Hearing Assistive Devices Research Articles

Apple AirPods Pro as a Hearing Assistive Device in Patients with Mild to Moderate Hearing Loss.

This study aimed to assess the feasibility of the Apple AirPods Pro with the headphone accommodation feature as a hearing assistive device for patients with mild to moderate hearing loss (HL). The study included a total of 35 participants with mild to moderate HL. To determine the degree of HL in the participants, a screening test using pure-tone audiometry was conducted prior to the main tests of functional gain, word recognition score (WRS), and sentence recognition in noisy environments. The study employed two hearing devices: the Bean (a personal sound amplification product, PSAP) and the AirPods Pro. Regarding functional gain, there were no significant differences between the Bean and the AirPods Pro at all frequencies, except 8 kHz. In terms of WRS, both the Bean and the AirPods Pro had higher scores than the unaided condition. In sentence recognition, both the Bean and the AirPods Pro had higher scores than the unaided condition. During real-ear measurement, the Bean demonstrated consistent frequency responses, while the AirPods had a deviation exceeding 10 dB SPL at 6 kHz in the left ear. This deviation was absent for all other frequencies. This study shows that the Apple AirPods Pro, with its headphone accommodation feature, performed similarly to a validated PSAP and improved hearing compared to unaided conditions.

Improving auditory attention decoding by classifying intracranial responses to glimpsed and masked acoustic events

Abstract Listeners with hearing loss have trouble following a conversation in multitalker environments. While modern hearing aids can generally amplify speech, these devices are unable to tune into a target speaker without first knowing to which speaker a user aims to attend. Brain-controlled hearing aids have been proposed using auditory attention decoding (AAD) methods, but current methods use the same model to compare the speech stimulus and neural response, regardless of the dynamic overlap between talkers which is known to influence neural encoding. Here, we propose a novel framework that directly classifies event-related potentials (ERPs) evoked by glimpsed and masked acoustic events to determine whether the source of the event was attended. We present a system that identifies auditory events using the local maxima in the envelope rate of change, assesses the temporal masking of auditory events relative to competing speakers, and utilizes masking-specific ERP classifiers to determine if the source of the event was attended. Using intracranial electrophysiological recordings, we showed that high gamma ERPs from recording sites in auditory cortex can effectively decode the attention of subjects. This method of AAD provides higher accuracy, shorter switch times, and more stable decoding results compared with traditional correlational methods, permitting the quick and accurate detection of changes in a listener’s attentional focus. This framework also holds unique potential for detecting instances of divided attention and inattention. Overall, we extend the scope of AAD algorithms by introducing the first linear, direct-classification method for determining a listener’s attentional focus that leverages the latest research in multitalker speech perception. This work represents another step toward informing the development of effective and intuitive brain-controlled hearing assistive devices.

Improved tactile speech robustness to background noise with a dual-path recurrent neural network noise-reduction method

Many people with hearing loss struggle to understand speech in noisy environments, making noise robustness critical for hearing-assistive devices. Recently developed haptic hearing aids, which convert audio to vibration, can improve speech-in-noise performance for cochlear implant (CI) users and assist those unable to access hearing-assistive devices. They are typically body-worn rather than head-mounted, allowing additional space for batteries and microprocessors, and so can deploy more sophisticated noise-reduction techniques. The current study assessed whether a real-time-feasible dual-path recurrent neural network (DPRNN) can improve tactile speech-in-noise performance. Audio was converted to vibration on the wrist using a vocoder method, either with or without noise reduction. Performance was tested for speech in a multi-talker noise (recorded at a party) with a 2.5-dB signal-to-noise ratio. An objective assessment showed the DPRNN improved the scale-invariant signal-to-distortion ratio by 8.6 dB and substantially outperformed traditional noise-reduction (log-MMSE). A behavioural assessment in 16 participants showed the DPRNN improved tactile-only sentence identification in noise by 8.2%. This suggests that advanced techniques like the DPRNN could substantially improve outcomes with haptic hearing aids. Low-cost haptic devices could soon be an important supplement to hearing-assistive devices such as CIs or offer an alternative for people who cannot access CI technology.

Cortical linear encoding and decoding of sounds: Similarities and differences between naturalistic speech and music listening.

