Objective: To date, the main focus in frequency lowering hearing aid studies has been in relation to speech perception abilities. With improvements in hearing aid technology, there is a growing interest in musical perception as a dimension that could improve hearing aid users’ quality of life. The purpose of this study was two-fold: Firstly, to develop a test of music perception for adult hearing aid users and secondly, to evaluate the influence of non-linear frequency compression (NFC) on music perception with the use of the Music Perception Test (MPT) compiled by the researcher. Research design and research sample: Phase 1 entailed the compilation of the MPT and can be described as design-based. A quasi-experimental research design was selected to establish the structure of the method employed in Phase 2, which involved the fitting of participants (n=40) with NFC hearing aids. Objective data was obtained with the hearing aids with NFC active and inactive. Phase 3 was characterized by a survey design which elicited subjective impressions of the participants’ musical experiences with NFC active and inactive. Results: Results proved that normal hearing adults as well as adults using hearing aids were able to complete all the sub-tests of the MPT. Furthermore, the use of NFC resulted in a statistically significant improvement in hearing aid users’ perception of timbre and melody, but not of pitch. Overall, no statistically significant improvement in their perception of rhythm was observed, although their performance on some rhythm sub-tests improved significantly. The use of NFC also brought about a statistically significant improvement in hearing aid users’ perception of the music qualities of overall fidelity, tinniness and reverberance. Although participants experienced the loudness, fullness, crispness, naturalness and pleasantness of music more positively with NFC, these benefits were not statistically significant. Conclusion: The MPT can be used successfully for assessing music perception in hearing aid users within the South African context and may therefore result in more accountable hearing aid fittings. The use of NFC may increase hearing aid users’ appreciation of music whilst not influencing music perception negatively. Given that a large percentage of hearing aid users express a loss in enjoyment of music, audiologists should not ignore the possible benefits of NFC, especially if one takes into account that previous research indicated speech perception benefits with this technology. / Thesis (DPhil)--University of Pretoria, 2012. / Speech-Language Pathology and Audiology / Unrestricted

La presbyacousie est une maladie qui concernerait plus de 12 millions de Français mais qui reste peu connue. Si elle n'est pas traitée tôt, elle peut entraîner de graves complications comme des troubles de la communication, de la dépression et des troubles cognitifs. Le constat actuel est que très peu de presbyacousiques sont traités, et lorsqu'ils le sont, le résultat semble insuffisant. L'objet de cette thèse est de proposer à partir des connaissances actuelles, des solutions adaptées aux besoins de ces patients, du dépistage à la réadaptation. Trois études ont été menées : l'étude « AcoumAudio », déclinée en trois volets a montré que l'acoumétrie vocale était un bon test de dépistage de la surdité chez les personnes âgées, d'évaluation du degré de perte auditive et de mesure du gain auditif fonctionnel après réhabilitation ; l'étude 1 intitulée « Privation sensorielle auditive et fonctionnement cognitif chez le sujet âgé (ACADem) » a montré que le port d'un appareillage auditif pouvait préserver d'une dégradation cognitive ; et l'étude 2 intitulée « Faisabilité d'une Réhabilitation Conjointe Audioprothétique et Orthophonique pour les Presbyacousiques (FRéCAOP) » a montré qu'il était possible de proposer une prise en charge plus complète et efficiente de la presbyacousie, dans un circuit de l'audition du GRAPsanté, incluant nécessairement un Aidant / Presbycusis is a disease that occurs in more than 12 million French people, but which is still not well known. If it is not treated early, it can lead to serious complications such as communication disorders, depression and cognitive impairment. The current situation is that very few presbycusic patients are treated, and when they are, the result seems insufficient. The purpose of this thesis is to propose using current data, solutions tailored to the needs of these patients, from screening to rehabilitation. Three studies were conducted: the "AcoumAudio" Study, available in three components showed that the vocal acoumetry was a good hearing test to screen elderly people, to evaluate the degree of hearing disorders and to measure functional auditory gain after rehabilitation; Study 1 entitled "Auditory deprivation and cognitive functioning in the elderly" showed that wearing hearing aids could preserve from cognitive deterioration; and Study 2 entitled "Feasibility of a Conjoint Rehabilitation involving audiology and speech therapy for presbycusis (FRéCAOP)" showed that it was possible to offer a more complete and efficient management of presbycusis, in the hearing circuit of GRAPsanté, necessarily including a caregiver

