Smartphones: Audiologic Considerations for Facilitating

Smartphones: Audiologic Considerations for Facilitating
Facilitating Communication with
Perry C. Hanavan, AuD
Augustana College
Sioux Falls, SD
2014 HLAA Convention
Austin, TX
Learning Objectives
1. Participants will be able to identify smartphone tools that
facilitate and enhance communication.
2. Participants will be able to identify smartphone apps that
facilitate and enhance communication.
3. Participants will be able to identify recent smartphone
developments that facilitate communication.
I have no relevant financial or nonfinancial relationships in the
products or services described, reviewed, evaluated or
compared this presentation
Ten Reasons for Inclusion of Smartphones
1. Hearing aids/Implants alone may not be enough
2. Communication Digital Swiss Knife
3. Central part of everyday life
4. Access to communication
5. Apps interact with HA and implant devices
6. Made For iPhone (MFi) (streamers unnecessary)
7. Apps for aural rehabilitation
8. Facilitate communication and repair strategies
9. Improve phone communication
10. Temporary PSAP device (AUD1 app)
Land lines: home and
1:1 conversations
Small group meetings
Alarm clock with vibrator and/or flashing light
HAC phone, texting, built in amplification, ringer connected
to visual or vibrator indicator, speech recognition
Personal communication device (FM or infrared)
Portable FM or infrared device placed in the middle of the
table, loop, real-time captioning, 1:1 personal
Personal communication device with directional mike
Large-area infrared, FM or loop system
HAC phone, vibrate option, texting, high volume output
1:1 device with directional mike, emergency siren
Portable infrared or FM device in middle of table
Captioning, Infrared, FM or loop connected to TV
Vibrator worn on body and flashing lights
Baby monitoring device with vibrating annunciator
Flashing lights and/or vibrating annunciator
Noisy restaurant
Large group meetings,
Cell phone
Family dinner
Door bell
Child care
Digital Swiss Army Knife
Volume control/Speaker phone
Direct Audio Input (DAI)/Loop compatible
Telecoil compatibility/HAC features
Closed Captioning
Text communication
Communication Apps
Increased audio bandwidth
Audio, visual, haptic (Vibration) features
Video conferencing (Skype, FaceTime, Google
• Electronic media (Internet, movies, music, etc.)
United Nations Study
• More people have access
to cell phones than
• 7 billion people:
– 6 billion have mobile
– 4.5 billion have access
to working toilets
Fastest Growing Technology
• Smartphones sales surpassed PCs in 2010
• “Mobile broadband uptake is growing at 30 per cent per year,
according to the 2013 State of the Broadband report, and will
be the fastest growing technology in history.”
Broadband Commission. (2013). State of Broadband Report 2013.
Smartphone Adoption
• Almost 2/3 of Americans owned a smartphone in 2013
• Sales of smartphones surpassed feature phones in 2013
Future Smartphones
• “Taking Moore's Law to its extreme
conclusion, smartphones should be packing
sub-20nm 256-bit, 32-core processors in
five years. ”
Stewart Wolpin Your Smartphone in 2018: 15 Futuristic
Features;, Jun 11, 2013,
Future Smartphones
• Augmented Reality (AR): refers to what
is perceive through one’s senses
enhanced through computer-generated
sensory input such as sound, video,
graphics and GPS data.
– More information is made available
by combining computer data to what
we see in real life.
• Example: Audio-Visual Speech
Recognition (AVSR) combines audio,
video, and facial expressions to capture
speaker’s voice.
Mirzaei MR, Ghorshi S, and Mortazavi M. 2014. Audio-visual
speech recognition techniques in augmented reality
environments. Vis. Comput. 30, 3 (March 2014), 245-257.
Future Smartphones
• 3D
• Holographic projections
– Provide better
speechreading cues in 3
Future Smartphones
• Ubiquitous, seamless Wi-Fi,
• Wi-Fi will create cellular-like automatic,
ubiquitous and secure Wi-Fi
connections. without ever losing a WiFi connection
Future Smartphones
• Biometric Data: Transmit
hearing aud/implant datalogging information regarding
listening conditions, sound
sampling, etc., to audiologist
Future Smartphones
• 4G LTE Advanced: Also known as
Long Time Evolution (LTE) Wideband
or LTE-A, will deliver data at 150-300
megabits per second (mbps)
– Up to 20 times faster than
current 4G LTE cellular
• HD Voice (7 kHz bandwidth)
• Full HD Voice (20 kHz bandwidth)
Anytime, Anywhere, Anything
• GM and Audi cars to offer
"connected cars" 2015
– GM vehicles integrate with the
iPhone or iPad and GM's own
OnStar service.
– Implications for Made for
iPhones Hearing Aids
Smartphone Vs. Feature Phone
• Smartphone: A cellular phone
that is able to perform many
of the functions of a computer,
typically having a relatively
large screen and an operating
system capable of running
general-purpose applications.
