UNIT IV

HEARING AND SPEECH AIDS

 Audiograms

 Types of deafness - conductive and nervous

 Hearing aids- Types, constructional and functional characteristics

 Cochlear implants- Need, constructional details

 Speech trainer

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 LIST OF IMPORTANT QUESTIONS

PART-A

1. What is deafness? What are the types of hearing loss? (N/D 2018) (N/D 2019)
2. What is an audiogram? (A/M 2018) (N/D 2019)(A/M 2019)
3. What are the challenges in the development of cochlear implant?
(A/M 2019)(N/D 18)
4. Give the Constructional details of speech trainer devices. (A/M 2018)
5. What are the common indicators for cochlear implant?
6. Define pure tone Audiometry. (A/M 2017)
7. List out the factors for designing a hearing aid system. (A/M 2017), (M/J 2016)
8. What is meant by hearing threshold? (N/D 2016)
9. What is importance of masking in Audiometer? (N/D 2016)
10. Distinguish air and bone conduction. (M/J 2016)

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 LIST OF IMPORTANT QUESTIONS

PART-B

1. Explain in detail about the constructional and functional characteristics of

analog and digital hearing aids.(N/D 2019)(N/D18) (OR) Elaborate the
construction and functional characteristics of hearing aids. (A/M 2019)(N/D
2016) (OR) Discuss the operation of DSP based hearing aid. (N/D 2016)

2. What are the different types of hearing aids? Explain BTE, ITE, ITC and CIC in
detail with suitable illustrations. (A/M 2017), (M/J 2016)

3. Explain in detail the constructional details of cochlear implants. (N/D 2019)

(A/M 2019)(N/D18)(OR)Explain the construction and characteristics features of
cochlear implants with examples.(A/M18)(OR)Explain the principle and
working of Cochlear implants with block diagram. (A/M 2017) (OR) Elaborate
the construction and function of Cochlear implant. (N/D 2016)

4. Classify various types of deafness and suggest suitable hearing aid devices to
suit each type hearing disability with emphasis of technical details.
(A/M18)(OR)Explain in detail about the Deafness or hearing loss and its types.

5. Explain the principle and working of automatic Bekesy audiometer with block
diagram. (M/J 2016)

6. Discuss in detail about an audiogram.

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 PART A

1. What is deafness? What are the types of hearing loss? (N/D 2018) (N/D 2019)
Partial or complete hearing loss. Levels of hearing impairment vary from a mild to a
total loss of hearing. A substantial number of hearing impairments are caused by
environmental factors such as noise, drugs, and toxins.it can also result from inherited
disorders.
Types:
There are two main types of hearing loss – Sensorineural and Conductive. It is also
possible to have both type present at the same time – something called a 'mixed' hearing
loss. More rarely, hearing loss can result from damage to the auditory part of the brain.
2. What is an audiogram? (A/M 2018) (N/D 2019)(A/M 2019)
An audiogram is a standard way o representing a person’s hearing loss. Most
audiograms cover the limited range 100h H z to 8000hz (8KHz) which is most important for
clear understanding of speech, and they plot the threshold of hearing relative to a
standardized curve that represents normal hearing in dB (HL).
They are not the same as equal-loudness contours, which are a set of curves
representing equal loudness at different levels, as well as at the threshold of hearing, in
absolute terms measured in dB SPL (sound pressure level).
3. What are the challenges in the development of cochlear implant?(A/M
2019)(N/D18)(OR) What are the common indicators for cochlear implant?
A cochlear implant is an electronic medical device that replaces the function of the
damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear implants
bypass the damaged hair cells of the inner ear (cochlea) to provide sound signals to the
brain.
 Have moderate to profound hearing loss in both ears

 Receive little or no benefit from hearing aids

 Score 50% or less on sentence recognition tests done by hearing professionals in

the ear to be implanted

 Score 60% or less on sentence recognition tests done by hearing professionals in

the non-implanted ear or in both ears with hearing aids.

