Gitte Keidser

Eriksholm Research Centre

Purpose There is a need for tools to study real-world communication abilities in people with hearing loss. We outline a potential method for this that analyzes gaze and use it to answer the question of when and how much listeners with hearing loss look toward a new talker in a conversation. Method Twenty-two older adults with hearing loss followed...

Purpose: The purpose of this work was to study the effects of background noise and hearing attenuation associated with earplugs on three physiological measures, assumed to be markers of effort investment and arousal, during interactive communication. Method: Twelve pairs of older people (average age of 63.2 years) with age-adjusted normal hearin...

This presentation details and evaluates a method for estimating the attended speaker during a two-person conversation by means of in-ear electro-oculography (EOG). Twenty-five hearing-impaired participants were fitted with molds equipped with EOG electrodes (in-ear EOG) and wore eye-tracking glasses while watching a video of two life-size people in...

No PDF available ABSTRACT The ability to understand speech in complex listening environments reflects an interaction of cognitive and sensory capacities that are difficult to capture with behavioural tests. The study of natural listening behaviours may lead to the development of new metrics that better reflect real-life communication abilities. To...

Ecological validity is a relatively new concept in hearing science. It has been cited as relevant with increasing frequency in publications over the past 20 years, but without any formal conceptual basis or clear motive. The sixth Eriksholm Workshop was convened to develop a deeper understanding of the concept for the purpose of applying it in hear...

Humans have evolved the unique capacity to efficiently communicate using the spoken word. Hearing plays a key role as a receiver in this process and dysfunction leads to difficulties in listening and communication. It is widely accepted that effective communication is not adequately captured with current behavioral speech tests that principally foc...

To increase the ecological validity of outcomes from laboratory evaluations of hearing and hearing devices, it is desirable to introduce more realistic outcome measures in the laboratory. This article presents and discusses three outcome measures that have been designed to go beyond traditional speech-in-noise measures to better reflect realistic e...

Trainable hearing aids let users fine-tune their hearing aid settings in their own listening environment: Based on consistent user-adjustments and information about the acoustic environment, the trainable aids will change environment-specific settings to the user’s preference. A requirement for effective fine-tuning is consistency of preference for...

Objectives This study investigates the hypothesis that hearing aid amplification reduces effort within conversation for both hearing aid wearers and their communication partners. Levels of effort, in the form of speech production modifications, required to maintain successful spoken communication in a range of acoustic environments are compared to...

To capture the demands of real-world listening, laboratory-based speech-in-noise tasks must better reflect the types of speech and environments listeners encounter in everyday life. This article reports the development of original sentence materials that were produced spontaneously with varying vocal efforts. These sentences were extracted from con...

Purpose This article describes patterns of speech modifications produced by talkers as a function of the degree of hearing impairment of communication partners during naturalistic conversations in noise. An explanation of observed speech modifications is proposed in terms of a generalization of the concept of effort. This account complements existi...

The concept of complex acoustic environments has appeared in several unrelated research areas within acoustics in different variations. Based on a review of the usage and evolution of this concept in the literature, a relevant framework was developed, which includes nine broad characteristics that are thought to drive the complexity of acoustic sce...

Purpose The aim of this study was to examine how hearing aid candidates perceive user-driven and app-controlled hearing aids and the effect these concepts have on traditional hearing health care delivery. Method Eleven adults (3 women, 8 men), recruited among 60 participants who had completed a research study evaluating an app-controlled, self-fit...

Background: Patients often need multiple fine-tuning appointments with their hearing health care provider to achieve satisfactory hearing aid outcomes. A smartphone app that enables patients to remotely request and receive new hearing aid settings could improve hearing health care access and efficiency. Introduction: We assessed the usability of...

Everyday listening environments are characterized by far more complex spatial, spectral and temporal sound field distributions than the acoustic stimuli that are typically employed in controlled laboratory settings. As such, the reproduction of acoustic listening environments has become important for several research avenues related to sound percep...

Purpose Hearing loss is associated with changes in brain volume in regions supporting auditory and cognitive processing. The purpose of this study was to determine whether there is a systematic association between hearing ability and brain volume in cross-sectional data from a large nonclinical cohort of middle-aged adults available from the UK Bio...

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hear...

Purpose The purpose of this study was to introduce a method of eliciting conversational behavior with many aspects of realism, which may be used to study the impacts of hearing impairment and noise on verbal communication; to describe the characteristics of speech and language participants produced during the task; and to assess participants' engag...

Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics—all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions—may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing l...

Objectives: Self-fitting hearing aids have the potential to increase the accessibility of hearing health care. The aims of this study were to (1) identify factors that are associated with the ability to successfully set up a pair of commercially available self-fitting hearing aids; 2) identify factors that are associated with the need for knowledg...

Self-fitting hearing aids (SFHAs)—devices that enable self-directed threshold measurements leading to a prescribed hearing aid (HA) setting, and fine-tuning, without the need for professional support—are now commercially available. This study examined outcomes obtained with one commercial SFHA, the Companion (SoundWorld Solutions), when support was...

This study describes the use of a novel conversation elicitation framework to collect fluent, dynamic conversational speech in simulated realistic acoustic environments of varying complexities. Our aim is to quantify speech modifications during conversation, which characterize effortful speech, as a function of the difficulty of the acoustic enviro...

Purpose: To determine the factor structure of a clinical tool for the assessment of hearing loss self-management, and to identify predictors of the total score on the assessment and the extracted factor scores. Materials and methods: Hearing loss self-management assessments were conducted with 62 older adults. The factor structure of the assessment...

Hearing impairment affects a person’s ability to communicate effectively. People with hearing loss (HL) report difficulty communicating in noise, even when the HL is compensated by conventional amplification. This study aims to investigate factors that contribute to understanding speech in noise. Nine adults with HL and nine controls participated i...

Objective: To evaluate the capacity of a self-management assessment tool to identify unmet hearing health care (HHC) needs; to determine whether such an assessment yields novel and clinically useful information. Design: Hearing loss self-management (HLSM) was assessed with the Partners in Health scale and the Cue and Response interview from the...

Objective: The National Acoustic Laboratories Dynamic Conversations Test (NAL-DCT) is a new test of speech comprehension that incorporates a realistic environment and dynamic speech materials that capture certain features of everyday conversations. The goal of this study was to assess the suitability of the test for studying the consequences of he...

Recent epidemiological data suggest the relation between hearing difficulty and depression is more evident in younger and middle-aged populations than in older adults. There are also suggestions that the relation may be more evident in specific subgroups; that is, other factors may influence a relationship between hearing and depression in differen...

Objective: This study set out to obtain information on the impact of trainable hearing aids among clinicians and hearing aid users and candidates. Design: Two online adaptive surveys were developed to evaluate provision, uptake and experience or expectation of trainable hearing aids. Study sample: Responses from 259 clinicians, 81 hearing aid users...

This paper can be accessed free of charge on: http://journals.lww.com/thehearingjournal/Fulltext/2016/11000/Preliminary_Observations_of_Self_Fitted_Hearing.7.aspx

Speech intelligibility is commonly assessed in rather unrealistic acoustic environments at negative signal-to-noise ratios (SNRs). As a consequence, the results seem unlikely to reflect the subjects’ experience in the real world. To improve the ecological validity of speech tests, different sound reproduction techniques have been used by researcher...

Speech produced in noisy environments (Lombard speech) is characterized by a range of acoustic and phonetic changes. These changes stem from increased speaking effort which reflects communicative intent as well as decreased auditory feedback of the speaker’s own voice. An accurate understanding of real-world Lombard effects is important in hearing...

Trainable hearing aids: clinical impact and reliability of training

Background: Many listeners with hearing loss report particular difficulties with multitalker communication situations, but these difficulties are not well predicted using current clinical and laboratory assessment tools. Purpose: The overall aim of this work is to create new speech tests that capture key aspects of multitalker communication situ...

Background: Hearing aids and personal sound amplification products that are designed to be self-fitted by the user at home are becoming increasingly available in the online marketplace. While these devices are often marketed as a low-cost alternative to traditional hearing health-care, little is known about people's ability to successfully use and...

Experimental work has shown better visuospatial working memory (VSWM) in profoundly deaf individuals compared to those with normal hearing. Other data, including the UK Biobank resource shows poorer VSWM in individuals with poorer hearing. Using the same database, the authors investigated VSWM in individuals who reported profound deafness. Included...

A self-contained, self-fitting hearing aid (SFHA) is a device that enables the user to perform both threshold measurements leading to a prescribed hearing aid setting and fine-tuning, without the need for audiological support or access to other equipment. The SFHA has been proposed as a potential solution to address unmet hearing health care in dev...

NAL News G ood self-management skills are the cornerstone to living well with a chronic health condition. A person with diabetes, for example, who regularly monitors his blood sugar levels and knows how to regulate his food intake is more likely to enjoy a better quality of life, an increased sense of independence, and greater self-efficacy than a...

