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  • 1
    In: Journal of the American Academy of Audiology, Georg Thieme Verlag KG, Vol. 29, No. 08 ( 2018-09), p. 706-721
    Abstract: The American Speech-Language-Hearing Association (ASHA) and American Academy of Audiology (AAA) have created Best Practice Guidelines for fitting hearing aids to adult patients. These guidelines recommend using real-ear measures (REM) to verify that measured output/gain of hearing aid(s) match a validated prescriptive target. Unfortunately, approximately 70–80% of audiologists do not routinely use REM when fitting hearing aids, instead relying on a manufacturer default “first-fit” setting. This is problematic because numerous studies report significant differences in REM between manufacturer first-fit and the same hearing aids using a REM or programmed-fit. These studies reported decreased prescribed gain/output in the higher frequencies for the first-fit compared with the programmed fit, which are important for recognizing speech. Currently, there is little research in peer-reviewed journals reporting if differences between hearing aids fitted using a manufacturer first-fit versus a programmed-fit result in significant differences in speech recognition in quiet, noise, and subjective outcomes. To examine if significant differences were present in monosyllabic word and phoneme recognition (consonant-nucleus-consonant; CNC) in quiet, sentence recognition in noise (Hearing in Noise Test; HINT), and subjective outcomes using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Speech, Spatial and Qualities of Hearing (SSQ) questionnaires between hearing aids fit using one manufacturer’s first-fit and the same hearing aids with a programmed-fit using REM to National Acoustic Laboratories Nonlinear Version 2 (NAL-NL2) prescriptive target. A double-blind randomized crossover design was used. Throughout the study, one investigator performed all REM whereas a second investigator measured speech recognition in quiet, noise, and scored subjective outcome measures. Twenty-four adults with bilateral normal sloping to moderately severe sensorineural hearing loss with no prior experience with amplification. The hearing aids were fit using the proprietary manufacturer default first-fit and a programmed-fit to NAL-NL2 using real-ear insertion gain measures. The order of the two fittings was randomly assigned and counterbalanced. Participants acclimatized to each setting for four weeks and returned for assessment of performance via the revised CNC word lists, HINT, APHAB, and SSQ for the respective fitting. (1) A significant median advantage of 15% (p 〈 0.001; 95% CI: 9.7–24.3%) for words and 7.7% (p 〈 0.001; 95% CI: 5.9–10.9%) for phonemes for the programmed-fit compared with first-fit at 50 dB sound pressure level (SPL) and 4% (p 〈 0.01; 95% CI: 1.7–6.3%) for words at 65 dB SPL; (2) No significant differences for the HINT reception threshold for sentences (RTS); (3) A significant median advantage of 4.2% [p 〈 0.04; 95% confidence interval (CI): −0.6–13.2%] for the programmed-fit compared with the first-fit for the background noise subscale problem score for the APHAB; (4) No significant differences on the SSQ. Improved word and phoneme recognition for soft and words for average speech in quiet were reported for the programmed-fit. Seventy-nine percent of the participants preferred the programmed-fitting versus first-fit. Hearing aids, therefore, should be verified and programmed using REM to a prescriptive target versus no verification using a first-fit.
    Type of Medium: Online Resource
    ISSN: 1050-0545 , 2157-3107
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
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  • 2
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    Online Resource
    Georg Thieme Verlag KG ; 2012
    In:  Journal of the American Academy of Audiology Vol. 23, No. 04 ( 2012-04), p. 276-282
    In: Journal of the American Academy of Audiology, Georg Thieme Verlag KG, Vol. 23, No. 04 ( 2012-04), p. 276-282
    Abstract: Background: 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. Purpose: 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. Research Design: 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. Conclusions: This case study highlights some of the obstacles and potential solutions for coupling a hearing aid to a severely collapsed ear canal.
