HAFM Online survey

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We are conducting research into the music listening behaviour of people (aged 18 and over) with hearing loss and who wear hearing aids for a minimum of one hour a day. As part of this study we have developed an online survey and would like to recruit as many participants as possible to take part.

To participate you will have

  • have a confirmed hearing loss (e.g. mild, moderate, severe or profound),
  • wear hearing aid(s) (but NOT a cochlear implant),
  • are between 18-90 years old

A BSL version of all the information and questions is available in the questionnaire

We will ask you about your

  • experiences of music in everyday life,
  • musical preferences
  • hearing
  • hearing aids

It should take about 30 minutes to complete and you will remain anonymous. If you leave your contact details, you will be entered into a prize draw to win one of three £75 cash prizes. Winners will be selected at random and notified in JANUARY 2017.

All the information we collect about you will be kept confidential and you will not be identifiable in any reports or publications.

The survey is available by clicking here

If you have any questions, please contact us at:

Email: musicandhearingaids@leeds.ac.uk

Text mobile: 07763648802

If you would be willing to follow us on Twitter @musicndeafness and retweet information about the survey that would be greatly appreciated.

If you do not wear hearing aids yourself, but know someone who does who might be willing to take part, please forward the following link: http://tinyurl.com/musicandhearingaids

Many thanks

‘Music and Hearing Aids team’

‘Hearing Aids for Music’ at ICMPC14 in San Francisco


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Earlier this month, I flew to San Francisco to attend and present at the 14th International Conference on Music Perception and Cognition which is a biennial conference covering fields such as acoustics and psychophysics, aesthetic perception and response, musical development, music education, and music, health and well-being.

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I presented findings from our first study (clinical questionnaire) which explored the extent of music listening issues and the frequency and success of discussions with audiologists about music. Data from 176 hearing aid (HA) users, aged 21 – 93 years old, showed that challenges with music listening were often experienced and almost half reported that this negatively affects their quality of life. Participants described issues listening to live music performances, hearing words in songs, the loss of music from their lives and associated social exclusion. The majority of participants had not discussed music with their audiologist. For those who had, some reported positive experiences wherein increased HA tailoring by the audiologist had enhanced music appreciation. Other experiences were less positive with no improvements reported. Results suggest that more could be done to help audiologists fit HAs for music and to inform HA users of their options. An overview of the results is available here.

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I then discussed preliminary findings from our second study (in-depth interviews, with collection of audiometric data). Data from 22 HA users, aged between 24-82 years old, with varying levels of hearing impairment, highlighted the complexities of listening to music with hearing aids. Some of the problems encountered mirrored those found in our first study and in previous work (e.g. Chasin & Hockley, 2014; Madsen & Moore, 2014) such as distortion (particularly at higher frequencies), a reduction in tone quality, and challenges listening to music in live contexts. However, there were less problems with feedback and distortion than anticipated, and positively, several interviewees reported that they did not experience any difficulties when listening to music with their hearing aids. These individuals tended to be non-musicians with milder levels of hearing loss, but nonetheless were highly engaged with music in everyday life.

Results show differences in hearing aid use according to people’s level of hearing impairment, level of musical engagement and training, the musical style(s) being listened to, and the context(s) in which the music is being heard. This supports theorising by Hargreaves and colleagues (e.g. Hargreaves et al., 2006) which stipulates that responses to music are a result of interactions between listener, music and contextual variables. However, our data provide new insights into how levels of hearing impairment, and the type and functionality of the HA technology affect musical experiences. There were differences in interviewees’ understanding of their HA technology (musicians stood out as being the most informed) and in the process of acclimatising to the new sound world. Problems experienced appear to be mediated by general attitudes towards the HA technology. Some were proactive in adjusting, adapting, and experimenting, whereas others were less inclined to explore the possibilities. Across all participants, the use of Assistive Listening Devices (ALDs) was low which suggests that HA users are not as aware as they could be about what tools are out there that could help. These are just some preliminary findings. We are conducting an in-depth analysis of the dataset and will be able to report a fuller analysis in due course.

This event was attended by Alinka Greasley.

Team engage public at ‘Be Curious’ event

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On Saturday 19th March, the Hearing Aids for Music team took part in the ‘Be Curious’ Festival, which gave the general public an opportunity to learn about research projects being undertaken at the University of Leeds through talks and interactive activities.

The theme of the Wellcome Trust funded university-wide event was ‘Health and Well-being’ and was intended for those curious about how the human body works, and factors affecting health and well-being. We focused on conveying information about how we hear, how easily our hearing can be damaged, and what speech (conversation) and music (classical, popular) sound like with differing levels of hearing loss. We also set up a booth so that people could take an online hearing test.

