Delivering Advanced Features Tailored for Severe to Profound Hearing Loss

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1 360 Feature Article: Number 2 Delivering Advanced Features Tailored for Severe to Profound Hearing Loss The goal of any hearing instrument is to provide the best audibility and sound quality possible for the client, whatever the degree of their hearing loss. Fitting people with severe to profound loss presents a unique challenge that requires a different approach. 360 was purpose-built to address the distinct needs of people with severe to profound hearing loss, with all of the hearing instrument settings and features designed to maximize client acceptance and satisfaction.

2 360 builds on the success of technologies that have proven effective for other degrees of hearing loss. Tailoring these innovative features for the super power user is a highly effective method of addressing severe to profound hearing loss, providing optimal audibility and sound awareness. 360 is available at two levels: 360+ offers a full complement of advanced innovations designed to deliver high performance even in the most challenging listening environments, while 360e provides solid, reliable performance. Speech Enhancement SP (360+) 360 is the first hearing instrument that customizes speech enhancement specifically to the needs of those with severe to profound hearing loss. Integrated features such as loudness compensation, level dependency and bandwidth provide improved speech clarity and ease of listening. The goal of speech enhancement SP is to maximize an individual s ability to access consonant and vowel cues to assist with speech clarity and understanding, while maintaining awareness of environmental sounds. This adaptive feature provides up to 8 db of additional amplification for both soft and average speech sounds in bands where speech is present. However, because loud speech is often audible without additional amplification, the application of speech enhancement is gradually reduced when the speech signal rises above an average conversational level until no additional gain is added. This level dependent speech enhancement ensures the greatest ease of Frequency Hz Output db Typical output for all signals speech enhancement SP OFF, loudness compensation OFF Output for speech signals speech enhancement SP ON, loudness compensation ON Output for non speech signals speech enhancement SP ON, loudness compensation ON 60 2

3 listening over a wide range of input levels. Every hearing instrument wearer has their own unique clarity preferences and those with severe to profound loss are certainly no exception. Speech enhancement SP, when provided at 8 db of additional gain, presents an opportunity to emphasize speech and separate other noise. Loudness compensation is a new feature designed to offset the intensity produced at these maximum settings, by applying a proportional reduction to the overall gain model. This allows the maximum amount of speech enhancement to be applied without introducing loudness tolerance issues. Once loudness compensation is activated there will be a reduction of non-speech sounds that are not desired by the listener. Even though this approach ensures the appropriate amplification of speech and the de-emphasizing of prevailing noise, it should not be confused with noise cancellation technology. Noise cancellers apply amplification which is then reduced when noise is present. Loudness compensation provides maximum amplification for speech without over amplifying environmental sounds. Speech enhancement SP can be applied across the entire frequency range (broadband) or to only low frequency weightings (narrowband). Most clients will prefer the broadband setting, which is the default. However for clients with only residual hearing in the low frequencies, narrowband speech enhancement SP may be preferred. Speech enhancement SP is stronger than ever before to satisfy the need for clarity with the severe to profound category. Speech enhancement SP can also be customized for the individual, by using the additional features of loudness compensation and bandwidth. Speech enhancement has been available on several Unitron Hearing products and speech enhancement SP has been created specifically for the 360+ hearing instrument. U:fit Tip: In the Configure screen, speech enhancement SP can be easily fine-tuned to optimize critical speech frequencies and provide a tailored response to a range that your client relies on most heavily. With programmable settings (off, mild, moderate, or maximum), the parameters can be adjusted from 4 db of speech enhancement up to a powerful 8 db, in increments of 2 db. Loudness compensation can also be turned on or off. db HL Frequency Hz Broadband SE Example of a hearing loss Narrowband SE Output MPO Speech enhancement: bandwidth Soft Expansion Input Loud Typical output levels (prescribed target gain) loudness compensation OFF Output level for non-speech signals loudness compensation ON Output level for speech signals loudness compensation ON Speech enhancement: level dependency and loudness compensation 3

4 AutoPro2 (360+) In addition to power, 360+ offers an exceptional automatic program, autopro2. AutoPro2 optimizes audibility within two distinct listening destinations: quiet and group/party noise. The two destinations provide distinct audiological goals by using independent features that can be applied differently in each destination. For listening in quiet environments the goal is to provide maximum audibility without having to account for distracting background noise sources. In noisy environments autopro2 employs a multiband directional microphone strategy and additional adaptive features to account for sources of distracting background noises. We know that individuals with severe to profound hearing loss are often required to give their full attention to the listening task at hand. They are very accustomed to staying in tune with the visuals around them, such as changes in body language, facial expressions and speech reading cues. Their hearing instrument should be designed to assist them in all these situations, autopro2 is preset to provide optimal audibility without effecting sound awareness in either a quiet or noisy environment. The settings in each autopro2 destination can be easily customized to suit the client s specific preferences. This includes adjusting frequency gain characteristics, microphone strategies, speech enhancement SP, noise reduction, wind noise manager, and antishock. The two destination automatic allows the fitter to customize automatic performance to each client s individual needs. As the client moves from a quiet to a noisy environment, autopro2 will detect and provide the optimal destination settings in the hearing instrument. As these settings take effect the client experiences a seamless transition that optimizes audibility and doesn t compromise sound awareness. AutoPro2 allows severe to profound clients to enjoy the benefits of an automatic program without compromising clarity or sound awareness. The independent destinations are preset to provide high client satisfaction, acceptance and optimum sound quality. U:fit Tip: Configure each destination (Quiet/Match Target and Group/Party Noise) independently in autopro2 to meet your audiological goals. 4

