Background noise is particularly damaging to speech intelligibility for people with hearing loss. The problem of reducing noise in hearing aids is one of great importance and great difficulty. Over the years, many solutions and different algorithms have been implemented in order to provide the optimal solution to the problem. Beamforming has been used for a long time and has therefore been extensively researched. Studying the performance of Minimum Variance Distortionless Response (MVDR) beamforming with a three- and four- microphone array compared to the conventional two-microphone array, the aim is to implement a speech signal enhancement and a noise reduction algorithm. By using multiple microphones, it is possible to achieve spatial selectivity, which is the ability to select certain signals based on the angle of incidence, and improve the performance of noise reduction beamformers. This thesis proposes the use of beamforming, an existing technique in order to create a new way to reduce noise transmitted by hearing aids. In order to reduce the complexity of that system, we use hybrid cascades, which are simpler beamformers of two inputs each and connected in series. The configurations that we consider are a three-microphone linear array (monaural beamformer), a three-microphone configuration with a two-microphone linear array and the 3rd microphone in the ear (monaural beamformer), a three-microphone configuration with a two-microphone linear array and the 3rd microphone on contra-lateral ear (binaural beamformer), and finally four-microphone configurations. We also investigate the performance improvement of the beamformer with more than two microphones for the different configurations, against the two-microphone beamformer reference. This can be measured by using objective measurements, such as the amount of noise suppression, target energy loss, output SNR, speech intelligibility index and speech quality evaluation. These objective measurements are good indicators of subjective performance. In this project, we prove that most hybrid structures can perform satisfyingly well compared to the full complexity beamformer. The low complexity beamformer is designed with a fixed target location (azimuth), where its weights are calibrated with respect to a target signal located in front of the listener and for a diffuse noise field. Both second- and third- order beamformers are tested in different acoustic scenarios, such as a car environment, a meeting room, a party occasion and a restaurant place. In those scenarios, the target signal is not arriving at the hearing aid directly from the front side of the listener and the noise field is not always diffuse. We thoroughly investigate what are the performance limitations in that case and how well the different cascades can perform. It is proven that there are some very critical factors, which can affect the performance of the fixed beamformer, concerning all the hybrid structures that were examined. Finally, we show that lower complexity cascades for both second- and third- order beamformers can perform similarly well as the full complexity beamformers when tested for a set of multiple Head Related Transfer Functions (HRTFs) that correspond to a real head shape.

Introdução: O envelhecimento da população é um fenômeno que tem ocorrido mundialmente, inclusive no Brasil, caracterizado por alterações físicas, cognitivas e sensoriais. Nesse contexto é possível verificar alterações sensoriais importantes como a deficiência auditiva, onde o uso do Aparelho de Amplificação Sonora individual (AASI) tem como proposta minimizar os efeitos da deficiência auditiva propiciando o maior aproveitamento da audição residual. No entanto, a dificuldade de manipulação do AASI é um dos fatores que fazem com que o indivíduo deficiente auditivo protele ou abandone o uso. Iniciativas utilizando Teleducação tem tido êxito na orientação de indivíduos na área da saúde, incluindo a Fonoaudiologia. Portanto, é necessário o desenvolvimento de projetos que auxiliem o deficiente auditivo idoso no processo de adaptação do AASI. Objetivo: avaliar o DVD Conhecendo e Aprendendo sobre o meu Aparelho Auditivo (Vol. 1) no processo de adaptação do AASI. Metodologia: A metodologia foi dividida em 2 etapas de desenvolvimento. Na primeira etapa o projeto foi dividido em duas fases, senda uma de avaliação e outra a reestruturação do material didatico. Na primeira fase o DVD foi, primeiramente, avaliado por 22 fonoaudiólogos e por 25 idosos usuários de AASI. Na segunda fase, as sugestões feitas pelos avaliadores foram analisadas para a reestruturação do referido DVD volume 1. A segunda etapa consistiu na verificação da eficácia da nova versão do DVD junto aos indivíduos deficientes auditivos idosos novos usuários de AASI, com um grupo controle, composto por 14 indivíduos, que receberam apenas as orientações fonoaudiológicas e o grupo