefit in threshold SNR was 10.9 dB for three HoH and 11.7 dB for five normal-hearing subjects. These results are slightly better than previous results of equivalent tests with a 3-in. array. With an innovative binaural fitting, a small benefit beyond that provided by diotic adaptive beamforming was observed: 12.5 dB for HoH and 13.3 dB for normal-hearing subjects, a 1.6 dB improvement over the diotic presentation. Subjectively, the binaural fitting preserved binaural hearing abilities, giving the user a sense of space, and providing left-right localization. Thus the goal of creating an adaptive beamformer that simultaneously provides excellent noise reduction and binaural hearing was achieved. Further work remains before the HAB-ITE can be incorporated into a real product, optimizing binaural adaptive beamforming, and integrating the concept with other technologies to produce a viable product prototype. [Work supported by NIH/NIDCD.

Options for Auditory Training for Adults with Hearing Loss.

PubMed

Olson, Anne D

2015-11-01

Hearing aid devices alone do not adequately compensate for sensory losses despite significant technological advances in digital technology. Overall use rates of amplification among adults with hearing loss remain low, and overall satisfaction and performance in noise can be improved. Although improved technology may partially address some listening problems, auditory training may be another alternative to improve speech recognition in noise and satisfaction with devices. The literature underlying auditory plasticity following placement of sensory devices suggests that additional auditory training may be needed for reorganization of the brain to occur. Furthermore, training may be required to acquire optimal performance from devices. Several auditory training programs that are readily accessible for adults with hearing loss, hearing aids, or cochlear implants are described. Programs that can be accessed via Web-based formats and smartphone technology are reviewed. A summary table is provided for easy access to programs with descriptions of features that allow hearing health care providers to assist clients in selecting the most appropriate auditory training program to fit their needs.

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.

Acoustic properties of vocal singing in prelingually-deafened children with cochlear implants or hearing aids.

PubMed

Mao, Yitao; Zhang, Mengchao; Nutter, Heather; Zhang, Yijing; Zhou, Qixin; Liu, Qiaoyun; Wu, Weijing; Xie, Dinghua; Xu, Li

2013-11-01

The purpose of the present study was to investigate vocal singing performance of hearing-impaired children with cochlear implants (CI) and hearing aids (HA) as well as to evaluate the relationship between demographic factors of those hearing-impaired children and their singing ability. Thirty-seven prelingually-deafened children with CIs and 31 prelingually-deafened children with HAs, and 37 normal-hearing (NH) children participated in the study. The fundamental frequencies (F0) of each note in the recorded songs were extracted and the duration of each sung note was measured. Five metrics were used to evaluate the pitch-related and rhythm-based aspects of singing accuracy. Children with CIs and HAs showed significantly poorer performance in either the pitch-based assessments or the rhythm-based measure than the NH children. No significant differences were seen between the CI and HA groups in all of these measures except for the mean deviation of the pitch intervals. For both hearing-impaired groups, length of device use was significantly correlated with singing accuracy. There is a marked deficit in vocal singing ability either in pitch or rhythm accuracy in a majority of prelingually-deafened children who have received CIs or fitted with HAs. Although an increased length of device use might facilitate singing performance to some extent, the chance for the hearing-impaired children fitted with either HAs or CIs to reach high proficiency in singing is quite slim. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Binaural model-based dynamic-range compression.

PubMed

Ernst, Stephan M A; Kortlang, Steffen; Grimm, Giso; Bisitz, Thomas; Kollmeier, Birger; Ewert, Stephan D

2018-01-26

Binaural cues such as interaural level differences (ILDs) are used to organise auditory perception and to segregate sound sources in complex acoustical environments. In bilaterally fitted hearing aids, dynamic-range compression operating independently at each ear potentially alters these ILDs, thus distorting binaural perception and sound source segregation. A binaurally-linked model-based fast-acting dynamic compression algorithm designed to approximate the normal-hearing basilar membrane (BM) input-output function in hearing-impaired listeners is suggested. A multi-center evaluation in comparison with an alternative binaural and two bilateral fittings was performed to assess the effect of binaural synchronisation on (a) speech intelligibility and (b) perceived quality in realistic conditions. 30 and 12 hearing impaired (HI) listeners were aided individually with the algorithms for both experimental parts, respectively. A small preference towards the proposed model-based algorithm in the direct quality comparison was found. However, no benefit of binaural-synchronisation regarding speech intelligibility was found, suggesting a dominant role of the better ear in all experimental conditions. The suggested binaural synchronisation of compression algorithms showed a limited effect on the tested outcome measures, however, linking could be situationally beneficial to preserve a natural binaural perception of the acoustical environment.

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

Adult hearing-aid users with cochlear dead regions restricted to high frequencies: Implications for amplification.

PubMed

Pepler, Anna; Lewis, Kathryn; Munro, Kevin J

2016-01-01

Cochlear dead regions (DR) are common in adult hearing-aid users, but are usually restricted to high frequencies. The aim was to determine the benefit of high-frequency amplification for ears with and without high-frequency DRs. Participants were fitted with the study hearing aid and tested under four conditions: unfiltered (NAL-NL2 prescription), and low-pass filtered at 1.5, 2, and 3 kHz. VCV stimuli were presented at 65 dB (A) in quiet and in 20-talker babble at a signal-to-babble ratio of 0 dB. Experienced adult hearing-aid users: one group of 18 with a DR edge frequency above 1.5 kHz, and a group of 18 matched controls. Overall performance was best in the unfiltered condition. There was no significant difference in mean performance between the two groups when tested in quiet. However, the DR group obtained less benefit from high-frequency amplification when tested in babble: the mean difference between the unfiltered and 3-kHz filtered condition was 6% and 13% for the DR group and controls, respectively. In adults with a moderate hearing loss and a restricted DR, speech recognition was always best in the unfiltered condition, although mean performance in babble was lower for the DR group.

Should visual speech cues (speechreading) be considered when fitting hearing aids?

NASA Astrophysics Data System (ADS)

Grant, Ken

2002-05-01

When talker and listener are face-to-face, visual speech cues become an important part of the communication environment, and yet, these cues are seldom considered when designing hearing aids. Models of auditory-visual speech recognition highlight the importance of complementary versus redundant speech information for predicting auditory-visual recognition performance. Thus, for hearing aids to work optimally when visual speech cues are present, it is important to know whether the cues provided by amplification and the cues provided by speechreading complement each other. In this talk, data will be reviewed that show nonmonotonicity between auditory-alone speech recognition and auditory-visual speech recognition, suggesting that efforts designed solely to improve auditory-alone recognition may not always result in improved auditory-visual recognition. Data will also be presented showing that one of the most important speech cues for enhancing auditory-visual speech recognition performance, voicing, is often the cue that benefits least from amplification.

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

Measurements of acoustic impedance at the input to the occluded ear canal.

PubMed

Larson, V D; Nelson, J A; Cooper, W A; Egolf, D P

1993-01-01

Multi-frequency (multi-component) acoustic impedance measurements may evolve into a sensitive technique for the remote detection of aural pathologies. Such data are also relevant to models used in hearing aid design and could be an asset to the hearing aid prescription and fitting process. This report describes the development and use of a broad-band procedure which acquires impedance data in 20 Hz intervals and describes a comparison of data collected at two sites by different investigators. Mean data were in excellent agreement, and an explanation for a single case of extreme normal variability is presented.

Practical considerations for a second-order directional hearing aid microphone system

NASA Astrophysics Data System (ADS)

Thompson, Stephen C.

2003-04-01

First-order directional microphone systems for hearing aids have been available for several years. Such a system uses two microphones and has a theoretical maximum free-field directivity index (DI) of 6.0 dB. A second-order microphone system using three microphones could provide a theoretical increase in free-field DI to 9.5 dB. These theoretical maximum DI values assume that the microphones have exactly matched sensitivities at all frequencies of interest. In practice, the individual microphones in the hearing aid always have slightly different sensitivities. For the small microphone separation necessary to fit in a hearing aid, these sensitivity matching errors degrade the directivity from the theoretical values, especially at low frequencies. This paper shows that, for first-order systems the directivity degradation due to sensitivity errors is relatively small. However, for second-order systems with practical microphone sensitivity matching specifications, the directivity degradation below 1 kHz is not tolerable. A hybrid order directive system is proposed that uses first-order processing at low frequencies and second-order directive processing at higher frequencies. This hybrid system is suggested as an alternative that could provide improved directivity index in the frequency regions that are important to speech intelligibility.

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.

Repeated Measurement of Absolute and Relative Judgments of Loudness: Clinical Relevance for Prescriptive Fitting of Aided Target Gains for soft, Comfortable, and Loud, But Ok Sound Levels.

PubMed

Formby, Craig; Payne, JoAnne; Yang, Xin; Wu, Delphanie; Parton, Jason M

2017-02-01

This study was undertaken with the purpose of streamlining clinical measures of loudness growth to facilitate and enhance prescriptive fitting of nonlinear hearing aids. Repeated measures of loudness at 500 and 3,000 Hz were obtained bilaterally at monthly intervals over a 6-month period from three groups of young adult listeners. All volunteers had normal audiometric hearing sensitivity and middle ear function, and all denied problems related to sound tolerance. Group 1 performed judgments of soft and loud, but OK for presentation of ascending sound levels. We defined these judgments operationally as absolute judgments of loudness. Group 2 initially performed loudness judgments across a continuum of seven loudness categories ranging from judgments of very soft to uncomfortably loud for presentation of ascending sound levels per the Contour Test of Loudness; we defined these judgments as relative judgments of loudness. In the same session, they then performed the absolute judgments for soft and loud, but OK sound levels. Group 3 performed the same set of loudness judgments as did group 2, but the task order was reversed such that they performed the absolute judgments initially within each test session followed by the relative judgments. The key findings from this study were as follows: (1) Within group, the absolute and relative tasks yielded clinically similar judgments for soft and for loud, but OK sound levels. These judgments were largely independent of task order, ear, frequency, or trial order within a given session. (2) Loudness judgments increased, on average, by ∼3 dB between the first and last test session, which is consistent with the commonly reported acclimatization effect reported for incremental changes in loudness discomfort levels as a consequence of chronic bilateral hearing aid use. (3) Measured and predicted comfortable judgments of loudness were in good agreement for the individual listener and for groups of listeners. These comfortable judgments bisect the measured levels judged for soft and for loud, but OK sounds. (4) Loudness judgments within the same loudness category varied across listeners within group by as much as 50 to 60 dB. Such large variation in judgments of loudness is problematic, especially because hearing-impaired listeners are known to exhibit similarly large ranges of intersubject response variation and, yet, poplar prescriptive fitting strategies continue to use average rather than individual loudness data to fit nonlinear hearing aids. The primary conclusions drawn from these findings are that reliable absolute judgments of soft and loud, but OK are clinically practical and economical to measure and, from these judgments, good estimates of comfortable loudness can also be predicted for individuals or for groups of listeners. Such loudness data, as measured as described in this report, offer promise for streamlining and enhancing prescriptive fitting of nonlinear hearing aids to target gain settings for soft (audible), comfortable , and loud, but OK (tolerable) sound inputs for the individual listener.

Repeated Measurement of Absolute and Relative Judgments of Loudness: Clinical Relevance for Prescriptive Fitting of Aided Target Gains for soft, Comfortable, and Loud, But Ok Sound Levels

PubMed Central

Formby, Craig; Payne, JoAnne; Yang, Xin; Wu, Delphanie; Parton, Jason M.

2017-01-01

This study was undertaken with the purpose of streamlining clinical measures of loudness growth to facilitate and enhance prescriptive fitting of nonlinear hearing aids. Repeated measures of loudness at 500 and 3,000 Hz were obtained bilaterally at monthly intervals over a 6-month period from three groups of young adult listeners. All volunteers had normal audiometric hearing sensitivity and middle ear function, and all denied problems related to sound tolerance. Group 1 performed judgments of soft and loud, but OK for presentation of ascending sound levels. We defined these judgments operationally as absolute judgments of loudness. Group 2 initially performed loudness judgments across a continuum of seven loudness categories ranging from judgments of very soft to uncomfortably loud for presentation of ascending sound levels per the Contour Test of Loudness; we defined these judgments as relative judgments of loudness. In the same session, they then performed the absolute judgments for soft and loud, but OK sound levels. Group 3 performed the same set of loudness judgments as did group 2, but the task order was reversed such that they performed the absolute judgments initially within each test session followed by the relative judgments. The key findings from this study were as follows: (1) Within group, the absolute and relative tasks yielded clinically similar judgments for soft and for loud, but OK sound levels. These judgments were largely independent of task order, ear, frequency, or trial order within a given session. (2) Loudness judgments increased, on average, by ∼3 dB between the first and last test session, which is consistent with the commonly reported acclimatization effect reported for incremental changes in loudness discomfort levels as a consequence of chronic bilateral hearing aid use. (3) Measured and predicted comfortable judgments of loudness were in good agreement for the individual listener and for groups of listeners. These comfortable judgments bisect the measured levels judged for soft and for loud, but OK sounds. (4) Loudness judgments within the same loudness category varied across listeners within group by as much as 50 to 60 dB. Such large variation in judgments of loudness is problematic, especially because hearing-impaired listeners are known to exhibit similarly large ranges of intersubject response variation and, yet, poplar prescriptive fitting strategies continue to use average rather than individual loudness data to fit nonlinear hearing aids. The primary conclusions drawn from these findings are that reliable absolute judgments of soft and loud, but OK are clinically practical and economical to measure and, from these judgments, good estimates of comfortable loudness can also be predicted for individuals or for groups of listeners. Such loudness data, as measured as described in this report, offer promise for streamlining and enhancing prescriptive fitting of nonlinear hearing aids to target gain settings for soft (audible), comfortable, and loud, but OK (tolerable) sound inputs for the individual listener. PMID:28286363

Structured Counseling for Auditory Dynamic Range Expansion.

PubMed

Gold, Susan L; Formby, Craig

2017-02-01

A structured counseling protocol is described that, when combined with low-level broadband sound therapy from bilateral sound generators, offers audiologists a new tool for facilitating the expansion of the auditory dynamic range (DR) for loudness. The protocol and its content are specifically designed to address and treat problems that impact hearing-impaired persons who, due to their reduced DRs, may be limited in the use and benefit of amplified sound from hearing aids. The reduced DRs may result from elevated audiometric thresholds and/or reduced sound tolerance as documented by lower-than-normal loudness discomfort levels (LDLs). Accordingly, the counseling protocol is appropriate for challenging and difficult-to-fit persons with sensorineural hearing losses who experience loudness recruitment or hyperacusis. Positive treatment outcomes for individuals with the former and latter conditions are highlighted in this issue by incremental shifts (improvements) in LDL and/or categorical loudness judgments, associated reduced complaints of sound intolerance, and functional improvements in daily communication, speech understanding, and quality of life leading to improved hearing aid benefit, satisfaction, and aided sound quality, posttreatment.

Structured Counseling for Auditory Dynamic Range Expansion

PubMed Central

Gold, Susan L.; Formby, Craig

2017-01-01

A structured counseling protocol is described that, when combined with low-level broadband sound therapy from bilateral sound generators, offers audiologists a new tool for facilitating the expansion of the auditory dynamic range (DR) for loudness. The protocol and its content are specifically designed to address and treat problems that impact hearing-impaired persons who, due to their reduced DRs, may be limited in the use and benefit of amplified sound from hearing aids. The reduced DRs may result from elevated audiometric thresholds and/or reduced sound tolerance as documented by lower-than-normal loudness discomfort levels (LDLs). Accordingly, the counseling protocol is appropriate for challenging and difficult-to-fit persons with sensorineural hearing losses who experience loudness recruitment or hyperacusis. Positive treatment outcomes for individuals with the former and latter conditions are highlighted in this issue by incremental shifts (improvements) in LDL and/or categorical loudness judgments, associated reduced complaints of sound intolerance, and functional improvements in daily communication, speech understanding, and quality of life leading to improved hearing aid benefit, satisfaction, and aided sound quality, posttreatment. PMID:28286367

Language ability in children with permanent hearing impairment: the influence of early management and family participation.

PubMed

Watkin, Peter; McCann, Donna; Law, Catherine; Mullee, Mark; Petrou, Stavros; Stevenson, Jim; Worsfold, Sarah; Yuen, Ho Ming; Kennedy, Colin

2007-09-01

The goal was to examine the relationships between management after confirmation, family participation, and speech and language outcomes in the same group of children with permanent childhood hearing impairment. Speech, oral language, and nonverbal abilities, expressed as z scores and adjusted in a regression model, and Family Participation Rating Scale scores were assessed at a mean age of 7.9 years for 120 children with bilateral permanent childhood hearing impairment from a 1992-1997 United Kingdom birth cohort. Ages at institution of management and hearing aid fitting were obtained retrospectively from case notes. Compared with children managed later (> 9 months), those managed early (< or = 9 months) had higher adjusted mean z scores for both receptive and expressive language, relative to nonverbal ability, but not for speech. Compared with children aided later, a smaller group of more-impaired children aided early did not have significantly higher scores for these outcomes. Family Participation Rating Scale scores showed significant positive correlations with language and speech intelligibility scores only for those with confirmation after 9 months and were highest for those with late confirmed, severe/profound, permanent childhood hearing impairment. Early management of permanent childhood hearing impairment results in improved language. Family participation is also an important factor in cases that are confirmed late, especially for children with severe or profound permanent childhood hearing impairment.

Nonlinear Frequency Compression in Hearing Aids: Impact on Speech and Language Development

PubMed Central

Bentler, Ruth; Walker, Elizabeth; McCreery, Ryan; Arenas, Richard M.; Roush, Patricia

2015-01-01

Objectives The research questions of this study were: (1) Are children using nonlinear frequency compression (NLFC) in their hearing aids getting better access to the speech signal than children using conventional processing schemes? The authors hypothesized that children whose hearing aids provided wider input bandwidth would have more access to the speech signal, as measured by an adaptation of the Speech Intelligibility Index, and (2) are speech and language skills different for children who have been fit with the two different technologies; if so, in what areas? The authors hypothesized that if the children were getting increased access to the speech signal as a result of their NLFC hearing aids (question 1), it would be possible to see improved performance in areas of speech production, morphosyntax, and speech perception compared with the group with conventional processing. Design Participants included 66 children with hearing loss recruited as part of a larger multisite National Institutes of Health–funded study, Outcomes for Children with Hearing Loss, designed to explore the developmental outcomes of children with mild to severe hearing loss. For the larger study, data on communication, academic and psychosocial skills were gathered in an accelerated longitudinal design, with entry into the study between 6 months and 7 years of age. Subjects in this report consisted of 3-, 4-, and 5-year-old children recruited at the North Carolina test site. All had at least at least 6 months of current hearing aid usage with their NLFC or conventional amplification. Demographic characteristics were compared at the three age levels as well as audibility and speech/language outcomes; speech-perception scores were compared for the 5-year-old groups. Results Results indicate that the audibility provided did not differ between the technology options. As a result, there was no difference between groups on speech or language outcome measures at 4 or 5 years of age, and no impact on speech perception (measured at 5 years of age). The difference in Comprehensive Assessment of Spoken Language and mean length of utterance scores for the 3-year-old group favoring the group with conventional amplification may be a consequence of confounding factors such as increased incidence of prematurity in the group using NLFC. Conclusions Children fit with NLFC had similar audibility, as measured by a modified Speech Intelligibility Index, compared with a matched group of children using conventional technology. In turn, there were no differences in their speech and language abilities. PMID:24892229

Nonlinear frequency compression in hearing aids: impact on speech and language development.

