In Sweden, about 10% of the adult population experienceshearing problems that cause them difficulties in everydaycommunication, and approximately 60 000 people are providedwith hearing aids each year. Despite the fact that modernhearing aids can facilitate speech communication in a widerange of listening environments, many hearing-aid users aredissatisfied with their hearing aids. It is likely that theclinical methods used for individual fitting of the hearingaids are not optimal. The current study investigates prescriptive methods fornonlinear, wide dynamic range compression (WDRC) hearinginstruments. The goal is to draw general conclusions about thepreferences of hearing aid users. Therefore, the prescriptionsare evaluated using well-established models of loudness andspeech intelligibility. Current methods differed considerably in prescribed gain.Evaluations in a laboratory test, with 20 hearing-impairedlisteners, showed that these differences led to largedifferences in perceived and calculated loudness, but only tominor differences in measured and predicted speech recognitionscores. The difference in loudness was explored in a studywhere 21 first-time hearing-aid users compared twoprescriptions. One method led to normal and the other toless-than-normal overall calculated loudness (according to theloudness model of Moore and Glasberg (1997)). The prescriptionthat led to less-than-normal overall loudness was clearlypreferred in field and in laboratory tests. Preferred overall loudness was then quantified.Hearing-impaired participants with mild to moderate hearingloss preferred considerably less-than-normal overall calculatedloudness in both eld and laboratory tests. There were nosignificant differences between inexperienced and experiencedhearing aid users. Normal-hearing participants, on the otherhand, preferred close-to-normal overall calculated loudness. Inaddition, a potential problem with the loudness model wasencountered: despite the fact that the hearing-impairedlisteners were provided with less than normal overallcalculated loudness, they rated loudness higher than thenormal-hearing listeners. The results refute the most commonly adopted rationale forprescriptive methods for WDRC hearing aids - that overallloudness should be restored to normal. Hearing-impairedlisteners with mild to moderate hearing loss preferredconsiderably less than normal overall loudness. This should betaken into account when deriving new prescriptive methods, andwhen providing clients with hearing aids. Key words:hearing impairment, hearing aid, nonlinear,WDRC, hearing aid experience, prescription, loudness, loudnessmodel, speech intelligibility, preference.

<p>In Sweden, about 10% of the adult population experienceshearing problems that cause them difficulties in everydaycommunication, and approximately 60 000 people are providedwith hearing aids each year. Despite the fact that modernhearing aids can facilitate speech communication in a widerange of listening environments, many hearing-aid users aredissatisfied with their hearing aids. It is likely that theclinical methods used for individual fitting of the hearingaids are not optimal.</p><p>The current study investigates prescriptive methods fornonlinear, wide dynamic range compression (WDRC) hearinginstruments. The goal is to draw general conclusions about thepreferences of hearing aid users. Therefore, the prescriptionsare evaluated using well-established models of loudness andspeech intelligibility.</p><p>Current methods differed considerably in prescribed gain.Evaluations in a laboratory test, with 20 hearing-impairedlisteners, showed that these differences led to largedifferences in perceived and calculated loudness, but only tominor differences in measured and predicted speech recognitionscores. The difference in loudness was explored in a studywhere 21 first-time hearing-aid users compared twoprescriptions. One method led to normal and the other toless-than-normal overall calculated loudness (according to theloudness model of Moore and Glasberg (1997)). The prescriptionthat led to less-than-normal overall loudness was clearlypreferred in field and in laboratory tests.