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A presentation on the Audibility Extender feature from Widex..
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Audibility Extender
Frequency lowering techniques
Available techniques either transpose or compress sound in the frequency domain
Aim is to make high frequency sounds audible
Frequency lowering techniques
This presentation
How does the Audibility Extender improve audibility?
Otherwise inaudible high frequency sounds are made audible Detection of
environmental sounds Identification of high
frequency speech sounds
How does theAudibility Extender function?
Linear frequency transposition:
/ Analyse spectrum/ Find sound/ Set target/ Transpose sound/ Filter sound/ Overlay sound
Preserves the temporal structure of sounds!
Dead regions in the cochleaKuk et al, 2009
Good hearing, good resolution
Low to high frequencies
Poorer hearing, poorer resolutionWhy use transposition?
Goodresolution
Moderateresolution
Poorresolution
Dead region
Evidence Based Practice
Subjective initial preference
High rating for simple stimuli (birdsong, music)
Initial lower rating for complex stimuli (speech)
Preference increases for speech
The Audibility Extender vs standard program setting
Auriemmo et al, 2009Kuk et al, 2006, 2007c
Language performanceHigh frequency speech sounds
Language performance
Spectral distribution of /s/
Important information: tense, possessiveness, plurals etc.
High frequency speech sounds
Pittman et al , 2003
Language performance
Improvement of perception and production of speech sounds documented in a wide range of studies
Audibility Extender studies
Kuk et al, 2009
Succesful use with children
Beneficial for language development
Especially high frequency consonant production
Increased confidence and self-esteem
Auriemmo et al, 2009
Succesful use with childrenSound examples showing improvement in /s/ sound
Initial fittingAuriemmo, 2009
After 6 weeks Auriemmo, 2009
They get some money and go outside and wait. They sit on the sidewalk until he comes. All of the kids want to buy some cold ice cream to eat.
Effects of training, acclimatisation and counselling
Training and acclimatisation is necessary to fully realise the potential of the Audibility Extender
Korhonen et al, 2008
Effects of training, acclimatisation and counselling
Councelling on expectations facilitates acceptance
Kuk et al, 2007b
Individualising the start frequency
The choice of an optimal start frequency contributes to the ultimate succes
Procedure for individual fine tuning is described in:
Kuk et al, 2007, Hearing Review
Main conclusions from studies
The Audibility Extender improves speech perception and production for children and adults with a severe-to-profound high frequency hearing loss
Initial low preference for speech sounds Counselling is necessary to facilitate acceptance Acclimatisation and training are essential for
improvements in speech perception/production Progress in language scores and acceptance occur fast
after targeted use of the Audibility Extender Individualising the start frequency further improves
performance on language tests Increase in confidence and self-esteem in school-aged
children
Recommendations on Audibility Extender use
Recommended audiogram range
Severe-to-profound high frequency hearing loss
Reasonable mid-frequency resolution
Do not lower if it can be amplified!
Recommendations on Audibility Extender use
Purpose is to improve audibility - primarily for speech sounds
Optimally set as first program Used on a 24/7 basis Combined with training
To encourage Audibility Extender use: Accept occasional (on-demand) use of Audibility Extender Accept use of a higher than needed start frequency Gradual adjustment of start frequency over time
Training and counselling!
Audibility Extender studiesAuriemmo J, Kuk F, Stenger P (2008). Criteria for Evaluating Performance of Linear Frequency Transposition
in Children, Hearing Journal, 61(4), 50-54
Auriemmo J, Kuk F, Lau C, Marshall S, Thiele N, Pikora M, Quick D, Stenger P (2009). Effect of Linear
Frequency Transposition on Speech Recognition and Production of School-Aged Children. Journal of the
American Academy of Audiology, 20(5)
Korhonen P, Kuk F (2008), Use of Linear Frequency Transposition in Simulated Hearing Loss. J Am Acad
Audiol, 19(10)
Kuk F, Korhonen P, Peeters H, Keenan D, Jessen A, Andersen H. (2006). Linear Frequency Transposition:
Extending the Audibility of High-Frequency Information, Hear Rev, 13(11), 42, 44-46, 48
Kuk F, Keenan D, Peeters H, Korhonen P, Hau O, Andersen H.(2007a). Critical Factors in Ensuring Efficacy of Frequency Transposition. Part 1: Individualizing the Start Frequency, Hear Rev 14(3): 60, 62-64, 66
Kuk F, Keenan D, Peeters H, Lau C, Crose, B.(2007b), Critical Factors in Ensuring Efficacy of Frequency Transposition. Part 2: Facilitating initial adjustment, Hearing Review, 14(4), 90, 92,95-96
Kuk F, Peeters H, Keenan D, Lau C (2007c), Use of Frequency Transposition in a Tin-Tube Open-Ear Fitting,
Hearing Journal, 60(4), 59-63
Kuk F, Keenan D, Korhonen P, Lau C (2009). Efficacy of Linear, Efficacy of Linear Frequency Transposition
on Consonant Identification in Quiet and Noise, J Am Acad Audiol , 20(8)
Smith J, Dann M, Brown M (2009), An Evaluation of Frequency Transposition for Hearing-Impaired School
Age Children. Deafness & Education International, 11 (2), 62-82
Where to find more information
www.widex.pro
Audibility Extender studies for download Fitting guidelines – fine tuning of start frequency Inspiration for training materials Contact information for further questions