PubMed

Bentler, Ruth; Walker, Elizabeth; McCreery, Ryan; Arenas, Richard M; Roush, Patricia

2014-01-01

The research questions of this study were: (1) Are children using nonlinear frequency compression (NLFC) in their hearing aids getting better access to the speech signal than children using conventional processing schemes? The authors hypothesized that children whose hearing aids provided wider input bandwidth would have more access to the speech signal, as measured by an adaptation of the Speech Intelligibility Index, and (2) are speech and language skills different for children who have been fit with the two different technologies; if so, in what areas? The authors hypothesized that if the children were getting increased access to the speech signal as a result of their NLFC hearing aids (question 1), it would be possible to see improved performance in areas of speech production, morphosyntax, and speech perception compared with the group with conventional processing. Participants included 66 children with hearing loss recruited as part of a larger multisite National Institutes of Health-funded study, Outcomes for Children with Hearing Loss, designed to explore the developmental outcomes of children with mild to severe hearing loss. For the larger study, data on communication, academic and psychosocial skills were gathered in an accelerated longitudinal design, with entry into the study between 6 months and 7 years of age. Subjects in this report consisted of 3-, 4-, and 5-year-old children recruited at the North Carolina test site. All had at least at least 6 months of current hearing aid usage with their NLFC or conventional amplification. Demographic characteristics were compared at the three age levels as well as audibility and speech/language outcomes; speech-perception scores were compared for the 5-year-old groups. Results indicate that the audibility provided did not differ between the technology options. As a result, there was no difference between groups on speech or language outcome measures at 4 or 5 years of age, and no impact on speech perception (measured at 5 years of age). The difference in Comprehensive Assessment of Spoken Language and mean length of utterance scores for the 3-year-old group favoring the group with conventional amplification may be a consequence of confounding factors such as increased incidence of prematurity in the group using NLFC. Children fit with NLFC had similar audibility, as measured by a modified Speech Intelligibility Index, compared with a matched group of children using conventional technology. In turn, there were no differences in their speech and language abilities.

Improving Collaborative Behaviour Planning in Adult Auditory Rehabilitation: Development of the I-PLAN Intervention Using the Behaviour Change Wheel.

PubMed

Barker, Fiona; Lusignan, Simon de; Deborah, Cooke

2018-05-18

The consequences of poorly managed hearing loss can be ameliorated with hearing aid use but rates of use are sub-optimal. The impact of audiologist behaviour on subsequent use, particularly over the long term, is unknown. This study aimed to describe the role of the behaviour change wheel in developing an intervention to introduce and embed particular clinical behaviours into adult hearing aid fitting consultations, within the framework of the Medical Research Council guidance on complex interventions. Following the steps of the behaviour change wheel, audiologist behaviours that might influence hearing aid use were identified based on a systematic review and qualitative work with audiologists. An analysis, using the COM-B model, identified potential drivers of the target behaviours. This was used to select intervention functions and behaviour change techniques likely to influence behaviour in this context. The target behaviours were as follows: giving information about the benefits of hearing aid use and the negative consequences of non-use, providing prompts for use and engaging in collaborative behavioural planning for use. The behavioural analysis suggested that psychological capability, opportunity and motivation were potential drivers of these behaviours. The intervention functions of education, coercion, training, environmental restructuring, modelling and enablement were selected and combined to develop a single complex intervention that seeks to address the target behaviours.

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.

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.

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

Comparisons of spectral characteristics of wind noise between omnidirectional and directional microphones.

PubMed

Chung, King

2012-06-01

Wind noise reduction is a topic of ongoing research and development for hearing aids and cochlear implants. The purposes of this study were to examine spectral characteristics of wind noise generated by directional (DIR) and omnidirectional (OMNI) microphones on different styles of hearing aids and to derive wind noise reduction strategies. Three digital hearing aids (BTE, ITE, and ITC) were fitted to Knowles Electronic Manikin for Acoustic Research. They were programmed to have linear amplification and matching frequency responses between the DIR and OMNI modes. Flow noise recordings were made from 0° to 360° azimuths at flow velocities of 4.5, 9.0, and 13.5 m/s in a quiet wind tunnel. Noise levels were analyzed in one-third octave bands from 100 to 8000 Hz. Comparison of wind noise revealed that DIR generally produced higher noise levels than OMNI for all hearing aids, but it could result in lower levels than OMNI at some frequencies and head angles. Wind noise reduction algorithms can be designed to detect noise levels of DIR and OMNI outputs in each frequency channel, remove the constraint to switch to OMNI in low-frequency channel(s) only, and adopt the microphone mode with lower noise levels to take advantage of the microphone differences.

Open ear hearing aids in tinnitus therapy: An efficacy comparison with sound generators.

PubMed

Parazzini, Marta; Del Bo, Luca; Jastreboff, Margaret; Tognola, Gabriella; Ravazzani, Paolo

2011-08-01

This study aimed to compare the effectiveness of tinnitus retraining therapy (TRT) with sound generators or with open ear hearing aids in the rehabilitation of tinnitus for a group of subjects who, according to Jastreboff categories, can be treated with both approaches to sound therapy (borderline of Category 1 and 2). This study was a prospective data collection with a parallel-group design which entailed that each subject was randomly assigned to one of the two treatments group: half of the subjects were fitted binaurally with sound generators, and the other half with open ear hearing aids. Both groups received the same educational counselling sessions. Ninety-one subjects passed the screening criteria and were enrolled into the study. Structured interviews, with a variety of measures evaluated through the use of visual-analog scales and the tinnitus handicap inventory self-administered questionnaire, were performed before the therapy and at 3, 6, and 12 months during the therapy. Data showed a highly significant improvement in both tinnitus treatments starting from the first three months and up to one year of therapy, with a progressive and statistically significant decrease in the disability every three months. TRT was equally effective with sound generator or open ear hearing aids: they gave basically identical, statistically indistinguishable results.

A comparison between parents of children with cochlear implants and parents of children with hearing aids regarding parental distress and treatment expectations.

PubMed

Spahn, Claudia; Richter, Bernhard; Burger, Thorsten; Löhle, Erwin; Wirsching, Michael

2003-09-01

The aim of the present study was to compare the parents of children with a hearing aid (HA) and children with a cochlear implant (CI) regarding their psychological distress, their expectations from treatment, their family climate, and the way they first obtained information on HA/CI. 154 parents (return quota 41%; 81 mothers and 73 fathers) of 90 children with a HA and 103 parents (return quota 59%; 57 mothers and 46 fathers) of 57 children with a CI were interviewed by means of a questionnaire. Both groups of parents felt distressed, particularly at the time of diagnosis. Their psychological well-being was gradually stabilized in the further course of rehabilitation. Due to the operation associated with it, fitting with a CI brought on a phase of heightened parental psychological distress compared with less invasive treatment with a HA. Regarding family climate, more distress was found in parents of CI children than in parents of HA children. Expectations from therapy appeared realistic in both parental groups; however, after CI fitting, the parents of the CI children showed heightened expectations by comparison with the parents of the HA children. The results of our study suggest that the parents of hearing impaired children fitted with a HA or a CI may be divided into two subgroups with divergent psychosocial parameters. For the counseling of the parents of hearing impaired children in clinical practice, it would seem important to take these specific differences into consideration.

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 ...

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.

A Model of Auditory-Cognitive Processing and Relevance to Clinical Applicability.

PubMed

Edwards, Brent

2016-01-01

Hearing loss and cognitive function interact in both a bottom-up and top-down relationship. Listening effort is tied to these interactions, and models have been developed to explain their relationship. The Ease of Language Understanding model in particular has gained considerable attention in its explanation of the effect of signal distortion on speech understanding. Signal distortion can also affect auditory scene analysis ability, however, resulting in a distorted auditory scene that can affect cognitive function, listening effort, and the allocation of cognitive resources. These effects are explained through an addition to the Ease of Language Understanding model. This model can be generalized to apply to all sounds, not only speech, representing the increased effort required for auditory environmental awareness and other nonspeech auditory tasks. While the authors have measures of speech understanding and cognitive load to quantify these interactions, they are lacking measures of the effect of hearing aid technology on auditory scene analysis ability and how effort and attention varies with the quality of an auditory scene. Additionally, the clinical relevance of hearing aid technology on cognitive function and the application of cognitive measures in hearing aid fittings will be limited until effectiveness is demonstrated in real-world situations.

Early language development in children with profound hearing loss fitted with a device at a young age: part II--content of the first lexicon.

PubMed

Nott, Pauline; Cowan, Robert; Brown, P Margaret; Wigglesworth, Gillian

2009-10-01

Lexical content is commonly understood to refer to the various categories of words that children produce and has been studied extensively in children with normal hearing. Unlike the hearing child, however, little is known about the word categories that make up the first lexicon of children with hearing loss (HL). Knowledge of the first lexicon is increasingly important, as infants with HL are now being detected through universal newborn hearing screening programs and fitted with hearing aids and cochlear implants in before 12 months of age. For these children, emergence of the first spoken words is a major milestone eagerly awaited by parents and one of the first verbal language goals of teachers and therapists working with such children. The purpose of this study was to evaluate the lexical content of the first 50 and 100 words produced by children with HL and to contrast this with that of a group of hearing children. Lexical content was compared in two groups of children: one group composed of 24 participants with severe profound or profound HL and a second group composed of 16 participants with normal hearing. Twenty-three participants in the HL group were fitted with a cochlear implant and one with bilateral hearing aids. All were "switched on" or fitted before 30 months of age. The Diary of Early Language (Di-EL) was used to collect a 100-word lexicon from each participant. All single word and frozen phrase data from each child's Di-EL were allocated to 1 of 15 word types grouped into four word categories (noun, predicate, grammatical, and paralexical), and the results were compared for both groups. The hearing and HL groups showed similar distributions of word categories, with nouns constituting the largest portion of the lexicon followed by predicates and paralexicals. Grammaticals made up the smallest portion of the lexicon. However, several significant differences were evident between the two groups. In both the 50- and 100-word lexicons, the hearing group used proportionately more nouns, fewer predicates, more common nouns, and fewer onomatopoeic words compared with the HL group. Further, more participants in the hearing group used grammatical word types other than adverbs (including pronouns) compared with the HL group. Overall, lexical content of the HL group was similar to that of the hearing group for both the 50- and 100-word lexicons, although some differences in proportional use were noted across word categories and types. It is suggested that differences in the quantity and diversity of language experienced by children with normal hearing compared with those with HL, together with differences in the input they receive, might in part explain these differences. The effect of quality of speech input and therapy method on the emerging lexicon and subsequent language development will be particularly important in informing appropriate intervention strategies for children with HL.

Hearing loss in Usher syndrome type II is nonprogressive.

PubMed

Reisser, Christoph F V; Kimberling, William J; Otterstedde, Christian R

2002-12-01

Usher syndrome is an autosomal recessive disorder characterized by sensorineural hearing loss and progressive visual loss secondary to retinitis pigmentosa. In the literature, a possible progression of the moderate to severe hearing loss in Usher syndrome type II (Usher II) is controversial. We studied the development of the hearing loss of 125 patients with a clinical diagnosis of Usher syndrome type II intraindividually and interindividually by repeatedly performing complete audiological and neuro-otologic examinations. Our data show a very characteristic slope of the hearing curve in all Usher II patients and no clinically relevant progression of the hearing loss over up to 17 years. The subjective impression of a deterioration of the communicative abilities of Usher II patients must therefore be attributed to the progressive visual loss. The patients should be reassured that changes in their hearing abilities are unlikely and should be provided with optimally fitted modern hearing aids.

A critical review of hearing-aid single-microphone noise-reduction studies in adults and children.

PubMed

Chong, Foong Yen; Jenstad, Lorienne M

2017-10-26

Single-microphone noise reduction (SMNR) is implemented in hearing aids to suppress background noise. The purpose of this article was to provide a critical review of peer-reviewed studies in adults and children with sensorineural hearing loss who were fitted with hearing aids incorporating SMNR. Articles published between 2000 and 2016 were searched in PUBMED and EBSCO databases. Thirty-two articles were included in the final review. Most studies with adult participants showed that SMNR has no effect on speech intelligibility. Positive results were reported for acceptance of background noise, preference, and listening effort. Studies of school-aged children were consistent with the findings of adult studies. No study with infants or young children of under 5 years old was found. Recent studies on noise-reduction systems not yet available in wearable hearing aids have documented benefits of noise reduction on memory for speech processing for older adults. This evidence supports the use of SMNR for adults and school-aged children when the aim is to improve listening comfort or reduce listening effort. Future research should test SMNR with infants and children who are younger than 5 years of age. Further development, testing, and clinical trials should be carried out on algorithms not yet available in wearable hearing aids. Testing higher cognitive level for speech processing and learning of novel sounds or words could show benefits of advanced signal processing features. These approaches should be expanded to other populations such as children and younger adults. Implications for rehabilitation The review provides a quick reference for students and clinicians regarding the efficacy and effectiveness of SMNR in wearable hearing aids. This information is useful during counseling session to build a realistic expectation among hearing aid users. Most studies in the adult population suggest that SMNR may provide some benefits to adult listeners in terms of listening comfort, acceptance of background noise, and release of cognitive load in a complex listening condition. However, it does not improve speech intelligibility. Studies that examined SMNR in the paediatric population suggest that SMNR may benefit older school-aged children, aged between 10 and 12 years old. The evidence supports the use of SMNR for adults and school-aged children when the aim is to improve listening comfort or reduce listening effort.

Barriers to early cochlear implantation.

PubMed

Dettman, Shani; Choo, Dawn; Dowell, Richard

2016-01-01

Identify variables associated with paediatric access to cochlear implants (CIs). Part 1. Trends over time for age at CI surgery (N = 802) and age at hearing aid (HA) fitting (n = 487) were examined with regard to periods before, during, and after newborn hearing screening (NHS). Part 2. Demographic factors were explored for 417 children implanted under 3 years of age. Part 3. Pre-implant steps for the first 20 children to receive CIs under 12 months were examined. Part 1. Age at HA fitting and CI surgery reduced over time, and were associated with NHS implementation. Part 2. For children implanted under 3 years, earlier age at HA fitting and higher family socio-economic status were associated with earlier CI. Progressive hearing loss was associated with later CIs. Children with a Connexin 26 diagnosis received CIs earlier than children with a premature / low birth weight history. Part 3. The longest pre-CI steps were Step 1: Birth to diagnosis/identification of hearing loss (mean 16.43 weeks), and Step 11: MRI scans to implant surgery (mean 15.05 weeks) for the first 20 infants with CIs under 12 months. NHS implementation was associated with reductions in age at device intervention in this cohort.

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

The Effects of Digital Noise Reduction on the Acceptance of Background Noise

PubMed Central

Mueller, H. Gustav; Weber, Jennifer; Hornsby, Benjamin W. Y.

2006-01-01

Modern hearing aids commonly employ digital noise reduction (DNR) algorithms. The potential benefit of these algorithms is to provide improved speech understanding in noise or, at the least, to provide relaxed listening or increased ease of listening. In this study, 22 adults were fitted with 16-channel wide-dynamic-range compression hearing aids containing DNR processing. The DNR includes both modulation-based and Wiener-filter-type algorithms working simultaneously. Both speech intelligibility and acceptable noise level (ANL) were assessed using the Hearing in Noise Test (HINT) with DNR on and DNR off. The ANL was also assessed without hearing aids. The results showed a significant mean improvement for the ANL (4.2 dB) for the DNR-on condition when compared to DNR-off condition. Moreover, there was a significant correlation between the magnitude of ANL improvement (relative to DNR on) and the DNR-off ANL. There was no significant mean improvement for the HINT for the DNR-on condition, and on an individual basis, the HINT score did not significantly correlate with either aided ANL (DNR on or DNR off). These findings suggest that at least within the constraints of the DNR algorithms and test conditions employed in this study, DNR can significantly improve the clinically measured ANL, which may result in improved ease of listening for speech-in-noise situations. PMID:16959732

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

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

Perceptions Toward Internet-Based Delivery of Hearing Aids among Older Hearing-Impaired Adults.

PubMed

Chandra, Navshika; Searchfield, Grant D

2016-06-01

Despite evidence that hearing aids can improve the social and psychological functioning of older hearing-impaired adults, hearing aid uptake is low. High cost of hearing aids and poor access to audiology services in rural areas are potential barriers to hearing aid acquisition. Methods of hearing aid delivery deviating from the traditional clinician-based model have been available to consumers for many years. One such method is Internet hearing aid sales. However, research exploring Internet-based hearing aid delivery, as a method to improve hearing aid uptake in this population, is limited. The purpose of this study was to explore the perceptions of older hearing aid users (aged ≥65 yr) toward Internet-based hearing aid delivery. A qualitative approach was adopted to investigate older adults' perceptions of buying hearing aids online. The sample consisted of 18 participants aged between 64 and 81 yr. Fourteen men and four women participated in this study. Participants were all experienced hearing aid users. Face-to-face semistructured interviews were conducted. An interview schedule guided the interview. Interviews were recorded with a voice recorder and transcribed verbatim. Thematic analysis of the data was carried out. Seven main themes emerged from the data. A general lack of awareness, but willingness to learn more about Internet hearing aid sales, was found. Two perceived benefits of Internet-based hearing aid delivery were identified: lower cost of hearing aids and greater convenience or physical accessibility. Numerous concerns and limitations were communicated. Concerns regarding the availability of clinical procedures, such as hearing tests, obtaining the correct-sized earmolds, and fine-tuning of hearing aids, were expressed. Participants conveyed distrust in online retailers. However, trust in and a preference for audiologists' expertise, which was not perceived to be available online, was found. Participants further conveyed a preference for face-to-face contact. Finally, in this sample, a general lack of familiarity and confidence in using the Internet was communicated. Internet sales of hearing aids is a controversial topic in audiology. Although Internet-based delivery of hearing aids was perceived by older adults to be potentially beneficial, several shortcomings and concerns were conveyed. Irrespective of opinion of the role of Internet sales, audiologists should consider the opinions of the elderly as to how different service models may improve hearing aid uptake. American Academy of Audiology.

Understanding the low uptake of bone-anchored hearing aids: a review.

PubMed

Powell, R; Wearden, A; Pardesi, S M; Green, K

2017-03-01

Bone-anchored hearing aids improve hearing for patients for whom conventional behind-the-ear aids are problematic. However, uptake of bone-anchored hearing aids is low and it is important to understand why this is the case. A narrative review was conducted. Studies examining why people accept or decline bone-anchored hearing aids and satisfaction levels of people with bone-anchored hearing aids were reviewed. Reasons for declining bone-anchored hearing aids included limited perceived benefits, concerns about surgery, aesthetic concerns and treatment cost. No studies providing in-depth analysis of the reasons for declining or accepting bone-anchored hearing aids were identified. Studies of patient satisfaction showed that most participants reported benefits with bone-anchored hearing aids. However, most studies used cross-sectional and/or retrospective designs and only included people with bone-anchored hearing aids. Important avenues for further research are in-depth qualitative research designed to fully understand the decision-making process for bone-anchored hearing aids and rigorous quantitative research comparing satisfaction of people who receive bone-anchored hearing aids with those who receive alternative (or no) treatments.

The perception of stress and intonation in children with a cochlear implant and a hearing aid.

