Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities, Minneapolis.
Center for Applied and Translational Sensory Science, University of Minnesota, Twin Cities, Minneapolis.
Am J Audiol. 2022 Jun 2;31(2):305-321. doi: 10.1044/2022_AJA-21-00164. Epub 2022 Mar 22.
Self-adjustment of hearing aid amplification enables wearers to customize the hearing aid output to match their preferences and could become an important tool for programming direct-to-consumer devices for people with mild-to-moderate hearing loss. One risk is that user-selected settings may provide inadequate audibility. This study assessed that risk by quantifying relationships between self-adjusted settings, subjective preferences, and speech recognition performance using speech at low levels in quiet, where achieving high speech audibility requires sufficient amplification.
Fifteen people with symmetric, mild-to-moderate sensorineural hearing loss self-adjusted hearing aid amplification while listening to speech in quiet at 45, 55, and 65 dBA. After self-adjustment, 11 participants made blinded ratings of their self-adjusted fit, their NAL-NL2 prescriptive fit, and experimenter-created fits with reduced gain. Participants completed blinded paired comparisons and sentence recognition assessments using these settings.
The gain of self-adjusted fits showed a large range of variability between participants. On average, self-adjusted gain was similar to NAL-NL2 prescribed gain for input signals of 55 dBA and slightly greater than prescribed gain for 45-dBA signals. Speech recognition scores for NAL-NL2 fits were consistently high, and differences in speech recognition results were strongly correlated with the overall preferences obtained from paired comparisons.
Self-adjusted fits are highly variable between individuals for low-audibility conditions. Nonetheless, self-adjusted fits are at least as satisfactory as NAL-NL2 fits, and listeners tend to disfavor settings that result in poorer speech recognition. The findings argue against concerns that self-adjustment will result in inadequate audibility compared to prescribed settings.
助听器放大的自我调节使佩戴者能够根据自己的喜好定制助听器输出，这可能成为为轻度到中度听力损失人群编程直接面向消费者设备的重要工具。一个风险是，用户选择的设置可能无法提供足够的可听度。本研究通过量化自我调节设置、主观偏好和使用安静环境中低水平语音的语音识别性能之间的关系来评估这种风险，在安静环境中，实现高语音可听度需要足够的放大。
15 名患有对称、轻度到中度感音神经性听力损失的人在 45、55 和 65 dBA 的安静环境中听语音时自我调节助听器放大。自我调节后，11 名参与者对他们的自我调节拟合、NAL-NL2 处方拟合和实验者创建的增益降低拟合进行了盲评。参与者使用这些设置完成了盲配对比较和句子识别评估。
自我调节拟合的增益在参与者之间表现出很大的变异性。平均而言，对于 55 dBA 的输入信号，自我调节增益与 NAL-NL2 处方增益相似，而对于 45 dBA 的信号，自我调节增益略大于处方增益。NAL-NL2 拟合的语音识别分数始终很高，并且语音识别结果的差异与从配对比较中获得的整体偏好强烈相关。
对于低可听度条件，个体之间的自我调节拟合差异很大。尽管如此，自我调节拟合至少与 NAL-NL2 拟合一样令人满意，并且听众往往不喜欢导致语音识别较差的设置。这些发现反对了自我调节会导致与处方设置相比可听度不足的担忧。
