Improving hearing aid outcomes in background noise: An investigation of outcome measures and patient factors
2022-11
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Improving hearing aid outcomes in background noise: An investigation of outcome measures and patient factors
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2022-11
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Background noise is reported to be one of the most difficult listening environments by hearing aid users. Digital noise reduction and directional microphones have been added to hearing aids and remote microphones and frequency modulation systems as accessories to help augment speech understanding in background noise for hearing aid users. Despite having this technology, patients still have concerns in background noise. This indicates that there is still a need for evidence-based tools for assessing patient speech understanding needs as well as quantifying amplification benefits in noise to help improve these situations. This dissertation seeks to investigate the advantages and disadvantages of current evidence-based practices tools available for improving speech understanding in noise for individuals with hearing loss. Three main research findings are reported in this dissertation. The first study examined the viability of using functional near infrared spectroscopy (fNIRS), a tool that can be used to measure the hemodynamic response to neural activity in the brain. This study sought to examine if fNIRS is a viable clinical tool for assessing the impact of different listening conditions, speech materials, and hearing aid settings on listening effort. Behavioral data supported the impact of signal degradation on intelligibility and that syntactically complex speech results in greater difficulty parsing content. fNIRS data supported that this difficulty in parsing content could be considered listening effort due to contrasts in hemodynamic responses in the lateral inferior frontal gyrus between grammatically simple and complex constructions. Future work should consider evaluating fNIRS in an older hearing loss group with contrasting degrees of hearing loss and speech complexity. The second study examined the viability of using spectral-ripple modulation detection thresholds (SMD), a tool that could help assess a person's broadband spectral processing abilities as an alternative for a person's speech understanding in noisy environments. In this study, SMD thresholds were examined in a group with normal hearing and a group with hearing loss to determine the impact of bandwidth and intensity on SMD thresholds. Results revealed a significant difference in bandwidth and level within the hearing loss and normal hearing groups, but not across groups. Future work should examine this effect using audibility-controlled conditions across the listener groups, such as simulating a hearing aid in these situations to determine the impact of amplification on SMD thresholds. The final study examined various listener factors that could influence a person's noise tolerance. The acceptable noise level test was used as a metric for noise tolerance. The listener factors that were examined included personality traits, digits in noise ability, and working memory along with hearing aid factors to determine if they can predict a person’s acceptable noise level. Results revealed that the Device Oriented Subjective Outcome subscale of listening effort and the digits in noise task were able to predict the acceptable noise level of a hearing aid user. Future work should look at other patient factors to predict noise tolerance. These three research studies aimed to determine what tests can provide a better assessment of listening needs in noise for persons with hearing loss. The second goal was to determine if individual factors were able to predict a person’s ability to tolerate background noise. The end goal of these studies is to use this information along with future research to determine which individuals would benefit from specific hearing aid settings and/or auditory training based on outcome measures and individual factors.
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University of Minnesota Ph.D. dissertation. November 2022. Major: Speech-Language-Hearing Sciences. Advisors: Evelyn Davies-Venn, Peggy Nelson. 1 computer file (PDF); xiv 167 pages.
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Oeding, Kristi. (2022). Improving hearing aid outcomes in background noise: An investigation of outcome measures and patient factors. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/252322.
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