Evaluation of Digital Remote Microphone Wireless Systems. Jace Wolfe

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1 Evaluation of Digital Remote Microphone Wireless Systems Jace Wolfe

2 The Hearts for Hearing Team Audiologists Additional Team Members Jace Wolfe, Ph.D., CCC-A Kris Hopper Kerri Brumley Pati Burns Krystal Prior, AuD Sherry Edwards Susan LaFleur Megan Miller Megan Marsh, AuD Reyna Romero Kristi Murphy Christian Boone Natalie Martella, AuD Darlene Hale Tanna Zach Sara Neumann, AuD Mila Morais, B.S., AuD Intern Elizabeth Musgrave, B.S., AuD Intern Speech-Language Pathologists Joanna T. Smith, M.S., CCC-SLP, LSLS Cert. AVT Tamara Elder, M.S. CCC-SLP, LSLS Cert. AVT Darcy Stowe, M.S. CCC-SLP, LSLS Cert. AVT Lindsay Hannah, M.S., CCC-SLP, LSLS Cert. AVT Carly Graham, M.S., CCC-SLP, LSLS Cert. AVT Casey Banks, M.S., CFY-SLP Jenn Bryngelson, M.S., CFY-SLP Tessa Hixon, M.S., CFY-SLP Jenna Reese, M.S., CFY-SLP

3 How Many Educational Audiologists in Oklahoma? 1

4 Road Map Adaptive Digital Broadband Wireless Technology Introduction Study with CI Users How about Hearing Aid Users? Classroom Audio Distribution Systems

5 A Noisy World! Living Room: 42 db A (with A.C. = 52 dba) Classroom Function: 68 dba School Auditorium: 79 dba School Cafeteria: 82 dba OKC Thunder Basketball: 100 dba The SNR in these environments is typically -5 to +5 db

6 The Evolution of Technology 1996 MicroLink - the first miniaturized ear-level FM receiver 2000 MLx - the first universal ear-level FM receiver 2003 MlxS - the first frequency-flexible FM system 2008 Dynamic FM - the first adaptive FM system

7 SNR (db) What about Dynamic FM? No FM Traditional FM: Gain is fixed Dynamic FM: Gain increases as ambient noise increases Surrounding Noise (db SPL)

8 Wolfe et al. (2009), JAAA Speech Recognition in Noise Results Advanced Bionics

9 The Evolution of Technology 1996 MicroLink - the first miniaturized ear-level FM receiver 2000 MLx - the first universal ear-level FM receiver 2003 MlxS - the first frequency-flexible FM system 2008 Dynamic FM - the first adaptive FM system 2013 Adaptive Digital Broadband Wireless System

10 Roger That! Audio signals are sampled, digitized and packaged in very short (160 μs) digital bursts of codes (packets) and broadcast several times, each at different channels between and GHz The 2.4 GHz ISM (Industry, Science and Medical) band is globally license free Frequency hopping between channels, in combination with repeated broadcast, avoids interference issues The frequency hopping is adaptive, both receivers and transmitters are searching continuously to find free channels and to avoid occupied channels Digital RF may allow for better control of the transmitted signal which may result in better performance

11 Does the Roger adaptive digital wireless system offer benefit for CI users?

12 Study Objectives Evaluate speech recognition in quiet and in noise with speech (HINT) at 85 dba at transmitter and classroom noise at 50, 55, 60, 65, 70, 75, 80 dba Evaluated 3 RF remote microphone systems: Fixed-gain FM MLxS Adaptive FM MLxi Digital RF Roger Ensure consistency of signal and a lack of interference.

13 Subjects 16 Advanced Bionics Recipients Harmony sound processors 11 bilateral Mean Age: 41.9 years (9-81) Length of CI Use: 9.7 years (8-13 years) HiRes & HiRes120 with 50/50 mixing ratio 21 Cochlear Recipients Nucleus 5 sound processors 9 bilateral Mean Age: 49.8 years (8-77) Length of CI Use: 4.7 years (6 mths - 9 years) ACE (20)/SPEAK (1) with ASC+ADRO and 1:1 mixing ratio

14 Results Advanced Bionics Recipients (n = 16) Wolfe et al., in press, JAAA

15 Results Cochlear Recipients (n = 21) Wolfe et al., in press, JAAA

16 Results Adaptive Digital technology resulted in significant improvements at 70, 75, and 80 dba noise levels over Fixed-gain and Adaptive FM technology. Adaptive FM technology resulted in significant improvements at 70, 75, and 80 dba noise levels over Fixed-gain FM technology. No differences were found between CI manufacturers.

