Research & Scholarly Achievement
at Gallaudet University

Rehabilitation Engineering Research Center on Technology for the Deaf and Hard of Hearing (DHH-RERC)

The Rehabilitation Engineering Research Center on Improving the Accessibility, Usability, and Performance of Technology for Individuals who are Deaf or Hard of Hearing (DHH-RERC) is funded by the National Institute on Disability, Independent Living, and Rehabilitation Research, under the Administration for Community Living at the US Department of Health and Human Services. The mission of the DHH-RERC is to provide consumers who are deaf or hard of hearing, as well as their families and clinicians, with the knowledge and tools necessary to:

  • Take control of their communication and hearing technologies, adapt those technologies to their needs in real-world environments, and achieve greater autonomy in their technology use
  • Derive full benefit of the shift from special purpose devices to increasingly powerful and interconnected consumer electronics.
Consumers who are deaf or hard of hearing, if given appropriate ways to control the technologies that they use, will be in the best position to meet their needs and make technology work for them. This is preferred to relying on clinical practitioners, hearing health providers, and other types of service providers, who all are removed from the firsthand experiences deaf and hard of hearing consumers need to be in charge of their communication needs. The technologies that are needed for this kind of paradigm shift have begun to emerge in recent years, and as a result people and devices have become increasingly interconnected. With respect to hearing loss, many rehabilitation and training activities that formerly could take place only face-to-face — such as in a clinical setting, or at dedicated events in buildings — can now potentially be done using consumer devices, online, and at every individual's own pace. Parallel to this development, the advent of interconnected mobile and wearable devices, which are more powerful than the desktop computers of yesterday, is leading to a convergence of hearing devices and consumer electronics that are becoming increasingly integrated. Apps are already on the market to control hearing aid settings from a mobile device, and there are countless opportunities for closer integration between apps and hearing devices. The DHH-RERC supports this paradigm shift through research, development, and knowledge of translation activities.

Dr. Christian Vogler, RERC Director
Linda Kozma-Spytek, RERC Co-Director


Project D2: Context-sensitive assessment of real-world listening situations via integrated smartphones and hearing aids

ID: 2635
Status: Ongoing
Start date: October 2016
End Date: September 2019

Description

In order to improve hearing aid outcomes, it is critical to understand listeners' perceptions with hearing aids in the real world so that problems/factors with them can be identified. To achieve this goal, field assessment tools are required that collect (1) perception data, (2) listening context information, which includes characteristics of listening activities, situations, and environments, and (3) hearing aid configuration. To overcome the many disadvantages of retrospective self-report assessments, a computer-based Ecological Momentary Assessment (EMA) system was developed. This system immediately and repeatedly records listeners' perceptions and listening context information in natural environments using mobile phones. AudioACE will be developed for this project, which builds on the previous system, and adds capabilities to respond to changes in listening context and intelligently records information that is relevant to the specific context; for example, silence and noisy conversational environments demand different types of data and responses. AudioACE will integrate hearing aids and mobile phones to capture hearing aid configurations for each listening context. Additionally, AudioACE will incorporate intelligent sampling techniques that trigger the delivery of momentary assessments based on the properties of the listening context (e.g., signal-to-noise ratio level). We will compare the sensitivity and efficiency of AudioACE and the previous system as part of a field study that evaluates the outcomes of directional microphone hearing aids.

Principal investigators

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Products

Hasan, S. S., Brummet, R., Chipara, O., & Wu, Y. H. (2017, May). Assessing the performance of hearing aids using surveys and audio data collected in situ. Presented at INFOCOM, 2017, IEEE International Conference on Computer Communications. Atlanta, GA.

Shabih Hasan, S., Brummet, R., Chipara, O., & Wu, Y.-H. (2017, May). Assessing the performance of hearing aids using surveys and audio data collected in situ.  Presented at Mission-Oriented Wireless Sensor and Cyber-Physical System Networking (MiSeNet.) Available athttp://homepage.divms.uiowa.edu/~ochipara/papers/misenet17.pdf

Wu, Y. H. (2017). 20Q: EMA Methodology - Research Findings and Clinical Potential. Audiology Online, Article 20193. Available at http://www.audiologyonline.com/articles/20q-ema-methodology-research-findings-20193.

Xu, J., Wu, Y. H., Stangl, E., Pentony, S., Vyas, D., Chipara, O., Hasan, S. S., Crukley, J., & Galster, J. (2017, July). Assessing auditory ecology of younger normal-hearing listeners and older hearing aid wearers using a smartphone/hearing aid-based ecological momentary assessment system. Presented at the 3rd International Meeting on Internet & Audiology, Louisville, KY.


