BrainHearingTM
Mandy Velasquez, Au.D., CCC-A
Pediatric Account Manager, TX/AL
Pediatric Amplification in Support of
the Developing Cognitive System
Why?
► Counseling time is limited
► Families can vary greatly in
their understanding of HL and
consequences
► Increased understanding can
lead to increased compliance
► Increased compliance = better
outcomes for children
It all starts with
the Brain
Supporting the child’s developing
cognitive system
Children with a sensory
disability are particularly
vulnerable
Cognitive
Development
► Auditory learning starts right away
► Neuronal network maturation is heavily dependent on
sensory stimulation.
► Sound is the basis of language, speech, reading,
bonding, socialization, etc.
For More Information: Sound as Part of Cognitive Development, Oticon White Paper*
*In preparation
Cognitive
Development
Children with a sensory
disability are particularly
vulnerable
• Critical and sensitive periods during maturation are
very important for normal development of sensory
function and appropriate amplification
Early
is
•needed
Brain imaging
by Hirshorn
al. (2014)
suggest to
to studies
provide
the etchild
access
that both auditory deprivation and language
the
stimulation needed to support the
experience reorganize the brain
of speech and language
•acquisition
Lack of auditory stimulation during early development
can also affect visual attention, visual sequence
abilities.
learning abilities and motor sequencing skills that
in turn can influence attention and language learning
(Lévesque et al 2014; Conway et al 2011; Dye & Hauser
2014)
For More Information: Sound as Part of Cognitive Development, Oticon White Paper*
*In preparation
How can we give
the We
child’s
brain
call developing
it “BrainHearing”
the best auditory stimulation?
What do we mean by
“BrainHearing”?
► Speech Understanding is a cognitive
process
► Our Opinion: signal processing should
support what the brain already does very
well
► We want to provide the brain with the
most useful auditory information
possible
► We want to fully support the natural
course of cognitive development
The True Effects of Hearing Loss
What are the consequences of Sensorineural
Hearing Loss?
Missing information
Distorted information
The effects of noise
Lost connection to the environment
Increased listening effort
The Oticon Brain Hearing Approach
Our Philosophy: Sound must serve as
a dependable source of information
for the developing child.
Sound must be:
Complete
Accurate
Consistent
IF sound is distorted or unreliable,
children do not learn to use it.
Providing Full Access to Sound
Implementing BrainHearing in Sensei
Goal: Providing Complete Access to Sound
HOW?
DSL i/o
Rationale
Extended
Bandwidth
Providing Full Access to Sound
Implementing BrainHearing in Sensei
Goal: Accuracy through intelligent speech
processing
HOW?
Speech Guard E
Voice Priority i
FreeFocus
Directionality
SpeechGuard E
►Oticon’s Adaptive Compression strategy that protects the
contrasts and clarity of speech, especially in complex
listening situations.
Goal:
 Stable gain to preserve full intensity &
envelope details of the speech waveform
Benefits:
 Better, cleaner sound quality
 Full information to the brain
14
Speech Guard E
Dynamic output: Hilbert envelopes of fast compression vs. Speech Guard
Speech Guard E:
increased residual
amplitude dynamics, are
clearly present
Acto (fast syllabic compression)
Agil (Speech Guard)
15
Speech Guard E research
 https://www.youtube.com/watch?v=k3ZM8lCfI7k
20
RESEARCH CONCLUSIONS:
Although slow, fast, and adaptive compression
affects the acoustic signal in a subtle fashion,
adaptive compression significantly impacts
perception of speech and environmental
sounds. (Pittman et al., JAAA, 2014)
GO AHEAD- video
VoicePriority i TM
Adaptive FM strategy
Increases FM signal gain as noise increases (when teacher speaking)
Facilitates understanding of
peers when teacher not speaking
 Increases FM signal gain
Technology built into Sensei,
as noise
increases around
not the FM receiver or transmitter
student (when teacher
speaking)
No matter where the child
is situated in the classroom
he/she gets individual FM
gain depending on the
noise around him/her.
 Technology built into
Sensei, not the FM receiver
or transmitter
Adaptive FM strategy in Sensei
VoicePriority i TM
22
VoicePriority i TM
• As the noise level increase
above “normal” levels (>58
dB SPL [A]) more gain is
added to the FM signal.
• Above 71 dB SPL (A) no
more than 13 dB gain is
added, to avoid
uncomfortable listen levels
and degraded sound quality.
23
Voice Priority Research
 https://www.youtube.com/watch?v=fXs-zz5wof8
Providing Full Access to Sound
Implementing BrainHearing in Sensei
Goal: Consistent Presentation of Sound
HOW?
LED
Indicator
Robust, Pediatric
Design
Sensei – and all current Oticon products
– are now IP58 classified
Communicating the
BrainHearing Approach
to Parents
Why?
Clarify Things for the Parents
Why?
Justifying your Recommendations
Why?
Parents want to feel know they’re doing what’s
best for their child
Tie-in to
development
Examples the
parents
recognize
Aspects of SNHL
the parents may
not appreciate
Amplification:
early and
consistently
Concern of
Parents
Hidden Cost of
Hearing Loss
Explain the why
of your
recommendations
Clear, simply
stated &
to the point
Allows you to discuss key
features within a bigger
context
...
Technology with a Purpose
Evidence
BrainHearing Approach: It’s a Dialogue,
a Conversation
Define the Key Issues
Define the Goal of Amplification
Show the Solution
Parents are not looking for Technology
...
They are looking for Solutions