ASHA Provider Requirements. What s new

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1 ASHA Provider Requirements According to ASHA s new provider requirements, I would like to introduce myself. I am Michael Sharp, Au.D., Territory Account Manager and Educational Specialist with the Education and Training team for Signia, for which I receive a salary. We have no other relevant financial or non-financial relationships. This type of disclosure is currently required by ASHA from all their providers. The next course session will focus on primax fitting algorithms and products, which are Siemens trademarks, Sivantos is a Trademark Licensee of Siemens AG. Consequently, we will not discuss products from other manufacturers. What s new primax Cellion RICs primax Motion P BTEs minipocket New TV Transmitter Tinnitus updates in Connexx Eight 1

2 Our audiological philosophy Two main fitting goals But what about effort? SpeechMaster Conducts three main functions SpeechMaster Noise Reduction Directionality Amplification Signal type Direction Adaptive Loudness compression Effortless Hearing An independent clinical study in the US has shown that primax provided a significant improvement in ease of listening in demanding listening environments. A methodology using objective brain behavior measures with electroencephalographic data, showed a significant reduction in listening effort for mild to moderate hearing impaired subjects using primax hearing instruments, when applying advanced features SpeechMaster and EchoShield. SpeechMaster The core algorithm of primax More than a single feature or innovation, SpeechMaster is a conglomerate of algorithms which work in concert to achieve less listening effort SpeechMaster is able to analyze the acoustic environment more precisely than ever before This precision allows SpeechMaster to employ the first technology that isolates the target speaker from unwanted speech and noise in all situations SpeechMaster is the conductor of the Universal program within primax 2

3 Can new, advanced algorithms significantly reduce listening effort? Independent research laboratory at the University of Northern Colorado: Clinical Studies Show Advanced Hearing Aid Technology Reduces Listening Effort, April 2016 Hearing Review Goal: Evaluate the objective and subjective listening effort using two new, advanced algorithms, SpeechMaster & EchoShield SpeechMaster & EchoShield 12 subjects Experienced hearing aid wearers Bilaterally, symmetrical downward-sloping sensory/neural hearing losses Bilaterally fitted Signia Pure 7px RIC New objective measurement Listening effort Electroencephalography (EEG) records electrical activity of the brain Records trains of electrical events produced by the brain during an adaptive speech-in-noise test, similar to the HINT Measures listening effort in real-time while speech recognition tasks are being conducted with the features ON versus OFF 2 conditions tested for SpeechMaster Direction Off = TruEar On = Narrow Directionality Loudness SpeechMaster Off SpeechMaster On An independent clinical study in the US has shown that primax provided a significant improvement in ease of listening in demanding listening environments. A methodology using objective brain behavior measures with electroencephalographic data, showed a significant reduction in listening effort for mild to moderate hearing impaired subjects using primax hearing instruments, when applying advanced features SpeechMaster and EchoShield. New objective measurement Listening effort The EEG sample is extracted to precisely coincide with the given listening task For meaningful interpretation of the EEG activity, mathematical calculations of phase vector are conducted (the Rayleigh Test) An independent clinical study in the US has shown that primax provided a significant improvement in ease of listening in demanding listening environments. A methodology using objective brain behavior measures with electroencephalographic data, showed a significant reduction in listening effort for mild to moderate hearing impaired subjects using primax hearing instruments, when applying advanced features SpeechMaster and EchoShield. 3

4 Combined with subjective measurement Listening effort An independent clinical study in the US has shown that primax provided a significant improvement in ease of listening in demanding listening environments. A methodology using objective brain behavior measures with electroencephalographic data, showed a significant reduction in listening effort for mild to moderate hearing impaired subjects using primax hearing instruments, when applying advanced features SpeechMaster and EchoShield. Clinical results New features significantly reduce listening effort Objective results Mean Objective Listening Effort Subjective results Effortless hearing to improve benefit & satisfaction An independent clinical study in the US has shown that primax provided a significant improvement in ease of listening in demanding listening environments. A methodology using objective brain behavior measures with electroencephalographic data, showed a significant reduction in listening effort for mild to moderate hearing impaired subjects using primax hearing instruments, when applying advanced features SpeechMaster and EchoShield. Clinical results New features significantly reduce listening effort Objective results Mean Objective Listening Effort Subjective results Effortless hearing to improve benefit & satisfaction An independent clinical study in the US has shown that primax provided a significant improvement in ease of listening in demanding listening environments. A methodology using objective brain behavior measures with electroencephalographic data, showed a significant reduction in listening effort for mild to moderate hearing impaired subjects using primax hearing instruments, when applying advanced features SpeechMaster and EchoShield. 4