Orientadores: Everardo Andrade da Costa, Christiane Marques do Couto / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T10:10:32Z (GMT). No. of bitstreams: 1 Arieta_AlinedeMoraes_D.pdf: 1729442 bytes, checksum: 2887ecc98db30769bd998782cb6716d0 (MD5) Previous issue date: 2013 / Resumo: A investigação do reconhecimento da fala na presença de ruído competidor, em situações de escuta assemelhadas às do dia a dia, torna-se cada vez mais necessária. Atualmente, na rotina audiológica nacional, esta avaliação ainda é realizada sem ruído, limitando as informações sobre o desempenho dos indivíduos em condições de vida real. Este problema se agrava nas perdas auditivas sensorioneurais, de alta ocorrência na sociedade. O objetivo desta pesquisa é avaliar o reconhecimento da fala sem e com ruído competidor, em diferentes grupos populacionais, com o teste - Hearing in Noise Test - HINT BRASIL - Um total de 268 sujeitos, 180 do gênero masculino e 78 do feminino, foram avaliados e divididos em: 66 normo-ouvintes; 70 normo-ouvintes com história de exposição a ruído ocupacional; 80 com perda auditiva sensorioneural, com história de exposição a ruído ocupacional e 52 usuários de próteses auditivas. O HINT Brasil foi aplicado com fones de ouvido e em campo livre nas condições: sem ruído (S); com ruído frontal (RF); ruído à direita (RD); ruído à esquerda (RE). Além disso, o programa fornece uma média ponderada das condições com ruído, a qual denomina Ruído Composto (RC). Os resultados foram computados em dB(A) na condição sem ruído e em dB Relação Sinal/Ruído nas condições com ruído. Nos testes com ruído, os valores obtidos em campo livre foram piores do que os obtidos com fones de ouvido. O grupo de normo-ouvintes exposto a ruído ocupacional apresentou pior desempenho ao HINT Brasil, na condição RC, em relação aos normo-ouvintes não expostos. O grupo de sujeitos com perda auditiva sensorioneural apresentou respostas piores em todas as condições de aplicação do HINT Brasil quando comparados aos normo-ouvintes com e sem exposição. No grupo de usuários de próteses auditivas, o desempenho para o HINT Brasil foi melhor com o uso das próteses em relação a não utilização delas / Abstract: The investigation to recognize speech in day-to-day conditions becomes increasingly necessary. Currently, on the national routine audiological, this evaluation is still performed without noise, limiting the information about the performance of individuals in real-life conditions. This problem is aggravated on sensorineural hearing loss, which has high prevalence in society. The purpose of this research is to evaluate speech recognition with and without noise in different population groups, using the HINT Brazil (Hearing in Noise Test - Portuguese version of Brazil). A total of 268 people, 180 males and 78 females were evaluated: 66 normal hearing, 70 normal hearing individuals with a history of occupational noise exposure, 80 with sensorineural hearing loss, with a history of occupational noise exposure and 52 users hearing aids. The HINT Brazil was applied, with headphones and soundfield on conditions: quiet (Q); Noise Front (NF) Noise Right (NR); Noise Left (NL). Additionally, the program provides an average of the noise conditions called Noise Composed (NC). The results were calculated on dB (A) with no noise conditions and dB Signal to Noise Ratio (S/R) in noisy conditions. On the tests with noise, the values obtained in soundfield were worse than the ones with headphones. The normal hearing group exposed to occupation noise presents worse performance with the HINT Brazil, in the condition RC, comparing to the ones not exposed. The sensoneural hearing loss group presented worse performance in all the conditions of the HINT Brazil comparing to the normal hearing with and without exposure. On the hearing aid users group, the HINT performance was better using the hearing aids / Doutorado / Epidemiologia / Doutora em Saúde Coletiva

