FM Systems Research Articles

A randomized control trial of interventions in school-aged children with auditory processing disorders

Objective: The primary purpose of the study was to compare intervention approaches for children with auditory processing disorder (APD): bottom-up training including activities focused on auditory perception, discrimination, and phonological awareness, and top-down training including a range of language activities. Another purpose was to determine the benefits of personal FM systems. Design: The study is a randomized control trial where participants were allocated to groups receiving one of the two interventions, with and without personal FM, or to the no intervention group. The six-week intervention included weekly one-hour sessions with a therapist in the clinic, plus 1–2 hours per week of parent-directed homework. Study sample: 55 children (7 to 13 years) with APD participated in the study. Intervention outcomes included reading, language, and auditory processing. Results: Positive outcomes were observed for both training approaches and personal FM systems on several measures. Pre-intervention nonverbal IQ, age, and severity of APD did not influence outcomes. Performance of control group participants did not change when retested after the intervention period. Conclusions: Both intervention approaches were beneficial and there were additional benefits with the use of personal FM. Positive results were not limited to the areas specifically targeted by the interventions.

Moving to Mainstream Preschool

Children with hearing loss have a world of opportunities available to them because of marvelous advances in hearing technology, including super-powered digital hearing aids, cochlear implants, wireless FM systems, infrared classroom technology for sound field, and the bone-anchored hearing aid (BAHA). These advances, along with the ability to identify children with hearing loss soon after birth and fit them quickly with hearing technology, have changed the face of intervention and education. It is important for clinicians to start listening and spoken language (LSL) intervention very early, because babies' brains' neural pathways have increased sensitivity to sound before age 3 years. When children with hearing loss learn to speak through listening, they may stay on a normal path to speech and language development (Cole & Flexer, 2007). Now, children with hearing loss who learn to listen and speak typically develop regional accents, clear speech production, the ability to grasp idioms and jokes, and competent conversational skills. The purpose of this article is to describe the processes that are typical as a child with hearing loss transitions from services provided by professionals at an outpatient cochlear implant center to services provided in school settings.

Clinically accurate assessment and grading of ototoxicity

To design a grading scale and audiologic protocols to better reflect clinical impact than the currently widely used classifications. Retrospective. Audiologic studies from 130 patients receiving cisplatin chemotherapy were analyzed. Pure-tone audiograms were evaluated using the newly proposed grading criteria, Brock criteria, and Common Terminology Criteria for Adverse Events (CTCAE). The resulting grades were then compared to recommended audiologic interventions. Auditory brainstem response (ABR) data and data on incidences of conductive hearing loss from other multi-institutional studies that the author participated in were compared to data from this cohort. Although the newly proposed, Brock, and CTCAE ototoxicity grades were significantly related to audiologist recommendations for assistive devices (P < .0001), the newly proposed criteria were more specific and allowed better delineation of different patients into distinct subgroups requiring either FM system (grade 2a) or hearing aid (grade 2b or higher). Multi-institutional data review indicated significant problems with ABR evaluations and separating out conductive hearing losses from ototoxicity. The newly proposed grading system needs to be paired with specific recommendations regarding audiologic monitoring protocols as well as active participation by the audiologists implementing the protocol to provide clinically accurate assessment and grading of ototoxicity.

Special Educators’ Perspectives on the Services and Benefits of Educational Audiologists

A 36-item survey was used to determine whether special educators have access to the services of an audiologist and whether they obtained benefit from the audiologist’s services. Additional goals included gathering information about special educators’ understanding of basic audiological concepts related to a school setting, added job responsibilities brought about by lack of access to an audiologist, and collaboration between these teachers and audiologists. The survey was emailed to special educators identified through online school district directories. A total of 39% of the surveyed special educators had access to an educational/contractual audiologist, with 71% of them believing they received benefit from these services. These benefits included provision of hearing screenings, in-services, and aural (re)habilitation. In all, 73% of the special educators judged their own background understanding of basic audiological information within the “low” range, and most of the special education teachers surveyed did not feel prepared to assist students with hearing aids, FM systems, or cochlear implants. Less than half of the special educators (47%) reported that collaboration between these professionals was strong where available. Special educators consider themselves unprepared to handle the audiological maintenance needs of their students’ equipment and are often unaware of the audiologist’s role, including their availability in schools.

