Real-ear Measurements with

the A-35

Presented by: Kristina FryeFrye Electronics, Inc

Topics Interface from the A-35

Entering an Audiogram and Creating a Target Performing Insertion Gain Measurements Measurements in SPL: Comparing HTLs and

UCLs Testing with Visible Speech Testing Open Fit Hearing Aids

Doing all this from the FONIX NOAH Module

FP35 Real-ear Screens Audiogram Entry Real-ear SPL Unaided & Aided Insertion GainMove between these four screens by using

NEXT and BACK

Audiogram Entry Screen

F2 — Select HTL/UCL/Bone F3 — Generate Target

Frequency

Amplitude

NAL-NL1 Target SettingsPress MENU and BACK to change target

settings Compression Channels (1-18) Aid Limiting (Type of output limiting) Fit Type (Unilateral or Bilateral) Reference (Almost always Head Surface)

The Compression and Channels settings have the most impact on the target!

Insertion Gain TestingPress NEXT until you enter the Real-ear Insertion Gain screen

Traditional Real-ear Protocol Measuring the Insertion Gain Response

Let’s get sidetracked for a few minutes…

PROS and CONS of Measuring the Unaided Response

Save Time!To save testing time, you can probably skip the unaided response measurement!

Thresholds are measured with an occluded response

Targets are generated from those thresholds

Many hearing aids alter the ear canal resonance when inserted, so the unaided response is extraneous data

Exceptions

Fitting a mild/moderate loss: Make sure that the hearing aid is proving a benefit to the patient

Checking the position of the probe microphone

When is the unaided response useful?

Back to the Protocol…

Proper Placement of Microphones

Marked 30 mmfrom the tip for Adultsand 25 mm for children

Probe Mic

RefMic

Inter-TragalNotch

Above the Pinna

Level the Sound Field Speaker Internal sound chamber

converts to sound field speaker; should be ear height

12 inches from the speaker at 45° angle

Stand away from the patient/loudspeaker during measurements

The hearing aid (if silent) and/or probe tube can be inserted during leveling

Press F5 and START in the Real-ear Measurement screen to level the sound field speaker

Choose the Curve with F2Four Curves Available Unaided Ins. Gain #1: 50 dB Ins. Gain #2: 70 dB Ins. Gain #3: 90 dB

Selected curve shown above F2

Testing Protocol For Quick Testing, measure only Ins. Gain

#2. This measures at average speech level (70 dB SPL)

For Complete Testing, measure Ins. Gain #1, #2, and #3 (50, 70, and 90 dB SPL)

If no unaided response is measured, the average is automatically substituted

Example of Insertion Gain Meas

Prescription: This patient could use more amplification between 2000-6000 Hz!

Overview for Quick Insertion Gain Testing Enter Audiogram Entry screen

Press F2 from Opening Screen. Use NEXT and BACK if necessary

Input audiogram and generate targetUse arrow keys to enter audiogram. Press F3 to generate target.

Enter Insertion Gain screenUse NEXT until screen appears

Level the sound field speakerPress F5 and START

Measure Ins. Gain #2 and fit to targetUse F2 to select curve. Press START/STOP to start and stop test

If desired, also measure Unaided response and Aided Curve #1 and #3

The Real-ear SPL Protocol

Compare the Real-ear Response to HTLs and UCLs on one graph

Real-ear SPL Screen

UCLs

Target

HTLs

Real-ear SPL Measurements

Aided 3 below UCLs

Aided 2 meet target

Aided 1 above HTLs

Goal:

Overview of the SPL Protocol Enter Audiogram Entry screen

Press F2 from Opening Screen. Use NEXT and BACK if necessary

Input audiogram and generate targetUse arrow keys to enter audiogram. Press F3 to generate target.

Enter Real-ear SPL screenUse NEXT until screen appears

Level the sound field speakerPress F5 and START

Measure Aided #1 to compare to HTLs Use F2 to select curve. Press START/STOP to start and stop test

Measure Aided #2 to compare to the target Measure Aided #3 to compare to UCLs

Visible Speech Use External Signals such as Live Voice in

the real-ear measurements Perform this measurement in the Real-ear

SPL screen NEW! Both the real-time response and the

average response are displayed

Example of Visible Speech

Average Response

Real-time Response

Visible Speech Protocol Enter Audiogram Entry screen

Press F2 from Opening Screen. Use NEXT and BACK if necessary

Input audiogram and generate targetUse arrow keys to enter audiogram. Press F3 to generate target.

Enter Real-ear SPL screenUse NEXT until screen appears

Put analyzer in Spectrum Analysis mode Use F4 to select the source type. Use DOWN arrow to turn source OFF.

Perform Visible Speech measurementPress START/STOP to start measurement. Begin speech signal.

Open Fit Hearing Aids Coupler measurements: Use our new Open

Fit Coupler! Real-ear measurements: Same protocol

but disable the reference microphone

Open Fit Coupler Insert the hearing aid

into the coupler as you would into the ear

No sealing is necessary

Produces a frequency response more like a real-ear response

For ANSI measurements to specifications, use HA-1 coupler

Real-ear Measurements Some Open Fit hearing aids interfere with

the reference microphone measurement outside the ear (feedback management and/or amplified signal escaping from ear)

Disable the REF MIC setting in the real-ear measurement screen local menu

Test as usual Expect very little amplification below 1000

Hz. Fit to target only in mid-to-high frequencies

Example of Open Fit Real-ear

Using the FONIX NOAH Module Friendly Windows-based interface Automatically use NOAH audiogram Can send NOAH audiogram to analyzer Perform real-ear and coupler

measurements from computer Save all results into NOAH database On Top window: Perform real-ear while

adjusting the hearing aid!

Interface

Now for a FONIX NOAH Module Demonstration!