Printing:This poster is 48” wide by 36” high. It’s designed to be printed on a large-format printer.

Customizing the Content:The placeholders in this poster are formatted for you. Type in the placeholders to add text, or click an icon to add a table, chart, SmartArt graphic, picture or multimedia file.To add or remove bullet points from text, just click the Bullets button on the Home tab.If you need more placeholders for titles, content or body text, just make a copy of what you need and drag it into place. PowerPoint’s Smart Guides will help you align it with everything else.Want to use your own pictures instead of ours? No problem! Just right-click a picture and choose Change Picture. Maintain the proportion of pictures as you resize by dragging a corner.

Effects of Nonlinear Frequency Compression on Performance of Individuals Who Speak Mandarin ChineseSuzanne Wright, B.A., Arun Joshi, B.S., Tiffany Ho, B.S., Christine Anderson, B.S., Jessalyn Dyson, B.A., Jerrica Box, B.S., Erin Schafer, Ph.D.

The University of North Texas

PURPOSEThe current project investigated the effects of amplification containing non-linear frequency compression (NLFC) on the speech recognition and subjective preferences of individuals who have hearing loss and speak Mandarin Chinese (MC).

BACKGROUNDConsidering the growth of the culturally and linguistically diverse populations in the United States (U.S.) over the past few decades, there is a need to incorporate sensitive, evidence-based assessment tools and treatment options into the hearing care of these populations (U.S. Census Bureau, 2011). Recent hearing aid research has focused on improving the audibility of high-frequency speech sounds, which are often inaudible with traditional hearing aids. One approach to achieving improved high-frequency audibility is the use of NLFC algorithms. Results of several studies support the use of NLFC over traditional amplification for improving speech recognition and sound quality of speech in children and adults with hearing loss who speak English (e.g., McCreery et al, in press; Parsa et al., 2013; Wolfe et al., 2010). However, to date, there are few, if any publications on the effect of NLFC on non-English speakers with hearing loss, particularly those who speak a tonal language. The purpose of this project was to examine the effects of NFLC on both the speech recognition and subjective preference perceptions of individuals who have hearing loss and speak MC.

OBJECTIVES• To provide evidence-based recommendations regarding the efficacy

and effectiveness of two amplification schemes for individuals who have hearing loss and speak MC as a primary language

• To improve overall communication abilities of speakers of MC who have sensorineural hearing loss

• To disseminate study results, to advocate for minority groups, and to increase awareness on multicultural issues related to fitting and optimizing hearing aids

METHODS•Participants to date included 7 adults (M= 68 years) with mild to

severe sensorineural hearing loss (Fig. 1), who speak MC as their first and primary language and English as a secondary language. Participants were fit with Audeo V90-13 hearing aids, matched to NAL-NL2 prescriptive targets (Keidser et al., 2011). Session 1 laboratory tasks:

• Comprehensive audiological assessment• Hearing device fitting (counterbalanced order)

• Program 1: NLFC off (auto)• Program 2: NLFC on (auto)

Session 2 laboratory tasks:• Hearing in Noise Test (HINT; Nilsson et al., 1994) • Mandarin Hearing in Noise Test (M-HINT; Wong, 2007)• Phonak Phoneme Perception Test • Mandarin Tone Identification Test (closed set; Krenmayr et al., 2011) • Subjective Preference Journal

RESULTS

CONCLUSIONS

Figure 1. Mean audiometric thresholds for study participants.

REFERENCESKeidser, G., Dillon H., Flax, M., Ching, T. & Brewer, S. (2011). The NAL-NL2 prescription procedure. Audiology Research, 1(1), 88-90.Krenmayr, A., Qi, B., Liu, B., Liu, H., Chen, X., Hand, D., … & Zierhofer, C., (2011). Development of a Mandarin tone identification test: Sensitivity

index d’ as a performance measures for individual tones. International Journal of Audiology, 50(3), 155-163.McCreery, R., Alexander, J., Brennan, M.A., Hoover, B., Kopun, J., & Stelmachowicz, P. (2014). The influence of audibility on