17 MED-EL and Roger Roger MLxi MLxS 20 0 N = 7 Quiet Wolfe et al., in press, Hearing Journal

18 What about hearing aids? Speech Recognition Benefits of Digital Adaptive Broadband Wireless Transmission Technology Linda M. Thibodeau AAA, 2013 Annaheim, CA

19 Percent Correct HINT Results (N=10) Fixed FM 0.50 Adaptive FM Adaptive Digital Quiet Average Noise Level (dba) Thibodeau, 2013

20 Objective Measures Adaptive Digital technology resulted in significant improvements for 65, 70, 75, and 80 dba noise levels over Fixed and Adaptive technology. The average improvement in speech recognition at the 80dBA level by Adaptive Digital over the current Adaptive FM was 35%! And Adaptive Digital over Fixed FM technology was 42%! Thibodeau, 2013

21 Roger receivers Plug & Play No channel management Water-resistant: Integrated receivers Operating range: 20m/66ft Roger X is 35% smaller than MLxi Power consumption: 3.1 ma

22 Roger MyLink Roger MyLink is a bodyworn receiver with inductive neckloop Suitable for all hearing systems with a T-Coil Not recommended for very young children

23 How about digital RF for classroom audio distribution systems (CADS)?

24 Classroom Audio Distribution Systems Goals: Create a uniform distribution of the sound of interest across the classroom, and provide a modest improvement in the signal-to-noise ratio. May utilize: FM Infrared Digital RF

25 Study Objectives Evaluate benefits of classroom audio distribution (CAD) systems for children with hearing loss or normal hearing. Compare performance in quiet and in noise obtained with an adaptive single-loudspeaker CAD vs. a fixed-gain, CAD utilizing 4 loudspeakers strategically placed in the classroom

26 Subjects 15 Children with Hearing Loss 6-13 years old Mean Age: 9.5 years old 4FPTA Range: 35 to Children with Normal Hearing 5-12 years old Mean Age: 8 years old 10 Adults with Normal Hearing years old Mean Age: 34 years old

27 Mean Hearing Loss Subjects wore a variety of behind-the-ear hearing aids. N = 15

28 Audio Enhancement Elite II Classroom Audio Distribution System Tear Drop Infrared Mic Audio Enhancement Elite II 30 Watt Receiver/Amplifier Infrared Dome Sensor Four WS09 Wall-mounted loudspeakers

29 Audio Enhancement Elite II Classroom Audio Distribution System Tear Drop Infrared Mic Audio Enhancement Elite II 30 Watt Receiver/Amplifier Infrared Dome Sensor Four WS09 Wall-mounted loudspeakers

30 Phonak DigiMaster 5000 Classroom Audio Distribution System Phonak DigiMaster 5000 Phonak inspiro transmitter

31 Phonak DigiMaster 5000 Classroom Audio Distribution System Utilizes digitally modulated (DM) radio frequency transmission Features adaptive (Dynamic) changes in loudspeaker gain dependent upon classroom noise levels. Features an array of 12 loudspeakers Emits sound in horizontal plane, with minimal vertical spread Reduce reverberation Distributes sound across classroom Loudspeakers positioned at head level Acoustic feedback cancellation

32 Classroom Setup Nose NOISE HINT NOISE Noise 8 in L1 22 ft, 4 in NOISE LEVEL: L1 = L2 18 ft L2 NOISE NOISE 15 ft, 5 in schematic diagram

33 Background Noise Classroom noise was presented from the four loudspeakers in the corners of the room. Nose NOISE HINT NOISE Noise 22 ft, 4 in L1 8 in NOISE LEVEL: L1 = L2 18 ft Noise levels measured at FM mic and subject location Tested in: Quiet & Noise at 50 dba 55 dba 60 dba 65 dba 70 dba 75 dba L2 NOISE NOISE 15 ft, 5 in schematic diagram

34 Classroom Setup Phonak DM5000 Nose NOISE HINT NOISE Noise AE Elite II 8 in AE Elite II L1 22 ft, 4 in NOISE LEVEL: L1 = L2 18 ft AE Elite II L2 AE Elite II NOISE NOISE 15 ft, 5 in schematic diagram

35 Classroom Setup HINT Sentences presented at 85 dba to FM mic Nose NOISE HINT NOISE 8 in L1 22 ft, 4 in NOISE LEVEL: L1 = L2 18 ft L2 The HINT sentence level at the subject was 64 dba NOISE NOISE 15 ft, 5 in schematic diagram