5 Building on our audiological philosophy Natural & feedback free sound quality Audibility better hearing than normal - clinically proven Effortless listening - clinically proven SpeechMaster Noise reduction, directionality, amplification Frequency Compression primax fit 12 khz extended bandwidth Dual-Mic Feedback Cancellation Sound Smoothing ewindscreen binaural 48 channel noise reduction Binaural OneMic directionality Narrow Directionality Spatial SpeechFocus 48 channel adaptive directionality Soft level directivity Directional speech enhancement e2e wireless 3.0 Virtual 8 microphone network transmission of audio signals Virtual 4 microphone network transmission of audio signals transmission of data (e.g. volume, programs) transmission of data (e.g. volume, programs) 5

6 max max Directionality Narrow directionality Standard Directionality Narrow Directionality Binaural OneMic directionality Natural Directionality (pinna) Enhanced Natural Directionality Spatial SpeechFocus Directional speech enhancement Noise reduction ewindscreen binaural SoundSmoothing left right microphone Replacement of poor signals receiver Speech & noise management Directional speech enhancement Precise noise reduction of specific noise source frequency without affecting adjacent frequencies Improves listening comfort and reduces listener fatigue Amplification primax fit feedback cancellation calc. feedback path 2 feedback path Phase cancellation Adaptive Parallel processing Acoustic fingerprint Frequency shift Continuous CGE bandwidth extension Frequency compression Amplification up to12 khz More brilliant and natural sound quality 6

7 Additional beneficial features EchoShield HD Music primax fit 12 khz extended bandwidth Dual-Mic Feedback Cancellation Sound Smoothing ewindscreen binaural 48 channel noise reduction Connexx Eight TouchControl App 2.1 Auto 6 Environment Classifier Automatic Accilimatization Intelligent learning Tinnitus Static + Ocean Waves TwinPhone CROS / BiCROS Frequency Compression Binaural OneMic directionality Narrow Directionality Spatial SpeechFocus 48 channel adaptive directionality Soft level directivity Directional speech enhancement Automatic environmental classifier Sound equalizer Automatically and accurately detects up to 6 different acoustic environments Ensures comfort with less need for manual programs Gain offsets for further personalization Quiet Speech in Quiet Speech in Noise Noise Car Music Varallyay, G., Pape, S., & Meyers, C. (2015, June). Automatic steering: the director of the binax soundtrack. AudiologyOnline, Article Retrieved from New features EchoShield HD Music primax fit 12 khz extended bandwidth Dual-Mic Feedback Cancellation Sound Smoothing ewindscreen binaural 48 channel noise reduction Notch Therapy Connexx Eight 8.2 TouchControl App 2.1 Auto 6 Environment Classifier Automatic Accilimatization Intelligent learning TwinPhone CROS / BiCROS Frequency Compression Binaural OneMic directionality Narrow Directionality Spatial SpeechFocus 48 channel adaptive directionality Soft level directivity Directional speech enhancement 7

8 TwinPhone TwinPhone TwinPhone is the perfect solution for people who primarily hand-hold phones ~60% of mobile phone users hand-hold even if hands-free is available* TwinPhone works with acoustic input and together with Autophone TwinPhone is automatically activated, in right or left HI, when a magnetic signal is detected It is automatically disengaged when the phone is removed from ear *US Department of Transportation NHTSA, The impact of hand-held and hands-free cell phone use on driving performance and safety-critical event risk. April 2013 Single-sided deafness CROS BiCROS Normal hearing Unaidable Hearing loss Unaidable CROS Pure Benefits Directionality focused to the front and skewed towards the unaidable side, which maintains the CROS benefit in noisy situations Natural sound quality with a low noise floor which is conducive to listening comfort and acceptance Energy efficient audio transmission with e2e 3.0 primax 312 battery = 130 hours / 8 days Competitor 312 battery = 72 hours / 4.5 days 8

