Effects of Adaptive Hearing Aid Directionality and Noise Reduction on Masked Speech Recognition for Children Who Are Hard of Hearing.

Purpose The purpose of this study was to evaluate speech-in-noise and speech-in-speech recognition associated with activation of a fully adaptive directional hearing aid algorithm in children with mild to severe bilateral sensory/neural hearing loss. Method Fourteen children (5-14 years old) who are hard of hearing participated in this study. Participants wore laboratory hearing aids. Open-set word recognition thresholds were measured adaptively for 2 hearing aid settings: (a) omnidirectional (OMNI) and (b) fully adaptive directionality. Each hearing aid setting was evaluated in 3 listening conditions. Fourteen children with normal hearing served as age-matched controls. Results Children who are hard of hearing required a more advantageous signal-to-noise ratio than children with normal hearing to achieve comparable performance in all 3 conditions. For children who are hard of hearing, the average improvement in signal-to-noise ratio when comparing fully adaptive directionality to OMNI was 4.0 dB in noise, regardless of target location. Children performed similarly with fully adaptive directionality and OMNI settings in the presence of the speech maskers. Conclusions Compared to OMNI, fully adaptive directionality improved speech recognition in steady noise for children who are hard of hearing, even when they were not facing the target source. This algorithm did not affect speech recognition when the background noise was speech. Although the use of hearing aids with fully adaptive directionality is not proposed as a substitute for remote microphone systems, it appears to offer several advantages over fixed directionality, because it does not depend on children facing the target talker and provides access to multiple talkers within the environment. Additional experiments are required to further evaluate children's performance under a variety of spatial configurations in the presence of both noise and speech maskers.