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Hearing Disorders: HELP
Articles by Todd A. Ricketts
Based on 17 articles published since 2010
(Why 17 articles?)

Between 2010 and 2020, Todd Ricketts wrote the following 17 articles about Hearing Disorders.
+ Citations + Abstracts
1 Review Hearing, Emotion, Amplification, Research, and Training Workshop: Current Understanding of Hearing Loss and Emotion Perception and Priorities for Future Research. 2018

Picou, Erin M / Singh, Gurjit / Goy, Huiwen / Russo, Frank / Hickson, Louise / Oxenham, Andrew J / Buono, Gabrielle H / Ricketts, Todd A / Launer, Stefan. ·1 Vanderbilt University School of Medicine, Nashville, TN, USA. · 2 Phonak Canada, Mississauga, ON, Canada. · 3 Department of Speech-Language Pathology, University of Toronto, ON, Canada. · 4 Department of Psychology, Ryerson University, Toronto, ON, Canada. · 5 School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia. · 6 Department of Psychology, University of Minnesota, MN, USA. · 7 Sonova AG, Stäfa, Switzerland. ·Trends Hear · Pubmed #30270810.

ABSTRACT: The question of how hearing loss and hearing rehabilitation affect patients' momentary emotional experiences is one that has received little attention but has considerable potential to affect patients' psychosocial function. This article is a product from the Hearing, Emotion, Amplification, Research, and Training workshop, which was convened to develop a consensus document describing research on emotion perception relevant for hearing research. This article outlines conceptual frameworks for the investigation of emotion in hearing research; available subjective, objective, neurophysiologic, and peripheral physiologic data acquisition research methods; the effects of age and hearing loss on emotion perception; potential rehabilitation strategies; priorities for future research; and implications for clinical audiologic rehabilitation. More broadly, this article aims to increase awareness about emotion perception research in audiology and to stimulate additional research on the topic.

2 Clinical Trial Efficacy of hearing-aid based telephone strategies for listeners with moderate-to-severe hearing loss. 2013

Picou, Erin M / Ricketts, Todd A. ·Vanderbilt University Medical Center, Nashville, TN. ·J Am Acad Audiol · Pubmed #23231817.

ABSTRACT: BACKGROUND: Understanding speech over the telephone when listening in noisy environments may present a significant challenge for listeners with moderate-to-severe hearing loss. PURPOSE: The purpose of this study was to compare speech recognition and subjective ratings across several hearing aid-based telephone listening strategies for individuals with moderate-to-severe sensorineural hearing loss. RESEARCH DESIGN: Speech recognition and subjective ratings were evaluated for a simulated telephone signal. The strategies evaluated included acoustic telephone, unilateral telecoil, unilateral wireless streaming, and bilateral wireless streaming. Participants were seated in a noisy room for all evaluations. STUDY SAMPLE: Eighteen adults, aged 49-88 yr, with moderate-to-severe sensorineural hearing loss participated. DATA COLLECTION AND ANALYSIS: Speech recognition scores on the Connected Speech Test were converted to rationalized arcsine units and analyzed using analysis of variance testing and Tukey post hoc analyses. Subjective ratings of ease and comfort were also analyzed in this manner. RESULTS: Speech recognition performance was poorest with acoustic coupling to the telephone and best with bilateral wireless routing. Telecoil coupling resulted in better speech recognition performance than acoustic coupling, but was significantly poorer than bilateral wireless routing. Furthermore, unilateral wireless routing and telecoil coupling generally led to similar speech recognition performance, except in lower-level background noise conditions, for which unilateral routing resulted in better performance than the telecoil. CONCLUSIONS: For people with moderate-to-severe sensorineural hearing loss, acoustic telephone listening with a hearing aid may not lead to acceptable performance in noise. Although unilateral routing options (telecoil and wireless streaming) improved performance, speech recognition performance and subjective ratings of ease and comfort were best when bilateral wireless routing was used. These results suggest that wireless routing is a potentially beneficial telephone listening strategy for listeners with moderate-to-severe hearing loss who are fitted with limited venting if the telephone signal is routed to both ears. Unilateral wireless routing may provide similar benefits to traditional unilateral telecoil. However, the newer wireless systems may have the advantage for some listeners in that they do not include some of the positioning constraints associated with telecoil use.

3 Article Musician and Nonmusician Hearing Aid Setting Preferences for Music and Speech Stimuli. 2019

D'Onofrio, Kristen L / Gifford, René H / Ricketts, Todd A. ·Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN. ·Am J Audiol · Pubmed #31091118.