    Type of Medium: Online Resource
    ISSN: 1050-0545 , 2157-3107
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2012
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  • 3
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2015
    In:  Journal of the American Academy of Audiology Vol. 26, No. 06 ( 2015-06), p. 547-562
    In: Journal of the American Academy of Audiology, Georg Thieme Verlag KG, Vol. 26, No. 06 ( 2015-06), p. 547-562
    Abstract: Background: One important factor that plays a role in front-end processing is the analog-to-digital converter within current hearing aids. The average input dynamic range of hearing aids is 96 dB SPL with an upper input limiting level (UILL) of 95–105 dB SPL. The UILL of standard hearing aids could distort loud signals, such as loud speech or music, which have root-mean-square values of 90 and 105 dB SPL with crest factors of 12 dB SPL to 14–20 dB SPL, respectively. This indicates that these loud sounds could create a distorted signal for patients when the input limiting level is reached. Purpose: To examine if significant differences in word recognition in noise, sound quality preferences, and subjective ratings of real-world performance exist between conventional and high UILL hearing aids. Research Design: Words in noise and sound quality preferences were assessed using recordings on a Knowles Electronic Manikin for Acoustic Research with conventional and high UILL hearing aids, different microphone modes, and listening conditions. Participants wore the hearing aids for 2 mo and completed questionnaires on subjective performance. Study Sample: Ten adults with bilateral slight to moderately severe sensorineural hearing loss were recruited. Results: A four-factor repeated-measures analysis of variance (ANOVA) revealed significant differences between the conventional and high UILL across microphone modes and listening conditions for words in noise [F (2, 18) = 6.0; p 〈 0.05]. A three-factor repeated-measures ANOVA for sound quality preferences revealed a significant difference only for presentation level [F (1, 9) = 81.0; p 〈 0.001]. A one-factor ANOVA did not reveal significant differences between the conventional and high UILL on subjective ratings of real-world performance. Conclusions: Word recognition and sound quality preferences revealed significant differences between the conventional and high UILL; however, there were no differences in subjective ratings of real-world performance. One participant preferred the conventional UILL, two the high UILL, and seven thought performance was equal, which may be due to the listening environments participants encountered, as evidenced by datalogging.
    Type of Medium: Online Resource
    ISSN: 1050-0545 , 2157-3107
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2015
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  • 4
    Online Resource
    Online Resource
    Acoustical Society of America (ASA) ; 2021
    In:  The Journal of the Acoustical Society of America Vol. 150, No. 4_Supplement ( 2021-10-01), p. A210-A210
    In: The Journal of the Acoustical Society of America, Acoustical Society of America (ASA), Vol. 150, No. 4_Supplement ( 2021-10-01), p. A210-A210
    Abstract: Social isolation and loneliness are significant risk factors for overall health, especially for older adults with vision or hearing impairment. This study was designed to understand the impact of the COVID-19 pandemic restrictions on the social /emotional wellbeing in adults with sensory impairment. Three groups of older adults -- vision loss (VL, N = 13), hearing loss (HL, N = 12 with cochlear implants and N = 12 with hearing aids), and controls (CTL, N = 18) -- were recruited from the Twin Cities community. They were interviewed at 6-week intervals from April 2020 to July 2021 concerning their wellbeing and social isolation. Overall, results show the widespread impact of the pandemic on social interactions and emotional wellbeing of older adults with sensory loss. All three groups had worse scores on the patient health questionnaire (PHQ-9) after the start of the pandemic. Older people with visual impairments were especially vulnerable to changes that led to a loss of independence. Although facial coverings impaired speech intelligibility for older people with hearing loss, the quieter acoustic environment during stay-at-home restrictions of gatherings may have mediated the negative effects. Results highlight unique factors that have affected older persons with sensory loss.
    Type of Medium: Online Resource
    ISSN: 0001-4966 , 1520-8524
    RVK:
    Language: English
    Publisher: Acoustical Society of America (ASA)
    Publication Date: 2021
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  • 5
    Online Resource
    Online Resource
    Acoustical Society of America (ASA) ; 2022
    In:  The Journal of the Acoustical Society of America Vol. 152, No. 4_Supplement ( 2022-10-01), p. A125-A125
    In: The Journal of the Acoustical Society of America, Acoustical Society of America (ASA), Vol. 152, No. 4_Supplement ( 2022-10-01), p. A125-A125
    Abstract: The University of Minnesota (UMN) has graduate programs that span the areas of Animal Bioacoustics, Psychological and Physiological Acoustics, and Speech Communication. Degrees are offered in Psychology (PhD), Speech-Language-Hearing Sciences (MA in speech-language pathology, AuD, and PhD in speech-language-hearing sciences), Biomedical Engineering (MS and PhD), Ecology, Evolution, and Behavior (PhD), and Neuroscience (PhD). Faculty across departments have a shared interest in understanding how the ear and brain work together to process sound and in developing new technologies and approaches for improving hearing disorders. Located on campus is the Center for Applied and Translational Sensory Science (CATSS), which provides opportunities for interdisciplinary collaborations across departments and industry to understand how sensory impairments work. Within CATSS is the Multi-Sensory Perception Lab, which houses shared equipment, including eye trackers and electroencephalography. The Center for Magnetic Resonance Research houses several ultrahigh field magnets, while the Center for Neural Engineering and affiliated faculty labs also house multiple neuromodulation and neurorecording devices to interact with and monitor neural activity in humans and animals.
