Radio Aids used in research studies

Phonak Microvox Connevans 220 Connevans Genie Sennheiser Microport

Phonic Ear 471R/ 475T Phonic Ear Solaris Phonak MLxS /MLx SmartLink & Campus S Tx

Fitting and Verification

We recommend that the initial fitting takes places at the CI centre when the user has a stable map and can report on sound quality

We liaise with local services about the optimum transmitting frequency and type of system requested

Validation Methods

Informal e.g. use of Ling sounds

Speech in Noise (or quiet) Task e.g. ATT

Electro-acoustic methods are being trialled

AIM 1

To establish compatibility of cochlear implant speech processors with commonly used FM systems Is interference an issue?

Do all systems work equally effectively over distance?

When new speech processors are released are there any new considerations?

Subjects

Older children and adults who were experienced CI users took part in the studies. A range of Nucleus speech processors were evaluated with radio aids

Research Methodology

The McCormick Automated Toy Test (ATT) was used to evaluate speech discrimination in noise and quiet. The format was modified to give a fixed noise level of 55dB(A) with the speech level varying, or with a fixed speech level of 70dB(A) and the noise level varying. In both formats the level at which the subject scores 71% correct is recorded

Results

• Speech discrimination scores in quiet and in noise improved on average when all FM systems were used• Sound quality at distance was rated as good by all subjects with all radio aids except the MLx at 10m when subjects reported a slight reduction in quality.• Interference-free transmission was achieved with all systems but inter-subject variability was observed• MicroLink MLxS radio aid receivers can be used successfully with the ESPrit 3G• Optimal gain levels for MLxS with the ESPrit 3G are between +6 to +12• The optimal transmitting frequency differs for the CI22 and CI24 implants

Use of Soundfield FM

In 2002 a small study looked at subjective and objective ratings of sound quality when using a radio aid in a soundfield treated room.

Results

Problems of compatibility were described particularly if the room had not received any acoustic treatment. However, results from the 2000 FM survey showed that only 3% centres reported the use of soundfield FM with CI’s in schools, whereas in 2005 this had risen to 25%, suggesting some of the previous problems have been addressed

The Impact of the use of FM systems with cochlear implants in

the UK over the last 10 yearsElizabeth Wood and Sarah Flynn

South of England Cochlear Implant Centre

CONCLUSIONS

• Radio Aids can be successfully used with cochlear implants

• User feedback to report on sound quality and interference is essential

• Training and setting up of appropriate gain and default frequency when using a radio aid is necessary

• Fitting and verification procedures are needed

• Close liaison between CI clinic and local serrvices is essential

• Liaison with radio aid and cochlear implant manufacturers has assisted and advanced our understanding

Method

A survey was sent out to all UK cochlear implant centres in 2000, then again in 2005, asking these questions

Results

In 2000 data was received from all 21 implant centres on 1241 children. In 2005 13/18 centres provided full information on 1763 children and 2 provided partial information on another 415 children.

In 2005 almost 30% of children with cochlear implants are fitted with a personal FM system.

Numbers of FM radio aids used in the UK

The biggest increase is the introduction and use of the ear-level plug-in FM systems (from 3% of CI users in 2000 to 22% in 2005). Users are generally older children

All centres said that a user should be able to report on sound quality and give feedback before fitting

Concerns reported were the fragile leads and cables, the size of the adaptors, and the need for a fitting protocol

At SOECIC 59% of children are fitted with personal FM radio aids

AIM 3

To develop training and resources to enable those who have day to day contact with the user to maintain, monitor and evaluate effective use of the FM system

What are the responsibilities of the CI centre and the local services?

How and where should evaluation take place?

What materials are available for fitting and evaluation?

Speech discrimination in noise Speech discrimination over distance

Noisespeaker

Speechspeaker

Noisespeaker

FM

2 metres

With implant only With implant and FM aid

20 cm

Speechspeaker

2 metres

Contact for further information ejw@isvr.soton.ac.uk

UserReport on sound quality

Provide feedback

UserReport on sound quality

Provide feedback

FamilySupport and encourageLiaise with school and

CI centre

FamilySupport and encourageLiaise with school and

CI centre

Local ServicesProvision and

Maintenance of FMDay-to day management

Liaison with school, family and CI centre

Training for staff

Local ServicesProvision and

Maintenance of FMDay-to day management

Liaison with school, family and CI centre

Training for staff

CI CentreInitial fitting and validationProvision of lead/adaptor

& troubleshooting guidanceTraining

CI CentreInitial fitting and validationProvision of lead/adaptor

& troubleshooting guidanceTraining

ATT

Tx

Subject at 3m with andwithout FM

receiver

Subject at 10m with &without FM

receiver

ATT

ResponsibilitiesAIM 2

To document the increasing use of FM and CI in the UK

How often are FM radio aids being used in the UK with cochlear implants?

Do Implant centres have a policy on when to fit an FM system?

What age are FM systems fitted and if they are not used why not?

Is a verification procedure used?

Are there any concerns, or feedback from local professionals or staff at the CI centres?