The Hearing Blog

March 13, 2012

Auditory Neuropathy Spectrum Disorder Conference 2012

Diagnosis and Management of Auditory Neuropathy Spectrum Disorders Conference, All Children's  Hospital, St Pete, Florida

We’ll be live blogging from the upcoming Conference on the Diagnosis and Management of Auditory Neuropathy Spectrum Disorders (ANSD), hosted by USF Professor Charles Berlin and Vanderbilt Professor Linda Hood, this Thursday through Saturday March 15th through 17th at All Children’s [sic] Hospital in St Petersburg, Florida.

Topics covered include:
• Results and Outcomes from more than 500 ANSD Patients
• Hearing Aids vs. Cochlear Implants
• Cortical Evoked Potentials
• Newest Developments in Trans-Tympanic ECochG
• Speech Language Management

You can follow developments on Twitter by using the #ANSD hashtag & by following @ANSD2012

On the docket are the following sessions: Just click the links below for the separate blog entries, as they become available…
Thursday:
• The Pathophysiology and Clinical Presentation of Auditory Neuropathy/Dys-Synchrony, by Charles Berlin PhD
• Hyperbilirubinemia and Bilirubin Induced Neurological Disease (BIND), by Steven Shapiro MD
• Sample Case Presentations and Discussions, by Courtney Oliszewski AuD, Sybil Faylo AuD & Bridget Rickman AuD
• Differentiating ANSD from Central Auditory Processing Disorders and the Use of Cortical Evoked Potentials in ANSD, by Thierry Morlet PhD
    For more on cortical potentials as discussed, please see Cortical Reorganization and Cross-Modal Plasticity in Children with Cochlear Implants: Clinical Implications by Dr Anu Sharma
• Cochlear Implants in Infants & Children with ANSD, by Kirsty Gardner-Berry PhD
    [Kirsty is coming all the way from Sydney Cochlear Implant Center, and we are looking forward to hearing her views on the Nucleus vs HiRes 90k vs i100 implant circuits.]

Friday:
• Genetics of Hearing Loss in General and auditory neuropathy/auditory dyssynchrony (AN/AD) in Particular, by Melissa Crenshaw MD
• Hands-on Practice Session in Otoacoustic Emissions (OAE) and Auditory Brainstem Response (ABR) Testing, by Kathy Slifer AuD
    [We're looking forward to this one, and will have pictures.]
• Pediatric Grand Rounds: Hyperbilirubinemia, by Steven Shapiro MD
• Variation in Detection and Discrimination Abilities in AN/AD: Implications for Management; by Linda Hood PhD
• Managing Infants with ANSD During the First 12 Months of Life – Let’s Not Just “Wait & See,” by Kirsty Gardner-Berry PhD

Saturday:
• The All Children’s Hospital Cochlear Implantation Process, Selection and Management, by Peter Orobello MD, Kathleen Wasylik MD, Anne Oliver MA, & Shelly Ash MS
• Hearing Aids, vs. Monaural vs. Binaural Cochlear Implantation Results in Speech and Language Acquisition, by Susan Spirakis AuD
    [We're looking forward to this one too, and will have questions regarding differing findings from Mike Dorman & his bimodal studies.]
• Little Patient, Big Doctor: My Journey and Experiences with Big Doctors vs Children as Patients, by Haleh Rabizadeh-Resnick JD
    [Haleh was the subject of the controversial report   Don't let a doctor destroy your baby's hearing on CNN]

   

September 28, 2011

FM: A Success Story In The Library

FM: A Success Story In The Library
By Sarah “Speak Up Librarian” Wegley.
Edited with an introduction by Dan Schwartz