</p><p>Preferred overall loudness was then quantified.Hearing-impaired participants with mild to moderate hearingloss preferred considerably less-than-normal overall calculatedloudness in both eld and laboratory tests. There were nosignificant differences between inexperienced and experiencedhearing aid users. Normal-hearing participants, on the otherhand, preferred close-to-normal overall calculated loudness. Inaddition, a potential problem with the loudness model wasencountered: despite the fact that the hearing-impairedlisteners were provided with less than normal overallcalculated loudness, they rated loudness higher than thenormal-hearing listeners.</p><p>The results refute the most commonly adopted rationale forprescriptive methods for WDRC hearing aids - that overallloudness should be restored to normal. Hearing-impairedlisteners with mild to moderate hearing loss preferredconsiderably less than normal overall loudness. This should betaken into account when deriving new prescriptive methods, andwhen providing clients with hearing aids.</p><p><b>Key words:</b>hearing impairment, hearing aid, nonlinear,WDRC, hearing aid experience, prescription, loudness, loudnessmodel, speech intelligibility, preference.</p>

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Introdução: Na etapa de verificação da adaptação, o aparelho de amplificação sonora individual vem sendo estudado nos últimos anos por diferentes protocolos e equipamentos, a fim de aumentar a satisfação do usuário. Objetivo: Elaborar um protocolo de verificação de aparelho de amplificação sonora individual utilizando o mapeamento visível da fala amplificada na prática clínica e verificar a satisfação do usuário. Método: Em estudo transversal randomizado duplo-cego, foram avaliados 60 indivíduos adultos separados em dois grupos, sem experiência prévia ao uso do aparelho de amplificação sonora individual modelo retroauricular de tecnologia digital. O Grupo A foi submetido ao Protocolo IIIA, contendo os testes de ganho de inserção, reconhecimento de palavras, mapeamento visível da fala amplificada com verificação sem aconselhamento e os questionários: Client Oriented Scale of Improvement e Satisfaction with amplification in daily life. O Grupo B respondeu ao protocolo IIIB composto por: teste de reconhecimento de palavras, Mapeamento visível da fala amplificada com aconselhamento e os mesmo questionários Client Oriented Scale of Improvement e Satisfaction with amplification in daily life. Resultados: Demonstraram moderada correlação entre o ganho de inserção e o mapeamento visível da fala amplificada. Quando este último registrou os estímulos: suave, médio e forte dentro do campo dinâmico auditivo para 10% de aumento na resposta do teste de reconhecimento de palavras, significou 0,4 a 0,5 pontos de aumento na satisfação do usuário para a situação de silêncio e 0,2 a 0,3 para a situação com ruído competitivo. Conclusões: O protocolo para a verificação do aparelho de amplificação sonora individual elaborado demonstrou ser efetivo para a prática clínica e auxiliar no aumento de satisfação do usuário. / Introduction: The hearing aid verification stage has been studied over many years by different protocols and equipments to increase de user satisfaction. Objective: design a hearing aid protocol using Visible Speech Mapping applied to clinical practice in order to analyze the user satisfaction. Method: The cross-sectional, randomized study was done with 60 adults, separated into two groups without prior amplification experience binaurally fitted with digital behind-the-ear hearing aid technology. Four weeks later, the group A answered Protocol IIIA covering insertion gain, Word recognition test, Visible Seech Mapping verification tool without counseling, Client Oriented Scale of Improvement and Satisfation with Amplification in Daily Life questionnaires. The group B was evaluated using the Protocol IIIB containing Word Recognition Test, Visible Speech Mapping verification and counseling tool, Client Oriented Scale of Improvement and Satisfation with Amplification in Daily Life questionnaries. Results: The results showed moderated correlation between insertion gain and Visible Speech Mapping analyzing the procedures when applied to the group A. When Visible Speech Mapping register a soft, medium and strong stimulus within de dynamic range, each 10% improvement at the Word Recognition Test´s result means a 0.4 to 0.5 points, at silence, and 0.2 a 0.3 points increase at speech-in- noise on the satisfaction global score. Conclusions: digital hearing aid verification protocol using Visible Speech Mapping has demonstrated to be effective to the clinical practice.

