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Melbourne, Australia

Dawson P.W.,ing Cooperative Research Center | Dawson P.W.,Cochlear Limited | Hersbach A.A.,Cochlear Limited | Swanson B.A.,Cochlear Limited
Ear and Hearing | Year: 2013

Objectives: The aim of this research is to describe the development of an adaptive Australian Sentence Test in Noise and to validate the test in terms of test-retest reliability and efficiency using data obtained from its clinical application. Design: The relative intelligibility of 1264 Bamford-Kowal-Bench (BKB)-like sentences in the presence of competing four-talker babble was assessed with cochlear implant recipients. Intensity adjustments to the babble segments were made to reduce intersentence variability. Computer software was developed to administer an adaptive speech reception threshold (SRT) test using these adjusted sentence/babble pairs and test-retest SRT data from a separate group of 23 cochlear implant recipients was analyzed, comparing different SRT calculation and test stopping rules. Results: The adjusted sentence/babble pairs were used in clinical studies to obtain an SRT by presenting 32 sentences. Analysis of test-retest pairs of SRT data from 23 recipients indicated that a psychometric fit SRT calculation rule provided better reliability than did the Hearing in Noise Test (HINT) calculation rule, or rules based on mean turns. This rule, using the morpheme correct scores for each sentence, gave a standard deviation for a single SRT of 0.76 dB. Further analyses revealed that the test could be shortened to 20 sentences with an increase of 0.19 dB in variability, while reducing the median test time by approximately 2 min. Conclusions: This article reports validation data for a new Australian Sentence Test In Noise. When 20 BKB-like sentences are used with a psychometric fit calculation rule, a standard deviation of approximately 1 dB is obtained in approximately 3 min 36 sec. © 2013 by Lippincott Williams and Wilkins. Source

Dawson P.W.,ing Cooperative Research Center | Dawson P.W.,Cochlear Limited | Mauger S.J.,ing Cooperative Research Center | Hersbach A.A.,Cochlear Limited
Ear and Hearing | Year: 2011

OBJECTIVE:: The aim of this study was to investigate whether a real-time noise reduction algorithm provided speech perception benefit for Cochlear™ Nucleus® cochlear implant recipients in the laboratory. Design: The noise reduction algorithm attenuated masker-dominated channels. It estimated the signal-to-noise ratio of each channel on a short-term basis from a single microphone input, using a recursive minimum statistics method. In this clinical evaluation, the algorithm was implemented in two programs (noise reduction programs 1 [NR1] and 2 [NR2]), which differed in their level of noise reduction. These programs used advanced combination encoder (ACE™) channel selection and were compared with ACE without noise reduction in 13 experienced cochlear implant subjects. An adaptive speech reception threshold (SRT) test provided the signal-to-noise ratio for 50% sentence intelligibility in three different types of noises: speech-weighted, cocktail party, and street-side city noise. Results: In all three noise types, mean SRTs for both NR programs were significantly better than those for ACE. The greatest improvement occurred for speech-weighted noise; the SRT benefit over ACE was 1.77 dB for NR1 and 2.14 dB for NR2. There were no significant differences in speech perception scores between the two NR programs. Subjects reported no degradation in sound quality with the experimental programs. Conclusions: The noise reduction algorithm was successful in improving sentence perception in speech-weighted noise, as well as in more dynamic types of background noise. The algorithm is currently being trialed in a behind-the-ear processor for take-home use. © 2011 Lippincott Williams & Wilkins, Inc. Source

Wang S.,Capital Medical University | Wang S.,Macquarie University | Wang S.,ing Cooperative Research Center | Xu L.,Ohio University | And 2 more authors.
JARO - Journal of the Association for Research in Otolaryngology | Year: 2011

It has been reported that normal-hearing Chinese speakers base their lexical tone recognition on fine structure regardless of temporal envelope cues. However, a few psychoacoustic and perceptual studies have demonstrated that listeners with sensorineural hearing impairment may have an impaired ability to use fine structure information, whereas their ability to use temporal envelope information is close to normal. The purpose of this study is to investigate the relative contributions of temporal envelope and fine structure cues to lexical tone recognition in normal-hearing and hearing-impaired native Mandarin Chinese speakers. Twenty-two normal-hearing subjects and 31 subjects with various degrees of sensorineural hearing loss participated in the study. Sixteen sets of Mandarin monosyllables with four tone patterns for each were processed through a "chimeric synthesizer" in which temporal envelope from a monosyllabic word of one tone was paired with fine structure from the same monosyllable of other tones. The chimeric tokens were generated in the three channel conditions (4, 8, and 16 channels). Results showed that differences in tone responses among the three channel conditions were minor. On average, 90.9%, 70.9%, 57.5%, and 38.2% of tone responses were consistent with fine structure for normal-hearing, moderate, moderate to severe, and severely hearing-impaired groups respectively, whereas 6.8%, 21.1%, 31.4%, and 44.7% of tone responses were consistent with temporal envelope cues for the above-mentioned groups. Tone responses that were consistent neither with temporal envelope nor fine structure had averages of 2.3%, 8.0%, 11.1%, and 17.1% for the above-mentioned groups of subjects. Pure-tone average thresholds were negatively correlated with tone responses that were consistent with fine structure, but were positively correlated with tone responses that were based on the temporal envelope cues. Consistent with the idea that the spectral resolvability is responsible for fine structure coding, these results demonstrated that, as hearing loss becomes more severe, lexical tone recognition relies increasingly on temporal envelope rather than fine structure cues due to the widened auditory filters. © 2011 Association for Research in Otolaryngology. Source

