Future Trends in Hearing Aids

Current AND Future Trends AND Technology in Fitting Hearing Aids
KUNNAMPALLIL GEJO JOHN,BASLP,MASLP
Amplification can be prescribed using a formula that links the characteristic of a person to the target amplification characteristics. This contrasts with an evaluative approach in which the hearing aid characteristics selected are those that are empirically observed to best suit the person. Prescriptive formulas can be based on threshold, supra threshold loudness judgments and the situation in which the hearing aids are to be worn. Future research may focus on determining what the benefits of hearing aid fitting are and how will each benefit can be achieved.
Candidates for multi-memory hearing aids
Multi-memory hearing aids are not for everyone. Estimates of the proportion of patients who will choose to use different programs in different listening conditions vary from 0% to 81%. If a person wears hearing aids in only one situation (e.g. listening to television), it is most unlikely that a multi-memory hearing aid will be beneficial. If a person wears hearing aids in several situations, but the listening conditions are the same in all these situations, it is again unlikely that a multi-memory hearing aid will be beneficial.
Recommending a multi-memory hearing aid

Consider recommending a multi-memory hearing aid if all three of the following are true: The patient plans to wear the hearing aid in at least two situations where the listening conditions differ. The patient is willing to switch between programs in different environments, and has the physical and mental capability to do this. For most multi-memory hearing aids, this will necessitate the patient being willing to carry and use a remote control. The patient has a high frequency average loss of greater than 55 dB-HL, or, has a baseline insertion gain target at 500 Hz of greater than 0 dB (both of these requirements will be met for the strongest candidates).
Prescription issues: present and future
Which processing strategies work? The first prescription issue that needs to be addressed whether a particular type of amplification should ever be recommended. That is, does this type of amplification have advantage for anyone. Despite much research the knowledge is limited and the question has to be addressed again for each new type of processing that appears.
The second problem is the choice to adequate evaluation measures. The traditional speech recognition tests are insensitive for hearing aid evaluation and may be incapable of demonstrating some of the advantages to be derived from new types of hearing aids. The future progress will require improved evaluation measures so that the answer to the question can be given, whether some type of processing have any advantage.
Who can benefit from a particular type of processing? Any processing will have disadvantages as well as advantages. Therefore a prescription issues how to choose the best types or processing for each individual. If multiple memories are used, the choose may be complicated because it may be desirable to use very different types of processing rather than the variations of frequency response, in two or more memories.
A future need is for more research company different types of processing with a view to determining how to choose the best type for particular hearing losses and needs.
What should be the prescriptive objectives? Speech intelligibility and loudness variations are two main objectives of the prescriptive formula. However, some other factors are also important such as a natural experience of environmental sounds in music, the ability to detect and locate sounds and natural feeling of spatial auditory perception.
In amplification required to optimize some objectives may differ from the required to optima other objectives. It is likely that the best amplification will be compromise among optimizing various objectives the assume varying degrees of importance for different people and at different times depending on the listener environment and personal preferences. A major area of research need is to determine what prescription objectives are important and what compromises are likely to be preferred by individuals under particular circumstances.
Audibility and speech intelligibility Audibility has always been a central concept in prescribing amplification; its significance is not properly appreciated. The relationship of audibility to speech intelligibility is exemplified in articulation index which is a method for estimating speech intelligibility from audibility. Over the years, the attempts have been made to use the Articulation index in either the development or evaluation of prescriptive procedures.
It is also necessary to account for hearing loss desensitization which may be explained as follows: If severe hearing losses the articulation index or predicts better speech intelligibility than is achieved. If the hearing loss is greatest at the high frequencies a give SI, at those frequencies will contribute less to intelligibility than the same amount of audibility at lower frequencies.
The general implications of hearing loss desensitization are that severe hearing losses and sloping high frequency hearing losses require considerably less high-frequency emphasis than might seem logical or indeed is prescribed by some procedures and that maximizing audibility over a wide frequency range is not always desirable.
However, question remains about the precise nature and size of hearing loss desensitization. For example does the value of a given amount of audibility at one frequency depend only on hearing level at that frequency or is it also influenced by the hearing at other frequencies and to what extent does speech intelligibility depend factors other than audibility.