36 Classroom Setup The output of the Phonak DigiMaster 5000 was set to the manufacturer s default setting. Nose NOISE L1 8 in HINT NOISE The gain of the Elite II was set to provide an equivalent level in quiet at the subject location. 22 ft, 4 in NOISE LEVEL: L1 = L2 This resulted in the HINT sentences being presented at 68 dba at the subject location. 18 ft L2 NOISE NOISE 15 ft, 5 in schematic diagram

37 Test Conditions No FM Phonak DM5000 alone Audio Enhancement Elite II alone Phonak DM Personal FM Inspiro to DM5000 and Personal FM Audio Enhancement Elite II + Personal FM Inspiro connected to audio output port of Elite II Personal FM alone Inspiro to personal FM

38 Results

39 % Correct Speech Recognition without FM Adults understand speech in noise better than children. Children with normal hearing understand speech in noise better than children with hearing loss. The difference between groups becomes greater at higher noise levels. Noise Level (dba) All groups experience more trouble in noise (60, 65, 70, & 75 db A). Performance became progressively poorer from 60 to 75 db A.

40 % Correct Normal Hearing Adults with CADS CADS improve adults speech recognition in noise at noise levels of 65, 70, and 75 db A. Phonak DM5000 Dynamic CADS provided better speech recognition in noise than Audio Enhancement Elite II system at 70 and 75 db A. Noise Level (dba)

41 % Correct Normal Hearing Children with CADS CADS improve speech recognition in noise of children with normal hearing at noise levels of 60, 65, 70, and 75 db A. Phonak DM5000 Dynamic CADS provided better speech recognition in noise than Audio Enhancement Elite II system at 70 and 75 db A. Noise Level (dba)

42 % Correct Children with Hearing Loss CADS Performance CADS improve speech recognition in noise of children with hearing loss at noise levels of 60, 65, 70, and 75 db A. Noise Level (dba) Phonak DM5000 Dynamic CADS provided better speech recognition in noise than Audio Enhancement Elite II system at 70 and 75 db A.

43 % Correct CADS Performance Across Groups Noise Level (dba)

44 What about personal FM?

45 CADS vs. CADS + Personal FM Personal FM better than no FM at all noise levels. Personal FM better than CADS at 60, 65, 70, and 75 db A.

46 Phonak CADS + Personal FM vs. Personal FM alone No difference in performance between CADS + personal FM vs. personal FM alone

47 % Correct Children with Hearing Loss CADS + FM vs. Personal FM Noise Level (dba)

48 Results Phonak CADS + personal FM and personal FM alone are both better than Audio Enhancement CADS + personal FM at 60, 65, 70, and 75 db A. Possible causes? Loss of adaptive (Dynamic) FM Loss of noise pre-processing at inspiro. Insufficient input from audio output of AE Elite II to inspiro

49 % Correct Children with Hearing Loss CADS vs. CADS + Personal FM What to do? Noise Level (dba)

50 Potential Upgrade Alternative Solution: Wear two mic/transmitters Digimaster X Plugs into the audio input port of existing CADS. Inspiro delivers signal to Digimaster X and to personal FM receiver

51 % Correct Good News! Children with Hearing Loss vs. Gold Standard Adults with Dynamic SF NH Children with Dynamic SF Children with HL and Dynamic SF Children with HL and Dynamic SF+Personal FM Quiet Noise Level (dba)

52 Conclusions/Clinical Implications Speech recognition in noise: Roger Digital > Adaptive FM>Fixed FM Adults > NH Children > Children with HL CADS improve speech recognition in noise for all subjects. Dynamic CADS > Fixed-gain CADS Personal FM: largest improvement in speech recognition in noise. Phonak Dynamic DM Personal FM provides better performance in noise than AE Elite II + Personal FM. Little to no speech recognition in noise improvement with Phonak CADS + Personal FM vs. Personal FM alone. But CADS may improve classroom acoustics in real world.

53 Acknowledgments Mila Morais, B.Sc., Audiology Intern Sara Neumann, AuD, Audiology Intern Pati Burns, B.Sc., Audiology Assistant Nathan Wells, B.Sc., Au.D. Student Joanna Smith, M.S., CCC-SLP, LSLS Erin Schafer, Ph.D., Audiologist Hans Mulder, Felix Goldbeck, & Francois Marqouis

54 Thank you for your attention!

Evaluation of Classroom Audio Distribution and Personal FM Systems. Jace Wolfe

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