BAA MAGAZINE SUMMER 2017 DRAFT 4

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FEATURE Figure 1. Touchscreen display with ‘Final Consonant’ words from the CAPT test (Marriage et al 2001). testing, a pre-test was performed which allowed us to measure speech identification thresholds and to set the signal-to-noise ratio to an equivalent level of difficulty across listeners. We also tested listeners using standard localisation and speech discrimination in noise tests carried out in the crescent of sound, a clinical test set up for assessing spatial hearing (Kitterick et al. 2011). Each task was carried out for each microphone setting and the order was counter balanced between subjects. Results: There were no statistically significant differences between the three hearing aid microphone settings in terms of relative localisation and word identification scores in the spatial speech assessment. However, it was clear that in its current form, the relative localisation task was too difficult for the hearing aid users with performance rarely exceeding that expected by chance. While word identification scores were better than chance, they were still below those of normal hearing listeners tested at a difficultymatched signal-to-noise ratio. During standard localisation and speech discrimination tasks, the hearing aid user’s performance was far better than in the simultaneous test. Results fell within the expected range for the test performance of person with normal hearing, as suggested by the reference data (Kitterick et al 2011). However, this does not imply that their localisation and speech discrimination abilities have been restored to near-normal levels as the testing environment is unrealistic of everyday life situations. There was no significant difference between microphone settings. It is important to note that the standard test of localisation measured absolute localisation rather than relative localisation, far fewer speakers were utilised and the test was in silence rather than in the presence of the multiple sources of background noise in Bizley et al (2015). A hearing aid microphone performance diary, adapted from that of Cord et al (2002), was used to investigate the subjective experience of each of the three microphone settings. There was a vast variation in results (recorded on visual analogue scales for particular situations) and all participants struggled significantly in the presence of background noise and high reverberation levels. The only situation in which one setting out-performed the others was for situations where the target signal was directly in front of the participant, when the binaural beamformer was rated as providing a significant advantage. Conclusion The discrepancy between performance estimated using current clinical tests and the spatial speech assessment suggests that standard clinical tests may be over estimating the abilities of hearing impaired listeners to identify or localise sounds in noisy environments. Results from the hearing aid microphone diary show no significant difference between the performances of the three microphone settings as experienced by the participant. This highlights the need for further counselling to hearing aid users on the limitations on certain hearing aid settings to avoid unrealistic expectations. We were unable to determine whether the microphone settings influenced localisation in noise as the hearing aid users were unable to perform this task. While the difference in outcomes with this test and standard tests emphasises the need for a more sensitive clinical assessment tool, further adaptation of the simultaneous task is required for it be suitable for measuring performance with hearing impaired listeners. Further adaptations of the test are being explored as part of an on-going programme of work and are yielding promising outcomes. References Bizey, J., Elliott, N., Wood, K. & Vickers, D., 2015. Simultaneous Assessment of Speech Identification and Spatial Discrimination: A Potential Testing Approach for Bilateral Cochlear Implant Users?. Trends in Hearing , Volume 19, pp. 1-11. Cord, M. S. R., Walden, B. & Dyrlund, O., 2002. Relationship between laboratory measures of directional advantage and everyday success with directional microphone hearing aids. Journal of the American Academy of Audiology, Volume 15, pp. 353-364. Kitterick, P., Lovett, R., Goman, A.., 2011. The AB-York crescent of sound: An apparatus for assessing spatial listening skills in children and adults. Cochlear Implants International , 12(3), pp. 164-169. Marriage, J., Vickers, D., Baer, T. & Moore, B., 2011. Using speech perception measures to guide the choice of amplification. In: A Sound Foundation through Early Amplification. Staefa, Switzerland: Phonak, pp. 273-279. Volck, A. et al., 2015. Sound Localisation measured by eye tracking. International Journal of Audiology, 54(12), pp. 976-983. BAA MAGAZINE / SUMMER 2017 / 24
INFORMATION BAA Members – Education and Information Days We are asking you to have your say… To keep you informed, up to date, current in clinical best practice and future trends, BAA is keen to understand the best and most efficient ways to do that. So keep watching your inboxes as a survey is on its way to you. Please spare 5 minutes to respond when it arrives to you – your responses to this short survey really will help us to shape these events in the right way for you. In the meantime, please feel free to send any comments or feedback to BAA@fitwise.co.uk CPD Just a reminder that there are templates and examples of CPD activity available on the website. We would love to hear from any of you who can share any great advice or examples on reflective CPD writing. How would you split up the country? BAA MAGAZINE / SUMMER 2017 / 25
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