5 Bass Enhancer (360+) Bass enhancer is a new feature that specifically benefits individuals with a severe to profound hearing loss. Those with a hearing loss in this range may receive little or no benefit from amplification in the high frequencies. Even when it appears that there is usable hearing in some of the higher frequencies, the signal may be too sharp or distorted when given the amount of amplification required to match fitting targets. Spectral cues may prove to be of little value with this degree of hearing loss and the focus on providing distortion free temporal cues may become the primary goal. Output (db) MPO Output Bass Enhancer OFF Bass Enhancer ON Frequency (Hz) Bass enhancer provides increased output in the low frequencies for individuals who are able to utilize, or have a preference for extended low frequency listening cues. Combined with the larger receiver on a regular sized hearing aid, this feature allows distortion-free power, producing the cleanest signal possible. Gain and MPO can then be raised in tandem with sufficient headroom for the power sensation that clients may prefer. The increased audibility in this area gives access to the distinctions of rhythm, voicing cues, manner of articulation and prosody. Additionally, bass enhancer may provide greater accessibility to cues for detection discrimination of most of the vowel sounds, and some of the consonants. U:fit Tip: With the flexibility to adjust this parameter for a 3 or 6 db enhancement, this feature can be fine-tuned to provide a balance between comfort and loudness levels. AntiShock 360 not only provides exceptional power, it also controls transient signals and impulse sounds so they do not overwhelm critical speech and environmental information. The abrupt sound of a door being slammed or keys dropping into a glass dish would startle most people. For a hearing aid wearer, these transient or impulse sounds can be jolting. AntiShock is an adaptive, nearly instantaneous algorithm that detects and reduces the leading edge of both soft and loud transients. This is all accomplished in a fraction of a millisecond, which is inaudible to the human ear. A normal relationship is maintained between speech and impulse signals so that intense transients do not mask the sound quality of the speech signal. Unlike other competitive products, this unique feature also maintains audibility of the transient and only reduces it to a comfortable level, so the client can still be fully aware of the environment and of the relationships between the various sounds. amplitude amplitude AntiShock OFF time Recorded output of hearing instrument for a signal containing speech with 4 impulse sounds. AntiShock reduces peak level of impulse sound while maintaining sound awareness and not affecting speech signals. AntiShock ON time AntiShock is the most sophisticated impulse suppression technology available and it s fully configurable by program. This feature is available on Unitron Hearing s entire line of digital hearing instruments. U:fit Tip: This feature can be configured to off, mild, moderate, or maximum reduction in Adjustments made will be applied to both programs simultaneously in autopro2 and can be set to individual preferences in manual programs. In 360e, antishock can be configured on or off in each program. 5

6 Noise Reduction There is a fine line between environmental awareness and excessive environmental noise. For a severe to profound hearing loss client they will need to establish with their fitter the best balance in order to maintain sound awareness and eliminate annoying environmental noises. Steady state noises such as fans, air conditioners, fridge motors, and car noises can all be fatiguing especially when having a conversation or listening to music. While some environmental sounds can be quite bothersome, individuals with a hearing loss in this category may prefer to hear some environmental noise in order to maintain an awareness of their surroundings. To that end, Unitron Hearing has introduced a less aggressive noise reduction model with a maximum noise reduction strength of 6 db. The 360 noise reduction feature operates only in those frequencies where the noise signal is dominant and there is no usable speech. The power requirement for conversation is maintained in frequencies where speech is the dominant signal. The sophisticated classifier analyzes each band along three dimensions, including how much the intensity levels change, how often the peak intensity changes, and how long the signal lasts. The classifier correctly indentifies whether the signal is noise that should be reduced for comfort, or whether it is a desirable speech or music signal. This allows speech enhancement SP and noise reduction to be complimentary to each other and gives the hearing aid wearer the greatest access to speech cues while reducing unwanted sounds for comfort. With intelligent noise reduction there are few requirements for the user to adjust the volume control in any of their listening environments. The noise reduction feature is available on many of Unitron Hearing s digital hearing instruments. U:fit Tip: For 360+, there is an option to adjust in 2 db steps and tailor each listening situation to allow a mild, moderate or maximum level of noise reduction. Noise reduction can be turned off if the individual prefers to receive maximum information from environmental sounds. In 360e, there is an option to turn this parameter on or off. Author: Sherry Bowman, M.CI.Sc 360 feature articles available: 1. Power. Uncompromised. 2. Delivering Advance Features Tailored for Severe to Profound Hearing Loss Built for Real-life. Built Enviro-Tough For more information on 360, visit