Improving Hearing Aid Function in Noisy Situations

Improving Hearing Aid Function in Noisy Situations

Optimizing FM Systems: Verification of Device Function at Fitting and Follow-Up Preserves Advantages of Use

Optimizing FM Systems: Verification of Device Function at Fitting and Follow-Up Preserves Advantages of Use

Parent Engagement in Audiologic Habilitation

Parent Engagement in Audiologic Habilitation

Pediatric Speech Perception in Noise

An acceptable acoustical environment is necessary for effective communication and learning. Children who experience abnormally poor speech perception in noise, including those with normal hearing sensitivity, are at risk for speech and language delay, reading disorders, psychosocial problems, and academic failure. The biological bases of speech perception in noise are complex and include processes at cortical as well as sub-cortical levels of the auditory nervous system. In children, the ability to perceive speech in degraded listening conditions improves significantly with age in parallel with developmental changes in the auditory nervous system. Difficulty in listening to speech in noisy surroundings is a common symptom associated with auditory processing disorders (APD). Clinical assessment of speech perception in noise quantifies potential problems that a child might face in daily listening situations. Optimally, pediatric speech in noise tests are designed to meet minimal psychometric criteria. A speech in noise test should be appropriate for the child's age and native language so as to minimize the role of linguistic factors. A diagnosis of APD should not be made based solely on a speech in noise test but, rather, on a battery of tests, each exploring a different suprathreshold auditory process. Speech in noise tests should be used and interpreted with extreme caution when assessing auditory processing in children with co-existing peripheral hearing loss. Children with normal hearing sensitivity, whose performance on tests using competing acoustic signals is below normal, can benefit from specific intervention and the use of signal enhancing devices such as FM systems. Keywords: ABR (auditory brainstem response), APD (auditory processing disorders), CANS (central auditory nervous system), (C)APD [(central) auditory processing disorders], HINT (Hearing In Noise Test), LISN (Listening in Spatialized Noise), MCR (message-to-competition ratio), SNR (signal-to-noise ratio), SRT (speech reception threshold)

Evaluation of noise reduction technologies in a contemporary cochlear implant system

Evaluation of noise reduction technologies in a contemporary cochlear implant system

Auditory Remediation for Patients With Landau-Kleffner Syndrome

Auditory Remediation for Patients With Landau-Kleffner Syndrome

Performance of Three LED-Based Fluorescence Microscopy Systems for Detection of Tuberculosis in Uganda

BackgroundDirect smear microscopy using Ziehl-Neelsen (ZN) staining is the mainstay of tuberculosis (TB) diagnosis in most high burden countries, but is limited by low sensitivity in routine practice, particularly in high human immunodeficiency virus (HIV) prevalence settings.MethodsWe compared the performance of three commercial light emitting diode (LED)-based microscopy systems (Primostar™ iLED, Lumin™ and AFTER®) for fluorescent detection of Mycobacterium tuberculosis with ZN microscopy on slides prepared from sputum of TB suspects. Examination time for LED-based fluorescent microscopy (LED FM) and ZN slides was also compared, and a qualitative user appraisal of the LED FM systems was carried out.ResultsLED FM was between 5.6 and 9.4% more sensitive than ZN microscopy, although the difference was not statistically significant. There was no significant difference in the sensitivity or specificity of the three LED FM systems, although the specificity of Fraen AFTER was somewhat lower than the other LED FM methods. Examination time for LED FM was 2 and 4 times less than for ZN microscopy. LED FM was highly acceptable to Ugandan technologists, although differences in operational performance of the three systems were reported.ConclusionsLED FM compares favourably with ZN microscopy, with equivalent specificity and a modest increase in sensitivity. Screening of slides was substantially quicker using LED FM than ZN, and LED FM was rated highly by laboratory technologists. Available commercial systems have different operational characteristics which should be considered prior to programmatic implementation.