Linear models are becoming increasingly popular to investigate brain activity in response to continuous and naturalistic stimuli. In the context of auditory perception, these predictive models can be 'encoding', when stimulus features are used to reconstruct brain activity, or 'decoding' when neural features are used to reconstruct the audio stimuli. These linear models are a central component of some brain-computer interfaces that can be integrated into hearing assistive devices (e.g., hearing aids). Such advanced neurotechnologies have been widely investigated when listening to speech stimuli but rarely when listening to music. Recent attempts at neural tracking of music show that the reconstruction performances are reduced compared with speech decoding. The present study investigates the performance of stimuli reconstruction and electroencephalogram prediction (decoding and encoding models) based on the cortical entrainment of temporal variations of the audio stimuli for both music and speech listening. Three hypotheses that may explain differences between speech and music stimuli reconstruction were tested to assess the importance of the speech-specific acoustic and linguistic factors. While the results obtained with encoding models suggest different underlying cortical processing between speech and music listening, no differences were found in terms of reconstruction of the stimuli or the cortical data. The results suggest that envelope-based linear modelling can be used to study both speech and music listening, despite the differences in the underlying cortical mechanisms.

HEARING INTERVENTION TO REDUCE COGNITIVE DECLINE: DESIGN AND FINDINGS OF THE ACHIEVE RANDOMIZED CONTROLLED TRIAL

Abstract Epidemiologic data consistently link age-related hearing loss with accelerated cognitive decline and incident dementia in large, population-based studies. Mechanistic pathways that could underlie this association include the effects of distorted peripheral encoding of sound on cognitive load, changes to brain structure/function, and/or reduced social engagement and increased loneliness. Importantly, these pathways may be amenable to comprehensive hearing rehabilitative treatment including hearing assistive technologies (e.g., hearing aids, other integrated hearing assistive devices) and rehabilitative training. To date, however, there has never been a randomized trial that has investigated whether hearing loss treatment could reduce cognitive and other functional decline in older adults without dementia. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial is a multicenter randomized control trial of 977 cognitively intact adults with untreated, mild-to-moderate hearing loss aged 70-84 years at baseline (2018-19) to determine efficacy of best-practices hearing intervention to reduce cognitive decline over 3 years (Clinicaltrials.gov Identifier: NCT03243422). This session, on behalf of the ACHIEVE Collaborative Research Group, will describe the overall design of the ACHIEVE trial including details about recruitment and implementation of both the hearing (amplification, auditory rehabilitation) and successful aging health education control interventions. We will also present the primary findings of the study – the effect of the hearing intervention vs. control on 3-year cognitive decline – as well as the effect of the hearing intervention on several pre-specified outcomes important for the health of older adults, including social engagement, mood disorders and quality of life.

The Role of Deep Learning Voice Recognition in Assisting Students with Hearing Impairments in Education

With the development of modern technology, deep learning sound recognition technology has gradually become an important tool in supporting the education of students with hearing impairments. This paper aims to explore the role of deep learning sound recognition in assisting the education of students with hearing impairments by comprehensively analyzing relevant literature and research findings. Firstly, the background and challenges of supporting the education of students with hearing impairments are introduced, emphasizing the potential of deep learning sound recognition technology in addressing these challenges. Subsequently, the principles and applications of deep learning sound recognition technology are elaborated, including sound feature extraction, model training, and sound classification. Furthermore, the actual applications of deep learning sound recognition technology in supporting the education of students with hearing impairments are discussed, such as speech recognition, speech synthesis, and assistive hearing devices. Finally, the advantages and limitations of deep learning sound recognition technology in supporting the education of students with hearing impairments are summarized, and future research directions and trends are proposed.

Parental Perspective on Impact of Hearing Assistive Devices on Children with Hearing Impairment

Being a common disability in Pakistan, hearing impairment causes the problem in the language development of the child. This cause delay in their speech and language development and need of using hearing assistive devices to fulfill their communicational needs. Parental perceptions regarding their children’s auditory behaviors by using these hearing assistive devices is essential. Objective: To evaluate the Parental perception of impact of hearing assistive devices of children with hearing impairment using PEACH questionnaire. Methods: This cross-sectional Study was conducted from Nov-2018 to Oct-2019 at Isra Institute of Rehabilitation Sciences, Isra University, Islamabad. Sample recruited N=100 parents of children with mild to profound hearing loss using hearing aids and cochlear implants using convenience sampling. Sample included both genders and 1 to 15 years of age. Basic demographic sheet and PEACH (Parents’ Evaluation of Aural/Oral Performance of Children) Questionnaire was used for data collection. The data were analyzed by SPSS version-22. Results: Results revealed a significant (p<0.05) association of Peech Category with type of hearing assistive device use with higher number of children with typical performance noted in cochlear implant 38(62.3%) group compared to hearing aid users17(43.6%) in quite environment. In noisy environment too, significantly (p=0.001) more cases 47(77.0%) revealed typical performance compared to hearing aid users. 18(46.2%). Children with higher hearing age and those who received speech therapy revealed better performance on PEACH questionnaire (p<0.001). Conclusions: Children using cochlear implants have better listening in everyday life conditions compared to hearing aid. It provides comprehension and understanding of language than hearing aid.

