Comparing NAL-NL1 and DSL v5 in Hearing Aids Fit to Children with Severe or Profound Hearing Loss: Goodness of Fit-to-Targets, Impacts on Predicted Loudness and Speech Intelligibility

Ching, Teresa Y. C.; Quar, Tian Kar; Johnson, Earl E.; Newall, Philip; Sharma, Mridula

doi:10.3766/jaaa.26.3.6

Cited by 16 publications

(13 citation statements)

References 42 publications

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“…This was due to the limitations of the hearing aid itself (Ching et al, 2010;McCreery et al, 2013;Quar et al, 2013). After comparing the fit-to-targets achieved by a commercial hearing aid among children with moderately severe to profound hearing losses, Ching et al (2015) reported that although targets between 250 and 2000 Hz were well matched for both NAL-NL1 and DSL v5 prescriptions, gain at 4000 Hz were matched for NAL-NL1 only. This is because the DSL v5 Child procedure normally prescribes higher overall gain, especially for high-frequency region (Ching et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…The HLD refers to the decreased ability of the damaged cochlea to extract information even when it is audible (Ching et al, 1998;. Ching et al (2015) reported that on average, the SII was lower for NAL-NL1 than for DSL v5 prescription at low input level. Lower SII and possible better fit-to-targets achieved by NAL-NL1 procedure may affect the conclusions made in this study.…”

Section: Discussionmentioning

confidence: 99%

“…The root-mean-square (RMS) was calculated and observed at four frequencies (500, 1000, 2000, and 4000 Hz) to assess if the manufacturer's prefit output deviated from the DSL v5 Child targets. RMS ,5 dB was considered to be an optimal fit-to-target that was achieved by the prefit procedure (McCreery et al, 2013;Ching et al, 2015). With regard to these criteria, 73% of the ears that were fitted with the prefit procedure deviated from the DSL v5 targets by more than 5 dB RMS.…”

Section: Fit-to-targets Achieved By Prefit Proceduresmentioning

confidence: 99%

“…The NAL procedure has a different fundamental in rationale from the DSL procedure which results in some differences in prescribed gains between the two procedures. The gain differences are the greatest when the hearing loss is severe to profound (Ching et al, 2015). Therefore, findings from previous studies that used the NAL-NL1 procedure could not be directly applied to fittings based on DSL v5 Child procedure.…”

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confidence: 98%

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The Effects of Manufacturer’s Prefit and Real-Ear Fitting on the Predicted Speech Perception of Children with Severe to Profound Hearing Loss

2019

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The use of probe microphone measures in hearing aid verification is often neglected or not fully used by practitioners. Some practitioners rely on simulated gain and output provided by manufacturer's fitting software to verify hearing aids.This study aims to evaluate the effectiveness of manufacturer’s prefit procedure in matching the prescribed real-ear targets. It also aims to study its correlated impact on the predicted speech perception in children with severe and profound hearing loss.This cross-sectional experiment was carried out by measuring the output of hearing aids based on prefit versus real-ear at low-, moderate-, and high-input levels. The predicted speech perception for different hearing aid fittings was determined based on the Speech Intelligibility Index (SII).Sixteen children (28 ears) aged between 4 and 7 yr, with severe to profound sensorineural hearing loss took part in the study.Two different types of hearing aids (Phonak and Unitron) were programmed based on their respective manufacturers’ Desired Sensation Levels (DSL) v5 Child procedure. The hearing aids were then verified using coupler-based measurements and individual real-ear-to-coupler differences. The prefit outputs were compared with the DSL v5 Child–prescribed outputs at low-, moderate-, and high-input levels. The hearing aids were then adjusted to closely match the prescribed output. The SIIs were calculated for the fittings before and after adjustment.Sixty four percent of fittings that were based on the prefit procedure achieved the optimal fit-to-targets, with less than 5-dB RMS deviations from the DSL v5 Child targets. After adjusting the hearing aids to attempt to meet the DSL v5 Child targets, 75% of the ears tested achieved the optimal fit-to-targets. On average, hearing aid outputs generated by the manufacturer’s prefit procedure had good and reasonable agreement with the DSL v5 Child–prescribed outputs at low- and mid-frequencies. Nonetheless, at 4000 Hz, the hearing aid output mostly fell below the DSL v5 Child–prescribed outputs. This was still the case even after the hearing aid was adjusted to attempt to match with the targets. At low input level, some prefit outputs were found to be higher than the prescribed outputs. The deviations of prefit outputs from the prescribed outputs were dependent on the type of hearing aid and input levels. There was no significant difference between the SII calculated for fittings based on the prefit and adjusted fit.Prefit procedure tends to produce outputs that were below the DSL v5 Child–prescribed outputs, with the largest mean difference at 4000 Hz. Even though the hearing aid gains were adjusted to attempt to match with the targets, the outputs were still below the targets. The limitations of hearing aids to match the DSL v5 Child targets at high-frequency region have resulted in no improvement in the children’s predicted speech perception.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Fit-to-targets Achieved By Prefit Proceduresmentioning

confidence: 99%

mentioning

confidence: 98%

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The Effects of Manufacturer’s Prefit and Real-Ear Fitting on the Predicted Speech Perception of Children with Severe to Profound Hearing Loss

2019

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“…Thus, audiologists continue to fit HAs for this population. Advances in digital HA technology and use of evidence-based best practices for HA fitting now enable close approximations to prescription targets in cases of S/PHL (Keidser et al, 2008;Quar et al, 2013;Ching et al, 2015), although a given listener's preferences along with the severity of the hearing loss can increase the difficulty of the fit for these listeners (Keidser et al, 2007).…”

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Patterns of Aided Loudness Growth in Experienced Adult Listeners with Early-Onset Severe–Profound Hearing Loss

Gottermeier

Filippo

2018

J Am Acad Audiol

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The variety of aided loudness growth patterns identified reflects the diversity known to characterize individuals with early-onset S/PHL. Loudness rating at the validation stage of HA fit with these listeners is likely to reveal nonnormal loudness, signaling need for further HA adjustment. High satisfaction, however, despite nonnormal loudness growth, suggests that listeners with poor auditory speech recognition may benefit more from aided loudness that supports pattern perception (via the time-intensity waveform of speech), different from most current-day prescription fits.

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Binaural source separation using auditory attention for salient and non-salient sounds

Geravanchizadeh

Zakeri²

2022

Applied Acoustics

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Comparing NAL-NL1 and DSL v5 in Hearing Aids Fit to Children with Severe or Profound Hearing Loss: Goodness of Fit-to-Targets, Impacts on Predicted Loudness and Speech Intelligibility

Cited by 16 publications

References 42 publications

The Effects of Manufacturer’s Prefit and Real-Ear Fitting on the Predicted Speech Perception of Children with Severe to Profound Hearing Loss

The Effects of Manufacturer’s Prefit and Real-Ear Fitting on the Predicted Speech Perception of Children with Severe to Profound Hearing Loss

Patterns of Aided Loudness Growth in Experienced Adult Listeners with Early-Onset Severe–Profound Hearing Loss

Binaural source separation using auditory attention for salient and non-salient sounds

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