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1/29/2016
1
FM: It’s Not Just For Kids
Dan Stover, Au.D., F-AAA
Territory Manager – Government Services and National Accounts
Agenda
2
• Introduction
• Why FM and What Is It?
• Solution Approach
• Research
• Current Products
Hearing Aids Aren’t the Only Devices Able to Help the Hearing
Impaired…
3
Where Do Hearing Instruments Work Best?
4
• Directional microphones work best in the near field, like face to face
discussions, up to a distance of 1.5 meters (~5 feet).
1.5 m
1.5 m
1.5 m
1.5 m
5
Distance
Nois
e
Noisy environment
Quiet environment
Face to face discussions
Nois
eN
ois
eN
ois
e
Distance
?
How Do We Overcome Noise and Distance Limitations?
6
1. Bring the microphone to the source, cutting the distance
2. Optimize signal-to-noise ratio (SNR) at the source with beam former
3. Adaptively adjust wireless transmitter signal and/or increase the gain of the
receiver when the ambient noise level becomes higher
4. Reduce the receiver gain if no voice is present
What technology can deliver all of this?
1/29/2016
2
7
Distance
Nois
e
Noisy environment
Quiet environment
Face to face discussions
Nois
eN
ois
eN
ois
e
Distance
Hearing in noise and over distance
»FM
FM Basics
8
• Frequency Modulation
• Transmits on various frequencies, depending on company and technology
• Improves SNR by bringing voice from transmitter to receiver
FM Components
9
• Transmitter
– Directional vs. omni
– One speaker vs. many
– Various levels of control
• Receiver
– T-Coil
– Integrated into hearing aid
– Bluetooth
Bluetooth vs. FM
10
• Bluetooth can only connect to one receiver at once
• Usually omnidirectional
• Doesn’t have noise reduction to improve SNR
• More inexpensive*
Solution Approach
11
• The solution approach in hearing health care is a holistic approach.
• It is the practice that based on a hearing and listening needs assessment, which
includes
– the assessment of the hearing and listening situations, and
– a full audiological assessment
• A single product approach will in most cases not meet all listening and
communication needs
• A complete solution is more likely to address all needs and leads to happier
patients
Hearing Aids Aren’t Always Enough
12
• The solution will often include more than just hearing aids, as there are
limitations based on physics in the capabilities of hearing aids to address all
the needs.
• It is important to look at how hearing loss impacts the individual’s whole life
and that of his or her significant others, as the partner or friends.
• Customers need support which encompasses more than just hearing aids
and involves more than just the person with hearing loss.
1/29/2016
3
Benefits Of the Solution Approach
13
For your client:
• Achievement of higher satisfaction by covering effectively more hearing situations.
This will lead to:
– improved quality of life of the client
– improved quality of life of the partner
– better performance on the job
For you, the hearing care professional:
• Improve your business by offering more customer satisfaction
• Increased referrals
• Position your clinic as a provider of overall solutions
Timing Is Everything
14
• Though many fitters like to wait to introduce accessories, the complete solution
works best when recommended at the first visit
• Fitting of the different components can be spread out over time, starting with the
hearing aids
• This early introduction of the complete solution will automatically adjust the
expectation level of the hearing aids only, as these are no longer the full solution
• Do not wait until hearing aids don’t meet expectations before introducing full
solution, because it is less likely to be successful.
Sergei Kochkin – Multiple Environmental Listening Utility
15
• Research has effectively shown that customer satisfaction increases if more
listening situations are addressed by the hearing solution(s)
• Sergei Kochkin: Increasing hearing aid adoption through multiple environmental
listening utility. The Hearing Journal 2007; 60(11): 28-31.
From This Research:
16
Customer satisfaction with hearing aids is strongly associated with what we call
“multiple environmental listening utility” or MELU.
When consumers are satisfied with their ability to function in many listening
situations, their overall satisfaction is very high.
When they are satisfied in few situations, their overall satisfaction is very low.
Situational Satisfaction = Overall Satisfaction
17
Probability of recommending hearing aids as a function of multiple environmental listening utility (MELU) (n=2066)
0
10
20
30
40
50
60
70
80
90
100
% R
ecom
men
de
d h
earin
g a
ids
Listening Situations Satisfied
More From This Research
18
A wireless approach to increasing MELU
Clearly, hearing aid performance must be improved if we are to achieve wider-scale
acceptance of hearing aids as a solution to hearing loss.