PubMed

Hegarty, Lauren; Faulkner, Andrew

2013-11-01

This study investigated whether low frequency information from a hearing aid improved the perception of stress and intonation by English-speaking children with cochlear implants. As pitch information is limited for cochlear implant users, this study also investigated if users rely more on the cues of duration and amplitude to perceive stress and intonation. Nine children with bimodal stimulation (cochlear implant and hearing aid) participated in two experiments. The first measured the just audible change in F0 (pitch) and amplitude for a speech-like word 'baba'. The second experiment examined the children's ability to identify focus in natural and manipulated sentences. Overall, group results did not show a bimodal advantage in perceiving stress and intonation. However, the children were significantly better at perceiving focus in sentences with natural speech compared with manipulated speech in both the CI and bimodal conditions. The results suggest that in the absence of pitch cues, amplitude and duration cues are used to perceive stress and intonation. However, the majority of children only perceived amplitude changes greater than the changes typically found in speech, implying duration cues were the most valuable. Taken together the findings suggest that for children with cochlear implants, cues to F0 may not be essential for prosody perception and in the absence of cues to F0 and amplitude, duration may offer an alternative cue. Although a bimodal advantage was not demonstrated for all participants, it is recommended that if clinically appropriate, a contralateral hearing aid is fitted and trialled to exploit any residual hearing.

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.

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.

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

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.

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.

[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…

Working memory, age, and hearing loss: susceptibility to hearing aid distortion.

PubMed

Arehart, Kathryn H; Souza, Pamela; Baca, Rosalinda; Kates, James M

2013-01-01

Hearing aids use complex processing intended to improve speech recognition. Although many listeners benefit from such processing, it can also introduce distortion that offsets or cancels intended benefits for some individuals. The purpose of the present study was to determine the effects of cognitive ability (working memory) on individual listeners' responses to distortion caused by frequency compression applied to noisy speech. The present study analyzed a large data set of intelligibility scores for frequency-compressed speech presented in quiet and at a range of signal-to-babble ratios. The intelligibility data set was based on scores from 26 adults with hearing loss with ages ranging from 62 to 92 years. The listeners were grouped based on working memory ability. The amount of signal modification (distortion) caused by frequency compression and noise was measured using a sound quality metric. Analysis of variance and hierarchical linear modeling were used to identify meaningful differences between subject groups as a function of signal distortion caused by frequency compression and noise. Working memory was a significant factor in listeners' intelligibility of sentences presented in babble noise and processed with frequency compression based on sinusoidal modeling. At maximum signal modification (caused by both frequency compression and babble noise), the factor of working memory (when controlling for age and hearing loss) accounted for 29.3% of the variance in intelligibility scores. Combining working memory, age, and hearing loss accounted for a total of 47.5% of the variability in intelligibility scores. Furthermore, as the total amount of signal distortion increased, listeners with higher working memory performed better on the intelligibility task than listeners with lower working memory did. Working memory is a significant factor in listeners' responses to total signal distortion caused by cumulative effects of babble noise and frequency compression implemented with sinusoidal modeling. These results, together with other studies focused on wide-dynamic range compression, suggest that older listeners with hearing loss and poor working memory are more susceptible to distortions caused by at least some types of hearing aid signal-processing algorithms and by noise, and that this increased susceptibility should be considered in the hearing aid fitting process.

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…

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.

Modern prescription theory and application: realistic expectations for speech recognition with hearing AIDS.

PubMed

Johnson, Earl E

2013-01-01

A major decision at the time of hearing aid fitting and dispensing is the amount of amplification to provide listeners (both adult and pediatric populations) for the appropriate compensation of sensorineural hearing impairment across a range of frequencies (e.g., 160-10000 Hz) and input levels (e.g., 50-75 dB sound pressure level). This article describes modern prescription theory for hearing aids within the context of a risk versus return trade-off and efficient frontier analyses. The expected return of amplification recommendations (i.e., generic prescriptions such as National Acoustic Laboratories-Non-Linear 2, NAL-NL2, and Desired Sensation Level Multiple Input/Output, DSL m[i/o]) for the Speech Intelligibility Index (SII) and high-frequency audibility were traded against a potential risk (i.e., loudness). The modeled performance of each prescription was compared one with another and with the efficient frontier of normal hearing sensitivity (i.e., a reference point for the most return with the least risk). For the pediatric population, NAL-NL2 was more efficient for SII, while DSL m[i/o] was more efficient for high-frequency audibility. For the adult population, NAL-NL2 was more efficient for SII, while the two prescriptions were similar with regard to high-frequency audibility. In terms of absolute return (i.e., not considering the risk of loudness), however, DSL m[i/o] prescribed more outright high-frequency audibility than NAL-NL2 for either aged population, particularly, as hearing loss increased. Given the principles and demonstrated accuracy of desensitization (reduced utility of audibility with increasing hearing loss) observed at the group level, additional high-frequency audibility beyond that of NAL-NL2 is not expected to make further contributions to speech intelligibility (recognition) for the average listener.

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 ...

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.

Monitoring the Hearing Handicap and the Recognition Threshold of Sentences of a Patient with Unilateral Auditory Neuropathy Spectrum Disorder with Use of a Hearing Aid.

PubMed

Lima, Aline Patrícia; Mantello, Erika Barioni; Anastasio, Adriana Ribeiro Tavares

2016-04-01

Introduction Treatment for auditory neuropathy spectrum disorder (ANSD) is not yet well established, including the use of hearing aids (HAs). Not all patients diagnosed with ASND have access to HAs, and in some cases HAs are even contraindicated. Objective To monitor the hearing handicap and the recognition threshold of sentences in silence and in noise in a patient with ASND using an HA. Resumed Report A 47-year-old woman reported moderate sensorineural hearing loss in the right ear and high-frequency loss of 4 kHz in the left ear, with bilateral otoacoustic emissions. Auditory brainstem response suggested changes in the functioning of the auditory pathway (up to the inferior colliculus) on the right. An HA was indicated on the right. The patient was tested within a 3-month period before the HA fitting with respect to recognition threshold of sentences in quiet and in noise and for handicap determination. After HA use, she showed a 2.1-dB improvement in the recognition threshold of sentences in silence, a 6.0-dB improvement for recognition threshold of sentences in noise, and a rapid improvement of the signal-to-noise ratio from +3.66 to -2.4 dB when compared with the same tests before the fitting of the HA. Conclusion There was a reduction of the auditory handicap, although speech perception continued to be severely limited. There was a significant improvement of the recognition threshold of sentences in silence and in noise and of the signal-to-noise ratio after 3 months of HA use.

Monitoring the Hearing Handicap and the Recognition Threshold of Sentences of a Patient with Unilateral Auditory Neuropathy Spectrum Disorder with Use of a Hearing Aid

PubMed Central

Lima, Aline Patrícia; Mantello, Erika Barioni; Anastasio, Adriana Ribeiro Tavares

2015-01-01

Introduction Treatment for auditory neuropathy spectrum disorder (ANSD) is not yet well established, including the use of hearing aids (HAs). Not all patients diagnosed with ASND have access to HAs, and in some cases HAs are even contraindicated. Objective To monitor the hearing handicap and the recognition threshold of sentences in silence and in noise in a patient with ASND using an HA. Resumed Report A 47-year-old woman reported moderate sensorineural hearing loss in the right ear and high-frequency loss of 4 kHz in the left ear, with bilateral otoacoustic emissions. Auditory brainstem response suggested changes in the functioning of the auditory pathway (up to the inferior colliculus) on the right. An HA was indicated on the right. The patient was tested within a 3-month period before the HA fitting with respect to recognition threshold of sentences in quiet and in noise and for handicap determination. After HA use, she showed a 2.1-dB improvement in the recognition threshold of sentences in silence, a 6.0-dB improvement for recognition threshold of sentences in noise, and a rapid improvement of the signal-to-noise ratio from +3.66 to −2.4 dB when compared with the same tests before the fitting of the HA. Conclusion There was a reduction of the auditory handicap, although speech perception continued to be severely limited. There was a significant improvement of the recognition threshold of sentences in silence and in noise and of the signal-to-noise ratio after 3 months of HA use. PMID:27096026

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.

Evaluation of Core Vocabulary Therapy for Deaf Children: Four Treatment Case Studies

ERIC Educational Resources Information Center

Herman, Rosalind; Ford, Katie; Thomas, Jane; Oyebade, Natalie; Bennett, Danita; Dodd, Barbara

2015-01-01

This study evaluated whether core vocabulary intervention (CVT) improved single word speech accuracy, consistency and intelligibility in four 9-11-year-old children with profound sensori-neural deafness fitted with cochlear implants and/or digital hearing aids. Their speech was characterized by inconsistent production of different error forms for…

The performance of an automatic acoustic-based program classifier compared to hearing aid users' manual selection of listening programs.

PubMed

Searchfield, Grant D; Linford, Tania; Kobayashi, Kei; Crowhen, David; Latzel, Matthias

2018-03-01

To compare preference for and performance of manually selected programmes to an automatic sound classifier, the Phonak AutoSense OS. A single blind repeated measures study. Participants were fit with Phonak Virto V90 ITE aids; preferences for different listening programmes were compared across four different sound scenarios (speech in: quiet, noise, loud noise and a car). Following a 4-week trial preferences were reassessed and the users preferred programme was compared to the automatic classifier for sound quality and hearing in noise (HINT test) using a 12 loudspeaker array. Twenty-five participants with symmetrical moderate-severe sensorineural hearing loss. Participant preferences of manual programme for scenarios varied considerably between and within sessions. A HINT Speech Reception Threshold (SRT) advantage was observed for the automatic classifier over participant's manual selection for speech in quiet, loud noise and car noise. Sound quality ratings were similar for both manual and automatic selections. The use of a sound classifier is a viable alternative to manual programme selection.

Horizontal localization and speech intelligibility with bilateral and unilateral hearing aid amplification.

PubMed

Köbler, S; Rosenhall, U

2002-10-01

Speech intelligibility and horizontal localization of 19 subjects with mild-to-moderate hearing loss were studied in order to evaluate the advantages and disadvantages of bilateral and unilateral hearing aid (HA) fittings. Eight loudspeakers were arranged in a circular array covering the horizontal plane around the subjects. Speech signals of a sentence test were delivered by one, randomly chosen, loudspeaker. At the same time, the other seven loudspeakers emitted noise with the same long-term average spectrum as the speech signals. The subjects were asked to repeat the speech signal and to point out the corresponding loudspeaker. Speech intelligibility was significantly improved by HAs, bilateral amplification being superior to unilateral. Horizontal localization could not be improved by HA amplification. However, bilateral HAs preserved the subjects' horizontal localization, whereas unilateral amplification decreased their horizontal localization abilities. Front-back confusions were common in the horizontal localization test. The results indicate that bilateral HA amplification has advantages compared with unilateral amplification.

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.

Amplification in the rehabilitation of unilateral deafness: speech in noise and directional hearing effects with bone-anchored hearing and contralateral routing of signal amplification.

PubMed

Lin, Li-Mei; Bowditch, Stephen; Anderson, Michael J; May, Bradford; Cox, Kenneth M; Niparko, John K

2006-02-01

Vibromechanical stimulation with a semi-implantable bone conductor (Entific BAHA device) overcomes some of the head-shadow effects in unilateral deafness. What specific rehabilitative benefits are observed when the functional ear exhibits normal hearing versus moderate sensorineural hearing loss (SNHL)? The authors conducted a prospective trial of subjects with unilateral deafness in a tertiary care center. This study comprised adults with unilateral deafness (pure-tone average [PTA] > 90 dB; Sp.D. < 20%) and either normal monaural hearing (n = 18) or moderate SNHL (PTA = 25-50 dB: Sp.D. > 75%) in the contralateral functional ear (n = 5). Subjects were fit with contralateral routing of signal (CROS) devices for 1 month and tested before (mastoid) implantation, fitting, and testing with a bone-anchored hearing aid (BAHA). Outcome measures were: 1) subjective benefit; 2) source localization tests (Source Azimuth Identification in Noise Test [SAINT]); 3) speech discrimination in quiet and in noise assessed with Hearing In Noise Test (HINT) protocols. There was consistent satisfaction with BAHA amplification and poor acceptance of CROS amplification. General directional hearing decreased with CROS use and was unchanged by BAHA and directional microphone aids. Relative to baseline and CROS, BAHA produced significantly better speech recognition in noise. Twenty-two of 23 subjects followed up in this study continue to use their BAHA device over an average follow-up period of 30.24 months (range, 51-12 months). BAHA amplification on the side of a deaf ear yields greater benefit in subjects with monaural hearing than does CROS amplification. Advantages likely related to averting the interference of speech signals delivered to the better ear, as occurs with conventional CROS amplification, while alleviating the negative head-shadow effects of unilateral deafness. The advantages of head-shadow reduction in enhancing speech recognition with noise in the hearing ear outweigh disadvantages inherent in head-shadow reduction that can occur by introducing noise from the deaf side. The level of hearing impairment correlates with incremental benefit provided by the BAHA. Patients with a moderate SNHL in the functioning ear perceived greater increments in benefit, especially in background noise, and demonstrated greater improvements in speech understanding with BAHA amplification.

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...

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…

Preferred Compression Speed for Speech and Music and Its Relationship to Sensitivity to Temporal Fine Structure.

PubMed

Moore, Brian C J; Sęk, Aleksander

2016-09-07

Multichannel amplitude compression is widely used in hearing aids. The preferred compression speed varies across individuals. Moore (2008) suggested that reduced sensitivity to temporal fine structure (TFS) may be associated with preference for slow compression. This idea was tested using a simulated hearing aid. It was also assessed whether preferences for compression speed depend on the type of stimulus: speech or music. Twenty-two hearing-impaired subjects were tested, and the stimulated hearing aid was fitted individually using the CAM2A method. On each trial, a given segment of speech or music was presented twice. One segment was processed with fast compression and the other with slow compression, and the order was balanced across trials. The subject indicated which segment was preferred and by how much. On average, slow compression was preferred over fast compression, more so for music, but there were distinct individual differences, which were highly correlated for speech and music. Sensitivity to TFS was assessed using the difference limen for frequency at 2000 Hz and by two measures of sensitivity to interaural phase at low frequencies. The results for the difference limens for frequency, but not the measures of sensitivity to interaural phase, supported the suggestion that preference for compression speed is affected by sensitivity to TFS. © The Author(s) 2016.

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.

PubMed Central

DE LUCIA, A.; PASTORE, V.; BRACCI LAUDIERO, L.; BUONISSIMO, I.; RICCI, G.

2016-01-01

SUMMARY Programmes for early childhood childhood hearing impairment identification allows to quickly start the appropriate hearing aid fitting and rehabilitation process; nevertheless, a large number of patients do not join the treatment program. The goal of this article is to present the results of a strategic review of the strengths, weaknesses, opportunities and threats connected with the audiologic/prosthetic/language follow-up process of children with bilateral permanent hearing impairment. Involving small children, the follow-up includes the involvement of specialised professionals of a multidisciplinary team and a complex and prolonged multi-faced management. Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the purpose of this analysis was to propose recommendations that can harmonise criteria for outcome evaluation and provide guidance on the most appropriate assessment methods to be used in the follow-up course of children with permanent hearing impairment. PMID:27054392

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

Impact of Hearing Aid Technology on Outcomes in Daily Life II: Speech Understanding and Listening Effort.

PubMed

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

2016-01-01

Modern hearing aid (HA) devices include a collection of acoustic signal-processing features designed to improve listening outcomes in a variety of daily auditory environments. Manufacturers market these features at successive levels of technological sophistication. The features included in costlier premium hearing devices are designed to result in further improvements to daily listening outcomes compared with the features included in basic hearing devices. However, independent research has not substantiated such improvements. This research was designed to explore differences in speech-understanding and listening-effort outcomes for older adults using premium-feature and basic-feature HAs in their daily lives. For this participant-blinded, repeated, crossover trial 45 older adults (mean age 70.3 years) with mild-to-moderate sensorineural hearing loss wore each of four pairs of bilaterally fitted HAs for 1 month. HAs were premium- and basic-feature devices from two major brands. After each 1-month trial, participants' speech-understanding and listening-effort outcomes were evaluated in the laboratory and in daily life. Three types of speech-understanding and listening-effort data were collected: measures of laboratory performance, responses to standardized self-report questionnaires, and participant diary entries about daily communication. The only statistically significant superiority for the premium-feature HAs occurred for listening effort in the loud laboratory condition and was demonstrated for only one of the tested brands. The predominant complaint of older adults with mild-to-moderate hearing impairment is difficulty understanding speech in various settings. The combined results of all the outcome measures used in this research suggest that, when fitted using scientifically based practices, both premium- and basic-feature HAs are capable of providing considerable, but essentially equivalent, improvements to speech understanding and listening effort in daily life for this population. For HA providers to make evidence-based recommendations to their clientele with hearing impairment it is essential that further independent research investigates the relative benefit/deficit of different levels of hearing technology across brands and manufacturers in these and other real-world listening domains.

Automatic Speech Recognition Predicts Speech Intelligibility and Comprehension for Listeners With Simulated Age-Related Hearing Loss.

PubMed

Fontan, Lionel; Ferrané, Isabelle; Farinas, Jérôme; Pinquier, Julien; Tardieu, Julien; Magnen, Cynthia; Gaillard, Pascal; Aumont, Xavier; Füllgrabe, Christian

2017-09-18

The purpose of this article is to assess speech processing for listeners with simulated age-related hearing loss (ARHL) and to investigate whether the observed performance can be replicated using an automatic speech recognition (ASR) system. The long-term goal of this research is to develop a system that will assist audiologists/hearing-aid dispensers in the fine-tuning of hearing aids. Sixty young participants with normal hearing listened to speech materials mimicking the perceptual consequences of ARHL at different levels of severity. Two intelligibility tests (repetition of words and sentences) and 1 comprehension test (responding to oral commands by moving virtual objects) were administered. Several language models were developed and used by the ASR system in order to fit human performances. Strong significant positive correlations were observed between human and ASR scores, with coefficients up to .99. However, the spectral smearing used to simulate losses in frequency selectivity caused larger declines in ASR performance than in human performance. Both intelligibility and comprehension scores for listeners with simulated ARHL are highly correlated with the performances of an ASR-based system. In the future, it needs to be determined if the ASR system is similarly successful in predicting speech processing in noise and by older people with ARHL.

Effects of bandwidth, compression speed, and gain at high frequencies on preferences for amplified music.

PubMed

Moore, Brian C J

2012-09-01

This article reviews a series of studies on the factors influencing sound quality preferences, mostly for jazz and classical music stimuli. The data were obtained using ratings of individual stimuli or using the method of paired comparisons. For normal-hearing participants, the highest ratings of sound quality were obtained when the reproduction bandwidth was wide (55 to 16000 Hz) and ripples in the frequency response were small (less than ± 5 dB). For hearing-impaired participants listening via a simulated five-channel compression hearing aid with gains set using the CAM2 fitting method, preferences for upper cutoff frequency varied across participants: Some preferred a 7.5- or 10-kHz upper cutoff frequency over a 5-kHz cutoff frequency, and some showed the opposite preference. Preferences for a higher upper cutoff frequency were associated with a shallow high-frequency slope of the audiogram. A subsequent study comparing the CAM2 and NAL-NL2 fitting methods, with gains slightly reduced for participants who were not experienced hearing aid users, showed a consistent preference for CAM2. Since the two methods differ mainly in the gain applied for frequencies above 4 kHz (CAM2 recommending higher gain than NAL-NL2), these results suggest that extending the upper cutoff frequency is beneficial. A system for reducing "overshoot" effects produced by compression gave small but significant benefits for sound quality of a percussion instrument (xylophone). For a high-input level (80 dB SPL), slow compression was preferred over fast compression.

Clinical study of a digital vs an analogue hearing aid.