experimental, composto por 13 indivíduos, que além das orientações fonoaudiológicas, também recebeu o material didático em DVD volume 2. A eficácia da versão do DVD foi mensurada por meio da utilização do questionário PHAST, o qual foi aplicado nos grupos E e F. Resultados: Na primeira etapa os avaliadores sugeriram atualização dos modelos de AASI retroauricular, inserção do tempo de ativação da pilha e menor velocidade de fala e legendas. A reestruturação do material didático em DVD foi realizada por meio do financiamento da FAPESP, que possibilitou a contratação de uma produtora para realizar o trabalho. Houve reestruturação do roteiro, das filmagens e das edições do vídeo. Quanto à segunda etapa, não houve diferença estatisticamente significante entre a facilidade/dificuldades de manuseio encontradas nos grupos controle e experimental. A avaliação feita pelo Grupo experimental sobre o quanto o DVD volume 2 ajudou na compreensão dos conteúdos sobre o AASI, a maioria da amostra relatou que esse ajudou muito em todos os pontos avaliados. A menor classificação foi satisfatória para os aspectos abordados no DVD, não havendo diferença estatisticamente significante quando comparado ao grupo de antigos usuários de AASI. Discussão: O material didático foi avaliado, sendo sua reestruturação respaldada em estudos voltados para elaboração de materiais didáticos à distância. Todas as dificuldades encontradas pelos grupos controle e experimental corroboraram com a literatura. As avaliações feitas pelo grupo experimental mostrou o elevado grau de satisfação com o DVD Volume 2. Conclusões: O DVD Conhecendo e Aprendendo sobre o meu Aparelho Auditivo volume 2 foi avaliado, se mostrando eficaz no auxílio de indivíduos idosos novos usuários de AASI retroauricular / Introduction: The high rate of aging is a phenomenon that has occurred worldwide, including Brazil and the process leads to physical, cognitive and sensory. One change is the sensory hearing loss, which may cause the wearer to isolation. The hearing aids (HA) are used to minimize the effects of hearing loss producing good results. However, the difficulty in handling the hearing aid is one of the factors that make a person deaf procrastinate or abandon the use. Teleducation initiatives have been successful using the instruction of individuals in health, including Speech Pathology and Audiology area. Therefore, it is necessary to develop projects that assist the hearing impaired elderly in the process of fitting of hearing aids. Objective: To evaluate the DVD \"Knowing and Understanding about My Hearing Aid\" in the process of fitting of hearing aids. Methodology: The methodology was divided into two stages of development. In the first phase of the first stage, the mentioned educational materials on DVD was first evaluated by 22 audiologists and 25 elderly hearing aid users. In the second phase of the first stage, the suggestions made by the evaluators were analyzed for the restructuring of this DVD Volume 1. The second step was to verify the effectiveness of the new version of the DVD along with the elderly hearing impaired individuals new hearing aid users, with a control group of 14 individuals who received only hearing aid orientation and the experimental group, composed of 13 individuals who apart from hearing aid orientation, also received educational materials on DVD Volume 2. The effectiveness of the DVD version was measured by using the PHAST questionnaire, which was applied in groups E and F. Results: In the first stage, the evaluators suggested updating of models of BTE hearing aids, insertion time of cell activation and slower rate of speech and subtitles. The restructuring of the teaching material on DVD was accomplished through funding from FAPESP, which enabled the hiring of a producer to do the job. There was a restructuring of the script, filming and edits the video. The second stage, there was no statistically significant difference between the ease / difficulty of handling found in the experimental and control groups. The assessment made by the experimental group over how much the Volume 2 DVD helped in understanding the content on their devices, most of the sample reported that this \"very helpful\" in all points evaluated. The lowest rating was \"satisfactory\" to the points raised in the DVD, with no statistically significant difference when compared to former users of hearing aids. Discussion: The teaching material was evaluated, and backed its restructuring in studies aimed at preparing distance learning materials. All the difficulties encountered by the control and experimental groups corroborated the literature. The assessments made by the experimental group showed the high degree of satisfaction with the DVD Volume 2. Conclusions: The DVD \"Knowing and Understanding My Hearing Aid\" Volume 2 was evaluated, proving effective in helping the elderly new users of BTE hearing aids.

