J Am Acad Audiol 2019; 30(07): 634-648
DOI: 10.3766/jaaa.18003
Articles
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Effects of Extended Input Dynamic Range on Laboratory and Field-Trial Evaluations in Adult Hearing Aid Users

Patrick N. Plyler
*   Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN
,
Mary Easterday
*   Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN
,
Thomas Behrens
†   Centre for Applied Audiology Research, Oticon, Copenhagen, Denmark
› Author Affiliations
Further Information

Publication History

21 March 2018

02 May 2018

Publication Date:
25 May 2020 (online)

Abstract

Background:

Digital hearing aids using a 16-bit analog-to-digital converter (ADC) provide a 96-dB input dynamic range. The level at which the ADC peak clips and distorts input signals ranges between 95 and 105 dB SPL. Recent research evaluated the effect of extending the input dynamic range in a commercially available hearing aid. Although the results were promising, several limitations were noted by the authors. Laboratory testing was conducted using recordings from hearing aids set for a flat 50-dB loss; however, field testing was conducted with hearing aids fitted for their hearing loss. In addition, participants rarely encountered input levels of sufficient intensity to adequately test the feature and were unable to directly compare aids with and without extended input dynamic range (EIDR) under identical conditions.

Purpose:

The effects of EIDR under realistic and repeatable test conditions both within and outside the laboratory setting were evaluated.

Research Design:

A repeated measures design was used. The experiment was single-blinded.

Study Sample:

Twenty adults (14 males and six females) between the ages of 30 and 71 years (average age 62 years) who were experienced hearing aid users participated.

Data Collection and Analysis:

Each participant was fit with Oticon Opn hearing instruments binaurally using the National Acoustics Laboratory-Nonlinear 1 fitting strategy. Participants completed a two-week trial period using hearing aids with EIDR and a two-week trial period without EIDR. The initial EIDR condition trial period was counterbalanced. After each trial, laboratory evaluations were obtained at 85 dBC using the Connected Speech Test, the Hearing in Noise Test, and the acceptable noise level (ANL). Satisfaction ratings were conducted at 85 dBC using speech in quiet and in noise as well as music. Field-trial evaluations were obtained using the abbreviated profile of hearing aid benefit (APHAB). Satisfaction ratings were also conducted in the field at 85 dBC using speech and music. After the study, each participant indicated which trial period they preferred overall. Repeated measures analysis of variances were conducted to assess listener performance. Pairwise comparisons were then completed for significant main effects.

Results:

In the laboratory, results did not reveal significant differences between EIDR conditions on any speech perception in noise test or any satisfaction rating measurement. In the field, results did not reveal significant differences between the EIDR conditions on the APHAB or on any of the satisfaction rating measurements. Nine participants (45%) preferred the EIDR condition. Fifteen participants (75%) indicated that speech clarity was the most important factor in determining the overall preference. Sixteen participants (80%) preferred the EIDR condition that resulted in the lower ANL.

Conclusions:

The use of EIDR in hearing aids within and outside the laboratory under realistic and repeatable test conditions did not positively or negatively impact performance or preference. Results disagreed with previous findings obtained in the laboratory that suggested EIDR improved performance; however, results agreed with previous findings obtained in the field. Future research may consider the effect of hearing aid experience, input level, and noise acceptance on potential benefit with EIDR.

This research was supported by a grant from Oticon.


Poster presentation at the 29th Annual American Academy of Audiology National Convention in Indianapolis, IN, 2017.


