Tony Gunnell Starkey Laboratories Limited

Transcription

1 Tony Gunnell Starkey Laboratories Limited

2 Four million people who it is thought could benefit from a hearing aid Source: RNID

3 Possible Reasons Little or No perceived problem/ benefit with aid Fear of Change Poor expectation Professional Phobia Vanity Cost Lack of support Comfort Listening Wearing

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5 Listening?40% LD significant hearing loss Complicated by other sensory loss typically sight Difficulty testing = lower detection rate High incidence Anatomical difference Downs syndrome Excessive wax recurrent glue-ear - Early onset presbyacusis

6 Downs Syndrome Non DS - Intellectually impaired

7 Two main Hearing aids non surgical Air Conduction Bone Conduction

8 Air Conduction Comfort Accuracy of Audiogram Air Bone gap

9 AC/ BC Accuracy

10 Air Conduction Comfort Anatomical difference REM

11 REM

12 Air Conduction Comfort

13 Speech Mapping

14 Speech Mapping

15 Air Conduction Comfort Impression taking

16 Earmould size Wax Thickness Wax varies day to day SLA?

17 Negative Waxing Standard Modeling Comfort Fit Modeling

18 Negative Waxing Standard Modeling Comfort Fit Modeling

19 Air Conduction Comfort Anatomical Venting restriction

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21 Feedback Up to 25dB ASG open fit Self Learning

22 Custom hearing instruments Reduced Occlusion Proprietary CIC Open Vent Options BAV IROS OPEN (IO) VSN (I2)

23 Custom hearing instruments Custom Family Standard up to 115/45 Power up to 120/55 Extreme Power up to 123/60 Absolute Power up to 131/71

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27 Volume control

28 Unibody design Nanocoating with supercharged monomer particles 100% water resistant ADVANCED HYDRASHIELD TM

29 T 2 Remote Compatible with Starkey S Series devices Phone must emit DTMF (dual-tone multi-frequency) signal Ensure keypad tones are enabled Optimal level is +15 SNR Adjusts volume, memory, mute and un mute

30 T 2 Remote T 2 Remote Turns on in Sleep Mode Press ** to Wake device Provide Command Auto return to Sleep Mode 20 seconds of command absence

31 No Volume control Use T 2 Remote for volume increase and decrease (The device will need to have Reserve Gain programmed in, if it doesn t already)

32 Auditory Cognition Phone use in cars Noise distracting 15 minute recovery Noise + MSD + LD =?

33 Comfort Control Personalized SNR activation threshold S Series 11 Speech-in-Noise 0 = -5 db 1 = -2.5 db 2 = 0 db (default) 3 = = +5 db

34 Speech Noise COMFORT CONTROL * 70 S/N = 0 db GAIN ADAPTATION Noise Noise Default Settings 35

35 Speech Noise S/N = -5 db GAIN ADAPTATION Maximize speech 40 35

36 Speech Noise S/N = + 5 db GAIN ADAPTATION Maximize comfort 35

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38 Bone Conduction Comfort No Impression No Occlusion No Ear mould BAHA? Headband? Glasses?

39 The Reality

40 Fitting Range Limited due to vibration +10dB from BAHA fixed to mastoid Adequate for most conductive loss

41 Any Style? Most types of spectacles possible plastic spectacles only with metal core (min. 1mm Ø) no porous material like aluminium no rimless spectacles stable design (Spring loaded hinge may need locking)

42 la belle BC-systems customer s selection criteria on the leaflet

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44 la belle BC-systems spectacles condition/ flexibility clearly defined by Contact Pressure Device BC 250 adjusting screw stick bushing bushing end red ring foam buffer measuring unit

45 la belle BC-systems spectacles condition/ flexibility clearly defined by Contact Pressure Device BC Put the spectacles on the table with the arms facing downwards. 2. Open the spectacle arms. 3. Place the end of the contact pressure unit on the right spectacle arm so that now bushing end and arm rest parallel on top of each other. 4. Turn the adjusting screw inwards or outwards until the foam buffer of the adjusting screw lies on top of the left arm. Now foam buffer and arm rest parallel on top each other.

