The effectiveness of an adaptive directional microphone design, as implemented in the Phonak Claro behind-the-ear hearing aid, is evaluated. Participants were fit bilaterally and tested in 2 environments, an anechoic chamber and a moderately reverberant classroom, with the microphones in the fixed (cardioid) setting and the adaptive setting. Five speakers were placed between 110 degrees and 250 degrees azimuth around the listener. Speech-weighted noise was presented from those speakers at an overall level (OAL) of 65 dB (A). Noise was increased by 8 dB from 1 speaker at a time, using 2-s modulation and random assignment, while the output from the other speakers was reduced to maintain the constant OAL. Results of 2 speech perception tasks used as outcome measures indicated that the adaptive system was not able to follow the dominant noise source in the presence of lower level noise sources. Self-report measures obtained after blinded home trials were consistent with laboratory findings that the participants did not perceive this adaptive microphone design to be more effective than the default fixed-microphone option.

The purpose of this study was to assess the relationship between the directivity of a directional microphone hearing aid and listener performance. Hearing aids were fit bilaterally to 19 subjects with sensorineural hearing loss, and five microphone conditions were assessed: omnidirectional, cardioid, hypercardioid, supercardioid, and "monofit," wherein the left hearing aid was set to omnidirectional and the right hearing aid to hypercardioid. Speech perception performance was assessed using the Hearing in Noise Test (HINT) and the Connected Speech Test (CST). Subjects also assessed eight domains of sound quality for three stimuli (speech in quiet, speech in noise, and music). A diffuse soundfield system composed of eight loudspeakers forming the corners of a cube was used to output the background noise for the speech perception tasks and the three stimuli used for sound quality judgments. Results indicated that there were no significant differences in the HINT or CST performance, or sound quality judgments, across the four directional microphone conditions when tested in a diffuse field. Of particular interest was the monofit condition: Performance on speech perception tests was the same whether one or two directional microphones were used.

Purpose This is a description of the clinical implementation and outcomes of progressive tinnitus management (PTM) at 2 Veterans Affairs (VA) medical centers: Both programs modified the protocol originally described by PTM developers. Method Modifications at both sites were classified according to an evidence-based framework set forth by Stirman, Miller, Toder, and Calloway (2013) . The Iowa City VA PTM program clinicians made 2 modifications and the Asheville, North Carolina, VA PTM program clinicians made 6 modifications to the standard PTM protocol. Pre–post outcome measures were analyzed for 20 veterans who completed the Iowa City program and for 200 veterans who completed the Asheville program. Results Veterans who completed the Iowa City program showed a statistically significant decrease in the average Tinnitus Handicap Inventory score ( Newman, Jacobson, & Spitzer, 1996 ). Veterans who completed the Asheville PTM program showed a statistically significant decrease in the average Tinnitus Functional Index (TFI) score. Outcomes in Asheville were compared to outcomes of a clinical trial of PTM conducted by the developers of PTM. The clinical work in Asheville resulted in a greater mean reduction on the TFI and a larger effect size using the TFI as compared to the results of the PTM clinical trial. Conclusions Clinician-directed modifications to PTM that are made to address the unique needs and circumstances of an individual clinic have potential to result in positive outcomes for patients. Clinicians providing care for patients with tinnitus using PTM who modify the protocol to meet the needs of their local setting are encouraged to collect and report the outcomes of their modifications to improve understanding of the impact of various types of modifications to PTM and other evidence-based practices.