ABSTRACT: Purpose The purpose of this study was to evaluate potential group differences between musicians and nonmusicians in their self-adjusted (SA) gain and compression settings for both music and speech stimuli. Speech recognition, sound quality, and strength of preference for the SA settings and the original prescriptive (National Acoustic Laboratories-Nonlinear 2 [NAL-NL2]) settings were also compared. Method Participants included 12 musician ( M = 60 years) and 12 nonmusician ( M = 55 years) adult hearing aid users with mild-moderate hearing loss, on average. Self-adjustments were made to hearing aid gain and compression settings for 2 music stimuli and a speech stimulus. Speech recognition in quiet and noise, sound quality for 6 dimensions (clarity, pleasantness, naturalness, fullness, brightness, and overall impression), and strength of preference ratings using paired comparisons were then assessed at both the NAL-NL2 settings and the participants' SA settings. Results On average, self-adjustments made by both groups were quite small (< 5 dB for gain and < 0.5 for compression ratio). Furthermore, SA changes to gain and compression ratio were not significantly different for musicians versus nonmusicians or for music versus speech. Finally, speech perception performance and sound quality ratings did not differ for the SA settings versus the NAL-NL2 settings, with the exception of the naturalness sound quality dimension. Conclusions These data suggest that a gain-frequency response specific to musicians and/or music inputs may not be necessary. Thus, current, validated prescriptive methods continue to be well supported as an appropriate starting place for listeners with mild-moderate hearing loss using open hearing aid fittings.

4 Article The relationship between speech recognition, behavioural listening effort, and subjective ratings. 2018

Picou, Erin M / Ricketts, Todd A. ·a Vanderbilt University Medical Center , Nashville , TN , USA. ·Int J Audiol · Pubmed #29381097.

ABSTRACT: OBJECTIVE: The purpose of this study was to evaluate the reliability and validity of four subjective questions related to listening effort. A secondary purpose of this study was to evaluate the effects of hearing aid beamforming microphone arrays on word recognition and listening effort. DESIGN: Participants answered subjective questions immediately following testing in a dual-task paradigm with three microphone settings in a moderately reverberant laboratory environment in two noise configurations. Participants rated their: (1) mental work, (2) desire to improve the situation, (3) tiredness, and (4) desire to give up. Data were analysed using repeated measures and reliability analyses. STUDY SAMPLE: Eighteen adults with symmetrical sensorineural hearing loss participated. RESULTS: Beamforming differentially affected word recognition and listening effort. Analysis revealed the same pattern of results for behavioural listening effort and subjective ratings of desire to improve the situation. Conversely, ratings of work revealed the same pattern of results as word recognition performance. Ratings of tiredness and desire to give up were unaffected by hearing aid microphone or noise configuration. CONCLUSIONS: Participant ratings of their desire to control the listening situation appear to reliable subjective indicators of listening effort that align with results from a behavioural measure of listening effort.

5 Article Hearing Technology Use and Management in School-Age Children: Reports from Data Logs, Parents, and Teachers. 2017

Gustafson, Samantha J / Ricketts, Todd A / Tharpe, Anne Marie. ·Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University School of Medicine, Nashville, TN. ·J Am Acad Audiol · Pubmed #29130436.

ABSTRACT: BACKGROUND: Consistency of hearing aid and remote microphone system use declines as school-age children with hearing loss age. One indicator of hearing aid use time is data logging, another is parent report. Recent data suggest that parents overestimate their children's hearing aid use time relative to data logging. The potential reasons for this disparity remain unclear. Because school-age children spend the majority of their day away from their parents and with their teachers, reports from teachers might serve as a valuable and additional tool for estimating hearing aid use time and management. PURPOSE: This study expands previous research on factors influencing hearing aid use time in school-age children using data logging records. Discrepancies between data logging records and parent reports were explored using custom surveys designed for parents and teachers. Responses from parents and teachers were used to examine hearing aid use, remote microphone system use, and hearing aid management in school-age children. STUDY SAMPLE: Thirteen children with mild-to-moderate hearing loss between the ages of 7 and 10 yr and their parents participated in this study. Teachers of ten of these children also participated. DATA COLLECTION AND ANALYSIS: Parents and teachers of children completed written surveys about each child's hearing aid use, remote microphone system use, and hearing aid management skills. Data logs were read from hearing aids using manufacturer's software. Multiple linear regression analysis and an intraclass correlation coefficient were used to examine factors influencing hearing aid use time and parent agreement with data logs. Parent report of hearing aid use time was compared across various activities and school and nonschool days. Survey responses from parents and teachers were compared to explore areas requiring potential improvement in audiological counseling. RESULTS: Average daily hearing aid use time was ∼6 hr per day as recorded with data logging technology. Children exhibiting greater degrees of hearing loss and those with poorer vocabulary were more likely to use hearing aids consistently than children with less hearing loss and better vocabulary. Parents overestimated hearing aid use by ∼1 hr per day relative to data logging records. Parent-reported use of hearing aids varied across activities but not across school and nonschool days. Overall, parents and teachers showed excellent agreement on hearing aid and remote microphone system use during school instruction but poor agreement when asked about the child's ability to manage their hearing devices independently. CONCLUSIONS: Parental reports of hearing aid use in young school-age children are largely consistent with data logging records and with teacher reports of hearing aid use in the classroom. Audiologists might find teacher reports helpful in learning more about children's hearing aid management and remote microphone system use during their time at school. This supplementary information can serve as an additional counseling tool to facilitate discussion about remote microphone system use and hearing aid management in school-age children with hearing loss.

