Fitting guide 1
This fitting guide gives an overview of how to fit ReSound LiNX wireless hearing instruments with ReSound Aventa 3.7. A ReSound LiNX 988 wireless binaural fitting is depicted. Not all features described in this fitting guide are applicable for LiNX 7 and 5 fittings, or for other models. The hearing instruments will appear in the Found Instruments section. Stop the process when all hearing instruments to be programmed have been found. Click on Beep for each hearing instrument to identify it, and assign it as a right or left device. When each hearing instrument has been assigned, click Continue. ReSound Aventa 3.7 fitting software supports all ReSound instruments built on the ReSound Range, Range II and Smart Range chips. Getting Started Prior to connecting to Aventa 3: 1. Attach the appropriate receiver for the patient s hearing loss to the hearing instruments. 2. ReSound devices require a battery when fitting. Make sure the battery is fresh and that it is inserted correctly. 3. a) For wireless fittings, insert Airlink in a USB slot on the fitting PC and wait for the message that new hardware has been found. Then open Aventa 3. b) For wired fittings, ensure that the programming interface (Speedlink, Hi-PRO or NOAHlink) is connected to the PC before launching Aventa 3. 4. Launch Aventa 3. For new fittings, Aventa 3 begins in the Start screen, where the patient s experience with amplification can be selected and connection to hearing instruments can be established. A window will appear showing the status of the connection, and will alert you to any recommendations for reconfiguration to a different receiver, based on the audiogram entered. Choose to either keep the Current configuration or another configuration. Ensure that the appropriate receiver chosen in this window is affixed to the hearing instrument. Click Continue. Remove the stickers from the size 312 batteries to activate them. Wait for 2 minutes for best results. Insert the battery into each hearing instrument. Click Connect in the upper right corner of the Aventa 3 Start screen. A window will provide vent configuration options. Choose the appropriate venting for the earmolds. Choose patient experience level Click Connect For wireless fittings, ensure Airlink is selected in the Connect Using: menu. Close the battery door of each hearing instrument to be programmed and click Connect. (To simulate a fitting, click Simulate. ) For wired fittings, choose the appropriate programming interface and connect the hearing instruments to the Speedlink, Hi-PRO or NOAHlink with the CS44 with Programming Adaptor; then click Connect. For high power hearing instruments such as the LN988, a window will alert you to the capability of the hearing instrument to exceed 132 db SPL. Click Continue. 2 3
A visualization of the connection process will appear. When device-to-device communication is enabled, program synchronization and Environmental Optimizer II will always be On. Throughout the fitting process, additional available deviceto-device communication features can be enabled or disabled. These available features include Binaural Directionality, Volume Synchronization, Synchronized SoftSwitching, Comfort Phone, and Synchronized Acceptance Manager. The device-to-device communication window keeps a continual record of the enabled device-to-device features. Next, a window will prompt calibration for DFS Ultra II. Click Calibrate to begin the calibration procedure. The progress of the calibration will be shown. Click Continue after calibration is completed. At this point, you may pair Unite accessories by clicking Unite Accessories, or proceed to the fitting by clicking Continue. In this guide Continue is selected. DFS calibration If DFS has not already been calibrated through the auto-prompt at the beginning of the fitting, it may be calibrated in the Fit screen. It is strongly recommended to always run the calibration at the start of a new fitting, or after any venting, dome, receiver, or earmold changes. This is because any such changes affect the feedback path and thus the performance of DFS Ultra II. Calibration button in the Fit screen Fitting the Hearing Instruments The Fit screen is displayed. In this screen, the hearing instrument gains and MPOs can be adjusted, and advanced features can be accessed. Maximum stable gain and Safe Fitting Once DFS Ultra II is calibrated, the Fit screen automatically opens with two shaded grey areas visible on the graph (in most cases). The darker grey shaded area indicates unavailable gain while the light grey indicates added maximum stable gain provided by DFS Ultra II. Maximum stable gain Unavailable gain Device-to-device communication ReSound LiNX supports device-to-device communication. The master switch to disable/enable this functionality can be found in the main menu under Instrument. The main menu in the header of the fitting software can be accessed in every Aventa 3.7 screen. If Safe Fitting is enabled, gain settings will be locked at the dark grey border. Safe Fitting can be turned off and on in the Fitting menu or set as a user preference. Note that if you have not calibrated DFS Ultra II, there will only be one shaded area which indicates the full-on gain of the particular hearing instrument. Device-to-device communication status and master switch 4 5
