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CMSD 5020 Hearing Measurement > Hearing Aids and Implants l > Flashcards

Hearing Aids and Implants l Flashcards

1
Q

Fill in the blanks related to the types of Hearing Loss:

A
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2
Q

speech information is carried by _____________________________________ (reflecting the movement of the articulators)

A

speech information is carried by the general shape of speech sounds (reflecting the movement of the articulators)

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3
Q

Each phone requires
__________________________
__________________________

intelligibility is best predicted by ______________________________________

A

Each phone requires
4 audible octaves or
4 speech features

Intelligibility is best predicted by audibility across a wide range

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4
Q

Hearing aids provide _______________________________________________

A

audibility across a wide range of frequencies

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5
Q

What does this graph show?

A

Threshold Shift: Loss of Audibility
We are asking ourselves is this person will be able to understand speech, sharp tunning curve etc.

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6
Q
A

Looking Closer (SNHL): Audibility and Tuning
Loss of tuning in SNHL
We can’t deal with the threshold shift unfortunately

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7
Q

What should we take into consideration when fitting HA?

A

Loudness Discomfort Level
You must take into consideration this level when fitting HA, so we need to estimate or predict it

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8
Q

Gain is:

A

how much things are ‘turned up’
how much sounds are turned up

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9
Q

How much gain to hear 0 dB at 1000 Hz?

A

Need 30 dB gain (which is a lot of gain to give someone to reach a 0 threshold)

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10
Q

How much gain to hear 0 dB at 4000 Hz?

A
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11
Q

What does this graph show?

A
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12
Q

What happens when someone speaks loudly (average level about 75 dB)?

What about the sound of the HVAC?

A

If the gain was already at 40 dB to reach 0 dB threshold, and someone speaks loudly, you’ll feel 115 dB level which would be TOO LOUD thus far too much gain.

Thus, we don’t really boost to 0 dB.

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13
Q

Speech is about ____ dB at 500 Hz and ____dB at 4 kHz

A

speech is about 65 dB at 500 Hz, 45 dB at 4 kHz

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14
Q

Speech has a dynamic range of about ____dB

A

30 dB

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15
Q

Should We Turn All Frequencies Up?

A

No, because boosting a certain range could cause other frequencies uncomfortable

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16
Q

What does it mean to use Frequency-Dependent Gain?

A

HA will have this option where you can shape the gain across the frequencies to fit speech in that range

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17
Q

What is compression?

A

different gain for different input levels
More gain for softer sounds
Less gain for louder sounds

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18
Q

What does this graph show?

A

It shows how much gain we predict to add speech by taking into consideration discomfort level

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19
Q

What are three features HA have to help shape speech safely?

A

Frequency-dependent gain
Compression
Output limiting

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20
Q

What are two fitting targets?

A

DSL
NAL

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21
Q

What is the DSL Approach?

A
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22
Q

How does the NAL work?

A

Can even calculate the SII

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23
Q

What is Compression specifically and what could it mean?

A

range of input levels is compressed into a smaller range of output levels

this could mean:
more gain for soft sounds (better for hearing pins drop)
less gain for loud sounds (more comfort)

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24
Q

What is Compression specifically and what could it mean?

A

range of input levels is compressed into a smaller range of output levels

this could mean:
more gain for soft sounds (better for hearing pins drop)
less gain for loud sounds (more comfort)