6 Article How directional microphones affect speech recognition, listening effort and localisation for listeners with moderate-to-severe hearing loss. 2017

Picou, Erin M / Ricketts, Todd A. ·a Department of Hearing and Speech Sciences , Vanderbilt University Medical Center , Nashville , TN , USA. ·Int J Audiol · Pubmed #28738747.

ABSTRACT: OBJECTIVE: The purpose of this study was to evaluate the effects of directional microphone use on laboratory measures of sentence recognition, listening effort and localisation. An additional purpose of this study was to evaluate the effects of asymmetric directional microphone use on the same laboratory measures. DESIGN: Three hearing aid conditions were evaluated: (1) bilateral omnidirectional microphones, (2) bilateral directional microphones and (3) asymmetric microphones (directional microphone for only one hearing aid). Sentence recognition performance was evaluated using a connected speech test. Listening effort was evaluated using a dual-task paradigm with a response time-based secondary task requiring word categorisation. Localisation was examined using a complex task requiring localisation and recall of speech originating from one of four loudspeakers in the horizontal plane (-60°, -45°, +45°, +60°). STUDY SAMPLE: Eighteen adults (M = 61.8 years) with symmetrical, moderate-to-severe hearing loss participated. RESULTS: Performance on each task was analysed separately using a repeated measures analysis of variance. Results revealed directional benefits for sentence recognition and listening effort, but microphone setting did not affect localisation. Performance was equivalent with symmetric and asymmetric directional configurations. CONCLUSIONS: Bilateral and asymmetric directional microphone configurations equally improved sentence recognition and listening effort; neither affected localisation or recall.

7 Article Directional Microphone Hearing Aids in School Environments: Working Toward Optimization. 2017

Ricketts, Todd A / Picou, Erin M / Galster, Jason. ·Vanderbilt University Medical Center, Nashville, TN. · Starkey Hearing Technologies, Eden Prairie, MN. ·J Speech Lang Hear Res · Pubmed #28114614.

ABSTRACT: Purpose: The hearing aid microphone setting (omnidirectional or directional) can be selected manually or automatically. This study examined the percentage of time the microphone setting selected using each method was judged to provide the best signal-to-noise ratio (SNR) for the talkers of interest in school environments. Method: A total of 26 children (aged 6-17 years) with hearing loss were fitted with study hearing aids and evaluated during 2 typical school days. Time-stamped hearing aid settings were compared with observer judgments of the microphone setting that provided the best SNR on the basis of the specific listening environment. Results: Despite training for appropriate use, school-age children were unlikely to consistently manually switch to the microphone setting that optimized SNR. Furthermore, there was only fair agreement between the observer judgments and the hearing aid setting chosen by the automatic switching algorithm. Factors contributing to disagreement included the hearing aid algorithm choosing the directional setting when the talker was not in front of the listener or when noise arrived only from the front quadrant and choosing the omnidirectional setting when the noise level was low. Conclusion: Consideration of listener preferences, talker position, sound level, and other factors in the classroom may be necessary to optimize microphone settings.

8 Article The Effects of Directional Processing on Objective and Subjective Listening Effort. 2017

Picou, Erin M / Moore, Travis M / Ricketts, Todd A. ·Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN. ·J Speech Lang Hear Res · Pubmed #28114609.