46 la belle BC-systems spectacles condition/ flexibility clearly defined by Contact Pressure Device BC Clamp the contact pressure device between the spectacle arms. 6. The pressing force of the spectacle arms should push the measuring unit in at least up to the red mark or deeper. 7. The spectacles are not suitable if the red mark is visible. The spectacles are suitable if the red mark is not visible.

47 la belle BC-systems temporary usage for testing/ Demonstrating Loosen the screw of the positioning aid if having broad spectacle arms. Tighten the screw if having narrow spectacle arms. Insert the module into the positioning aid as shown. Then turn the module downwards so that the bone conductor rests against the spectacle arm. Placing the bone conductor behind the ear.

48 The New Spectacle Click System Fitted as standard to all AC and BC monaural / binaural orders. Allows module to be fitted onto alternative sets of spectacles. Customers retain spectacles if module requires service/repair.

49 The Click!

50 Hard to position on Mastoid? bending the BC device for testing wrong right do not use hot air

51 la belle BC-systems

52 la belle BC-systems marking of la belle module Have the spectacles adjusted by an optician. Put on the glasses. Hold the module parallel to the ear. The metal chamber has to be positioned in front of the ear. Then mark the beginning of the chamber on the spectacle arm. If no module is available, mark the arm at the beginning of the ear. When ordering, please inform whether the marking was done, with or without module.

53 la belle BC-systems using as wireless CROS-system Benefits no cable only 1 device 1 battery low background noise no closed ears less interference-prone than FM-systems acceptance of own voice no operation (BAHA) no hearing aid appearance

54 la belle BC-systems using as wireless CROS-system deaf side BC-module sound-damping approx. 10 db

55 la belle BC-systems special CROS test set-up 1. Words without noise 2. Words with noise result: good Comprehension result: Poor Comprehension 3. ditto with additional BC-system result: good Comprehension Blah Blah Blah Hello noise 60 db words 65 db

56 la belle BC-systems customer s selection criteria (mechanical) bone conductor below Standard Version

57 la belle BC-systems customer s selection criteria (mechanical) bone conductor above Special Version e.g. for cholesteatoma operated patients

58 la belle BC-systems Power version special bone conductor device realised by sourced out microphone gain benefit approx. 10 db free of feedback

59 Plano Lens

60 la belle BC-systems BC headset Standard BC mounted on a special headset One ore two sides

61 Headband or elasticated hat

62 la belle BC-systems flexible small individual headband mounted inside

63 Air Conduction Spectacles Launched in 1989 Cosmetic solution Customers own spectacles RIC model Perfect for CROS/BICROS

64 AC Fitting Range

65 Open Fitting advantage Need for good Low Frequencies!

66 CROS/BICROS Cros mic positioned by either ; 1.Hinge (default) 2.Dummy housing 3.Dummy module

67 Features All fully digital 2 or 4 Channels 12 gain adjustment bands 1 4 programs Feedback cancellation system Compression Directional microphone technology Battery type 312 User friendly programming software

68 CROS BiCROS

69 What would help you? Please contact me if any questions: Tony Gunnell Technical training Associate

70 References Relationships between hearing and auditory cognition in Down s syndrome youth - Michael M Marcell Developing hearing screening, audiometric testing and achieving aural health for people who have a learning disability Ridgeway partnership (oxford learning disability NHS trust) Cognitive issues with hearing aids or why the brain matters B Edwards and E Hafter 2006 Invisible Hearing loss among obvious multiple Disabilities, part 2: The case of the missing hearing aids Vishakha W. Rawool, PhD Marke Trak surveys Sergei Kochkin A comparison of three hearing aid manufacturers recommended first fit to two generic prescriptive targets with the paediatric population Kristen Bretz