Audiologist- Versus Patient-Driven Hearing Aid Fitting Protocols

George A. Lindley; Catherine V. Palmer; John Durrant; Sheila Pratt

doi:10.1055/s-2001-14978

Seminars in Hearing, Inhaltsverzeichnis

Semin Hear 2001; 22(2): 139-160
DOI: 10.1055/s-2001-14978

Audiologist- Versus Patient-Driven Hearing Aid Fitting Protocols

George A. Lindley¹ , Catherine V. Palmer² , John Durrant² , Sheila Pratt²

¹Department of Communication, Towson University, Towson, Maryland
²Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania

Abstract

ABSTRACT

Past research has demonstrated that predicted speech intelligibility is higher when hearing aids are adjusted using an audiologist-driven (AD) fitting protocol versus a patient-driven (PD) fitting protocol. This results from a greater amount of high-frequency amplification. Use of an AD fitting protocol assumes that the wearer will eventually adapt to the prescribed hearing aid settings. The purpose of this investigation was to compare the speech intelligibility and sound quality provided by hearing aids adjusted using an AD versus a PD fitting protocol. In addition, the degree of adaptation to the loudness and sound quality provided by AD settings was investigated over an 8-week period. Analysis of group data showed that the AD protocol, as implemented in this investigation, did not yield higher speech intelligibility. In addition, no significant changes in loudness and/or sound quality judgments were found over the 8-week period. Several participants did demonstrate significant adaptation. Reasons for the lack of adaptation in most participants are hypothesized. These include degree of damage to the cochlea and differences in loudness growth patterns between individuals with hearing loss and individuals with normal hearing.

