Fitting children with advanced sound processing algorithms in their hearing devices is not always straightforward. Does the clinical evidence support it? Will it provide more access to all sounds, promote incidental learning, and improve speech understanding in challenging environments? These questions are frequently considered, and a conservative approach is often taken. Whereas, when fitting adults, there is typically clinical evidence to support advanced sound processing and they are better at reporting sound quality issues, so audiologists are more likely to take a less conservative fitting approach. However, if we take too much of a conventional approach with children, are we missing an opportunity to provide improvements in sound quality, hearing in noise, and reduced listening effort?
In 2019, OpenSound NavigatorTM was incorporated into the Ponto 4 sound processor. The success of this sound processing strategy had been seen in Oticon hearing aids with many research studies documenting the benefits provided to patients. So, what is unique about OpenSound Navigator that might provide optimal benefit for children with hearing loss?
OpenSound Navigator is a groundbreaking speech enhancement algorithm that preserves speech and reduces noise in complex sound environments. OpenSound Navigator operates as a holistic system that handles all sound environments from the quietest to the noisiest, by selectively reducing the dominant noise sources while preserving speech in all directions. OpenSound Navigator adapts seamlessly without modes or mode switches. Utilizing an omnidirectional beam that captures a 360° sound panorama of the environment along with a back-facing cardioid that estimates noise from the sides and back provides users with a natural sound experience.
Research has been conducted in children using OpenSound Navigator. Browning et al, 2019 demonstrated OpenSound Navigator improves speech recognition in noise for children. In fact, with speech to the front and noise from behind, OpenSound Navigator provided an average 5 dB SNR improvement as compared to an omnidirectional microphone. Elaine Ng, 2017 further demonstrated that OpenSound Navigator reduces perceived listening effort during a speech recognition task. This benefit is particularly important because hearing loss imposes increased fatigue and effort as experienced by children. Oticon Medical’s BrainHearing™ technology is designed to support the unique day-to-day challenges and developmental needs of children. Together with hearing technology prescribed according to best practice, OpenSound Navigator delivers an optimized speech signal and hence provides these children with the optimal conditions to listen and learn.
Based on the supporting research, we recommend the fitting of OpenSound Navigator in a child’s Ponto™ 4 sound processor starting at one year of age. From ages one to four years, we suggest OpenSound Navigator is active with the transition set to low, and then as the child ages to four years and older, the transition can be adjusted to medium or high similar to adult recommendations. These are the default pediatric settings incorporated into Genie Medical (2019) fitting software. To summarize, unlike conventional directionality and noise reduction technology, OpenSound Navigator does not require children to look directly at the talker the whole time to enjoy better speech understanding in noise. Young listeners may move around freely and can still experience the benefits of OpenSound Navigator.
Another important feature of OpenSound Navigator is that it preserves interfering speech coming from different directions. This new technology allows access to other talkers in the environment, which is fundamental to incidental learning for school-age children.
The groundbreaking technology of OpenSound Navigator marks a breakthrough in the development of speech enhancement systems. It is not only designed to improve acoustics at the child’s ears, but also to facilitate the brain’s own processing. It does not isolate the front talker but preserves access to all talkers. Its accurate and fast spatially informed noise estimator allows the Balance module to selectively attenuate noise sources at given locations. The Noise Removal module removes the remaining noise even between words. OpenSound Navigator opens many possibilities for new pediatric users.
To learn more about the clinical evidence supporting OpenSound Navigator in children we encourage you to register for our upcoming training on April 21, 2021 or reach out to your regional clinical specialist.
About the Author
Carissa Moeggenberg is an audiologist who has worked in the hearing healthcare field for the past 28 years. She is presently the Training Manager for Oticon Medical.
Jenna M. Browning, Emily Buss, Mary Flaherty, Tim Vallier, and Lori J. Leibolda American Journal of Audiology Vol. 28, 101–113, March 2019 Elaine Ng, E. 2017. Benefits of OpenSound Navigator in children. Oticon Whitepaper. Genie Medical (2019) Fitting Software