Evaluation of Potential Benefits and Limitations of Noise-Management Technologies for Children with Hearing Aids.

Abstract

Children with hearing loss frequently experience difficulty understanding speech in the presence of noise. Although remote microphone systems are likely to be the most effective solution to improve speech recognition in noise, the focus of this study centers on the evaluation of hearing aid noise management technologies including directional microphones, adaptive noise reduction (ANR), and frequency-gain shaping. These technologies can improve children's speech recognition, listening comfort, and/or sound quality in noise. However, individual contributions of these technologies as well as the effect of hearing aid microphone mode on localization abilities in children is unknown. The objectives of this study were to (1) compare children's speech recognition and subjective perceptions across five hearing aid noise management technology conditions and (2) compare localization abilities across three hearing aid microphone modes. A single-group, repeated measures design was used to evaluate performance differences and subjective ratings. Fourteen children with mild to moderately severe hearing loss. Children's sentence recognition, listening comfort, sound quality, and localization were assessed in a room with an eight-loudspeaker array. The use of adaptive directional microphone technology improves children's speech recognition in noise when the signal of interest arrives from the front and is spatially separated from the competing noise. In contrast, the use of adaptive directional microphone technology may result in a decrease in speech recognition in noise when the signal of interest arrives from behind. The use of a microphone mode that mimics the natural directivity of the unaided auricle provides a slight improvement in speech recognition in noise compared with omnidirectional use with limited decrement in speech recognition in noise when the signal of interest arrives from behind. The use of ANR and frequency-gain shaping provide no change in children's speech recognition in noise. The use of adaptive directional microphone technology, ANR, and frequency-gain shaping improve children's listening comfort, perceived ability to understand speech in noise, and overall listening experience. Children prefer to use each of these noise management technologies regardless of whether the signal of interest arrives from the front or from behind. The use of adaptive directional microphone technology does not result in a decrease in children's localization abilities when compared with the omnidirectional condition. The best localization performance occurred with use of the microphone mode that mimicked the directivity of the unaided auricle.