A concessão do Sistema de Frequência Modulada para estudantes com deficiência auditiva representa um avanço no que diz respeito à participação desses alunos com maior igualdade de condições no âmbito da aprendizagem. É comum encontrar resistência ao uso deste dispositivo por adolescentes, sendo essa uma fase da vida conflituosa, de muitas mudanças fisiológicas, emocionais e necessidade de pertencimento. O objetivo deste estudo foi investigar o uso do Sistema de Frequência Modulada por adolescentes em um Serviço Público de Saúde. Foram analisados os prontuários de 310 adolescentes e coletados os dados demográficos, socioeconômicos e da consistência do uso do Sistema de Frequência Modulada. A estatística descritiva foi realizada por meio do teste Qui-Quadrado (X²), sendo adotado nível de significância de 5% (p=<0,05). Participaram jovens de ambos os gêneros, com deficiência auditiva bilateral (96,45%), provenientes de todo o Brasil, da classe social Baixa Superior (61,83%) e com escolaridade de ensino fundamental II (57,42%)e estudantes da rede pública (80,28%). A investigação da consistência do uso do dispositivo baseou-se nos 185 adolescentes que retornaram para consulta de acompanhamento entre os anos de 2013 e 2016, dos quais 155 revelaram fazer uso (83,78%), principalmente na escola (63,26%), ou ainda para ver televisão (30,52%) ou ouvir música (29,11%). Dentre os 113 (61,08%) que alegaram dificuldades no uso, 40,32% indicaram a vergonha como maior problema, seguido de quebra do Aparelho de Amplificação Sonora Individual ou do FM (20,16%) e falta de apoio dos professores (17,74%). Dentre os 30 adolescentes que revelaram não fazer uso, 20 devolveram (6,45%), justificando principalmente pela sensação de ausência de benefício, contudo mais da metade não o experienciou em sala de aula (68,75%). Conclui-se que a maioria dos adolescentes faz uso consistente do Sistema de Frequência Modulada; houve relação entre o uso consistente e grau de escolaridade dos pais; os estudantes de escola privada são mais adeptos ao uso consistente do que os da escola pública. É indicado o uso de um protocolo de seleção, adaptação e acompanhamento do uso do Sistema de Frequência Modulada, o desenvolvimento de estratégias clínicas e parcerias com a educação que favoreçam a adesão ao uso consistente, ressaltando-se o importante papel do Assistente Social em orientar e garantir o acesso aos direitos sociais desses jovens, visando a acessibilidade ao estudante com deficiência auditiva em condições de igualdade para o seu pleno desenvolvimento intelectual e social. / Granting the Frequency Modulation system to students with hearing loss represents an advancement in the participation of these students in a learning environment. Resistance to the use of FM system is common among adolescents, who are going through a confusing time in their lives, dealing with conflicting emotions, physiological changes and the need to belong. This study aimed to investigate the use of Frequency Modulation system by adolescents in a public hearing health service. To collect demographic and socioeconomic data and the consistency of FM system usage, medical records of 310 adolescents were analyzed. The descriptive statistic was analyzed using Chi-square test (X²) at a 5% level of significance (p=<0.05). Adolescents of both sexes from all regions of the country were part of the study, 96.45% of them with bilateral hearing loss; 61.83% of them were from upper-lower class; 57.42% from middle school; and 80.28% from public schools. The analysis of the consistency of FM system usage was based on 185 adolescents who returned for follow-up consultation between 2013 and 2016. From that amount, 155 use FM system (83.78%): mostly to go to school (63.26%), but also to watch TV (30.52%) or to listen to music (29.11%). From the 185 adolescents, 133 (61.08%) claimed that they had difficulties in using the FM system. Embarrassment was indicated as the main cause (40.32%), followed by FM system or hearing aid being broken (20.16%), or lack of support from their teachers (17.74%). Also, 30 of the 185 adolescents did not use FM system: 20 returned the device (6.45%), mostly claiming lack of benefit, even though half of them never used the FM system in the classroom (68.75%). The study showed that most adolescents use the Frequency Modulation system consistently; there was a correlation between consistency usage and parents educational level; and it also showed that private school students use FM system with more consistency than public school students. A protocol for selecting, fitting and monitoring the use of the Frequency Modulation system is recommended. The development of clinical strategies and the incentive to make partnerships with Education to promote the consistent use of FM system is indicated. Also, the important role the social workers play needs to be emphasized. As professionals, they guide and guaranty the access to the social rights of these adolescents and provide accessibility to the hearing-impaired students creating conditions of equality for their full intellectual and social development.