    Type of Medium: Online Resource
    ISSN: 0001-4966 , 1520-8524
    RVK:
    Language: English
    Publisher: Acoustical Society of America (ASA)
    Publication Date: 2022
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  • 6
    Online Resource
    Online Resource
    Acoustical Society of America (ASA) ; 2018
    In:  The Journal of the Acoustical Society of America Vol. 143, No. 3_Supplement ( 2018-03-01), p. 1748-1748
    In: The Journal of the Acoustical Society of America, Acoustical Society of America (ASA), Vol. 143, No. 3_Supplement ( 2018-03-01), p. 1748-1748
    Abstract: Listeners with hearing loss often need to listen to speech signals at high intensities to ensure proper audibility. Spectral processing deteriorates at high intensities, but signal acoustics such as bandwidth and filtering can be used to mitigate this deterioration. This study evaluated the effect of carrier bandwidth on broadband spectral processing at high intensities for individuals with hearing loss. Spectral modulation detection thresholds were measured using a rippled noise carrier with varying bandwidths from 1 to 4 octaves, to assess whether individuals with hearing loss were more susceptible to the deleterious effects of high-intensity compared to their counterparts with normal hearing. Results show that spectral processing degrades at high intensities. Listeners with hearing loss benefited from the increase in signal bandwidth at high intensities much more than their counterparts with normal hearing. Our findings suggest that spectral processing for broadband signals involve within and across channel resolution and both succumb to the negative effect of level-induced broadening of auditory-filter bandwidths. A better understanding of how filtering can be used to alleviate the adverse effect of high-intensity signals could prove useful for improving outcomes for those individuals whose only viable treatment option often involves listening to speech signals at high intensities.
    Type of Medium: Online Resource
    ISSN: 0001-4966 , 1520-8524
    RVK:
    Language: English
    Publisher: Acoustical Society of America (ASA)
    Publication Date: 2018
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  • 7
    Online Resource
    Online Resource
    Acoustical Society of America (ASA) ; 2019
    In:  The Journal of the Acoustical Society of America Vol. 146, No. 4_Supplement ( 2019-10-01), p. 2925-2925
    In: The Journal of the Acoustical Society of America, Acoustical Society of America (ASA), Vol. 146, No. 4_Supplement ( 2019-10-01), p. 2925-2925
    Abstract: It is nearly axiomatic that audiovisual (AV) speech is more intelligible than audio-only (A-only) speech, particularly when the speech is presented in a challenging listening environment, such as in background noise [e.g., MacLeod and Summerfield, Br. J. Audiol., 2 (1987)]. No previous research on audiovisual speech perception has examined the perception of children’s speech. Children may elicit a smaller AV benefit than adults, as their visual articulatory movements are more variable than adults’ [e.g., Smith and Goffman, J. Speech Lang. Hear. Res. 41 (1998)] , and hence are less informative perceptual cues. Alternatively, the overall lower intelligibility of children’s A-only speech might lead them to elicit overall higher AV benefits than adults. To examine this question, we collected developmentally appropriate sentence productions from five, 4-6 year old children, and five sex-matched adults. Ongoing work is examining the intelligibility of these sentences in multitalker babble in A-only and AV conditions in a variety of signal-to-noise ratios, so that we can compare AV benefits for children and adults when A-only intelligibility is matched. Both sentence intelligibility and eye gaze during perception are being measured. Results will help us understand the role of individual-speaker variation on the magnitude of AV benefit.