ABSTRACT: Purpose: The purposes of this investigation were (a) to evaluate the effects of hearing aid directional processing on subjective and objective listening effort and (b) to investigate the potential relationships between subjective and objective measures of effort. Method: Sixteen adults with mild to severe hearing loss were tested with study hearing aids programmed with 3 settings: omnidirectional, fixed directional, and bilateral beamformer. A dual-task paradigm and subjective ratings were used to assess objective and subjective listening effort, respectively, in 2 signal-to-noise ratios. Testing occurred in rooms with either low or moderate reverberation. Results: Directional processing improved subjective and objective listening effort, although benefit for objective effort was found only in moderate reverberation. Subjective reports of work and tiredness were more highly correlated with word recognition performance than objective listening effort. However, subjective ratings about control were significantly correlated with objective listening effort. Conclusions: Directional microphone technology in hearing aids has the potential to improve listening effort in moderately reverberant environments. In addition, subjective questions that probe a listener's desire to exercise control may be a viable method for eliciting ratings that are significantly related to objective listening effort.

9 Article Evaluation of the effects of nonlinear frequency compression on speech recognition and sound quality for adults with mild to moderate hearing loss. 2015

Picou, Erin M / Marcrum, Steven C / Ricketts, Todd A. ·* Deparment of Hearing and Speech Sciences, Vanderbilt University Medical Center , Nashville , USA. ·Int J Audiol · Pubmed #25731581.

ABSTRACT: OBJECTIVE: While potentially improving audibility for listeners with considerable high frequency hearing loss, the effects of implementing nonlinear frequency compression (NFC) for listeners with moderate high frequency hearing loss are unclear. The purpose of this study was to investigate the effects of activating NFC for listeners who are not traditionally considered candidates for this technology. DESIGN: Participants wore study hearing aids with NFC activated for a 3-4 week trial period. After the trial period, they were tested with NFC and with conventional processing on measures of consonant discrimination threshold in quiet, consonant recognition in quiet, sentence recognition in noise, and acceptableness of sound quality of speech and music. STUDY SAMPLE: Seventeen adult listeners with symmetrical, mild to moderate sensorineural hearing loss participated. Better ear, high frequency pure-tone averages (4, 6, and 8 kHz) were 60 dB HL or better. RESULTS: Activating NFC resulted in lower (better) thresholds for discrimination of /s/, whose spectral center was 9 kHz. There were no other significant effects of NFC compared to conventional processing. CONCLUSION: These data suggest that the benefits, and detriments, of activating NFC may be limited for this population.

10 Article The effect of changing the secondary task in dual-task paradigms for measuring listening effort. 2014

Picou, Erin M / Ricketts, Todd A. ·The Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennesse, USA. ·Ear Hear · Pubmed #24992491.

ABSTRACT: OBJECTIVES: The purpose of this study was to evaluate the effect of changing the secondary task in dual-task paradigms that measure listening effort. Specifically, the effects of increasing the secondary task complexity or the depth of processing on a paradigm's sensitivity to changes in listening effort were quantified in a series of two experiments. Specific factors investigated within each experiment were background noise and visual cues. DESIGN: Participants in Experiment 1 were adults with normal hearing (mean age 23 years) and participants in Experiment 2 were adults with mild sloping to moderately severe sensorineural hearing loss (mean age 60.1 years). In both experiments, participants were tested using three dual-task paradigms. These paradigms had identical primary tasks, which were always monosyllable word recognition. The secondary tasks were all physical reaction time measures. The stimulus for the secondary task varied by paradigm and was a (1) simple visual probe, (2) a complex visual probe, or (3) the category of word presented. In this way, the secondary tasks mainly varied from the simple paradigm by either complexity or depth of speech processing. Using all three paradigms, participants were tested in four conditions, (1) auditory-only stimuli in quiet, (2) auditory-only stimuli in noise, (3) auditory-visual stimuli in quiet, and (4) auditory-visual stimuli in noise. During auditory-visual conditions, the talker's face was visible. Signal-to-noise ratios used during conditions with background noise were set individually so word recognition performance was matched in auditory-only and auditory-visual conditions. In noise, word recognition performance was approximately 80% and 65% for Experiments 1 and 2, respectively. RESULTS: For both experiments, word recognition performance was stable across the three paradigms, confirming that none of the secondary tasks interfered with the primary task. In Experiment 1 (listeners with normal hearing), analysis of median reaction times revealed a significant main effect of background noise on listening effort only with the paradigm that required deep processing. Visual cues did not change listening effort as measured with any of the three dual-task paradigms. In Experiment 2 (listeners with hearing loss), analysis of median reaction times revealed expected significant effects of background noise using all three paradigms, but no significant effects of visual cues. CONCLUSIONS: None of the dual-task paradigms were sensitive to the effects of visual cues. Furthermore, changing the complexity of the secondary task did not change dual-task paradigm sensitivity to the effects of background noise on listening effort for either group of listeners. However, the paradigm whose secondary task involved deeper processing was more sensitive to the effects of background noise for both groups of listeners. While this paradigm differed from the others in several respects, depth of processing may be partially responsible for the increased sensitivity. Therefore, this paradigm may be a valuable tool for evaluating other factors that affect listening effort.

