Sensing the environment : development of monitoring aids for persons with profound deafness or deafblindness

Earlier studies of persons with deafness (D) and/or deafblindness (DB) have primarily focused on the mobility and communication problems. The purpose of the present study was to develop technology for monitoring aids to improve the ability of persons with D and/or DB to detect, identify, and perceive direction of events that produce sounds in their surroundings. The purpose was achieved stepwise in four studies. In Study I, the focus was on hearing aids for persons with residual low frequency hearing. In Study II-IV, the focus was on vibratory aids for persons with total D. In Study I, six signal processing algorithms (calculation methods) based on two principles, transposition and modulation, were developed and evaluated regarding auditory identification of environmental sounds. Twenty persons with normal hearing listened to 45 environmental sounds processed with the six different algorithms and identified them in three experiments. In Exp. 1, the sounds were unknown and the subjects had to identify them freely. In Exp. 2 and 3, the sounds were known and the subjects had to identify them by choosing one of 45 sounds. The transposing algorithms showed better results (median value in Exp. 3, 64%-69%) than the modulating algorithms (40%-52%) did, and they were good candidates for implementing in a hearing aid for persons with residual low frequency hearing. In Study II, eight algorithms were developed based on three principles, transposition, modulation, and filtration – in addition to No Processing as reference, and evaluated for vibratory identification of environmental sounds. The transposing algorithms and the modulating algorithms were also adapted to the vibratory thresholds of the skin. Nineteen persons with profound D tested the algorithms using a stationary, wideband vibrator and identified them by choosing one of 10 randomly selected from the list of 45 sounds. One transposing algorithm and two modulating algorithms showed better (p<0.05) scores than did the No Processing method. Two transposing and three modulating algorithms showed better (p<0.05) scores than did the filtering algorithm. Adaptation to the vibratory thresholds of the skin did not improve the vibratory identification results. In Study III, the two transposing algorithms and the three modulating algorithms with the best identification scores in Study II, plus their adapted alternative, were evaluated in a laboratory study. Five persons from Study II with profound D tested the algorithms using a portable narrowband vibrator and identified the sounds by choosing one of 45 sounds in three experiments (Exp. 1, 2, and 3). In Exp. 1, the sounds were pre-processed and directly fed to the vibrator. In Exp. 2 and 3, the sounds were presented in an acoustic test room, without or with background noise (SNR=+5 dB), and processed in real time. Five of the algorithms had acceptable results (27%-41%) in the three experiments and constitute candidates for a miniaturized vibratory aid (VA). The algorithms had the same rank order in both tests in the acoustic room (Exp. 2, and 3), and the noise did not worsen the identification results. In Study IV, the portable vibrotactile monitoring aid (with stationary processor) for detection, identification and directional perception of environmental sounds was evaluated in a field study. The same five persons with profound D as in Study III tested the aid using a randomly chosen algorithm, drawn from the five with the best results in Study III, in a home and in a traffic environment. The persons identified 12 events at home and five events in a traffic environment when they were inexperienced (the events were unknown) and later when they were experienced (the events were known). The VA consistently improved the ability with regard to detection, identification and directional perception of environmental sounds for all five persons. It is concluded that the selected algorithms improve the ability to detect, and identify sound emitting events. In future, the algorithms will be implemented in a low frequency hearing aid for persons with low frequency residual hearing or in a fully portable vibratory monitoring aid, for persons with profound D or DB to improve their ability to sense the environment