KEYWORD

Hearing aids - hearing loss - adaptation

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Referenzen

REFERENCES

1 Lindley G, Palmer C, Durrant J, Pratt S. Adaptation to loudness and environmental stimuli in three newly fitted hearing aid users. J Am Acad Audiol . 2000; 11 316-322
2 Rankovic C. Derivation of frequency-gain characteristics for maximizing speech perception in noise. J Speech Hear Res . 1995; 38 913-930
3 Ricketts T. Fitting hearing aids to individual loudness-perception measures. Ear Hear . 1996; 17 124-132
4 Stelmachowicz P, Dalzell S, Peterson D, Kopun J, Lewis D, Hoover B. Comparison of threshold-based fitting strategies for nonlinear hearing aids. Ear Hear . 1998; 19 131-138
5 Cornelisse L, Seewald R, Jamieson D. The input/output formula: a theoretical approach to the fitting of personal amplification devices. J Acoust Soc Am . 1995; 97 1854-1864
6 Valente M, Van Vliet D. The independent hearing aid fitting forum (IHAFF) protocol. Trends Amplification . 1997; 2 6-35
7 Gitles T, Niquette P. FIG6 in ten. Hear Rev . 1995; 2 28-30
8 Byrne D, Dillon H. The National Acoustic Laboratories' (NAL) new procedure for selecting the gain and frequency response of a hearing aid. Ear Hear . 1986; 7 257-265
9 American National Standards Institute. Methods for Calculation of the Speech Intelligibility Index. ANSI S2.5-1997. New York: ANSI; 1997 Accredited Standards Committee S3, Bioacoustics
10 American National Standards Institute. Procedure for the Computation of Loudness of Noise. ANSI S3.4-1980. Accredited Standards Committee S3, Bioacoustics New York: ANSI; 1980
11 Palmer C, Valente M, Powers T A, Mueller H G. The impact of restoring normal loudness growth on speech understanding as a function of signal-to-noise ratio and input level. Paper presented at NIH/VA Hearing Aid Research and Development Conference, Bethesda, MD, September 1997
12 Lindley G. Audiologist versus patient-driven hearing aid fitting protocols. Unpublished dissertation, University of Pittsburgh, 2000
13 Allen J, Hall J, Jeng P. Loudness growth in 1/2-octave bands (LGOB): a procedure for the assessment of loudness. J Acoust Soc Am . 1990; 88 745-753
14 Davis H, Hudgins C, Marquis R. The selection of hearing aids. Laryngoscope . 1946; 56 85-163
15 Schmitz H. Loudness discomfort level modification. J Speech Hear Res . 1969; 12 807-817
16 Silverman S. Tolerance for pure tone and speech in normal and defective hearing. Ann Otol Rhinol Laryngol . 1947; 56 658-676
17 Byrne D, Dirks D. Effects of acclimatization and deprivation on non-speech auditory abilities. Ear Hear . 1986; 17 29S-37S
18 Gatehouse S. The time course and magnitude of perceptual acclimatization to frequency responses: evidence from monaural fitting of hearing aids. J Acoust Soc Am . 1992; 92 1258-1268
19 Walden B, Schuchman G, Sedge R. The reliability and validity of the comfort level method of setting hearing aid gain. J Speech Hear Disord . 1977; 42 455-461
20 Berger K, Hagberg E. Gain usage based on hearing aid experience and subject age. Ear Hear . 1982; 3 235-237
21 Leijon A, Lindkvist A, Anders R, Israelsson B. Preferred hearing aid gain in everyday use after prescriptive fitting. Ear Hear . 1990; 11 299-303
22 Bentler R, Niebuhr D, Getta J, Anderson C. Longitudinal study of hearing aid effectiveness. I: Objective measures. J Speech Hear Res . 1993; 36 808-819
23 Kuk F, Lau C. Effect of hearing aid experience on preferred insertion gain selection. J Am Acad Audiol . 1996; 7 274-281
24 Horwitz A, Turner C. The time course of hearing aid benefit. Ear Hear . 1997; 18 1-11
25 Humes L, Barlow N, Garner C, Wilson D. Prescribed clinician-fit versus as-worn coupler gain in a group of elderly hearing-aid wearers. J Speech Lang Hear Res . 2000; 43 879-892
26 Hawkins D, Naidoo S. Comparison of sound quality and clarity with asymmetrical peak clipping and compression output limiting. J Am Acad Audiol . 1994; 4 221-228
27 Fortune T, Preeves D. Hearing aid saturation, coherence, and aided loudness discomfort. J Am Acad Audiol . 1992; 3 81-93
28 Palmer C. The impact of hearing loss and hearing aid experience on sound quality judgments. Semin Hear . 2001; 22 125-138
29 Ovegaard A, Lundberg G, Hagerman B, Gabrielsson A, Bengtsson M, Brandstrom U. Sound quality judgment during acclimatization of hearing aid. Scand Audiol . 1997; 26 43-51
30 Keppel G. Design and Analysis: A Researcher's Handbook. Upper Saddle River, NJ: Prentice Hall
31 Nilsson M, Soli S, Sullivan J. Development of the Hearing in Noise Test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am . 1994; 95 1085-1099
32 Edgerton B, Danhauer J. Clinical Implications of Speech Discrimination Testing Using Nonsense Syllables. Baltimore: University Press; 1979
33 Edgerton B, Danhauer J, Rizzo S. Practice effects for normal listeners performance on a nonsense syllable test. J Aud Res . 1981; 21 125-131
34 Cox R, McDaniel D. Development of the speech intelligibility rating (SIR) test for hearing aid comparisons. J Speech Hear Res . 1989; 32 347-352
35 Palmer C. The influence of individual ear canal and eardrum characteristics on speech intelligibility and sound quality judgments. Unpublished dissertation, Northwestern University, 1991
36 Palmer C, Wilber L, Killion M, Canter J. Influence of external ear characteristics on intelligibility and quality judgments. ASHA . 1991; 33 161
37 Cox R, Alexander G, Taylor I, Gray G. The contour test of loudness perception. Ear Hear . 1997; 18 388-400
38 Cox R, Rivera I. Predictability and reliability of hearing aid benefit measured using the PHAB. J Am Acad Audiol . 1992; 3 242-254
39 Arlinger S, Gatehouse S, Benter R. Report of the Eriksholm workshop on auditory deprivation and acclimatization. Ear Hear . 1996; 17 87S-90S
40 Turner C, Cummings K. Speech audibility for listeners with high frequency hearing loss. Am J Audiol . 1999; 8 47-56
41 Bentler R, Pavlovic C. Comparison of discomfort levels obtained with pure tones and multitone complexes. J Acoust Soc Am . 1989; 86 126-132
42 Garnier S, Micheyl C, Arthaud P, Berger-Vachon C, Collet L. Temporal loudness integration and spectral loudness summation in normal-hearing and hearing impaired listeners. Acta Otolaryngol . 1999; 119 154-157