The significance of audibility for prescribing amplification is much less understood than is generally believed and is thus an important subject for future research.
Loudness issues: Some aspects of loudness are vitally important for hearing aid prescription. Significant sounds needs to be made audible but not uncomfortable. Loudness is a major determined of preferred gain levels. The relative loudness of different bands of speech will influence the total audibility of speech at the preferred overall loudness level.
Future research should focus on establishing what range of loudness levels, hearing aid wearers prefers rather than assuming that the normal range is best. The preferred range may or may not turn out to be predictable from psychoacoustic measurements.
Acclimatization to hearing aids: Acclimatization occurs over several weeks even for a moderate change in frequency response. It depends upon what type of amplification the person is using. Most of the literature suggests that acclimatization effects are small. With regard to the prescription, one important question for future research is whether acclimatization affects the assessment of amplification measurements/requirements.
In particular, would people with severe hearing losses make more use of high frequency information if they had been accustomed to hearing it better?
What measurements will be made in future prescriptions: Future prescriptive procedures may make use of auditory tests other than those in current use speech recognition by listeners with impaired hearing cannot be fully explained by audibility, suggesting that other abilities have a ratio.
It is often suggested that frequency resolution should be related to speech recognition, but so far no strong correlation has been demonstrated after HTL is controlled for. Literature demonstrates high correlation between frequency resolution and HTL. Frequency resolution may be a consideration for deciding how many bands should be used in a multi band hearing aid and in deciding what range it should cover.
Another measurement which will be used would be temporal resolution. Temporal resolution could be a consideration for choosing time constants and possible compression ratios for compression system. Although logical possibilities exist, no definite evidence is present that frequency or temporal resolution measures will prove useful for hearing aid prescription. It is also possible that more analytical types of speech recognition tests could find a role in future prescriptive procedure.
Such tests could show how the prescription of specific phonemes is influenced by variations in audibility in different frequency bands. Substantial research would be required to show whether this approach could lead to a practical prescriptive procedure and it so develop such a procedure.
Tests of sound localization would be another future development that can be useful in hearing aid prescription especially in the choice of ear mould type. Such measures could become a regular part of the prescription process.
Till now hearing aid prescriptions has made little use of any formal measures of listening environments, social needs or personal preferences. To a degree compression compensates for changes in listening environments in so far as these involve changing input levels to hearing aids.
The advent and multiple memory hearing aids has drawn attention to the need to consider environments, needs any preferences. This experience may stimulate thinking about how such factors could be considered in other aspects of hearing aid prescription. Methods need to be developed for assessing these factors and for research into how they are related to amplification requirements.
Music and Hearing aids what is in future?
The most intense components of speech are the low back vowels e.g. (a) in the father. At the level of the listeners ear these sounds even it shouted, rarely exceed 85 dB SPL and are more typically 75-82 dB SPL. In contrast the more intense elements of music measured at the same ear level location are in the order of 100-110 dB SPL with occasional peaks about 118 dB SPL. This is true not only of rock, but classical music as well.
Since most engineers have had speech input in mind when designing hearing aid, it is understandable that the peak input limiting level of hearing aids has been set to about 85 dB SPL. Peak clipping or limiting may occur at various points in a hearing aid, but if it occurs before the controlling elements, or the ND converter, adjusting hearing aids setting will not prove it.
Hearing aids are normally designed so that this does not happen for the peak levels encountered in speech but the peak levels encountered in music may well cause clipping in the early stapes of the hearing aid amplifier. The parameter is not found on hearing aid specifications sheet. So in future there is a need to develop the prescription and the technology to accommodate for music perception.
Manufacturer specific prescription procedures: Is there any need of validation in future:
Most programmable and digital hearing aids are fitted with device specific software. The software is used to calculate the required amplification and to program the aid to match the prescription. There is no problem as such to use the procedures developed by manufacturers. Such procedures are based on research conducted by or for the manufacturers, in collaboration with independent researchers.