Introdução: Zumbido é um sintoma de alterações nas vias auditivas com etiologia variada. Muitos pacientes com perda auditiva possuem zumbido e um dos tratamentos é o uso dos aparelhos auditivos. Os aparelhos auditivos amplificam os sons externos e os pacientes passam a perceber melhor os sons do ambiente, diminuindo a percepção do zumbido e proporcionando melhora na entrada do som por meio do enriquecimento sonoro. Contudo, é visto na literatura que alguns pacientes não observam a diminuição do incômodo e da percepção do zumbido ao utilizar os aparelhos auditivos. O estudo da audição periférica nestes pacientes poderia fornecer informações sobre fatores que dificultam a redução da percepção do zumbido com o uso de aparelhos auditivos. Objetivo: Avaliar as características audiológicas de pacientes com zumbido e perda de audição e verificar se há diferenças entre o grupo que obteve redução na percepção do zumbido com o uso de aparelhos auditivos e o grupo que não obteve o mesmo benefício. Método: Foram avaliados 29 sujeitos, divididos em dois Grupos, sendo Grupo I (GI) composto por 20 sujeitos que observaram melhora na percepção do zumbido após dois meses de uso dos aparelhos auditivos, e o Grupo II (GII) composto por nove, que não observaram melhora na percepção do zumbido. A pontuação na Escala Visual Analógica (EVA) determinou a divisão dos grupos. Foram aplicados: questionários para avaliar o incômodo do zumbido (Tinnitus Handicap Inventory -THI) e a melhora da percepção auditiva (Hearing Handicap Inventory Elderly Screening Version- HHIE-S); avaliações audiológicas (audiometria de via área e óssea, índice de reconhecimento de fala, identificação do limiar diferencial de intensidade índice, emissões otoacústicas), testes de processamento auditivo temporal (Gaps-in-Noise-GIN, Teste de Detecção de Intervalo Aleatório-RGDT, testes Padrão de Frequência e Duração -TPF e TPD respectivamente) e medidas psicoacústicas do zumbido (pitch, loudness e Limiar Mínimo de Mascaramento - MML) antes da adaptação dos aparelhos auditivos e após dois meses de uso dos aparelhos auditivos. Os sujeitos tinham entre 28 e 68 anos (média 55 anos) de ambos os sexos, e usaram aparelhos auditivos da mesma marca, com as regulagens adequadas para cada sujeito. Resultados: Não houve diferença significativa entre os grupos nos testes audiológicos aplicados. Nos testes auditivos temporais, a porcentagem de acerto do Grupo I foi superior ao Grupo II, com tendência à significância estatística no TPF. Foi observada diferença estatística nos questionários THI, HHIE-S no GI e GII após o uso dos aparelhos, diminuindo a pontuação. Com relação às medidas psicoacústicas, houve diferença estatística significante entre o Loudness e MML iniciais e finais do GI e diferença entre os grupos no loudness e no MML final. Conclusão: As caraterísticas audiológicas avaliadas não foram suficientes para indicar se o paciente com perda de audição se beneficiaria com a diminuição na percepção do zumbido com dois meses de uso de aparelhos auditivos. Indivíduos com desempenho pobre no TPF tem tendência a não reduzir a percepção do zumbido com o uso de aparelhos auditivos. O presente estudo aponta para a necessidade de investigar outras características que podem estar associadas à dificuldade na redução na percepção do zumbido com o uso de aparelhos auditivos / Introduction: Tinnitus is a symptom of damage of the auditory pathways with varied etiology. Many patients with hearing loss have tinnitus and one of its treatments is the use of hearing aids. Hearing aids amplify external sounds and patients are able to better understand the sounds of the environment, reducing the perception of the tinnitus and improving sound input through enriched acoustics. However, according to literature, some patients do not observe discomfort and tinnitus perception decrease using hearing aids. The study of peripheral hearing in these patients could provide information on factors that make it difficult to reduce tinnitus perception with the use of hearing aids. Objective: To evaluate audiological characteristics of patients with tinnitus and hearing loss, and verify if there are differences between the group that obtained reduction in tinnitus perception with the use of hearing aids and the group that did not obtain the same benefit. Methods: 29 subjects, divided into two groups: Group I (GI) composed of 20 subjects who observed improvement in tinnitus perception after two months of hearing aids use and Group II (GII) with nine subjects who did not observe improvement in tinnitus perception, were evaluated. The