PubMed

Bille, M; Jensen, A M; Kjaerbøl, E; Vesterager, V; Sibelle, P; Nielsen, H

1999-01-01

Digital signal processing in hearing instruments has brought new perspectives to the compensation of hearing impairment and may result in alleviation of the adverse effects of hearing problems. This study compares a commercially available digital signal processing hearing aid (HA) (Senso) with a modern analogue HA with programmable fitting (Logo). The HAs tested are identical in appearance and, in spite of a different mode of operation, the study design ensured blinding of the test subjects. Outcome parameters were: improvements in speech recognition score in noise (deltaSRSN) with the HAs; overall preference for HA; overall satisfaction; and various measures of HA performance evaluated by a self-assessment questionnaire. A total of 28 experienced HA users with sensorineural hearing impairment were included and 25 completed the trial. No significant differences were found in deltaSRSN between the two HAs. Eleven subjects indicated an overall preference for the digital HA, 10 preferred the analogue HA and 4 had no preference. Concerning overall satisfaction, 8 subjects rated the digital HA superior to the analogue one, whereas 7 indicated a superior rating for the analogue HA and 10 rated the HAs equal. Acceptability of noise from traffic was the only outcome parameter which gave a significant difference between the HAs in favour of the digital HA. It is concluded that there are no significant differences in outcome between the digital and analogue signal processing HAs tested by these experienced HA-users.

Speech understanding in noise with an eyeglass hearing aid: asymmetric fitting and the head shadow benefit of anterior microphones.

PubMed

Mens, Lucas H M

2011-01-01

To test speech understanding in noise using array microphones integrated in an eyeglass device and to test if microphones placed anteriorly at the temple provide better directivity than above the pinna. Sentences were presented from the front and uncorrelated noise from 45, 135, 225 and 315°. Fifteen hearing impaired participants with a significant speech discrimination loss were included, as well as 5 normal hearing listeners. The device (Varibel) improved speech understanding in noise compared to most conventional directional devices with a directional benefit of 5.3 dB in the asymmetric fit mode, which was not significantly different from the bilateral fully directional mode (6.3 dB). Anterior microphones outperformed microphones at a conventional position above the pinna by 2.6 dB. By integrating microphones in an eyeglass frame, a long array can be used resulting in a higher directionality index and improved speech understanding in noise. An asymmetric fit did not significantly reduce performance and can be considered to increase acceptance and environmental awareness. Directional microphones at the temple seemed to profit more from the head shadow than above the pinna, better suppressing noise from behind the listener.

Hearing Aid Use and Mild Hearing Impairment: Learnings from Big Data.

PubMed

Timmer, Barbra H B; Hickson, Louise; Launer, Stefan

2017-09-01

Previous research, mostly reliant on self-reports, has indicated that hearing aid (HA) use is related to the degree of hearing impairment (HI). No large-scale investigation of the relationship between data-logged HA use and HI has been conducted to date. This study aimed to investigate if objective measures of overall daily HA use and HA use in various listening environments are different for adults with mild HI compared to adults with moderate HI. This retrospective study used data extracted from a database of fitting appointments from an international group of HA providers. Only data from the participants' most recent fitting appointment were included in the final dataset. A total of 8,489 bilateral HA fittings of adults over the age of 18 yr, conducted between January 2013 and June 2014, were included. Participants were subsequently allocated to HI groups, based on British Society of Audiology and American Speech-Language-Hearing Association audiometric descriptors. Fitting data from participating HA providers were regularly transferred to a central server. The data, with all personal information except age and gender removed, contained participants' four-frequency average (at 500, 1000, 2000, and 4000 Hz) as well as information on HA characteristics and usage. Following data cleaning, bivariate and post hoc statistical analyses were conducted. The total sample of adults' average daily HA use was 8.52 hr (interquartile range [IQR] = 5.49-11.77) in the left ear and 8.51 hr (IQR = 5.49-11.72) in the right ear. With a few exceptions, there were no statistical differences between hours of HA use for participants with mild HI compared to those with moderate impairment. Across all mild and moderate HI groups, the most common overall HA usage was between 8 and 12 hr per day. Other factors such as age, gender, and HA style also showed no relationship to hours of use. HAs were used, on average, for 7 hr (IQR = 4.27-9.96) per day in quiet and 1 hr (IQR = 0.33-1.41) per day in noisy listening situations. Clinical populations with mild HI use HAs as frequently as those with a moderate HI. These findings support the recommendation of HAs for adults with milder degrees of HI. American Academy of Audiology

Spectrotemporal Modulation Sensitivity as a Predictor of Speech-Reception Performance in Noise With Hearing Aids

PubMed Central

Danielsson, Henrik; Hällgren, Mathias; Stenfelt, Stefan; Rönnberg, Jerker; Lunner, Thomas

2016-01-01

The audiogram predicts <30% of the variance in speech-reception thresholds (SRTs) for hearing-impaired (HI) listeners fitted with individualized frequency-dependent gain. The remaining variance could reflect suprathreshold distortion in the auditory pathways or nonauditory factors such as cognitive processing. The relationship between a measure of suprathreshold auditory function—spectrotemporal modulation (STM) sensitivity—and SRTs in noise was examined for 154 HI listeners fitted with individualized frequency-specific gain. SRTs were measured for 65-dB SPL sentences presented in speech-weighted noise or four-talker babble to an individually programmed master hearing aid, with the output of an ear-simulating coupler played through insert earphones. Modulation-depth detection thresholds were measured over headphones for STM (2cycles/octave density, 4-Hz rate) applied to an 85-dB SPL, 2-kHz lowpass-filtered pink-noise carrier. SRTs were correlated with both the high-frequency (2–6 kHz) pure-tone average (HFA; R2 = .31) and STM sensitivity (R2 = .28). Combined with the HFA, STM sensitivity significantly improved the SRT prediction (ΔR2 = .13; total R2 = .44). The remaining unaccounted variance might be attributable to variability in cognitive function and other dimensions of suprathreshold distortion. STM sensitivity was most critical in predicting SRTs for listeners < 65 years old or with HFA <53 dB HL. Results are discussed in the context of previous work suggesting that STM sensitivity for low rates and low-frequency carriers is impaired by a reduced ability to use temporal fine-structure information to detect dynamic spectra. STM detection is a fast test of suprathreshold auditory function for frequencies <2 kHz that complements the HFA to predict variability in hearing-aid outcomes for speech perception in noise. PMID:27815546

21 CFR 874.3300 - Hearing Aid.

Code of Federal Regulations, 2010 CFR

2010-04-01

... generic type of device includes the air-conduction hearing aid and the bone-conduction hearing aid, but... subpart E of part 807 of this chapter subject to § 874.9. (2) Class II for the bone-conduction hearing aid...

21 CFR 874.3300 - Hearing Aid.

Code of Federal Regulations, 2012 CFR

2012-04-01

... generic type of device includes the air-conduction hearing aid and the bone-conduction hearing aid, but... subpart E of part 807 of this chapter subject to § 874.9. (2) Class II for the bone-conduction hearing aid...

21 CFR 874.3300 - Hearing Aid.

Code of Federal Regulations, 2014 CFR

2014-04-01

... generic type of device includes the air-conduction hearing aid and the bone-conduction hearing aid, but... subpart E of part 807 of this chapter subject to § 874.9. (2) Class II for the bone-conduction hearing aid...

21 CFR 874.3300 - Hearing Aid.

Code of Federal Regulations, 2013 CFR

2013-04-01

... generic type of device includes the air-conduction hearing aid and the bone-conduction hearing aid, but... subpart E of part 807 of this chapter subject to § 874.9. (2) Class II for the bone-conduction hearing aid...

21 CFR 874.3300 - Hearing Aid.

Code of Federal Regulations, 2011 CFR

2011-04-01

... generic type of device includes the air-conduction hearing aid and the bone-conduction hearing aid, but... subpart E of part 807 of this chapter subject to § 874.9. (2) Class II for the bone-conduction hearing aid...

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

PubMed Central

Gordon-Salant, Sandra; Callahan, Julia S.

2010-01-01

Objectives 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 and closed captioning, 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 (hearing aids and closed captioning) compared to conditions without these devices. A secondary purpose was to examine the frequency of hearing aid use and closed captioning use among a sample of older hearing aid wearers. Design The investigation entailed a randomized, repeated-measures design of 15 older adults (59–82 years) with bilateral sensorineural hearing losses who wore hearing aids. Participants viewed three types of televised programs (news, drama, 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 hearing aids or closed captioning), hearing aids only, closed captioning only, and hearing aids + closed captioning. Pilot testing with young normal-hearing listeners was conducted also 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 19-in flat screen television. Questionnaires were also administered to participants to determine frequency of hearing aid use and closed captioning use while watching television. Results A significant effect of viewing condition was observed for all programs. Participants exhibited significantly better speech recognition scores in conditions with closed captioning than those without closed captioning (p<.01). Use of personal hearing aids did not significantly improve recognition of televised speech compared to the unaided condition. The condition effect was similar across the three different programs. Most of the participants (73%) regularly wore their hearing aids while watching television; very few of them (13%) had ever used closed captioning. Conclusions On average, use of closed captioning while watching television dramatically improved speech understanding by a sample of older hearing-impaired adults compared to conditions without closed captioning, including when hearing aids were worn. PMID:19444122

Listening Effort and Speech Recognition with Frequency Compression Amplification for Children and Adults with Hearing Loss.

PubMed

Brennan, Marc A; Lewis, Dawna; McCreery, Ryan; Kopun, Judy; Alexander, Joshua M

2017-10-01

Nonlinear frequency compression (NFC) can improve the audibility of high-frequency sounds by lowering them to a frequency where audibility is better; however, this lowering results in spectral distortion. Consequently, performance is a combination of the effects of increased access to high-frequency sounds and the detrimental effects of spectral distortion. Previous work has demonstrated positive benefits of NFC on speech recognition when NFC is set to improve audibility while minimizing distortion. However, the extent to which NFC impacts listening effort is not well understood, especially for children with sensorineural hearing loss (SNHL). To examine the impact of NFC on recognition and listening effort for speech in adults and children with SNHL. Within-subject, quasi-experimental study. Participants listened to amplified nonsense words that were (1) frequency-lowered using NFC, (2) low-pass filtered at 5 kHz to simulate the restricted bandwidth (RBW) of conventional hearing aid processing, or (3) low-pass filtered at 10 kHz to simulate extended bandwidth (EBW) amplification. Fourteen children (8-16 yr) and 14 adults (19-65 yr) with mild-to-severe SNHL. Participants listened to speech processed by a hearing aid simulator that amplified input signals to fit a prescriptive target fitting procedure. Participants were blinded to the type of processing. Participants' responses to each nonsense word were analyzed for accuracy and verbal-response time (VRT; listening effort). A multivariate analysis of variance and linear mixed model were used to determine the effect of hearing-aid signal processing on nonsense word recognition and VRT. Both children and adults identified the nonsense words and initial consonants better with EBW and NFC than with RBW. The type of processing did not affect the identification of the vowels or final consonants. There was no effect of age on recognition of the nonsense words, initial consonants, medial vowels, or final consonants. VRT did not change significantly with the type of processing or age. Both adults and children demonstrated improved speech recognition with access to the high-frequency sounds in speech. Listening effort as measured by VRT was not affected by access to high-frequency sounds. American Academy of Audiology

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).

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.

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.

Cantonese tone production performance of mainstream school children with hearing impairment.

PubMed

Cheung, Karen K L; Lau, Ada H Y; Lam, Joffee H S; Lee, Kathy Y S

2014-12-01

This study investigated the Cantonese tone production ability of children with hearing impairment studying in mainstream schools. The participants were 87 Cantonese-speaking children with mild-to-profound degrees of hearing loss aged 5.92-13.58 in Hong Kong. Most of the children were fitted with hearing aids (n = 65); 17 of them had profound hearing impairment, one who had severe hearing loss had cochlear implantation, and four who had mild hearing loss were without any hearing device. The Hong Kong Cantonese Articulation Test was administered, and the tones produced were rated by two of the authors and a speech-language pathologist. Group effects of tones, hearing loss level, and also an interaction of the two were found to be significant. The children with profound hearing impairment performed significantly worse than most of the other children. Tone 1 was produced most accurately, whereas tone 6 productions were the poorest. No relationship was found between the number of years of mainstreaming and tone production ability. Tone production error pattern revealed that confusion patterns in tone perception coincided with those in production. Tones having a similar fundamental frequency (F0) at the onset also posed difficulty in tone production for children with hearing impairment.

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)

Hearing Assistive Technology Considerations for Older Individuals With Dual Sensory Loss

PubMed Central

Kricos, Patricia B.

2007-01-01

This article focuses on the current state of the science related to audiologic rehabilitation of individuals with dual sensory impairment, with an emphasis on considerations for provision of appropriate hearing assistive technology for this population. A substantial increase in the number of older adults is predicted in the coming years, many of whom will have significant age-related impairments in hearing and vision. Thus, hearing care professionals will be called on increasingly to attend to the special needs of people with dual sensory impairment to ensure maximal quality of life and independence for these individuals. Access to sound is critical for individuals who live with compromises in both vision and hearing. Hearing assistive technology may improve not only their speech perception but also their connection and orientation to the environment, as well as enable greater mobility. Thus, the audiologist's provision of appropriate and carefully selected hearing assistive technology may contribute dramatically to the quality of life of the individual with dual sensory loss. Prefitting, fitting, and postfitting considerations in providing hearing aids and other assistive technology to individuals with dual sensory impairment are reviewed. PMID:18080391

Follow-up of permanent hearing impairment in childhood.

PubMed

Della Volpe, A; De Lucia, A; Pastore, V; Bracci Laudiero, L; Buonissimo, I; Ricci, G

2016-02-01

Programmes for early childhood childhood hearing impairment identification allows to quickly start the appropriate hearing aid fitting and rehabilitation process; nevertheless, a large number of patients do not join the treatment program. The goal of this article is to present the results of a strategic review of the strengths, weaknesses, opportunities and threats connected with the audiologic/prosthetic/language follow-up process of children with bilateral permanent hearing impairment. Involving small children, the follow-up includes the involvement of specialised professionals of a multidisciplinary team and a complex and prolonged multi-faced management. Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the purpose of this analysis was to propose recommendations that can harmonise criteria for outcome evaluation and provide guidance on the most appropriate assessment methods to be used in the follow-up course of children with permanent hearing impairment. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

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.

Is there a hearing aid for the thinking person?

PubMed

Hafter, Ervin R

2010-10-01

The history of auditory prosthesis has generally concentrated on bottom-up processing, that is, on audibility. However, a growing interest in top-down processing has focused on correlations between success with a hearing aid and such higher order processing as the patient's intelligence, problem solving and language skills, and the perceived effort of day-to-day listening. Examination of two cases of cognitive effects in hearing that illustrate less-often-studied issues: (1) Individual subjects in a study use different listening strategies, a fact that, if not known to the experimenter, can lead to errors in interpretation; (2) A measure of shared attention can point to otherwise unknown functional effects of an algorithm used in hearing aids. In the two examples described above: (1) Patients with cochlear implants served in a study of the binaural precedence effect, that is, echo suppression. (2) Individuals identifying speech-in-noise benefit from noise reduction (NR) when the criterion was improved performance in simultaneous tests of verbal memory or visual reaction times. Studies of hearing impairment, either in the laboratory or in a fitting session, should include study of the complex stimuli that make up the natural environment, conditions where the thinking auditory brain adopts strategies for dealing with large amounts of input data. In addition to well-known factors that must be included in communication, such things as familiarity, syntax, and semantics, the work here shows that strategic listening can affect even how we deal with seemingly simpler requirements, localizing sounds in a reverberant auditory scene and listening for speech in noise when busy with other cognitive tasks. American Academy of Audiology.

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.

[Auditory rehabilitation programmes for adults: what do we know about their effectiveness?].

PubMed

Cardemil, Felipe; Aguayo, Lorena; Fuente, Adrian

2014-01-01

Hearing loss ranks third among the health conditions that involve disability-adjusted life years. Hearing aids are the most commonly used treatment option in people with hearing loss. However, a number of auditory rehabilitation programmes have been developed with the aim of improving communicative abilities in people with hearing loss. The objective of this review was to determine the effectiveness of auditory rehabilitation programmes focused on communication strategies. This was a narrative revision. A literature search using PUBMED was carried out. This search included systematic reviews investigating the effectiveness of auditory training and individual and group auditory rehabilitation programmes with the main focus on counselling and communicative strategies for adults with hearing loss. Each study was analysed in terms of the type of intervention used and the results obtained. Three articles were identified: one article about the effectiveness of auditory training programmes and 2 systematic reviews that investigated the effectiveness of communicative programmes in adults with hearing loss. The "Active Communication Education" programme appears to be an effective group programme of auditory rehabilitation that may be used with older Spanish-speaking adults. The utility of hearing aid fitting and communicative programmes as rehabilitation options are associated with improvements in social participation and quality of life in patients with hearing loss, especially group auditory rehabilitation programmes, which seem to have good potential for reducing activity limitations and social participation restrictions, and thus for improving patient quality of life. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

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.

Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

PubMed

Cupples, Linda; Ching, Teresa Yc; Button, Laura; Seeto, Mark; Zhang, Vicky; Whitfield, Jessica; Gunnourie, Miriam; Martin, Louise; Marnane, Vivienne

2017-09-12

This study investigated the factors influencing 5-year language, speech and everyday functioning of children with congenital hearing loss. Standardised tests including PLS-4, PPVT-4 and DEAP were directly administered to children. Parent reports on language (CDI) and everyday functioning (PEACH) were collected. Regression analyses were conducted to examine the influence of a range of demographic variables on outcomes. Participants were 339 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. Children's average receptive and expressive language scores were approximately 1 SD below the mean of typically developing children, and scores on speech production and everyday functioning were more than 1 SD below. Regression models accounted for 70-23% of variance in scores across different tests. Earlier CI switch-on and higher non-verbal ability were associated with better outcomes in most domains. Earlier HA fitting and use of oral communication were associated with better outcomes on directly administered language assessments. Severity of hearing loss and maternal education influenced outcomes of children with HAs. The presence of additional disabilities affected outcomes of children with CIs. The findings provide strong evidence for the benefits of early HA fitting and early CI for improving children's outcomes.

[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.

Sensorineural hearing loss in hemorrhagic dengue?

PubMed

Ribeiro, Bruna Natália Freire; Guimarães, Alexandre Caixeta; Yazawa, Felipe; Takara, Tammy Fumiko Messias; de Carvalho, Guilherme Machado; Zappelini, Carlos Eduardo Monteiro

2015-01-01

Dengue is an acute febrile infectious disease, with high fever followed by symptoms flu-like. Dengue hemorrhagic fever (DHF) is a vascular leak syndrome and could present spontaneous bleeding and worsening of symptoms after some days. Dengue could have some ENT manifestations, however hearing loss is not one of them. Sudden hearing loss is considered as sensorineural or perceptual hearing loss with a sudden onset in a person without other prior otological history. The relation between infectious diseases and sudden hearing are been investigated, some viruses were already linked, but the relation between dengue virus and sudden hearing still remains unknown. This article has the goal of presenting a case of DHF that evolved with SSHL in his hospitalization process. We report a 60 years-male patient of with DHF who developed bilateral secretory otitis media and sensorineural hearing loss after the fifth day of onset of symptoms. His hearing loss remained even after 7 months and the patient was referred for hearing aid fitting. This is the first case report that brings together DHF and sudden hearing loss. In the development of this case no other cause to sudden hearing loss was found and the correlation between dengue and hearing loss was questioned. In the literature review was found that some viruses, as mumps virus, varicella-zoster virus and HSV-1 and HSV-2 are related to sudden hearing loss, all of them fit in the viral theory. Besides the viral theory of sudden hearing loss, there is the vascular theory that is the occlusion of the end artery that supplies the cochlea. DHF has a vascular commitment, and the hypothesis of a vascular cause could be elicited in this case. Many studies in this area are needed and this article has the objective of elicit the discussion about the subject. Could dengue be associated with sensorineural hearing loss? Copyright © 2015. Published by Elsevier Ltd.