The procedures are subjected to expert scrutiny through the normal publication and review processes and are validated by independent research. However, scientific concerns are present, when the procedures developed by manufacturers are not open for independent validation. The problem for the audiologist is that he cant decide what amplification is best for the patient.
Indeed the Audiologist may not know what amplification is provided. It is therefore difficult to know whether the fitting formula is generally acceptable or whether it should be varied for a particular individual.
One more scientific concern is that some manufacturers fitting method may not be very best or may be of unknown validity. The manufacturers procedure may be less likely to be published and if so will not to accessible for validation studies. So, in future there is a need for the validation of all the prescriptive procedures.
Such research needs to examine the validity of different prescriptive rationales each of which could be used as the basis for a number of specific procedures. In addition each procedure need to be validated in its final form because inevitably sources of error will occur in calculations, measurements and assumptions needed to translate a rationale in to practical procedures.
A challenge for the future is to assess the validity of prescription concepts such as normalizing loudness, independently of the validity of any particular procedure
Future possibilities in ratings and quality judgements
Absolute ratings of speech quality or intelligibility and paired comparison preference judgments of speech quality or intelligibility have often used in research studies over the last 15 years but have been used clinically except in very informal ways.
Hearing aids are increasingly using devices and algorithms aimed at reducing the effects of background noise. These include directional microphones, switchable dual microphone, directional microphones, low-frequency compression circuits and multi channel aids where the gain in each channel depends on the estimated signal and noise levels within each channel.
These devise thus affect speech intelligibility and sound quality in different ways, and at present no validated rules exist for saying which content requires which processing scheme under which acoustic conditions. Whenever there are no reliable studies for prescription an increased emphasis must be placed on empirical evaluation and fine tuning.
Therefore in future increased use of more formal clinical evaluations using paired comparison ratings of sound quality or speech intelligibility is expected. Such comparisons will require appropriate stimuli (e.g. continuous discourse against a variety of background noises) and knowledge of which types of noises and signal to noise ratios are most useful for examining the advantages of different processing schemes in the hearing clinic.
Research aimed at acquiring this knowledge will provide a start on forming prescriptive rules that may eventually make the subjective evaluations unnecessary.
Hearing aid software predictive gain values: how accurate are they?
With the advent of digitally programmable and digital signal processing hearing aids, the clinician is offered a variety of choices for how to view hearing aid performance in the software provided by hearing aid manufacturers. On the programming screen one can choose to display how the hearing aid is programmed in a number of ways depending on the manufacturer
Options found in NOAH programming modules include: 2- cc gain 2- cc output 2 cc SPL 2- cc SPLogram insertion gain simulated insertion gain KEMAR gain
amplified long term speech spectrum real ear SPLogram Ear simulator gain simulated real ear SPL Real-ear aided gain. None of these on screen representation have been made with the actual hearing aid; rather they represent simulations based on average and expected performance values.
Since the audiologists sees these simulated values while programming and adjusting hearing aid, he or she may be tempted to believe that the computer screen values are for the specific hearing aid programmed for the specific patient being fitted with the device.
Unfortunately this is not the case. The 2 cc coupler gain values are what the manufacture is specifying as the standard for the model, not for the particular device being programmed. Given tolerances of components such as the microphone and receiver, the values in hearing aid could vary as much as plus or minus 5 dB some frequencies.
Pediatric hearing aid fitting with non-linear hearing aids
The basic problem of pediatric population is to fill the missing information than do the older individuals whose hearing loss occurred after they had acquired language. Before fitting of non-linear instruments on a child lets examine how the non linear instrument meets the basic amplification goals.
The hearing aid gain is set so that conversational speech is audible and the main output is set below the wearers comfort level. When the listeners try to hear soft speech, they are instructed to turn down the volume control
A non-linear hearing aid adjusts its gain based on the input level. In single channel non-linear instruments the loudest input signal controls the overall gain of the hearing aid. For example, in a room where an air conditioner generates loud, low frequency noise, the single channel processor will turn and the gain across all frequencies. This is of course reduces the audibility of all inputs including high frequency sounds.
To allow for independent gain control in the specific frequency regions, the hearing aid must have multiple channels. In the condition of air conditioner a three channel non linear hearing aid would reduce pain in the low frequency channel without changing the gain in the mid and high frequency channels. The processing may allow more gain for soft inputs such as high frequency speech sounds (e.g. /s/ and /f/).
