Evaluation of speech reception threshold in noise in young Cochlear™ Nucleus(®) system 6 implant recipients using two different digital remote microphone technologies and a speech enhancement sound processing algorithm

Parents' experiences of remote microphone systems for children with hearing loss

PURPOSE

Remote microphone systems improve intelligibility in difficult conditions when the performance of hearing aids/cochlear implants is insufficient. The purpose of this study was to explore parents' experiences with remote microphone systems for their children with hearing loss and to determine the advantages and disadvantages as perceived by parents.

MATERIALS AND METHODS

Data were collected by means of semi-structured interviews with parents of children with moderate to profound bilateral hearing loss (2-19 years old). The open coding method and thematic analysis were used. The final sample consisted of 19 mothers and 9 fathers who had experience with remote microphone systems.

RESULTS

Parents listed the advantages of remote microphone systems for their child, for themselves and for other carers, such as better hearing and understanding, a life more similar to that of their peers without hearing loss, safety in road traffic, lower fatigue, vocabulary acquisition, better school results. Some limitations were identified, namely low benefits, technical issues and a reluctance to use the device by children or teachers.

CONCLUSIONS

It is crucial to provide parents with information about assistive devices and the consequences of limited access to hearing speech. Professionals should motivate parents, children and teachers to use remote microphone systems even in situations when the benefit may not be obvious if there is a potential benefit for the child.

IMPLICATIONS FOR REHABILITATIONThe main advantages of remote microphone systems perceived by parents are better hearing and understanding, a life more similar to peers without hearing loss, safety in traffic, lower fatigue, vocabulary acquisition and better school results.The main disadvantages are for parents: persisting hearing problems, low benefits, technical issues and a reluctance to use the device by children or teachers.Sufficient and accurate information is needed about remote microphone systems, but also about the consequences of hearing loss in general.The possibility to try wireless devices before buying and troubleshooting help is appreciated.

Speech Recognition in Noise in Single-Sided Deaf Cochlear Implant Children on Using Adaptive Digital Microphone Technology

BACKGROUND

 Previous research demonstrated benefits of adaptive digital microphone technologies (ADMTs) in adults with single-sided deafness (SSD) having a cochlear implant (CI). Children with SSD are especially affected by background noise because of their noise exposure in kindergarten and school.

PURPOSE

 This article aims to evaluate possible effects of ADMT on speech recognition in background noise in children with SSD who use a CI.

STUDY SAMPLE

 Ten children between 5 and 11 years of age were included.

DATA COLLECTION AND ANALYSIS

 Speech recognition in noise was assessed for one frontal distant and two lateral speakers. The speech stimulus was presented at a speech level of 65 dB(A) and noise at a level of 55 dB(A). For the presentation condition with one frontal speaker, four listening conditions were assessed: (1) normal-hearing (NH) ear and CI turned off; (2) NH ear and CI; (3) NH ear and CI with ADMT; and (4) NH ear with ADMT and CI. Listening conditions (2) to (4) were also tested for each lateral speaker. The frontal speaker was positioned directly in front of the participant, whereas the lateral speakers were positioned at angles of 90 degrees and -90 degrees to the participant's head.

RESULTS

 Children with SSD who use a CI significantly benefit from the application of ADMT in speech recognition in noise for frontal distant and for lateral speakers. Speech recognition improved significantly with ADMT at the CI and the NH ears.

CONCLUSION

 Application of ADMT significantly improves speech recognition in noise in children with SSD who use a CI and can therefore be highly recommended. The decision of whether to apply ADMT at the CI NH ear or bilaterally should be made for each child individually.

Effect of wireless remote microphone application on speech discrimination in noise in children with cochlear implants

OBJECTIVES

Although cochlear implantation has significantly contributed to the speech perception of cochlear implant (CI) users, these individuals still have significant difficulty in understanding speech, especially in noisy environments and keeping track of the target speaker in the presence of speech sounds of others. This study was aimed to evaluate the effect of wireless Remote Microphones (RM) on speech discrimination scores in noise in child CI users.

MATERIALS AND METHODS

Twenty children with unilateral cochlear implantation were enrolled in this study with mean ± SD age of 5.8 ± 0.83 years who have undergone CI for at least one year. Speech discrimination scores in noise were assessed using the Words-in-Noise (WIN) test at a constant signal-to-noise ratio (SNR) of 0 dB, in the presence and absence of a wireless RM. Three loudspeakers were placed at a distance of 1 m in front of the child to present the speech and babble noise. The wireless microphone was placed on a base with a height equivalent to the height of the middle speech loudspeaker at a distance of 30 cm from it.

FINDINGS

The mean speech discrimination score in noise in the absence of wireless RM in all children was obtained 34% (6.8 words out of 20 words), with minimum and maximum of 15% and 50% words. Findings revealed the mean speech discrimination score in noise in the presence of wireless RMs is equivalent to 65% (13 words out of 20 words), with the minimum and maximum scores of 35% and 95%, respectively. The result showed that speech discrimination scores in noise improved in the presence of wireless RM.

CONCLUSION

The significant improvement was observed in speech discrimination in noise in all cochlear implanted children when the wireless RM was used, as compared to the absence of a wireless RM, which suggests the usefulness of this hearing aid accessory in CI users.

A directional remote-microphone for bimodal cochlear implant recipients

To evaluate whether speech recognition in noise differs according to whether a wireless remote microphone is connected to just the cochlear implant (CI) or to both the CI and to the hearing aid (HA) in bimodal CI users. The second aim was to evaluate the additional benefit of the directional microphone mode compared with the omnidirectional microphone mode of the wireless microphone. This prospective study measured Speech Recognition Thresholds (SRT) in babble noise in a 'within-subjects repeated measures design' for different listening conditions. Eighteen postlingually deafened adult bimodal CI users. No difference in speech recognition in noise in the bimodal listening condition was found between the wireless microphone connected to the CI only and to both the CI and the HA. An improvement of 4.1 dB was found for switching from the omnidirectional microphone mode to the directional mode in the CI only condition. The use of a wireless microphone improved speech recognition in noise for bimodal CI users. The use of the directional microphone mode led to a substantial additional improvement of speech perception in noise for situations with one target signal.