Introdução: Na etapa de verificação da adaptação, o aparelho de amplificação sonora individual vem sendo estudado nos últimos anos por diferentes protocolos e equipamentos, a fim de aumentar a satisfação do usuário. Objetivo: Elaborar um protocolo de verificação de aparelho de amplificação sonora individual utilizando o mapeamento visível da fala amplificada na prática clínica e verificar a satisfação do usuário. Método: Em estudo transversal randomizado duplo-cego, foram avaliados 60 indivíduos adultos separados em dois grupos, sem experiência prévia ao uso do aparelho de amplificação sonora individual modelo retroauricular de tecnologia digital. O Grupo A foi submetido ao Protocolo IIIA, contendo os testes de ganho de inserção, reconhecimento de palavras, mapeamento visível da fala amplificada com verificação sem aconselhamento e os questionários: Client Oriented Scale of Improvement e Satisfaction with amplification in daily life. O Grupo B respondeu ao protocolo IIIB composto por: teste de reconhecimento de palavras, Mapeamento visível da fala amplificada com aconselhamento e os mesmo questionários Client Oriented Scale of Improvement e Satisfaction with amplification in daily life. Resultados: Demonstraram moderada correlação entre o ganho de inserção e o mapeamento visível da fala amplificada. Quando este último registrou os estímulos: suave, médio e forte dentro do campo dinâmico auditivo para 10% de aumento na resposta do teste de reconhecimento de palavras, significou 0,4 a 0,5 pontos de aumento na satisfação do usuário para a situação de silêncio e 0,2 a 0,3 para a situação com ruído competitivo. Conclusões: O protocolo para a verificação do aparelho de amplificação sonora individual elaborado demonstrou ser efetivo para a prática clínica e auxiliar no aumento de satisfação do usuário. / Introduction: The hearing aid verification stage has been studied over many years by different protocols and equipments to increase de user satisfaction. Objective: design a hearing aid protocol using Visible Speech Mapping applied to clinical practice in order to analyze the user satisfaction. Method: The cross-sectional, randomized study was done with 60 adults, separated into two groups without prior amplification experience binaurally fitted with digital behind-the-ear hearing aid technology. Four weeks later, the group A answered Protocol IIIA covering insertion gain, Word recognition test, Visible Seech Mapping verification tool without counseling, Client Oriented Scale of Improvement and Satisfation with Amplification in Daily Life questionnaires. The group B was evaluated using the Protocol IIIB containing Word Recognition Test, Visible Speech Mapping verification and counseling tool, Client Oriented Scale of Improvement and Satisfation with Amplification in Daily Life questionnaries. Results: The results showed moderated correlation between insertion gain and Visible Speech Mapping analyzing the procedures when applied to the group A. When Visible Speech Mapping register a soft, medium and strong stimulus within de dynamic range, each 10% improvement at the Word Recognition Test´s result means a 0.4 to 0.5 points, at silence, and 0.2 a 0.3 points increase at speech-in- noise on the satisfaction global score. Conclusions: digital hearing aid verification protocol using Visible Speech Mapping has demonstrated to be effective to the clinical practice.