Visual Analogue Scale (VAS) score determined the division of the groups. The questionnaires Hearing Handicap Inventory Elderly Screening (HHIE-S) and Tinnitus Handicap Inventory (THI), audiological evaluation (pure tone and bone conduction audiometry, speech recognition index, short increment sensitivity index, otoacoustic emissions), temporal auditory processing tests (Gaps-in-Noise-GIN, Random Interval Detection Test-RGDT, frequency and duration tests (PPS and DPT) and psychoacoustic measures of tinnitus (pitch, loudness and MML) before the fitting of hearing aids and after two months of use were conducted. Subjects were aged between 28 and 68 (mean age 55 years), both sexes, and used same brand hearing aids, with the appropriate fitting for each subject. Results: There was no significant difference between the groups in the audiological tests. Temporal auditory tests accuracy percentage of Group I was higher than Group II, with a tendency to statistical significance in the PPS. Statistical difference was observed in the THI, HHIE-S for GI and GII after the hearing aids use, reducing the score. Regarding psychoacoustic measures, there was significant statistical difference between initial and final loudness and MML in GI, and intergroup difference (GI and GII) in the final MML and loudness. Conclusion: The evaluated audiologic characteristics were not sufficient to indicate if the patient with hearing loss would benefit from a decrease in tinnitus perception after two months of hearing aids use. Individuals with poor PPS performance tend not to reduce tinnitus perception with hearing aids use. The present study indicates the need to investigate other characteristics that may be associated with the difficulty in reducing tinnitus perception with hearing aids use

A demanda crescente de usuários de implante coclear (IC) e a distribuição irregular de profissionais especializados no país, tornam necessário o deslocamento de pacientes por longas distâncias para os atendimentos, com consequente aumento dos custos diretos e indiretos do tratamento. A teleconsulta pode ser vista como uma alternativa em potencial para o acesso desta população a estes serviços. O presente ensaio clínico, randomizado, controlado, avaliou a eficácia da teleconsulta síncrona na programação dos sistemas de IC em usuários acompanhados em um Programa de Implante Coclear credenciado pelo Sistema Único de Saúde. Participaram do estudo 79 indivíduos com idades entre nove e 68 anos (média de 21,6), 41 do sexo masculino e 38 do sexo feminino, usuários de IC por um período de 0,58 a 24,75 anos. Estes indivíduos foram divididos em dois grupos, de acordo com o modo de programação do IC: controle (n=40), que realizou o procedimento face a face e experimental (n=39) que realizou a teleconsulta síncrona. Treze fonoaudiólogos sem experiência na programação do dispositivo atuaram como facilitadores das teleconsultas. Os procedimentos de programação do IC englobaram a telemetria de impedância, definição dos níveis de estimulação elétrica, varredura e balanceamento dos eletrodos e ajuste fino da programação. Como medidas de avaliação de resultados foram utilizados o tempo dispendido na consulta, a audiometria em campo livre, o percentual de reconhecimento de sentenças no silêncio e no ruído, o limiar de reconhecimento de sentenças no silêncio e ruído (HINT-Brasil), a avaliação da satisfação com a consulta (escala MISS-21) e de aspectos pertinentes à teleconsulta. Os facilitadores responderam as questões abertas referentes à suas impressões dos atendimentos. Os dados foram analisados por meio de estatística inferencial (testes t de Student, Wilcoxon, Mann-Whitney e correlação de Spearman). Os resultados mostraram que após a programação do IC, em média, os participantes apresentaram limiares audiométricos abaixo de 30 dB NA. O reconhecimento da fala pós atendimento, respectivamente para os grupos experimental e controle, foram de 81,3% e 83,8% (silêncio) e 57,9% e 58,1% (ruído). No HINT-Brasil os resultados foram, respectivamente, para os grupos experimental e controle 61,4 dB NA e 61,8 dB NA (silêncio) e relação S/R de 9,5 dB NA e 10,4 dB NA (ruído). Os participantes estiveram satisfeitos com a consulta. Não houve diferença estatisticamente significativa entre os grupos em nenhuma das medidas de resultado. Todos os participantes relataram que teleconsulta pode ser vista como uma alternativa viável ao atendimento face a face e sua aplicação clínica facilitaria a rotina de pacientes usuários de IC. Os facilitadores destacaram a sua importância para o aprendizado e como ferramenta