Safe Fitting On To remove a program, click on the red x next to the program name. Note that program removal can only occur for programs 2, 3 or 4; the first program cannot be deleted. Select the x to remove the program Safe Fitting Off Programs can also be directly copied and pasted into a different program in Aventa 3.7. Enter the program you want to copy and click Copy in the program handling toolbar. Then enter the Program you want to overwrite with the copied program and click Paste. Available programs to paste to are briefly highlighted in red. This copying and pasting of programs can be applied for one or both ears for each program except Binaural Directionality or Natural Directionality II, which require both ears to have the same program simultaneously. Copy and paste a program to another program Program management The Program tabs are located between the graph and the gain handles. This is where programs can be changed, compared, recalculated, autorelated, copied, added or removed. To the right of the 4 standard programs are the PhoneNow program tab and the wireless accessory program tabs. Program names that will appear on the user s iphone or accessory may be personalized by clicking Manage Program Names. Program names must be at least three characters, and programs may not share the same name. Program names longer than ten characters may be truncated. If changes are made, click Save. Program handling toolbar Manage Program Names options Aventa 3.7 now offers an easy way to reorder and remove programs, through the Manage Programs option in the program handling toolbar. To reorder a selected program, press the up or down arrow. Manage Programs option Select up or down arrow to re-order programs 6 7
Typical Program 1 Options Binaural Directionality (LiNX 9 level binaural hearing instrument fittings) Binaural Directionality uses ReSound s 2.4 GHz wireless technology to allow the hearing instruments to work together, dynamically selecting the best microphone response for the listening environment. The result may be a bilateral omnidirectional, bilateral directional or an asymmetric omnidirectional and directional response, depending on the analysis of speech and noise detectors from both hearing instruments. This provides the user with the optimal combination of speech understanding in noise plus a more natural sense of surroundings - even in the most difficult listening situations. It is available as a program. In the Advanced Features view (accessed under Tools in the left of the screen), it will appear as Automatic for each ear. Helpful Hint about Autorelating Gains: To ensure gains are autorelated appropriately at the end of the fitting, it may be helpful to establish a preference to prompt for autorelating when the fitting is saved. In the main menu, select Edit and then Preferences. For the entry Prompt for Autorelate on Save, select Prompt Each Time and click Save. This will prompt you to autorelate any gain changes you may have made to one program to any other program before completing the save process. Natural Directionality II (LiNX 9 and 7 level binaural hearing instrument fittings) Natural Directionality II for LiNX 9 level binaural hearing instrument fittings can selected by changing the Binaural Directionality advanced feature setting from Automatic to Focus Ear or Monitor Ear for each ear. It is also activated automatically when device-to-device communication is disabled. Selecting Focus Ear changes the other side to Monitor Ear and changes the program name to Natural Directionality II When device-to-device communication is disabled, choices for the Focus (fixed directional) and Monitor (omnidirectional) ears will automatically appear in the Advanced Features view. The Focus and Monitor ears are prescribed based on the audiogram and any speech audiometry data that may be available, but this selection can be reversed through Aventa. To return to Binaural Directionality, choose Automatic. For LiNX 7 level binaural hearing instrument fittings, Natural Directionality II is automatically selected as Program 1. Advanced features Feature settings including Sound Shaper, Low Frequency Boost, Expansion, DFS Ultra II, NoiseTracker II, and directional options are accessed by clicking Advanced Features in the Tools menu on the left side of the screen. These feature settings apply to the currently selected program. Selecting Advanced Features allows for changing feature settings Gain adjustment By default, Aventa calculates the gain settings for the particular audiogram using the Audiogram+ fitting rationale. To fine-tune a program, adjust the gain manually by using the gain handles or by using the Aventa Guide, where fine-tuning solutions to patient complaints can be automatically applied. Once fine-tuning is complete, the relative gain changes can be applied to any or all other programs by clicking the Autorelate button in the program handling tool bar beneath the program tabs. Select which programs to autorelate by checking the boxes. You may choose whether to apply changes made to MPO or Sound Shaper for each program. 8 9
