The robustness of hearing aid microphone preferences in everyday listening environments

Automatic directionality algorithms currently implemented in hearing aids assume that hearing-impaired persons with similar hearing losses will prefer the same microphone processing mode in a specific everyday listening environment. The purpose of this study was to evaluate the robustness of microphone preferences in everyday listening. Two hearing-impaired persons made microphone preference judgments (omnidirectional preferred, directional preferred, no preference) in a variety of everyday listening situations. Simultaneously, these acoustic environments were recorded through the omnidirectional and directional microphone processing modes. The acoustic recordings were later presented in a laboratory setting for microphone preferences to the original two listeners and other listeners who differed in hearing ability and experience with directional microphone processing. The original two listeners were able to replicate their live microphone preferences in the laboratory with a high degree of accuracy. This suggests that the basis of the original live microphone preferences were largely represented in the acoustic recordings. Other hearing-impaired and normal-hearing participants who listened to the environmental recordings also accurately replicated the original live omnidirectional preferences; however, directional preferences were not as robust across the listeners. When the laboratory rating did not replicate the live directional microphone preference, listeners almost always expressed no preference for either microphone mode. Hence, a preference for omnidirectional processing was rarely expressed by any of the participants to recorded sites where directional processing had been preferred as a live judgment and vice versa. These results are interpreted to provide little basis for customizing automatic directionality algorithms for individual patients. The implications of these findings for hearing aid design are discussed.     

Directivity of different hearing aid microphone locations

In this study, we present a new method to derive a single-number measure of the directivity of hearing aids. The method is an extension of the conventional directivity index (DI), and is called overall directivity index (ODI). The directivities of five different hearing aid styles were compared with that of the open ear. The behind-the-ear (BTE) style showed the lowest directionality compared to the other hearing aid styles and the open ear. There were only minor differences in directivity between any of the four different hearing aid styles placed in the ear and of the open ear canal. The conventional measure of DI is less suitable for hearing aids, because it ignores sound coming from other than the frontal direction. To quantify directionality of a hearing aid in a real-life situation, we suggest the single-number ODI, weighted with the articulation index and related to a listening segment of 0-30 degrees. An application of the data is shown for a BTE with a directional microphone.     

Recognition performance for four combinations of FM system and hearing aid microphone signals in adverse listening conditions.

OBJECTIVE: Children with moderate to severe hearing loss routinely use personal frequency modulated (FM) systems in the classroom to improve the signal to noise ratio of teacher-directed speech with notable success. Attention is now being given to the ability of these children to hear other students via the hearing aid (HA) microphone while using an FM system. As a result, a variety of FM system and HA microphone combinations have been recommended for classroom use. To date, there are no studies regarding the efficacy of these FM/HA combinations. The purpose of this study was to evaluate recognition performance using four FM/HA combinations and to characterize that performance for stimuli received primarily through FM system and HA microphone transmission. DESIGN: Recognition performance for FM system and HA microphone signals was evaluated for two symmetrical and two asymmetrical FM/HA combinations using two commercially available FM systems (one conventional and one FM-precedence circuit). Eleven children (ages 9 to 12) with moderate to severe sensorineural hearing loss and eight children (ages 10 to 11) with normal hearing served as subjects. The two symmetrical FM/HA combinations included: 1) binaural FM system and HA microphone input using the conventional FM system, and 2) binaural FM and HA input using the FM-precedence circuit. The conventional FM system was used for the two asymmetrical combinations and included: 1) binaural FM input and monaural HA input, and 2) FM input to one ear and HA input to the other. Stimuli were 33 consonants presented in the form of nonsense syllables. The stimuli were presented through three loudspeakers representing a teacher and two fellow students in a classroom environment. Speech shaped noise was presented through two additional loudspeakers. RESULTS: In general, no statistically significant differences in recognition performance were found between any of the FM/HA combinations. Mean recognition scores for HA microphone transmission (55%) were significantly poorer than those for FM system transmission (75%). As expected, initial consonants were more easily recognized than final consonants via FM system and HA microphone transmission. However, voiceless consonants were more easily recognized than voiced consonants via HA microphone transmission, which was not predicted on the basis of previous research. CONCLUSIONS: These results suggest that a certain amount of flexibility is present when choosing an FM/HA combination. However, recognition performance via the HA microphones was consistently poorer than performance via FM transmission. Because relevant material also originates from fellow students (e.g., answering teacher-directed questions), input via the HAs is often as important as information originating from the teacher. The results suggest that attempts to improve performance for signals transmitted through the HA microphones in a classroom setting would benefit children with hearing loss.     

