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Expectations for speech in noise?

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I have been trialing Phonak L90 RLs for almost a month. I have been back to the audiologist 3 times so far as I have been disappointed In my ability to hear speech in noise. My audiologist put two additional programs in the , one called speech in noise and the other speech in loud noise. In an attempt to quantify what I am hearing, I have attempted to test my understanding of speech at measured sound levels. For background noise I used the YouTube channel “Restaurant Noise” and for sound measurement I used a Radio Shack sound meter. I asked my wife to read some material in a quiet setting (without background noise) and it registered at about 55 . I added the background noise (have a surround speaker system) and I found that I could pick up enough words while not looking at her to understand context with some effort with a background noise level of 60dB. There does not seem to be perceptible difference between the two HA noise settings. My question is whether that is a great improvement or whether I should hope for more. I am using power domes rather than ear molds. I am getting on toward the later part of my 45 day trial period and will have to make a decision on whether to keep these soon. I was hoping for better, but maybe my expectations are not reasonable.

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Speech in noise, the holy grail.
It’s so very difficult to answer your question because your hearing is very personal.

Let’s say you are an experienced hearing aid person. You wear your aids every day. Let’s also say that those aids were not fit properly and you were not getting all the needed sounds for a long time.

Now let’s say you get new aids that are properly fit for your loss. In this scenario your brain is getting a bunch of new sounds that it has to learn, it takes some time.

Or it could be a number of different scenarios.

Are you fitted with ear molds?

Hopefully more experienced members will help with your questions.

If you’re truly able to understand 55dB speech in 60dB noise, that is fantastic. Typically one needs the speech to be louder than the background noise. For some people it needs to be 15dB or more above the above the background noise. If you need the ultimate for speech in noise, consider a PartnerMic for one on one or a Roger Select, On or Table Microphone for group settings. If the later, make sure you understand the need for receiver licenses.

As other have stated, speech understanding in really loud noise is the ultimate torture test for hearing aids. I believe that speech in loud noise can be divided into two categories.

  1. Speech in random loud noise: This is trying to understand speech when there is a ton of noise but the noise is created by machinery, traffic or a large crowd. The Lumity hearing aids do really well with this type of noise.

  2. Speech in loud noise caused by many speakers in close proximity: This is the WORST case. This is where you are at a table in a restaurant and there are many conversations going on at the same time. The conversations could be at your table or other tables that are close by and the voice volume levels are similar. The big issue here is that Lumity (or other new hearing aids) can’t decide which speech source they should focus on. When this scenario occurs, you find find you cannot hear the person you are talking to but you can hear a louder person at a table beside/behind you. In other words, the hearing aids are focusing on someone else other than the person you are talking to. Not sure there is a good solution to this problem other using a Roger microphone or making sure you pick a table against the wall and make sure you have your back to the wall to minimize the number of speakers nearby. You can try to force Lumity into the “Speech in Very Loud Noise” program and you can also try to narrow the microphone focus in the app to see if this helps.

As others have stated, you need more signal than noise (signal to noise ratio) for the hearing aids to be effective so anything you can do to minimize noise is helpful. Incidentally, people with normal hearing also struggle to hear in these types of situations.

Jordan

Thanks for the input. I guess the fact that my brain was able to capture enough of the words at 5 under the background noise level and still make some sense of her words is good. I think the background noise would be random since even though the YouTube clip is restaurant noise with voices, the room speakers are in five specific locations, all a few feet farther away from me than the six feet distance I was from my wife. I agree, a real life test would be better.

Some people need up to 20dB Signal-to-Noise () help in noise. Hearing aids alone only provide 4-6 of SNR help, even with the special noise programs and directional mics. If you are someone who really struggles in noise, you could benefit from adding a remote mic (which provide 16-20 dB SNR help) to your hearing aids that transmits the sound directly into your ears. You need to mute the mics on your aids while using the remote mic to keep that noise out. It is a gamechanger for me. Did you have a Speech In Noise test like the ?

I think the bottom line is if there was a particular brand that did a great job with speech in noise we’d all be wearing that brand. Unfortunately we’re not.

In reply to @sufhl

I wondered too whether OP had a speech in noise test done. From what I’ve learned on this forum and my testing in restaurants and other noisy venues, my severe speech in noise loss just will never be corrected by any currently existing hearing aids. Presumably those mic accessories may help, but I do ok either without hearing aids or with a program that dulls most background noise if I’m dining with no more than 3 other people.

My audiologist did not perform any tests. She is just using the I got at Costco and HearingLife. Looking at those reports, there are Word Recognition Scores but no tests of speech in noise. The results section of the HearingLife report is blank. This is a painful learning experience. I have learned much more from this forum than from the audiologists or specialists that I have seen.

In reply to @hass5744

@hass5744 said:

I think the bottom line is if there was a particular brand that did a great job with speech in noise we’d all be wearing that brand. Unfortunately we’re not.

The question is whether whatever aid we are using has been adjusted properly to maximize whatever help the can muster

Sorry I don’t agree with that. But the severity of ones loss certainly plays into it. But every manufacturer raves about their aids ability to handle speech in sound. But if you look at all the threads on this forum regarding that matter it continues to be a major short coming.

Agreed @hass5744… And that’s an almost reverse cookie bite loss that @raylock1 has, they are “Notoriously Hard” to fit… The truth is, no one hears well in loud background noise, even folks with perfect hearing, how can we expect hearing aids to correct this, it’s just not going to happen… And like others have stated, unless you are using an (Assistive Listening Device) like the Roger On remote mic in loud background noise, then the (Signal Noise Ratio) can’t cut it in hearing aids, so it ain’t going to happen, and no matter what the hearing aid manufacturers tell us in their advertising blurb, we are going to struggle badly, in loud background noise…Unfortunately, it is just one of those things, we have to learn to accept… My apologies for being so blunt! Cheers Kev

No problem. Wouldn’t it be nice if the hearing aid companies stated exactly what you just said.

I have the same hearing aids and a very conscientious audiologist who works hard. Phonak Audeo Paradise P90R’s.
he encouraged me to use programs such as those and use the myPhonak APP to doctor them.

What I learned:
If I take the automatic program, doctor it with the app, and save it–it’s not automatic anymore! Frustrated me because I want the hearing aids to be automatic. (they are now.)

I used an electric hand dryer at work as my noise source, and talked to a colleague there. Noisy–

I made real progress. I got to his office early for an appointment. I was sitting about8 feet away from his receptionist and couldn’t understand anything she said when she was talking on the phone.

Automatic—Zip Nothing.
using the program that the hearing aids selected I started playing.

Biggest change was when I added a LOT of Dynamic. That really really helped.

He finally adjusted my programs the way I wanted. Difference was the test was repeatable in his office.

Finally—he uses (real ear measurement?) so that’ good. However, he talks himself for the word recognition. Wish it was recorded.

Dave
Hope this helps.

Edited

In reply to @sufhl

@sufhl said:

If you are someone who really struggles in noise, you could benefit from adding a remote mic

I agree with everything in this post, and I’m about to replace my Roger Pen with a Roger On, which I have tested to be even better. Take a look at this YouTube16( When Hearing Aids Alone Aren’t Enough: Remote Microphones and TV Listening Devices).

@raylock1 said:

I am using power domes rather than ear molds.

@raylock1: Look, I’m not an audiologist, but I have a steeply-sloping similar to yours, and IMO, molds are needed to permit the devices to deliver optimal comprehension/performance.

(You may be “penny wise and pound foolish” not to ante up and test the fairly by using molds.)

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