TY - JOUR
T1 - Self-Adjustment of Hearing Aid Amplification for Lower Speech Levels
T2 - Independent Ratings, Paired Comparisons, and Speech Recognition
AU - Perry, Trevor T.
AU - Nelson, Peggy B.
N1 - Publisher Copyright:
© 2022 American Speech-Language-Hearing Association.
PY - 2022/6
Y1 - 2022/6
N2 - Purpose: Self-adjustment of hearing aid amplification enables wearers to cus-tomize 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 relation-ships 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. Method: 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. Results: 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 con-sistently high, and differences in speech recognition results were strongly corre-lated with the overall preferences obtained from paired comparisons. Conclusions: 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.
AB - Purpose: Self-adjustment of hearing aid amplification enables wearers to cus-tomize 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 relation-ships 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. Method: 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. Results: 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 con-sistently high, and differences in speech recognition results were strongly corre-lated with the overall preferences obtained from paired comparisons. Conclusions: 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.
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U2 - 10.1044/2022_AJA-21-00164
DO - 10.1044/2022_AJA-21-00164
M3 - Article
C2 - 35316099
AN - SCOPUS:85131270746
SN - 1059-0889
VL - 31
SP - 305
EP - 321
JO - American Journal of Audiology
JF - American Journal of Audiology
IS - 2
ER -