(Google Online Dictionary)
• Smartphone: A mobile phone
with a touch screen, third
party operating system,
Internet accessible and used
for communication. (Hanavan,
• Feature Phone: A mobile
phone that incorporates
features such as the ability to
access the Internet and store
and play music but lacks the
advanced functionality of a
smartphone (Google Online
Phone Vs. Phablet Vs. Tablet
• Smartphone
– Typically varying screen sizes from 3
inches to 5 inches
• Phablet
– Device that combines capabilities of
smartphones and tablets, usually larger
than a smartphone, but smaller than a
• Tablet
– Device that has a touch screen interface,
and usually larger than a phablet
Operating Systems Vs. Applications
• Operating System (OS): Software that runs/manages the
smartphone computer memory, processes, and all of its
application software (apps) and hardware.
– Android
50.3% U.S. sales, 3Q 2013
– iOS
– Windows Phone
– Blackberry
– Other
• Application Software (Apps): Smartphone software that
causes the smartphone to perform useful tasks beyond the
running of the computer itself.
U.S. Smartphone OS (2014)
Smartphone Adoption in U.S. (2014)
Practical Hearing Aid Skills Test-Revised
• Eight tasks on the PHAST-R cover the following skills:
(1) hearing aid insertion
(2) hearing aid removal
(3) opening the battery door
(4) changing the hearing aid battery
(5) cleaning the aid
(6) manipulating the volume control
(7) telephone use (ranked highest)
(8) use of the noise program
Desjardins & Doherty, (2012). Objective verification of hearing aid
users’ ability to use and care for their hearing aids. 2012 ARA Institute.
Wireless – Acoustic Coupling Comparison
• Phone signal transmitted to both ears results in significantly
better speech recognition compared to signal to only one ear.
Picou EM, Ricketts TA. Comparison of wireless and acoustic hearing aid-based
telephone listening strategies. Ear Hear. 2011;32(2):209-220.
Evaluated HA Telephone Strategies
Research conditions:
• Acoustic telephone w/wo plugging opposite ear
• Unilateral telecoil w/wo plugging opposite ear
• Unilateral wireless streaming
• Bilateral wireless streaming (best)
Picou EM, Ricketts TA. (2013) Efficacy of Hearing-Aid Based Telephone Strategies for
Listeners with Moderate-to-Severe Hearing Loss. Journal of the American Academy of
Audiology 24:59-70.
Mobile Phone Bandwidth
• Compared audible bandwidths
• Significant improvement in phoneme-recognition scores with
increased audio bandwidth of 7.5 compared to 3.5 kHz
Mackersie CL, Qi Y, Boothroyd A, et al. (2009). Evaluation of cellular phone technology
with digital hearing aid features: effects of encoding and individualized amplification.
J Am Acad Audiol.;20(2):109-118.
Internet Telephone Quality
• Internet versus conventional telephone quality
• Speech perception not significantly different than CD quality
• Significantly improved speech perception to hearing-impaired
and normal-hearing adults through doubling the frequency
range and through conserving audio quality during digital
sound processing.
Mantokoudis G, Kompis M, Dubach P, et al. (2010). How Internet Telephony Could
Improve Communication for Hearing-Impaired Individuals. Otology & Neurotology;
Vol. 31:7, pp 1014-1021 doi: 10.1097/MAO.0b013e3181ec1d46
Internet Video Telephony
Internet Video Conferencing:
• Sufficient lip shape information for speech reading by
individuals who are deaf and CI users
• Significant audio-visual benefits observed for CI users;
Mantokoudis G, Dähler C, Dubach P, Kompis M, Caversaccio MD, and Senn P.
(2013). Internet Video Telephony Allows Speech Reading by Deaf Individuals and
Improves Speech Perception by Cochlear Implant Users. PLoS ONE.
Internet Video Telephony
Skype (CI and deaf subjects)
• Transmits sufficient information for speechreading
• Significant audio-visual benefits observed for CI users
• Speechreading cues available although scores poorer than
face to face
Mantokoudis G, Dähler C, Dubach P, Kompis M, Caversaccio MD, and Senn P. (2013).
Internet Video Telephony Allows Speech Reading by Deaf Individuals and Improves Speech
Perception by Cochlear Implant Users. PLoS ONE. doi:10.1371/journal.pone.0054770
• 4th Generation/Long Term Evolution
• LTE voice (U.S. began implementation 2013)
• If adopted, will there be HD Voice available between calls of
various service providers?
• Adoption of Full HD Voice would have positive implications for
very high voice quality via cell phones
Smartphone Input
to HA/Implant Device
Earphone or
Magnetic Induction
Neckloop or Silloutte
Direct Audio Input
Adaptors or Cords
Radio Frequency
Magnetic Induction,
DAI, RF (including
Mono headset or earplug
patch cord
• 3.5 mm mono audio
jack for smartphone
• Some streamers use
2.5 mm jack
Accessories for iPhone
DAI patchcords
• 3.5 mm jack for most smartphones
and 2.5 mm jack to connect to
streamer 3.5 mm jack with either
mono or binaural universal 3 pin
Euro jack patchcord to connect to
Recent Configuration
Smartphone with
(remote control)
HA, Implant
Smartphone Connections to Streamers
• Bernafon SoundGate 2 and Phone Adapter 2 streamers
• GN ReSound Unite PhoneClip+ and Resound Control
• Oticon ConnectLine Streamer Pro features "mini-mic" neck
• Phonak Roger Pen and Inspiro wireless microphone transmits
to hearing aids via proprietary 2.4 GHz.
