Question About Clarity

As I previously posted, I’m trialing a pair of BTE Unitron Quantom 12’s.

I’m having trouble understanding speech when watching TV. Tried all sorts of settings, but many words and phrases pass right on by and I have to ask my wife what was said.

Is this common? Is it something that can be adjusted?

I have other issues which I mentioned in my previous post several days ago.

Would appreciate some advice.

You have a flat hearing loss as I have with substantial low frequency loss. I had to switch to power receivers and power domes to keep some of the low frequencies in and that improved speech clarity while watching TV. Pros on this forum may chime in and help more then I can.

You have to ask yourself, what you are missing. Is it clarity or volume? Ie; does speech clarity improve with added volume from the tv, or does it just get louder, but offer no improvment in clarity.

This should help you decide, and know what to ask for when you go see your practitioner.

Volume doesn’t improve clarity.

I’ve experimented with increasing TV volume while decreasing HA volume and the reverse. I’ve done this with all three program modes. (with what’s been on TV lately, mode #4, mute, is the best choice … joke!!)

Also used the scroll wheel to adjust tone clarity with little no success in each mode.

The best performance, and then very little, is putting the HA’s in the telephone program mode while watching TV.

Again, don’t know if it’s a HA performance problem or just the need of adjustment.

Unless there’s a way to improve the clarity, I doubt I’ll keep these past the trial period.

Suggestions?

Well, there is one more thing to try before deciding on going another route.

Set the volume of the tv to your wife’s prefered volume intensity while wearing your hearing aids, then adjust the volume of the hearing aids to your prefered intensity. Does this improve the sound quality? If not, adjust your comfort/clarity tone control up all the way. Does that improve the clarity? If not, then your hearing aids are not configured for your loss the way you need them to be. If it does improve, then relay the information of what you did to your hearing aids to make them sound good. The onboard DataLogger will be of use to them as well.

I hope that helps.

Another possible suggestion is to find out what your speech discrimination scores were on the hearing test you obtained. If your percentages were less than 50% or 60% then it’s highly possible that the distortion you are experiencing has little to do with the hearing aids and more to do with the damaged system the sounds are being sent into.

Speech testing can tell us a lot as far as that goes. It’s not to say that the hearing aids aren’t at fault, but it’s an important factor to take into account when changes to the hearing aids make little difference in clarity.

If you can find the results and post them that would help in providing you with a more accurate answer as we will have a more complete picture of your hearing.

I have found that the quality of the sound of the TV makes a huge difference. I have an 18 year old TV that I watch in my bedroom. No matter what I do with the volume on the aids or on the TV I have a problem with clarity. On the other hand my other TV has it’s sound routed through a receiver and then to speakers. I have NO trouble with clarity when I watch/listen in this situation.

I have a print out of my hearing test, but I’m not sure what to look for that will tell me what the speech discrimination score is.

There should be an area with the letters WDS or SRT. SRT will usually have a number next to it and this is the softest speech sound you could understand. WDS will typically have a % and then a numerical value next to it. It indicates what percentage of words you got correct at whatever presentation level (the numerical value).

Often looks like this:
R L
SRT 30 40
WDS 84% 76%
@70 @80

or something similar. if the % are low, say 60 or below then, in general, speech will always sound fairly mushy or unclear even with increases in volume due to the underlying damage that has taken place in the cochlea.

It’s also possible that whoever did your test didn’t do the speech testing…I’ve heard of pros (usually HIS’s in this area) that omit that part of the test.

There’s a chart on the hearing chart print out with the heading: Binaural/Dichotic

There’s an AC column for R & L, all the below are in that column. There many more columns, but they are empty.

For the Right:

SRT 70

WRS1 85

Score: 80

MCL 85
UCL 110

For the Left:

SRT 75

WRS1 90

Score 84

MCL 90
UCL 105

Maybe you can explain these numbers. I’ve never received an adequate explanation in almost 10 years of wearing HA’s. I’ve only heard the audiologist mention % of word discrimination loss. I think they mentioned I have an 85% and 75% loss in this area. Whatever it is, it’s probably not good.

The information is off a chart dated 12/5/11 the specialist at COSTCO printed out for me. It’s the only chart that’s ever been handed to me. I was looking at Phonak, Resound Futures, Starkey and then these Unitrons. I felt the Unitron provider, which dealt in many brands, was providing me with the least amount of BS, best technical advice and had 18 years of experience in our community.

ALSO: WHY when you print the hearing chart is the right ear on the left side of the page and the left ear on the right??? Perhaps because if the audiologist is looking at the patient the right is on the left and left is on the right??? Just wondering.

From what you’ve posted, It looks like your word recognition scores (WRS) are 80% in the right ear and 84% in the left ear, which is pretty darn good, especially if you aren’t hearing speech until 70 and 75dBHL which is what the SRT (speech recognition/reception threshold) is. MCL = most comfortable level, UCL = Uncomfortable level. Not sure if it’s for speech or tones but it appears that since there is no frequency listed with those values, it’s most likely for speech. The thing is, the SRT’s you have listed are far higher than what I’d expect with a hearing loss like yours. I’d expect them to be more around 55/60 and not 70/75, but that’s really a minor detail. Those word recognition scores are more valuable when it comes to hearing aids.