Solving the cocktail party problem using Multi-modal Hearing Assistive Technology Prototype

Hearing loss is a major global health problem, affecting over 1.5 billion people. According to estimations by the World Health Organization, 83% of those who could benefit from hearing assistive devices do not use them. The limited adoption of hearing aids can be attributed to the suboptimal performance in acoustically challenging environments, such as cocktail parties, where there are multiple competing speakers and noise sources leading to poor speech intelligibility for hearing impaired listeners. This work presents a first-of-its-kind real-time, multi-modal speech enhancement system that can effectively enhance speech in challenging real noisy environments. The system exploits both audio and visual cues to isolate the target speaker's voice from interfering background noises. The system is developed using deep neural networks and is integrated with the Open Master Hearing Aid (openMHA) platform. The integrated prototype was evaluated in a cocktail party setting to isolate the target speaker's voice from interfering speakers, music, and other non-speech noise sources and was able to significantly improve the speech intelligibility of hearing impaired listeners. This work has the potential to improve the quality of life for hearing impaired listeners by facilitating effective communication in cocktail party environments.

Vocal health of parents of children with hearing assistive devices.

VH (Vocal health) is the need of the hour. VH of parents of children with hearing assistive devices (HAD) reveals a literature gap, during the habilitation process of their children. To explore the vocal health of parents of children with hearing assistive devices. This cross-sectional study was conducted at Riphah International University from September to December 2021. Study recruited N=384 parents of Hearing Impaired children (HIC) using HAD for at least two years, of both genders and aged 2-9 years using convenience sampling. Voice-related quality of life (V-RQOL), and vocal health Index (VHI) -10 were used for data collection. Data was analyzed on SPSS Version 25. Descriptive statistics, Anova and t-test were utilized to see difference between means of groups. P<0.05 shows significant-results. Parents of children using hearing assistive devices had excellent V-RQOL score in 350(91.14%) parents. There was no significant difference in V=RQOL as regards type of hearing assistive device use (p=0.102), laterality of device use (p=0.918) and degree of hearing loss (p=0.143). However, type of hearing loss revealed significant difference (p=0.021). Also VHI score revealed significantly (p=0.008) lower means in parents of children with cochlear implants. Current study concludes that the parents raising hearing impaired children with hearing assistive devices, possess good vocal health as determined by VHI and V-RQOL scores with only a very small number of parents reporting vocal symptoms.

The Hearing Aid Effect in the 2020s: Where Do We Stand?

Introduction The 'hearingaideffect' is a negativeperception toward individuals using hearingassistive devices (HADs), which is a primary reason for parentsand childrenrefusing to use them. We aimed to determine the current perception toward individuals using HADs and the associated factors. Methods A 30-item photo-based survey was conducted to analyze the participants' perception toward individuals using HADs as comparedto healthy(H) individuals and individuals with disabilities (D). The survey was validated with an intrarater reliability of 86%. A cross-sectional study was conducted by approaching individuals who visited one of the largest shopping centers in a metropolitan city to participate in the survey. Demographic information, including age, gender, and educational background, was collected. Results A total of 517 participants completed the survey. Nearly two-thirds of the participants (59.7%) did not consider individuals using HADs as those who needed assistance as compared to H individuals. Interestingly, Generation X and Z participants had a significantly better perception toward individuals using HADs (63.1% and 59%, respectively) as compared to participants of the Baby Boomers generation (54.3%). The majority of participants who considered HD use a handicap compared to healthy individuals (79.9%) did not have a family member that used aHAD. Conclusion The stigma of wearing a HAD is significantly reducing with time, and the younger generations are not considering it as a disability. This is an important point that can be highlighted while counseling parents and young adults who are candidates for HAD use.