– Wireless transmitter that can stream smartphone audio
using Bluetooth 4.0 wideband receiver from Bluetooth
• Siemens miniTek feature a "mini-mic" streamer
• Starkey SurfLink Mobile streamer
• Unitron uDirect2 features neck streamer
• Widex WidexLink M-DEX streamer features audible caller ID
in both ears
New Connection Paradigm
(with App)
Streams audio directly to HA
and serves as remote with app
HA, Implant via
Bluetooth 4.0
Bluetooth 4.0 and MFi Hearing Aids
Hearing Aid
GN ReSound
ReSound Smart
* Oticon continues to use streamer with MFi
ReSound Smart App with LiNX
• ReSound LiNX and one or more of the
following devices:
– iPhone 5s, iPhone 5c, iPhone 5,
iPad (4th generation), iPad Air,
iPad mini, iPad mini with Retina
display (running in 2X mode), and
iPod touch (5th generation).
– iOS 7.X or later
– Optimized for iPhone 5s, iPhone
5c, iPhone 5.
GN ReSound LiNX Smart App
ReSound Smart App (iOS)
The ReSound Smart™ app controls and personalizes hearing
First hearing aid app with a direct connection between ReSound
LiNX™ hearing aids and iPhone®, iPad® or iPod touch®.
• Adjust volume settings on your hearing aids
• Change manual and streamer programs
• Adjust treble and bass
• Link a program and settings to favorite places
• See battery and connection status
• Stream phone calls, music, audio from videos, movies &
games, turn-by-turn directions, FaceTime® conversations, Siri®
• Help locate lost or misplaced hearing aids
ReSound (iOS, Android)(free)
ReSound Steamers)
Starkey Hearing HaloTM
• MFi
• Stream calls, FaceTime®, music from iPhone
directly to hearing aids using Bluetooth® 4.0
wireless technology
• Remotely control aids with iPhone app
• Help hear comfortably in noise
• Eliminate buzzing and whistling
Oticon MFi
• Oticon’s MFi solution
available for all existing and
future users of Oticon’s
ConnectLine instruments
• iPhone 5
Oticon Hearing Diary App (iOS)(free)
Mind Builder (iOS) $.99
Auditory Verbal (iPad)($3.99)
Neurelec Rehabilitation Game
Hear Coach (iOS)(free)
Cochlear HOPE Words Lite and HD
Cochlear HOPE Words HD(iOS)($1.99)
• Cochlear HOPE program
• Adopted from Speech Sounds and Speech Sounds Vowels
• Listen to a word and matching their speech production to
what they heard.
• Vocabulary development also facilitated
• Each letter of alphabet has twenty different flashcards
Auditory Figure-Ground (iOS)($29.99)
ListenListen Game (iOS)($1.99)
Sound Match (iOS) free
Weather Alert USA (iOS)($3.99)
AUD-1 (iOS)($2.99)
EarTrumpet (iOS)($2.99)
• Medical student developed
app for iPhone and iPad
which has to enhance and
adjust sound to discretely
improve hearing experience
through earphones
provided on your device.
• Developed in collaboration
with the Otolaryngology
Head and Neck Surgery
Department at the
University of California,
Siemens Hearing Test (iOS)(free)
Ling 6 (iOS)(Android)(free)
Too Loud (iOS)(free)
Sound AMP R (iOS)($4.99)
EARs (iOS)($3.99)
SoundPoint (iOS)(free)
Hamilton Mobile WebCapTel (free)
Wireless CapTel by Sprint (free)
IP-Relay (iOS)(free)
Purple P3 (Android/iOS)(free)
SorensonVRS (free)
Ntouch (VRS/VCO)(iOS/Android)(free)
ClearCaptions (Android/iPhone)(free)
AuditoryVoIP (iOS) $4.99
• Users can choose preferred sound quality and volume from
various default settings
• The technology is specifically optimized for the frequency
range of a telephone signal“
• Compatible with iPhone 4, iPhone 4S, iPhone 5 or iPod™
Note: AuditoryVoIP require a paid account with an SIP
• Compatible with iOS 6. Functionality in iOS 7 is not
guaranteed. (An iOS 7 compatible version is in progress.)
Tap Tap (iOS)($2.99)
Myeardroid (Android)(free)
Z5 Mobile (Android/iOS)(free)
Netflix (iOS)(Android)(Windows)(free)
Netflix Subtitles
TED Talks with TEDiSUB (free)
TuneWiki (iOS)(Windows)(Android)(free)
Lyrics Lite (Android/iOS)(free)
Speak It (Android)(free)
Virtual Voice (Android)(free)
iSpeech Translator (All)(free)
Dragon Diction (iOS)
Mobile Skype
Google Hangouts (Android/iOS)(free)
FaceTime (iOS)(free)
Cochlear BAHA Support
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