Another consideration with hearing aids is ensuring the audibility of soft sounds. One approach is to lower the compression threshold of the nonlinear hearing aid. When this is done only the gain for the low input sounds is increased while gain for conversational and loud speech remains as prescribed for the hearing loss.
Compatibility of hearing aids with digital telephones or other electronic device
The electronic devices and mobile phones causes interference to the hearing aids, audiologist will need to consider whether the hearing aids they prescribe are compatible with the other electronic device that the hearing aid wearer wishes to use will come into close contact with. Indeed the audiologist should be considering how other devices can be used, alone or in conjunction with hearing aids to optimize the communicative efficiency of the patient.
Consequently more and more hearing aids will become usable with digital mobile phones. However, it is likely to be a long time and perhaps will never happen, before all types of hearing aids can be used with all types of phones. The audiologist will therefore need to consider the immunity question in the hearing aid selection and evaluation process
The Bluetooth Hearing Aid
Bluetooth enabled hearing aids use this wireless technology twofold. Bluetooth wireless technology allows for communication between two hearing aids. This helps to get the most natural hearing enhancement possible. The two hearing aids "talk" to each other to make instantaneous enhancements to improve hearing.
Another exciting function of Bluetooth enabled hearing aids is wireless connectivity with other Bluetooth enabled devices such as cell phones and music players. This technology is a vast improvement over hearing aids in the past which were often incompatible with other devices.
The Future Both hearing aid manufacturers and headset manufacturers will be moving forward and closer together as they recognize the need and demand for universal hearing assistance products. Product solutions that incorporate the effectiveness of the wireless headset and the amplification and soundshaping of hearing aids will provide audiologists with an affordable, self-programmable solution that might very well initiate a change in the business model of Audiology practices.
The integration of ALDs and Bluetooth headsets will offer greatly improved hearing capabilities for users. The hearing aid becomes a multi-use device that no longer identifies people as hard of hearing, but becomes the communication device of the future. This universally-designed solution will become the "must-have" communication device that keeps people connected anywhere, anytime.
Audiologists will be in a position to offer hearing solutions that are self-programmable and more affordable. The stigma of wearing hearing aids will fade away as the perceptions of technology transform from "hearing aid" to "communication device."
"The convergence of Bluetooth, ALDs and hearing instrument technologies will change the perception of the public about hearing assistance and will impact product and service delivery channels.
Fashionable hearing aids
Called 'designer' hearing aids. "The ideas on display include a remote control to block out irritating sounds, a device to enable people to have a clear conversation in a noisy bar, and hearing aids designed as fashionable jewellery or must-have gadgets. Another concept, known as the Goldfish, instantly replays the previous 10 seconds of sound to the wearer in case they have failed to catch someone's name. It is based on the idea that goldfish only have 10 seconds of memory. "
ARTICLES:
New Fitting Tools and Processing Strategies Anna O'Brien, MAud, Lorrie Scheller, MS, and Tom Scheller, BSEE A technical review of a new hearing instrument that uses unified signal processing designed to reduce spectral smearing and features a number of advanced software-based fitting tools.
In recent years, the challenge among hearing instrument manufacturers has been to create a hearing system that operates in a manner similar to the human ear, offering natural sound quality in a multitude of listening situations, functioning automatically, and adapting instantaneously to every change in the sound environment. Listening comfort, feedback control, elimination of occlusion and flexibility to adjust to the wearers needs also have been primary developmental considerations.
Ear, Nose and Throat Clinic at the University Hospital in Zurich to develop a new non-linear approach to hearing loss compensation. The result is a new-generation device called Symbio which features a processing scheme designed to work differently from other products on the market.
Speech in Focus: Using Signal Processing
Hearing loss is probably the most isolating sensory impairment people experience. In addition to loss of audibility, one of the most critical deficits is increased susceptibility to noise. This is largely due to the fact that sensorineural hearing impairment causes abnormally broad auditory filters due to loss of outer hair cell function. The main social consequence of hearing loss is increased difficulty in understanding speechespecially in the presence of competing noise. This difficulty is most likely due to a combination of reduced audibility and loss of frequency selectivity.