9 CROS and BiCROS clinical studies CROS Study BiCROS Study Target speech originated from poorer side; speech-shaped noise on the better side SNR 50 improvement of 1-2 db with Signia CROS Target speech originated from poorer side; multi-talker babble on the better side (SNR +5 db) Speech recognition improved to above 90% with BiCROS CROS Pure Pure primax Motion primax CROS Pure Transmitter Compatible with any wireless primax instrument Cellion primax Motion P primax Insio primax EchoShield Feature of the Reverberant Room program Designed to reduce the negative effects of reverberation Clinical proof of reduced listening effort 9

10 HD music Live Musician Recorded No DNR Directionality Extended input range No DNR TruEar Extended input range No DNR TruEar More linear Tinnitus update Signia GmbH 2016/RESTRICTED USE Signia GmbH is a trademark licensee of Siemens AG Tinnitus update We support your clinical choices with multiple ways to treat tinnitus! Traditional static signals to help facilitate habituation White noise High Tone noise Pink noise Brownian noise Speech noise Customized noise shaping for partial masking or complete masking Modulated Ocean Waves to help promote relaxation Boulder Beach Sandy Beach Rocky Beach Pebble Beach NEW! Notch Therapy for patients with tonal tinnitus 10

11 Tinnitus Notch Therapy Patented and clinically proven Candidates for Notch Therapy Tonal Tinnitus- pure-tone, whistling, ringing or humming sound Any type and degree of hearing loss Tinnitus pitch assessment via Connexx 8.2 Easy step-by-step process No additional tools required Current view of tinnitus In Post-synaptic neural activity an excitatory and inhibitory imbalance due to damaged inner hair cells leads to: Neural hyperactivity (increased spontaneous activity) Reduction in the inhibitory capacity of neurons that are deprived of input Inhibitory Excitatory This leads to increased neural synchronicity which can be perceived as Tonal Tinnitus Notch Therapy How does it work? A filtered notch (0.5 octave), centered at the pitch of the tinnitus, is provided through the hearing aids. By notching the amplification we attack tinnitus on two fronts: 1) Enhancing the auditory environment to compensate for the hearing loss 2) Suppressing the tinnitus associated neural hyperactivity by stimulating lateral inhibition The brain is trained to provide more inhibition to the area of the notched amplification. The result is a decrease in the perception of tinnitus loudness. 11

12 Performance level differentiation (new features) SpeechMaster 7px 5px 3px EchoShield HD music TwinPhone* CROS / BiCROS Notch Therapy ewindscreen binaural manual *TwinPhone not available for Insio primax CIC or IIC Product portfolio: 7px, 5px, 3px Ace Pure Cellion Motion SA & SX Motion P Insio 7px and 5px only All products remote control compatible via touchcontrol App CROS Pure The energy efficient wireless transmitter for CROS & BiCROS fittings. Compatible with any wireless primax instrument including Pure, Motion & Insio. Product portfolio: 7px, 5px, 3px Ace primax minireceiver (S/M/P/HP) Size 10A battery No e2e wireless 3.0 IP 67 Pure primax minireceiver 2.0 (S/M/P/HP) Size 312 battery Rechargeable Wireless connectivity Telecoil DAI compatibility via easytek Compatible with CROS Pure IP 67. Cellion primax (7px, 5px) minireceiver 2.0 (S/M/P/HP) Lithium ion Power Cell Inductive charging e2e wireless 3.0 Telecoil Newly designed push button Auto On/Off Compatible with CROS Pure IP68. Motion primax Connexx ThinTube (125/53 db) Earhook (130/60 db) Size 13 battery Rechargeable (SX) Telecoil DAI via integrated audio shoebattery door (SA) Compatible with CROS Pure IP67 Motion P primax Earhook (135 / 77 db) Connexx ThinTube (129 / 65 db) Size 13 battery Wireless Telecoil DAI battery door (optional) Compatible with CROS Pure IP67 Insio primax Telecoil option (ITE, HS, ITC) e2e wireless option (incl. IIC & CIC) All compatible with touchcontrol App Matrix up to 124/65 db Compatible with CROS Pure 12

13 Cellion Revolutionary battery-free hearing Signia GmbH 2016/RESTRICTED USE Signia GmbH is a trademark licensee of Siemens AG Cellion primax Inductive charging The simplest hearing aid to manage No charging contacts No battery door No contacts The highest capacity power cell 48mAh capacity 24 hours continuous use with unlimited streaming (even with HP receiver!) Up to 3 years power cell lifetime No battery door Cellion primax Push Button Push button and programming port Lift button for programming CS44 CS44 Push button options: Program change Volume (binaural) Tinnitus therapy volume (binaural) On/Off function (optional) 13