de formação continuada. A teleconsulta síncrona foi eficaz na programação dos sistemas de IC e amplamente aceita pelos usuários e profissionais. / The growing number of cochlear implant (CI) users and the uneven distribution of specialized professionals in the country makes necessary patients traveling over long distances to receive care, with consequent increase in direct and indirect costs of treatment. The telehealth can be viewed as an alternative for this population to access such services. This clinical randomized, controlled clinical trial evaluated the efficacy of synchronous teleconsultation in the programming of CI systems in a Cochlear Implant Program accredited by the National Health System in Brazil. Participate in this study 79 subjects aged between nine and 68 years (average 21.6), 41 males and 38 females, CI users for a period from 0.58 to 24.75 years. The participants were divided into two groups, according to the nature of consultation: control group (n = 40), who performed the CI programming face-to-face and experimental group (n = 39) who performed the CI programming through the synchronous teleconsultation. Thirteen audiologists without experience in CI programming acted as facilitators of teleconsultation. The CI programming procedures encompassed the impedance telemetry, setting of electrical stimulation levels, sweeping and balancing of the electrodes and programming evaluation in live speech mode. The outcome measures were the time spent in consultation, free field audiometry, the percentage of sentence recognition in quiet and in noise, the sentence recognition threshold in silence and noise (HINT-Brazil), satisfaction with the consultation (MISS-21 scale) and aspects related to teleconsultation. The facilitators responded open questions regarding their impressions of the teleconsultations. Data were analyzed using inferential statistics (Student t test, Wilcoxon, Mann-Whitney and Spearman correlation). The results showed that after CI programming, on average, the participants had audiometric thresholds below 30 dB HL. The speech perception for the experimental and control groups post CI programming were respectively, 81.3% and 83.8% (in silence) and 57.9% and 58.1% (in noise). In HINT-Brazil the results were, respectively, for the experimental and control groups 61.4 and 61.8 dB (silence) and S/N ratio of 9.5 dB and 10.4 dB (in noise). Participants were satisfied with the teleconsultation. There were no statistically significant difference between the groups in any of the outcome measures. All participants reported that teleconsultation could be a viable alternative to facilitate CI users follow up routine. Facilitators emphasized the importance of teleconsultation for learning and for continuing education. The teleconsultation was effective in programming the CI systems and accepted by users and professionals.

It is well-known that many people like to listen to music when they are running,something that is not always available for people with hearing aids [1].The experience of music is not often taken into account when people have lostparts of their hearing, but music is in many ways important for the well-being[2]. In this project has an application been developed, to make certain audioparameters accessible for adjustments according to the users individual hearing.The parameters chosen were latency, compression, balance and loudness. Theseparameters have been chosen with the argument that they have big impact onthe experience of the music. As an example there might be latency betweenthe hearing aids between the left and the right hearing. Very often people withhearing aids have different hearing at the left and the right ear, therefore thebalance was chosen as a parameter. Compression were chosen with respect tothe fact that hearing loss often leads to less capability to hear frequencies indifferent frequencies areas. Loudness was chosen due to that it is a subjectiveparameter, that will have different impact on different individuals. The parametershave been chosen with a hypothesis that they may affect the hearingexperience for different individuals. The result show that the participants changed audio settings, each of theaudio parameters to different values and appreciated the function to changethese parameters. The participants said that the application developed in thisproject, improved their music experience and they said that they would appreciateto use an application like this, to get more value of listening to music. Theapplication was well designed and easy to use during a sport session.

