A Different Approach to the Noise Problem of the Hearing Impaired

Villchur, Edgar

doi:10.1044/1059-0889.0202.47

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…In the old days, hearing aids often distorted and restricted the available information so badly that they made things worse. What Villchur (1993) argued and demonstrated was that clarifying the speech was the first order of business, asking rhetorically, 'Would you prefer clear speech in clear noise or muffled speech in muffled noise? '…”

Section: More On Noisementioning

confidence: 99%

Hearing Aids: Past, Present, Future: Moving Toward Normal Conversations in Noise

1997

British Journal of Audiology

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We have heard puzzling things lately regarding hearing aids. One rumour suggests that a new type of signal processing will improve the recognition of speech in noise, even though research has failed to demonstrate a significant improvement for any new type of signal processingcompression, digital signal processing, or other over clean linear amplification whose frequency response and gain have been properly adjusted for the test conditions (provided the test conditions are constrained to constant presentation levels and the subjects are not profoundly hearing impaired). Those same research results are sometimes interpreted as an argument for linear amplification by those who forget that in the real world individuals rarely have the controls necessary to provide the treble boost for low-level sounds required for best intelligibility, or a research audiologist ready at hand to set those controIs.2 In the USA, we have official government pronouncements from the FDA (Food and Drug Administration) that all hearing aids use basically the same type of circuits and that hearing aids cannot help in noise (Kessler, 1993).The interesting common element in these comments is that they are all directed at the principal remaining unsolved problem reported by hearing aid wearers: that of hearing in noise. In this editorial, I argue the following points.First, it is true that a properly adjusted linear hearing aid might provide roughly as good intel-'This editorial presents the personal opinion of the author and does not necessarily reflect the views of the Editor, or of the Editorial Board. 21n the real world, there is often a substantial practical advantage to TILL (treble increases at low levels) processing over the old-fashioned only-one-frequency-responseyou're-stuck-with-it linear processing. ligibility in noise for most hearing aid wearers as sophisticated compression hearing aids. This is provided that the linear aid has the appropriate compromise frequency equalization, is regularly readjusted by its user each time the listening situation changes, and it has none of the traditional defects which reduce available speech information (narrow bandwidth, distortion, irregular frequency response, or frequency response inappropriate to the hearing loss).Second, it is true, in particular, that there is little laboratory evidence that improved speech intelligibility will result from a hearing aid automatically adjusting its gain and frequency response in order to restore normal loudness relationships, attempting to reject stationary noise, or any other signal processing yet tested. (In practice, however, this statement really applies to laboratory research in which, for example, one-third-octave-band equalization is used to provide the 'linear' equalization appropriate to each test presentation level. As the required equalization often depends dramatically on level, as shown by Skinner (1976), the results of many such experiments should perhaps not be labelled 'linear' but instead 'experimenter-controlled-TILL' processing.)Third,...

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Section: More On Noisementioning

confidence: 99%

Hearing Aids: Past, Present, Future: Moving Toward Normal Conversations in Noise

1997

British Journal of Audiology

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“…This Figure 2 Relationship between AI and percent correct for spondees or sentences, words in sentences, and isolated monosyllables. 18 article attempts to summarize what we can quantify about the problem and its origins.…”

Section: Audibility and Channel Capacitymentioning

confidence: 99%

“…Nonetheless, Figure 12 underscores the first order of business for hearing aid design and fitting: Increase audibility. As Villchur 18 stated, ". .…”

Section: Audibility Ai Vs Channel Capacitymentioning

confidence: 99%

“…33 Maximum intelligibility for most patients comes when everything-speech and noiseare made completely audible. 18 In many cases, this means increasing the amount of audible noise. In a situation where 50% of the speech cues are masked by noise, the person with nor- mal hearing will have no trouble understanding sentences.…”

Section: Applicationmentioning

confidence: 99%

“…If that person has a channel capacity of only 50%, then only 12.5% of the speech cues will reach their brain. As Villchur 18 illustrated, improved intelligibility in noise can result when all of the speech (and of the noise) is made audible, so that the full 50% of the speech cues left unmasked are audible. In this case the person with 50% channel capacity starts with twice as many audible cues, so that 25% of the speech cues reach the brain even after half are lost to diminished channel capacity.…”

Section: Applicationmentioning

confidence: 99%

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New Thinking on Hearing in Noise: A Generalized Articulation Index