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 Many people have cochlear devices in both ears (bilateral). Listening with two ears
can improve your ability to identify the direction of sound and separate the sounds you want
to hear from those you don’t.
4. Give the Constructional details of speech trainer devices. (A/M 2018)
Digital speech trainer is a device in the innovation of Delayed Speech & Language in
child with Hearing Impairment, Autism, Down Syndrome & Developmental Delay.
The working of speechifi hinges upon the three-modality principle, namely, auditory,
visual and tactile principle.
Speechifi store and deliver high quality sound with full acoustic energy which
enables a person to listen properly and differentiate between two distinct sounds.
The functionality of light system enhances attention and eye-contact. The device
operates to use original voice in speech stimulation, which in turn works towards speedier
recovery.
5. Define pure tone Audiometry. (A/M 2017)
Pure tone Audiometry (PTA) is the key hearing test used to identify hearing
threshold levels of an individual, enabling determination of the degree, type and
configuration of a hearing loss. Thus, providing the basis for diagnosis and Management.
6. List out the factors for designing a hearing aid system. (A/M 2017), (M/J 2016)
The critical components of a hearing aid design are in the audio-processing path.
The one or more microphones and the receiver are chosen in conjunction with the
preamplifiers (if required) and the speaker amplifiers.
Class D amplifiers are used in modern hearing aids due to their low-power
operation, low distortion, and small size as compared to Class A and B amplifier. Whether
the audio bandwidth is 20kHz or limited to 8kHz, the audio codec should have a high SNR
to preserve and reproduce sounds accurately.
The heart of the system is the digital signal processor (DSP), which is where all of
the benefits of a digital hearing aid are implemented. The DSP implementation is
manufacturer dependent.
In general, it performs compression/expansion by band, positive feedback reduction,
noise reduction, and speech enhancement. It also processes directional information and
can generate its own signals to help improve fitting a hearing aid to a patient.

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7. What is meant by hearing threshold? (N/D 2016)
The threshold pressure level of a sound is the lowest level at which an observer can
discriminate between the desired sound and the noise background always present in the
auditory system.
The hearing threshold is the sound level below which a person's ear is unable to
detect any sound. For adults, 0 dB is the reference level. A threshold shift is an increase in
the hearing threshold for a particular sound frequency.
8. What is importance of masking in Audiometer? (N/D 2016)
In the presence of monaural and asymmetrical binaural hearing losses, there is
serious difficulty in obtaining accurate measures of hearing for the poorer ear. The answer
to the problem is to eliminate responses from the better ear by masking in order, to shift the
threshold to a higher level, permitting greater intensities to be presented to the poorer ear
without any danger of cross-over.
If the difference in air conduction acuity between the two ears is 50 dB or more, then
it is advisable to place a masking noise over the better hearing ear while determining the
threshold in the other.
Masking efficiency depends upon the nature of masking sound as well as its
intensity. A pure tone can be used to mask other pure tones. However, over a range of test
frequencies, masking efficiency of a pure tone is low as compared to a noise composed of
many frequencies, as usually provided in commercial audiometers.
9. Distinguish air and bone conduction. (M/J 2016)
In air-conduction testing, a pure tone is presented via an earphone (or a
loudspeaker). The signal travels through the air in the outer ear to the middle ear and then
to the cochlea in the inner ear.
In bone-conduction testing, instead of using an earphone, an electromechanical
earphone is placed on the skull.
10. Define hearing aids.
A hearing aid is an electro-acoustic device which typically fits in or behind the
wearer’s ear, and is designed to amplify and modulate sound for the wearer.
Earlier devices, known as an “ear trumpet” or “ear horn” were passive funnel-like
amplication cones designed to gather sound energy and direct it into the ear canal. Similar
devices include the bone anchored hearing aid, an cochlear implant.

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11. What is Sensori-neural hearing?
A sensorineural hearing loss is defined as damage to the hair cells in the cochlea
(this is the sensory hearing organ) or damage to the neural pathways of hearing (nerves).
With this type of hearing loss it is not always possible to tell which part is damaged and is
therefore often listed together as sensorineural hearing loss.
12. Define Audiometry.
Audiometry is the testing of a person’s ability to hear various sound frequencies. The
test is performed with the use of electronic equipment called an audiometer. This testing is
usually administered by a trained technician called an audiologist.
13. Brief out basic function of ear?
Sound funnels through the pinna into the external auditory canal, a short tube that
ends at the eardrum (tympanic membrane). Sound causes the eardrum and its tiny
attached bones in the middle portion of the ear to vibrate, and the vibrations are conducted
to the nearby cochlea.
14. What are cochlear transplants?
A cochlear implant is an electronic medical device that replaces the function of the
damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear
implants bypass the damaged hair cells of the inner ear (cochlea) to provide sound signals
to the brain.
15. Write two types of deafness.
There are two main types of hearing loss – Sensorineural and Conductive. It is also
possible to have both type present at the same time – something called a 'mixed' hearing
loss. More rarely, hearing loss can result from damage to the auditory part of the brain.
16. What is the complication of cochlear implant?
Cochlear Implant Complications Are Rare-But Can Be Lethal. Cochlear
implantation has become a safe procedure-and, as result of refinements in devices and
surgical techniques, complications are atypical. The major complication to be feared is
meningitis, which is rare but potentially fatal.
17. How will you test the hearing ability of a person? What is the standard level for a
normal human beings? (or) How is Hearing Tested?
 Audiometry involves the testing of hearing.
 Humans can generally hear sounds with frequencies between 20 Hz and 20,000 Hz.