Predicting success with hearing aids in everyday living

Persons with impaired hearing who are candidates for amplification are not all equally successful with hearing aids in daily living. Having the ability to predict success with amplification in everyday life from measures that can be obtained during an initial evaluation of the patient's candidacy would result in greater patient satisfaction with hearing aids and more efficient use of clinical resources. This study investigated the relationship between various demographic and audiometric measures, and two measures of hearing aid success in 50 hearing aid wearers. Audiometric predictors included measures of audibility and suprathreshold distortion. The unaided and aided signal-to-noise ratio (SNR) loss on the QuickSIN test provided the best predictors of hearing aid success in daily living. However, much of this predictive relationship appeared attributable to the patient's age.     

The effect of reference microphone placement on sound pressure levels at an ear level hearing aid microphone

The present study was designed to investigate the effects of reference microphone location on probe tube microphone measures of hearing aid response. The reference microphone of a clinical probe tube microphone system was located either at a position on the cheek (position A) or in close proximity to the microphone of an ear level hearing aid (position B). With sound pressure level (SPL) held constant at the reference microphone, the SPL at the position of the hearing aid microphone was measured at 14 test frequencies using a 1/8-inch condenser microphone. Measures were obtained on ten male and ten female subjects. Results indicated large frequency-dependent deviations in SPL at the hearing aid microphone, compared to that measured at the reference microphone, when the reference microphone was at position A. In the 1200 to 2000 Hz range, the SPL at the hearing aid microphone was as much as 9.5 dB higher than at the reference microphone. There were no large frequency-dependent variations with the reference microphone in position B, but the SPL at the hearing aid microphone location was approximately 3 dB higher than at the reference microphone. Results suggest that estimates of hearing aid output can be affected markedly by the reference microphone location. Clinical implications of the impact of reference microphone location on probe microphone measures of hearing aid gain and saturation sound pressure levels are discussed.     

Predicting directional hearing aid benefit for individual listeners

The fitting of directional microphone hearing aids is becoming increasingly more routine, and this fitting option has proven to be a successful method to improve speech intelligibility in many noisy listening environments. Data suggest, however, that some hearing-impaired listeners receive significantly more directional benefit than others. It is of interest, therefore, to determine if directional benefit is predictable from identifiable audiologic factors. In this report, we examined whether the slope of audiometric configuration, amount of high-frequency hearing loss, and/or the aided omnidirectional performance for a speech-in-noise intelligibility task could be used to predict the magnitude of directional hearing aid benefit. Overall results obtained from three separate investigations revealed no significant correlation between the slope of audiometric configuration or amount of high-frequency hearing loss and the benefit obtained from directional microphone hearing instruments. Although there was a significant, negative relationship between aided omnidirectional performance and the directional benefit obtained in one study, there was considerable variability among individual participants, and nearly all of the listeners with the best omnidirectional hearing aid performance still received significant additional benefit from directional amplification. These results suggest that audiologists should consider the use of directional amplification for patients regardless of audiogram slope, high-frequency hearing loss, or omnidirectional speech intelligibility score.     

An objective measure for selecting microphone modes in OMNI/DIR hearing aid circuits

OBJECTIVES: Studies have shown that listener preferences for omnidirectional (OMNI) or directional (DIR) processing in hearing aids depend largely on the characteristics of the listening environment, including the relative locations of the listener, signal sources, and noise sources; and whether reverberation is present. Many modern hearing aids incorporate algorithms to switch automatically between microphone modes based on an analysis of the acoustic environment. Little work has been done, however, to evaluate these devices with respect to user preferences, or to compare the outputs of different signal processing algorithms directly to make informed choices between the different microphone modes. This study describes a strategy for automatically switching between DIR and OMNI microphone modes based on a direct comparison between acoustic speech signals processed by DIR and OMNI algorithms in the same listening environment. In addition, data are shown regarding how a decision to choose one microphone mode over another might change as a function of speech to noise ratio (SNR) and spatial orientation of the listener. DESIGN: Speech and noise signals were presented at a variety of SNR's and in different spatial orientations relative to a listener's head. Monaural recordings, made in both OMNI and DIR microphone processing modes, were analyzed using a model of auditory processing that highlights the spectral and temporal dynamics of speech. Differences between OMNI and DIR processing were expressed in terms of a modified spectrotemporal modulation index (mSTMI) developed specifically for this hearing aid application. Differences in mSTMI values were compared with intelligibility measures and user preference judgments made under the same listening conditions. RESULTS: A comparison between the results of the mSTMI analyses and behavioral data (intelligibility and preference judgments) showed excellent agreement, especially in stationary noise backgrounds. In addition, the mSTMI was found to be sensitive to changes in SNR as well as spatial orientation of the listener relative to signal and noise sources. Subsequent mSTMI analyses on hearing aid recordings obtained from real-life environments with more than one talker and modulated noise backgrounds also showed promise for predicting the preferred microphone setting in varied and complex listening environments.     