Directionality Directional options in standard microphone programs (except Binaural Directionality and Natural Directionality II) include Omni, AutoScope Adaptive Directionality, SoftSwitching and Fixed Directionality. With AutoScope or MultiScope Adaptive Directionality, the beam width can be modified. The AutoScope option enables the beam width to automatically widen or narrow depending on the acoustic surroundings. The SoftSwitching option seamlessly enables and disables AutoScope/MultiScope Adaptive Directionality depending on the listening environment. The response can be either omnidirectional or directional, based on the signal-to-noise ratio and direction of speech in the listening situation. When device-to-device communication is activated, Synchronized SoftSwitching will be automatically applied. A fixed hypercardioid directional response can also be selected instead of the adaptive directional options. Auto DFS is a feature option that allows for a standard setting of DFS to be applied, in certain cases where it is not possible to calibrate DFS while the patient is wearing the hearing instrument (e.g. if the hearing instruments are being pre-programmed or if the patient is not present ). Auto DFS is automatically turned On when the No response is chosen for the auto-prompt to calibrate DFS. Auto DFS can also be turned Off in the Advanced Features section. If DFS has already been calibrated, the Auto DFS options ( On and Off ) are automatically grayed out. Auto DFS settings are grayed out when DFS Ultra II has already been calibrated Directional Mix All directional programs and options use the Directional Mix Processor, which applies a directional response for high frequencies and an omnidirectional response for low frequencies. The Directional Mix setting determines the degree of directionality in the output of the hearing instrument(s). Directional Mix applies omnidirectional processing below a crossover frequency and directional processing above that frequency. A higher Directional Mix setting indicates more of the signal is being processed with directionality, and the crossover frequency will be lower. For LiNX 9 level hearing instrument fittings, the Directional Mix setting can be adjusted in Aventa 3. The default setting (depicted in bold typeface when the menu for the feature is pulled down) is prescribed depending on the hearing instrument model selected and the degree of low-frequency hearing loss. When the Directional Mix setting is changed, the crossover frequency will be briefly highlighted on the gain display screen. Directional Mix option with temporary visualization of crossover frequency Sound Shaper Sound Shaper is a proportional frequency compression system. Its default setting is Off. The recommended setting, based on the audiogram, is in bold typeface when the menu options are pulled down. The frequency region affected by a change in Sound Shaper setting will be briefly highlighted on the gain display screen when it is activated. DFS Ultra II DFS Ultra II combines feedback cancellation and WhistleControl. Possible settings are Off, Mild, Moderate, Strong and Music Mode. Selecting the Off setting disables DFS Ultra II entirely. The Mild, Moderate, and Strong settings are most appropriate for speech and everyday inputs, and refer to the levels of WhistleControl that will be active together with the feedback cancellation. WhistleControl restores gain to the desired response in feedback-critical situations like phone use. The Music Mode setting controls feedback while maintaining a truer representation of music. Music Mode automatically incorporates a Mild degree of WhistleControl. The default setting for DFS Ultra II is Mild in every program except the Music program, in which the default setting is Music Mode. If gain increases are made during finetuning, or if intermittent feedback is reported by the patient, the setting should be changed to Moderate or Strong. Low Frequency Boost Low Frequency Boost can be applied for users desiring more gain from 250-1000 Hz. Low, Medium and High settings will be achieved unless the max gain has already been met at these frequencies. The frequency region affected by a change in Low Frequency Boost setting will be briefly highlighted on the gain display screen. 10 11
NoiseTracker II NoiseTracker II levels can be set to be environmentally dependent for all standard listening programs in LiNX 9 level hearing instrument fittings. This means that the degree of noise reduction applied at any moment depends on the listening environment. Per environment noise reduction levels can be reset to Default values, or the feature can be turned off by resetting to Zero. Alternately, fixed levels (e.g., Mild ) may be selected. For LiNX 7 and 5 level hearing instrument fittings, fixed levels of NoiseTracker II are available. WindGuard WindGuard uses signal processing to reduce wind noise, and is available at different settings Synchronized Acceptance Manager Synchronized Acceptance Manager allows for gradual gain increases from the current programmed gains to Experience - Non-linear gains or other fine tuned gains over a specified amount of time. The patient s average daily use can also be entered to personalize the fitting. This feature is set as a default to Off. Finetuned gain changes done at the current fitting can be preserved by selecting the checkbox. (Thus, if gains are decreased by 2 db at certain frequencies during the current fitting, the final levels will reflect a 2 db decrease at those frequencies with respect to the final or prescribed Experience Non-linear gains). Synchronization of this feature is recommended in case of a loss of one hearing instrument during the acclimatization time. Once activated, the Acceptance Manager progress will appear on the Fit screen. Final gain levels will appear as dotted lines. Physical properties Physical Properties can also be found in Tools on the Fit screen. Depending on the hearing instrument models being fitted, the dome and tube selection for open fittings as well as venting options for closed fittings can be entered. Selections in this screen affect the display of gains in the Fit screen. For example, when