title: A proposed electroacoustic test protocol for personal FM receivers coupled to cochlear implant sound processors.
abstract: BACKGROUND
  Current fitting guidelines from the American Academy of Audiology (Academy) support the use of objective electroacoustic measures and behavioral testing when fitting frequency modulation (FM) systems to hearing aids. However, only behavioral testing is recommended when fitting FM systems to individuals with cochlear implants (CIs) because a protocol for conducting electroacoustic measures has yet to be developed for this population.
  
  
  OBJECTIVE
  The purpose of this study was to propose and examine the validity of a newly developed, objective, electroacoustic test protocol for fitting electrically and electromagnetically coupled FM systems to CI sound processors.
  
  
  METHODS
  Electroacoustic measures were conducted and replicated in the laboratory with three contemporary CI sound processors and several FM system combinations. A repeated measures design was used with four participants to examine the validity of the proposed electroacoustic test protocol.
  
  
  METHODS
  Three contemporary CI sound processors were tested electroacoustically in the laboratory while coupled to combinations of five FM receivers and four FM transmitters. Two adolescents using Cochlear Nucleus 5 sound processors and two adult participants using MED-EL OPUS 2 sound processors completed behavioral and subjective measures.
  
  
  METHODS
  Using current hearing aid practice guidelines from the Academy, electroacoustic measurements were conducted in the laboratory with the CIs and FM systems to determine transparency, where equivalent inputs to the CI and FM microphones result in equivalent outputs. Using a hearing aid analyzer, acoustic output from the CI sound processor was measured via monitor earphones and specialized equipment from CI manufacturers with 65 dB SPL speech inputs (1) to the sound processor and (2) to the FM transmitter microphones. The FM gain or volume was adjusted to attempt to achieve transparency for outputs from the two input devices. The four participants completed some or all of the following measures: speech recognition in noise without and with two FM systems in a classroom, loudness ratings without and with two FM systems measures in a quiet condition in a classroom, and questionnaires.
  
  
  RESULTS
  Transparency was achieved for most CI and FM combinations, but most systems required adjustments to FM gain or volume relative to the manufacturer default setting. Despite adjustments to the systems, transparency was not attainable for some FM receiver and transmitter combinations. Behavioral testing in four participants provided preliminary support to the proposed electroacoustic test protocol.
  
  
  CONCLUSIONS
  Valid and reliable electroacoustic test measures may be feasible with CIs coupled to FM systems with specialized equipment from the CI manufacturer. Advances in equipment available for electroacoustic testing with these devices as well as additional research will lend further support to this objective approach to fitting FM systems to CIs.
authors.affiliation: Department of Speech and Hearing Sciences, University of North Texas.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Schafer
authors.affiliation: Department of Speech and Hearing Sciences, University of North Texas.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Musgrave
authors.affiliation: Department of Speech and Hearing Sciences, University of North Texas.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Momin
authors.affiliation: Oticon A/S, Smørum, Denmark.
authors.forename: Carl
authors.initials: C
authors.lastname: Sandrock
authors.affiliation: Department of Speech and Hearing Sciences, University of North Texas.
authors.forename: Denise
authors.initials: D
authors.lastname: Romine
mesh_terms: D000293:Adolescent; D000328:Adult; D000669:Amplifiers, Electronic; D002648:Child; D003054:Cochlear Implants; D055590:Electromagnetic Phenomena; D004867:Equipment Design; D006801:Humans; D008144:Loudness Perception / Q000502:physiology; D008422:Materials Testing / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D009622:Noise; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D017755:Prosthesis Fitting / Q000379:methods* / Q000592:standards; D059629:Signal-To-Noise Ratio; D013067:Speech Perception / Q000502:physiology; D013069:Speech Reception Threshold Test / Q000379:methods