Download Quick Guide – Visible Speech Mapping

Quick Guide – Visible Speech Mapping
The purpose of this Quick Guide is to give clinicians a short introduction to Visible Speech Mapping during the
hearing aid fitting process and patient counseling.
Introduction
Verification of the hearing aid fitting is a very important part of the fitting process. To try to make this process a
bit easier, rather than using traditional real-ear measurements, hearing care professionals can use the Visible
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Speech Mapping modules in the Affinity and Callisto™ suites. Visible Speech Mapping is an intuitive tool which
helps hearing care professionals better explain the benefits of amplification.
Getting Started
Speech Mapping is a Real Ear Aided Response (REAR) measurement; therefore the same equipment that is
needed for a REAR is also needed. To start, follow the steps below.
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1. Launch the Affinity or Callisto™ Suite through your patient management system, NOAH, OtoAccess™ or
Standalone.
2. Enter/Select an audiogram from NOAH or from the AUD module (if using Standalone). If no audiogram is
entered or selected, no targets will be displayed.
3. Launch the REM module by clicking on the REM tab.
Prepare the patient for REM
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4. Connect the REM headset to the Affinity or Callisto™ hardware.
5. Connect a probe tubes to the REM reference microphones.
6. Click on the Tube Calibration button
and follow the instructions on the screen.
7. Position the patient approximately 0.5 meters from the REM loudspeaker.
8. Perform otoscopy to ensure the ear canal is clear.
9. Snap the REM headsets on the REM headband and place on patient’s ear.
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Measurement Steps
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3
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5
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Figure 1: the Visible Speech Mapping screen
1. Choose the Visible Speech Mapping protocol from the drop down menu.
2. Choose the appropriate options with in the Fitting Prescription Settings window, which will appear
automatically when the Speech Mapping protocol is chosen:
The fitting formula can also be changed by expanding the “advanced view” option (#2 above).
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3. To verify the fitting, select the ISTS signal (to use a calibrated speech-like signal for verification) .
4. Click on the Visible Speech Mapping button at the bottom left of the screen. If using an Open Fitting
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configuration, click on the “Calibrate for Open Fit” before proceeding with verification.
5. Click on the slider to adjust the input level of the ISTS signal; suggested start level is 65 dB SPL. Click
START.
6. Repeat step 5 using soft and loud levels; suggested levels are 50-55 dB SPL and 75-80 dB SPL,
respectively.
7. Change the Input signal to Warble Tone. Using the slider (Figure 1, number 5) to increase the level of the
signal to 90. Click START to measure the MPO.
NOTE: If choosing DSLv.5, the MPO targets will automatically appear, since the UCL thresholds are
always predicted from the audiogram. If choosing NAL-NL1 or NAL-NL2, the UCL thresholds need to be
entered in the audiogram screen for the MPO targets to be generated.
8. Fine tune the hearing aid if necessary, to match the target. Use the On Top mode button
minimize the REM screen and to bring it “on top” of the hearing aid manufacturer software.
9. Counsel the patient, using the tools described below .
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Counseling Elements in Visible Speech Mapping
Upper line :
louder speech components
Lower line :
softer speech components
The Speech Spectrum: used to counsel
regarding audibility.
 For example: showing the patient that
soft sounds (lower line on image to the
left) are below the thresholds could help
counsel on expectations of hearing aid
performance.
 It could also help HCPs demonstrate the
effects of fine tuning the HI.
Using Live Speech Mapping or
Environmental sounds.
 Select the “Live Voice” feature to
demonstrate the effects, benefits and
limits of amplification.
 Use a whisper to show how the hearing
aid reacts to it.
 Ask the significant other to stand far
away from the hearing instrument user
and talk; this helps demonstrate some
of the limits of the hearing instrument.
 Play environmental sounds to
demonstrate how they sound with the
hearing aid.
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For instructions on how to do the open fitting calibration, please refer to the REM Quick Guide
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Counseling overlays.
 Use visuals to help explain the hearing
loss to patients.
 Adding visual information helps
understanding of amplification and
hearing loss.
 Choose from “Familiar Sounds”
examples, Phonemes and Speech
Banana.
Unaided
Aided
Unaided vs Aided.
 Easily visually demonstrate the
difference between unprocessed vs
processed/amplified sound.
 Can demonstrate the effect of adaptive
hearing aid features.
 Frequency Shifting.
 Noise reduction.
Speech Intelligibility Index.
Use this to visibly show, using a percentage,
improvement in speech intelligibility from
unaided to aided.
Adaptive Feature example 1: Demonstrating
Frequency Shifting.
 Red curve: Unaided vs Aided, normal
amplification.
 Blue curve: Unaided vs Aided after
activating a frequency shifting algorithm
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Adaptive feature example 2: Demonstrating
Noise Reduction.
 Red Curve: Unaided and Aided with
Noise Reduction feature OFF.
 Blue Curve: Unaided and Aided with
Noise Reduction feature set to MAX.
UCLs
Hearing Loss,
reversed, and
converted to
dB SPL
Dynamic Range
Dynamic range.
 The dynamic range is the range
between the softest sound the ear can
detect and the loudest sound the ear
can tolerate (thresholds and UCLs).
 Use the Speech Mapping graph to
explain the consequences and
limitations of narrowed dynamic ranges.
 Demonstrate the difference between a
normal dynamic range (normal hearing
to UCL) and a narrowed dynamic range
(hearing loss to UCL).
Normal Hearing in SPL
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