Hearing instruments are effective in increasing the audibility of sounds; however, they cannot reliably alleviate the effects of reduced frequency selectivity. This results in the often heard comment that hearing instruments improve speech understanding in quiet environments, but are not very effective when there is background noise.
Graphic illustration of multi channel versus a unified signal processing approach.
Processing schemes with a large number of channels may reduce the spectral contrasts in the speech signal. This spectral smearing has been found to significantly reduce understanding of speech in both quiet and noise, and may also reduce sound quality. In fact, van Schijndel et al. found that distorted coding of spectral cues was the main factor associated with reduced speech discrimination in noise for hearing impaired subjects. Distorted coding of spectral cues had greater negative impact than distorted temporal or distorted intensity cue coding.
A unified signal processing approach called CASI (Continuously Adaptive Speech Integrity) is utilized in Symbio. With this approach, flexible input-dependent filter characteristics are applied to the whole signal, allowing frequency-dependent compression without splitting the signal into channels. This approach to signal processing is designed to provide the benefits of multichannel amplification (ie, extremely flexible frequency and compression adjustment), but without the drawbacks and potential degradation of the speech signal caused by spectral smearing.
Schematic of the hearing instrument and external feedback path. The panel on the left presents the gain path through the hearing instrument, with the Adaptive Feedback Canceller active. The panel on the right represents the feedback path (eg, leakage through a vent or around the shell/ear mold
The Adaptive Feedback Canceller works by comparing the hearing instrument output with the input from the hearing instrument microphone, determining which portion of the microphone signal is feedback, and subtracting this from the incoming signal prior to the amplification block (Figure) .In this way, the incoming signal is cleansed of feedback, and the desired gain is applied to the signal.
Dynamic Frequency Mapping. Traditionally, hearing care professionals have looked at graphs of dBHL vs frequency and/or graphs of input vs output. To adjust the instrument response, modifications are made to the frequency response or the compression (input/output). Because these two responses are intrinsically linked, a change in one always results in a hidden change in the other.
Dynamic Frequency mapping software.
With the new hearing instrument, the traditional 2-dimensional views (frequency response and input/output graphs) are still present. However, a 3-dimensional view is offered called Dynamic Frequency Mappinga visualization of the instrument response over frequency and input simultaneously, giving the hearing care professional a better overview of the true hearing instrument performance .
The hearing instrument system has been developed to combine the advantages of sample sounds with in situ verification of the signal level, ensuring greater accuracy in fine tuning. This is meant to provide more accuracy than systems containing a single calibration signal. The situational verification tool system is available for use at any stage of the fitting, but is also integrated with the Client Interactive Fitting Assistant to help zero-in on specific frequency areas that the client finds unsatisfactory..
Intuitive software leads the dispenser through a set of proposed adjustments that can then be evaluated by the client, allowing quick, easy and accurate adjustment of the instrument response. This is designed to provide a more controlled and accurate approach to fine-tuning, increasing the probability of client satisfaction
Clinical verification of a hearing aid with artificial intelligence Mark C. Flynn & Thomas Lunner Artificial intelligence uses parallel processing to determine simultaneously the best solution from the full range of processing options. The decision making is based on which solution provides the best speech-go-noise ratio (SpNR). Applying AI to hearing aids allows new audiologic solutions to be applied through complex, problem-solving algorithms.
Syncro, which was introduced in 2004, is built on a new digital platform that implements advanced adaptive directionality, noise management, and wide dynamic range compression. Artificial intelligence is the foundation of the voice priority processing (VPP) system, which oversees three signal processing approaches: Multiband adaptive directionality, Tri state noise management, and voice aligned compression.
All these systems are designed to work in synergy to optimize the signal progressively, with the priority being to supply the best possible speech understanding. The unity of this signal processing goal, combined with decision making through parallel processing, is intended to ensure that correct decisions are being made and that all systems are working toward improving speech understanding in noise
syncro provided significant benefits over other advanced digital hearing instruments, including Adapto and participants own hearing aids. These benefits include greatly improved speech understanding scores in noise and reported improvements in subjects daily listening environment. In terms of speech understanding, the difference between the test and the reference hearing aid were greater than 2 dB (SBR).