A variety of algorithms intended for the new generation of hearing aids is presented in this thesis. The main contribution of this work is the hidden Markov model (HMM) approach to classifying listening environments. This method is efficient and robust and well suited for hearing aid applications. This thesis shows that several advanced classification methods can be implemented in digital hearing aids with reasonable requirements on memory and calculation resources. A method for analyzing complex hearing aid algorithms is presented. Data from each hearing aid and listening environment is displayed in three different forms: (1) Effective temporal characteristics (Gain-Time), (2) Effective compression characteristics (Input-Output), and (3) Effective frequency response (Insertion Gain). The method works as intended. Changes in the behavior of a hearing aid can be seen under realistic listening conditions. It is possible that the proposed method of analyzing hearing instruments generates too much information for the user. An automatic gain controlled (AGC) hearing aid algorithm adapting to two sound sources in the listening environment is presented. The main idea of this algorithm is to: (1) adapt slowly (in approximately 10 seconds) to varying listening environments, e.g. when the user leaves a disciplined conference for a multi-babble coffee-break; (2) switch rapidly(in about 100 ms) between different dominant sound sources within one listening situation, such as the change from the user's own voice to a distant speaker's voice in a quiet conference room; (3) instantly reduce gain for strong transient sounds and then quickly return to the previous gain setting; and (4) not change the gain in silent pauses but instead keep the gain setting of the previous sound source. An acoustic evaluation shows that the algorithm works as intended. A system for listening environment classification in hearing aids is also presented. The task is to automatically classify three different listening environments: 'speech in quiet', 'speech in traffic', and 'speech in babble'. The study shows that the three listening environments can be robustly classified at a variety of signal-to-noise ratios with only a small set of pre-trained source HMMs. The measured classification hit rate was 96.7-99.5% when the classifier was tested with sounds representing one of the three environment categories included in the classifier. False alarm rates were0.2-1.7% in these tests. The study also shows that the system can be implemented with the available resources in today's digital hearing aids. Another implementation of the classifier shows that it is possible to automatically detect when the person wearing the hearing aid uses the telephone. It is demonstrated that future hearing aids may be able to distinguish between the sound of a face-to-face conversation and a telephone conversation, both in noisy and quiet surroundings. However, this classification algorithm alone may not be fast enough to prevent initial feedback problems when the user places the telephone handset at the ear. A method using the classifier result for estimating signal and noise spectra for different listening environments is presented. This evaluation shows that it is possible to robustly estimate signal and noise spectra given that the classifier has good performance. An implementation and an evaluation of a single keyword recognizer for a hearing instrument are presented. The performance for the best parameter setting gives 7e-5 [1/s] in false alarm rate, i.e. one false alarm for every four hours of continuous speech from the user, 100% hit rate for an indoors quiet environment, 71% hit rate for an outdoors/traffic environment and 50% hit rate for a babble noise environment. The memory resource needed for the implemented system is estimated to 1820 words (16-bits). Optimization of the algorithm together with improved technology will inevitably make it possible to implement the system in a digital hearing aid within the next couple of years. A solution to extend the number of keywords and integrate the system with a sound environment classifier is also outlined. / QC 20100611

To date, very few studies have been conducted focusing on ratings of music and music listening experience of hearing aid (HA) users. This study aimed to collect more detailed and descriptive information via a questionnaire, on the music listening experience and ratings of musical sounds from postlingually deafened adults. The following hypotheses were posed: (i) ratings for music from HA users who have been assessed for a cochlear implant (HA-CI group) will be worse than those who have not been assessed for a CI (HA-NCI group); and (ii) HA users with a moderate or worse hearing loss (Moderate+ subgroup) will provide lower ratings for music than those with a mild hearing loss (Mild subgroup). A questionnaire by She (2008), was modified for this study, and subsequently called the University of Canterbury Music Listening Questionnaire – HA version (UCMLQ_HA). The questionnaire was divided into the following seven sections: music listening and music background, sound quality ratings, music styles, music preferences, music recognition, factors affecting music listening enjoyment, and a music training programme. Thirteen HA-CI recipients and 98 HA-NCI recipients returned the questionnaire. The HA-NCI group was divided into two subgroups: mild hearing loss (n = 51), and moderate or worse hearing loss (Moderate+; n = 47). Essentially findings were consistent with hypothesis one, but only partially consistent with hypothesis two. The HA-CI group provided lower ratings for ‘pleasantness’ and ‘naturalness’ of instruments (p = 0.007), and found music styles to be less ‘pleasant’ (p < 0.001) than the HA-NCI group. For musical styles, the HA-CI group preferred solo performers whereas the HA-NCI group preferred groups of performers. In addition to ratings of music, the HA-CI group provided significantly lower ratings for music listening (p = 0.001), and overall music enjoyment (p = 0.021) than the HA-NCI group. For the comparisons between the Mild and Moderate+ subgroups, the Mild subgroup found Instruments to sound significantly ‘less noisy’ (p < 0.001) and ‘less sharp’ (p < 0.001) than the Moderate+ subgroup. The Moderate+ subgroup provided higher ratings for overall enjoyment of listening to music with HAs than the Mild subgroup (p = 0.044). Both subgroups rated the drum kit (the lowest rated Instrument) to be significantly less pleasant and less natural than all other Instruments. It was also found that all musical styles were significantly more pleasant than Pop/Rock. There were similarities between the groups for music preferences; the male singer was significantly preferred over female singers (p = 0.021), and low-pitched instruments were significantly preferred over high-pitched instruments (p = 0.04). Classical music was also selected as the style that sounded the best with their HAs and listened to the most often. Almost all of the respondents indicated that they would like music in general to sound it would to those with normal hearing (97.1%). Close to 30% indicated that they would be interested in an MTP and would like it to focus on a wide range of music and feature commonly known tunes. In addition, training sessions should consist of two 30 minute sessions per week. Overall this study indicates that ratings of music differ with level of hearing loss to some degree. The general consensus was that music did not sound as they would expect it to sound to a person with normal hearing, and that respondents would like to enjoy listening to music more.