FM listening evaluation for children: adaptação para a língua portuguesa

INTRODUÇÃO: A inclusão do deficiente auditivo na escola é assegurada pelo poder público no Brasil por documentos oficiais e o sistema FM é um instrumento da tecnologia assistiva que o professor deve ter acesso. OBJETIVO: traduzir e adaptar para a Língua Portuguesa o questionário FM Listening Evaluation for children. MÉTODOS: A tradução e adaptação do questionário FM Listening Evaluation incluíram a tradução para o idioma português, adaptação lingüística e revisão das equivalências gramatical e idiomática e adaptação; também foi avaliada a reprodutibilidade intra-pesquisadores. O questionário foi aplicado nos professores e na fonoaudióloga de 12 crianças de sete a treze anos deficientes auditivas, usuárias de Aparelho de Amplificação Sonora Individual e adaptadas com sistema FM. RESULTADOS: A tradução e adaptação do questionário resultaram no novo inventário:AVALIAÇÃO DO SISTEMA FM, apresentando diferença significativa entre os resultados de ruído e: via auditiva e silêncio; - distância e: via auditiva e silêncio; - via auditiva e: ruído, distância e silêncio; - silêncio e: ruído, distância e via auditiva. Houve diferença significativa sem e com o Sistema FM, sendo que neste a pontuação foi sempre maior. Na comparação intrapesquisadores evidenciou-se diferença significativa entre: pontuação total com FM; via auditiva sem FM e ruído com FM. CONCLUSÃO: O questionário Avaliação do Sistema FM foi considerado um instrumento confiável para verificação e acompanhamento dos benefícios do Sistema FM podendo favorecer assim o processo de inclusão escolar do aluno deficiente auditivo.

Listening in Color: An Audiologist’s CI Journey

Listening in Color: An Audiologist’s CI Journey

Individual FM Systems for Children: Where Are We Now?

FM systems have been used for children with hearing loss for over 30 years. Over time, their use has expanded to include children with normal hearing who have special listening needs. This paper provides a brief discussion of current issues in FM system use for children.

Goldenhar syndrome with moderate hearing loss: An FM system in a school environment

Abstract A young girl with Goldenhar syndrome and bilateral, unbalanced, fluctuating and progressive hearing loss successfully employed an FM system during classroom activities. Teacher and student questionnaires revealed overall satisfaction with the FM system, as well as a significant progress in the academic performance. Schoolchildren with mild hearing loss often reject the use of conventional hearing aids during school hours, when acoustic inadequacies and social stigma eclipse any perceived benefit. FM systems such as EduLink™ are a viable alternative in those situations and, in some instances, may predispose reluctant patients to accept a more conventional hearing solution.

Do I really need an FM system?

Do I really need an FM system?

Speech perception in noise with and without FM technology

In the presence of a (central) auditory processing disorder [(C)APD] central hearing processes are disturbed, leading to impaired speech perception in noise. Poor acoustics in educational institutions exacerbates the problem. In children affected by (C)APD this can result in impaired development of language, reading and writing acquisition as well as other skills. A total of 66 children aged 6-11 years completed the Oldenburg sentence test in noise (OlSa) with and without an FM system. Children with normal OlSa test results formed the control group (group 1), while group 2a comprised children with an unremarkable re-test result and group 2b comprised children who produced abnormal results even in the re-test. All children achieved improved speech intelligibility using the FM system. The greatest difference between results with and without FM system was seen in group 2b (9.53 dB S/N). Group 1 achieved an improvement of 8.86 dB S/N and group 2a 7.89 dB S/N. Children with detected auditory selection problems benefit most from the use of an FM system for improved speech understanding. This should be borne in mind in the diagnosis and therapy of these children.