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 PART B
1. Explain in detail about the constructional and functional characteristics of analog
and digital hearing aids.(N/D 2019)(N/D18)(OR) (OR) Elaborate the construction
and functional characteristics of hearing aids. (A/M 2019)(N/D 2016) (OR) Discuss
the operation of DSP based hearing aid. (N/D 2016)
Hearing loss has many forms. The most common is related to the body aging
process and to long-term cumulative exposure of the ear to sound energy. As one grows
older, it becomes more difficult to hear.
The ear becomes less sensitive to sound, less precise as a sound analyzer and less
effective as a speech processor. Loss of hearing differs greatly in different individuals.
Changes in the ear occur gradually over time.
However, by the time the changes are manifested, it is estimated that approximately
30 to 50 percent or more of the sensory cells in the inner ear have suffered irreparable
structural damage or are missing. Under these conditions, the only choice available for
hearing-impaired individuals is to wear a hearing aid.
Hearing impairment is caused by either loss in sensitivity (loss in perceived
loudness), or loss in the ability to discriminate different speech sounds or both. Loss of
loudness may be due to either increased mechanical impedance between the outer ear and
the inner ear or by the reduced sensitivity of the sensory organ of hearing.
Conventional Hearing Aid
Modern hearing aids have evolved from single-transistor amplifiers to modern multi-
channel designs containing hundreds and even thousands of transistors. A typical design is
shown in Figure 1.
The basic functional parts include a microphone and associated preamplifier, an
automatic gain control circuit (AGC), a set of active filters, a mixer and power amplifier, an
output transducer or receiver. The total circuitry works on a battery.
The use of multiple channels in this design provides different compression
characteristics for different frequency ranges. Typically, the crossover frequencies of the
channels and the compression characteristics can be adjusted with potentiometers.
Most of the latest hearing aids are electronically programmable. The programmable
parameters are downloaded from a computer-based system and stored in digital registers.
The register outputs are used to switch resistor networks that control various analog
circuitry.

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 The active filters are adjusted to generally provide for low-frequency attenuation of
up to 30–40 dB relative to the high-frequency response. This is because most hearing aid
wearers require high frequency gain.

Fig 1. Conventional Hearing Aid

Conventional analog type hearing aid
The transducer in a hearing aid, which is a microphone, can be realized in an
integrated form with a field-effect transistor preamplifier. The preamplifier is housed in the
metallic, microphone case to shield its input from extraneous noise.
On the other hand, the receiver is an electromagnetic device, which drives a
miniature diaphragm to produce acoustic output. The acoustic output is routed to the ear-
mould through a flexible tubing whose frequency response can be altered to boost the high-
frequency response. This is done by tapering its inside diameter from the ear mould back to
the receiver port end.
All the electronics circuitry is packaged in a housing, which can be designed for
fitting to the ear in any one of the following ways:
 Placing all the components in a pocket-sized enclosure or box which is connected
to the output transducer worn in the ear. The box can be carried in the shirt pocket
or carried with a belt around the waist. With the availability of miniature-sized aids,
this approach is no longer employed.
 The components are packaged in a curved module, which is designed to fit
comfortably behind the ear.
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  The most popular design is in which the total package can be put inside the outer
ear.
Much depends on the performance of the filters for further reduction of the size and
improvement in the working of the hearing aids. The dynamic range of an operational
amplifier, which is the basic building block of an electronic filter, decreases as the three
halves power of feature size.
Since dynamic range of analog hearing aids is already marginally acceptable, it
appears that further reduction in size to achieve increased processing complexity is not
practical. The potential for greater dynamic range, with less power consumption and
greater complexity in hearing aid design is feasible only with digital processing
technologies.
Digital Hearing Aid
A typical digital hearing aid is illustrated in Fig.2. The major parts are the
microphone, an analog-to-digital converter (ADC), the digital signal processor (DSP), the
digital-to-analog converter (DAC), the receiver and a two port memory.
Essentially, sound waves picked up by the microphone and transformed into
electrical signals are converted into digital form by an A-D converter. A typical microphone
will have an internal noise of 20 dB SPL (sound pressure level) when referred to the input
and maximum undistorted output corresponding to a signal of about 90 dB SPL.
Allowing some margin for peak performance, the total dynamic range required of the
ADC is 80 dB. This requirement can be achieved with a 14 bit A–D converter.
The DSP is a fixed (wired-program) digital processing device containing an array of
adders, multipliers and registers which provide the fundamental operations necessary for
implementing various digital algorithms.
In a general-purpose DSP, considerable power is consumed in executing the
programme instructions. Since power consumption is a major consideration in the design of
hearing aids, the wired-program approach is followed.
The DSP is associated with a two-port memory, which is used to store processing
parameters that can be down loaded from the external programmer to the hearing aid while
it is adjusted for the intended user.