Relationship between laboratory measures of directional advantage and everyday success with directional microphone hearing aids

The improvement in speech recognition in noise obtained with directional microphones compared to omnidirectional microphones is referred to as the directional advantage. Laboratory studies have revealed substantial differences in the magnitude of the directional advantage across hearing-impaired listeners. This investigation examined whether persons who were successful users of directional microphone hearing aids in everyday living tended to obtain a larger directional advantage in the test booth than persons who were unsuccessful users. Results revealed that the mean directional advantage did not differ significantly between patients who used the directional mode regularly and those who reported little or no benefit from directional microphones in daily living and, therefore, tended to leave their hearing aids set in the default omnidirectional mode. Success with directional microphone hearing aids in everyday living, therefore, cannot be reliably predicted by the magnitude of the directional advantage obtained in the clinic.     

Wireless binaural hearing aid technology for telephone use and listening in wind noise

Objective: To assess the speech perception benefits of binaural streaming technology for bilateral hearing aid users in two difficult listening conditions.

Design: Two studies were conducted to compare hearing aid processing features relating to telephone use and wind noise. Speech perception testing was conducted in four different experimental conditions in each study.

Study sample: Ten bilaterally-aided children in each study.

Results: Significant improvements in speech perception were obtained with a wireless feature for telephone use. Significant speech perception benefits were also obtained with wireless hearing aid features when listening to speech in simulated wind noise.

Conclusions: Binaural signal processing algorithms can significantly improve speech perception for bilateral hearing aid users in challenging listening situations.     

Clinical trials with a programmable hearing aid set for various listening environments

A conventional hearing aid has a frequency response that does not change much at normal listening levels. It is therefore unlikely that optimal speech intelligibility and optimal listening comfort can be obtained simultaneously, or in different listening environments. With a programmable hearing aid with multiple memories the listener can choose between a range of sound pictures, which increases the chance of finding a suitable frequency curve for each listening situation. The programmable hearing aid with eight separate settings stored in eight memories, was compared with personal hearing aids fitted according to the recommendations of the National Acoustic Laboratories (NAL) by 22 experienced hearing aid users. One memory of the programmable hearing aid was initially fitted according to the NAL recommendation. The other memories were programmed to give variations around that recommendation. One aim was to investigate whether the hearing-impaired user took advantage of different frequency responses to achieve listening improvements in acoustically different environments. Another aim was to evaluate the ergonomic and acoustical features of the programmable hearing aid, compared with other well fitted hearing aids. The evaluations were based on comparisons of the test hearing aid to the personal aid for each subject, looking at speech tests, direct paired comparison judgements, sound quality judgements and interviews. A majority of the subjects experienced substantial benefit from being able to use different frequency response curves in different environments. With the test hearing aid the subjects performed better in speech discrimination tests in noise.(ABSTRACT TRUNCATED AT 250 WORDS)     

Localisation of speech through similar and dissimilar binaural hearing aid listening modes

This paper compared the localisation abilities in the horizontal plane of 12 adults with bilateral asymmetrical sensorineural hearing impairment whilst listening to speech using each one of the following three binaural hearing aid listening modes: (a) binaural listening with two similar ear-level hearing aids, (b) binaural listening with two similar bodyworm hearing aids and, (c) binaural listening with two dissimilar hearing aids (one ear-level, one bodyworn). It was found that the differences in localisation ability between the three binaural hearing aid listening modes were small and none of them proved to be statistically significant. It was concluded that where possible binaural hearing aids should be of similar type and model, although in situations where this could not be achieved or was not indicated, the issuing of dissimilar binaural hearing aids should not be discouraged.