venting is changed, the amount of roll-off in the low frequencies will be adjusted to show how this physical change affects the expected real ear response. An option to (re)calibrate DFS is provided in case the change entered in Physical Properties accompanies a physical hardware change of the vent/tube/dome on the hearing instrument. To set a final level different than the Experience Non-linear gain prescription, move the Acceptance Manager Progress all the way to the right to 100% (i.e., A is next to B). Ensure the box above the gain handles indicates End Gains (B). Select the gain handles desired and fine tune the gains to the desired levels. Then move the Acceptance Manager Progress all the way to the left to 0%. Environmental Optimizer II (LiNX 9 level hearing instrument fittings) Another Tool in the Fit screen is the Environmental Optimizer II. Environmental Optimizer II allows specific gain and NoiseTracker II adjustments for a possible combination of seven different environments, ensuring the user receives optimal gain and noise reduction settings as the acoustic environment changes. If device-to-device communication is enabled, the hearing instruments will optimize and synchronize the Environmental Optimizer II gain and noise reduction settings for a binaural fitting (Binaural Environmental Optimizer II). LiNX 7 level hearing instrument fittings offer Environmental Optimizer, which allows specific gain adjustments only per environment. Beeps and Volume Control Once fine-tuning is complete, click on Beeps and Volume Control in the Tools section on the Fit screen. A window will appear with two tabs: Standard Beeps and Manual Controls. In the Standard Beeps tab, all the acoustic indicators can be demonstrated, changed, added and removed. Low or high frequency beeps can also be selected. Overall gain settings are optimized for the acoustic environment Click Adjust NoiseTracker II to view or alter noise reduction per environment settings Select which beeps will be activated Adjust beep levels and demo beeps 12 13
The Manual Controls tab contains options such as enabling and disabling the program button and adjusting the volume control range. Bluetooth Smart Devices Up to 5 Bluetooth Smart Devices can be paired to the hearing instruments, but pairing must occur outside of Aventa. This panel shows you the status of previously paired Bluetooth smart devices and also allows you to remove pairing to previously paired devices. The hearing instruments associated with these Bluetooth devices can also be viewed. Bluetooth Smart Devices and ReSound Unite Accessories Management The functionality for managing connectivity to Bluetooth smart devices and ReSound Unite accessories can be accessed both from the Pre-Fit and the Fit screens. Saving and Completing the Fitting Once the fitting is complete, click Save at the bottom right of the Fit or Summary screens. Once the data is saved to the hearing instruments and to the database, options to Exit Aventa or Continue Fitting appear in the lower right corner of the window. After the Save process, it is safe to disconnect the hearing instrument(s). If any changes are made after the save process, it will be necessary to re-save the data before disconnecting. To pair Unite wireless accessories with the hearing instruments, click Add and follow the instructions on the screen to put the selected accessory in pairing mode. Once the accessory is successfully paired, it is displayed with a graphic of the device and the Add button changes to Remove. Summary screen The Summary screen allows the clinician to print information for the patient, a third party, or for chart notes. Notes can be entered, saved and printed as needed. Once the Unite accessories are paired with the hearing instrument(s), click Done. Accessory pairing can also be achieved outside of Aventa, with the hearing instruments and the Unite accessory alone. Selecting the Edit Template button allows for customization of the clinician or patient report 14 15
ReSound helps people rediscover hearing. We develop hearing solutions that emulate the function of the natural ear, letting you forget your hearing loss and enabling you to live a rich, active and fulfilling life. ReSound LiNX TM, the world s smartest hearing aid and the world s first Made for iphone hearing aid let s you hear more of everything. From speech that s clear, strong and easy to understand, to your favorite music and the voices of your loved ones streamed from your iphone, ipad or ipod touch directly to your hearing aids. You ll enjoy an intuitive, effortless hearing experience like no other. www.resound.com/linx Worldwide headquarters United Kingdom Australia New Zealand ReSound A/S Lautrupbjerg 7 DK-2750 Ballerup Denmark Tel.: +45 45 75 11 11 Fax: +45 45 75 11 19 www.resound.com GN ReSound Ltd. Kirtlington Business Centre Portway Kirtlington Oxon OX5 3JA Tel.: +44 1869 352 800 Fax: +44 1869 343 466 GN ReSound Pty. Ltd. Unit R1 Regents Park Estate 391 Park Road Regents Park NSW 2143 Tel.: (free) 1800 658 955 Fax: 02 9743 7472 www.gnresound.com.au GN ReSound (NZ) Ltd. Ground Floor, North Entrance 4 Fred Thomas Drive Takapuna Auckland, 0622 Tel.: (free) 0800 900 126 Fax: (free) 0800 007 695 M201092-GB-14.07-Rev.A www.gnresound.co.uk www.gnresound.co.nz The trademarks listed are owned and used by The GN ReSound Group and its related affiliates. 2014. Apple, iphone, ipad and ipod touch are trademarks of Apple Inc., registered in the U.S. and other 16countries. Bluetooth is a trademark of Bluetooth SIG, Inc.