On occasion, when someone has real success we’ll post it on The Hearing Blog under their byline, so other people can learn from it. When my friend Sarah was having trouble understanding speech with her workplace, she first tried a hand-held “Pocket Talker” style assistive device coupled to her hearing aids via an inductive neckloop. But, this didn’t work very well, suffering from interference in certain places and just overall poor performance. However, at the Hearing Loss Association of America convention, Sarah saw — And heard — the benefits of using an FM transmitter & receiver to bring sound from the speaker’s lips straight to her ears, regardless of the amount of background  noise in the library where she works. Although originally looking at the pricey Oticon system, I suggested instead the Bellman Audio Domino, which costs less, works better, and in fact the Classic version is what we use. Fortunately for Sarah, her university library employer agreed to buy an FM system for her, and they purchased the premium Pro version, which has the unique ability for the wearer to remotely switch the transmitter microphone from omnidirectional to zoom with just a touch of the button on the receiver.

Sarah was so excited at the performance, she wrote not one, but two blog articles on it, here and two days later here. Following are excerpts from her articles:

I am very excited to share with all of you that I have found a solution to my hearing difficulties at the reference desk. The answer for me is the Bellman Audio Domino Pro FM system. I have one that comes with a neckloop so the beautiful, clear sound goes directly into my hearing aids’ telecoils. Here’s a summary of the advantages I’ve experienced while wearing the FM system at the reference desk:

  • No lipreading required! I can hear even the whisperers;
  • I can now hear patrons behind me who are trying to get my attention;
  • I can hear the phone clearly when I am away from the desk helping a patron at a computer. Before I relied on keeping an eye out for the red flashing light which signals an incoming call;
  • The HVAC [heating, ventilating, and air conditioning] noises that bothered me before have faded away to being unnoticeable;
  • I can easily hear my coworkers at the desk.
  • No more tension from straining to hear.

Best of all, my employer purchased the system for me to use at work so there was no cost to me. So, how does the system work you may be wondering. There are two main parts – a receiver and a transmitter. The transmitter is about the size of a cell phone. I place it on the reference desk and am wirelessly connected to it so I can walk away from it at any time which is particularly useful in my situation. The receiver I wear clipped onto my pants pocket. The neckloop mentioned before plugs into the receiver. I’ve worn the neckloop under my clothes and I think it’s rather unobtrusive. The same size as the transmitter, the receiver is noticeable since it hangs outside my clothing. But that’s important so I can access the volume and function controls.

When I walk away from the desk to assist a patron one-on-one at a computer, I switch a button on the receiver so sound is no longer coming from the transmitter but coming instead from the internal microphone on the receiver. I have learned to put the receiver in the pants pocket closest to the patron for best results.

If I forget to switch the function from transmitter to receiver and a conversation occurs at the desk while I’m away, I can hear every word clearly. It’s incredible but a bit distracting from my focus on the patron beside me.

Another funny thing for me is the realization that patrons have conversations with each other while they’re working at the computers. Now that I’m wearing the FM, I can hear people chatting. My coworkers just shook their heads when I reported in wide eyed amazement that “the students talk to each other!” Heh.

For me wearing the FM system makes me feel like this might be what normal hearing is like. I don’t give my hearing a thought. It just happens. It’s actually easy. I can’t believe how much I was missing even with hearing aids.

A coworker asked me why I didn’t wear the FM system all the time then. At first I was horrified at the thought of hearing ALL the time at work. I like my quiet. It helps me concentrate on my work. Later, I realized a better response would have been to explain that the FM system helps in difficult listening situations. Such as I was experiencing at the public reference desk with the people who whisper and the HVAC noise. Back at my cubicle, my coworkers know to get my attention and come talk to me directly rather than call out from across the room. For me, it’s better that way.

I recommend the Bellman Audio Domino Pro FM system with two thumbs up. I’d like to thank my friend Dan Schwartzwho suggested this system and provided lots of helpful assistance before and after I got it.

Bellman Audio Domino Pro

Here's a photo of my FM System in its travel case. At the top is the neckloop, on the left is the charging device with plug. In the center is a clip-on microphone I can give a speaker to wear if I have to attend a meeting. Next over is the transmitter. At far right is the receiver.