11 Article Potential benefits and limitations of three types of directional processing in hearing aids. 2014

Picou, Erin M / Aspell, Elizabeth / Ricketts, Todd A. ·1Vanderbilt University Medical Center, Nashville, Tennessee, USA; and 2JFK Johnson Rehabilitation Institute, Edison, New Jersey, USA. ·Ear Hear · Pubmed #24518429.

ABSTRACT: OBJECTIVES: The purpose of this study was to evaluate hearing aid users' performance on four tasks across three types of directional processing implemented by the same pair of commercially available behind-the-ear hearing aids. The three types of directional processing were mild, moderate, and strong. The mild processing aimed at emulating the directionality of an unoccluded ear. The moderate processing was a traditional adaptive directional type. The strong directional processing was a cue-preserving bilateral beamformer. The four tasks included gross localization, sentence recognition, listening effort, and subjective preference. METHODS: Eighteen adults aged 48 to 83 years ((Equation is included in full-text article.)= 69.1, σ = 10.9) with sensorineural hearing loss participated in this study. Each participant was fitted bilaterally and the three types of directional processing were matched for frequency response but varied by directionality (mild, moderate, and strong). Performance was always evaluated in background noise, which surrounded the listener. Sentence recognition was evaluated in low and moderate reverberation, while gross localization, listening effort, and subjective ratings were evaluated only in moderate reverberation. Sentence recognition and gross localization were evaluated using auditory-only and auditory-visual stimuli (talker's face visible). The gross localization task included assessment of the ability to identify the origin of words, in addition to the ability to recall those words. Listening effort was evaluated using auditory-visual stimuli and a dual-task paradigm where the secondary task was a simple reaction time to a visual stimulus. RESULTS: The results revealed similar gross localization abilities across moderate and strong directional processing when visual stimuli were present. Conversely, localization accuracy was significantly poorer with the strong directional processing than with moderate directional processing in auditory-only conditions, but only for signals presented at the greatest eccentricities (±60 degrees). Regardless of signal to noise ratio or degree of reverberation, the moderate and strong directional processing resulted in significantly better sentence recognition in noise than the mild directional processing. In addition, sentence recognition in moderate reverberation was significantly better with strong directional processing than with moderate directional processing (~ 4 to 12 rationalized arcsine units across conditions), regardless of signal to noise ratio. Although not statistically significant, the same trend was present in low reverberation. There were no significant differences in listening effort or subjective preference across directional processing. CONCLUSIONS: The strong directional processing, which was a cue-preserving bilateral beamformer, provided additional sentence recognition benefit in realistic listening situations. Furthermore, despite reducing the interaural differences, the authors measured no significant negative consequences on listening effort or subjective preference, although it is unknown whether differences might be found using more sensitive measures. In addition, gross localization was disrupted at large eccentricities if visual cues were not present. While further study is needed, these results support consideration of this cue-preserving, bilateral beamformer technology for patients who experience difficulty with speech recognition in noise, which is not adequately addressed by conventional directional hearing aid processing.

12 Article Test-retest reliability of probe-microphone verification in children fitted with open and closed hearing aid tips. 2013

Kim, Hannah / Ricketts, Todd A. ·Reston Ear Nose and Throat, PC, Reston, VA. ·J Am Acad Audiol · Pubmed #24047950.

ABSTRACT: PURPOSE: To investigate the test-retest reliability of real-ear aided response (REAR) measures in open and closed hearing aid fittings in children using appropriate probe-microphone calibration techniques (stored equalization for open fittings and concurrent equalization for closed fittings). RESEARCH DESIGN: Probe-microphone measurements were completed for two mini-behind-the-ear (BTE) hearing aids which were coupled to the ear using open and closed eartips via thin (0.9 mm) tubing. Before probe-microphone testing, the gain of each of the test hearing aids was programmed using an artificial ear simulator (IEC 711) and a Knowles Electronic Manikin for Acoustic Research to match the National Acoustic Laboratories-Non-Linear, version 1 targets for one of two separate hearing loss configurations using an Audioscan Verifit. No further adjustments were made, and the same amplifier gain was used within each hearing aid across both eartip configurations and all participants. Probe-microphone testing included real-ear occluded response (REOR) and REAR measures using the Verifit's standard speech signal (the carrot passage) presented at 65 dB sound pressure level (SPL). Two repeated probe-microphone measures were made for each participant with the probe-tube and hearing aid removed and repositioned between each trial in order to assess intrasubject measurement variability. These procedures were repeated using both open and closed domes. STUDY SAMPLE: Thirty-two children, ages ranging from 4 to 14 yr. RESULTS: The test-retest standard deviations for open and closed measures did not exceed 4 dB at any frequency. There was also no significant difference between the open (stored equalization) and closed (concurrent equalization) methods. Reliability was particularly similar in the high frequencies and was also quite similar to that reported in previous research. There was no correlation between reliability and age, suggesting high reliability across all ages evaluated. CONCLUSIONS: The findings from this study suggest that reliable probe-microphone measurements are obtainable on children 4 yr and older for both traditional unvented and open-canal hearing aid fittings. These data suggest that clinicians should not avoid fitting open technology to children as young as 4 y because of concerns regarding the reliability of verification techniques.