Project D3: Interactive learning environment for optimizing technology use

ID: 2641
Status: Ongoing
Start date: October 2014
End Date: September 2019

Description

For a person with hearing loss, technological developments continue to expand the sensory management options available through hearing devices. The diversity and sophistication of these new hearing enhancement options bring about an ever-increasing need for guidance and support in becoming a knowledgeable and effective user of a hearing device.

There is also a growing realization that more realistic conditions during training may lead to greater transfer of acquired skills. Similarly, the importance of realistic expectations in setting aural rehabilitation goals, both on the part of the hearing device user and the clinician/audiologist, is universally acknowledged. To develop such expectations and ensure that the aural rehabilitation goals are challenging yet attainable for the user, an individualized and interactive process is needed. It is likely to include not only measurements of the person's hearing loss, but also a more efficient (sensitive and specific) assessment of his/her listening, comprehension, and communication abilities, as well as aural rehabilitation goals and expectations.

The goal of this project is to develop a prototype training/counseling program to simulate in some relevant ways a variety of real-life listening situations so that a person can experience both the benefits and limitations of their new hearing device, and develop more realistic auditory rehabilitation goals and expectations. To accomplish this, the training program will utilize an interactive learning environment based on self-directed exploration of the relationship between (i) acoustic factors that affect hearing/sound processing, and (ii) technological solutions and communication strategies that are aimed at improving sound detection, speech comprehension, and the overall listening experience. The proposed training program is aimed at providing an alternative to the prevailing intensive learning paradigm and is believed to address several of its shortcomings. Realistic simulations of real-life listening situations will allow direct, structured experience that neither auditory training nor informational counseling provide.

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Products

Barac-Cikoja, D., Cole, K., Frick, A., & Pizappi, N. (2016). Using self-directed exploration to optimize hearing aid use in a noisy environment. Presented at the International Hearing Aid Research Conference (IHCON). Tahoe City, CA.


Project R1: Enhanced aural rehabilitation for cochlear implant users via telerehab technology

ID: 2642
Status: Ongoing
Start date: October 2014
End Date: September 2019

Description

The project aims to improve performance of cochlear implant (CI) users with enhanced aural rehabilitation (AR) strategies via telehealth technology, maximizing both access to auditory information and functional outcomes for individuals with hearing loss. Using a randomized controlled trial of AR via telerehab we will be able to demonstrate greater performance and usability of technology, and at the same time yield significantly greater accessibility to this effective intervention.

Although there is great potential in AR services for CI users, there are both financial and non-financial barriers to AR service delivery. In surveys of U.S. adults, 21% reported nonfinancial barriers including accessibility (mobility, distance, and transportation problems), accommodation (too busy with work or caring for family), and availability. Those from rural areas report limited qualified providers, financial constraints, and reduced transportation access. As the population ages, which comprises a sizable portion of adults receiving CIs, mobility issues contribute a noteworthy barrier to AR access.

Telehealth technologies are commonly regarded as promising options to improve access to health services. The previous RERC on Hearing Enhancement developed a state-of-the art rehabilitation program conducted in clinical settings. Adapting this successful rehabilitation protocol for telerehab has the potential of greatly extending access to much needed rehabilitative services. It also lets consumers take advantage of the increasingly interconnected world in which they live.

Principal investigators

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Products

Snyder, A., Bakke, M., & Bernstein, C. (2017). Inter­rater reliability of the Cochlear Implant Skills Review (CISR). Presentation at the American Auditory Society. Scottsdale, AZ.

Vogler, C., & Kozma-Spytek, L. (2017). Comments of the DHH-RERC on the FCC Public Notice on Actions to Accelerate Adoption and Accessibility of Broadband-Enabled Health Care Solutions and Advanced Technologies. Washington DC: FCC, GN Docket 16-46, May 24, 2017.


Project R2: User-driven customization of cochlear implant programming

ID: 2643
Status: Ongoing
Start date: October 2014
End Date: September 2019

Description

Essential to the outcomes with a CI is the manner in which the external portion of the device, the speech processor, is programmed. Research has shown that each CI user requires an individualized set of programming parameters to achieve optimal performance. Importantly, no one set of parameters has been found to be optimal for all CI users.