Bluetooth Technology in Hearing Aids: A Clinician’s Perspective

Bluetooth hearing aid technology enables a hearing aid user to connect to many electronic devices hands-free. Cell phones, MP3 players, computers, GPS devices, and FM systems are just a few of the many devices that can be connected to Bluetooth-enabled hearing aids. Bluetooth technology has made it possible for a cell phone to ring directly into the hearing aid(s) and for the call to be answered by pushing a button on a small controller. This allows for convenient hands-free communication as well as binaural hearing that provides for a much clearer signal than when using a phone on one ear. Moreover, Bluetooth technology provides for communication and coordination between two hearing aids resulting in improved speech audibility and localization. This communication also can be manipulated to accommodate special listening needs as in the case of asymmetrical hearing loss. Bluetooth technology helps enhance the listening experience for those who are hard-of-hearing and expands the opportunities for enjoying modern electronics.

Benefits of Adaptive FM Systems on Speech Recognition in Noise for Listeners Who Use Hearing Aids

To compare the benefits of adaptive FM and fixed FM systems through measurement of speech recognition in noise with adults and students in clinical and real-world settings. Five adults and 5 students with moderate-to-severe hearing loss completed objective and subjective speech recognition in noise measures with the 2 types of FM processing. Sentence recognition was evaluated in a classroom for 5 competing noise levels ranging from 54 to 80 dBA while the FM microphone was positioned 6 in. from the signal loudspeaker to receive input at 84 dB SPL. The subjective measures included 2 classroom activities and 6 auditory lessons in a noisy, public aquarium. On the objective measures, adaptive FM processing resulted in significantly better speech recognition in noise than fixed FM processing for 68- and 73-dBA noise levels. On the subjective measures, all individuals preferred adaptive over fixed processing for half of the activities. Adaptive processing was also preferred by most (8-9) individuals for the remaining 4 activities. The adaptive FM processing resulted in significant improvements at the higher noise levels and was preferred by the majority of participants in most of the conditions.

Users' perspectives on the benefits of FM systems with cochlear implants

This study explored: (1) the benefits of an FM system in real-world environments from the perspective of adults with coch-lear implants, and (2) the factors and barriers to using an FM system with a cochlear implant. Using a qualitative research design, 14 adults with unilateral cochlear implants recorded their experiences during a two-month trial period with a personal FM system and responded to a questionnaire at the end of the trial. A detailed analysis of 169 journal entries (230 hours of FM use) permitted a description of the benefits and negative aspects associated with FM use in everyday listening environments. The primary benefits were related to improved access to and quality of sound, improved distance listening, ease of listening, and better social integration. Negative perceptions were associated with the equipment both with regard to physical aspects and adjustments. In addition, technical, individual, social, and environmental factors were identified that can influence the user's decision to use the FM device. Questionnaire responses indicated that the majority of individuals rated the FM system as somewhat or very helpful. The findings suggest that FM systems can improve communication in everyday listening environments for some adults with cochlear implants.SumarioEste estudio exploró: (1) los beneficios de un sistema FM en ambientes de la vida real desde la perspectiva de adultos con implante coclear, y (2) los factores y barreras del uso de un sistema FM con un implante coclear. Durante un periodo de 2 meses y mediante un diseño de investigación cualitativo, 14 adultos con implantes cocleares unilaterales registraron sus experiencias con un sistema personal de FM y respondieron a un cuestionario al final del ensayo. Un análisis detallado de 169 de anotaciones en el diario (230 horas de uso del FM) permitieron una descripción de los beneficios y los aspectos negativos asociados con el uso del FM en ambientes de escucha cotidianos. Los beneficios primarios estuvieron relacionados con mejor acceso y mejor calidad de sonido, mejoría en la audición a distancia, facilidad para escuchar y mejor integración social. Las percepciones negativas se asociaron con el equipo, tanto en relación con sus aspectos físicos, como con los ajustes. Además, se identificaron factores técnicos, individuales, sociales y ambientales que pueden influir en la decisión del usuario de utilizar un dispositivo de FM. Las respuestas del cuestionario indicaron que la mayoría de los individuos calificaron el sistema de FM como un tanto útil o muy útil. Los hallazgos sugieren que los sistemas FM pueden mejorar la comunicación en los ambientes cotidianos de escucha para algunos adultos con implante coclear.