Given that each 1 dB in SNR equals an approximate increase in speech understanding of 10%, this indicates that syncro delivers approximately 20% grater speech understanding than the reference instrument. To put this in perspective, the reference instrument (Adapto) recently demonstrated the best speech understanding in quiet and noise in a blind comparison with two other levels of technology (WDRC digital and analog). Therefore, one can clearly see the improvement in speech understanding delivered by a hearing aid built on a new platform incorporating artificial intelligence.
In terms of user preferences, the significant reported benefits were in complex listening environments (e.g. speech in traffic or multiple talkers). It is in such situations that we would expect the parallel processing to deliver better speech understanding and greater comfort than other digital platforms through its ability to select from a vast array of possible choices the solution that provides the best possible speech-to-noise ratio.
These gains in speech understanding did not come at the expense of other dimensions such as sound quality and comfort. Therefore, one need not view hearing aids as being either speech-focused or comfort-focused. The results show that the use of AI can enable a hearing aid to deliver excellent speech understanding in various environments while at the same time increasing a users perception of comfort and overall sound quality.
Importantly, the results for the speech understandingin-noise test evaluated one area of contention. That is whether or not increased vent size (i.e. OpenEar Acoustics), which provides relief from occlusion, may remove the benefit of directional microphones. study demonstrates clearly that collection vents with an average faceplate size of 2.2 mm continue to provide significant directional benefit. Directional benefit remains possible with Syncro because the hearing aid microphone system is specifically designed to work with Open Ear Acoustics.
In terms of directionality, the results provide support for the split-directional mode. While the first band (of the four) is held in omni directional mode, the results demonstrated that users were able to gain a significant directional benefit. The split-directionality provides a transparent transition between the omni directional and full-directional modes, which allows the implementation of directionality at lower input levels than would be possible otherwise.
In summary, it is crucial to remember that observed differences between the standard digital hearing instruments and those built on a platform of parallel processing on measures of performance in background noise and complex listening situations. While standard instruments will use single pieces of information in trying to predict the auditory environment, syncro uses parallel processing to analyze multiple processing options and select the best solution. The underlying processing strategy is to maximize the speech-to-noise ratio at all times and thereby optimize speech understanding.
Hearing Aids for Musicians Marshall Chasin, AuD Understanding and managing the four physical differences between speech and music allows the hearing care professional to approximate the correct electro acoustic parameters and enhance the enjoyment of listening to music.
When comparing music to speech, there are four essential physical differences that warrant consideration during a hearing aid (or cochlear implant) fitting. Understanding these differences and selecting appropriate hearing aid circuitry will help to optimize the enjoyment of music for the hard-of-hearing listener. This applies equally to those who are musicians as to those who like to listen to (sometimes loud) music.
In most cases, regardless of the music program in the hearing aid, if the front ends is distorting (because of musics more intense input), nothing implemented later in a hearing aid can improve the situation. Understanding and managing the four physical differences between speech and music will allow the hearing health care professional to approximate the electro acoustic parameters to provide maximum enjoyment of music for musicians and music-lovers.
Acoustic Structure of Music four primary physical differences between speech and music are: The long-term spectrum of music vs speech. Differing overall intensities. Crest factors. Phonetic vs. phonemic perceptual requirements.
One Channel is Best for Music In sharp contrast to hearing speech (especially in noise), one channelor, equivalently, many channels with the same compression ratios and knee pointsappears to be the appropriate choice for hearing music. This recommendation derives from clinical work with hundreds of hard-of-hearing musicians over the past 20 years.
Unlike speech, for most types of music the relative balance between the lower frequency fundamental energy and the higher frequency harmonics is crucial. High fidelity music is related to many parameters, one of which is the audibility of the higher frequency harmonics at the correct amplitude. Poor fidelity can result from the intensity of these harmonics being too low or too high. A multi-channel hearing aid that uses differing activation points and differing degrees of compression for various channels runs the distinct risk of severely altering this important low-frequency (fundamental)/high-frequency (harmonic) balance
. Subsequently a music program within a hearing aid should be one channel or equivalently a multi-channel system where all compression parameters are set in a similar fashion. It has been suggested that, in some bass heavy situations, a two-channel system may be useful with the lower frequency channel set at 500 Hz with greater attenuation at higher input levels (L. Revit, personal communication, 2004).