Killion¹

2002

Semin Hear

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The articulation index (AI) theory serves to predict word recognition scores when the number of speech cues have been reduced by noise or lack of audibility. It fails to predict how poorly some subjects do in noise, even when all speech cues have been made audible with amplification. Such subjects require an unusually large signal-to-noise ratio (SNR) for a given performance level, and are said to have a large SNR loss. We have found that the AI can be generalized to predict word recognition scores in the case of missing (speech cue) dots. Some speech cues appear to be lost on the way to the brain even though they were audible. Corliss 1 suggested the term channel capacity to describe this phenomenon, and we adopt that term for our use. In this article, the substantial psychoacoustic and physiological evidence in favor of this generalized AI is described. Perhaps the strongest evidence is (1) the SNR loss of subjects is poorly predicted by the degree of their audiometric loss, and (2) their wideband word-recognition performance in noise can be predicted from their channel capacity inferred from filtered speech experiments.Learning Outcomes: Upon completion of this article, the reader will be able to define and discuss channel capacity, signal-to-noise ratio loss, the importance of audibility to speech understanding, and choices in sensory aids that impact audibility and SNR losses.audiogram method for estimating the Articulation Index (AI) shown in Figure 1. Any of the count-the-dots methods shown by Mueller and Killion, 2 Humes, 3 or Pavlovic, 4 will give similar results. In the Mueller and Killion method, each of the 100 dots represents 1% of The informal title of this article summarizes the essential argument: Inaudible dots and missing dots (dis)appear all the same to the brain.The "dots" refer to the graphical representation of speech cues in the Count-the-Dots

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The Desired Sensation Level Multistage Input/Output Algorithm

Scollie

Seewald

Cornelisse³

et al. 2005

Trends in Amplification

334

300

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The Desired Sensation Level (DSL) Method was revised to support hearing instrument fitting for infants, young children, and adults who use modern hearing instrument technologies, including multichannel compression, expansion, and multimemory capability. The aims of this revision are to maintain aspects of the previous versions of the DSL Method that have been supported by research, while extending the method to account for adult-child differences in preference and listening requirements. The goals of this version (5.0) include avoiding loudness discomfort, selecting a frequency response that meets audibility requirements, choosing compression characteristics that appropriately match technology to the user's needs, and accommodating the overall prescription to meet individual needs for use in various listening environments. This review summarizes the status of research on the use of the DSL Method with pediatric and adult populations and presents a series of revisions that have been made during the generation of DSL v5.0. This article concludes with case examples that illustrate key differences between the DSL v4.1 and DSL v5.0 prescriptions. et al., 1995).Since that revision, DSL[i/o] has been evaluated in both adult and pediatric populations in a number of studies. In this chapter, we will summarize the current status of DSL evaluation work in children and adults and argue the need for different prescriptive targets for adults and children. We will also present research describing electroacoustic and signal processing issues that have motivated us to make modifications to the input/output structure of the DSL target functions. These modifications will be described, and several case studies will illustrate the magnitude and type of changes to prescriptive targets in DSL v5.0. Outcomes for ChildrenStudies using the DSL Method with the pediatric population have been done with various aims and purposes. Some studies have sought to determine whether DSL-related outcomes differ from those of alternative fittings (Snik and Stollman, 1995;Ching et al., 1997;Scollie et al. 2000) or to compare subversions of DSL such as linear vs nonlinear (Jenstad et al., 1999;Jenstad et al., 2000). Other studies have used DSL as the fitting method within general pediatric hearing and amplification research, such as when evaluating signal processing options or audibility effects in children with hearing loss (Moeller et al., 1996;Bamford et al., 1999;Christensen, 1999;Gravel et al., 1999;Hanin, 1999;Lear et al., 1999;Pittman and Stelmachowicz, 2000;Stelmachowicz et al., 2000;Stelmachowicz et al., 2001;Condie et al., 2002;Stelmachowicz et al., 2002). Other authors incorporate the DSL Method, including the associated clinical procedures described by Bagatto et al., 2005, within recommended clinical guidelines for pediatric amplification (e.g., The Pediatric Working Group 1996; American Academy of Audiology, 2004). Ongoing research will, therefore, likely always strive to determine the best methods for prescribing the signal processing ch...

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A Different Approach to the Noise Problem of the Hearing Impaired

Cited by 4 publications

References 10 publications

Hearing Aids: Past, Present, Future: Moving Toward Normal Conversations in Noise

Hearing Aids: Past, Present, Future: Moving Toward Normal Conversations in Noise

New Thinking on Hearing in Noise: A Generalized Articulation Index

The Desired Sensation Level Multistage Input/Output Algorithm

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