To establish the effect of self-rated and measured functional hearing on depression, taking age and gender into account. Additionally, the study investigates if hearing-aid usage mitigates the effect, and if other physical health problems and social engagement confound it. Cross-sectional data from the UK Biobank resource, including subjective and...

Verbal reasoning performance is an indicator of the ability to think constructively in everyday life and relies on both crystallized and fluid intelligence. This study aimed to determine the effect of functional hearing on verbal reasoning when controlling for age, gender, and education. In addition, the study investigated whether hearing aid usage...

The overall goal of this work is to create new speech perception tests that more closely resemble real world communication and offer an alternative or complement to the commonly used sentence recall test. We describe the development of a new ongoing speech comprehension test based on short everyday passages and on-the-go questions. We also describe...

It is well-established that communication involves the working memory system, which becomes increasingly engaged in understanding speech as the input signal degrades. The more resources allocated to recovering a degraded input signal, the fewer resources, referred to as cognitive spare capacity (CSC), remain for higher-level processing of speech. U...

There is increasing demand in the hearing research community for the creation of laboratory environments that better simulate challenging real-world listening environments. The hope is that the use of such environments for testing will lead to more meaningful assessments of listening ability, and better predictions about the performance of hearing...

A reliable and valid method for the automatic in situ measurement of hearing thresholds is a prerequisite for the feasibility of a self-fitting hearing aid, whether such a device becomes an automated component of an audiological management program or is fitted by the user independently of a clinician. Issues that must be addressed before implementa...

The UK Biobank offers cross-sectional epidemiological data collected on >500,000 individuals in the UK between 40 and 70 years of age. Using the UK Biobank data, the aim of this study was to investigate the effects of functional hearing loss and hearing aid usage on visuospatial memory function. This selection of variables resulted in a sub-sample...

Objective: The acceptable noise level (ANL), a measure of noise tolerance, has been proposed as a predictor for successful hearing aid use. The aims of this study were to obtain normative data, and to evaluate the clinical feasibility and predictive value of an Australian version of the ANL test in an older population. Design: Repeated ANL measu...

Background: Large variations in perceptual directional microphone benefit, which far exceed the variation expected from physical performance measures of directional microphones, have been reported in the literature. The cause for the individual variation has not been systematically investigated. Purpose: To determine the factors that are respons...

The primary objective of this study was to determine whether a combination of automatically administered pure-tone audiometry and a tone-in-noise detection task, both delivered via an air conduction (AC) pathway, could reliably and validly predict the presence of a conductive component to the hearing loss. The authors hypothesized that performance...

An auditory prosthesis (30) comprising a microphone (27) for receiving the sound and producing a microphone signal responding to the received sound, an output device for providing audio signals in a form receivable by a user of the prosthesis (30), a sound processing unit (33) operable to receive the microphone signal and carry out a processing ope...

Objective: To introduce and verify an algorithm designed to administer adaptive speech-in- noise testing to a specified reliability at selectable points on the psychometric function. Design: Speech-in-noise performances were measured using BKB sentences presented in diffuse babble-noise, using morphemic scoring. Target of the algorithm was a tes...

The speech reception threshold (SRT) is routinely measured in the laboratory to assess speech understanding in noise, but is often reported to be a poor predictor of performance in real world listening situations. The overall goal of this work is to determine whether introducing realistic aspects to speech tests can better capture individual differ...

Objectives: Commercial trainable hearing aids (HA) (i.e., devices that for a period are adjusted by the user in different acoustic environments and that subsequently with changing environments automatically adapt to the user's preferred settings), are readily available; however, little information exists about the efficacy of training a HA. The pu...

Objective: The purpose of the study was twofold: (1) to assess the ability of hearing-impaired adults in the developing world to independently and accurately assemble a pair of hearing aids by following instructions that were written and illustrated according to best-practice health literacy principles; and (2) to determine which factors influence...

NAL-NL1, the first procedure from the National Acoustic Laboratories (NAL) for prescribing nonlinear gain, was a purely theoretically derived formula aimed at maximizing speech intelligibility for any input level of speech while keeping the overall loudness of speech at or below normal loudness. The formula was obtained through an optimization proc...

The ability to correctly localize sounds is important for general awareness of the auditory scene and communication in adverse acoustic conditions. However, most localization studies are performed in rather simple and artificial conditions. In particular, very few studies have considered localization in reverberant environments or in the presence o...