Bakgrund: År 2050 förväntas en fjärdedel av världens befolkning ha någon form av hörselnedsättning och år 2021 förskrevs 91 453 hörapparater till patienter från olika regionala hörselmottagningar i Sverige. Förenta nationerna har tagit fram Agenda 2030 för att främja hållbar utveckling varav mål 12 syftar till att förändra världens konsumtions- och produktionsmönster. Samhället är idag beroende av hörapparattekniken men det saknas forskning om hur tekniken återbrukas. Tidigare studier visar att patienter ställer sig positivt till återanvändandet av pacemakers men kostnaden var en betydande faktor. Syfte: Syftet med studien är att undersöka patienters attityder till återbrukade hörapparater ur ett hållbarhetsperspektiv. Metod: En enkätstudie genomfördes med 19 frågor, varav 2 fritextsvar, som konstruerades i ORU-survey för att besvara frågeställningarna. Resultatet analyserades genom deskriptiv analys och Kruskal Wallis H-test. Resultat: Deskriptiv analys visar att respondenterna är övervägande positiva till återbrukade hörapparater. De flesta uttrycker att det är viktigt att hörapparaten är producerad med hänsyn till miljön samt att det är viktigt att de är utrustade med den senaste tekniken. Kruskal Wallis H-test visar ingen signifikant skillnad i hur man ställer sig till att använda en delvis återbrukad hörapparat i relation till attityden till hållbar utveckling. Slutsatser: Trots att Kruskal Wallis H-test inte visade någon signifikant skillnad i hur man ställer sig till att använda en återbrukad hörapparat i relation till den generella attityden till återbruk var majoriteten positiva till återbrukade hörapparater. Resultatet indikerar en positiv attityd hos respondenterna, men vidare forskning krävs. / Background: In year 2050, a quarter of the world's population is expected to have some type of hearing impairment. In year 2021, 91 453 hearing aids were prescribed to patients from various regional hearing clinics in Sweden. The United Nations has developed Agenda 2030 to promote sustainable development, of which goal 12 aims to change the world’s consumption and production patterns. Today, society is dependent on hearing aid technology, but there is a lack of research on the reuse of the technology. Previous studies show that patients are positive about the reuse of pacemakers, but cost was a significant factor. Aim: The aim of this study was to examine the patients’ attitudes towards partially reused hearing aids from a sustainable perspective. Methods: A questionnaire with 19 questions, of which 2 were free text responses, was constructed in the database ORU-Survey. Results were analyzed through descriptive analysis and the non-parametric test Kruskal Wallis H-test. Results: Descriptive statistics show that the respondents are mostly positive to reused hearing aids. Most respondents express that it is important that their hearing aid is produced sustainably and contains the latest technology. Kruskal Wallis H-test present no significant difference in patients attitudes towards using a reused hearing aid and the attitudes towards sustainable development. Conclusions: Although the results from the Kruskal Wallis H-test showed no significant difference the majority were positive towards the reuse of hearing aids. This result indicates an overall positive attitude towards the reuse of hearing aids but further research is required.

Bakgrund: Förmågan att kunna lokalisera ljud är en binaural process som försvåras i samband med hörselnedsättning, eftersom tillgången till akustiska ledtrådar begränsas. Hörapparattillverkare strävar efter att främja användarnas tillgång till dessa ledtrådar genom nya innovationer. Den vanligaste modellen av hörapparat är i dagsläget bakom-örat-apparaten med högtalarenhet i hörselgången (RIE). Modellens mikrofonplacering bakom örat tillåter inte användaren att utnyttja öronmusslans akustiska egenskaper som hjälper vid ljudlokalisation. En hörapparattillverkare har därför tagit fram en ny teknik (M&RIE) som implementerar en ytterligare mikrofon placerad i hörselgången som bland annat syftar till att gynna användarens förmåga att lokalisera ljud. Syftet med denna studie är att undersöka ljudlokalisationsförmågan i horisontalplan med de två högtalarenheterna “M&RIE” och “RIE” hos normalhörande vuxna. Metod: 18 normalhörande deltagare genomförde tre lokalisationstest med respektive teknik. Signalerna i testen bestod av ett pulserande brus, en biltuta samt en ringklocka. Resultat: RIE presterade generellt bättre än M&RIE i lokalisationstestet vid samtliga signaler. En mindre andel bak-fram-förväxlingar skedde vid lokalisation med RIE än med M&RIE. Slutsatser: Den begränsande faktorn att M&RIE behöver anpassas med täta domer leder till nackdel i lokalisationsförmåga vid anpassning för mild hörselnedsättning. Undersökningen indikerar att fördelen av en öppen anpassning hos RIE är större än fördelen av en extra mikrofon i hörselgången för normalhörande