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Amplification and Assistive Devices (AAD)

Speech Map: Test Box Versus On-Ear

PP306 - Speech Map: Test Box vs. On-Ear

POSTERS

Location: Halls A1-A2

Instructional Level: Intermediate

Lead Presenter(s)

Katelin Van Lanen

Northern Illinois University

Disclosure(s): No financial or nonfinancial relationships to disclose.

PDF Handouts Slides

Contributor(s)

BK

Blythe H. Kitner, AuD

Clinical Associate Professor
Northern Illinois University
Northern Illinois University
Dekalb, Illinois

Disclosure(s): No financial or nonfinancial relationships to disclose.
King Chung, PhD

Professor
Mass General Hospital Institute of Health Professions
Mass General Hospital Institute of Health Professions

Disclosure(s): No financial or nonfinancial relationships to disclose.

PDF Slides

Abstract: The purpose of this study is to examine the relationship between hearing aid verification condition in open and closed fit conditions. The verification conditions included simulated real-ear measurements (S-REM) with open fit, real-ear aided response (REAR) with open fit, S-REM with occluded fit, and REAR with occluded fit with one manufacturer's receiver-in-the-canal devices. Following S-REM match to target, REAR test conditions were completed. Frequency specific mean differences in NAL-NL2 match to target were evaluated via ANOVA for each input level between conditions. Results reveal the differences between match to target via S-REM and REAR and open versus closed dome.

Summary:

Objective: The purpose of this study is to examine the relationship between hearing aid verification condition and match to NAL-NL2 target in both open fit and occluded fit conditions. The results of this study are important because there is paucity of the literature on the accuracy of simulated real-ear measurements (S-REM) when using the measured real-ear to coupler difference (RECD) for an open fit. Scollie (2016) found that venting effects with open fittings are not well-represented using RECD with a coupler-based measurement. Pumford and colleagues (2021) discussed the Verifit2 software update, which included transformations to complete open fitting couple-based measurements. The Verifit2 transformations for open-fit settings have not been verified and the accuracy of the transformations to meet NAL-NL2 targets are unknown.

Methods: This experimental study examined the difference of average match to target between hearing aid verification conditions in 13 adults (19 ears) with mild to moderate sensorineural hearing loss while using measured RECD. The verification conditions included S-REM in the open fit condition, real-ear aided response (REAR) with an open dome, S-REM in the occluded fit condition, and REAR with an occluded dome with one manufacturer's receive-in-the-canal devices. Following S-REM match to target, the REAR test condition was completed with each dome-type. Frequency specific mean differences at each input level between the verification conditions were evaluated via a total of 30 one-way ANOVAs. The results reveal the differences between match to target via S-REM and REAR and open versus occluded dome.

Results: Results for REAR with an open dome significantly deviated from target compared to S-REM in the open fit condition, meaning that less gain was provided with REAR with an open dome. Similarly, results for REAR with an occluded dome significantly deviated from target compared to S-REM in the occluded fit condition, meaning that less gain was also provided with REAR with an occluded dome. In the open fit REAR condition, there was more gain lost in the lower frequencies and in the occluded fit REAR condition, there was more gain lost in the higher frequencies.

Conclusion: REAR provides less gain than S-REM and this varies by frequency. Using an occluded dome versus an open dome does not resolve this difference. This demonstrates that matching to target with S-REM may provide less gain. Therefore, REAR continues to be the gold standard for fitting hearing aids with both open and occluded domes.
Learning Objectives:
Demonstrate knowledge of real-ear verification and coupler-based verification.
Evaluate the deviation from target when fitting open hearing aids in a test box using real-ear to coupler difference and simulated real-ear measurement.
Interpret and apply the results from this study to everyday clinical practice.