How we hear

How loud is too loud?

Hearing loss – what it sounds like (conversation)

Hearing loss – what it sounds like (music)

Hearing test

We’d like to thank audiology@leeds for providing us with model ears, Alex Santos for designing our hearing awareness posters, and Action on Hearing Loss and Hear the World Foundation organisations for supplying us with leaflets and online resources.

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Feedback

As part of the event, feedback was collected from visitors. Respondents included children and adults (age range 4-66 years old) and their responses indicated that our activities were effective in raising awareness of the prevalence and causes of hearing loss, and of healthy hearing behaviour.

What did you like best?

“Ear workshop” [Aged 12]

“Ears!” [Aged 4]

Did you learn anything new today?

“Hearing aids info” [Aged 39]

“Hearing – how it is damaged.” [Aged 44]

“Lots about hearing impairments and how to prevent hearing loss” [Aged 45]

“Extent and causes of hearing loss” [Aged 35]

Will it change anything you do? If so, in what way(s)?

“It will change how loud I listen to music through headphones” [Aged 14]

“Yes, iPads will be turned down and will buy ear defenders for my son playing drums” [Aged 44]

“Get my hearing checked more regularly!” [Aged 50]

How likely are you to tell someone else what you’ve learnt?

64% reported that they were ‘Very Likely’ to tell someone else what they had learnt.

Visitors were intrigued by the microscopic pictures of hair cells, and were surprised to learn how easily hair cells can be damaged. The hearing simulations, including the opportunity to listen to Sting’s Fields of Gold, and Eros Ramazzotti’s Sei Un Pensiero Speciale with different severities of hearing impairment, were popular with both younger and older visitors as they contemplated what their lives would be like with hearing loss. Several visitors who got their ears tested in our booth reported that it had prompted them to go and get their ears tested by a professional. Overall, feedback suggested that the activities were very informative!

This event was led by Alinka Greasley and Jackie Salter.

‘Effects of Advanced Hearing aid settings on Music Perception’

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Some practical tips for audiologists and listeners

In January 2016 we attended a seminar on the effects of advanced hearing aid features at Cardiff Metropolitan University.  This was a useful opportunity to hear from world renowned speakers on the science behind challenges with listening to music with hearing aids, feedback and practical tips from the clinical world and also insights into the benefits and limitations of hearing aid technology.

We heard from Professor Brian Moore on the effects of both hearing loss and hearing aids on music perception and from Marshall Chasin on fitting aids for musicians.  We were reminded that damage to the inner ear is not always obvious in relation to the audiogram. The Audiogram (a hearing test) is a very broad way of testing hearing and for Noise induced hearing loss (NIHL), a person may even have a normal audiogram but with underlying damage to the inner ear that causes difficulties in discriminating sounds (for more on Hidden Hearing Loss, see Chris Plack’s recent BSA seminar).  To perceive music well we need to be able to discriminate a much wider range of frequencies than is tested with an average hearing test.

Another relevant point for listening is that with hearing loss, as well as losing the ability to pick out specific sounds we also have poorer localisation skills or abilities to tell where sound is coming from.  For music this can be really important in separating sounds out from a mixed musical signal of several instruments or voices.

Specifically with hearing aids, multi-channel aids can flatten the spectrum of the musical signal which can make it harder to identify instruments.  A recent paper by Madsen, Stone, McKinney, Fitz & Moore (2015) explored the effects of wide dynamic range compression on identifying instruments and identified lower reports of clarity when using WDRC versus linear amplification.  The effects of slow versus fast compression are more complex and may relate to the type of music being listened to.

There are pros and cons of both fast acting and slow compression. Slow acting compression can facilitate being able to pick out the main tune/instrument when louder backing sounds are there, which otherwise might cause the hearing aid to cut sounds levels down too quickly.  However, it does not restore loudness perception to ‘normal’ and is not good if various sources are at different levels.  In the time it takes to recover, we can miss dynamic changes in music. Overall the consensus of opinion was that there seems to be a preference for slow compression versus fast acting compression for music but this is very dependent on setting and type of music being listened to (Moore & Sek, forthcoming).

Other Considerations for fitting aids:

In terms of microphones, directional microphones can be useful, and can help to pick out specific instruments in the presence of competing sounds.  However, they can also make things worse by reducing ability to hear the separation of sounds (where sounds are located and that they are coming from separate sources); again, this depends on the listening setting.

Low Frequency (LF) gain:  The limited LF in the Hearing aid bandwidth can also be a problem as we don’t get amplification of the lower pitches and the LF range of music exceeds the typical range we are concerned with for speech.  The LFs are limited on purpose for speech to prevent LF masking where the low frequency sounds potentially cover over the speech sounds.