To date, very few studies have been conducted focusing on ratings of music and music listening experience of hearing aid (HA) users. This study aimed to collect more detailed and descriptive information via a questionnaire, on the music listening experience and ratings of musical sounds from postlingually deafened adults. The following hypotheses were posed: (i) ratings for music from HA users who have been assessed for a cochlear implant (HA-CI group) will be worse than those who have not been assessed for a CI (HA-NCI group); and (ii) HA users with a moderate or worse hearing loss (Moderate+ subgroup) will provide lower ratings for music than those with a mild hearing loss (Mild subgroup). A questionnaire by She (2008), was modified for this study, and subsequently called the University of Canterbury Music Listening Questionnaire – HA version (UCMLQ_HA). The questionnaire was divided into the following seven sections: music listening and music background, sound quality ratings, music styles, music preferences, music recognition, factors affecting music listening enjoyment, and a music training programme. Thirteen HA-CI recipients and 98 HA-NCI recipients returned the questionnaire. The HA-NCI group was divided into two subgroups: mild hearing loss (n = 51), and moderate or worse hearing loss (Moderate+; n = 47). Essentially findings were consistent with hypothesis one, but only partially consistent with hypothesis two. The HA-CI group provided lower ratings for ‘pleasantness’ and ‘naturalness’ of instruments (p = 0.007), and found music styles to be less ‘pleasant’ (p < 0.001) than the HA-NCI group. For musical styles, the HA-CI group preferred solo performers whereas the HA-NCI group preferred groups of performers. In addition to ratings of music, the HA-CI group provided significantly lower ratings for music listening (p = 0.001), and overall music enjoyment (p = 0.021) than the HA-NCI group. For the comparisons between the Mild and Moderate+ subgroups, the Mild subgroup found Instruments to sound significantly ‘less noisy’ (p < 0.001) and ‘less sharp’ (p < 0.001) than the Moderate+ subgroup. The Moderate+ subgroup provided higher ratings for overall enjoyment of listening to music with HAs than the Mild subgroup (p = 0.044). Both subgroups rated the drum kit (the lowest rated Instrument) to be significantly less pleasant and less natural than all other Instruments. It was also found that all musical styles were significantly more pleasant than Pop/Rock. There were similarities between the groups for music preferences; the male singer was significantly preferred over female singers (p = 0.021), and low-pitched instruments were significantly preferred over high-pitched instruments (p = 0.04). Classical music was also selected as the style that sounded the best with their HAs and listened to the most often. Almost all of the respondents indicated that they would like music in general to sound it would to those with normal hearing (97.1%). Close to 30% indicated that they would be interested in an MTP and would like it to focus on a wide range of music and feature commonly known tunes. In addition, training sessions should consist of two 30 minute sessions per week. Overall this study indicates that ratings of music differ with level of hearing loss to some degree. The general consensus was that music did not sound as they would expect it to sound to a person with normal hearing, and that respondents would like to enjoy listening to music more.

