Benefits of Advanced Hearing Aid Technologies to Children (and Adults) with Hearing Loss
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1 Benefits of Advanced Hearing Aid Technologies to Children (and Adults) with Hearing Loss CAA 2012 Andrea Pittman Arizona State University
2 Children with Hearing Loss 1 million 30 million Adults Children
3 Characteristic Kids Age Hearing Loss Significant Impact?
4 Age
5 Characteristic Kids Age Hearing Loss Significant Impact? Yes
6 Hearing Level (Pittman & Stelmachowicz, 2002) Adults (n=248) Children (n=227) Frequency (Hz) Frequency (Hz) Hearing Level (db HL)
7 Hearing Level (Pittman & Stelmachowicz, 2002) 21% Severe 10% Profound 30% Moderate 39% Mild Mild (15 40 db HL) Moderate (41 60 db HL) Severe (61 80 db HL) Profound (>80 db HL) Hearing Level (db) Frequency (khz)
8 Characteristic Kids Age Hearing Loss Significant Impact? Yes Yes
9 Age & Hearing Loss Profound HEARING LOSS (degree) Mild AGE (years)
10 Characteristic Kid Age Hearing Loss Listening Environment Level Noise Reverberation Significant Impact? Yes Yes Yes Yes Yes
11 Characteristic Kid Age Hearing Loss Listening Environment Level Noise Reverberation Hearing Aid Amplification Amplitude Compression Directional Microphones Digital Noise Reduction Frequency Lowering Significant Impact? Yes Yes Yes Yes Yes Hearing Aid Bandwidth
12 Amplitude Compression (Jenstad et al, 1999) Children 12 HI Children (& adults) NONSENSE WORDS SENTENCES 120 HEARING LOSS (degree) PERFORMANCE (Rau) AGE (years) 0 UNAIDED LINEAR WDRC HEARING AID CONDITION
13 Directional Microphones (Ricketts, Galster & Tharpe, 2007) Children 26 HI Children HEARING LOSS (degree) AGE (years)
14 Digital Noise Reduction (Stelmachowicz et al, 2011) Children 16 HI Children HEARING LOSS (degree) AGE (years)
15 Digital Noise Reduction (Stelmachowicz et al, 2010) Children 16 HI Children 5 7 YR OLD 8 10 YR OLD HEARING LOSS (degree) AGE (years) 0 db 5 db 10 db 0 db 5 db 10 db SIGNAL TO NOISE RATIO
16 Frequency Lowering (Glista et al, 2009) Children 11 HI Children HEARING LOSS (degree) AGE (years)
17 Hearing Aid Bandwidth (Stelmachowicz et al, 2007) Children 24 HI Children 32 NH Children HEARING LOSS (degree) AGE (years)
18 Characteristic Kid Age Hearing Loss Listening Environment Level Noise Reverberation Hearing Aid Amplification Amplitude Compression Directional Microphones Digital Noise Reduction Frequency Lowering Hearing Aid Bandwidth Significant Impact? Yes Yes Yes Yes Yes Yes Not really Yes No Sometimes Maybe
19 Receptive Vocabulary (Pittman, ) Children 76 HI Children 137 NH Children Delayed lexical development as a function of age HEARING LOSS (degree) AGE (years)
20 Receptive Vocabulary (Blamey et al., 2001) Children 40 HA Children 47 CI Children Impaired lexical development as a function of age HEARING LOSS (degree) AGE (years)
21 What do children do all day? 1. Manage complex environments 2. Learn new words
22 Listening Effort and Fatigue (Hicks & Tharpe, 2002) Children 14 HI Children 14 NH Children HEARING LOSS (degree) AGE (years)
23 Listening Effort and Fatigue (Hicks & Tharpe, 2002) Auditory Word repetition Percent words correct Varied signal to noise Visual Button pushing Reaction time
24 Listening Effort and Fatigue (Hicks & Tharpe, 2002) Auditory Word repetition Percent words correct Varied signal to noise Visual Button pushing Reaction time Word Repetition Signal to Noise Ratio Reaction Time Signal to Noise Ratio
25 Listening Effort and Fatigue (Hicks & Tharpe, 2002) Auditory Word repetition Percent words correct Visual Button pushing Reaction time
26 Managing Complex Tasks (Pittman, 2011) Children 30 HI Children 50 NH Children HEARING LOSS (degree) AGE (years)
27 Managing Complex Tasks (Pittman, 2011) Auditory Word categorization Percent words correct O db SNR Visual Dot to dot games Dots/minute Person Food Animal
28 Managing Complex Tasks (Pittman, 2011) Auditory Word categorization Percent words correct O db SNR Noise Reduction Off Person Noise Reduction On Food Animal
29 Managing Complex Tasks (Pittman, 2011)
30 Auditory/Visual Task Preference (Pittman et al, fresh from the booth) Children 23 HI Children 32 NH Children HEARING LOSS (degree) Person Food Animal AGE (years)
31 Auditory/Visual Task Preference (Pittman et al, fresh from the booth) CHILDREN WITH NORMAL HEARING CHILDREN WITH HEARING LOSS # COMPLETED CORRECTLY AUDITORY VISUAL 0 Alone w/ Competitors 0 Alone w/ Competitors
32 Conclusions Children with hearing loss excel at visual tasks. In children with hearing loss, visual competitors detract from auditory task performance. Complex environments appear to be most detrimental to a child s weakest modality.