Presently, programming the speech processor is typically done heuristically in clinics following a manufacturer-recommended procedure. Given the complexity of the programming space and limited guidance on effective programming protocols, clinicians tend to rely on “default” manufacturer-recommended programming parameters. These default parameters may be used without exploration of other options, eliminating individualized optimization to achieve maximum performance. This trend is exacerbated by non-scientific factors such as limited manpower and clinic resources as well as low reimbursement for audiology services. As a result, individual customization of programming parameters for optimized speech understanding is not being accomplished.

In this project, we aim to develop a consumer-driven, user-interface system assisting the programming process. The most notable feature of the proposed system is that it will allow CI users to control the programming of the device themselves and enable them to personally explore a wider range of programming parameters. Consequently, individual customization can be achieved to maximize performance at the individual level with less time from the audiologists. This also opens the door for user-driven customization of other types of hearing devices in the future, thereby giving consumers with hearing loss greater control over their use of technology.

Principal investigators

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Products

Kwon, B. J., Holden, L. J., Lopez, B., Holden, T., Cooper, J., & Firszt, J. (2017, July). Self-exploration of MAPs by cochlear implant users. Poster presented at Conference on Implantable Auditory Prostheses, Lake Tahoe, CA.


Project R3: Validation of hearing aid fitting for infants and toddlers

ID: 2644
Status: Ongoing
Start date: October 2015
End Date: September 2019

Description

Current assessment protocols cannot be used to evaluate hearing aid settings in infants younger than 2.5 years of age, which poses a significant challenge when fitting amplification at such an early age. Further, the inherent variability of unconditioned behavioral responses in infants older than 6 months adds difficulty when making a clinical judgment of appropriate amplification.

Identification of hearing in the newborn period requires a physiological protocol because reliable conditioned behavioral responses cannot be obtained in the first 6 to 7 months of life. In the newborn period, a physiological protocol is also needed to validate hearing aid fitting of children with a speech discrimination procedure because obtaining a behavioral response for speech discrimination is not possible at this age.

Likewise, there is a critical need to develop an objective behavioral measure of speech discrimination that can be reliable and valid for children between 7 and 9 months of age and 2.5 years of age, when auditory discrimination, the current standard for validation of hearing aid fitting, can be used. Two years is too long to wait to validate a hearing aid fitting done at 6 months of age, and 1.5 years is too long to validate a cochlear implant map for a 12-month-old who has been recently implanted. A behavioral procedure needs to be done immediately after the fitting of amplification and this procedure needs to provide specific information about what the child is hearing with the amplification.

The project aims to fill in the current gaps in validating amplification fitting for infants and toddlers below the age of 3 years, demonstrating that physiological measures can be used immediately after the first hearing aid fitting, followed by a behavioral validation beginning at 7 to 9 months of age. Coupled with improvements to parent report instruments, the project also aims to provide a procedure for assessing auditory development after the fitting of amplification that is developmentally sensitive, and these instruments will be used for progress monitoring rather than as an inadequate validation of hearing aid fitting in infants.

The research will inform future technology developments: an app for visual reinforcement infant speech discrimination that will allow parents and early intervention providers to do discrimination work prelinguistically in the home, a LENA mobile reporting mechanism that will be consumer-friendly and provide parents feedback on their child’s auditory environment, and a portable EEG unit that can be used to test for physiological responses in the infant’s home.

Principal investigators

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Products

Gilley, P. M., & Uhler, K (2017). Assessing speech perception in infancy: A comparison of two electrophysiological measures. The Annual Ultimate Midwinter Meeting for Otolaryngology and Otology-Audiology. Vail, CO.

Gilley, P. M., & Uhler, K (2017). Developing a tool to assess speech perception in infancy. American Academy of Audiology. Indianapolis, IN.

Gilley, P. M., Uhler, K., Watson, K., & Yoshinaga-Itano, C (2017). Spectral-temporal EEG dynamics of speech discrimination processing in infants during sleep. BMC Neuroscience, 18(1):34.

Uhler, K., Gilley, P. M., Watson, K., & Ross, R. G. (2017). Three-month-old speech contrast MMRTF predicts performance on behavioral measures of speech discrimination at 7 months. Presented at the Biennial Meeting of the Society for Research in Child Development. Austin, TX.

Yoshinaga-Itano, C. (2017). CAEP, VRISD, Parent Questionnaires, Ling sounds: Validating hearing aid fitting in young children. Listen and Chat, Denver, CO.

Yoshinaga-Itano, C. (2017). Technology advances transforming the future of pediatric audiology. CDC workshop, Atlanta, GA.

