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Hearing well in noise (with and without assistive technologies)

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I do realise that hearing well in background noise is more or less the holy grail of hearing aid technology and adjustments, but I still want to have a(nother) go at this. The basic question is very simple: How to get the best possible speech understanding in noise, where the noise consists of other people talking? My current hearing aids are Phonak Audéo Marvel with open domes. I have a speech in noise programme, but I’m not very happy with the way it functions (and have found it hard to get it adjusted, since noisy situations aren’t easy to recreate in the audiologist’s office). I also have access to Roger table mics and a Roger pen. The Roger pen is helpful in noisy situations, but there might be more to do regarding adjusting it too.

A very long background to the above question: I work as a university professor and find myself in lots of challenging listening situations, many of them in my second language (English). Typically, the challenging listening situations consist of trying to understand what one person (or worse, a small group of people) are saying in a background noise created by other people speaking (conferences and other events, meetings in restaurants, less well-organised meetings, the list goes on and on).,To some extent I can control such situations (by chairing meetings and keeping a strict talking order, for example) or just avoid them (conference dinners) - but networking is an important (and interesting and fun!) part of my job, and I do find myself in lots of situations that I cannot really control. I’m in my mid-forties, so hopefully I have a long working-life in front of me, so I need sustainable solutions.

My hearing loss was diagnosed thirteen years ago. Most likely I’ve had some degree of hearing loss since childhood (my parents noticed that I wasn’t able to hear crickets when I was very young and told my pediatrician, but somehow I passed both the pediatrician’s audiometry and the school hearing tests). As a young adult I was aware that I didn’t hear high frequency sounds, but it didn’t bother me (and I didn’t experience any issues with my hearing). My hearing seems to have started to decline further in my late twenties and in my early thirties I was struggling with understanding speech at a distance and speech in noise. Had my first real hearing test and found out that I have a steep ski-slope type of hearing loss (sensorineural). No family history of hearing loss and no childhood illnesses, so the whole thing is (as so often) a bit of an enigma. When I had my first hearing test in 2012 my hearing at 2000 Hz was within the normal range (15/25 ), slopping to 90/95 dB at 8000 Hz. Today my hearing at 2000 Hz is at 55/70 dB and 1500 Hz have also started to go (35/50 dB). 6000 and 8000 Hz are at about 100/110 dB and I hear buzzing rather than pure tones (indicating dead zones in the cochlea). Hence, my hearing loss is progressing at a relatively slow rate. My word recognition scores are still excellent (right ear 82% at 80dB and left ear 88% at 75 dB). Any sort of advice regarding hearing better in noise are welcome, including hearing aid adjustments, use of assistive technology, and general strategies.

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Edited

Yeah, as you say, a solution to hearing in noise is the holy grail.

There is no panacea but my instant reaction to your post is that there is better tech out there now that will give you better performance.

Upgrade your Roger Pen to a Roger On iN or Roger Select.

Upgrade your hearing aids to either a Phonak Lumity, Oticon Real/More, Resound Omnia. Or any other premium device - from either Widex/Sivantos, Starkey, Unitron, Phillips, Bernafon. The Phonak Marvel is 4 years old and has been superseded by 2 new generations of Phonak aids.

Audio Intelligence from Cambridge have made an assistive device, Orsana, which looks superior to even the latest Phonak Roger products. They are currently seeking sales channels for it via hearing aid companies.

Hi Tea,

My is a little bit similar to yours. And like you I also have reasonable recognition with properly set up hearing aids. But it’s not as good as my audiogram shows and it’s not as good as yours. On the other hand, I’m absolutely deaf at some frequencies.

I use a prescription called Phonak Adaptive Digital Contrast. It preserves envelope structure of a speech signal, but sacrifices temporal fine structure. The standard phonak algorithm does the opposite. For people who are quite lossy, the contrast algorithm can be more helpful. I also use semi linear amplification, not the prescribed setting.

I avoid open domes in noise. I use smaller vents. They screen out some of the noise. That seems to help, although it does sacrifice some of my natural low frequency hearing. I’ve tried the roger pen in noise and it’s disappointed me, in contrast to the way I benefit from it on zoom.

I’ve experimented with rolling off high frequency amplification, because with my genetics I have cochlear dead zones and I know amplifying too far into those regions can sometimes make things worse instead of better. The other thing I do is rely on Sound Recover, the frequency shifting algorithm by Phonak. It helps me understand speech.