Tactile displays for auditory augmentation–A scoping review and reflections on music applications for hearing impaired users

The field of tactile augmentation has progressed greatly over the past 27 years and currently constitutes an emerging area of research, bridging topics ranging from neuroscience to robotics. One particular area of interest is studying the usage of tactile augmentation to provide inclusive musical experiences for deaf or hard-of-hearing individuals. This article details a scoping review that investigates and organizes tactile displays used for the augmentation of music from the field of hearing assistive devices, documented in 63 scientific publications. The focus is on the hardware, software, mapping, and evaluation of these displays, to identify established methods and techniques, as well as potential gaps in the literature. To achieve this purpose, a catalog of devices was created from the available literature indexed in the Scopus® database. We set up a list of 12 descriptors belonging to physical, auditory, perceptual, purpose and evaluation domains; each tactile display identified was categorized based on those. The frequency of use among these descriptors was analyzed and as well as the eventual relationship between them. Results indicate that the field is relatively new, with 80% of the literature indexed being published after 2009. Moreover, most of the research is conducted in laboratories, with limited industry reach. Most of the studies have low reliability due to small sample sizes, and sometimes low validity due to limited access to the targeted population (e.g., evaluating systems designed for cochlear implant users, on normal hearing individuals). When it comes to the tactile displays, the results show that the hand area is targeted by the majority of the systems, probably due to the higher sensitivity afforded by it, and that there are only a couple of popular mapping systems used by the majority of researchers. Additional aspects of the displays were investigated, including the historical distribution of various characteristics (e.g., number of actuators, or actuators type) as well as the sonic material used as input. Finally, a discussion of the current state of the tactile augmentation of music is presented, as well as suggestions for potential future research.

The role of hearing professionals for over-the-counter hearing aids

Adults with all levels of hearing loss have faced financial and accessibility constraints in obtaining prescription hearing aids. To increase access to hearing aids, the Food and Drug Administration (FDA) has created a new designation of over-the-counter (OTC) hearing aids for adults with perceived mild to moderate hearing loss. The goal of this article is to describe the incorporation of OTC hearing aid users into established audiology services. A proposed workflow was created by otolaryngologists and audiologists at Johns Hopkins University School of Medicine and is being implemented at outpatient audiology offices. We used published criteria for appropriate OTC hearing aid usage and disqualifying criteria hearing specialists should be aware of. The proposed workflow describes the multiple entry points for OTC hearing aid users seeking access to care and appropriate objectives for these visits. The new FDA ruling has increased the accessibility of hearing assistance devices; however, the varying degrees of retailer support systems could lead to improper fitting and other technical problems for some patients trialing new hearing aids. Our proposed workflow aims to describe the incorporation of established hearing assistance services with the new OTC hearing aid market.

Perception of Prosody in Hearing-Impaired Individuals and Users of Hearing Assistive Devices: An Overview of Recent Advances.

Prosody perception is an essential component of speech communication and social interaction through which both linguistic and emotional information are conveyed. Considering the importance of the auditory system in processing prosody-related acoustic features, the aim of this review article is to review the effects of hearing impairment on prosody perception in children and adults. It also assesses the performance of hearing assistive devices in restoring prosodic perception. Following a comprehensive online database search, two lines of inquiry were targeted. The first summarizes recent attempts toward determining the effects of hearing loss and interacting factors such as age and cognitive resources on prosody perception. The second analyzes studies reporting beneficial or detrimental impacts of hearing aids, cochlear implants, and bimodal stimulation on prosodic abilities in people with hearing loss. The reviewed studies indicate that hearing-impaired individuals vary widely in perceiving affective and linguistic prosody, depending on factors such as hearing loss severity, chronological age, and cognitive status. In addition, most of the emerging information points to limitations of hearing assistive devices in processing and transmitting the acoustic features of prosody. The existing literature is incomplete in several respects, including the lack of a consensus on how and to what extent hearing prostheses affect prosody perception, especially the linguistic function of prosody, and a gap in assessing prosody under challenging listening situations such as noise. This review article proposes directions that future research could follow to provide a better understanding of prosody processing in those with hearing impairment, which may help health care professionals and designers of assistive technology to develop innovative diagnostic and rehabilitation tools. https://doi.org/10.23641/asha.21809772.

Smartphone-bundled earphones as personal sound amplification products in adults with sensorineural hearing loss.