Yoshinaga-Itano, C. (2017).  EHDI in the 21st century.  Early Hearing Loss Detection: Protocols for Diagnostic Audiological Assessment Follow-up to Newborn Hearing Screening, Presentation at NCHAM. Cincinnati Children’s Hospital, Cincinnati, OH.

Yoshinaga-Itano, C. (2017, February). Recommended practices for family-centered early intervention with families who have infants and toddlers who are deaf or hard of hearing. Presented at the OSUMC Eye and Ear Institute Open House Conference. Columbus, OH.

Yoshinaga-Itano, C. (2017, July). Impact of EHDI in the 21st Century. Presented at Frontiers in Hearing: Auditory Development and Disorders Symposium. Estes Park, CO.

Yoshinaga-Itano, C. (2017, October). The infant brain and children who are deaf or hard of hearing. Presented to the Association of State and Territorial Health Officials. Washington, DC.

Yoshinaga-Itano, C. (2017, October). Transforming what we do in early intervention with technological advances. Presented to Getting it Right 0-5:  Together we make a difference, Ear Foundation and AG Bell Association, London, England. 

Yoshinaga-Itano, C. (2017, September). Technology advances transforming the future of audiology. Presented at the 50th Anniversary of the British Society of Audiology, e-learning conference, taped.

Yoshinaga-Itano, C. (2017, September). Validating hearing aid fitting and cochlear implant maps of very young children. Presented at the 10th Asia Pacific Conference on Speech, Language and Hearing (APCSLH2017), Narita, Japan.

Yoshinaga-Itano, C., Sedey, A. L., Wiggin, M., & Chung, W. (2017).  Early hearing detection and vocabulary of children with hearing loss.  Pediatrics. 140(2):e20162964, DOI: https:// doi. org/ 10. 1542.


Standards work and technical assistance

ID: 3209
Status: Ongoing
Start date: October 2014
End Date: September 2019

Description

Standards work and technical assistance from the RERC is being provided to stakeholders (e.g., consumers, industry, standards bodies) across a range of issues that include, but are not limited to: (1) Compatibility and Connectivity between hearing devices and other technologies: ANSI ASC C63 on Electromagnetic Compatibility S8 WG19 – compatibility between wireless communication devices and hearing aids, standards activity within the International Telecommunications Union and the Bluetooth Special Interest Groups on hearing device connectivity, and the Wireless HAC Refresh. (2) Policy and Regulatory Intersection between emerging mainstream wearable technologies that can provide hearing assistance and more traditional hearing assistive technology and devices: Consumer Technology Association activities on personal sound amplification products. (3) Technology Design Considerations for use in cases specific to consumers who are hard of hearing or deaf: Results from the RERC’s focus groups in Project D1 will inform this issue by helping to develop a better understanding of the user experience from the perspective of hard of hearing and deaf consumers, and then helping to effectively communicate that to industry for use in products beginning at the design and development phase. (4) Other technical standards activity, including real-time text policy and standardization: ATIS IMSESINet real-time text standardization, FCC rulemaking on real-time text.

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Scholarship and creative activity

2017

Vogler, C. (2017, June).  Real Time Text: A roadmap for global adoption. Panel presentation at the M-Enabling Summit, Washington, DC.

Vogler, C. (2017, September).  DAC Updates. Panel presentation at the 2017 NASRA Conference, Golden, CO.

Vogler, C. (2017, September).  Real Time Text. Panel presentation at the 2017 NASRA Conference, Golden, CO.

Vogler, C., Vanderheiden, G., & Hellström, G. (2016). Ex Parte on the FCC Real-Time Text NPRM. Washington DC: FCC, CG Dockets 16-145 and 15-178, November 8, 2016.

Vogler, C., Vanderheiden, G., & Hellström, G. (2017). Comments of the DHH-RERC, UIITA-RERC, Omnitor, and Consumer Groups on the FCC Real-Time Text FNPR. Washington DC: FCC, CG Dockets 16-145 and 15-178, February 23, 2017.

Vogler, C., Vanderheiden, G., & Hellström, G. (2017). Reply to Comments of the DHH-RERC, UIITA-RERC, Omnitor, and Consumer Groups on the FCC Real-Time Text FNPR. Washington DC: FCC, CG Dockets 16-145 and 15-178, March 24, 2017.

Vogler, C., Vanderheiden, G., & Hellström, G. (2017). Reply to Comments on the T-Mobile petition for reconsideration, FCC Real-Time Text NPRM. Washington DC: FCC, CG Dockets 16-145 and 15-178, April 10, 2017.

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