Hearing Aid Selection Research Articles

Intelligibility ratings of continuous discourse: application to hearing aid selection.

Twelve normal-hearing subjects rated the intelligibility of 35-s, hearing-aid-processed continuous discourse (CD) passages. Three talkers (two male, one female), four hearing aids, and two signal-to-babble (S/B) ratios were used in a completely crossed design. Research questions concerned: (1) ability of listeners to rate intelligibility, (2) sensitivity of hearing aid rankings were based on intelligibility ratings for three CD passages per instrument, and (3) dependence of hearing aid rankings on (a) S/B ratio, and (b) talker characteristics. Results were: (1) listeners were able to rate intelligibility, (2) rankings based on intelligibility ratings of three CD passages per hearing aid were capable of identifying two superior instruments within a group of four hearing aids that were similar in frequency/gain function, (3) listening in a more difficult S/B ratio substantially decreased the sensitivity of the hearing aid rankings for the female talker but had only minor effects on the rankings for the male talkers, and (4) hearing aid intelligibility rankings were found to be different for different talkers. Applications to hearing aid selection are discussed.

Magnitude estimation of loudness. I: Application to hearing aid selection.

Three experiments were conducted to explore the utility of magnitude estimation of loudness for hearing aid selection. In Experiment 1 the loudness discomfort level (LDL), most comfortable loudness (MCL), and magnitude estimations (MEs) of loudness were obtained from normal-hearing subjects. MCLs fell within a range of loudness that was relatively low on the loudness function. The LDLs were lower than previously published values. Experiment 2 was performed to identify the source of disparity between our LDL data and previously reported results. The effects of instructions are demonstrated and discussed. In Experiment 3 magnitude estimations of loudness were used to determine the loudness of tonal stimuli selected to represent 1/3 octave band levels of speech. Over the 500-4000 Hz range, the contributions of the various frequency regions to the loudness of speech appears to be nearly constant. Methods are proposed for (a) predicting the frequency-gain response of a hearing aid that restores normal loudness for speech for the hearing-impaired listener and (b) psychophysically evaluating the compression characteristic of a hearing aid.

Self-report approach to assessing benefit derived from amplification.

The ultimate goal of hearing aid selection procedures is successful use of amplification in everyday communication. The need to validate selection procedures is widely recognized, but the development of relevant criterion measures is a prerequisite to evaluation of predictive validity. This study explored the feasibility of using a self-report method of measuring success with amplification. A 64-item questionnaire was administered to 128 experienced hearing aid users who rated the benefit received from amplification in a variety of situations. Internal consistency reliability was excellent (alpha = .96), indicating that the perceived benefit is sufficiently consistent across situations to yield reliable measures of individual differences among patients. Factor analysis of the interitem correlation matrix, however, led to the identification of four types of situations that might be assessed separately: (a) noisy situations; (b) quiet situations with the speaker in proximity; (c) situations with reduced signal information; and (d) situations with nonspeech stimuli. In general, patients reported significantly more benefit from their aids in quiet situations than in noise. A self-report methodology for measuring successful use of amplification in daily life appears promising as a criterion measure in predictive validation studies of hearing aid selection procedures.

Hearing-aid selection: an integrated approach.

This paper outlines the application of a general model of audiological rehabilitation to hearing-aid selection in its broadest sense. In it an attempt is made to take into account the non-acoustical as well as the acoustical factors. From the standpoint of an extension of the general model, it illustrates the way in which the information obtained in the evaluative part of the rehabilitative model may be applied in the remedial part of that model. The overall aim in this is to facilitate an evolution of the process of hearing-aid selection from a clinical 'art' to a clinical 'science' considering all relevant factors.

Hearing Aid Prescription Rules Using Insertion Gain Measurements

Many of the decisions regarding hearing aid selection and use are based mainly upon clinical impressions. It was therefore decided to investigate whether the old fitting of 25 aided subjects with moderate hearing loss could be improved by using more precise prescription rules and a real ear measuring technique. The rules formulated should give a frequency response of moderate low and pronounced high frequency gain. The application of these rules resulted in improved high frequency gain and better speech discrimination for consonants in noise. As a result of the investigation, the routine procedure of hearing aid fitting has been revised. Earmold modifications of different types should be used more often and real ear canal measurements are recommended for incorporation in the routine examination of hearing aid performance.

Speech Audiometry for Hearing Aid Selection

Speech Audiometry for Hearing Aid Selection

Performance characteristics for hearing aid microphone versus telephone and telephone/telecoil reception modes.

Two hearing aids and three telephone receivers were used to compare electroacoustic and word intelligibility data for hearing aid microphone reception versus telephone/telephone and telephone/telecoil reception. Measurements included test reference position gain and frequency response characteristics (Experiment 1) and word intelligibility scores (Experiment 2). The results indicated that performance was similar for hearing aid microphone reception and telephone/telephone reception. Telephone/telecoil performance varied, depending on which telephone receiver was involved, but was poorer than hearing aid microphone performance. Recommendations were made concerning the selection of hearing aids and the management of hearing aid users relative to telephone/telecoil communication.

Early identification of hearing loss: practices and procedures.

Early identification and management of hearing loss is of critical importance for maximizing a hearing-impaired child's language-learning potential. This article discusses the benefits of early identification. The process of identification of hearing loss in preschool children, including infant screening techniques, audiological testing methods, and other tests used to determine the kind and degree of hearing loss, are discussed. Appropriate habilitation and educational placement is also discussed, including hearing aid selection and parent participation.

Role of auditory brain stem response in the selection of hearing aids.