33 LEARNING NEW WORDS
34 The Word Learning Process Word Learning Model (Storkel & Lee 2011) Triggering Detection of a new word Configuration Form a stable acoustic representation Form a semantic representation Engagement Using the new word with other words
35 Non word Detection (Pittman & Schuett, in press) Children 19 HI Children 29 NH Children HEARING LOSS (degree) AGE (years)
36 Non word Detection (Pittman & Schuett, in press) Close all three doors. Cooks make hot foom. They want pum gorn.
37 Non word Detection (Pittman & Schuett, in press) Overall performance (percent correct) Error analyses Under triggering Over triggering PERCETNT OF TOTAL OVER UNDER CORRECT
38 Non word Detection (Pittman & Schuett, in press) 100% PERCENT OF TOTAL 80% 60% 40% 20% OVER UNDER CORRECT 0% NH HL NH HL QUIET STEADY STATE NOISE
39 Non Word Detection and Bandwidth (Pittman et al, in process) Children 19 HI Children 33 NH Children 31 HI Adults 18 NH Adults HEARING LOSS (degree) LEVEL (db SPL) NB WB 9 khz 4 khz FREQUENCY (Hz) AGE (years)
40 Non Word Detection and Bandwidth (Pittman et al, in process) 4 khz 9 khz Close all three doors. Cooks make hot foom. They want pum gorn.
41 Non Word Detection and Bandwidth (Pittman et al, in process) 100% PECENT OF TOTAL 80% 60% 40% 20% OVER UNDER CORRECT 0% NHA NHC HIA HIC GROUP
42 Non Word Detection and Bandwidth (Pittman et al, in process) 100% PECENT OF TOTAL 80% 60% 40% 20% OVER UNDER CORRECT 0% NHA NHC HIA HIC GROUP
43 Conclusions Hearing loss disrupts the detection of new words and may prolong the word learning process. A subtle hearing aid feature, like extended bandwidth, may significantly improve the detection of new words.
44 Word Learning and Bandwidth (Pittman, 2008) Children 26 HI Children 41 NH Children HEARING LOSS (degree) AGE (years)
45 Word Learning and Bandwidth (Pittman, 2008) PERFORMANCE (%) TRIALS /
46 Word Learning and Bandwidth (Pittman, 2008) PERFORMANCE (%) Averaged Data Arithmetic Averaged Fits Mean TRIALS
47 Word Learning and Bandwidth (Pittman, 2008) PERFORMANCE (%) NHC (9k Hz) HIC (9k Hz) HIC (4k Hz) TRIALS
48 Word Learning and Noise Reduction (Pittman, 2011) Children 26 HI Children 40 NH Children Noise Reduction Off HEARING LOSS (degree) Noise Reduction On AGE (years)
49 Word Learning and Noise Reduction (Pittman, 2011) Normal Hearing PERFORMANCE (%) YEAR OLDS TRIAL YEAR OLDS QUIET NOISE TRIAL
50 Word Learning and Noise Reduction (Pittman, 2011) Hearing Loss PERFORMANCE (%) YEAR OLDS YEAR OLDS TRIAL QUIET NOISE NOISE REDUCTION TRIAL
51 SO WHAT CAN WE CONCLUDE?
52 Conclusions Speech perception tests are sensitive to the overall effects of amplification. Cognitively demanding tasks are sensitive to the subtle effects of advanced hearing aid features.
53 Advanced Hearing Aid Features Digital noise reduction 1. Maintains auditory task performance in a complex environment 2. Promotes word learning in older grade school children with hearing loss Extended high frequency bandwidth 1. Aides in the detection of new words 2. Promotes word learning in younger and older grade school children.
54 Acknowledgements Funding ASHA Foundation Phonak AG Professional Assistance Oticon Phonak Resound Siemens Sonic Starkey Widex Research Assistants Rachel Henrickson Nicole Corbin Mollie Hiipakka Madalyn Rash Ashley Pederson Amanda Willman Allison Latto Brittany Schuett Devin Anderson Samantha Gustafson
55 Acknowledgements Funding ASHA Foundation Phonak AG Professional Assistance Oticon Phonak Resound Siemens Sonic Starkey Widex Research Assistants Rachel Henrickson Nicole Corbin Mollie Hiipakka Thanks! Madalyn Rash Ashley Pederson Amanda Willman Allison Latto Brittany Schuett Devin Anderson Samantha Gustafson
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