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 Fig 2. Block diagram of a digital hearing aid

The dynamic range requirements of the DAC are more severe. Some hearing
impaired listeners have almost normal sensitivity at low frequencies but significantly
elevated thresholds at high frequencies.
Since the conversion noise generated by the DAC has a uniform spectrum and is a
function of the overall output signal level, high-level high-frequency sounds can create low-
frequency noise and distortion that falls above the threshold at low frequencies.
The digital hearing aids are implemented with CMOS technology, with a feature size
of 1 mm or less and with an estimated power consumption of 20 mW. An estimated 10,000
CMOS inverters are required to implement 400,000 multiply-add operations for filtering,
compression functions and other processing requirements.
The digital hearing aids promise to provide capabilities of superior signal processing,
ease of fitting and stable long-term performance. However, they are still under
development. It has often been seen that a person buys a hearing aid but does not use it
because it does not help very much.
The basic reason is that the impaired ear has its capacity to process speech and
hearing aids are simply sound amplifiers that do not compensate for the loss of processing
power.

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 It needs to be emphasized that today’s hearing aids are at an early stage of
development and need to reach a highly refined stage before they can find wide spread
and useful applications.
The potential areas of improvement include shaping the frequency response to
invert the patient’s hearing loss, enhancing the signal-to-noise ratio with adaptive filtering,
reducing acoustic feedback and compressing/expanding signals with minimum distortion.
2. What are the different types of hearing aids? Explain BTE, ITE, ITC and CIC in
detail with suitable illustrations. (A/M 2017), (M/J 2016)
Types of hearing aids

Fig 3. Different types of hearing aids

Behind-the-Ear (BTE) hearing aids
Behind-the-ear (BTE) hearing aids sit behind the ear and deliver sound into the ear
either via ‘sound tube’. The sound tube can either be 2mm diameter acoustic tubing
channelled through a custom-made earmould, or a discreet ‘thin-tube’ attached to an ear
dome or custom-made micro-mould which fits inside the ear canal.
BTE hearing aids house either a size 10 (Yellow), size 312 (Brown) or size 13
(Orange) battery depending on the style and size selected. The typical lifespan of a size 10
battery is between 3-5 days, size 312 battery between 5-7 days and size 13 battery
between 10-14 days but this can vary depending upon the number of hours per day the
hearing aid is worn, the severity of hearing loss and the technology level of hearing aid.
Benefits
 BTE hearing aids with thin-tubes can often be more discreet and invisible than
custom invisible-in-canal (IIC) and completely-in-canal (CIC) hearing aids.
 Very powerful so suitable for profound hearing losses
 Different ear domes and earmoulds can be fitted making them suitable for a
variety of types of hearing losses.
 Dual-microphones help to improve speech understanding in noise.