13 Article Speech recognition for bilaterally asymmetric and symmetric hearing aid microphone modes in simulated classroom environments. 2013

Ricketts, Todd A / Picou, Erin M. ·Vanderbilt University Medical Center, Department of Hearing and Speech Science, Dan Maddox Hearing Aid Research Laboratory, Vanderbilt Bill Wilkerson Center, Nashville, TN, USA. todd.a.ricketts@vanderbilt.edu ·Ear Hear · Pubmed #23524508.

ABSTRACT: OBJECTIVES: This study aimed to evaluate the potential utility of asymmetrical and symmetrical directional hearing aid fittings for school-age children in simulated classroom environments. This study also aimed to evaluate speech recognition performance of children with normal hearing in the same listening environments. DESIGN: Two groups of school-age children 11 to 17 years of age participated in this study. Twenty participants had normal hearing, and 29 participants had sensorineural hearing loss. Participants with hearing loss were fitted with behind-the-ear hearing aids with clinically appropriate venting and were tested in 3 hearing aid configurations: bilateral omnidirectional, bilateral directional, and asymmetrical directional microphones. Speech recognition testing was completed in each microphone configuration in 3 environments: Talker-Front, Talker-Back, and Question-Answer situations. During testing, the location of the speech signal changed, but participants were always seated in a noisy, moderately reverberant classroom-like room. RESULTS: For all conditions, results revealed expected effects of directional microphones on speech recognition performance. When the signal of interest was in front of the listener, bilateral directional microphone was best, and when the signal of interest was behind the listener, bilateral omnidirectional microphone was best. Performance with asymmetric directional microphones was between the 2 symmetrical conditions. The magnitudes of directional benefits and decrements were not significantly correlated. In comparison with their peers with normal hearing, children with hearing loss performed similarly to their peers with normal hearing when fitted with directional microphones and the speech was from the front. In contrast, children with normal hearing still outperformed children with hearing loss if the speech originated from behind, even when the children were fitted with the optimal hearing aid microphone mode for the situation. CONCLUSIONS: Bilateral directional microphones can be effective in improving speech recognition performance for children in the classroom, as long as child is facing the talker of interest. Bilateral directional microphones, however, can impair performance if the signal originates from behind a listener. However, these data suggest that the magnitude of decrement is not predictable from an individual's benefit. The results re-emphasize the importance of appropriate switching between microphone modes so children can take full advantage of directional benefits without being hurt by directional decrements. An asymmetric fitting limits decrements, but does not lead to maximum speech recognition scores when compared with the optimal symmetrical fitting. Therefore, the asymmetric mode may not be the best option as a default fitting for children in a classroom environment. While directional microphones improve performance for children with hearing loss, their performance in most conditions continues to be impaired relative to their normal-hearing peers, particularly when the signals of interest originate from behind or from an unpredictable location.

14 Article How hearing aids, background noise, and visual cues influence objective listening effort. 2013

Picou, Erin M / Ricketts, Todd A / Hornsby, Benjamin W Y. ·Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA. erin.picou@vanderbilt.edu ·Ear Hear · Pubmed #23416751.