The current status of audiologic rehabilitation for profound unilateral sensorineural hearing loss.

PubMed

Bishop, Charles E; Eby, Thomas L

2010-03-01

Audiologic rehabilitation of individuals with profound unilateral sensorineural hearing loss (USNHL) has traditionally been limited to the use of air-conduction contralateral routing of sound (CROS) hearing aids. Treatment for these individuals has expanded with new applications of the bone-anchored hearing aid (BAHA), transcranial hearing aid (t-CROS), and the cochlear implant. In this article, the authors review the literature that addresses these various treatment options. Contemporary review Historical information is available that describes the limited efficacy of air-conduction CROS hearing aids in lifting hearing handicap associated with USNHL. Current investigations on providing cross hearing are generally focused on use of the BAHA. Little is known at present whether new developments in hearing aid technology can improve on conventional air-conduction CROS or t-CROS approaches. Interestingly, the cochlear implant seems to be a viable option for individuals with USNHL and tinnitus who also have intact auditory nerve pathways. There is indication in the literature that BAHA provides greater relief of hearing handicap associated with USNHL than CROS hearing aids; however, both have been found to provide limited patient satisfaction and seemingly fall short of restoring true sound localization. Adequate trials have not been performed comparing BAHA with the best CROS hearing aid technology. Transcranial hearing aids and cochlear implants are experimental methods to treat USNHL and hold promise, although there remains a lack of studies available to fully support this.

Combined Electric and Acoustic Stimulation With Hearing Preservation: Effect of Cochlear Implant Low-Frequency Cutoff on Speech Understanding and Perceived Listening Difficulty.

PubMed

Gifford, René H; Davis, Timothy J; Sunderhaus, Linsey W; Menapace, Christine; Buck, Barbara; Crosson, Jillian; O'Neill, Lori; Beiter, Anne; Segel, Phil

The primary objective of this study was to assess the effect of electric and acoustic overlap for speech understanding in typical listening conditions using semidiffuse noise. This study used a within-subjects, repeated measures design including 11 experienced adult implant recipients (13 ears) with functional residual hearing in the implanted and nonimplanted ear. The aided acoustic bandwidth was fixed and the low-frequency cutoff for the cochlear implant (CI) was varied systematically. Assessments were completed in the R-SPACE sound-simulation system which includes a semidiffuse restaurant noise originating from eight loudspeakers placed circumferentially about the subject's head. AzBio sentences were presented at 67 dBA with signal to noise ratio varying between +10 and 0 dB determined individually to yield approximately 50 to 60% correct for the CI-alone condition with full CI bandwidth. Listening conditions for all subjects included CI alone, bimodal (CI + contralateral hearing aid), and bilateral-aided electric and acoustic stimulation (EAS; CI + bilateral hearing aid). Low-frequency cutoffs both below and above the original "clinical software recommendation" frequency were tested for all patients, in all conditions. Subjects estimated listening difficulty for all conditions using listener ratings based on a visual analog scale. Three primary findings were that (1) there was statistically significant benefit of preserved acoustic hearing in the implanted ear for most overlap conditions, (2) the default clinical software recommendation rarely yielded the highest level of speech recognition (1 of 13 ears), and (3) greater EAS overlap than that provided by the clinical recommendation yielded significant improvements in speech understanding. For standard-electrode CI recipients with preserved hearing, spectral overlap of acoustic and electric stimuli yielded significantly better speech understanding and less listening effort in a laboratory-based, restaurant-noise simulation. In conclusion, EAS patients may derive more benefit from greater acoustic and electric overlap than given in current software fitting recommendations, which are based solely on audiometric threshold. These data have larger scientific implications, as previous studies may not have assessed outcomes with optimized EAS parameters, thereby underestimating the benefit afforded by hearing preservation.

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

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.

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.

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.

What factors influence help-seeking for hearing impairment and hearing aid adoption in older adults?

PubMed

Meyer, Carly; Hickson, Louise

2012-02-01

The purpose of this review paper was to identify factors that influence older adults' decisions to seek help for hearing impairment and to adopt hearing aids. A literature search of abstracts within peer-reviewed journal articles published in English between 1990 and 2010 was conducted in online bibliographic databases using the keywords: hearing; impair* or loss; seek* or candidate* or applicant* or acquir*; and hearing aid* or help or advice. Twenty-two articles that were directly relevant to this topic were included in this review. The evidence suggests that individuals are more likely to seek help for hearing impairment and/or adopt hearing aids if they: (1) have a moderate to severe hearing impairment and self-reported hearing-related activity limitations or participation restrictions; (2) are older; (3) perceive their hearing as poor; (4) consider there to be more benefits than barriers to amplification; and (5) perceive their significant other/s as supportive of hearing rehabilitation. A barrier to help-seeking for hearing impairment and hearing aid adoption appears to be general practitioners' management of age-related hearing impairment.

Modern Prescription Theory and Application: Realistic Expectations for Speech Recognition With Hearing Aids

PubMed Central

2013-01-01

A major decision at the time of hearing aid fitting and dispensing is the amount of amplification to provide listeners (both adult and pediatric populations) for the appropriate compensation of sensorineural hearing impairment across a range of frequencies (e.g., 160–10000 Hz) and input levels (e.g., 50–75 dB sound pressure level). This article describes modern prescription theory for hearing aids within the context of a risk versus return trade-off and efficient frontier analyses. The expected return of amplification recommendations (i.e., generic prescriptions such as National Acoustic Laboratories—Non-Linear 2, NAL-NL2, and Desired Sensation Level Multiple Input/Output, DSL m[i/o]) for the Speech Intelligibility Index (SII) and high-frequency audibility were traded against a potential risk (i.e., loudness). The modeled performance of each prescription was compared one with another and with the efficient frontier of normal hearing sensitivity (i.e., a reference point for the most return with the least risk). For the pediatric population, NAL-NL2 was more efficient for SII, while DSL m[i/o] was more efficient for high-frequency audibility. For the adult population, NAL-NL2 was more efficient for SII, while the two prescriptions were similar with regard to high-frequency audibility. In terms of absolute return (i.e., not considering the risk of loudness), however, DSL m[i/o] prescribed more outright high-frequency audibility than NAL-NL2 for either aged population, particularly, as hearing loss increased. Given the principles and demonstrated accuracy of desensitization (reduced utility of audibility with increasing hearing loss) observed at the group level, additional high-frequency audibility beyond that of NAL-NL2 is not expected to make further contributions to speech intelligibility (recognition) for the average listener. PMID:24253361

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.

An evaluation of the performance of two binaural beamformers in complex and dynamic multitalker environments.

PubMed

Best, Virginia; Mejia, Jorge; Freeston, Katrina; van Hoesel, Richard J; Dillon, Harvey

2015-01-01

Binaural beamformers are super-directional hearing aids created by combining microphone outputs from each side of the head. While they offer substantial improvements in SNR over conventional directional hearing aids, the benefits (and possible limitations) of these devices in realistic, complex listening situations have not yet been fully explored. In this study we evaluated the performance of two experimental binaural beamformers. Testing was carried out using a horizontal loudspeaker array. Background noise was created using recorded conversations. Performance measures included speech intelligibility, localization in noise, acceptable noise level, subjective ratings, and a novel dynamic speech intelligibility measure. Participants were 27 listeners with bilateral hearing loss, fitted with BTE prototypes that could be switched between conventional directional or binaural beamformer microphone modes. Relative to the conventional directional microphones, both binaural beamformer modes were generally superior for tasks involving fixed frontal targets, but not always for situations involving dynamic target locations. Binaural beamformers show promise for enhancing listening in complex situations when the location of the source of interest is predictable.

An evaluation of the performance of two binaural beamformers in complex and dynamic multitalker environments

PubMed Central

Best, Virginia; Mejia, Jorge; Freeston, Katrina; van Hoesel, Richard J.; Dillon, Harvey

2016-01-01

Objective Binaural beamformers are super-directional hearing aids created by combining microphone outputs from each side of the head. While they offer substantial improvements in SNR over conventional directional hearing aids, the benefits (and possible limitations) of these devices in realistic, complex listening situations have not yet been fully explored. In this study we evaluated the performance of two experimental binaural beamformers. Design Testing was carried out using a horizontal loudspeaker array. Background noise was created using recorded conversations. Performance measures included speech intelligibility, localisation in noise, acceptable noise level, subjective ratings, and a novel dynamic speech intelligibility measure. Study sample Participants were 27 listeners with bilateral hearing loss, fitted with BTE prototypes that could be switched between conventional directional or binaural beamformer microphone modes. Results Relative to the conventional directional microphones, both binaural beamformer modes were generally superior for tasks involving fixed frontal targets, but not always for situations involving dynamic target locations. Conclusions Binaural beamformers show promise for enhancing listening in complex situations when the location of the source of interest is predictable. PMID:26140298

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.

[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.

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

PubMed Central

GALLUS, R.; DE CARLINI, M.; PICCIOTTI, P.M.; MUZZI, E.; CICIRIELLO, E.; ORZAN, E.; CONTI, G.

2016-01-01

SUMMARY Diagnosis of child permanent hearing impairment (PHI) can be made with extreme timeliness compared to the past thanks to improvements in PHI identification through newborn hearing screening programmes. It now becomes essential to provide an effective amplification as quickly as possible in order to restore auditory function and favour speech and language development. The early fitting of hearing aids and possible later cochlear implantation indeed prompts the development of central auditory pathways, connections with secondary sensory brain areas, as well as with motor and articulatory cortex. The aim of this paper is to report the results of a strategic analysis that involves identification of strengths, weaknesses, opportunities and threats regarding the process of achieving early amplification in all cases of significant childhood PHI. The analysis is focused on the Italian situation and is part of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children". PMID:27054389

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.

Exploring Audiologists' Language and Hearing Aid Uptake in Initial Rehabilitation Appointments.

PubMed

Sciacca, Anna; Meyer, Carly; Ekberg, Katie; Barr, Caitlin; Hickson, Louise

2017-06-13

The study aimed (a) to profile audiologists' language during the diagnosis and management planning phase of hearing assessment appointments and (b) to explore associations between audiologists' language and patients' decisions to obtain hearing aids. Sixty-two audiologist-patient dyads participated. Patient participants were aged 55 years or older. Hearing assessment appointments were audiovisually recorded and transcribed for analysis. Audiologists' language was profiled using two measures: general language complexity and use of jargon. A binomial, multivariate logistic regression analysis was conducted to investigate the associations between these language measures and hearing aid uptake. The logistic regression model revealed that the Flesch-Kincaid reading grade level of audiologists' language was significantly associated with hearing aid uptake. Patients were less likely to obtain hearing aids when audiologists' language was at a higher reading grade level. No associations were found between audiologists' use of jargon and hearing aid uptake. Audiologists' use of complex language may present a barrier for patients to understand hearing rehabilitation recommendations. Reduced understanding may limit patient participation in the decision-making process and result in patients being less willing to trial hearing aids. Clear, concise language is recommended to facilitate shared decision making.

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.

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...

[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 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

[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.

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.

A systematic review of studies measuring and reporting hearing aid usage in older adults since 1999: a descriptive summary of measurement tools.

PubMed

Perez, Elvira; Edmonds, Barrie A

2012-01-01

A systematic review was conducted to identify and quality assess how studies published since 1999 have measured and reported the usage of hearing aids in older adults. The relationship between usage and other dimensions of hearing aid outcome, age and hearing loss are summarised. Articles were identified through systematic searches in PubMed/MEDLINE, The University of Nottingham Online Catalogue, Web of Science and through reference checking. (1) participants aged fifty years or over with sensori-neural hearing loss, (2) provision of an air conduction hearing aid, (3) inclusion of hearing aid usage measure(s) and (4) published between 1999 and 2011. Of the initial 1933 papers obtained from the searches, a total of 64 were found eligible for review and were quality assessed on six dimensions: study design, choice of outcome instruments, level of reporting (usage, age, and audiometry) and cross validation of usage measures. Five papers were rated as being of high quality (scoring 10-12), 35 papers were rated as being of moderate quality (scoring 7-9), 22 as low quality (scoring 4-6) and two as very low quality (scoring 0-2). Fifteen different methods were identified for assessing the usage of hearing aids. Generally, the usage data reviewed was not well specified. There was a lack of consistency and robustness in the way that usage of hearing aids was assessed and categorised. There is a need for more standardised level of reporting of hearing aid usage data to further understand the relationship between usage and hearing aid outcomes.

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.

Auditory Outcomes with Hearing Rehabilitation in Children with Unilateral Hearing Loss: A Systematic Review.

PubMed

Appachi, Swathi; Specht, Jessica L; Raol, Nikhila; Lieu, Judith E C; Cohen, Michael S; Dedhia, Kavita; Anne, Samantha

2017-10-01

Objective Options for management of unilateral hearing loss (UHL) in children include conventional hearing aids, bone-conduction hearing devices, contralateral routing of signal (CROS) aids, and frequency-modulating (FM) systems. The objective of this study was to systematically review the current literature to characterize auditory outcomes of hearing rehabilitation options in UHL. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to January 2016. Manual searches of bibliographies were also performed. Review Methods Studies analyzing auditory outcomes of hearing amplification in children with UHL were included. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Results Of the 249 articles identified, 12 met inclusion criteria. Seven articles solely focused on outcomes with bone-conduction hearing devices. Outcomes favored improved pure-tone averages, speech recognition thresholds, and sound localization in implanted patients. Five studies focused on FM systems, conventional hearing aids, or CROS hearing aids. Limited data are available but suggest a trend toward improvement in speech perception with hearing aids. FM systems were shown to have the most benefit for speech recognition in noise. Studies evaluating CROS hearing aids demonstrated variable outcomes. Conclusions Data evaluating functional and objective auditory measures following hearing amplification in children with UHL are limited. Most studies do suggest improvement in speech perception, speech recognition in noise, and sound localization with a hearing rehabilitation device.

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…

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.

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.

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

ACEMg-mediated hearing preservation in cochlear implant patients receiving different electrode lengths (PROHEARING): study protocol for a randomized controlled trial.

PubMed

Scheper, Verena; Leifholz, Melanie; von der Leyen, Heiko; Keller, Miriam; Denkena, Ute; Koch, Armin; Karch, Annika; Miller, Josef; Lenarz, Thomas

2016-08-08

The indications for a cochlear implant (CI) have been extended to include patients with some residual hearing. Shorter and thinner atraumatic electrodes have been designed to preserve the residual hearing in the implanted ear. However, the insertion of the electrode array into the cochlea, with potential mechanical trauma and the presence of this foreign body inside the cochlea, may lead to free radical formation and reduced blood perfusion of the cochlea which can result in the loss of residual hearing. In this single-center, randomized, placebo-controlled, double-blind phase II clinical trial the effect of free radical scavengers and a vasodilator on the residual hearing of 140 CI patients will be evaluated. The formulation is composed of β-carotene (vitamin A), ascorbic acid (vitamin C), dl-α-tocopherol acetate (vitamin E) and the vasodilator magnesium (Mg), or ACEMg. Medication is administered twice daily per os for approximately 3 months. The primary measure is based upon the reduction in postoperative low-frequency air-conducted pure-tone thresholds compared to preoperative thresholds in ACEMg-treated patients compared to those of a placebo group. Additionally, the effect of different electrode lengths (20, 24 and 28 mm) is analyzed. Study visits are scheduled 2 days before surgery, at first fitting, which is the adjustment and start of stimulation via CI 4 weeks after surgery and 3, 6, 9 and 12 months after first fitting. The primary endpoint is the air-conduction hearing loss at 500 Hz 3 months after first fitting. Additionally, speech recognition tests, hearing aid benefit in the implanted ear and electrophysiological measurements of implant function are assessed. Since this is a blinded clinical trial and recruitment is still ongoing, data continue to accrue and we cannot yet analyze the outcome of the ACEMg treatment. There is an unfulfilled need for new strategies to preserve acoustic hearing in CI patients. This study will provide first-in-man data on ACEMg-mediated protection of residual hearing in CI patients. Performing all surgeries and patient follow-up at one study site improves consistency in diagnosis and therapy and less variability in surgery, audiological test techniques and fitting. This approach will allow investigation of the influence of ACEMg on residual hearing in CI patients. The German Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) application number 4039192, was registered on 6 December 2013 with protocol amendment version 3.0 from 19 August 2014. EudraCT number: 2012-005002-22 .

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

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

Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.

PubMed

Johnstone, Patti M; Yeager, Kelly R; Pomeroy, Marnie L; Hawk, Nicole

2018-04-01

Open-fit domes (OFDs) coupled with behind-the-ear (BTE) hearing aids were designed for adult listeners with moderate-to-severe bilateral high-frequency hearing loss (BHFL) with little to no concurrent loss in the lower frequencies. Adult research shows that BHFL degrades sound localization accuracy (SLA) and that BTE hearing aids with conventional earmolds (CEs) make matters worse. In contrast, research has shown that OFDs enhance spatial hearing percepts in adults with BHFL. Although the benefits of OFDs have been studied in adults with BHFL, no published studies to date have investigated the use of OFDs in children with the same hearing loss configuration. This study seeks to use SLA measurements to assess efficacy of bilateral OFDs in children with BHFL. To measure SLA in children with BHFL to determine the extent to which hearing loss, age, duration of CE use, and OFDs affect localization accuracy. A within-participant experimental design using repeated measures was used to determine the effect of OFDs on localization accuracy in children with BHFL. A between-participant experimental design was used to compare localization accuracy between children with BHFL and age-matched controls with normal hearing (NH). Eighteen children with BHFL who used CE and 18 age-matched NH controls. Children in both groups were divided into two age groups: older children (10-16 yr) and younger children (6-9 yr). All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, "baseball": the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Localization error was calculated across the loudspeaker array for each listening condition. A significant interaction was found between immediate benefit from OFD and duration of CE usage. Longer CE usage was associated with degraded localization accuracy using OFDs. Regardless of chronological age, children who had used CEs for <6 yr showed immediate localization benefit using OFDs, whereas children who had used CEs for >6 yr showed immediate localization interference using OFDs. Development, however, may play a role in SLA in children with BHFL. When unaided, older children had significantly better localization acuity than younger children with BHFL. When compared to age-matched controls, children with BHFL of all ages showed greater localization error. Nearly all (94% [17/18]) children with BHFL spontaneously reported immediate own-voice improvement when using OFDs. OFDs can provide sound localization benefit to younger children with BHFL. However, immediate benefit from OFDs is reduced by prolonged use of CEs. Although developmental factors may play a role in improving localization abilities over time, children with BHFL will rarely equal that of peers without early use of minimally disruptive hearing aid technology. Also, the occlusion effect likely impacts children far more than currently thought. American Academy of Audiology.

A Systematic Review of Studies Measuring and Reporting Hearing Aid Usage in Older Adults since 1999: A Descriptive Summary of Measurement Tools

PubMed Central

Perez, Elvira; Edmonds, Barrie A.

2012-01-01

Objective A systematic review was conducted to identify and quality assess how studies published since 1999 have measured and reported the usage of hearing aids in older adults. The relationship between usage and other dimensions of hearing aid outcome, age and hearing loss are summarised. Data sources Articles were identified through systematic searches in PubMed/MEDLINE, The University of Nottingham Online Catalogue, Web of Science and through reference checking. Study eligibility criteria: (1) participants aged fifty years or over with sensori-neural hearing loss, (2) provision of an air conduction hearing aid, (3) inclusion of hearing aid usage measure(s) and (4) published between 1999 and 2011. Results Of the initial 1933 papers obtained from the searches, a total of 64 were found eligible for review and were quality assessed on six dimensions: study design, choice of outcome instruments, level of reporting (usage, age, and audiometry) and cross validation of usage measures. Five papers were rated as being of high quality (scoring 10–12), 35 papers were rated as being of moderate quality (scoring 7–9), 22 as low quality (scoring 4–6) and two as very low quality (scoring 0–2). Fifteen different methods were identified for assessing the usage of hearing aids. Conclusions Generally, the usage data reviewed was not well specified. There was a lack of consistency and robustness in the way that usage of hearing aids was assessed and categorised. There is a need for more standardised level of reporting of hearing aid usage data to further understand the relationship between usage and hearing aid outcomes. PMID:22479312

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 Ling 6(HL) test: typical pediatric performance data and clinical use evaluation.