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  Wireless and telecoil options.
Limitations
 Not always appropriate if you have poor vision or manual dexterity.
 A less natural and crisper sound quality when compared to receiver-in-canal
(RIC) hearing aids as the sound is being transmitted through a tube creating
artificial peaks and troughs (tube resonances)
 Tubing needs regular replacement as can become hard and brittle which affects
sound quality and transmission.
 Condensation build-up inside the tubing can also affect sound quality and
transmission. Moisture-free tubing can be used but can slip out of the earmould
easily and cause irritation to the side of the ear if makes contact due to its
‘rubbery’ texture.
 Microphone more susceptible to damage due to dead skin from behind the ear.
 Loss of natural acoustics provided by the external ear (pinna) that help with
localising the direction of sound from in front and behind you.
 Telephone receiver needs to be held in slightly unnatural position over the top of
the ear next to the hearing aid microphone.
ITE hearing aids
In-the-canal (ITE) hearing aids are the largest of all custom hearing aids. They are
designed and sculptured to fit either half your external ear (cavum concha) or the entire
external ear (cavum and cymba concha). Extraction cords can be fitted to ITE hearing aids
to help insert and remove them from the ear.
ITE hearing aids house a size 13 (Orange) battery. The typical lifespan of a size 13
battery is between 10-14 days, but this can vary depending upon the number of hours per
day the hearing aid is worn, the severity of hearing loss and the technology level of hearing
aid.
Benefits
 Very powerful and can be suitable for profound hearing losses.
 Ideal for somebody who has limited dexterity and reduced vision.
 Dual-microphones help to improve speech understanding in noise.
 Wireless and telecoil options
 Increased surface area means they are less likely to:
 feedback (e.g. whistle) due to acoustic leakage

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  work loose whilst talking and chewing, especially if you have a straight and
inclined ear canal shape.
Limitations
 Not as discreet as invisible-in-canal (IIC) and completely-in-canal (CIC) hearing
aids.
 Slight loss of natural acoustics provided by the external ear (pinna) that help with
localising the direction of sound from in front and behind you.
 Telephone receiver needs to be held in slightly unnatural position over front
microphone.
 As with all custom hearing aids, ITE hearing aids may need to be ‘re-shelled’ from
time to time since the ear canal cartilage can change shape and size. This is not
covered under the warranty and will require new ear impressions.
ITC hearing aids
in-the-canal (ITC) hearing aids are larger than mini-canal (MC) hearing aids. They are
designed and sculptured to fit in the lower third of your external ear (cavum concha).
Extraction cords can be fitted to ITC hearing aids to help insert and remove them from the
ear.
ITC hearing aids house a size 312 (Brown) battery. The typical lifespan of a size 312
battery is between 5-7 days, but this can vary depending upon the number of hours per day
the hearing aid is worn, the severity of hearing loss and the technology level of hearing aid.
Benefits
 More powerful than their size initially suggests and typically suitable for mild to
severe/profound hearing losses.
 Ideal for somebody who has limited dexterity and reduced vision.
 Dual-microphones help to improve speech understanding in noise.
 Wireless and telecoil options
 Increased surface area means they are less likely to:
 feedback (e.g. whistle) due to acoustic leakage
 work loose whilst talking and chewing, especially if you have a straight and
inclined ear canal shape.
Limitations
 Not as discreet as invisible-in-canal (IIC) and completely-in-canal (CIC) hearing
aids.

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  Slight loss of natural acoustics provided by the external ear (pinna) that help with
localising the direction of sound from in front and behind you.
 Telephone receiver needs to be held in slightly unnatural position over front
microphone.
 As with all custom hearing aids, ITC hearing aids may need to be ‘re-shelled’ from
time to time since the ear canal cartilage can change shape and size. This is not
covered under the warranty and will require new ear impressions.
CIC hearing aids
Before invisible-in-canal (IIC) hearing aids, completely-in-canal (CIC) hearings were
the smallest custom hearing aids available. They are designed and sculptured to fit almost
entirely inside your ear canal (external auditory meatus) and are therefore almost invisible,
with only the faceplate and battery drawer usually visible. Extraction cords are usually fitted
to CIC hearing aids to help insert and remove them from the ear.
CIC hearing aids house size 10 (Yellow) battery. The typical lifespan of a size 10
battery is between 3-5 days, but this can vary depending upon the number of hours per day
the hearing aid is worn, the severity of hearing loss and the technology level of hearing aid.
Benefits
 Small size and low profile.
 More powerful than their small size initially suggests and typically suitable for mild
to severe/profound hearing losses.
 The location of the microphone in the ear canal, as opposed to behind the ear,
helps with:
 using the telephone.
 the preservation of the natural acoustics provided by the external ear (pinna) that
help with localising the direction of sound from in front and behind you.
 Most manufacturers offer CIC hearing aids with both wireless and telecoil options,
albeit they are slightly larger in size.
Limitations
 Single omni-directional microphone that is sensitive to sounds arriving from all
around you. Subsequently, they are not always best equipped for when hearing in
the presence of background noise.
 Ear anatomy must be of a certain shape and size to house all the electronic
components inside.
 Not appropriate if you have poor vision or manual dexterity.
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  Require more maintenance and are more susceptible to damage due to ear wax
ingression inside the microphone port, which is located near the ear canal
entrance.
 Smaller surface area means they are more likely to:
 feedback (e.g. whistle) due to acoustic leakage
 work loose whilst talking and chewing, especially if you have a straight and
inclined ear canal shape.
 As with all custom hearing aids, CIC hearing aids may need to be ‘re-shelled’ from
time to time since the ear canal cartilage can change shape and size. This is not
covered under the warranty and will require new ear impressions.
3. Explain in detail the constructional details of cochlear implants. (N/D 2019)(A//M
2019)(N/D18)(OR)Explain the construction and characteristics features of cochlear
implants with examples.(A/M18)(OR)Explain the principle and working of Cochlear
implants with block diagram. (A/M 2017) (OR) Elaborate the construction and
function of Cochlear implant. (N/D 2016)
A cochlear implant is a small, complex electronic device that can help to provide a
sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant
consists of an external portion that sits behind the ear and a second portion that is
surgically placed under the skin (see figure). An implant has the following parts:

 A microphone, which picks up sound from the environment.

 A speech processor, which selects and arranges sounds picked up by the

microphone.

 A transmitter and receiver/stimulator, which receive signals from the speech

processor and convert them into electric impulses.

 An electrode array, which is a group of electrodes that collects the impulses from the

stimulator and sends them to different regions of the auditory nerve.

An implant does not restore normal hearing. Instead, it can give a deaf person a
useful representation of sounds in the environment and help him or her to understand
speech.

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 Fig 4. Ear with cochlear Implant

Cochlear Implants
Sensori-neural deafness affects a large number of people throughout the world
(Spelman,1999). The treatment of choice for the sensori-neural deaf is the cochlear
prosthesis or cochlear implant.
Sensori-neural deafness can be caused either by cochlear damage or by damage
within the auditory nerve or to the neurons of the central auditory system. The hair cells are
the sensory cells that transduce mechanical motion into signals that can be recognized by
auditory neurons.
The auditory neurons carry information from the hair cells to the cochlear nucleus in
the brainstem and, via the cochlear nucleus, to higher nuclei in the brain.
The normal cochlea and the associated neurons of the central auditory system
provide information about both the frequency content and intensity of the auditory signal.
Information is conveyed to the acoustic nerve about frequency content by the mechanically
tuned properties of the basilar membrane.
The inner hair cells, which connect to the vast majority of afferent neurons, are
thought to be the sensory cells of the cochlea whereas the role of the outer hair cells is still
under investigation.
The location of hair cells along the cochlea determines their optimal response to
frequency: hair cells at the apex are responsive to low frequencies, while hair cells at the
base are responsive to high frequencies. The distribution of frequencies along the spiral is
logarithmic.
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 Fig 5. Cochlear part of the human ear

Details of cochlear part of the human ear

If the damage to the auditory system is peripheral in the inner ear, then a cochlear
implant can be used. In the general design of a cochlear implant, the sound is decomposed
into frequency bands of use for the transmission and reception of speech, and critical
features of the signals within those frequency bands are delivered to auditory neurons via
an array of electrodes.

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Fig 6. Diagram of the basilar membrane showing the base and the apex. The position
of maximum displacement in response to sinusoid of different frequency (in Hz) is
indicated
A block diagram of a generic cochlear implant is shown in Fig. 6. The microphone
converts acoustic signals into electrical signals. The electrical signals are amplified and
encoded in various ways in the block called stimulus encoder.
In the vast majority of implants, the stimulus encoder is worn outside the head,
producing a serially coded signal that is transmitted with a transcutaneous link, most often
inductive.
The link sends both data and power to an internal circuit that decodes the serial data
stream and decomposes it into signals that are delivered to the current sources that drive
the electrodes of the cochlear electrode array.
Each electrode of the array is driven with either a pulsatile or an analog electrical
signal. The signals traverse the tissues of the inner ear, usually the fluids of the scala
tympani, and excite the auditory neurons.
The excitation depends upon the number of intact neurons that remain, the proximity
of the electrode array to the neurons, and the spatial and temporal characteristics of the
current-density fields that affect the neurons.