  Here is a video from Bellman describing the Audio Domino Pro Sarah uses daily. There is a similar video for the Audio Domino Classic here.

 

Short link to this story: http://wp.me/p1mNFo-P

Coming soon: The next article in our series on FM titled: FM: The Unfair Classroom Advantage

February 19, 2011

TIA Urges FCC to Retain Existing Hearing Aid Compatibility Requirements

Washington, D.C.  The Telecommunications Industry Association (TIA)  filed comments with the FCC on Monday, 14 February in response to its request for comments on existing Hearing Aid Compatibility (HAC) requirements. TIA urged the Commission to retain existing HAC regulations, which have been enormously successfully in promoting innovation and accessibility in the wireless market place.

HAC regulations require mobile service providers and device manufacturers to offer a certain amount of hearing aid compatible devices to ensure accessibility by consumers with hearing aids. Per the Better Hearing InstitutesMarkeTrak VII industry survey there are approximately 8.4 million people wearing hearing aids, of which a subset of 5.1 million people have T-coils of unknown orientation (polarization). The percentage benchmarks are a result of a consensus plan developed by consumers, industry, and standards organizations in 2008, with an agreement to review in 2010. TIA comments are part of this review.

TIA, which represents companies that manufacture and supply the products and services used in global communications across all technology platforms, urged the FCC to delay revising HAC percentages or revising technical requirements tied to the standard by stating in its filing that: “Issues concerning the ANSI C63.19-2007 standard should be revised after the 2010 standard is adopted and manufacturers have had the opportunity to test and obtain HAC certification.”

On behalf of its members TIA submitted the following comments regarding the Wireless Telecommunications Bureau’s Public Notice:

  • TIA should retain the existing benchmarks adopted in 2008 and provide time for manufacturers and service providers to test and deploy new models and services under the current standard.
  • Consistent with Section 710 of the Communications Act, FCC concerns related to HAC requirements would be more effectively addressed through the standards development process. TIA recommended that all relevant industry stakeholders should be presented with the opportunity to engage the HAC industry in that process.
  • The FCC should continue to ensure that information collected under the Accessibility Act not impose an undue burden on manufacturers and service providers. The current reporting requirements, which TIA argued could be streamlined, have proven effective in responding to consumer input.
  • The FCC should not dictate technical standards for handset manufacturers. To do so would jeopardize industry innovation in improving such features as volume control, display screens and backlights.
  • TIA urged the FCC to facilitate collaboration among all stakeholders including the Food and Drug Administration (FDA), in order to facilitate a dialogue among hearing aid manufacturers and hearing aid users.
  • “TIA members have been integral to the successful implementation of the Commission’s hearing aid compatibility policies,” TIA stated in its filing. “Consistent with its recently-announced Innovation Package of policy recommendations, TIA submits that by encouraging collaboration among stakeholders and the utilization of voluntary consensus-based standards, the Commission can continue to improve accessibility and encourage innovation, thereby meeting its statutory obligations under Section 710 of the Communications Act and maintaining the enormous success of the Commission’s HAC regime.”

    In its filing, TIA also pointed out FCC Chairman Julius Genachowski’s “decision to follow the recent Presidential memorandum to Federal agencies targeting burdensome regulations.”

    “TIA’s members – companies in the information and communications technology industry – are among the most innovative in the world,” said Vice President for Government Affairs Danielle Coffey. “President Obama recognizes that, while sometimes regulation is necessary, it is imperative that we carefully consider the impact regulations will have on bringing new and improved products and services to the marketplace.”

    TIA’s full comments on Hearing Aid Compatibility (PDF opens in a new window) are available on its FCC filings page at tiaonline.org.

    July 13, 2010

    Series on FM: Soliciting User Experiences&c.