deltagare vid horisontell ljudlokalisation. / Background: The ability to localize sounds is a binaural process that is limited by hearing loss due to a decreased access to acoustic cues. Hearing aid manufacturers strive to promote users' access to these cues through new innovations. Currently, the most common type of hearing aid is the behind-the-ear device with the speaker unit located in the ear canal (RIE). The model's microphone placement behind the ear does not allow the user to take advantage of the acoustic properties of the pinna, which aid sound localization. Therefore, a hearing aid manufacturer has developed a new technology (M&RIE) that implements an additional microphone placed in the ear canal, which aims to benefit its users' ability to locate sounds. Aim: The aim of this study is to investigate the ability to locate sound in the horizontal plane using the two speaker units "M&RIE" and "RIE" in normal-hearing adults. Methods: 18 normal-hearing participants performed three localization tests with each technology. The signals in the tests consisted of a pulsating noise, a car horn, and a bicycle bell. Results: RIE generally outperformed M&RIE in the localization test for all signals. A lower percentage of back-front-confusions occurred in localization with RIE than with M&RIE. Conclusions: The limiting factor that M&RIE must be fitted with occluded domes leads to a disadvantage in the localization ability when fitted for mild hearing loss. The study indicates that the advantage of an open-fit in RIE is greater than the advantage of an extra microphone in the ear canal for normal-hearing participants in horizontal sound localization.

Bakgrund: Personer i åldersspannet 65 till 85 år utgör en stor del av alla hörselskadade iSverige idag. Dessa utgör därmed en stor patientgrupp inom hörselvården. Således är detrelevant att inventera deras förväntningar på hörapparater eftersom förväntningar hos denblivande hörapparatanvändaren kan påverka resultatet vid hörapparatutprovningen. Patientermed höga förväntningar blir oftare nöjdare med sina hörapparater. Genom att ha ett brabemötande och vara lyhörd för patientens förväntningar och önskemål, samt ge patientenadekvat information, kan audionomen hjälpa patienten att uppnå en mer lyckadhörselrehabilitering.Syfte: Syftet med studien var att undersöka vilka förväntningar äldre blivandehörapparatanvändare i åldrarna 65 till 85 år har på hörapparater och hörapparatutprovningen.Metod: Elva blivande hörapparatanvändare intervjuades i en kvalitativ intervjustudie medsemistrukturerade frågor. Insamlade data analyserades sedan med en kvalitativinnehållsanalys.Resultat: Analysen av förväntningarna resulterade i fyra olika teman: förväntade effekter påhörandet, förväntningar på hörapparater, förväntade effekter på livssituationen ochförväntningar på hörapparatutprovningen.Slutsats: De uttryckta förväntningarna på hörapparater och hörapparatutprovningen vargenerellt positiva. Kärnan i förväntningarna handlar om förbättrad kommunikation och ökadlivskvalitet. Det finns också en medvetenhet om hörapparaters begränsningar. Audionomenförväntas kunna ge ett bra bemötande och sprida sina kunskaper till patienterna. För att göradetta behöver audionomen få verktyg för att identifiera och träna på att bemöta patientersförväntningar och på så sätt säkerställa nöjda hörapparatanvändare. / Background: Patients aged between 65-85 years is a large group of patients in the hearinghealth care. Hence, it is important to learn what their expectations may be comprised ofbecause expectations in potential hearing aid users may affect the result of the hearing aidfitting. Patients with high expectations are often more satisfied with their hearing aids. Theaudiologist can, by being responsive to patient's expectations and wishes, and give patientsadequate information, help patients to reach a more successful hearing rehabilitation.Purpose: The purpose of the study was to investigate expectations on hearing aids andhearing aid fitting in elderly (65-85 years) potential hearing aid users.Study design: Eleven participants were individually interviewed in a qualitative interviewstudywith semi-structured questions. Collected data were analysed with a qualitative contentanalysis.Result: The analysis of the expectations resulted in four different themes: expected effects onhearing, expectations on hearing aids, expectations on the life situation and expectations onhearing aid fitting.Conclusion: The expressed expectations on hearing aids and hearing aid fitting weregenerally positive. The core of the expectations contains improved communication andimproved quality of life. There is an awareness of hearing aid limitations. Audiologists areexpected to have a good reception and spread their knowledge to their patients. To do this, theaudiologist need to get tools to identify and practice meeting patients' expectations and thusensure satisfied hearing aid users.