Boisvert I.,Macquarie University | Boisvert I.,ing Cooperative Research Center | Boisvert I.,Kimab - Corrosion And Metals Research Institute | McMahon C.M.,Macquarie University | And 4 more authors.
Ear and Hearing | Year: 2011

OBJECTIVES: Making evidence-based recommendations to prospective unilateral cochlear implant recipients on the potential benefits of implanting one or the other ear is challenging for cochlear implant teams. This particularly occurs in cases where a hearing aid has only been used in one ear for many years (referred to here as the "hearing ear"), and the contralateral ear has, in essence, been sound-deprived. In such cases, research to date is inconclusive, and little anecdotal evidence exists to inform the debate and support best clinical practice. DESIGN: Retrospective data on speech recognition outcomes of 16 adult participants who received a cochlear implant in an ear deprived of sound for a minimum of 15 yr were analyzed. All subjects were implanted through the Quebec Cochlear Implant Program and were provided with personalized intensive rehabilitation services. Data obtained from clinical records included demographic data and speech recognition scores measured after implantation with the sentences of a multimedia auditory test battery in the auditory-only condition. Speech recognition outcomes were compared with the duration of auditory deprivation in the implanted ear, bilateral significant hearing loss, and auditory stimulation before bilateral significant hearing loss. RESULTS: Using nonparametric correlation analyses, a strong negative correlation was demonstrated between speech recognition scores and the duration of bilateral significant hearing loss and with the duration of auditory stimulation before bilateral significant hearing loss. No significant correlation with the duration of auditory deprivation or with the duration of prior auditory stimulation in the implanted ear was found. CONCLUSIONS: These findings suggest that functional outcomes of cochlear implantation for unilateral sound deprivation may be more strongly influenced by central processes than peripheral effects stemming from the deprivation per se. This indicates the relevance of considering the client's history of binaural hearing rather than the hearing in each ear individually when discussing possible outcomes with a cochlear implant. Copyright © 2011 by Lippincott Williams & Wilkins. Source

Convery E.,ing Cooperative Research Center | Convery E.,Macquarie University | Keidser G.,ing Cooperative Research Center | Seeto M.,ing Cooperative Research Center | And 2 more authors.
Journal of the American Academy of Audiology | Year: 2015

Background: A reliable and valid method for the automatic in situ measurement of hearing thresholds is a prerequisite for the feasibility of a self-fitting hearing aid, whether such a device becomes an automated component of an audiological management program or is fitted by the user independently of a clinician. Issues that must be addressed before implementation of the procedure into a self-fitting hearing aid include the role of real-ear-to-dial difference correction factors in ensuring accurate results and the ability of potential users to successfully self-direct the procedure. Purpose: The purpose of this study was to evaluate the reliability and validity of an automatic audiometry algorithm that is fully implemented in a wearable hearing aid, to determine to what extent reliability and validity are affected when the procedure is self-directed by the user, and to investigate contributors to a successful outcome. Research Design: Design was a two-phase correlational study. Study Sample: A total of 60 adults with mild to moderately severe hearing loss participated in both studies: 20 in Study 1 and 40 in Study 2. Twenty-seven participants in Study 2 attended with a partner. Participants in both phases were selected for inclusion if their thresholds were within the output limitations of the test device. Data Collection and Analysis: In both phases, participants performed automatic audiometry through a receiver-in-canal, behind-the-ear hearing aid coupled to an open dome. In Study 1, the experimenter directed the task. In Study 2, participants followed a set of written, illustrated instructions to perform automatic audiometry independently of the experimenter, with optional assistance from a lay partner. Standardized measures of hearing aid self-efficacy, locus of control, cognitive function, health literacy, and manual dexterity were administered. Statistical analysis examined the repeatability of automatic audiometry; the match between automatically and manually measured thresholds; and contributors to successful, independent completion of the automatic audiometry procedure. Results: When the procedure was directed by an audiologist, automatic audiometry yielded reliable and valid thresholds. Reliability and validity were negatively affected when the procedure was self-directed by the user, but the results were still clinically acceptable: test-retest correspondence was 10 dB or lower in 97% of cases, and 91% of automatic thresholds were within 10 dB of their manual counterparts. However, only 58% of participants were able to achieve a complete audiogram in both ears. Cognitive function significantly influenced accurate and independent performance of the automatic audiometry procedure; accuracy was further affected by locus of control and level of education. Several characteristics of the automatic audiometry algorithm played an additional role in the outcome. Conclusions: Average transducer- and coupling-specific correction factors are sufficient for a self-directed in situ audiometry procedure to yield clinically reliable and valid hearing thresholds. Before implementation in a self-fitting hearing aid, however, the algorithm and test instructions should be refined in an effort to increase the proportion of users who are able to achieve complete audiometric results. Further evaluation of the procedure, particularly among populations likely to form the primary audience of a self-fitting hearing aid, should be undertaken. Source

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