    Update #1 January 27, 2011: Please scroll halfway down to red portion of the text

    The project of rating two new digital FM systems, the Bellman & Symfon Audio Domino (PDF w/specs) ($495 street)  and the Etymotic Research Companion (specshow it works) system ($699 street w/three transmitters and ER-6i isolator earphones) is turning out to be a three-part series of articles, taking much more time than I expected… And I am soliciting comments on any FM system about your user, parent, teacher or hearing healthcare professional experiences — Good .AND. Bad. Please post your experiences in either the Comment section below, or email them to me at Dan@Snip.Net

    The first of the three will be how and why FM — When it’s done properly — is a tremendous help to the hearing impaired and others, from infants & toddlers receiving auditory therapy, to children (including those with cognitive impairments), to high school & college students in large classrooms & lectures, to adults on the job, and in noisy social situations, to the elderly watching TV.

    Most of the first article in this series will center upon the discussion on these 4 pages in Jamie Berke’s About.Com Deafness Forum.  [And Yes, the story about the beer is true!]

    The second article in the series will deal with the situation when FM is .NOT. done properly, and interference or other issues result. Phonak’s FM system appears to be a serial offender, but there are other culprits. This article will go into the techno-details on things like multipath distortion vs dropouts, transmitter power, and other things a computer geek or Ham Radio operator would understand… So the challenge is to make it readable for the average parent.

    The third article in the series will be test results from these three systems:

    § The Bellman & Symfon Audio Domino (PDF w/specs) ($495 as tested with earphones) is a flexible single transmitter system, with excellent audio quality, decent range, and highly directional microphones on both the transmitter & receiver;

    § The Etymotic Research Companion (specshow it works) system ($699 as tested with three transmitters and ER-6i isolator earphones) ships with either one or three transmitters, and is the only system (besides the Phonak DynaMic extension to the troublesome Inspiro) that provides many-to-one capability;

    § The Comfort Audio Contego ($795 as tested w/neckloop) is a single encrypted transmitter system; and was screened by the author at the HLAA Convention in Milwaukee.

    Update #1: Due to time constraints I have not been able to fully update this blog entry; however I posted this reply on Dr. A.U. Bankaitis’ blog:

    Although they have differences, the Bellman Audio Domino Classic costs $200 less, and performs as well as the Comfort Contego. While the Contego has a zoom mic, the Audio Domino Classic has a tone control on the receiver, and also when stereo is input into the transmitter jack, the system switches to digital stereo (more on this in a moment).

    Previously, A.U. raised a point about the 40ms latency of the Audio Domino vs 10ms delay in the Contego (vs. no latency with analog!) and how it can interfere with lipreading cues. [Note:In googling Comfort Contego specifications there is no mention of latency.] From personal experience, I haven’t noticed any latency issues; but more importantly, if either system is used with a TV, it is important to note that with the shift from NTSC to HDTV the lead/lag for the separate AC3 and MPEG audio streams can be up to 150mSec (and in practice is often much higher), so the (supposed) 30ms delta between the two doesn’t seem to be a factor.

    Now, let’s say your patient wants a zoom mic on the transmitter & receiver: With the Contego, the user has to walk over and manually switch the transmitter. But, remember when I said above that the Bellman Audio Domino Classic transmits in digital stereo? Well, so does the Audio Domino Pro… But also, the Pro version does something Really Clever: The audio from the omni mic rides on the left channel simultaneously with the audio from the zoom mic! This way, the user need only push the button on the receiver to “zoom” the transmitter, saving endless user fiddling.

    My friend Sarah, who blogs on her Speak Up Librarian website received upon my recommendation the Audio Domino Pro from her employer to use at work. She wrote two extensive first-person reviews here and here that are worth reading.

    Finally, I welcome everyone’s own observations of FM ALD’s, whether good or bad; clinician or user, on The Hearing Blog’s article covering all things FM.

    Update #1: January 27, 2011 @3:45PM EST

    Powered by WordPress