PubMed

Glista, Danielle; Scollie, Susan; Moodie, Sheila; Easwar, Vijayalakshmi

2014-01-01

The Ling 6(HL) test offers a calibrated version of naturally produced speech sounds in dB HL for evaluation of detection thresholds. Aided performance has been previously characterized in adults. The purpose of this work was to evaluate and refine the Ling 6(HL) test for use in pediatric hearing aid outcome measurement. This work is presented across two studies incorporating an integrated knowledge translation approach in the characterization of normative and typical performance, and in the evaluation of clinical feasibility, utility, acceptability, and implementation. A total of 57 children, 28 normally hearing and 29 with binaural sensorineural hearing loss, were included in Study 1. Children wore their own hearing aids fitted using Desired Sensation Level v5.0. Nine clinicians from The Network of Pediatric Audiologists participated in Study 2. A CD-based test format was used in the collection of unaided and aided detection thresholds in laboratory and clinical settings; thresholds were measured clinically as part of routine clinical care. Confidence intervals were derived to characterize normal performance and typical aided performance according to hearing loss severity. Unaided-aided performance was analyzed using a repeated-measures analysis of variance. The audiologists completed an online questionnaire evaluating the quality, feasibility/executability, utility/comparative value/relative advantage, acceptability/applicability, and interpretability, in addition to recommendation and general comments sections. Ling 6(HL) thresholds were reliably measured with children 3-18 yr old. Normative and typical performance ranges were translated into a scoring tool for use in pediatric outcome measurement. In general, questionnaire respondents generally agreed that the Ling 6(HL) test was a high-quality outcome evaluation tool that can be implemented successfully in clinical settings. By actively collaborating with pediatric audiologists and using an integrated knowledge translation framework, this work supported the creation of an evidence-based clinical tool that has the potential to be implemented in, and useful to, clinical practice. More research is needed to characterize performance in alternative listening conditions to facilitate use with infants, for example. Future efforts focused on monitoring the use of the Ling 6(HL) test in daily clinical practice may help describe whether clinical use has been maintained across time and if any additional adaptations are necessary to facilitate clinical uptake. American Academy of Audiology.

Children with Auditory Neuropathy Spectrum Disorder Fitted with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Current Practice and Outcomes.

PubMed

Walker, Elizabeth; McCreery, Ryan; Spratford, Meredith; Roush, Patricia

2016-03-01

Up to 15% of children with permanent hearing loss (HL) have auditory neuropathy spectrum disorder (ANSD), which involves normal outer hair cell function and disordered afferent neural activity in the auditory nerve or brainstem. Given the varying presentations of ANSD in children, there is a need for more evidence-based research on appropriate clinical interventions for this population. This study compared the speech production, speech perception, and language outcomes of children with ANSD, who are hard of hearing, to children with similar degrees of mild-to-moderately severe sensorineural hearing loss (SNHL), all of whom were fitted with bilateral hearing aids (HAs) based on the American Academy of Audiology pediatric amplification guidelines. Speech perception and communication outcomes data were gathered in a prospective accelerated longitudinal design, with entry into the study between six mo and seven yr of age. Three sites were involved in participant recruitment: Boys Town National Research Hospital, the University of North Carolina at Chapel Hill, and the University of Iowa. The sample consisted of 12 children with ANSD and 22 children with SNHL. The groups were matched based on better-ear pure-tone average, better-ear aided speech intelligibility index, gender, maternal education level, and newborn hearing screening result (i.e., pass or refer). Children and their families participated in an initial baseline visit, followed by visits twice a year for children <2 yr of age and once a yr for children >2 yr of age. Paired-sample t-tests were used to compare children with ANSD to children with SNHL. Paired t-tests indicated no significant differences between the ANSD and SNHL groups on language and articulation measures. Children with ANSD displayed functional speech perception skills in quiet. Although the number of participants was too small to conduct statistical analyses for speech perception testing, there appeared to be a trend in which the ANSD group performed more poorly in background noise with HAs, compared to the SNHL group. The American Academy of Audiology Pediatric Amplification Guidelines recommend that children with ANSD receive an HA trial if their behavioral thresholds are sufficiently high enough to impede speech perception at conversational levels. For children with ANSD in the mild-to-severe HL range, the current results support this recommendation, as children with ANSD can achieve functional outcomes similar to peers with SNHL. 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.

The Speech, Spatial and Qualities of Hearing Scale (SSQ)

PubMed Central

Gatehouse, Stuart; Noble, William

2017-01-01

The Speech, Spatial and Qualities of Hearing Scale (SSQ) is designed to measure a range of hearing disabilities across several domains. Particular attention is given to hearing speech in a variety of competing contexts, and to the directional, distance and movement components of spatial hearing. In addition, the abilities both to segregate sounds and to attend to simultaneous speech streams are assessed, reflecting the reality of hearing in the everyday world. Qualities of hearing experience include ease of listening, and the naturalness, clarity and identifiability of different speakers, different musical pieces and instruments, and different everyday sounds. Application of the SSQ to 153 new clinic clients prior to hearing aid fitting showed that the greatest difficulty was experienced with simultaneous speech streams, ease of listening, listening in groups and in noise, and judging distance and movement. SSQ ratings were compared with an independent measure of handicap. After differences in hearing level were controlled for, it was found that identification, attention and effort problems, as well as spatial hearing problems, feature prominently in the disability–handicap relationship, along with certain features of speech hearing. The results implicate aspects of temporal and spatial dynamics of hearing disability in the experience of handicap. The SSQ shows promise as an instrument for evaluating interventions of various kinds, particularly (but not exclusively) those that implicate binaural function. PMID:15035561

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.

Comparison of an Electromagnetic Middle Ear Implant and Hearing Aid Word Recognition Performance to Word Recognition Performance Obtained Under Earphones.

PubMed

Chang, C Y Joseph; Spearman, Michael; Spearman, Brian; McCraney, Anna; Glasscock, Michael E

2017-10-01

To report the results of patients with the Maxum middle ear implant (MEI) and compare word recognition scores (WRS) and speech perception gap (SP Gap) of Maxum versus optimally fit hearing aids (HA). Case series with chart review. Single, private otology clinic. Eleven ears, in nine adult patients (two women; average age 62.7 yr). Twelve consecutive ears with moderate to severe sensorineural hearing loss (SNHL) underwent implantation of the Maxum system. One patient was not included due to inadequate preoperative testing. Primary outcome measures included word recognition score (WRS) and SP Gap (maximum word understanding [PB max] - WRSaided) improvement compared with HAs. The average Maxum WRS was 64.7% (range, 28-94%), a 41.6% improvement (range, 10-66%) over HAs (p < 0.001). The average Maxum SP Gap was 6.6% (range, -8 to 24%), a 41.6% improvement (range, 10-66%) over HAs (p < 0.001). These data demonstrate that the Maxum provides superior WRS than HAs for patients with significant aided SP Gaps. There is a significant, very strong correlation between Maxum WRS and PB max (r = 0.85, p = 0.001). This implies that PB max may reasonably predict WRS outcomes with Maxum before implantation, and the SP Gap can reasonably predict the degree of additional potential benefit with Maxum. In advising patients who may be candidates for both a CI and MEI, PB max and SP Gap measurements will provide useful predictive information to help clinicians counsel patients on their choice of hearing technology. 4.

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.

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

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.

Single-channel in-ear-EEG detects the focus of auditory attention to concurrent tone streams and mixed speech.

PubMed

Fiedler, Lorenz; Wöstmann, Malte; Graversen, Carina; Brandmeyer, Alex; Lunner, Thomas; Obleser, Jonas

2017-06-01

Conventional, multi-channel scalp electroencephalography (EEG) allows the identification of the attended speaker in concurrent-listening ('cocktail party') scenarios. This implies that EEG might provide valuable information to complement hearing aids with some form of EEG and to install a level of neuro-feedback. To investigate whether a listener's attentional focus can be detected from single-channel hearing-aid-compatible EEG configurations, we recorded EEG from three electrodes inside the ear canal ('in-Ear-EEG') and additionally from 64 electrodes on the scalp. In two different, concurrent listening tasks, participants (n  =  7) were fitted with individualized in-Ear-EEG pieces and were either asked to attend to one of two dichotically-presented, concurrent tone streams or to one of two diotically-presented, concurrent audiobooks. A forward encoding model was trained to predict the EEG response at single EEG channels. Each individual participants' attentional focus could be detected from single-channel EEG response recorded from short-distance configurations consisting only of a single in-Ear-EEG electrode and an adjacent scalp-EEG electrode. The differences in neural responses to attended and ignored stimuli were consistent in morphology (i.e. polarity and latency of components) across subjects. In sum, our findings show that the EEG response from a single-channel, hearing-aid-compatible configuration provides valuable information to identify a listener's focus of attention.

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

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.

Neuromodulatory Effects of Auditory Training and Hearing Aid Use on Audiovisual Speech Perception in Elderly Individuals

PubMed Central

Yu, Luodi; Rao, Aparna; Zhang, Yang; Burton, Philip C.; Rishiq, Dania; Abrams, Harvey

2017-01-01

Although audiovisual (AV) training has been shown to improve overall speech perception in hearing-impaired listeners, there has been a lack of direct brain imaging data to help elucidate the neural networks and neural plasticity associated with hearing aid (HA) use and auditory training targeting speechreading. For this purpose, the current clinical case study reports functional magnetic resonance imaging (fMRI) data from two hearing-impaired patients who were first-time HA users. During the study period, both patients used HAs for 8 weeks; only one received a training program named ReadMyQuipsTM (RMQ) targeting speechreading during the second half of the study period for 4 weeks. Identical fMRI tests were administered at pre-fitting and at the end of the 8 weeks. Regions of interest (ROI) including auditory cortex and visual cortex for uni-sensory processing, and superior temporal sulcus (STS) for AV integration, were identified for each person through independent functional localizer task. The results showed experience-dependent changes involving ROIs of auditory cortex, STS and functional connectivity between uni-sensory ROIs and STS from pretest to posttest in both cases. These data provide initial evidence for the malleable experience-driven cortical functionality for AV speech perception in elderly hearing-impaired people and call for further studies with a much larger subject sample and systematic control to fill in the knowledge gap to understand brain plasticity associated with auditory rehabilitation in the aging population. PMID:28270763

[Pre- and posttreatment results of an inpatient neurotologic and psychosomatic tinnitus therapy].

PubMed

Schaaf, H; Hesse, G

2015-08-01

Inpatient treatment of chronic complex tinnitus can be necessary for patients with a high symptomatic strain, mostly accompanied by a corresponding mental comorbidity, and/or for patients that can only perceive their psychogenic suffering through somatization into tinnitus. We report the results of 368 consecutively treated inpatients with chronic complex tinnitus. Patients' audiometric data were collected, and at the beginning and end of treatment, the Mini-Tinnitus Questionnaire (Mini-TQ12; Hiller und Goebel) was completed, as was the German version of the Hospitality Anxiety and Depression Score (HADS). Effect sizes were calculated for both questionnaires. Mean treatment duration was 38.8 days (standard deviation, SD: 13.6 days). The main therapeutic elements were intensive disorder-specific neurotologic counselling and psychoeducation; improvement of hearing by fitting of hearing aids, complemented by an individualized hearing therapy; and intensive individual and group-based psychotherapy. In addition to tinnitus, 82.1% of the patients had reduced hearing requiring rehabilitation with hearing aids. After hospitalization, a highly significant improvement in tinnitus strain could be demonstrated by the Mini-TQ12. Furthermore, a significant reduction in the depression and anxiety components of HADS was also achieved, with high effect sizes of 1.6 to 2.2. No reduction of tinnitus symptoms to a medium- or low-range level was experienced by 8.9% of patients. With corresponding symptomatic suffering, disorder-specific inpatient tinnitus treatment comprising neurotologic and psychosomatic alignment can achieve medium- to high-range therapeutic effects.

Neuromodulatory Effects of Auditory Training and Hearing Aid Use on Audiovisual Speech Perception in Elderly Individuals.

PubMed

Yu, Luodi; Rao, Aparna; Zhang, Yang; Burton, Philip C; Rishiq, Dania; Abrams, Harvey

2017-01-01

Although audiovisual (AV) training has been shown to improve overall speech perception in hearing-impaired listeners, there has been a lack of direct brain imaging data to help elucidate the neural networks and neural plasticity associated with hearing aid (HA) use and auditory training targeting speechreading. For this purpose, the current clinical case study reports functional magnetic resonance imaging (fMRI) data from two hearing-impaired patients who were first-time HA users. During the study period, both patients used HAs for 8 weeks; only one received a training program named ReadMyQuips TM (RMQ) targeting speechreading during the second half of the study period for 4 weeks. Identical fMRI tests were administered at pre-fitting and at the end of the 8 weeks. Regions of interest (ROI) including auditory cortex and visual cortex for uni-sensory processing, and superior temporal sulcus (STS) for AV integration, were identified for each person through independent functional localizer task. The results showed experience-dependent changes involving ROIs of auditory cortex, STS and functional connectivity between uni-sensory ROIs and STS from pretest to posttest in both cases. These data provide initial evidence for the malleable experience-driven cortical functionality for AV speech perception in elderly hearing-impaired people and call for further studies with a much larger subject sample and systematic control to fill in the knowledge gap to understand brain plasticity associated with auditory rehabilitation in the aging population.

Trends in cochlear implants.

PubMed

Zeng, Fan-Gang

2004-01-01

More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management.

Skin Necrosis After Implantation With the BAHA Attract: A Case Report and Review of the Literature.

PubMed

Chen, Stephanie Y; Mancuso, Dean; Lalwani, Anil K

2017-03-01

The bone-anchored hearing aid (BAHA) Attract is a transcutaneous bone conduction hearing aid that uses magnetic coupling to enable sound conduction. We report the first case of skin necrosis associated with the BAHA Attract and perform a literature review of soft tissue complications related to the device. A single patient who was found to develop skin necrosis 2 weeks after being fitted for the BAHA Attract speech processor. After the patient developed skin necrosis from the device, she was advised to immediately discontinue use of the Attract to allow complete wound healing, upon which the Attract was successfully converted to a percutaneous BAHA. We monitored for the development of skin complications from the BAHA Attract. The patient's immediate postoperative course was unremarkable and she was fitted with a speech processor of M5 magnet strength at 1 month postoperatively. After 1 week of use, she reported discomfort and was advised to downgrade to an M4 magnet; however, she continued to use the M5 and the following week was found to have developed skin necrosis around the device. Despite the infrequency of skin necrosis related to the BAHA Attract, it must be considered in counseling and managing candidates for the device.

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.

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.

Determination of preferred parameters for multichannel compression using individually fitted simulated hearing AIDS and paired comparisons.

PubMed

Moore, Brian C J; Füllgrabe, Christian; Stone, Michael A

2011-01-01

To determine preferred parameters of multichannel compression using individually fitted simulated hearing aids and a method of paired comparisons. Fourteen participants with mild to moderate hearing loss listened via a simulated five-channel compression hearing aid fitted using the CAMEQ2-HF method to pairs of speech sounds (a male talker and a female talker) and musical sounds (a percussion instrument, orchestral classical music, and a jazz trio) presented sequentially and indicated which sound of the pair was preferred and by how much. The sounds in each pair were derived from the same token and differed along a single dimension in the type of processing applied. For the speech sounds, participants judged either pleasantness or clarity; in the latter case, the speech was presented in noise at a 2-dB signal-to-noise ratio. For musical sounds, they judged pleasantness. The parameters explored were time delay of the audio signal relative to the gain control signal (the alignment delay), compression speed (attack and release times), bandwidth (5, 7.5, or 10 kHz), and gain at high frequencies relative to that prescribed by CAMEQ2-HF. Pleasantness increased with increasing alignment delay only for the percussive musical sound. Clarity was not affected by alignment delay. There was a trend for pleasantness to decrease slightly with increasing bandwidth, but this was significant only for female speech with fast compression. Judged clarity was significantly higher for the 7.5- and 10-kHz bandwidths than for the 5-kHz bandwidth for both slow and fast compression and for both talker genders. Compression speed had little effect on pleasantness for 50- or 65-dB SPL input levels, but slow compression was generally judged as slightly more pleasant than fast compression for an 80-dB SPL input level. Clarity was higher for slow than for fast compression for input levels of 80 and 65 dB SPL but not for a level of 50 dB SPL. Preferences for pleasantness were approximately equal with CAMEQ2-HF gains and with gains slightly reduced at high frequencies and were lower when gains were slightly increased at high frequencies. Speech clarity was not affected by changing the gain at high frequencies. Effects of alignment delay were small except for the percussive sound. A wider bandwidth was slightly preferred for speech clarity. Speech clarity was slightly greater with slow compression, especially at high levels. Preferred high-frequency gains were close to or a little below those prescribed by CAMEQ2-HF.

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.

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/.

Development and Initial Validation of a Consumer Questionnaire to Predict the Presence of Ear Disease.

PubMed

Kleindienst, Samantha J; Zapala, David A; Nielsen, Donald W; Griffith, James W; Rishiq, Dania; Lundy, Larry; Dhar, Sumitrajit

2017-10-01

The already large population of individuals with age- or noise-related hearing loss in the United States is increasing, yet hearing aids remain largely inaccessible. The recent decision by the US Food and Drug Administration to not enforce the medical examination prior to hearing aid fitting highlights the need to reengineer consumer protections when increasing accessibility. A self-administered tool to estimate ear disease risk would provide disease surveillance without posing an unreasonable barrier to hearing aid procurement. To develop and validate a consumer questionnaire for the self-assessment of risk for ear diseases associated with hearing loss. The questionnaire was developed using established methods including expert opinion to validate and create questions, and cognitive interviews to ensure that questions were clear to respondents. Exploratory structural equation modeling, logistic regression, and receiver operating characteristic curve analysis were used to determine sensitivity and specificity with blinded neurotologist opinion as the criterion for evaluation. Patients 40 to 80 years old with ear or hearing complaints necessitating a neurotologic examination and a control group of participants with a diagnosis of age- or noise-related hearing loss participated at the Departments of Otorhinolaryngology and Audiology of Mayo Clinic Florida. Sensitivity and specificity of the prototype questionnaire to identify individuals with targeted diseases. Of 307 participants (mean [SD] age, 62.9 [9.8] years; 148 [48%] female), 75% (n = 231) were enrolled with targeted disease(s) identified on neurotologic assessment and 25% (n = 76) with age- or noise-related hearing loss. Participants were randomly divided into a training sample (80% [n = 246; 185 with disease, 61 controls]) and a test sample (20% [n = 61; 46 with disease, 15 controls]). Using a simple scoring method, a sensitivity of 94% (95% CI, 89%-97%) and specificity of 61% (95% CI, 47%-73%) were established in the training sample. Applying this cutoff to the test sample resulted in 85% (95% CI, 71%-93%) sensitivity and 47% (95% CI, 22%-73%) specificity. This is the first self-assessment tool designed to assess an individual's risk for ear disease. Our preliminary results demonstrate a high sensitivity to disease detection. A further validated and refined version of this questionnaire may serve as an efficacious tool for improving access to hearing health care while minimizing the risk for missed ear diseases.