ABSTRACT: OBJECTIVES: The purpose of this article was to evaluate factors that influence the listening effort experienced when processing speech for people with hearing loss. Specifically, the change in listening effort resulting from introducing hearing aids, visual cues, and background noise was evaluated. An additional exploratory aim was to investigate the possible relationships between the magnitude of listening effort change and individual listeners' working memory capacity, verbal processing speed, or lipreading skill. DESIGN: Twenty-seven participants with bilateral sensorineural hearing loss were fitted with linear behind-the-ear hearing aids and tested using a dual-task paradigm designed to evaluate listening effort. The primary task was monosyllable word recognition and the secondary task was a visual reaction time task. The test conditions varied by hearing aids (unaided, aided), visual cues (auditory-only, auditory-visual), and background noise (present, absent). For all participants, the signal to noise ratio was set individually so that speech recognition performance in noise was approximately 60% in both the auditory-only and auditory-visual conditions. In addition to measures of listening effort, working memory capacity, verbal processing speed, and lipreading ability were measured using the Automated Operational Span Task, a Lexical Decision Task, and the Revised Shortened Utley Lipreading Test, respectively. RESULTS: In general, the effects measured using the objective measure of listening effort were small (~10 msec). Results indicated that background noise increased listening effort, and hearing aids reduced listening effort, while visual cues did not influence listening effort. With regard to the individual variables, verbal processing speed was negatively correlated with hearing aid benefit for listening effort; faster processors were less likely to derive benefit. Working memory capacity, verbal processing speed, and lipreading ability were related to benefit from visual cues. No variables were related to changes in listening effort resulting from the addition of background noise. CONCLUSIONS: The results of this study suggest that, on the average, hearing aids can reduce objectively measured listening effort. Furthermore, people who are slow verbal processors are more likely to derive hearing aid benefit for listening effort, perhaps because hearing aids improve the auditory input. Although background noise increased objective listening effort, no listener characteristic predicted susceptibility to noise. With regard to visual cues, while there was no effect on average of providing visual cues, there were some listener characteristics that were related to changes in listening effort with vision. Although these relationships are exploratory, they do suggest that these inherent listener characteristics like working memory capacity, verbal processing speed, and lipreading ability may influence susceptibility to changes in listening effort and thus warrant further study.

15 Article Style preference survey: a report on the psychometric properties and a cross-validation experiment. 2013

Smith, Sherri L / Ricketts, Todd / McArdle, Rachel A / Chisolm, Theresa H / Alexander, Genevieve / Bratt, Gene. ·Research Service, Department of Veterans Affairs, James H. Quillen Veterans Affairs Medical Center, Mountain Home, TN 37684, USA. sherri.smith@va.gov ·J Am Acad Audiol · Pubmed #23357803.

ABSTRACT: BACKGROUND: Several self-report measures exist that target different aspects of outcomes for hearing aid use. Currently, no comprehensive questionnaire specifically assesses factors that may be important for differentiating outcomes pertaining to hearing aid style. PURPOSE: The goal of this work was to develop the Style Preference Survey (SPS), a questionnaire aimed at outcomes associated with hearing aid style differences. Two experiments were conducted. After initial item development, Experiment 1 was conducted to refine the items and to determine its psychometric properties. Experiment 2 was designed to cross-validate the findings from the initial experiment. RESEARCH DESIGN: An observational design was used in both experiments. STUDY SAMPLE: Participants who wore traditional, custom-fitted (TC) or open-canal (OC) style hearing aids from 3 mo to 3 yr completed the initial experiment. One-hundred and eighty-four binaural hearing aid users (120 of whom wore TC hearing aids and 64 of whom wore OC hearing aids) participated. A new sample of TC and OC users (n = 185) participated in the cross-validation experiment. DATA COLLECTION AND ANALYSIS: Currently available self-report measures were reviewed to identify items that might differentiate between hearing aid styles, particularly preference for OC versus TC hearing aid styles. A total of 15 items were selected and modified from available self-report measures. An additional 55 items were developed through consensus of six audiologists for the initial version of the SPS. In the first experiment, the initial SPS version was mailed to 550 veterans who met the inclusion criteria. A total of 184 completed the SPS. Approximately three weeks later, a subset of participants (n = 83) completed the SPS a second time. Basic analyses were conducted to evaluate the psychometric properties of the SPS including subscale structure, internal consistency, test-retest reliability, and responsiveness. Based on the results of Experiment 1, the SPS was revised. A cross-validation experiment was then conducted using the revised version of the SPS to confirm the subscale structure, internal consistency, and responsiveness of the questionnaire in a new sample of participants. RESULTS: The final factor analysis led to the ultimate version of the SPS, which had a total of 35 items encompassing five subscales: (1) Feedback, (2) Occlusion/Own Voice Effects, (3) Localization, (4) Fit, Comfort, and Cosmetics, and (5) Ease of Use. The internal consistency of the total SPS (Cronbach's α = .92) and of the subscales (each Cronbach's α > .75) was high. Intraclass correlations (ICCs) showed that the test-retest reliability of the total SPS (ICC = .93) and of the subscales (each ICC > .80) also was high. TC hearing aid users had significantly poorer outcomes than OC hearing aid users on 4 of the 5 subscales, suggesting that the SPS largely is responsive to factors related to style-specific differences. CONCLUSIONS: The results suggest that the SPS has good psychometric properties and is a valid and reliable measure of outcomes related to style-specific, hearing aid preference.