Given the low prevalence of hearing aid use among individuals with hearing loss due to their high costs and social stigma, personal sound amplification products (PSAPs) may serve as alternatives with adequate hearing compensation and greater accessibility. This study examined the electroacoustic features of hearing aids and selected smartphone-bundled earphones, specifically AirPods, as PSAPs, and compared hearing performances among adults with mild-to-moderate hearing loss when aided with each hearing assistive device. Our results indicated that AirPods Pro met four out of five PSAP standards. No significant differences were found regarding speech perception between AirPods Pro and hearing aids in quiet but not with the presence of background noises. AirPods Pro may have the potential to be a hearing assistive device for adults with mild-to-moderate hearing loss. More research is needed to investigate the safety and feasibility of using earphones bundled with other smartphones as PSAPs.

An Umbo Microphone for Fully-Implantable Assistive Hearing Devices

This article presents an implantable microphone for sensing the displacement of the umbo, the end of the malleus where it attaches to the center tip of the cone-shaped tympanic membrane. The sensor comprises a piezoelectric polyvinylidene fluoride (PVDF) film with copper–nickel electrodes suspended across a brass cylinder. The cylinder is oriented so that the umbo pushes on the film center, causing a static and acoustically driven dynamic film displacement. An amplifier filters the resulting piezoelectric charge to produce an output signal. The sensor enables the full implantation of assistive hearing devices, which can restore hearing without inhibiting the user’s lifestyle, while enabling better sound localization in noisy environments.

Automatic User Preferences Selection of Smart Hearing Aid Using BioAid.

Noisy environments, changes and variations in the volume of speech, and non-face-to-face conversations impair the user experience with hearing aids. Generally, a hearing aid amplifies sounds so that a hearing-impaired person can listen, converse, and actively engage in daily activities. Presently, there are some sophisticated hearing aid algorithms available that operate on numerous frequency bands to not only amplify but also provide tuning and noise filtering to minimize background distractions. One of those is the BioAid assistive hearing system, which is an open-source, freely available downloadable app with twenty-four tuning settings. Critically, with this device, a person suffering with hearing loss must manually alter the settings/tuning of their hearing device when their surroundings and scene changes in order to attain a comfortable level of hearing. However, this manual switching among multiple tuning settings is inconvenient and cumbersome since the user is forced to switch to the state that best matches the scene every time the auditory environment changes. The goal of this study is to eliminate this manual switching and automate the BioAid with a scene classification algorithm so that the system automatically identifies the user-selected preferences based on adequate training. The aim of acoustic scene classification is to recognize the audio signature of one of the predefined scene classes that best represent the environment in which it was recorded. BioAid, an open-source biological inspired hearing aid algorithm, is used after conversion to Python. The proposed method consists of two main parts: classification of auditory scenes and selection of hearing aid tuning settings based on user experiences. The DCASE2017 dataset is utilized for scene classification. Among the many classifiers that were trained and tested, random forests have the highest accuracy of 99.7%. In the second part, clean speech audios from the LJ speech dataset are combined with scenes, and the user is asked to listen to the resulting audios and adjust the presets and subsets. A CSV file stores the selection of presets and subsets at which the user can hear clearly against the scenes. Various classifiers are trained on the dataset of user preferences. After training, clean speech audio was convolved with the scene and fed as input to the scene classifier that predicts the scene. The predicted scene was then fed as input to the preset classifier that predicts the user’s choice for preset and subset. The BioAid is automatically tuned to the predicted selection. The accuracy of random forest in the prediction of presets and subsets was 100%. This proposed approach has great potential to eliminate the tedious manual switching of hearing assistive device parameters by allowing hearing-impaired individuals to actively participate in daily life by automatically adjusting hearing aid settings based on the acoustic scene.

Feeling disabled: Vowel quality and assistive hearing devices in embodying affect

AbstractPrevious research has proposed that phonetic variation may index affect prior to indexing other social meanings. This study explores whether the affective indexicality of vowels identified in previous studies can also be observed among deaf or hard-of-hearing speakers, in this case, speakers of Taiwan Mandarin. The results suggest that /i/ backing is invoked to signal negative affect. This study also demonstrates how assistive devices like hearing aids and cochlear implants can be considered semiotic resources. For deaf or hard-of-hearing speakers, assistive hearing devices enter into a process of bricolage with linguistic and other symbolic resources, generating new potentials for the embodiment of affect. (Affect, iconicity, Taiwan Mandarin, embodied sociolinguistics, deafness)*

The sensitivity of bone conduction for dental implants.