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25
How does compression work?
when a loud input comes in, compression reduces the gain so compression tends to make things softer compression + gain increase can make soft sounds louder
26
What are the two types of compression?
Slow and Fast compression
27
Describe slow compression:
automatic volume control can make sounds softer in loud environments It doesn’t affect the spectral shape gain is reduced by compressor, compression never has time to release (at least not until speech is finished)
28
Describe fast compression:
changes dynamic range of speech can make the softer parts of speech louder
29
Compression is done in ____________________
Frequency channels
30
Give an example of how compression is done in Frequency Channels.
Consider the word ‘shoe’ Compressor would turn down gain after intense /∫/ Changes the dynamic range of speech
31
How does slow compression Affect the spectral shape?
Slow compression doesn’t affect spectral shape gain is reduced by compressor, compression never has time to release (at least not until speech is finished)
32
What about fast multi-channel compression?
In the low frequencies, input is low (40 dB) receives extra ‘soft sound’ gain in the high frequencies, input is moderate (65 dB) receives average gain SPECTRAL CONTRAST is reduced – the shape is distorted
33
Contrast across frequency changing over time. This is what tells us how the mouth is moving, and what the word is
34
Fast compression can provide more _____________________________________________________________________________________________ which is likely better for_________________________________________
Fast compression can provide more audibility for the softest sounds, but can also distort speech likely better for younger and cognitively-sharp listeners (Gatehouse et al. 2006)
35
Slow compression can provide ______________________________________________________________________ which likely better for ___________________________________________________
Slow compression can provide automatic level control, with less distortion of speech likely better for older and less cognitively-sharp listeners (Gatehouse et al. 2006)
36
What are three types of in-the-ear custom HA styles?
37
What are three BTE HA styles?
38
What are the 5 basic HA components?
39
What are the processing steps in digital HA?
40
What are 3 basic hearing aid fitting goals?
appropriate gain and compression to provide optimal audibility and intelligibility of speech appropriate output limiting to ensure safety and comfort physical comfort in the ear
41
How are the fitting HA goals met?
taking an ear impression adjusting the hearing aid to meet fitting targets (using software and real-ear measurement) adjusting the sound levels and fit based on listener feedback
42
What are the classic hearing aid problems?
Feedback Occlusion Effect Background noise is annoying Hard to hear speech in background noise Hard to manipulate small controls Batteries Wax
43
How does feedback affect HA and what is the traditional solution against it?
sound from receiver leaks out of ear canal and enters microphone this happens over and over again, sound keeps getting louder traditional solution is to reduce gain in high frequencies (i.e., the high-cut control)
44
How does occlusion affect HA fitting?
45
How can we deal with the occlusion effect for HA?
Venting this has been the standard solution for many years venting reduces occlusion “open fit” hearing aids have little-to-no occlusion
46
What is the difference between open vs closed HA fittings?
47
How does open fitting affect feedback?
but open fittings make feedback much worse!
48
What would be an effect that could be caused from closed fittings compared to open fittings?
Occlusion Effect
49
Feedback cancellation reduces ______________________________________________________________
feedback and makes it possible to increase venting
50
What is a sone?
Sones are linear, meaning that 1.0 sone is exactly half as loud as 2.0 sones, and 2.0 sones is half as loud as 4.0 sones. Sones are typically measured in half-sone increments (1.5, 2.0, 2.5, etc.), but there are some cases as products get quieter, where sones will be listed in tenth-sone increments (0.6, 0.7, 0.8, 0.9, etc.)
51
Open vs Closed Fittings: Everything Leaks!
Even if feedback can be cancelled, large vents reduce the transmission of low-frequency sound
52
What are the pros of vents and open fittings?
occlusion effect eliminated fewer otologic problems
53
What are the cons of vents and open fittings?
reduced high-frequency gain (with risk of feedback) reduced low-frequency gain (leakage out of ear)
54
What is the role of detail?
The loss of resolution in SNHL makes it more difficult to separate speech from noise (and from other speakers)
55
How can we deal with the hearing aid problem that can be hard to hear speech in background noise?
Directional microphones Adaptive Directional Microphones Remote Microphone Systems
56
What do directional microphones do?
Directional microphones reduce sounds from behind (or the side), so it is easier to separate target speech from the noise
57
In directional microphones, when sound comes from the back, it reaches:_______________________________________________
both sides of the diaphragm at the same time (and is cancelled)
58
Describe adaptive directional microphones. (3)
typical modern hearing aids use two microphones and electronics to achieve directivity the directional characteristics can be turned on and off the directional polar characteristics can be tuned to reduce the most noise
59
Describe remote microphone systems.
these provide the best signal-to-noise ratio they allow complete selection of the sound source (which is then much easier to hear and understand)
60
What are solutions for hard to manipulate small controls dillema?
Solutions for Dexterity Problems: automatic programs remote controls touch-sensitive controls handles on hearing aids
61
How can we deal with the battery life hearing aid problem?
* The batteries require a high and consistent current - Most compact way to do this is to take advantage of the air (as part of the chemical reaction) – zinc air the sticker prevents this from occurring before use -Rechargeable Hearing Aids
62
How can we deal with the wax buildup hearing aid problem?
wax-busters no-wax systems behind-the-ear
63
What are 3 basic BTE non-custom hearing aid styles?
64
What are the flexible aspects of new hearing aid styles?
Microphone Location Receiver Position / Sound Outlet Open/Closed Fitting Size and Shape
65
What would be the three possible microphone positions of new hearing aid styles?
Over the ear In the ear In the canal
66
What do microphone in the canal provide?
Concha resonances Canal resonances Head-related transfer function (localization) Natural directivity No room for directional microphones
67
What do microphone in the ear provide?
No concha resonances No canal resonances Some natural directivity (depends on pinna shape and orientation) Some room for directional microphones
68
What do microphone over the ear provide?
No concha resonances No canal resonances No natural directivity Most room for directional microphones
69
What are the two receiver positions of new hearing styles?
BTE and ITC
70
Describe BTE receiver position.
Sound must pass through tube to enter canal Receiver is protected from ear moisture, drainage and wax
71
Describe ITC receiver position.
Sound delivered directly to ear no tubing resonances no protection from wax
72
Explain how telephone can be used with HA?
telecoils are tiny magnetic coils that pick up energy from telephone receivers or large induction loops acoustic telephone programs are another option bluetooth connections are becoming more prevalent
73
How can HA deal with soft noises?
very soft sounds can be particularly annoying most hearing aids try to get rid of them with expansion (the opposite of compression) less gain for soft sounds
74
What are extra technical features of hearing aids?
data logging frequency compression/transposition bluetooth compatibility binaural integration
75
How is data logging done in HA?
how often vc is adjusted, and where volume is left some hearing aids will adjust start-up volume automatically what programs are used in what settings when feedback occurs how often aid is worn what the listener’s environments are like
76
What is frequency transposition?
speech is an abstract pattern details don’t matter – we can use music as the base when someone has a precipitous hearing loss, why not move the pattern that they can’t hear onto a lower frequency band
77
How does Bluetooth Compatibility / DAI help?
this is extremely useful for talking on the telephone and controlling the device Devices can also be used with DAI
78
What is binaural integration and how does it relate to HA?
timing and level differences are important for sound localization hearing aids are constantly adjusting their levels (compression, noise reduction, adaptive directionality, etc.) it might be useful to synchronize this processing across the ears
79
“Levels” and Mark-Ups
Entry Level Yesterday’s Mid-level Mid-Level Yesterday’s High-End High-End Today’s high-end

CMSD 5020 Hearing Measurement (10 decks)

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