In this regard consider open fitting where possible as a preference so there is natural acoustic use of LF where hearing is good for these frequencies. Music tends to be louder than speech so even with some mild LF loss we may well still hear the LF cues effectively without needing amplification from the hearing aid. Go for as wide a bandwidth as possible in the aid, again as the range of musical sounds tends to exceed that of speech.

Many aids have frequency lowering technology available but this can introduce inharmonicity where high and low harmonics are out of tune. This was considered manageable over 2 kHz as listeners with high frequency (HF) hearing loss may be unlikely to detect the mistuning with high harmonics.

Smoothing the peaks in frequency response during the fitting may help, though more evidence is needed for this.  Feedback cancellation can also be problematic as it can mistake musical tones for feedback.  Where there is frequency shifting involved this may potential alter perception of pitch and or harmonics.

The peak input limiting level of aids are a significant problem; we know music typically has a wider and higher dynamic range than speech and peak input limiting levels below 105dB simply mean we lose some of the input signal for music resulting in poor sound quality.  We were played examples of this in the seminar down to 92dB peak input limiting and the effects were very obvious.  Whilst for speech anything above 85dB is likely not to be problematic, this is not the case for music and we cut out an awful lot by the aid being optimised for speech (to hear for yourself, click here)

One issue for these factors in hearing aid fittings is that we don’t always have access to all these areas transparently in the fitting software or on the specification sheet.  In some cases it is hard to know exactly what and how the aid is affecting input or rather what algorithms are in use. Changes to compressions that used to be more obvious may be in the fitting tools but without specific parameters and it may be that clinicians will need to ask manufacturers more about what the aid is doing so that we can optimise for individual listeners.

Strategies for fitting:

NB: remember in the music program not the speech program

Consider slow compression

Higher input peak limiting

Take off feedback manager

Use open fitting where possible

Turn off frequency transpositions

Turn off noise reduction algorithms

Set OSPL90 6dB lower than for speech

If possible, play some musical scales in the clinic and check listener can hear each note

Choose the widest available bandwidth for mild losses;  consider using a narrower HF bandwidth for HL >60dB HL, and for steeper slopes to test for cochlear dead regions where patients are reporting specific discrimination problems.

Strategies for listening

When listening to recorded music – lower volume on the sound source and increase the volume on the aid

Consider use of Assistive Listening Devices (ALDs) such as using FM system as input or streamers, loop or direct audio input (DAI). Connevans have a range of ALDs that may be helpful.

Use scotch tape to cover the hearing aid microphone (this provides 10-12dB attenuation up to 4,000Hz)

Also consider whether a listener with lower degrees of loss is actually better without hearing aids for music listening given the overall louder dynamics of music.

This event was attended by Harriet Crook and Alinka Greasley.

References

Chasin, M. & Hockley, N. S. (2014). Some characteristics of amplified music through hearing aids. Hearing Research, 308, 2-12.

Madsen, S. M. K., Stone, M. A., McKinney, M. F., Fitz, K. & Moore, B. C. J. (2015). Effects of wide dynamic-range compression on the perceived clarity of individual musical instruments. Journal of the Acoustic Society of America, 137, 1867-1876.

Moore, B.C.J.  & Sek, A. (2015). Comparison of the CAM2A and NAL-NL2 hearing-aid fitting methods for participants with a wide range of hearing losses. International Journal of Audiology, 55(2), 1-8.

Get in touch

If you have any thoughts, please email the project team:

musicandhearingaids@leeds.ac.uk

You can also get updates about the project and information about music and deafness on our twitter feed @musicndeafness.

‘Hearing aids for music’ project secures £250k AHRC funding

ahrc-logoThe School of Music at the University of Leeds is celebrating as Dr Alinka Greasley has secured a significant research grant from the Arts and Humanities Research Council.

Dr Alinka Greasley is a Music Psychologist who has secured an award of £247,295 for a project that will explore the music listening behaviour of people with hearing impairments.

The three year interdisciplinary project will bring together researchers in the fields of music psychology and clinical audiology and represents the first large-scale systematic investigation of how music listening experiences are affected by deafness and the use of hearing aids.

She will lead the project accompanied by Co-Investigator Dr Harriet Crook, from Sheffield Teaching Hospitals NHS Foundation Trust and Dr Robert Fulford, Post Doctoral Research Fellow in Music Psychology at the University of Leeds.

The research will benefit from the input of a highly esteemed advisory panel consisting of academics and practitioners with expertise in auditory processing, signal processing, HA fitting, HA manufacturing, hearing therapy and deaf education.