A self-fitting, self-contained hearing aid is a device that can be managed entirely by the user, without assistance from a hearing health care professional or the need for special equipment. A key component of such a device is an automated audiometer that will enable the user to self-administer measurements of in situ thresholds, which the hearing...

A self-fitting hearing aid, designed to be assembled and programmed without audiological or computer support, could bring amplification to millions of people in developing countries, who remain unaided due to the lack of a local, professional, audiological infrastructure. The ability to assemble and insert a hearing aid is fundamental to the succes...

The need for reliable access to hearing health care services is growing globally, particularly in developing countries and in remotely located, underserved regions in many parts of the developed world. Individuals with hearing loss in these areas are at a significant disadvantage due to the scarcity of local hearing health care professionals and th...

A self-fitting hearing aid is a personal amplification device that is designed to be assembled, programmed, and fine-tuned by the user, without the need for additional equipment or professional support. A written description of the device was presented to 80 older adults with a hearing impairment, all of whom were residents of an urban area in a de...

NAL-NL2 is the second generation of prescription procedures from The National Acoustic Laboratories (NAL) for fitting wide dynamic range compression (WDRC) instruments. Like its predecessor NALNL1 (Dillon, 1999), NAL-NL2 aims at making speech intelligible and overall loudness comfortable. This aim is mainly driven by a belief that these factors are...

Adults with severe and profound hearing loss tend to be long-term, full-time users of amplification who are highly reliant on their hearing aids. As a result of these characteristics, they are often reluctant to update their hearing aids when new features or signal-processing algorithms become available. Due to the electroacoustic constraints of ol...

Data from this study suggest that as long as a sound contains the low-frequency information that allows ITD cues to be accessed, left/right discrimination is not severely affected by an interaural gain mismatch of up to 9 dB. Consequently, for the purpose of improving localization performance, it is more important to preserve the ITD than the IID c...

Audiometric measurements through a hearing aid ('in-situ') may facilitate provision of hearing services where these are limited. This study investigated the validity and reliability of in-situ air conduction hearing thresholds measured with closed and open domes relative to thresholds measured with insert earphones, and explored sources of variabil...

Objectives: To determine the effect of spectral differences between stimuli used for verification of hearing aid gain in nonlinear devices. Design: The spectra of nine stimuli from five analyzing systems were obtained. Results: Most stimuli closely duplicated one of two well-specified spectra. The difference between these two input spectra res...

The aim of this study was to evaluate a clinical test proposed to verify the output setting of hearing aids. Across three test sites, 56 bilaterally fitted hearing aid users were recruited. They answered questions about real-life loudness discomfort experiences and then completed the output verification test. Using an ascending method, a 1,500 kHz...

Frequency-dependent microphone directionality alters the spectral shape of sound as a function of arrival azimuth. The influence of this on horizontal-plane localization performance was investigated. Using a 360 degrees loudspeaker array and five stimuli with different spectral characteristics, localization performance was measured on 21 hearing-im...

This study questions the basic assumption that prescriptive methods for nonlinear, wide dynamic range compression (WDRC) hearing aids should restore overall loudness to normal. Fifteen normal-hearing listeners and twenty-four hearing-impaired listeners (with mild to moderate hearing loss, twelve with and twelve without hearing aid experience) parti...

An abstract is unavailable. This article is available as HTML full text and PDF.

To investigate the long-term benefit of multichannel wide dynamic range compression (WDRC) alone and in combination with directional microphones and noise reduction/speech enhancement for listeners with severe or profound hearing loss. At the conclusion of a research project, 39 participants with severe or profound hearing loss were fitted with WDR...

This study aimed to determine whether gain adaptation occurs, and at which frequency bands, among new hearing aid (HA) users. Fifty new and 26 experienced HA users were fitted with three listening programs (NAL-NL1 and NAL-NL1 with low- and high-frequency cuts) in the same hearing instrument family. Real-life gain preferences and comfortable loudne...

Self-adjustments of variable hearing aid parameters are essential for trainable hearing aids to provide customized amplification for different listening environments. Prompted by a finding of Dreschler et al. [Ear Hear. 29, 214-227 (2008)], this study investigates the effect of the base line (starting) response on self-adjustments of gain in differ...

In a research study conducted at the National Acoustic Laboratories (NAL), a group of severely and profoundly hearing-impaired users of amplification was fit with wide dynamic range compression (WDRC) for the first time. Many of the study participants expressed reservations about their initial sound experience with the new devices, prompting the ex...