I am also trying a speech to text device called SpeakSee. It seems helpful so far but I don’t know much about it yet. It was developed by a Dutch child of Deaf adults. The company is based in Rotterdam. The device includes microphones people wear and with high fidelity and very quickly speech transcription to your phone or computer occurs.

I hope this is helpful. I do rely on lip reading as well. And sometimes having someone nearby who will repeat what was said or will answer a question for me is helpful. Or if someone will speak into Live Transcribe on my phone, a speech to text application, that can help help a lot too.

Also, although you mention sporadic hearing loss in your family, that is exactly the phenotype for a specific type of genetic high frequency hearing loss that involves low frequency retention of hearing. There are a number of publications that speak to this. In addition, there’s a laboratory that just reclassified many mutations in hearing loss genes as truly being responsible for the hearing phenotype. These were previously classified as benign and without effect.

I agree with earmolds and sound recover.

My opinion is you are losing too many highs to have good understanding in noise as well as in quiet. Using technology will take an effort to learn it but you will do much better. I know this technology worked great for me.

@Tea said:

My current hearing aids are Phonak Audéo Marvel with open domes. I have a speech in noise programme, but I’m not very happy with the way it functions (and have found it hard to get it adjusted, since noisy situations aren’t easy to recreate in the audiologist’s office).

Since you (rightly so) use an open domes, this type of dome allows noise to get through the vent holes into your ear naturally, so any kind of beam forming to aggressively attenuate sounds from behind and the sides to let you focus on sound in the front (normally speech) will not be very effective, because the open domes leak all sounds in and prevent any sound blocking.

Since you’re using Phonak aids, inquire about the active vent receivers (a Phonak exclusive feature). They can be programmed to close off in noisy situations so you can get more effective sound blocking to make the front beam forming more effective. But in normal (not very noisy situations), the active vent receivers will open up the vent openings to minimize occlusion for you.

Since I am not as technical as many, I can’t speak with eloquence. However, from my experiences, I have been using the Philips 9040s from Costco for about 6 weeks now. The Speech in Noise program has helped me significantly in those noisy areas. I used to struggle a lot and while these aren’t perfect, they are much better than my previous (KS7s).

In reply to @glucas

Thank you! I’m in Sweden, with a general health care system that covers hearing aids (similar to the NHS). This means I don’t pay out of pocket for my hearing aids and am entitled to new aids every four years (or when a change in hearing requires a new type of hearing aids). I have another two years before I can get new hearing aids through the general health care system, but could of course buy my own hearing aids if I felt that the difference in performance would motivate it. It may also be possible to get a new and more advanced technology if I can make a good argument about how it’s necessary for my professional needs.

Hadn’t heard about Orsana, this seems interesting! I’m also in Cambridge on a regular basis, so might be possible for me to try it out.

In reply to @billgem

Yet another thing I hadn’t heard about - looks super interesting! Seems reasonable that at some point should be able to make a real difference to how hearing aids handle speech (there are some research studies about this, but I haven’t dug deep into it). However, there’s not that much information on the Whisper web-page regarding fitting range (apart from that it’s not suitable for profound losses) or availability outside of the US. What’s your personal experience of Whisper like?

In reply to @Raudrive

I’ve made an effort to use sound recover, but after several adjustments I just had to give up. I couldn’t get used to the way it sounded (wasn’t able to get rid of the lisping s-sounds, for example). My own (very non-professional) guess is that because I’ve with all likelihood never been able to hear very high frequency sounds my brain just couldn’t make out what was going on. I would be prepared to give it another go when I get new hearing aids, but I don’t really see how more could be done with the hearing aids I’ve currently got.

My speech understanding in non-challenging listening situations is excellent (I even listen to the radio without hearing aids in bed). I think this is what make the contrast to challenging listening situation so stark - it doesn’t take much in terms of noise, bad acoustics or distance for my speech understanding to deteriorate very quickly.

I’ve had an earmold on my worse ear before (I had Oticons then and the feedback control on those weren’t as good as it is on my current hearing aids). Power domes (or any kind of more occluding domes) drive me nuts.

In reply to @Tea

Yes. I have just come back from my Italian class. We had to switch college a couple of weeks ago because of a funding issue with the original college and the new class had high ceilings and very bad acoustics. This week I decided to take my Roger On iN. I wasn’t really expecting much, just some help with hearing the teacher - but the difference was night and day! It was the first time I had used it in a classroom scenario and it did a brilliant job at homing in on my Italian teacher and also - as it has the intelligence, to be able to switch around the class - we were all sitting in a upside down U formation. And that was without even giving the Roger device to the teacher which I could have done. So yeah - you might find that useful in a classroom setting.