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 Fig 7. Cochlear implants parts

In single channel implants, only one electrode is used. In multi-channel cochlear

implants, an electrode array is inserted in the cochlear so that different auditory nerve fibres
can be stimulated at different places, thereby exploiting the place mechanism for coding
frequencies.
Different electrodes are stimulated, depending on the frequency of the signal.
Electrodes near the base of the cochlea are stimulated with high frequency signals while
electrodes near the apex are stimulated with low frequency signals.
The signal processor is responsible for breaking the input signal into different
frequency bands or channels and delivering the filtered signals to the appropriate
electrodes.
Different types of cochlear implants are available which differ in the following
characteristics :

 Electrode design: Number of electrodes and their configurations

 Type of stimulation: Analog or pulsatile
 Transmission link: Transcutaneous or percutaneous
 Signal processing: Waveform representation or feature extraction
Cochlear implants have been a spectacular success story for biomedical engineers.
They have been successful in restoring partial hearing to profoundly deaf people.
While not all patients are able to talk on the telephone when they use their implants,
a substantial number can, and all users can improve their communication skills by using lip
reading.

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 Users can hear environmental sounds such as automobile horns, knocks at the
door, and sirens. Despite the maturity of today’s cochlear implants, there are exciting
opportunities for bioengineers to advance designs to provide better devices to the patients.
4. Classify various types of deafness and suggest suitable hearing aid devices to
suit each type hearing disability with emphasis of technical details.
(A/M18)(OR)Explain in detail about the Deafness or hearing loss and its types.
Hearing loss, also known as hearing impairment, is a partial or total inability to hear.
A deaf person has little to no hearing. Hearing loss may occur in one or both ears. In
children hearing problems can affect the ability to learn spoken language and in adults it
can cause work related difficulties.
In some people, particularly older people, hearing loss can result in loneliness.
Hearing loss can be temporary or permanent.
Hearing loss may be caused by a number of factors, including: genetics, ageing,
exposure to noise, some infections, birth complications, trauma to the ear, and certain
medications or toxins.
A common condition that results in hearing loss is chronic ear infections. Certain
infections during pregnancy such as syphilis and rubella may also cause hearing loss.
Hearing loss is diagnosed when hearing testing finds that a person is unable to hear
25 decibels in at least one ear.
Testing for poor hearing is recommended for all newborns. Hearing loss can be
categorised as mild, moderate, moderate-severe, severe, or profound. There are three
main types of hearing loss, conductive hearing loss, sensorineural hearing loss, and mixed
hearing loss.
a) Conductive hearing loss
A conductive hearing loss is caused by any condition or disease that impedes the
conveyance of sound in its mechanical form through the middle ear cavity to the inner ear.
A conductive hearing loss can be the result of a blockage in the external ear canal
or can be caused by any disorder that unfavorably effects the middle ear's ability to
transmit the mechanical energy to the stapes footplate.
This result is the reduction of one of the physical attributes of sound called intensity
(loudness), so the energy reaching the inner ear is lower or less intense than that in the
original stimulus.

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 Therefore, more energy is needed for individuals with a conductive hearing loss to
hear sound, but once it's loud enough and the mechanical impediment is overcome, the ear
works in a normal way.
Generally, the cause of conductive hearing loss can be identified and treated
resulting in a complete or partial improvement in hearing.
Following the completion of medical treatment for causes of the conductive hearing
loss, hearing aids are effective in correcting the remaining hearing loss.
b) Sensorineural Hearing Loss
Sensorineural hearing loss results from inner ear or auditory nerve dysfunction. The
sensory component may be from damage to the organ of Corti, an inability of the hair cells
to stimulate the nerves of hearing or a metabolic problem in the fluids of the inner ear.
The neural or retro cochlear component can be the result of severe damage to the
organ of Corti that causes the nerves of hearing to degenerate or it can be an inability of
the hearing nerves themselves to convey neuro chemical information through the central
auditory pathways.
The reason for sensorineural hearing loss sometimes cannot be determined, it does
not typically respond favorably to medical treatment, and it is typically described as an
irreversible, permanent condition.
Like conductive hearing loss, sensorineural hearing loss reduces the intensity of
sound, but it might also introduce an element of distortion into what is heard resulting in
sounds being unclear even when they are loud enough.
Once any medically treatable conditions have been ruled out, individuals with a
sensorineural hearing loss can be fit with hearing aids to give them access to speech and
other important sounds.
c) Mixed Hearing Loss
A mixed hearing loss can be thought of as a sensorineural hearing loss with a
conductive component overlaying all or part of the audiometric range tested. So, in
addition to some irreversible hearing loss caused by an inner ear or auditory nerve
disorder, there is also a dysfunction of the middle ear mechanism that makes the hearing
worse than the sensorineural loss alone.
The conductive component may be amenable to medical treatment and reversal of
the associated hearing loss, but the sensorineural component will most likely be
permanent.