This article describes an electrophysiological taxonomy of patients who are unwilling to continue wearing their hearing aids or are dissatisfied with the performance of the aid. Because the responses on which the taxonomy is based do not depend upon patient cooperation, they can be used in the pediatric population, where alternative procedures are less than optimal. Examples of how this electrophysiological taxonomy relates to patient management decisions are also provided.

The Selection of Hearing Aids With Regards to Speech Intelligibility

The Selection of Hearing Aids With Regards to Speech Intelligibility

Hearing aid selection by brainstem audiometry.

Hearing aid selection and adjustment by means of brainstem audiometry was tested in 29 hearing impaired children. A projection procedure is introduced which employs normal and pathological intensity-amplitude functions. This method enables determination of some basic properties of appropriate hearing aids, such as average gain, type of compression, compression factor and onset level. Hearing aid evaluation is discussed for two examples of conductive and sensorineural impairment.

Hearing aid selection: a data base approach.

Hearing aid selection: a data base approach.

Hearing Aid Selection by Brainstem Audiometry

Hearing Aid Selection by Brainstem Audiometry

The SPL hearing meter.

An instrument, the SPL Hearing Meter, was devised for the measurement of hearing threshold with a hearing aid earphone in order to make a direct comparison between the hearing threshold and the output sound pressure level of a hearing aid. The author found this a handy tool for selection and adjustment of hearing aids.

Hearing-aid fitting protocol.

A five appointment programme protocol for hearing-aid selection, fitting and client guidance is described. The full protocol requires a maximum work load average of 3 h per client, and is appropriate for the vast majority of psychologically and physically intact first time aid users. Drawn up for use mainly with an elderly population, the protocol is equally appropriate with younger adult clients contacts over a relatively short time to allow repetition and reinforcement and develop motivation. Each appointment has been designed to contain a proportion of instruction, a proportion of assessment and evaluation, and a proportion of advice and guidance. Clients proceed in accordance with individual capacity, but do not proceed beyond any point until performance is verified. A number of recently developed methods are incorporated into the protocol. These include methods of aid selection, ear impression taking, aided threshold testing and validity checks and speech test selection.

Rehabilitation Strategies for Sensorineural Hearing Loss,

This book comprises clinical and research articles presented at the Second Symposium on the Application of Signal Processing Concepts to Hearing Aids, Pennsylvania State University, March 23-24, 1979. The initial article presents the role of the otolaryngologist, as viewed by an otolaryngologist, in the hearing rehabilitation process. There are four articleson hearing aid selection procedures. One stresses the need for working closely with the patient during a period of weeks in matching electroacoustical factors with needs in everyday situations. Another compares different real-ear procedures in which amplification is evaluated by behavioral responses. In a third article, the question of binaural vs monaural hearing aids is discussed, and it is emphasized that the decision must rest on thorough testing of hearing aid use in both modes. The fourth article points out the advantages of frequency-selective amplification and output limiting in providing maximum speech intelligibility and comfort. Topics treated in other articles

Clinical Implications of Nonverbal Methods of Hearing Aid Selection and Fitting

Clinical Implications of Nonverbal Methods of Hearing Aid Selection and Fitting

Auditory and Hearing Prosthetics Research

The title of this book is deceptive in that it uses the word prosthetics but has only one brief article dealing with auditory prostheses (Glattke, Overview of Non-Conventional Aids to Hearing, pages 331-343). As a book on current hearing aid research, it can be viewed with less disfavor. This book is the result of a conference held at the University of Wyoming in July 1977. The participants (and authors) are all either engineers or audiologists. The topics covered by these authors are what one would expect from a conference on hearing aids. Included is an excellent report by Lybarger on the acoustics of earmolds. The section dealing with selection of conventional hearing aids includes several competent works; however, for the most part, these reviews are uninspiring, because the authors too often used their space to tout their own work rather than cover the topic. It is unfortunate that the one

Loudness Discomfort Level for Speech

This study was undertaken to compare the speech loudness discomfort levels (LDL's) with two instructional sets which have been proposed for saturation sound pressure level selection of hearing aids. The phraseology recommended by McCandless and by Berger was presented to normal-hearing and hearing-impaired listeners. The normal-hearing subjects obtained mean LDL's of 94.6 and 111.9 dB SPL for these respective instructions, which was statistically significant. The hearing-impaired listeners also showed LDL's with Berger's instructions (114.7 dB SPL) to be significantly higher than with McCandless' instructional set (109.3 dB SPL). Consequently, this investigation suggests that these two instructional sets may lead to substantially different saturation sound pressure levels. Further studies are needed to determine the most appropriate phraseology for LDL measurement, including the assessment of speech intelligibility at various saturation sound pressure levels. Another instructional set was constructed which (1) includes an explanation to patients of the purpose and importance of the test, (2) requests listeners to indicate the upper level they are "willing" to listen as opposed to the level they are "able" to listen, (3) instructs patients to search thoroughly around their LDL before making a final judgment, and (4) contains a statement that the LDL should be made with the understanding that the speech could be listened to for a period of time. Whatever instructions are used, clinicians are advised to interpret their LDL's very cautiously until validational studies are available.

Preferred listening levels for bands of speech in relation to hearing aid selection.

The Most Comfortable Loudness Level (MCL) was measured for 24 normal-hearing subjects, using narrow bands of speech having centre frequencies of 0.25, 0.5, 1.2 and 4kHz. MCL's were equivalent for octave band and one-third octave band stimuli. The sensation levels (SL) for various frequencies closely matched the SL of the 60 phon equal loudness contour for pure tones. It was concluded, for levels around MCL, sounds which are equally comfortable are equally loud and that equal loudness contours for pure tones are also applicable to narrow bands of speech. Some implications for hearing aid selection are discussed. However, this investigation was primarily a preliminary to other studies more directly related to hearing aid selection issues.