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AUDIOLOGICAL FOUNDATIONS Dr. Sharmala
Naidoo Chief Audiologist, IDF Luzern, April 1999

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Research and Development

• Initial phases of specifications with Dr. Harvey
  Dillon
• Overall Audiology concept with Dr. Charles Berlin
• Details for Software specifications with Dr. Bob
  Traynor and Sister Companies
• Validation
• - Software
• - Sister companies
• - Super Users Group International (SUGI)
• - Product and Audiology concept testing on
  patients
• -In-house testing (Switzerland)
• -Multi-Site Clinical Field Trials
• - Dr. Ruth Bentler and Dr. Dave Fabry (USA)
• - Greg Upfold (Australia)

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Chuck
Dave
Ruth
Harvey
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GOAL Provide the customer with user-friendly
software package based on validated audiological
implementation of technologically advanced
features that will ensure user/patient
satisfaction and produce a
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• Fitting Rationales
• Formulated on the average ear
• 1. Familiar loudness based non-linear
  fitting rationales
• -Fig. 6 and DSL I/O
• 2. Maximization of Speech Intelligibility
• - New NAL NL1

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Predicting speech intelligibility

• Basic Speech Intelligibility Index (SII)
• Previously known as Articulation Index (AI)
• SII S Ai.Ii

Ai
30
1/3 octave SPL
Threshold
Frequency Harvey Dillon, 1999
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The Speech Intelligibility Index (SII)
also known as Articulation Index (AI)

• SII audibility x importance

Harvey Dillon, 1999
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Some details on NAL NL1Harvey Dillon, 1999

• Calculate total loudness
• Articulation Index (AI) modified
• Speech intelligibility for hearing impaired
• Corrections for losses gt 40 dB HL
• Hearing Loss Desensitization
• 52 audiograms

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With the 52 audiograms. Harvey Dillon, 1999

• Input audiogram
• Choose an overall level of speech e.g. 40 dB SPL
• Computer manipulates gain
• Calculates overall loudness and SII
• Continues to change gain until maximal SII
• Repeat for levels from 50-90 dB SPL
• Repeat for 51 audiograms

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Simplified by a formula Harvey Dillon, 1999

• Hearing threshold at a frequency
• Three frequency average
• Slope of audiogram
• Overall level of speech input signal
• Long formula with insertion gain at each
  frequency and each speech level

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Complicated!!

• NAL NL1 software program simplifies process
• Do not see the formula
• Bernafon special version simplifies it further
• NAL NL1 selected
• All taken care of

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Preliminary Evidence of NAL NL1 Harvey Dillon,
1999

• NAL NL1 versus IHAFF
• Quiet
• - 10 prefer NAL NL1
• - 5 no preference
• Noise
• 12 prefer NAL NL1
• 5 have no preference
• Higher speech intelligibility with flat losses

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Average based rationales..

• Loudness and speech intelligibility rationales
  are based on average data
• Rationales used as a starting point
• Fine tuning conducted to focus on the patient
• What about the individuals unique properties of
  the ear and hearing?

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• What about individualizing the fitting
  rationales to the patients ear ?
• take into account
• dimensions of the ear
• hearing aid shell
• hearing aid acoustics

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Individualizing the fitting.

• Built in Sine Generator
• Verification of comfort and loudness
• Simplified method
• Quick and easy
• Decrease fine tuning
• Decrease return visits
• Patients Benefit from the verification

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BENEFIT!

• Verification
• ensure comfort for moderate sounds
• appropriate maximum power output when hearing aid
  is in saturation

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Implementation into SoftwareRoger Weber

• Programming stages of the Alpha version
• Preliminary sample
• Testing
• Bern
• Sisters
• SUGI
• Field Trials

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Summary

• Enhanced sound quality, comfort, and clarity.
• Familiar loudness based fitting rationales of
  Fig.6 and DSL I/O.
• Improved speech intelligibility through the new
  NALNL1 fitting rationale.
• Personalized verification of comfort and loudness
  judgements through BENEFIT.
• Decreased feedback in most situation.

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Summary continued.

• Optimal performance in various listening
  environments through the access of multiple
  memories.
• Closer match of target responses through the use
  of a flexible five band movable equalization
  filter.
• Quick fitting sessions made possible through a
  user-friendly software interface.

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Summary continued...

• Many new features
• Validation through tests on patients
• at Bernafon in Switzerland
• International clinical field trials in Australia
  and USA
• Provide us with case studies and much more.

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