Dental implants are connected to the alveolar bone by osseointegration. Dental implants could be used as a potential bone conduction (BC) hearing assistive device in the mouth. However, the BC threshold of dental implants has not been reported. The present study aimed to examine the pure tone auditory thresholds of normal human subjects to BC stimulation of the implants. Dental implants showed a significantly lower BC threshold than natural teeth and mastoids. Mandibular dental implants had BC sensitivity similar to that of maxillary dental implants. The BC threshold of anterior dental implants was significantly lower than that of posterior dental implants. Dental implants exhibited excellent BC properties.

Profiling hearing aid users through big data explainable artificial intelligence techniques.

Debilitating hearing loss (HL) affects ~6% of the human population. Only 20% of the people in need of a hearing assistive device will eventually seek and acquire one. The number of people that are satisfied with their Hearing Aids (HAids) and continue using them in the long term is even lower. Understanding the personal, behavioral, environmental, or other factors that correlate with the optimal HAid fitting and with users' experience of HAids is a significant step in improving patient satisfaction and quality of life, while reducing societal and financial burden. In SMART BEAR we are addressing this need by making use of the capacity of modern HAids to provide dynamic logging of their operation and by combining this information with a big amount of information about the medical, environmental, and social context of each HAid user. We are studying hearing rehabilitation through a 12-month continuous monitoring of HL patients, collecting data, such as participants' demographics, audiometric and medical data, their cognitive and mental status, their habits, and preferences, through a set of medical devices and wearables, as well as through face-to-face and remote clinical assessments and fitting/fine-tuning sessions. Descriptive, AI-based analysis and assessment of the relationships between heterogeneous data and HL-related parameters will help clinical researchers to better understand the overall health profiles of HL patients, and to identify patterns or relations that may be proven essential for future clinical trials. In addition, the future state and behavioral (e.g., HAids Satisfiability and HAids usage) of the patients will be predicted with time-dependent machine learning models to assist the clinical researchers to decide on the nature of the interventions. Explainable Artificial Intelligence (XAI) techniques will be leveraged to better understand the factors that play a significant role in the success of a hearing rehabilitation program, constructing patient profiles. This paper is a conceptual one aiming to describe the upcoming data collection process and proposed framework for providing a comprehensive profile for patients with HL in the context of EU-funded SMART BEAR project. Such patient profiles can be invaluable in HL treatment as they can help to identify the characteristics making patients more prone to drop out and stop using their HAids, using their HAids sufficiently long during the day, and being more satisfied by their HAids experience. They can also help decrease the number of needed remote sessions with their Audiologist for counseling, and/or HAids fine tuning, or the number of manual changes of HAids program (as indication of poor sound quality and bad adaptation of HAids configuration to patients' real needs and daily challenges), leading to reduced healthcare cost.

Comparing In-ear EOG for Eye-Movement Estimation With Eye-Tracking: Accuracy, Calibration, and Speech Comprehension.

This presentation details and evaluates a method for estimating the attended speaker during a two-person conversation by means of in-ear electro-oculography (EOG). Twenty-five hearing-impaired participants were fitted with molds equipped with EOG electrodes (in-ear EOG) and wore eye-tracking glasses while watching a video of two life-size people in a dialog solving a Diapix task. The dialogue was directionally presented and together with background noise in the frontal hemisphere at 60 dB SPL. During three conditions of steering (none, in-ear EOG, conventional eye-tracking), participants' comprehension was periodically measured using multiple-choice questions. Based on eye movement detection by in-ear EOG or conventional eye-tracking, the estimated attended speaker was amplified by 6 dB. In the in-ear EOG condition, the estimate was based on one selected channel pair of electrodes out of 36 possible electrodes. A novel calibration procedure introducing three different metrics was used to select the measurement channel. The in-ear EOG attended speaker estimates were compared to those of the eye-tracker. Across participants, the mean accuracy of in-ear EOG estimation of the attended speaker was 68%, ranging from 50 to 89%. Based on offline simulation, it was established that higher scoring metrics obtained for a channel with the calibration procedure were significantly associated with better data quality. Results showed a statistically significant improvement in comprehension of about 10% in both steering conditions relative to the no-steering condition. Comprehension in the two steering conditions was not significantly different. Further, better comprehension obtained under the in-ear EOG condition was significantly correlated with more accurate estimation of the attended speaker. In conclusion, this study shows promising results in the use of in-ear EOG for visual attention estimation with potential for applicability in hearing assistive devices.