1/29/2016

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FM: It’s Not Just For Kids

Dan Stover, Au.D., F-AAA

Territory Manager – Government Services and National Accounts

Agenda

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• 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?

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• 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?

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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?

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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

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• Frequency Modulation

• Transmits on various frequencies, depending on company and technology

• Improves SNR by bringing voice from transmitter to receiver

FM Components

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• Transmitter

– Directional vs. omni

– One speaker vs. many

– Various levels of control

• Receiver

– T-Coil

– Integrated into hearing aid

– Bluetooth

Bluetooth vs. FM

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• Bluetooth can only connect to one receiver at once

• Usually omnidirectional

• Doesn’t have noise reduction to improve SNR

• More inexpensive*

Solution Approach

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• 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

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• 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.

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Benefits Of the Solution Approach

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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

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• 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

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• 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:

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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

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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

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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.

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Current FM Products

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Comfort Audio

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• 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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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

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Main Differences

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• 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

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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

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• 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

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Why Dynamic?

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• 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?

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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

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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

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The Test Set-Up

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Speech Understanding In Noise - Roger vs. Normal Hearing

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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

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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

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Difference In Speech Understanding

Roger Clip-On Mic vs. Phonak RemoteMic

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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

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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

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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

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Roger Pen and Roger EasyPen

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Automatic Microphone Modes For Roger Pen and Roger

EasyPen

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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

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Roger Clip-On Mic

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Feature Overview

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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

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• 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?

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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

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Listening Room

1/29/2016

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Hearing Like Me- Online community www.bringsoundtolife.com

Use technology to succeed in different situations