In an earlier paper,* a wireless solution was proposed for hearing aid wearers.
This paper recommended:
• Miniaturized internal wireless receivers in every hearing aid
• Simplicity of operation for end-user
* Boothroyd A, Fitz K, Kindred J, et al: Hearing aids and wireless technology. Hear Rev 2007;14(6):44-47.
1/29/2016
4
Current FM Products
19
Comfort Audio
20
• Widest range of options
• Options for near and far field
• Transmitter and receiver adjustment, in some cases
• Digital signal
Microphone DM10
Micro Receiver DT20
Close Range, Low Noise (omni)
Microphone DM10
Receiver DH10
Close Range
Microphone DM10
Micro Receiver DT20
Microphone DM30
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5
Reduce Background Noise (directional)Avoid Distance AND Background Noise
Conference Microphone DC10
• PSE – Perceptual Speech enhancement:Emphasises speech, removes noise
• 4 different microphone modes: music, omni-wide, omni-narrow, zoom
• FFC – Free Frequency Check:Indicates suitable frequencies
• External microphone/Line-in
• Connection to mobile via Bluetooth
• Operating time: up to 8 hours
• Charging time: approx. 5 hours
Micro Receiver DT20
• SST receiver
• Mini receiver with digital sound processing and digital sound transfer
• Weighs approx. 1.5 g
• Connected to the hearing instrument’s audio boot (Europlug)
• Powered by the hearing instrument’s battery
• Programmed wirelessly with Programmer DT20
27
Main Differences
28
• 5->10
– Line in
– Volume control
– Searches for clean channel
• 10->20
– Integrated receiver
• 20->30
– Headphone socket
– Induction loop
• 30->90
– Zoom mic
– Bluetooth
Comfort Duett
1/29/2016
6
Comfort Duett
• Easy to use
• “Self clarifying” design
• Simple and intuitive
• Large sized buttons with contrast colored symbols
Flexible
• TV & Telephone-accessory
• Rechargeable batteries
Small and discreet
Comfort Duett user situations
Comfort Contego
Easy to use
• Clear display
• Long operating time (up to 20 hours)
Flexibel
• Directional mode– for conversations
• Omnidirectional mode – for large meetings
• TV-kit
• In the car, guided tours etc.
Excellent sound quality
• without time lag
Comfort Contego – at home Comfort Contego – in everyday situations
1/29/2016
7
• 10 dB Advantage is a compromise between different listening objectives
– remote talker
– own voice
– nearby environment
• For remote talker, a higher advantage is desirable, especially in higher
ambient noise levels
• For own voice and nearby signals, no advantage is required
• For speech in quiet conditions, 10 dB advantage is still a good starting
position
FM Compromise
37
Why Dynamic?
38
• Provides best possible SNR by adjusting based on input and environment
• More appropriate for a wider range of SNRs
SNR At Ear Level
40 45 50 55 60 65 70 75 80 85
40
35
30
25
20
15
10
5
0
-5
-10
-15
-20
No FM
Traditional FM
Dynamic FM
Surrounding Noise (dB SPL)
SN
R (
dB
)
HINT Results
(HINT) Words % correct (10 subjects)
54 63 68 73 80
dB (A)
0
20
40
60
80
100
%
Dynamic FM
Traditional FM
Thibodeau, 2007
What Is Roger?