A deficiência auditiva pode ter impacto negativo na qualidade de vida do indivíduo interferindo nas esferas das atividades e participação. O Aparelho de Amplificação Sonora Individual (AASI) é uma alternativa viável de tratamento para grande parte desta população. Entretanto, a simples aquisição de AASI não garante a resolução da deficiência. Estudos vêm apontando benefícios do aconselhamento de ajuste pessoal ao usuário de AASI desde a etapa de diagnóstico audiológico, favorecendo o processo de adaptação. Neste sentido, o objetivo deste estudo foi analisar o modelo transteórico de aconselhamento (MTT) que tem permitido uma abordagem mais ampla do indivíduo de maneira a englobar o sistema de crenças e aspectos motivacionais em candidatos a uso de AASI. Participaram deste estudo 20 candidatos (10 homens e 10 mulheres), com idades entre 25 e 64 anos (média = 52,95 anos) e deficiência auditiva neurossensorial bilateral de grau variando entre leve e severa. As estratégias utilizadas para o aconselhamento foram: a Escala de Prontidão (EP) e a Balança Decisória (BD), ambas propostas pelo Ida Institute, e as Proposições de Babeu et al. (2004). O aconselhamento foi realizado em três sessões: após o diagnóstico audiológico; no retorno para o teste com AASI, mas antes do mesmo; e após, ao menos, uma semana de utilização do AASI. Em cada sessão eram aplicadas as três ferramentas. As atitudes dos participantes foram avaliadas nos três momentos por meio do Questionário de Atitudes frente à Deficiência Auditiva (ALHQ). Como resultado, os participantes de modo geral mostraram por meio da EP, nos três momentos, que consideravam ser muito importante a melhora da audição e percebiam-se preparados para o uso do AASI. A BD indicou os elementos a serem trabalhados e que levaram os participantes a atribuírem valores na EP e a escolha nas Proposições de Babeu et al. (2004) por meio de reflexões quanto às vantagens e desvantagens com relação à audição prejudicada e ao uso de AASI. Tanto a BD quanto as Proposições de Babeu et al. (2004) possibilitaram a discriminação do estágio de mudança a que cada participante se encontrava. A maioria dos participantes indicou o estágio de ação para a sua condição motivacional nos três momentos. Comparando as atitudes dos participantes nesses três momentos, foram evidenciadas diferenças estatisticamente significantes somente com a influência da experiência com AASI (subescalas de Negação da perda auditiva e Estratégias negativas de enfrentamento). Embora não tenham sido evidenciadas diferenças estatisticamente significantes sem esta influência, a diminuição na amplitude do desvio padrão nas subescalas de Estima Relacionada à Audição e Associações Negativas sugere uma tendência maior à disposição para mudanças a qual pode ser atribuída ao aconselhamento uma vez que nesta etapa o participante ainda não utilizava AASI. Conclui-se que, o MTT aplicado às etapas iniciais do processo de adaptação do AASI constitui em uma proposta objetiva e factível para que este processo englobe aspectos importantes tais como o sistema de crenças, ideias, sentimentos e a condição motivacional do candidato, permitindo identificar as diferenças individuais bem como organizar as próximas etapas do processo de adaptação. / Hearing loss can negatively impact the quality of life of individuals, interfering their activities and participation. Hearing aids (HA) can be a viable treatment alternative for most of this population. However, the mere acquisition of HA does not guarantee the resolution of hearing loss. Researchers have emphasized the benefits of personal adjustment counseling for hearing aid users from audiology diagnostic step , facilitating the fitting process. This study, in particular, analyzed the transtheoretical model of counseling (MTT), which allows a broad approach to each individual, encompassing a system of beliefs and motivational aspects of the candidates who will begin using HA. This study included 20 volunteers10 men and 10 women) aged between 25 and 64 years (mean = 53 years) with bilateral sensorineural hearing loss varying between mild and severe. Three strategies were employed for counseling the volunteers, (1) the Readiness Scale (RS) strategy and (2) the Decisional Balance (DB) strategy, both from the Ida Institute, and (3) the Propositions of Babeu et al. (2004) strategy. Counseling was conducted during three sessions, (1) after the audiological diagnosis, (2) just prior to the first test with HA, and (3) after at least one week of using HA. During each session, the three strategies were applied. The attitudes of the participants were also evaluated over these three time periods using the Attitudes towards Loss of Hearing Questionnaire (ALHQ). Under the context of the RS strategy, the subjects demonstrated during the three sessions that was very important to improve ones hearing and perceived themselves prepared for hearing aid use. The BD strategy indicated elements to be improved, allowing participants to assign the values of the RS and chose the propositions of Babeu et al. (2004) by analyzing the advantages and disadvantages in relation to impaired hearing and the use of HA. Both the BD strategy and the propositions of Babeu et al. (2004) strategy allowed the discrimination of the stages of change that each participant experienced. Most participants indicated the action stage for their motivational condition during the three sessions. When comparing the attitudes of participants during these three sessions, significant differences were found only after using HA (subscales of \"denial of hearing loss\" and \"negative coping strategies\"). Although no statistically significant differences without this influence were found, the decrease in the amplitude of the standard deviation in the subscales of hearing-related esteem and negative associations might suggest that patients with out HA are more willing to change after counseling . It is concluded that when the MTT is applied to the initial steps of the hearing aid fitting process that an objective and feasible proposal can incorporate important aspects such as beliefs, ideas, feelings and motivational conditions of candidates, to identify their individual differences and organize the next steps of the fitting process, facilitating this process.