    Type of Medium: Online Resource
    ISSN: 0001-4966 , 1520-8524
    RVK:
    Language: English
    Publisher: Acoustical Society of America (ASA)
    Publication Date: 2019
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  • 8
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2010
    In:  Seminars in Hearing Vol. 31, No. 04 ( 2010-11), p. 366-377
    In: Seminars in Hearing, Georg Thieme Verlag KG, Vol. 31, No. 04 ( 2010-11), p. 366-377
    Type of Medium: Online Resource
    ISSN: 0734-0451 , 1098-8955
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2010
    detail.hit.zdb_id: 2072479-2
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  • 9
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2013
    In:  Journal of the American Academy of Audiology Vol. 24, No. 10 ( 2013-11), p. 980-991
    In: Journal of the American Academy of Audiology, Georg Thieme Verlag KG, Vol. 24, No. 10 ( 2013-11), p. 980-991
    Abstract: Background: 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. Purpose: 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. Research Design: A randomized block repeated measures single blind design was used to assess differences between no NR, mild NR, and maximum NR listening conditions. Study Sample: 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. Data Collection and Analysis: 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: 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. Conclusions: 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.
    Type of Medium: Online Resource
    ISSN: 1050-0545 , 2157-3107
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2013
    detail.hit.zdb_id: 2069736-3
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  • 10
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2019
    In:  Journal of the American Academy of Audiology Vol. 30, No. 06 ( 2019-06), p. 502-515
    In: Journal of the American Academy of Audiology, Georg Thieme Verlag KG, Vol. 30, No. 06 ( 2019-06), p. 502-515
    Abstract: Hearing loss can lead to isolation and social withdrawal. The telephone oftentimes connects persons with hearing loss to society; however, telephone use is impeded by narrow bandwidth, loss of visual cues, electromagnetic interference, and inherent phone-line noise. In the past, research assessing telephone communication has consistently reported that switching from the microphone to a telecoil will typically result in the acoustic signal being discernibly softer. Properly used telecoils improve the signal-to-noise ratio (SNR), decrease the chance for acoustic feedback, and overcome the impact of distance and reverberation creating an opportunity for clearer telephone communication. Little research, however, has examined matching the telecoil frequency response to the prescribed target of the microphone frequency response (National Acoustics Laboratories, Non-Linear, version 1 [NAL-NL1]). The primary goal of this study was to determine if differences exist in speech recognition for sentences (AZ-BIO) and consonant–vowel nucleus-consonant monosyllabic words (CNC) between two telecoil conditions (default and programmed). A secondary goal was to determine if differences exist in speech recognition for sentences between male and female talkers. A single-blinded randomized controlled trial. Twenty experienced adult hearing aid users with bilateral symmetric slight to severe sensorineural hearing loss were recruited from Washington University in St. Louis School of Medicine. In addition, ten normal-hearing participants were recruited to determine the presentation level of the speech stimuli for the hearing aid participants. Participants underwent real-ear measures to program the microphone frequency response of a receiver-in-the-canal hearing aid to NAL-NL1. Using the manufacturer software, one telecoil program remained as the manufacturer default and a second telecoil program was programmed so the sound pressure level for an inductive telephone simulator frequency response matching the microphone’s frequency response to obtain as close to a 0 dB relative simulated equivalent telephone sensitivity value as possible. Participants then completed speech recognition measures including AZ-BIO sentences (male and female talkers) and CNC monosyllabic words and phonemes, using both telecoil programs. A mixed model analysis was performed to examine if significant differences in speech recognition exist between the two conditions and speech stimuli. Results revealed significant improvement in overall speech recognition for the programmed telecoil performance compared with default telecoil performance (p 〈 0.001). Also, improved performance in the programmed telecoil was reported with a male talker (p 〈 0.001) and performance for sentences compared with monosyllabic words (p 〈 0.001) or phonemes (p 〈 0.001). The programmed telecoil condition revealed significant improvement in speech recognition for all speech stimuli conditions compared with the default telecoil (sentences, monosyllables, and phonemes). Additional improvement was observed in both telecoil conditions when the talker was male.
    Type of Medium: Online Resource
    ISSN: 1050-0545 , 2157-3107
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2019
    detail.hit.zdb_id: 2069736-3
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