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.

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.

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.

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

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...

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

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.

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…

Optimal electrode selection for multi-channel electroencephalogram based detection of auditory steady-state responses.

PubMed

Van Dun, Bram; Wouters, Jan; Moonen, Marc

2009-07-01

Auditory steady-state responses (ASSRs) are used for hearing threshold estimation at audiometric frequencies. Hearing impaired newborns, in particular, benefit from this technique as it allows for a more precise diagnosis than traditional techniques, and a hearing aid can be better fitted at an early age. However, measurement duration of current single-channel techniques is still too long for clinical widespread use. This paper evaluates the practical performance of a multi-channel electroencephalogram (EEG) processing strategy based on a detection theory approach. A minimum electrode set is determined for ASSRs with frequencies between 80 and 110 Hz using eight-channel EEG measurements of ten normal-hearing adults. This set provides a near-optimal hearing threshold estimate for all subjects and improves response detection significantly for EEG data with numerous artifacts. Multi-channel processing does not significantly improve response detection for EEG data with few artifacts. In this case, best response detection is obtained when noise-weighted averaging is applied on single-channel data. The same test setup (eight channels, ten normal-hearing subjects) is also used to determine a minimum electrode setup for 10-Hz ASSRs. This configuration allows to record near-optimal signal-to-noise ratios for 80% of subjects.

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.

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

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.

Nonlinear frequency compression: effects on sound quality ratings of speech and music.

PubMed

Parsa, Vijay; Scollie, Susan; Glista, Danielle; Seelisch, Andreas

2013-03-01

Frequency lowering technologies offer an alternative amplification solution for severe to profound high frequency hearing losses. While frequency lowering technologies may improve audibility of high frequency sounds, the very nature of this processing can affect the perceived sound quality. This article reports the results from two studies that investigated the impact of a nonlinear frequency compression (NFC) algorithm on perceived sound quality. In the first study, the cutoff frequency and compression ratio parameters of the NFC algorithm were varied, and their effect on the speech quality was measured subjectively with 12 normal hearing adults, 12 normal hearing children, 13 hearing impaired adults, and 9 hearing impaired children. In the second study, 12 normal hearing and 8 hearing impaired adult listeners rated the quality of speech in quiet, speech in noise, and music after processing with a different set of NFC parameters. Results showed that the cutoff frequency parameter had more impact on sound quality ratings than the compression ratio, and that the hearing impaired adults were more tolerant to increased frequency compression than normal hearing adults. No statistically significant differences were found in the sound quality ratings of speech-in-noise and music stimuli processed through various NFC settings by hearing impaired listeners. These findings suggest that there may be an acceptable range of NFC settings for hearing impaired individuals where sound quality is not adversely affected. These results may assist an Audiologist in clinical NFC hearing aid fittings for achieving a balance between high frequency audibility and sound quality.

Home-based Early Intervention on Auditory and Speech Development in Mandarin-speaking Deaf Infants and Toddlers with Chronological Aged 7-24 Months.

PubMed

Yang, Ying; Liu, Yue-Hui; Fu, Ming-Fu; Li, Chun-Lin; Wang, Li-Yan; Wang, Qi; Sun, Xi-Bin

2015-08-20

Early auditory and speech development in home-based early intervention of infants and toddlers with hearing loss younger than 2 years are still spare in China. This study aimed to observe the development of auditory and speech in deaf infants and toddlers who were fitted with hearing aids and/or received cochlear implantation between the chronological ages of 7-24 months, and analyze the effect of chronological age and recovery time on auditory and speech development in the course of home-based early intervention. This longitudinal study included 55 hearing impaired children with severe and profound binaural deafness, who were divided into Group A (7-12 months), Group B (13-18 months) and Group C (19-24 months) based on the chronological age. Categories auditory performance (CAP) and speech intelligibility rating scale (SIR) were used to evaluate auditory and speech development at baseline and 3, 6, 9, 12, 18, and 24 months of habilitation. Descriptive statistics were used to describe demographic features and were analyzed by repeated measures analysis of variance. With 24 months of hearing intervention, 78% of the patients were able to understand common phrases and conversation without lip-reading, 96% of the patients were intelligible to a listener. In three groups, children showed the rapid growth of trend features in each period of habilitation. CAP and SIR scores have developed rapidly within 24 months after fitted auxiliary device in Group A, which performed much better auditory and speech abilities than Group B (P < 0.05) and Group C (P < 0.05). Group B achieved better results than Group C, whereas no significant differences were observed between Group B and Group C (P > 0.05). The data suggested the early hearing intervention and home-based habilitation benefit auditory and speech development. Chronological age and recovery time may be major factors for aural verbal outcomes in hearing impaired children. The development of auditory and speech in hearing impaired children may be relatively crucial in thefirst year's habilitation after fitted with the auxiliary device.

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.

Effects of early auditory experience on the spoken language of deaf children at 3 years of age.

PubMed

Nicholas, Johanna Grant; Geers, Ann E

2006-06-01

By age 3, typically developing children have achieved extensive vocabulary and syntax skills that facilitate both cognitive and social development. Substantial delays in spoken language acquisition have been documented for children with severe to profound deafness, even those with auditory oral training and early hearing aid use. This study documents the spoken language skills achieved by orally educated 3-yr-olds whose profound hearing loss was identified and hearing aids fitted between 1 and 30 mo of age and who received a cochlear implant between 12 and 38 mo of age. The purpose of the analysis was to examine the effects of age, duration, and type of early auditory experience on spoken language competence at age 3.5 yr. The spoken language skills of 76 children who had used a cochlear implant for at least 7 mo were evaluated via standardized 30-minute language sample analysis, a parent-completed vocabulary checklist, and a teacher language-rating scale. The children were recruited from and enrolled in oral education programs or therapy practices across the United States. Inclusion criteria included presumed deaf since birth, English the primary language of the home, no other known conditions that interfere with speech/language development, enrolled in programs using oral education methods, and no known problems with the cochlear implant lasting more than 30 days. Strong correlations were obtained among all language measures. Therefore, principal components analysis was used to derive a single Language Factor score for each child. A number of possible predictors of language outcome were examined, including age at identification and intervention with a hearing aid, duration of use of a hearing aid, pre-implant pure-tone average (PTA) threshold with a hearing aid, PTA threshold with a cochlear implant, and duration of use of a cochlear implant/age at implantation (the last two variables were practically identical because all children were tested between 40 and 44 mo of age). Examination of the independent influence of these predictors through multiple regression analysis revealed that pre-implant-aided PTA threshold and duration of cochlear implant use (i.e., age at implant) accounted for 58% of the variance in Language Factor scores. A significant negative coefficient associated with pre-implant-aided threshold indicated that children with poorer hearing before implantation exhibited poorer language skills at age 3.5 yr. Likewise, a strong positive coefficient associated with duration of implant use indicated that children who had used their implant for a longer period of time (i.e., who were implanted at an earlier age) exhibited better language at age 3.5 yr. Age at identification and amplification was unrelated to language outcome, as was aided threshold with the cochlear implant. A significant quadratic trend in the relation between duration of implant use and language score revealed a steady increase in language skill (at age 3.5 yr) for each additional month of use of a cochlear implant after the first 12 mo of implant use. The advantage to language of longer implant use became more pronounced over time. Longer use of a cochlear implant in infancy and very early childhood dramatically affects the amount of spoken language exhibited by 3-yr-old, profoundly deaf children. In this sample, the amount of pre-implant intervention with a hearing aid was not related to language outcome at 3.5 yr of age. Rather, it was cochlear implantation at a younger age that served to promote spoken language competence. The previously identified language-facilitating factors of early identification of hearing impairment and early educational intervention may not be sufficient for optimizing spoken language of profoundly deaf children unless it leads to early cochlear implantation.

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.

Trends in Cochlear Implants

PubMed Central

Zeng, Fan-Gang

2004-01-01

More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management. PMID:15247993

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…

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.

Infant vocalizations and the early diagnosis of severe hearing impairment.

PubMed

Eilers, R E; Oller, D K

1994-02-01

To determine whether late onset of canonical babbling could be used as a criterion to determine risk of hearing impairment, we obtained vocalization samples longitudinally from 94 infants with normal hearing and 37 infants with severe to profound hearing impairment. Parents were instructed to report the onset of canonical babbling (the production of well-formed syllables such as "da," "na," "bee," "yaya"). Verification that the infants were producing canonical syllables was collected in laboratory audio recordings. Infants with normal hearing produced canonical vocalizations before 11 months of age (range, 3 to 10 months; mode, 7 months); infants who were deaf failed to produce canonical syllables until 11 months of age or older, often well into the third year of life (range, 11 to 49 months; mode, 24 months). The correlation between age at onset of the canonical stage and age at auditory amplification was 0.68, indicating that early identification and fitting of hearing aids is of significant benefit to infants learning language. The fact that there is no overlap in the distribution of the onset of canonical babbling between infants with normal hearing and infants with hearing impairment means that the failure of otherwise healthy infants to produce canonical syllables before 11 months of age should be considered a serious risk factor for hearing impairment and, when observed, should result in immediate referral for audiologic evaluation.

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.

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.

Single-channel in-ear-EEG detects the focus of auditory attention to concurrent tone streams and mixed speech

NASA Astrophysics Data System (ADS)

Fiedler, Lorenz; Wöstmann, Malte; Graversen, Carina; Brandmeyer, Alex; Lunner, Thomas; Obleser, Jonas

2017-06-01

Objective. Conventional, multi-channel scalp electroencephalography (EEG) allows the identification of the attended speaker in concurrent-listening (‘cocktail party’) scenarios. This implies that EEG might provide valuable information to complement hearing aids with some form of EEG and to install a level of neuro-feedback. Approach. To investigate whether a listener’s attentional focus can be detected from single-channel hearing-aid-compatible EEG configurations, we recorded EEG from three electrodes inside the ear canal (‘in-Ear-EEG’) and additionally from 64 electrodes on the scalp. In two different, concurrent listening tasks, participants (n  =  7) were fitted with individualized in-Ear-EEG pieces and were either asked to attend to one of two dichotically-presented, concurrent tone streams or to one of two diotically-presented, concurrent audiobooks. A forward encoding model was trained to predict the EEG response at single EEG channels. Main results. Each individual participants’ attentional focus could be detected from single-channel EEG response recorded from short-distance configurations consisting only of a single in-Ear-EEG electrode and an adjacent scalp-EEG electrode. The differences in neural responses to attended and ignored stimuli were consistent in morphology (i.e. polarity and latency of components) across subjects. Significance. In sum, our findings show that the EEG response from a single-channel, hearing-aid-compatible configuration provides valuable information to identify a listener’s focus of attention.

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.

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

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…

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…

A Qualitative Study on Knowledge and Attitude towards Risk Factors, Early Identification and Intervention of Infant Hearing Loss among Puerperal Mothers- A Short Survey.

PubMed

Dudda, Ravi; Muniyappa, Hanumanth Prasad; Puttaraju, Sahana; Lakshmi, M S

2017-07-01

Maternal active participation and their support are critical for the success of early hearing loss detection program. Erroneous maternal decisions may have large life long consequences on the infant's life. The mothers' knowledge and their attitudes towards infant hearing loss is the basis for their decisions. The present study was done to determine the mothers' knowledge and their attitude towards risk factors of infant hearing loss, its early identification and intervention and also awareness of effect of consanguinity on hearing loss. In this cross-sectional questionnaire survey study, a total of 100 mothers were interviewed using the questionnaire which consisted of three sections namely risk factors, early identification and early intervention of hearing loss. Chi-square test was used to establish relationship between consanguineous and non-consanguineous mother's responses to its effect on hearing loss. A p-value < 0.05 was considered as significant. Mothers' awareness was significantly high for visible causes (ear pain/discharge, head injury and slap to ear) of hearing loss. Positive attitude was seen for importance of screening programs and follow up testing. Moderate level of awareness was found on hazards of consanguinity and benefits of early identification. However, mothers were least aware of neonatal jaundice, NICU admission (>5 days), signs of late-onset and neural hearing loss, management of hearing loss, hearing aid fitting and therapy necessity, which might interfere in early detection and intervention of hearing loss. It is crucial to educate mothers on few risk factors and management of hearing loss to reduce its consequences.

Sentence recognition in noise and perceived benefit of noise reduction on the receiver and transmitter sides of a BICROS hearing aid.

PubMed

Oeding, Kristi; Valente, Michael

2013-01-01

In the past, bilateral contralateral routing of signals (BICROS) amplification incorporated omnidirectional microphones on the transmitter and receiver sides and some models utilized noise reduction (NR) on the receiver side. Little research has examined the performance of BICROS amplification in background noise. However, previous studies examining contralateral routing of signals (CROS) amplification have reported that the presence of background noise on the transmitter side negatively affected speech recognition. Recently, NR was introduced as a feature on the receiver and transmitter sides of BICROS amplification, which has the potential to decrease the impact of noise on the wanted speech signal by decreasing unwanted noise directed to the transmitter side. The primary goal of this study was to examine differences in the reception threshold for sentences (RTS in dB) using the Hearing in Noise Test (HINT) in a diffuse listening environment between unaided and three aided BICROS conditions (no NR, mild NR, and maximum NR) in the Tandem 16 BICROS. A secondary goal was to examine real-world subjective impressions of the Tandem 16 BICROS compared to unaided. A randomized block repeated measures single blind design was used to assess differences between no NR, mild NR, and maximum NR listening conditions. Twenty-one adult participants with asymmetric sensorineural hearing loss (ASNHL) and experience with BICROS amplification were recruited from Washington University in St. Louis School of Medicine. Participants were fit with the National Acoustic Laboratories' Nonlinear version 1 prescriptive target (NAL-NL1) with the Tandem 16 BICROS at the initial visit and then verified using real-ear insertion gain (REIG) measures. Participants acclimatized to the Tandem 16 BICROS for 4 wk before returning for final testing. Participants were tested utilizing HINT sentences examining differences in RTS between unaided and three aided listening conditions. Subjective benefit was determined via the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire between the Tandem 16 BICROS and unaided. A repeated measures analysis of variance (ANOVA) was utilized to analyze the results of the HINT and APHAB. Results revealed no significant differences in the RTS between unaided, no NR, mild NR, and maximum NR. Subjective impressions using the APHAB revealed statistically and clinically significant benefit with the Tandem 16 BICROS compared to unaided for the Ease of Communication (EC), Background Noise (BN), and Reverberation (RV) subscales. The RTS was not significantly different between unaided, no NR, mild NR, and maximum NR. None of the three aided listening conditions were significantly different from unaided performance as has been reported for previous studies examining CROS hearing aids. Further, based on comments from participants and previous research studies with conventional hearing aids, manufacturers of BICROS amplification should consider incorporating directional microphones and independent volume controls on the receiver and transmitter sides to potentially provide further improvement in signal-to-noise ratio (SNR) for patients with ASNHL. American Academy of Audiology.

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.

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.

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...

Perception of Musical Emotion in the Students with Cognitive and Acquired Hearing Loss.

PubMed

Mazaheryazdi, Malihe; Aghasoleimani, Mina; Karimi, Maryam; Arjmand, Pirooz

2018-01-01

Hearing loss can affect the perception of emotional reaction to the music. The present study investigated whether the students with congenital hearing loss exposed to the deaf culture, percept the same emotion from the music as students with acquired hearing loss. Participants were divided into two groups; 30 students with bilaterally congenital moderate to severe hearing loss that were selected from deaf schools located in Tehran, Iran and 30 students with an acquired hearing loss with the same degree of hearing loss selected from Amiralam Hospital, Tehran, Iran and compared with the group of 30 age and gender-matched normal hearing subjects served our control in 2012. The musical stimuli consisted of three different sequences of music, (sadness, happiness, and fear) each with the duration of 60 sec. The students were asked to point to the lists of words that best matched with their emotions. Emotional perception of sadness, happiness, and fear in congenital hearing loss children was significantly poorly than acquired hearing loss and normal hearing group ( P <0.001). There was no significant difference in the emotional perception of sadness, happiness, and fear among the group of acquired hearing loss and normal hearing group ( P =0.75), ( P =1) and ( P =0.16) respectively. Neural plasticity induced by hearing assistant devises may be affected by the time when a hearing aid was first fitted and how the auditory system responds to the reintroduction of certain sounds via amplification. Therefore, children who experienced auditory input of different sound patterns in their early childhood will show more perceptual flexibility in different situations than the children with congenital hearing loss and Deaf culture.

Contribution of hearing aids to music perception by cochlear implant users.

PubMed

Peterson, Nathaniel; Bergeson, Tonya R

2015-09-01

Modern cochlear implant (CI) encoding strategies represent the temporal envelope of sounds well but provide limited spectral information. This deficit in spectral information has been implicated as a contributing factor to difficulty with speech perception in noisy conditions, discriminating between talkers and melody recognition. One way to supplement spectral information for CI users is by fitting a hearing aid (HA) to the non-implanted ear. In this study 14 postlingually deaf adults (half with a unilateral CI and the other half with a CI and an HA (CI + HA)) were tested on measures of music perception and familiar melody recognition. CI + HA listeners performed significantly better than CI-only listeners on all pitch-based music perception tasks. The CI + HA group did not perform significantly better than the CI-only group in the two tasks that relied on duration cues. Recognition of familiar melodies was significantly enhanced for the group wearing an HA in addition to their CI. This advantage in melody recognition was increased when melodic sequences were presented with the addition of harmony. These results show that, for CI recipients with aidable hearing in the non-implanted ear, using a HA in addition to their implant improves perception of musical pitch and recognition of real-world melodies.

Initial Development of a Spatially Separated Speech-in-Noise and Localization Training Program

PubMed Central

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

2010-01-01

Objective This article describes the initial development of a novel approach for training hearing-impaired listeners to improve their ability to understand speech in the presence of background noise and to also improve their ability to localize sounds. Design Most people with hearing loss, even those well fit with hearing devices, still experience significant problems understanding speech in noise. Prior research suggests that at least some subjects can experience improved speech understanding with training. However, all training systems that we are aware of have one basic, critical limitation. They do not provide spatial separation of the speech and noise, therefore ignoring the potential benefits of training binaural hearing. In this paper we describe our initial experience with a home-based training system that includes spatially separated speech-in-noise and localization training. Results Throughout the development of this system patient input, training and preliminary pilot data from individuals with bilateral cochlear implants were utilized. Positive feedback from subjective reports indicated that some individuals were engaged in the treatment, and formal testing showed benefit. Feedback and practical issues resulted from the reduction of an eight-loudspeaker to a two-loudspeaker system. Conclusions These preliminary findings suggest we have successfully developed a viable spatial hearing training system that can improve binaural hearing in noise and localization. Applications include, but are not limited to, hearing with hearing aids and cochlear implants. PMID:20701836

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

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

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.

21 CFR 874.3950 - Transcutaneous air conduction hearing aid system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Transcutaneous air conduction hearing aid system. 874.3950 Section 874.3950 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Conduction Hearing Aid System (TACHAS); Guidance for Industry and FDA.” See § 874.1 for the availability of...