Given your pretty good scores I’d think you’d do much better with clarity on the hearing aids than you are. It’s possible that your pro hasn’t found the right fitting formula or processing scheme yet…I know I’ve had to change fitting formulas sometimes for some patients (usually reducing compression) to help with clarity. It might be that the Unitron HA’s just aren’t right for you. If after multiple adjustments they still don’t sound good then ask to try a different brand. I find that 99% of the time when I have a patient who doesn’t like the sound quality of a particular hearing aid and no amount of adjustments help, switching to a different manufacturer usually resolves the issues and they are happy. Hopefully the pro you have is just a comfortable with the other brands as they are with Unitron and you’ll be able to find the right hearing aid for you.

As for the Left/Right thing, it’s not always like that but a lot of the standard forms (I made my own the way I like it) have that reversed because of the way it’s displayed on our computer monitor. A lot of patients will face the pro during testing and that means that the right ear is really on the left side. I’m sure there’s a better, more official reason, but it’s just always the way it’s been as far as I know…lol.

WOW!!! Thanks for the wealth of information. I feel a little better now that it might be the HA’s and not me. I was going to see if I could get an adjustment this afternoon, but I wanted to read your response prior to doing that.

I sometimes have a tough time following a conversation if the subject is changed mid-stream. I don’t recognize a few words and start scratching my head as to what’s being said. But I hope these new BTE’s will help correct that with some more fine tuning. I’ll let you know if there’s an improvement.

Thanks again.

No problem. There are some other issues that do play into HA success beyond the WDS scores and hearing loss. If someone has diminished working memory or central processing problems it will negatively impact HA functionality as well. I don’t know of anyone who is doing any kind of evaluations for establishing working memory…it’s a fairly new concept that is being passed around the HA world.

So, based on what you posted and your discussion with DocAudio, the problem is with your hearing aids…

Go back and try the things I mentioned so you can figure out how to adjust your hearing aids. Based on your hearing test results, I think you aren’t getting enough overall volume and clarity, but try it and see.

Also, you need to keep in mind, that any hearing aid you try that is set this way, will result in the same situation. It is best to understand your own situation so that you can guide your technician to the results you are looking for. Lastly, always trust your instincts. If you don’t feel something is right, do something about it.

I’ve done the experiment you recommended. Again, last night, I had my wife adjust the TV volume to her liking. Then I experimented with all sorts of settings with my HA’s. Volume and tone were the primary adjustments.

Yes, I do need more volume. But the clarity is still lacking. AND this depends upon the channel or type of program being watched.

A movie is harder for me to follow than a talk program, like Hannity. So, it leads me to believe that knowing what the subject content is helps me follow the program better. With a movie I find myself asking my wife, “What did he just say?”, especially those movies where they speak in a whisper or a heavy accent.

I’m calling for an adjustment appointment today.

I also need to rid myself of much of the “white noise” while driving the car. The sound od road noise and even the heater fan require me to reduce HA volume to be comfortable while playing the radio, again talk radio, not music.

Also, I (we) didn’t state we were giving up on these HA’s. My interpretation is that #1) we need to do some tune-up work with my provider #2) if that doesn’t work we’ll look at other options.

PS: If I use auto related terms, like “tune-up”, it’s 'cause I’m a car guy. Being in the military, owning and driving race cars, attending motorsports events for fun and then as an occupation for 20+ years probably did the damage I’m living with now. Could be worse.

Great! It sounds like you are prepared for your appointment, armed with the information you need to modify the programming for maximum benefit.

As for the white noise in your car, there are 3 automatic programs in your hearing aids. Each of them can be adjusted separately. I would recommend you have the Smart Focus settings decreased in the “Speech in noise” setting and reduced to -5 or greater in the “Noise” setting. Perhaps an increase in the program switching sensitivity setting may be of benefit.

I hope that helps.

You know this is a BIG help. I’ll run that bit of information by my provider tomorrow.

I was experimenting again tonight with the TV.

This time, after setting the volume for my wife, I adjusted on my HA’s again. I had to turn the HA volume up more than last night.

Then, after she went to bed early I watched “Titantic”. Best setting was volume of TV turned up about 25% more and HA volume adjusted down.

My appointment should be an interesting one.

Modifieddriver.

I have a similar problem with TV sound. More volume helps, but have you tried a neck loop with the aids using the “T” switch?

This brings the sound closer to you, and you control the volume. I have my aids set to “T +mic” which means I can hear others around me while listening to the TV.

I’ll ask about this later today at my appointment.

Thanks for the tip.

JohnD, the telecoil/neckloop combo is more of a european thing. But I always ask, if your hearing aids are more than able to do the job, why add more equipment?

I only like adding things strictly if the hearing aids are not capable enough.