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Educational Considerationsfor Hearing Assistance Technologies

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10 views3 pages

Educational Considerationsfor Hearing Assistance Technologies

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ruguoisdorn
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© © All Rights Reserved
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Educational Considerations

for Hearing Assistance Technologies (HAT)

Carisa Reyes, AuD.

Students who are deaf or hard of hearing can benefit greatly from appropriately fit hearing aids and
cochlear implants. However, classrooms are noisy places and children—even those with normal hearing—
cannot listen in noise as well as adults due to their still-developing auditory systems. Typical classrooms
have noise levels that are almost as loud as (if not louder than) the teacher’s voice. Acoustic
modifications are helpful in reducing the amount of background noise and reverberation (echo) that can
make listening for learning difficult, and preferential seating is helpful in reducing the speaker to listener
distance. It should be noted that these modifications alone are usually not enough. It is important to
remember that students who are deaf and hard of hearing need the speaker’s
voice to be significantly enhanced over the noise level for maximum audibility.
This may translate into better attention and greatly reduced listening effort,
which often leads to optimal learning.

Signal-to-noise ratio enhancement can be accomplished using remote


microphone technologies including Classroom Audio Distribution Systems
(CADS; a.k.a. sound field systems) and/or personal systems. A comparison of
both systems can be found in the table below:

CADS Personal Systems


How does it work? Utilizes infrared, FM or digital wireless FM or digital wireless transmission to
transmission to a loudspeaker or student’s receiver unit directly or via
loudspeakers direct audio input interface, telecoil
coupling or via Bluetooth streamer
Advantages  Benefits all children with normal  May be able to provide optimal
hearing but should especially be signal-to-noise enhancement for
considered for those with fluctuating children who are deaf & hard of
hearing loss due to recurrent middle hearing
ear fluid, those who have learning or  Small & portable
attention difficulties & those learning
a second language.
 No need to “hook-up” anything to
the child
 Easy to determine if there is a
problem with the equipment
Disadvantages  Not able to provide adequate speech  May require additional equipment
in noise enhancement for students (e.g. audio shoes, FM cable, etc.) to
with more than minimal hearing loss interface with the students’ devices
 Not easy to transport  More complex to troubleshoot
 May not be helpful if classroom
acoustic environment is especially
poor & can even increase noise
levels (Lubman & Sutherland, 2008)
It should be noted that if the child utilizes a hearing aid or cochlear implant, the use of personal signal
enhancement technology with or without CADS is recommended over the use of CADS alone because
these have been proven to provide sufficient signal-to-noise ratio enhancement to allow children to
have the best auditory access in the educational setting (Anderson et al., 2005; Schafer & Kleineck,
2009; Wolfe, 2012).

Just like fitting a hearing aid or a cochlear implant, the system needs to be verified to ensure proper
function and adequate benefit. For example, it is not recommended that a personal system be placed
on the child’s equipment right out of the box without properly fitting the device(s). Verification is
usually completed by the educational audiologist using published guidelines (American Academy of
Audiology, 2008 & 2011).

Regular equipment checks and listening checks are also important, especially for young children who may
not be able to give feedback (Schafer & Sweeney, 2011). Hearing Assistance Technologies (HAT) add
another layer of complexity in terms of hearing technology in the school. These systems will not benefit
the children if they are not functioning properly. Problems that could occur include malfunctioning
teacher transmitter microphones, receivers that are on the incorrect channel/network & malfunctioning
audio shoes or interface cables (for attaching receivers to the hearing aid or cochlear implant).

Special Considerations for Cochlear Implant Users

Collaboration between the family, school and the implant center is very
important when selecting, fitting and verifying HAT for implant recipients.
Interfacing these systems to the cochlear implant is fairly complex and unlike
with hearing aids, one cannot listen to how the signal interacts with the child’s
device output. Certain implant settings may need to be implemented and/or
changed in order to maximize HAT benefit without sacrificing how the child is
hearing through his or her implant microphone (Wolfe et al., 2011; Wolfe & Schafer, 2008). Also, specific
frequencies may be recommended with particular devices to reduce the likelihood of interference. In
addition, the receiver settings may need to be adjusted depending on whether or not the child is
demonstrating expected benefit (Schafer et al., 2009).

In summary, remote microphone hearing assistance technologies should be considered for all students in
order to improve acoustic accessibility so that they are able to learn in the “least restrictive environment”.
If you think your child or student would benefit from CADS or personal systems, please contact your
educational audiologist or clinical audiologist.

References:

American Academy of Audiology (2008). AAA Clinical Practice Guidelines: Remote Microphone Hearing
Assistance Technologies for Children and Youth Birth-21 Years.

American Academy of Audiology (2011). AAA Clinical Practice Guidelines: Remote Microphone Hearing
Assistance Technologies for Children and Youth Birth-21 Years, Supplement B: Classroom Audio
Distribution Systems—Selection & Fitting. Retrieved from:
http://www.audiology.org/resources/documentlibrary/Documents/20110926_HAT_GuidelinesSupp_B.pdf.
American National Standards Institute/Acoustical Society of America (2010). Acoustical Performance
Criteria, Design Requirements, and Guidelines for Schools (ANSI s12.60-2010). New York: American
National Standards Institute.

American Speech-Language-Hearing Association. (2005). Acoustics in educational settings: Position


statement. Available from http://www.asha.org/docs/html/PS2005-00028.html.

Anderson, K., Goldstein, H., Colodzin, L., & Iglehart, F. (2005). Benefit of S/N enhancing devices to
speech perception of children listening in a typical classroom with hearing aids or a cochlear implant.
Journal of Educational Audiology, 12, 16–30.

Lubman, D. & Sutherland, L. (2008) Soundfield amplification is a poor substitute for good classroom
acoustics. Journal of the Acoustical Society of America, 123(5), 3919.

Schafer, E. C. & Sweeney, M. (2012, April 03). A Sound Classroom Environment. The ASHA Leader.

Schafer E. & Kleineck M. (2009). Improvements in speech-recognition performance using cochlear


implants and three types of FM systems: A meta-analytic approach. Journal of Educational Audiology, 15,
4–14.

Schafer E., Wolfe J., Lawless T., et al. (2009). Effects of FM-receiver gain on speech-recognition
performance of adults with cochlear implants. International Journal of Audiology, 48, 196-203.

Smaldino J. & Flexer, C. (2012). Handbook of Acoustic Accessibility. New York: Thieme Medical
Publishers.

Wolfe J. (2012, December). Evaluation of classroom audio distribution systems & personal FM. Paper
presented at the Advances in Audiology: Tomorrow’s Solutions for Today’s Challenges Conference, Las
Vegas NV.

Wolfe J., Schafer E., John A., et al. (2011). The effect of front-end processing on cochlear implant
performance of children. Otology & Neurotology, 32, 533-538.

Wolfe J. & Schafer, E. (2008). Optimizing the benefit of sound processors coupled to personal FM
systems. Journal of the American Academy of Audiology, 19, 585-594.

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