Audibility Extender Feature from Widex

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