speech recognition with nonlinear frequency compression for children and adults with hearing loss. Ear & Hearing, 35(4), 440-447. Nilsson, M., Soli, S.D., & Sullivan, J.A. (1994). Development of the Hearing in Noise Test for the measurement of speech reception thresholds in

quiet and in noise. J Acous Soc Am, 95(2), 1085-1099.Parsa, V., Scollie, S., Glista, D., & Seelisch, A. (2013). Nonlinear frequency compression: Effects on sound quality ratings of speech

and music. Trends in Amplification, 17(1), 54-68.U.S. Census Bureau. (2011). Language use in the United States: 2011 [American Community Survey Reports]. Retrieved from

http://www.census.gov/prod/2010pubs/acs-12.pdf. Wolfe, J., John, A., Schafer, E., Nyffeler, M., Boretzki, M., & Caraway, T. (2010). Evaluation of nonlinear frequency compression for

school-age children with moderate to moderately severe hearing loss. J Am Acad Audio, 21(10), 618-628. Wong, L., Soli, S., Liu, S., Han, N., & Huang, M. (2007). Development of the Mandarin hearing in noise test (MHINT). Ear and

Hearing, 28(2), 70S-74S.

ACKNOWLEDGEMENTS

Figure 2. Sentence recognition performance in quiet as a function of hearing device setting.*

Figure 3. Sentence recognition performance in noise as a function of hearing device setting.*

Figure 4. Tone Identification performance in quiet as a function of hearing device setting.*

Figure 5. Detection thresholds in quiet on the Phoneme Perception Test.*

Figure 6. Recognition thresholds in quiet on the sub-test of the Phoneme Perception Test.*

TR FC TR FCEnglish (HINT) Mandarin (MHINT)

02468

10121416

Quiet

dB H

L

TR FC TR FCEnglish (HINT) Mandarin (MHINT)

-6-5-4-3-2-1012

NoisedB

SN

R

/SH/-3

kHz

/SH/-5

kHz

/S/ -6 kHz

/S/-9 kHz

0

10

20

30

40

Phoneme Perception (Detection)

TraditionalFrequency Compression

dB H

L

/SH/-

3 kHz

/SH/-

5 kHz

/S/-6

kHz

/S/-9

kHz

0

10

20

30

40

Phoneme Perception Test (Recognition)

TraditionalFrequency Compression

dB H

L

Traditional Frequency Compression

0%10%20%30%40%50%60%70%80%90%

100%

Tone Identification

Scor

es

250 500 1000 2000 3000 4000 6000 80000

10

20

30

40

50

60

70

80

90

100Average Audiometric Thresholds

Right Ear Left Ear Frequency (Hz)

Thre

shol

d (d

B H

L)

This project was funded by the ASHA Grant Program for Projects on Multicultural Activities and equipment support was provided by Phonak. We would also like to thank the participants in our study.

Behavioral Measures:• On average, there was no significant difference in behavioral

performance when using NLFC or traditional amplification for:• Speech recognition in quiet and in noise in English (Fig. 2)• Speech recognition in quiet and in noise in MC (Fig. 3)• Closed-set tone identification on the Mandarin Tone Identification

Test (Fig. 4)• Detection and recognition of high-frequency phonemes (Fig. 5 & 6)

Subjective Measures:• According to participant journals:

• 4 participants reported no preference for either program• 2 participants preferred the traditional program; 1 preferred NLFC

Noteworthy Trends and Future Research:• In quiet, there were no differences in speech recognition performance in

English versus MC.• Conversely, in noise, speech recognition in English was substantially

poorer than performance in MC, which supports previous research showing poor performance in noise for a non-native language.

• Behavioral results showing no differences between types of amplification are likely related to the variability in the degree of hearing losses in our patients. A larger and more homogenous sample of participants will be needed to further examine behavioral performance with NLFC.

• Overall, it does not appear that NLFC hinders or benefits individuals with hearing loss who speak MC. Decisions regarding the use of NLFC should be determined on an individual basis via behavioral testing and subjective preferences.

*Vertical bars represent one standard deviation.