Sounds perceived as annoying by hearing-aid users in their daily soundscape

Hearing aid Experiences of Adult Hearing aid Owners During and After Fitting: A Systematic Review of Qualitative Studies

There has been an increasing number of qualitative studies exploring the experiences and perceptions of adult hearing aid owners throughout their hearing aid journey. As these studies and reported experiences vary greatly, a systematic review was conducted to identify and synthesize the key concepts in adult hearing aid owners' experiences during and after fitting. A systematic search of three electronic databases was conducted, yielding 443 results. Articles were evaluated for inclusion based on pre-determined eligibility criteria, including conventional, smartphone-connected, and direct-to-consumer hearing devices. Twenty-five studies met the inclusion criteria. The quality of the included articles was evaluated using the Rating of Qualitative Research scale. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and the Synthesis Without Meta-Analysis (SWiM) were followed. A narrative synthesis was conducted, and studies were grouped into three main domains, namely experiences of owners related to a) hearing aid adoption and fitting (n = 3), b) hearing aid use (n = 20), and c) hearing aid sub-optimal use (n = 25). Hearing aid owners mainly reported on how their attitude towards hearing aids affected experiences during the fitting stage. Improved psychosocial functioning was the most prevalent perceived benefit of hearing aid use. Owners described sub-optimal use in terms of hearing device-related and non-device-related concepts. The COM-B (capability, opportunity, motivation-behavior) model is used to discuss specific service-delivery, hearing-device, and hearing-aid-owner related concepts and clinical implications, including behavior change techniques to enhance understanding of the concepts that hearing aid owners perceive as essential to improve hearing aid experiences.

The Impact of Age on Noise Sensitivity in Cochlear Implant Recipients

OBJECTIVE

To evaluate the impact of different open set sentence recognition tests in quiet, +10 dB signal to noise ratio (SNR), and +5 dB SNR in adult cochlear implant (CI) recipients above and below 65 years of age.

STUDY DESIGN AND SETTING

Multi-institution, prospective, non-randomized, single-subject repeated measures design.

PATIENTS

Ninety six adults more than or equal to 18 years old with postlingual bilateral sensorineural hearing loss.

INTERVENTIONS

Participants received a CI532 in one ear. Speech perception measures were evaluated before and 6-months after activation.

MAIN OUTCOME MEASURES

Subjects completed consonant-nucleus-constant (CNC) words in quiet and AzBio sentences in noise using +10 and +5 dB SNR, and Montreal Cognitive Assessment (MOCA).

RESULTS

Ninety six adult patients were enrolled (n = 70 older [≥65 yr], n = 26 younger [<65 yr]). There was no difference in CNC scores (CI alone 58.4% versus 67.5%, p = 0.0857; best aided 66.7% versus 76.1%, p = 0.3357). Older adults performed worse on AzBio +10 dB SNR compared with younger patients (CI alone 37.4% versus 56.9%, p = 0.0006; best aided 51.4% versus 68.2%; p = 0.01), and in AzBio +5 dB SNR (CI alone 7.7% versus 11.2%, p = 0.0002; best aided 15.3% versus 22.3%, p = 0.0005). The magnitude of change in AzBio +10 dB SNR was significantly less in older adults in CI alone (15.3% versus 22.3%; p = 0.0493) but not best aided (21.5% versus 31.3%; p = 0.105). The magnitude of change was drastically worse in AzBio +5 dB SNR for older adults (CI alone 6.7% versus 22.1%, p = 0.0014; best aided 9.5% versus 21.5%; p = 0.0142). There was no significant difference in MOCA between the two age groups.

CONCLUSIONS

While both older and younger patients have similar outcomes with respect to CNC word scores in quiet, the addition of noise disproportionally impacts older patients. Caution should be exercised testing the elderly in noise; testing in noise may disproportionally impact performance expectations and should be more carefully considered when used for candidacy criteria and counseling. Future studies need to further investigate the disproportionate effect of noise on candidacy testing and its impact on how elderly patients are qualified.

Environmental Noise Classification with Inception-Dense Blocks for Hearing Aids

Hearing aids are increasingly essential for people with hearing loss. For this purpose, environmental noise estimation and classification are some of the required technologies. However, some noise classifiers utilize multiple audio features, which cause intense computation. In addition, such noise classifiers employ inputs of different time lengths, which may affect classification performance. Thus, this paper proposes a model architecture for noise classification, and performs experiments with three different audio segment time lengths. The proposed model attains fewer floating-point operations and parameters by utilizing the log-scaled mel-spectrogram as an input feature. The proposed models are evaluated with classification accuracy, computational complexity, trainable parameters, and inference time on the UrbanSound8k dataset and HANS dataset. The experimental results showed that the proposed model outperforms other models on two datasets. Furthermore, compared with other models, the proposed model reduces model complexity and inference time while maintaining classification accuracy. As a result, the proposed noise classification for hearing aids offers less computational complexity without compromising performance.

