Journal of the American Academy of Audiology最新文献

Background:  Remote-microphone (RM) systems are designed to reduce the impact of poor acoustics on speech understanding. However, there is limited research examining the effects of adding reverberation to noise on speech understanding when using hearing aids (HAs) and RM systems. Given the significant challenges posed by environments with poor acoustics for children who are hard of hearing, we evaluated the ability of a novel RM system to address the effects of noise and reverberation.

Purpose:  We assessed the effect of a recently developed RM system on aided speech perception of children who were hard of hearing in noise and reverberation and how their performance compared to peers who are not hard of hearing (i.e., who have hearing thresholds no greater than 15 dB HL). The effect of aided speech audibility on sentence recognition when using an RM system also was assessed.

Study sample:  Twenty-two children with mild to severe hearing loss and 17 children who were not hard of hearing (i.e., with hearing thresholds no greater than 15 dB HL) (7-18 years) participated.

Data collection and analysis:  An adaptive procedure was used to determine the signal-to-noise ratio for 50 and 95% correct sentence recognition in noise and noise plus reverberation (RT 300 ms). Linear mixed models were used to examine the effect of listening conditions on speech recognition with RMs for both groups of children and the effects of aided audibility on performance across all listening conditions for children who were hard of hearing.

Results:  Children who were hard of hearing had poorer speech recognition for HAs alone than for HAs plus RM. Regardless of hearing status, children had poorer speech recognition in noise plus reverberation than in noise alone. Children who were hard of hearing had poorer speech recognition than peers with thresholds no greater than 15 dB HL when using HAs alone but comparable or better speech recognition with HAs plus RM. Children with better-aided audibility with the HAs showed better speech recognition with the HAs alone and with HAs plus RM.

Conclusion:  Providing HAs that maximize speech audibility and coupling them with RM systems has the potential to improve communication access and outcomes for children who are hard of hearing in environments with noise and reverberation.

Background: Hearing aid responses can be verified with the Real-Ear Aided Response (REAR). Procedures for predicting the REAR from coupler-based verification exist, but have not incorporated corrections for venting, limiting their use and validity for vented and open fittings. A commercially available system for including venting effects in simulated real-ear measurement (S-REM) has recently been developed.

Purpose: To evaluate the accuracy of a vent-corrected S-REM for predicting the REAR across test levels, for fittings with a wide range of coupling styles including modular domes.

Research design: This was a within-subject comparison study using technical measures. Retrospective file review was used to obtain previously measured REARs from 104 fittings in 52 adults and three hearing aid styles. Prospective data collection was used to re-measure each fitting at three test levels using S-REM with and without venting corrections. Comparison of differences by frequency band was performed to assess the impact of the venting correction.

Results: The vent model reduced low-frequency error by up to 11 dB, and the effects were consistent with the expected effects of venting in hearing aid fitting: fittings with more open dome or tip styles had a larger improvement when the vent model was added. A larger sample of fittings was obtained for dome/sleeve couplings than for custom fittings.

Conclusions: The vent-corrected S-REM system evaluated in this study provides improved fitting accuracy for dome or sleeve-fitted hearing aids for adults and supports the use of vented S-REM for open fittings. Further studies to examine a representative sample of custom tip or mold fittings, and fittings for children are future directions.