 
  • REFERENCES

  • American National Standards Institute (ANSI) 1999 Maximum Ambient Noise Levels for Audiometric Test Rooms (ANSI S3.1-1999). New York, NY: ANSI
  • Baekgaard L, Knudsen N, Arshad T, Andersen H. 2013; Designing hearing aid technology to support benefits in demanding situations, part 1. Hear Rev 20 (03) 42-59
  • Baekgaard L, Rose S, Andersen H. 2013; Designing hearing aid technology to support benefits in demanding situations, part 2. Hear Rev 20 (06) 30-33
  • Boike KT, Souza PE. 2000; Effect of compression ratio on speech recognition and speech-quality ratings with wide dynamic range compression amplification. J Speech Lang Hear Res 43: 456-468
  • Byrne D, Dillon H, Ching T, Katsch R, Keidser G. 2001; NAL-NL1 procedure for fitting nonlinear hearing aids: characteristics and comparisons with other procedures. J Am Acad Audiol 12 (01) 37-51
  • Chasin M. 2006; Can your hearing aid handle loud music? A quick test will tell you. Hear J 59 (12) 22-24
  • Chasin M. 2012; Music and hearing aids—an introduction. Trends Amplif 16 (03) 136-139
  • Cox R, Alexander G, Gilmore C. 1987; Development of the connected speech test (CST). Ear Hear 8: 119-126
  • Cox R, Alexander G, Gilmore C, Pusakulich K. 1988; Use of the connected speech test (CST) with hearing-impaired listeners. Ear Hear 9: 198-207
  • Cox RM, Alexander GC. 1995; The abbreviated profile of hearing aid benefit. Ear Hear 16: 176-186
  • Crain TR, Van Tasell DJ. 1994; Effect of peak clipping on speech recognition threshold. Ear Hear 15 (06) 443-453
  • Dawson P, Dillon H, Battaglia J. 1990; Output limiting compression for the severe-profoundly deaf. Austral J Audiol 13: 1-12
  • Freyaldenhoven MC, Nabelek AK, Burchfield SB, Thelin JW. 2005; Acceptable noise level as a measure of directional hearing aid benefit. J Am Acad Audiol 16 (04) 228-236
  • Gatehouse S, Noble W. 2004; The speech, spatial and qualities of hearing scale (SSQ). Int J Audiol 43 (02) 85-99
  • Hockley NS, Bahlmann F, Fulton B. 2012; Analog-to-digital conversion to accommodate the dynamics of live music in hearing instruments. Trends Amplif 16 (03) 146-158
  • Kirchberger M, Ross FA. 2016; Dynamic range across multiple genres and the perception of dynamic compression in hearing-impaired listeners. Trends Hear 20: 1-16
  • Kuk F, Lau C, Korhonen P, Crose B. 2014; Evaluating hearing aid processing at high and very high input levels. Hear Rev 21 (03) 32-37
  • Nabelek AK, Freyaldenhoven MC, Tampas JW, Burchfield SB, Muenchen RA. 2006; Acceptable noise level as a predictor of hearing aid use. J Am Acad Audiol 17 (09) 635-649
  • Nabelek AK, Tampas JW, Burchfield SB. 2004; Comparison of speech perception in background noise with acceptance of background noise in aided and unaided conditions. J Speech Lang Hear Res 47: 1001-1011
  • Nilsson M, Soli S, Sullivan J. 1994; Development of the hearing in noise test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am 95: 1085-1099
  • Nunnally JC, Bernstein IH. 1994. Psychometric Theory. New York, NY: McGraw-Hill;
  • Oeding K, Valente M. 2015; The effect of a high upper input limiting level on word recognition in noise, sound quality preferences, and subjective ratings of real-world performance. J Am Acad Audiol 26 (06) 547-562
  • Plyler PN, Lang R, Monroe A, Gaudiano P. 2015; The effects of audio-visual stimulation on the acceptance of background noise in listeners with normal and impaired hearing. J Am Acad Audiol 26 (05) 451-460
  • Schmidt M. 2012; Musicians and hearing aid design—is your hearing instrument being overworked?. Trends Amplif 16 (03) 140-145
  • Stelmachowicz PG, Lewis DE, Hoover B, Keefe DH. 1999; Subjective effects of peak clipping and compression limiting in normal and hearing-impaired children and adults. J Acoust Soc Am 105 (01) 412-422
  • Studebaker GA. 1985; A “rationalized” arcsine transform. J Speech Hear Res 28: 455-462
  • Velleman PF, Wilkinson L. 1993; Nominal, ordinal, interval, and ratio typologies are misleading. Am Stat 47: 65-72
  • Venema TH. 2017. Compression for Clinicians: A Compass for Hearing Aid Fittings. San Diego, CA: Plural Publishing;