Upload
camille-lobley
View
238
Download
2
Tags:
Embed Size (px)
Citation preview
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 [email protected]
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?