14 Cellion Charger Feature summary Smart design for easy handling Status LEDs Fast charging Dehumidifier Power packs Cellion charger Charger Smart design for easy handling Simply lay in position Side independent charging Auto On/Off Cellion Charger Simple to understand LEDs 1 orange = 33% 2 orange = 66% 3 orange = 99% 3 green = Full charge 14

15 Cellion Charger Fast charging 4 hours for a full charge (up to 24 hours of continuous use) 30 minute charge gives 7 hours use Most users only need 2 hour charge for one day of normal use (up to 16 hours) Cellion Charger Dehumidifier function* Offers 90 minutes of gentle drying for Cellion hearing instruments Promotes lifetime of Cellion hearing instruments *Alternative drying options recommended for excessive moisture Cellion Charger Power pack tips Cellion needs ~500mAh per charge A 2000mAh pack provides 4 charges Flexible and inexpensive option A recommended list will be provided 15

16 Cellion Summary Revolutionary battery-free hearing The world s first inductive charging hearing aid with lithium-ion 2.0 charging technology Lithium ion Closed-shell design primax Accessories minipocket Small & easy-to-use remote control Same acoustic transmission signal as touchcontrol App Simple pairing process Readily available CR2450 battery Battery lasts ~ 1 year 16

17 minipocket Features LED Speaker Volume buttons Key lock switch Program button ( ) Key ring minipocket Key functions minipocket Pairing procedure 1. Move Key Lock switch to Lock position 2. Turn on hearing aids and place in ears 3. Hold down the button on the remote control while switching the key lock to the unlock position 4. Release button (LED on ) 5. Press & hold button until the pairing confirmation tone is heard 6. Move Key Lock switch to Lock position to exit pairing mode 17

18 minipocket Broadcast level (defaults to strongest signal) 1. Move Key Lock switch to Lock position 2. Hold down the button on the remote control while switching the key lock to the unlock position 3. Release button (LED on ) 4. To switch to the lowest broadcast level, press until the LED flashes slowly 5. To switch to the strongest broadcast level, press until the LED flashes quickly 6. Move Key Lock switch to Lock position to exit this mode easypocket Remote control for wearers who do not own a Smartphone Visual display Programmable features with Connexx What s new for easytek? easytek Sleeve New VoiceLink 18

19 New TV Transmitter Replaces existing transmitter used for streaming audio to the hearing instruments via easytek / minitek Designed specifically for TV usage - other audio sources possible Intuitive interface for digital optical outputs Compatible with 3.5mm and RCA outputs echarger Convenient solution for ALL wearers! Change batteries once a year Smart status indicators Includes an electronic drying feature Rechargeable Products Pure primax Carat binax Motion SX primax Motion PX binax S Receiver M & P Receivers hours / day hours / day touchcontrol App v2.1 Discreet & easy adjustments Change programs Adjust volume Mute hearing-instrument mics Adjust SoundBalance control Adjust Tinnitus Therapy Signal Adjust Spatial Configurator primax only features: QR Code setup Battery status 19

20 easytek App Universal Spatial Configurator Discreet & easy adjustments Change programs Adjust volume Mute hearing-instrument mics Adjust SoundBalance control Adjust Tinnitus Therapy Signal Adjust Spatial Configurator Select external sources View battery life of instruments / easytek Clinically proven better than normal hearing with less listening effort An independent clinical study in the US has shown that primax provided a significant improvement in ease of listening in demanding listening environments. A methodology using objective brain behavior measures with electroencephalographic data, showed a significant reduction in listening effort for mild to moderate hearing impaired subjects using primax hearing instruments, when applying advanced features SpeechMaster and EchoShield. *Two clinical studies have shown that binax provides better than normal hearing in certain demanding environments Signia GmbH (University 2016/RESTRICTED of Northern Colorado, USE 2014; Oldenburg Horzentrum, 2013). Speech Reception Thresholds (SRT) in cocktail-party situations improved up to 2.9 db for wearers with Signia mild to GmbH moderate is a trademark hearing loss licensee using Carat of Siemens binax or AGPure binax hearing aids with narrow directionality, compared to people with normal hearing. 20