16 Article Horizontal plane localization in single-sided deaf adults fitted with a bone-anchored hearing aid (Baha). 2012

Grantham, D Wesley / Ashmead, Daniel H / Haynes, David S / Hornsby, Benjamin W Y / Labadie, Robert F / Ricketts, Todd A. ·Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA. d.wesley.grantham@vanderbilt.edu ·Ear Hear · Pubmed #22588268.

ABSTRACT: OBJECTIVES: : One purpose of this investigation was to evaluate the effect of a unilateral bone-anchored hearing aid (Baha) on horizontal plane localization performance in single-sided deaf adults who had either a conductive or sensorineural hearing loss in their impaired ear. The use of a 33-loudspeaker array allowed for a finer response measure than has previously been used to investigate localization in this population. In addition, a detailed analysis of error patterns allowed an evaluation of the contribution of random error and bias error to the total rms error computed in the various conditions studied. A second purpose was to investigate the effect of stimulus duration and head-turning on localization performance. DESIGN: : Two groups of single-sided deaf adults were tested in a localization task in which they had to identify the direction of a spoken phrase on each trial. One group had a sensorineural hearing loss (SNHL group; N = 7), and the other group had a conductive hearing loss (CHL group; N = 5). In addition, a control group of four normal-hearing adults was tested. The spoken phrase was either 1250 msec in duration (a male saying "Where am I coming from now?") or 341 msec in duration (the same male saying "Where?"). For the longer-duration phrase, subjects were tested in conditions in which they either were or were not allowed to move their heads before the termination of the phrase. The source came from one of nine positions in the front horizontal plane (from -79° to +79°). The response range included 33 choices (from -90° to +90°, separated by 5.6°). Subjects were tested in all stimulus conditions, both with and without the Baha device. Overall rms error was computed for each condition. Contributions of random error and bias error to the overall error were also computed. RESULTS: : There was considerable intersubject variability in all conditions. However, for the CHL group, the average overall error was significantly smaller when the Baha was on than when it was off. Further analysis of error patterns indicated that this improvement was primarily based on reduced response bias when the device was on; that is, the average response azimuth was nearer to the source azimuth when the device was on than when it was off. The SNHL group, on the other hand, had significantly greater overall error when the Baha was on than when it was off. Collapsed across listening conditions and groups, localization performance was significantly better with the 1250 msec stimulus than with the 341 msec stimulus. However, for the longer-duration stimulus, there was no significant beneficial effect of head-turning. Error scores in all conditions for both groups were considerably larger than those in the normal-hearing control group. CONCLUSIONS: : On average, single-sided deaf adults with CHL showed improved localization ability when using the Baha, whereas single-sided deaf adults with SNHL showed a decrement in performance when using the device. These results may have implications for clinical counseling for patients with unilateral hearing impairment.

17 Article Comparison of wireless and acoustic hearing aid-based telephone listening strategies. 2011

Picou, Erin M / Ricketts, Todd A. ·Vanderbilt University Medical Center, Department of Hearing and Speech Science, Nashville, TN 37232-8242, USA. erin.picou@vanderbilt.edu ·Ear Hear · Pubmed #20808225.

ABSTRACT: OBJECTIVE: The purpose of this study was to examine speech recognition through hearing aids for seven telephone listening conditions. DESIGN: Speech recognition scores were measured for 20 participants in six wireless routing transmission conditions and one acoustic telephone condition. In the wireless conditions, the speech signal was delivered to both ears simultaneously (bilateral speech) or to one ear (unilateral speech). The effect of changing the noise level in the nontest ear during unilateral conditions was also examined. Participants were fitted with hearing aids using both nonoccluding and occluding dome ear tips. Participants were seated in a room with background noise present and speech was transmitted to the participants without additional noise. RESULTS: There was no effect of changing the noise level in the nontest ear and no difference between unilateral wireless routing and acoustic telephone listening. For wireless transmission, bilateral presentation resulted in significantly better speech recognition than unilateral presentation. Bilateral wireless conditions allowed for significantly better recognition than the acoustic telephone condition for participants fitted with occluding ear tips only. CONCLUSION: Routing the signal to both hearing aids resulted in significantly better speech recognition than unilateral signal routing. Wireless signal routing was shown to be beneficial compared with acoustic telephone listening and in some conditions resulted in the best performance of all of the listening conditions evaluated. However, this advantage was only evident when the signal was routed to both ears and when hearing aid wearers were fitted with occluding domes. Therefore, it is expected that the benefits of this new wireless streaming technology over existing telephone coupling methods will be most evident clinically in hearing aid wearers who require more limited venting than is typically used in open canal fittings.