As malformações congênitas de orelha causam dificuldades auditivas, interferindo no desenvolvimento das habilidades de fala e linguagem e, consequentemente, prejudicando o desenvolvimento social, emocional, cognitivo e acadêmico da criança. Para minimizar estas dificuldades, o aparelho de amplificação sonora individual (AASI) por condução óssea é indicado. Com a possibilidade de adaptação do sistema de frequência modulada (FM) pelo SUS, de acordo com a portaria n° 1.274 do Ministério da Saúde, de 25 de junho de 2013, o objetivo deste trabalho foi avaliar o benefício deste dispositivo em crianças e adolescentes com malformação de orelha externa e/ou média, usuários de AASI por condução óssea, sob a ótica dos próprios usuários, seus pais e professores. Participaram da pesquisa vinte e quatro crianças e adolescentes, doze pais ou responsáveis e doze professores. Foram utilizados os instrumentos: Listas de Sentenças em Português, para avaliar a percepção de fala no ruído e Classroom Participation Questionnaire (CPQ), para a auto avaliação da participação em sala de aula (usuários); Questionário Avaliação do Sistema FM, para avaliar o desempenho em diferentes situações auditivas (pais) e Screening Instrument For Targeting Educational Risk in Secondary Students (SIFTER), para a avaliação do desempenho acadêmico (professor). Todas as avaliações foram realizadas nas condições com e sem o sistema de FM e para a comparação dos resultados foi utilizado o teste t pareado. Em todos os procedimentos estatísticos foi adotado nível de significância de 5% (p<0,05). Foi observada diferença significante com o uso do sistema de FM para todos os aspectos avaliados, evidenciando o benefício da adaptação deste dispositivo para esta população. / Congenital ear malformations cause hearing impairment, interfering with speech and language development, and, consequently, impairing the social, emotional, cognitive and academic development of the child. Bone conduction hearing aids are indicated to minimize these difficulties. With the possibility of fitting the FM System by the Brazilian Health Public System, according to the ordinance no. 1,274 from the Ministry of Health, dated June 25, 2013, this study aimed to evaluate the benefit of the FM System in children and adolescents with external ear and/or middle ear malformation, users of bone conduction hearing aids, through the perspective of the users, their parents and teachers. Twenty-four children and adolescents, twelve parents or guardians, and twelve teachers participated in this study. The instruments used were: Sentence Lists in Brazilian Portuguese, to evaluate speech perception in noise, and Classroom Participation Questionnaire (CPQ), for self-assessment of classroom participation (users); FM System Evaluation Questionnaire, to evaluate performance in different auditory situations (parents); and Screening Instrument for Targeting Educational Risk in Secondary Students (SIFTER), to evaluate academic performance (teachers). All evaluations were performed with and without the FM System, and the paired t-test was used to compare the results. A significance level of 5% was adopted (p<0.05) in all statistical tests. A significant difference was observed with the use of the FM system in all aspects evaluated, demonstrating the benefit of fitting this device in this population.