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

Suppression of Tinnitus in a Patient with Unilateral Sudden Hearing Loss: A Case Report

PubMed Central

Fioretti, Alessandra; Peri, Giorgia; Eibenstein, Alberto

2012-01-01

We describe a case of a 67-year-old woman with severe disabling right-sided tinnitus, mild hyperacusis, and headache. The tinnitus was associated with sudden right hearing loss and vertigo, which occurred about 18 months before. Magnetic resonance imaging (MRI) resulted in normal anatomical structures of the cochlea and of the cranial nerves showing a partial empty sella syndrome with suprasellar cistern hernia. Angio-MR revealed a bilateral contact between the anterior-inferior cerebellar artery (AICA) and the acoustic-facial nerve with a potential neurovascular conflict. Surgery was considered unnecessary after further evaluations. The right ear was successfully treated with a combination device (hearing aid plus sound generator). Shortly after a standard fitting procedure, the patient reported a reduction of tinnitus, hyperacusis, and headache which completely disappeared at the follow-up evaluation after 3, 6, and 12 months. This paper demonstrates that the combination device resulted in a complete tinnitus and hyperacusis suppression in a patient with unilateral sensorineural sudden hearing loss. Our paper further supports the restoration of peripheral sensory input for the treatment of tinnitus associated with hearing loss in selected patients. PMID:23227400

Participation in regular classroom of student with hearing loss: frequency modulation system use.

PubMed

Jacob, Regina Tangerino de Souza; Alves, Tacianne Kriscia Machado; Moret, Adriane Lima Mortari; Morettin, Marina; Santos, Larissa Germiniani Dos; Mondelli, Maria Fernanda Capoani Garcia

2014-01-01

Translate and adapt to Portuguese the Classroom Participation Questionnaire (CPQ) and compare the participation in regular classroom of students with hearing impairment with and without the use of frequency modulation (FM) System. The translation and adaptation of CPQ included the translation into Portuguese, linguistic adaptation and review of grammatical and idiomatic equivalences. The questionnaire was administered to 15 children and teenagers using hearing aids (HA) and/or cochlear implant (CI), fitted with personal FM System. The translation of the English CPQ into the Portuguese instrument resulted in the "Questionário de participação em sala de aula" with the same number of questions as the original version; regarding linguistic adaptation, no difficulty was observed in the understanding of the items proposed in the application for students with hearing loss. The CPQ instrument was translated and culturally adapted for the Brazilian population, being named "Questionário de participação em sala de aula" in the Portuguese version. The study contributes to observation and monitoring of participation in regular classroom of students with hearing impairment using FM System. In general, students reported increased confidence and participation in the classroom with the use of FM System.

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.

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.

Prototype to product—developing a commercially viable neural prosthesis

NASA Astrophysics Data System (ADS)

Seligman, Peter

2009-12-01

The Cochlear implant or 'Bionic ear' is a device that enables people who do not get sufficient benefit from a hearing aid to communicate with the hearing world. The Cochlear implant is not an amplifier, but a device that electrically stimulates the auditory nerve in a way that crudely mimics normal hearing, thus providing a hearing percept. Many recipients are able to understand running speech without the help of lipreading. Cochlear implants have reached a stage of maturity where there are now 170 000 recipients implanted worldwide. The commercial development of these devices has occurred over the last 30 years. This development has been multidisciplinary, including audiologists, engineers, both mechanical and electrical, histologists, materials scientists, physiologists, surgeons and speech pathologists. This paper will trace the development of the device we have today, from the engineering perspective. The special challenges of designing an active device that will work in the human body for a lifetime will be outlined. These challenges include biocompatibility, extreme reliability, safety, patient fitting and surgical issues. It is emphasized that the successful development of a neural prosthesis requires the partnership of academia and industry.

Prototype to product-developing a commercially viable neural prosthesis.

PubMed

Seligman, Peter

2009-12-01

The Cochlear implant or 'Bionic ear' is a device that enables people who do not get sufficient benefit from a hearing aid to communicate with the hearing world. The Cochlear implant is not an amplifier, but a device that electrically stimulates the auditory nerve in a way that crudely mimics normal hearing, thus providing a hearing percept. Many recipients are able to understand running speech without the help of lipreading. Cochlear implants have reached a stage of maturity where there are now 170 000 recipients implanted worldwide. The commercial development of these devices has occurred over the last 30 years. This development has been multidisciplinary, including audiologists, engineers, both mechanical and electrical, histologists, materials scientists, physiologists, surgeons and speech pathologists. This paper will trace the development of the device we have today, from the engineering perspective. The special challenges of designing an active device that will work in the human body for a lifetime will be outlined. These challenges include biocompatibility, extreme reliability, safety, patient fitting and surgical issues. It is emphasized that the successful development of a neural prosthesis requires the partnership of academia and industry.

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.

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

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

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.

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 ...

Binaural Interference and the Effects of Age and Hearing Loss.

PubMed

Mussoi, Bruna S S; Bentler, Ruth A

2017-01-01

The existence of binaural interference, defined here as poorer speech recognition with both ears than with the better ear alone, is well documented. Studies have suggested that its prevalence may be higher in the elderly population. However, no study to date has explored binaural interference in groups of younger and older adults in conditions that favor binaural processing (i.e., in spatially separated noise). Also, the effects of hearing loss have not been studied. To examine binaural interference through speech perception tests, in groups of younger adults with normal hearing, older adults with normal hearing for their age, and older adults with hearing loss. A cross-sectional study. Thirty-three participants with symmetric thresholds were recruited from the University of Iowa community. Participants were grouped as follows: younger with normal hearing (18-28 yr, n = 12), older with normal hearing for their age (73-87 yr, n = 9), and older with hearing loss (78-94 yr, n = 12). Prior noise exposure was ruled out. The Connected Speech Test (CST) and Hearing in Noise Test (HINT) were administered to all participants bilaterally, and to each ear separately. Test materials were presented in the sound field with speech at 0° azimuth and the noise at 180°. The Dichotic Digits Test (DDT) was administered to all participants through earphones. Hearing aids were not used during testing. Group results were compared with repeated measures and one-way analysis of variances, as appropriate. Within-subject analyses using pre-established critical differences for each test were also performed. The HINT revealed no effect of condition (individual ear versus bilateral presentation) using group analysis, although within-subject analysis showed that 27% of the participants had binaural interference (18% had binaural advantage). On the CST, there was significant binaural advantage across all groups with group data analysis, as well as for 12% of the participants at each of the two signal-to-babble ratios (SBRs) tested. One participant had binaural interference at each SBR. Finally, on the DDT, a significant right-ear advantage was found with group data, and for at least some participants. Regarding age effects, more participants in the pooled elderly groups had binaural interference (33.3%) than in the younger group (16.7%), on the HINT. The presence of hearing loss yielded overall lower scores, but none of the comparisons between bilateral and unilateral performance were affected by hearing loss. Results of within-subject analyses on the HINT agree with previous findings of binaural interference in ≥17% of listeners. Across all groups, a significant right-ear advantage was also seen on the DDT. HINT results support the notion that the prevalence of binaural interference is likely higher in the elderly population. Hearing loss, however, did not affect the differences between bilateral and better unilateral scores. The possibility of binaural interference should be considered when fitting hearing aids to listeners with symmetric hearing loss. Comparing bilateral to unilateral (unaided) performance on tests such as the HINT may provide the clinician with objective data to support subjective preference for one hearing aid as opposed to two. American Academy of Audiology

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.

Challenges and Recent Developments in Hearing Aids: Part I. Speech Understanding in Noise, Microphone Technologies and Noise Reduction Algorithms

PubMed Central

Chung, King

2004-01-01

This review discusses the challenges in hearing aid design and fitting and the recent developments in advanced signal processing technologies to meet these challenges. The first part of the review discusses the basic concepts and the building blocks of digital signal processing algorithms, namely, the signal detection and analysis unit, the decision rules, and the time constants involved in the execution of the decision. In addition, mechanisms and the differences in the implementation of various strategies used to reduce the negative effects of noise are discussed. These technologies include the microphone technologies that take advantage of the spatial differences between speech and noise and the noise reduction algorithms that take advantage of the spectral difference and temporal separation between speech and noise. The specific technologies discussed in this paper include first-order directional microphones, adaptive directional microphones, second-order directional microphones, microphone matching algorithms, array microphones, multichannel adaptive noise reduction algorithms, and synchrony detection noise reduction algorithms. Verification data for these technologies, if available, are also summarized. PMID:15678225

A Qualitative Study on Knowledge and Attitude towards Risk Factors, Early Identification and Intervention of Infant Hearing Loss among Puerperal Mothers- A Short Survey

PubMed Central

Dudda, Ravi; Muniyappa, Hanumanth Prasad; Lakshmi, M.S

2017-01-01

Introduction Maternal active participation and their support are critical for the success of early hearing loss detection program. Erroneous maternal decisions may have large life long consequences on the infant’s life. The mothers’ knowledge and their attitudes towards infant hearing loss is the basis for their decisions. Aim The present study was done to determine the mothers’ knowledge and their attitude towards risk factors of infant hearing loss, its early identification and intervention and also awareness of effect of consanguinity on hearing loss. Materials and Methods In this cross-sectional questionnaire survey study, a total of 100 mothers were interviewed using the questionnaire which consisted of three sections namely risk factors, early identification and early intervention of hearing loss. Chi-square test was used to establish relationship between consanguineous and non-consanguineous mother’s responses to its effect on hearing loss. A p-value < 0.05 was considered as significant. Results Mothers’ awareness was significantly high for visible causes (ear pain/discharge, head injury and slap to ear) of hearing loss. Positive attitude was seen for importance of screening programs and follow up testing. Moderate level of awareness was found on hazards of consanguinity and benefits of early identification. However, mothers were least aware of neonatal jaundice, NICU admission (>5 days), signs of late-onset and neural hearing loss, management of hearing loss, hearing aid fitting and therapy necessity, which might interfere in early detection and intervention of hearing loss. Conclusion It is crucial to educate mothers on few risk factors and management of hearing loss to reduce its consequences. PMID:28892940

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

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.

Hearing protector fit testing with off-shore oil-rig inspectors in Louisiana and Texas.

PubMed

Murphy, William J; Themann, Christa L; Murata, Taichi K

2016-11-01

This field study aimed to assess the noise reduction of hearing protection for individual workers, demonstrate the effectiveness of training on the level of protection achieved, and measure the time required to implement hearing protector fit testing in the workplace. The National Institute for Occupational Safety and Health (NIOSH) conducted field studies in Louisiana and Texas to test the performance of HPD Well-Fit. Fit tests were performed on 126 inspectors and engineers working in the offshore oil industry. Workers were fit tested with the goal of achieving a 25-dB PAR. Less than half of the workers were achieving sufficient protection from their hearing protectors prior to NIOSH intervention and training; following re-fitting and re-training, over 85% of the workers achieved sufficient protection. Typical test times were 6-12 minutes. Fit testing of the workers' earplugs identified those workers who were and were not achieving the desired level of protection. Recommendations for other hearing protection solutions were made for workers who could not achieve the target PAR. The study demonstrates the need for individual hearing protector fit testing and addresses some of the barriers to implementation.

Binaural integration: a challenge to overcome for children with hearing loss.

PubMed

Gordon, Karen A; Cushing, Sharon L; Easwar, Vijayalakshmi; Polonenko, Melissa J; Papsin, Blake C

2017-12-01

Access to bilateral hearing can be provided to children with hearing loss by fitting appropriate hearing devices to each affected ear. It is not clear, however, that bilateral input is properly integrated through hearing devices to promote binaural hearing. In the present review, we examine evidence indicating that abnormal binaural hearing continues to be a challenge for children with hearing loss despite early access to bilateral input. Behavioral responses and electrophysiological data in children, combined with data from developing animal models, reveal that deafness in early life disrupts binaural hearing and that present hearing devices are unable to reverse these changes and/or promote expected development. Possible limitations of hearing devices include mismatches in binaural place, level, and timing of stimulation. Such mismatches could be common in children with hearing loss. One potential solution is to modify present device fitting beyond providing audibility to each ear by implementing binaural fitting targets. Efforts to better integrate bilateral input could improve spatial hearing in children with hearing loss.

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...

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…

Verification of a Proposed Clinical Electroacoustic Test Protocol for Personal Digital Modulation Receivers Coupled to Cochlear Implant Sound Processors.

PubMed

Nair, Erika L; Sousa, Rhonda; Wannagot, Shannon

Guidelines established by the AAA currently recommend behavioral testing when fitting frequency modulated (FM) systems to individuals with cochlear implants (CIs). A protocol for completing electroacoustic measures has not yet been validated for personal FM systems or digital modulation (DM) systems coupled to CI sound processors. In response, some professionals have used or altered the AAA electroacoustic verification steps for fitting FM systems to hearing aids when fitting FM systems to CI sound processors. More recently steps were outlined in a proposed protocol. The purpose of this research is to review and compare the electroacoustic test measures outlined in a 2013 article by Schafer and colleagues in the Journal of the American Academy of Audiology titled "A Proposed Electroacoustic Test Protocol for Personal FM Receivers Coupled to Cochlear Implant Sound Processors" to the AAA electroacoustic verification steps for fitting FM systems to hearing aids when fitting DM systems to CI users. Electroacoustic measures were conducted on 71 CI sound processors and Phonak Roger DM systems using a proposed protocol and an adapted AAA protocol. Phonak's recommended default receiver gain setting was used for each CI sound processor manufacturer and adjusted if necessary to achieve transparency. Electroacoustic measures were conducted on Cochlear and Advanced Bionics (AB) sound processors. In this study, 28 Cochlear Nucleus 5/CP810 sound processors, 26 Cochlear Nucleus 6/CP910 sound processors, and 17 AB Naida CI Q70 sound processors were coupled in various combinations to Phonak Roger DM dedicated receivers (25 Phonak Roger 14 receivers-Cochlear dedicated receiver-and 9 Phonak Roger 17 receivers-AB dedicated receiver) and 20 Phonak Roger Inspiro transmitters. Employing both the AAA and the Schafer et al protocols, electroacoustic measurements were conducted with the Audioscan Verifit in a clinical setting on 71 CI sound processors and Phonak Roger DM systems to determine transparency and verify FM advantage, comparing speech inputs (65 dB SPL) in an effort to achieve equal outputs. If transparency was not achieved at Phonak's recommended default receiver gain, adjustments were made to the receiver gain. The integrity of the signal was monitored with the appropriate manufacturer's monitor earphones. Using the AAA hearing aid protocol, 50 of the 71 CI sound processors achieved transparency, and 59 of the 71 CI sound processors achieved transparency when using the proposed protocol at Phonak's recommended default receiver gain. After the receiver gain was adjusted, 3 of 21 CI sound processors still did not meet transparency using the AAA protocol, and 2 of 12 CI sound processors still did not meet transparency using the Schafer et al proposed protocol. Both protocols were shown to be effective in taking reliable electroacoustic measurements and demonstrate transparency. Both protocols are felt to be clinically feasible and to address the needs of populations that are unable to reliably report regarding the integrity of their personal DM systems. American Academy of Audiology

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.

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.

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.

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.

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

Cochlear compression: perceptual measures and implications for normal and impaired hearing.

PubMed

Oxenham, Andrew J; Bacon, Sid P

2003-10-01

This article provides a review of recent developments in our understanding of how cochlear nonlinearity affects sound perception and how a loss of the nonlinearity associated with cochlear hearing impairment changes the way sounds are perceived. The response of the healthy mammalian basilar membrane (BM) to sound is sharply tuned, highly nonlinear, and compressive. Damage to the outer hair cells (OHCs) results in changes to all three attributes: in the case of total OHC loss, the response of the BM becomes broadly tuned and linear. Many of the differences in auditory perception and performance between normal-hearing and hearing-impaired listeners can be explained in terms of these changes in BM response. Effects that can be accounted for in this way include poorer audiometric thresholds, loudness recruitment, reduced frequency selectivity, and changes in apparent temporal processing. All these effects can influence the ability of hearing-impaired listeners to perceive speech, especially in complex acoustic backgrounds. A number of behavioral methods have been proposed to estimate cochlear nonlinearity in individual listeners. By separating the effects of cochlear nonlinearity from other aspects of hearing impairment, such methods may contribute towards identifying the different physiological mechanisms responsible for hearing loss in individual patients. This in turn may lead to more accurate diagnoses and more effective hearing-aid fitting for individual patients. A remaining challenge is to devise a behavioral measure that is sufficiently accurate and efficient to be used in a clinical setting.

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.

[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.

Mild-moderate congenital hearing loss: secular trends in outcomes across four systems of detection.

PubMed

Carew, P; Mensah, F K; Rance, G; Flynn, T; Poulakis, Z; Wake, M

2018-01-01

Universal newborn hearing screening (UNHS) targets moderate or greater hearing loss. However, UNHS also frequently detects children with mild loss that results in many receiving early treatment. The benefits of this approach are not yet established. We aimed to (i) compare language and psychosocial outcomes between four hearing loss detection systems for children aged 5-8 years with congenital mild-moderate hearing loss; (ii) determine whether age of detection predicts outcomes; and (iii) compare outcomes between children identified via well-established UNHS and the general population. Linear regression adjusted for potential confounding factors was used throughout. Via a quasi-experimental design, language and psychosocial outcomes were compared across four population-based Australian systems of hearing loss detection: opportunistic detection, born 1991-1993, n = 50; universal risk factor referral, born 2003-2005, n = 34; newly established UNHS, born 2003-2005, n = 41; and well-established UNHS, born 2007-2010, n = 21. In pooled analyses, we examined whether age of detection predicted outcomes. Outcomes were similarly compared between the current well-established UNHS system and typically developing children in the Early Language in Victoria Study, born 2003, n = 1217. Age at diagnosis and hearing aid fitting fell steadily across the four systems. For moderate losses, mean expressive language (P for trend .05) and receptive vocabulary (P for trend .06) improved across the four systems, but benefit was not obvious for mild losses. In pooled analyses, diagnosis before age six months predicted better language outcomes for moderate losses. Children with mild-moderate losses exposed to well-established UNHS continue to experience expressive language scores well below children in the general population (adjusted mean difference -8.9 points, 95% CI -14.7 to -3.1). Treatment arising from UNHS appears to be clearly benefitting children with moderate hearing losses. However, rigorous trials are needed to quantify benefits, versus costs and potential harms, of early aiding of children with mild losses. © 2017 John Wiley & Sons Ltd.

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.

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

Effects of hearing aid settings for electric-acoustic stimulation.

PubMed

Dillon, Margaret T; Buss, Emily; Pillsbury, Harold C; Adunka, Oliver F; Buchman, Craig A; Adunka, Marcia C

2014-02-01

Cochlear implant (CI) recipients with postoperative hearing preservation may utilize an ipsilateral bimodal listening condition known as electric-acoustic stimulation (EAS). Studies on EAS have reported significant improvements in speech perception abilities over CI-alone listening conditions. Adjustments to the hearing aid (HA) settings to match prescription targets routinely used in the programming of conventional amplification may provide additional gains in speech perception abilities. Investigate the difference in users' speech perception scores when listening with the recommended HA settings for EAS patients versus HA settings adjusted to match National Acoustic Laboratories' nonlinear fitting procedure version 1 (NAL-NL1) targets. Prospective analysis of the influence of HA settings. Nine EAS recipients with greater than 12 mo of listening experience with the DUET speech processor. Subjects were tested in the EAS listening condition with two different HA setting configurations. Speech perception materials included consonant-nucleus-consonant (CNC) words in quiet, AzBio sentences in 10-talker speech babble at a signal-to-noise ratio (SNR) of +10, and the Bamford-Kowal-Bench sentences in noise (BKB-SIN) test. The speech perception performance on each test measure was compared between the two HA configurations. Subjects experienced a significant improvement in speech perception abilities with the HA settings adjusted to match NAL-NL1 targets over the recommended HA settings. EAS subjects have been shown to experience improvements in speech perception abilities when listening to ipsilateral combined stimulation. This population's abilities may be underestimated with current HA settings. Tailoring the HA output to the patient's individual hearing loss offers improved outcomes on speech perception measures. American Academy of Audiology.

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...