Objective: A positive relation between audibility and speech understanding has been established for cochlear implant (CI) recipients. Sound-field thresholds of 20 dB HL across the frequency range provide CI users the opportunity to understand soft and very soft speech. However, programming the sound processor to attain good audibility can be time consuming and difficult for some patients. To address these issues, Advanced Bionics (AB) developed the SoftVoice algorithm designed to remove system noise and thereby improve audibility of soft speech. The present studies aimed to evaluate the efficacy of SoftVoice in optimizing AB CI recipients' soft-speech perception. Design: Two studies were conducted. Study 1 had two phases, 1A and 1B. Sixteen adult, AB CI recipients participated in Study 1A. Acute testing was performed in the unilateral CI condition using a Harmony processor programmed with participants' everyday-use program (Everyday) and that same program but with SoftVoice implemented. Speech recognition measures were administered at several presentation levels in quiet (35-60 dB SPL) and in noise (60 dB SPL). In Study 1B, ten of the participants compared Everyday and SoftVoice at home to obtain feedback regarding use of SoftVoice in various environments. During Study 2, soft-speech perception was acutely measured with Everyday and SoftVoice for ten participants using the Naida CI Q70 processor. Results with the Harmony (Study 1A) and Naida processors were compared. Additionally, Study 2 evaluated programming options for setting electrode threshold levels (Tlevels or Ts) to improve the useablity of SoftVoice in daily life. Results: Study 1A showed significantly higher scores with SoftVoice than Everyday at soft presentation levels (35, 40, 45 and 50 dB SPL) and no significant differences between programs at a conversational level (60 dB SPL) in quiet or in noise. After take-home experience with SoftVoice and Everyday (Study 1B), five of ten participants reported preferring SoftVoice over Everyday; however, six reported bothersome environmental sound when listening with SoftVoice at home. Results of Study 2 indicated similar soft-speech perception between Harmony and Naida processors.
Objective For patients who have received cochlear implants (CIs), speech-perception testing requires specialized equipment. This limits locations where these services can be provided, which can introduce barriers for provision of care. Providing speech test stimuli directly to the CI via wireless digital audio streaming (DAS) or wired direct audio input (DAI) allows for testing without the need for a sound booth (SB). A few studies have investigated the use of DAI for testing speech perception in CIs, but none have evaluated DAS. The goal of this study was to compare speech perception testing in CI users via DAS versus a traditional SB to determine if differences exist between the two presentation modes. We also sought to determine whether pre-processing the DAS signal with room acoustics (reverberation and noise floor) to emulate the SB environment would affect performance differences between the SB and DAS. Design In Experiment 1, speech perception was measured for monosyllabic words in quiet and sentences in quiet and in noise. Scores were obtained in a SB and compared to those obtained via DAS with unprocessed speech (DAS-U) for 11 adult CI users (12 ears). In Experiment 2, speech perception was measured for sentences in noise, where both the speech and noise stimuli were pre-processed to emulate the SB environment. Scores were obtained for 11 adult CI users (12 ears) in the SB, via DAS-U, and via DAS with the processed speech (DAS-P). Results For Experiment 1, there was no significant difference between SB and DAS-U conditions for words or sentences in quiet. However, DAS-U scores were significantly better than SB scores for sentences in noise. For Experiment 2, there was no significant difference between the SB and DAS-P conditions. Similar to Experiment 1, DAS-U scores were significantly better than SB or DAS-P scores. Conclusions By pre-processing the test materials to emulate the noise and reverberation characteristics of a traditional SB, we can account for differences in speech-perception scores between those obtained via DAS and in a SB.
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