Edited

In reply to @cohen

Thank you for your long and thoughtful reply! I’m also completely deaf in the highest frequencies (there is a response at 6/8000 Hz, but I just hear a buzzing sound, not pure tones). Therefore we’ve turned off amplification at those frequencies. Tried Sound recover when I got my current hearing aids, could not get it to work, despite several rounds of adjustments. Long story short: hate it.

I’ve experimented a bit with speech-to-text-apps, but they seem to be coping with speech in noise just as badly as I do (and when it’s quiet I don’t need them). Also, they’re not as far developed in Swedish (my first language) as in English yet, and in English they seem to be doing the best with native speakers (I’m often around second language speakers of English). I expect there to be a rapid development in these technologies, though, with an increased use of - so would imagine this to become increasingly more useful.

I haven’t made any effort to have my hearing loss diagnosed and I’m not sure how useful it would be to know exactly which genes that are involved (I assume my hearing loss is genetic, as there isn’t really any other explanation). I can totally see how other people would be interested in getting a definite answer to what causes their hearing loss, but at least at this point I don’t see much practical implications for myself. If (when?) my hearing loss progress to a point where hearing aids aren’t helpful anymore I guess it can be useful to have an indication of how much low frequency hearing I’m likely to retain over time (and genetic testing might be the answer to that).

In reply to @glucas

Yep, my Roger pen and my three Roger table mics are must when I’m teaching. Incredible for overcoming issues related to distance and to some extent also bad acoustics. I also find that the Roger pen does help in noise, but maybe not as much as I would like it to. But, then, my good speech understanding in quiet circumstances makes me a picky customer :slight_smile:

In reply to @Tea

@Tea said:

I’ve made an effort to use sound recover, but after several adjustments I just had to give up. I couldn’t get used to the way it sounded (wasn’t able to get rid of the lisping s-sounds,

This comment tells us the sound recover settings are a little too aggressive. It needs to be backed off until the S sound does not lisp. It’s also a good idea to try and test only one ear at a time doing this. Sometimes it’s very hard to differentiate which ear is causing an issue.

I can see not needing earmolds. Your is borderline for molds with some people, not everyone. The local pros would probably say you do not need molds.

With your audiogram it’s hard for me to understand that you can listen to a radio and understand it without hearing aids.

Well, here is a high frequency loss much worse than yours. I use Phonak Naida Paradise with ear molds with a slight vent. Sound recover works. I hear birds pretty well. No doubt you need to back off the upper limits or your wife will definitley come with a lisp that seems like she is drunk. I fine tune my own aids, but a good audi should be good with sound recover.

Noisy restaurants will never be good, but Roger can help.

In reply to @Raudrive

Raudrive, regarding your last comment in your post, it has puzzled me too. I can listen to very soft radio or lectures in a quiet room without hearing aids and understand them well. I’m the same as Tea in that regard. But I struggle in meetings and in noise even with hearing aids.

In reply to @Raudrive

The audiologist started our aggressive with sound recover and then dialed it back. One problem, though, was that we were never able to find a sweet spot where I could hear s-sound from more high-pitched voices, while at the same time the s-sound from more low-pitched voices didn’t sound like a lisp. Eventually we (or, I, more like it) gave up. I did have high motivation to make it work and also find the technology interesting as such, but from what I’ve read frequency shifting techniques are a bit hit and miss, where some people don’t really tolerate it.

In reply to @cohen

Having read about other people’s experiences on this website I’ve come to the conclusion that I’ve probably got pretty well-functioning hearing for someone with my . There are obviously lots of sounds I don’t hear (without or with hearing aids) and I do benefit a lot from my hearing aids, but at least under very good listening conditions my speech understanding is still excellent.

@Tea said:

There are obviously lots of sounds I don’t hear (without or with hearing aids) and I do benefit a lot from my hearing aids, but at least under very good listening conditions my speech understanding is still excellent.

Many people are very good at listening to the whole context and whatever they can’t hear, they can still make up for it by analyzing and guessing the rest of what they can’t hear, as long as the context is there. That’s why one may do poorly on the WRT (word recognition test) that comprises of just single words and has no context behind the words, but nevertheless can still function OK in a one on one but quiet environment.

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