A concessão do Sistema de Frequência Modulada para estudantes com deficiência auditiva representa um avanço no que diz respeito à participação desses alunos com maior igualdade de condições no âmbito da aprendizagem. É comum encontrar resistência ao uso deste dispositivo por adolescentes, sendo essa uma fase da vida conflituosa, de muitas mudanças fisiológicas, emocionais e necessidade de pertencimento. O objetivo deste estudo foi investigar o uso do Sistema de Frequência Modulada por adolescentes em um Serviço Público de Saúde. Foram analisados os prontuários de 310 adolescentes e coletados os dados demográficos, socioeconômicos e da consistência do uso do Sistema de Frequência Modulada. A estatística descritiva foi realizada por meio do teste Qui-Quadrado (X²), sendo adotado nível de significância de 5% (p=<0,05). Participaram jovens de ambos os gêneros, com deficiência auditiva bilateral (96,45%), provenientes de todo o Brasil, da classe social Baixa Superior (61,83%) e com escolaridade de ensino fundamental II (57,42%)e estudantes da rede pública (80,28%). A investigação da consistência do uso do dispositivo baseou-se nos 185 adolescentes que retornaram para consulta de acompanhamento entre os anos de 2013 e 2016, dos quais 155 revelaram fazer uso (83,78%), principalmente na escola (63,26%), ou ainda para ver televisão (30,52%) ou ouvir música (29,11%). Dentre os 113 (61,08%) que alegaram dificuldades no uso, 40,32% indicaram a vergonha como maior problema, seguido de quebra do Aparelho de Amplificação Sonora Individual ou do FM (20,16%) e falta de apoio dos professores (17,74%). Dentre os 30 adolescentes que revelaram não fazer uso, 20 devolveram (6,45%), justificando principalmente pela sensação de ausência de benefício, contudo mais da metade não o experienciou em sala de aula (68,75%). Conclui-se que a maioria dos adolescentes faz uso consistente do Sistema de Frequência Modulada; houve relação entre o uso consistente e grau de escolaridade dos pais; os estudantes de escola privada são mais adeptos ao uso consistente do que os da escola pública. É indicado o uso de um protocolo de seleção, adaptação e acompanhamento do uso do Sistema de Frequência Modulada, o desenvolvimento de estratégias clínicas e parcerias com a educação que favoreçam a adesão ao uso consistente, ressaltando-se o importante papel do Assistente Social em orientar e garantir o acesso aos direitos sociais desses jovens, visando a acessibilidade ao estudante com deficiência auditiva em condições de igualdade para o seu pleno desenvolvimento intelectual e social. / Granting the Frequency Modulation system to students with hearing loss represents an advancement in the participation of these students in a learning environment. Resistance to the use of FM system is common among adolescents, who are going through a confusing time in their lives, dealing with conflicting emotions, physiological changes and the need to belong. This study aimed to investigate the use of Frequency Modulation system by adolescents in a public hearing health service. To collect demographic and socioeconomic data and the consistency of FM system usage, medical records of 310 adolescents were analyzed. The descriptive statistic was analyzed using Chi-square test (X²) at a 5% level of significance (p=<0.05). Adolescents of both sexes from all regions of the country were part of the study, 96.45% of them with bilateral hearing loss; 61.83% of them were from upper-lower class; 57.42% from middle school; and 80.28% from public schools. The analysis of the consistency of FM system usage was based on 185 adolescents who returned for follow-up consultation between 2013 and 2016. From that amount, 155 use FM system (83.78%): mostly to go to school (63.26%), but also to watch TV (30.52%) or to listen to music (29.11%). From the 185 adolescents, 133 (61.08%) claimed that they had difficulties in using the FM system. Embarrassment was indicated as the main cause (40.32%), followed by FM system or hearing aid being broken (20.16%), or lack of support from their teachers (17.74%). Also, 30 of the 185 adolescents did not use FM system: 20 returned the device (6.45%), mostly claiming lack of benefit, even though half of them never used the FM system in the classroom (68.75%). The study showed that most adolescents use the Frequency Modulation system consistently; there was a correlation between consistency usage and parents educational level; and it also showed that private school students use FM system with more consistency than public school students. A protocol for selecting, fitting and monitoring the use of the Frequency Modulation system is recommended. The development of clinical strategies and the incentive to make partnerships with Education to promote the consistent use of FM system is indicated. Also, the important role the social workers play needs to be emphasized. As professionals, they guide and guaranty the access to the social rights of these adolescents and provide accessibility to the hearing-impaired students creating conditions of equality for their full intellectual and social development.