41
Operates on
2.4 GHz band
(ISM), with
intelligent adaptive
protocols
Design-
integrated
receivers for
Phonak
hearing aids
Allows for
ultralow acoustic
delay and
reliable long-
range broadcast
The Evidence: Speech Understanding In Noise and Over
Distance
42
Dr. Linda Thibodeau
• University of Texas, Dallas
• Speech-in-noise testing
11 listeners using their own BTE hearing instruments
• Ages 16 to 78
• Randomized, blinded
• Different noise levels
15 normal hearing listeners (no hearing aids, no Roger)
Comparison of speech recognition scores between HI users with
a Roger system and normal hearing listeners
1/29/2016
8
The Test Set-Up
43
Speech Understanding In Noise - Roger vs. Normal Hearing
44
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Quiet 50 55 60 65 70 75 80
Pe
rce
nt co
rre
ct
Noise level (dB (A))
With Roger,
62%
better
Normal hearing listeners
(N=15)
Hearing aid users with
Roger (N=10)
Subjective Evidence
45
What the study participants actually said about Roger:
Clear,
I understood
really good
Very clear and
crisp,
comfortable
noise
Even with background
noise I could
understand the
speaker easily
Loved this! Easy to
understand
and background noise
was significantly reduced
• While both Roger and companion mics can overcome the negative effects of
distance on speech understanding, Roger provides some additional benefits:
– Optimizes SNR at the source with beamforming directional microphones
– Adaptively mixes the wireless microphone signal with the microphone of the
hearing instrument by increasing the gain of the Roger receiver in noisy
environments
– Reduces the gain when no speech is present
Roger vs. Companion Microphones
46
Difference In Speech Understanding
Roger Clip-On Mic vs. Phonak RemoteMic
47
Roger Clip-On Mic
Phonak
RemoteMic
0
10
20
30
40
50
60
70
80
90
100
Speech recognition
score (in %)
Jace Wolfe, 2014, Wireless Microphone Comparison
Quiet 55 65 75 80
Noise level
in dB(A)
Create a Dynamic SoundField With Existing Speakers
• Digimaster X
– Connect to receiver
– Reduce equipment needed
1/29/2016
9
Soundfield Amplification With Intelligence
• Simplicity of use
• Dynamic adjustment for a comfortable listening experience
• No feedback or echo
• Reduced speaker vocal strain
• Additional microphones through the MultiTalker Network
• Compatible with personal FM
inspiroDynaMic
Dig
iMaste
r
SNR Without a Wireless Microphone
• Noise is often equally distributed throughout a room
• Speech level drops over distance
N
S
N
S
Talker ListenerTalker
50
= ?
SNR With Traditional FM
N
S
N
SN
S+
Compression
S
HI mic
signal
FM signal FM + M
N
51
Directional Microphones
• The closer to the source, the more effective a
directional microphone
• Wireless microphones, especially lapel style,
which are not directional, miss out on an
opportunity for increased performance,
especially in noisy conditions
• When in doubt: listen to such systems in noisy
conditions and compare with an
omnidirectional wireless microphone systemS
N
52
Roger Pen and Roger EasyPen
53
Automatic Microphone Modes For Roger Pen and Roger
EasyPen
54
Conference Interview Lanyard
Orientation Horizontal In-between Vertical
Noise level Quiet
(<70 dB(A))
Noise
(>70 dB(A))
Quiet
Noisy
All levels
Pickup
distance
Up to 3 m
all around
Up to 1 m
frontal
4 m 1
m
20 cm
Signal
processing
Omni Fixed
Beamformer
NEW adaptive Beamformer Adaptive
Beamformer
1/29/2016
10
Roger Clip-On Mic
55
Feature Overview
56
Adaptive behavior
Noise cancellation
Mute
Microphone modes
Switching between
microphone modes
Audio input
Bluetooth to cell
phones
MultiTalker
Network
Receiver
compatibility
Docking station
Roger Clip-On Mic
Lapel mode
N.A.
(02) unlimited
Two ear level (03) or
one Roger MyLink (03)
Roger Pen
Conference mode
Interview mode
Lanyard mode
Automatic or Manual
(02) unlimited
(03) unlimited
Roger EasyPen
Conference mode
Interview mode
Lanyard mode
Automatic
(02) unlimited
(03) unlimited
Design-integrated Roger Receivers
57
• Roger offers all the following SNR enhancement factors in high noise
conditions:
1. Bringing the microphone to the source, cutting out the distance
2. Optimizing SNR at the source with beam former
3. Adaptively mixing transmitter signal gain and receiver gain
4. Reducing the gain when no voice is present
Why Roger?
58
Online Resources
• https://www.phonakpro.com/com/b2b/en/support/fm_supportcenter/fm_configurator
.html
• https://www.phonakpro.com/com/b2b/en/support/roger-support-center/roger-
configurator.html
• http://www.oticon.com/products/wireless-accessories/connectline/fm.aspx
• http://www.widex.com/en/hearing-aids/hearing-aid-accessories/dex-hearing-aid-
remote-controls/fm-dex
59
Listening Room