Depuis le début des années 80, les systèmes d’éducation à travers le monde recommandent l’intégration des élèves malentendants en classe ordinaire. Malgré l’utilisation d’aides auditives et de système MF, les élèves vivent des périodes où l’amplification reçue est insuffisante ou non optimale. Ces périodes sont causées par des facteurs influençant leurs conditions de communication et cela peut nuire à leurs apprentissages. Pourtant, les études sur ces situations vécues par les élèves ont très peu considéré leur point de vue. L’étude présentée vise à 1) de documenter les perceptions des situations de communication en classe mentionnées par des élèves malentendants intégrés, appareillés et ayant un système MF décerné ou rapportées à des professionnels; 2) de comprendre le contexte dans lequel des conditions non optimales de communication surviennent; 3) d’identifier les stratégies compensatoires rapportées par l’élève ou son locuteur ou déployées lors de leur participation aux activités de classe. Cette étude de cas multiples combine des données qualitatives et quantitatives recueillies à partir d’entrevues en profondeur auprès de huit élèves malentendants, de courtes entrevues avec leur enseignant et leur intervenant principal et une session d’observation en classe au cours de laquelle le niveau de bruit a été mesuré et les positions de l’enseignant ont été notées. Les données ont été analysées de manière longitudinale afin de décrire les participants et transversale afin de les comparer. Les résultats montrent que les élèves malentendants parlent de leurs situations de communication en classe, surtout les plus difficiles en associant toutes leurs difficultés au locuteur ou au milieu et non à eux-mêmes. Pour ce qui est du contexte, des niveaux élevés de bruit ont été mesurés et les positions des enseignants montrent qu’ils sont généralement loin de l’enfant malentendant ou qu’ils ne lui font pas face. Par ailleurs, les enseignants mentionnent ne pas avoir assez d’informations pour bien venir en aide à ces élèves. Enfin, les élèves et leurs enseignants utilisent différentes stratégies de communication, mais celles-ci ne sont pas toujours efficaces pour faciliter la communication. Toutes ces constatations mènent à des pistes de solutions visant à améliorer les situations de communication en classe et le contexte dans lequel les élèves apprennent, notamment l’accroissement des connaissances des divers acteurs et de leur collaboration entre eux. / For more than three decades, school authorities have encouraged the education of children with hearing loss in inclusive settings. Despite the use of technologies such as hearing aids and FM systems and because of a series of factors influencing verbal communication conditions, hearing-impaired students integrated in mainstreamed classes experience periods of non-optimal amplification that can hamper learning activities. Only a few studies have been conducted by taking the students’ points of view into consideration. This study aims at 1) documenting the perceptions that mainstreamed hearing-impaired students using amplification and allowed to a FM system have or have reported to professionals of their communication situations in class, 2) describing the context in which communication conditions occur, 3) identifying the compensatory strategies known or used by students and speakers while they participate in class activities. This multiple-case study combines qualitative and quantitative data collected from in-depth interviews with eight hearing-impaired students, from short interviews with each student’s teacher and main professional, and from observation sessions during which the level of noise in the classroom were measured and the positions of the teacher were noted. The data were analyzed longitudinally to describe the students and transversely to compare the students. The results showed that hearing-impaired elementary school students can talk about their classroom communication situations; often, for the most difficult ones, students relate all of their difficulties to the speaker and the environment, and not to themselves. As for the context, the results showed that teachers were mostly far from the students and not facing them, that formal teaching was not often done, and that classrooms were noisy. Furthermore, teachers mention that they didn’t have enough information in order to fully help these students. Teachers and students also use different communication strategies, but these strategies are not always efficient in improving communication. All of these results point to solutions for improving classroom communication and the context in which students learn by increasing knowledge and collaboration between the different actors.