Subjective criteria underlying noise-tolerance in the presence of speech

OBJECTIVE

The objective was to determine the relative contribution of four criteria (loudness, annoyance, distraction, speech interference) to participants' noise-tolerance thresholds (NTT).

DESIGN

While listening to speech in noise set at the highest signal-to-noise ratio at which noise became unacceptable (noise tolerance threshold), participants completed paired-comparison judgments of loudness, annoyance, distraction, and speech interference to determine the noise domain(s) that were most important in their noise tolerance judgments. Participants also completed absolute ratings of the noise using the same noise domains, which were combined with the paired comparison data for analysis.

STUDY SAMPLE

Sixty-three adults with normal hearing participated.

RESULTS

For the entire group, speech interference and distraction were the largest contributors to noise tolerance. A cluster analysis indicated three distinct groups: criteria were dominated by either annoyance (33%); distraction (48%), or speech interference (19%). Significant differences in NTT among the groups revealed the highest mean NTT for the annoyance group and lowest NTT for the speech interference group.

CONCLUSION

The majority of participants based NTTs on criteria related to the noise itself (annoyance or distraction) and had greater noise sensitivity than the smaller group of participants who focused more on speech intelligibility in the noise.

Aging and Direct-to-Consumer Prescription Drug Television Ads: The Effects of Individual Differences and Risk Presentation

To determine how individual difference (age, cognition, and hearing) and risk presentation (audio frequency, speed, and organization) variables affect viewing of direct-to-consumer (DTC) prescription drug television ads, participants (N = 1,075) from four age groups across the adult lifespan took an in-person hearing examination, watched a DTC television ad, and responded to survey questions. Results showed that increased age was related to reduced cognition and hearing ability, as well as lower ad comprehension and risk recall. Greater speed and more complex organization of the ad's risk information lowered risk recall and claim recognition. Audio frequency had no effect. Cognitive abilities mediated the relationship between age and risk recall. Our findings suggest that older adults are likely to have more difficulty recalling and understanding the risks presented in DTC television ads. Risk information can be presented in ways that facilitate or inhibit recall and recognition among individuals across the lifespan.

TV listening and hearing aids

TV listening plays a large role in the lives of hearing-impaired (HI) individuals. Yet, few studies have examined TV listening in this group. In this paper, we report the findings of an online survey on TV listening conducted among HI individuals with and without hearing aids (HAs) in the United States in 2015. The research investigated if and in what form TV listening experiences of unaided and aided HI individuals might differ with regard to their viewing habits, difficulties they experience, and compensation strategies they employ. 515 HI people of ages 50+ years participated, 260 of whom owned HAs. HA users reported that they watched TV or video on average for 6 hours 10 min per day, 57 minutes longer than the duration reported by non-HA owners. Furthermore, HA users indicated fewer difficulties when watching TV than non-HA owners, suggesting that HA usage alleviated difficulties with TV listening. Nevertheless, the most frequent problems were still encountered by more than 39% of the HA users. Difficulties increased with greater self-reported unaided hearing disability, and female participants indicated more problems than male participants. Finally, those with carpeted floors reported fewer difficulties than those without carpets. The most frequently used compensation strategies were changing TV or HA volumes and using closed captioning. Only few HA users used audio streaming accessories. Given the exploratory nature of this study, further research is needed to inform interventions and improve the TV listening experiences of HI viewers.

Auditory Environment Across the Life Span of Cochlear Implant Users: Insights From Data Logging

PURPOSE

We describe the natural auditory environment of people with cochlear implants (CIs), how it changes across the life span, and how it varies between individuals.

METHOD

We performed a retrospective cross-sectional analysis of Cochlear Nucleus 6 CI sound-processor data logs. The logs were obtained from 1,501 people with CIs (ages 0-96 years). They covered over 2.4 million hr of implant use and indicated how much time the CI users had spent in various acoustical environments. We investigated exposure to spoken language, noise, music, and quiet, and analyzed variation between age groups, users, and countries.

RESULTS

CI users spent a substantial part of their daily life in noisy environments. As a consequence, most speech was presented in background noise. We found significant differences between age groups for all auditory scenes. Yet even within the same age group and country, variability between individuals was substantial.

CONCLUSIONS

Regardless of their age, people with CIs face challenging acoustical environments in their daily life. Our results underline the importance of supporting them with assistive listening technology. Moreover, we found large differences between individuals' auditory diets that might contribute to differences in rehabilitation outcomes. Their causes and effects should be investigated further.