The clinical rules of thumb for setting compression parameters for speech are rather straightforward. The compression detectors are set based on the crest factor of speech which is on the order of 12 dB (eg, as discussed earlier, the peaks are 12 dB more intense than the RMS). For speech, compression systems function to limit overly intense outputs and to ensure that soft sounds are heard as soft sounds, medium sounds are heard as medium sounds, and intense sounds are heard as intense (but not uncomfortable) sounds.
In short, these systems take the dynamic range of speech (30-35 dB) and alter it to correspond with the dynamic range of the hard-of-hearing person. And, there is no inherent reason why a wide dynamic range compression (WDRC) system that works well for a client with speech as input, should not also work well for music. However, the dynamic range of music is typically much greater than that of speechtypically being on the order of 80-100 dB.
if the hearing aid utilizes a peak detector to activate the compression circuit, the detector in a music program should be set about 5-8 dB higher than for speech. This is related to the larger crest factor of music (18 dB vs. 12 dB for speech), and care should be taken that these peaks do not activate the compression circuit prematurely.
Feedback reduction systems. In most cases, since the spectral intensity of music is greater than that for speech, feedback is not an issue. The gain of the hearing aid for these higher-level inputs is typically less than that for speech. However, if feedback reduction is required, or the feedback circuit cannot be disabled in a music program (as it can be for example, in the Bernafon ICOS) then those systems that utilize a gain reduction method (eg, Phonak Perseo or Widex Diva, although the Widex Diva only uses this approach for the music program) would be the best for music.
Noise reduction systems. Like feedback reduction systems, it would be best to disable the noise reduction system when listening to music. Typically, the signal to noise ratio (SNR) is quite favorable when listening to music, so noise reduction is unnecessary. However, for some hearing aids, the noise reduction system cannot be disabled, and since the primary benefit for noise reduction systems seems to be for improving listening comfort rather than reducing noise, choosing an approach for music that has minimal effect may be beneficial for a music program.
Most noise reduction systems in use today use a form of modulation detection. The modulation is simply the changing from quiet to more intense portions in a wave form. The rate at which it does this each second is called the modulation rate. For speech, it is roughly the number of times that one opens and closes ones mouth every second and has most of its response in the 4-6 Hz region. The modulation depth is the difference in decibels between the quietest and most intense elements. For speech this is typically 30-35 dB . For noise the modulation rate is typically very low (<2 Hz, if not zero) and the related modulation depth is also very low (<15 dB). In contrast, for music, the modulation rate can be as high as 100 Hz with a modulation depth of 60 dB.
Defining The Music Program In conclusion, a music program, or a set of optimal electro acoustic parameters for enjoying music would include: 1) A sufficiently high peak input limiting level so more intense components of music are not distorted at the front end of the hearing aid. 2) Either a single channel or a multichannel system in which all channels are set for similar compression ratios and knee points. 3) A compression system similar to the speech-based compression system with an RMS detector compression scheme and with a knee point 5-8 dB higher if the hearing aid uses a peak compression detector.
4) A disabled feedback reduction system, or a feedback reduction system that uses gain reduction or a more sophisticated form of phase feedback cancellation (either one with short and long attack times or one that only operates on a restricted range of frequencies such as over 2000 Hz). 5) If the noise reduction system cannot be disabled, a circuit that distinguishes between low (4-6 Hz) and high (10-100 Hz) modulation rates may be useful for differentiating speech from music, and automatically turning on a music program.
Thank you.

Future Trends in Hearing Aids

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Current AND Future Trends AND Technology in Fitting Hearing Aids

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Candidates for multi-memory hearing aids

Recommending a multi-memory hearing aid

Prescription issues: present and future

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Music and Hearing aids what is in future?

Manufacturer specific prescription procedures: Is there any need of validation in future:

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Future possibilities in ratings and quality judgements

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Pediatric hearing aid fitting with non-linear hearing aids

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Compatibility of hearing aids with digital telephones or other electronic device

The Bluetooth Hearing Aid

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Fashionable hearing aids

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Speech in Focus: Using Signal Processing

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Graphic illustration of multi channel versus a unified signal processing approach.

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

Dynamic Frequency mapping software.

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

KUNNAMPALLIL GEJO JOHN,BASLP,MASLP

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