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Hearing aid users often complain of poor speech understanding in the presence of background noise. There have been many attempts to overcome this problem by hearing aid manufactures and dispensers. The purpose of the present study was to determine if differences existed between three different styles of hearing aids (i.e. in the ear (ITE), in the canal (ITC), and completely in the canal (CIC)) in the presence of a multi-talker babble. Five sensori-neural hearing impaired subjects were selected from the Portland State University audiology clinic. The subjects were required to listen to a recording of the California Consonant Test (CCT) against a background noise of multi-talker babble. Stimuli were presented through headphones in the sound booth. The stimuli were recorded through three different hearing aids placed on KEMAR's left ear and adjusted to a 10 dB signal-to-noise ratio. Once the speech samples were recorded and digitized, they were routed through a GSl-16 audiometer to the listener. In order to determine performance differences across the three hearing aid configurations from within a single-subject design, each subject's performance was compared in a pairwise fashion between the hearing aid configurations. An analysis of the data was completed using the Randomization test. Using this statistical model, no significant difference was found between the individual scores. Further research is warranted to determine if a better measure exists that qualitatively defines the effect of microphone placement on speech understanding ability in hearing aid users.

Industrial workers who have sustained hearing losses often wear hearing aids on the job in order to hear their co-worker's speech. However they risk damaging their hearing further by amplifying the high levels of background noise typical of such environments. The Occupational Safety and Health Administration (OSHA) has established guidelines to protect workers' hearing. A maximum allowable level of 90 dBA averaged over a period of eight hours is considered safe. Wearing hearing aids on the job may expose an individual to a considerably higher levels, however no guidelines as to maximum allowable levels of amplified noise exist at this time. This study evaluated the performance of four hearing aids in noise to determine which would provide appropriate amplification without exceeding the OSHA maximum. The instruments were adjusted to provide 14 different frequency responses and placed on the Knowles Mannequin for Acoustic Research (KEMAR). A microphone in the position of KEMAR's eardrum recorded amplified levels of taped industrial noise. A sound level meter integrated the levels to give the OSHA Time Weighted Average (TWA), simulating the acoustic effect of an 8-hour noise exposure on an industrial worker. Amplified noise remained below the OSHA maximum (90 dBA) in 2 of the 14 hearing aid conditions studied. Noise amplified by the Argosy Expander, an experimental noise-reducing hearing aid, remained below the OSHA maximum when the instrument was set to provide minimum gain and maximum noise reduction. The Argosy 3-Channel Clock also maintained amplified noise at a safe level when adjusted to provide gain only in a limited frequency region. Noise amplified by the Danavox Aura X programmed to provide a TILL response remained within one dB of the OSHA maximum. This study demonstrated that it is possible to use amplification in environments with constant background noise without risking additional noise-induced hearing loss. Two hearing aids were proven effective in maintaining amplified industrial noise at safe levels, however determining their effect on speech intelligibility in noise is beyond the scope of this study. Further research is needed to address this issue.

These two joint-studies used recorded versions of the Northwestern University Auditory Test Number 6 (NU-6) and the California Consonant Test (CCT) in the hearing aid evaluations (HAEs) of 12 male and one female subjects, aged 41 to 87 years. They exhibited precipitous high frequency losses beyond 1 kHz in at least one ear. All subjects were evaluated without amplification and while monaurally aided with two conventional high pass hearing aids. Ten of the subjects were evaluated in multi-talker noise and 11 were tested in quiet. Since the CCT was more heavily weighted than the NU-6 with target phonemes sensitive to high frequency losses, it was hypothesized that the CCT might be more sensitive than the NU-6 to significant differences between aided and/or unaided performances of these particularly high frequency impaired subjects. The data collected in noise and in quiet was analyzed separately with the one-way analysis of variance (ANOVA) for repeated measures. No significant differences were found in noise or quiet between the aided performances on either the CCT or the NU-6. The NU-6 in noise, however, revealed significant degrees of aided improvement at the .01 level of confidence that the CCT did not. The addition of noise seemed to make the CCT too difficult for these subjects. In quiet, both tests seemed to be as equally sensitive in revealing significant aided improvement at the .01 level of confidence. The lower mean CCT scores in quiet, however, seemed to indicate that if unaided NU-6 performances are too high to allow for significant aided improvement or significant differences between aids, the more time consuming CCT might be appropriate.