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 Hearing aids can be beneficial for individuals with a mixed hearing loss, but caution
must be exercised by the hearing care professional if the conductive component is due to
an active ear infection. Central Hearing Loss Central hearing loss is caused by a problem
with the auditory nerve or sound centres.
Sounds waves may travel through the ear but this nerve pathway is unable to send
electrical impulses to the brain. As a result the hearing centres do not receive the signals
correctly. Central hearing loss can be a result of a head injury or disease.
A common symptom is the ability to detect sound but not being able to understand it.
What is Tinnitus? Tinnitus is described as any sensation of sound in the absence of any
external stimulation. It is often described as a ringing, buzzing or pulsing sensation in the
ears.
Tinnitus is thought to be caused by damage to the outer, middle or inner ear or the
hearing nerve in the brain. The damage to the hearing system can result from a number of
different sources, such as; noise exposure, age-related changes in the inner ear, certain
medications, head injuries, wax, etc.
d) Dizziness
Dizziness is a common complaint from many clients, especially those over the age
of 70. Benign paroxysmal positional vertigo (BPPV) is the most common cause of
positional vertigo. Vertigo refers to the perception of movement (i.e. spinning or turning).
The words: benign, paroxysmal and positional all describe the type of vertigo.
'Benign' refers to the idea that it is not life-threatening and there is no known cause;
'paroxysmal' suggests that there is a common cycle to the response and that it goes away
and 'positional' refers to the fact that the vertigo is a result of a particular head or body
movement.
Symptoms of BPPV include dizziness when lying down, rolling over or changing
head positions. The perception of movement usually lasts less than a minute and is
sometimes accompanied by a longer lasting feeling of nausea.do not receive the signals
correctly.
Central hearing loss can be a result of a head injury or disease. A common symptom
is the ability to detect sound but not being able to understand it.
e) Presbycusis
Presbycusis simply means age-related hearing loss. Typically, Presbycusis comes
on gradually and equally in both ears. In most cases, it’s the result of changes in the ear
that happen as people get older.
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 Often, Presbycusis involves damage to the inner ear, making it a sensorineural
hearing loss. Cardiovascular disease, diabetes, other health conditions common with
aging, and ototoxic medications that can damage the inner ear all can contribute to
presbycusis.
In addition to what aging does to the inner ear, common age-related changes to the
brain can make it more difficult to understand conversations in challenging listening
situations such as in restaurants or when several people are talking at once.
f) Noise-induced Hearing Loss
Noise-induced hearing loss is a type of sensorineural hearing loss. It’s caused by
damage to the delicate hair cells in the inner ear that vibrate in response to sound waves.
Just as we can overload an electrical circuit, we can overload these hair cells with too
much noise or sounds that are too loud.
The hair cells that enable us to clearly hear higher-frequency sounds tend to go first.
Although noise-induced hearing loss is largely preventable, it’s a significant societal
problem due to so much noise in the world around us.
Any sounds at or above 85 decibels for a prolonged period of time can be unsafe to
a person’s hearing. (The intensity of sound is measured in decibels.) To put that in
perspective, most heavy city traffic and school cafeterias are at about 85 decibels, and
fireworks are in the 140-to-165 decibels range, according to It’s A Noisy Planet.
It’s also important to realize that something like the single bang of a firecracker at
close range can permanently damage hearing in an instant.
Because noise-induced hearing loss is so common, attributing gradual hearing loss
over time strictly to aging can be somewhat misleading. In middle-aged and older people,
it’s often difficult to distinguish what percentage of a sensorineural hearing loss is
attributable to aging and what percentage is the result of repeated exposure to noise.
g) Tinnitus
Often called “ringing in the ears,” tinnitus is the perception of a sound in a person’s
ears or head that has no external source. Many people with tinnitus experience a ringing,
humming, buzzing, or chirping sound.
Others even perceive singing or music. Experts believe that neural hyperactivity—
that is, overstimulation of the nerves—leads to this perception of sound.
Often, tinnitus is the by-product of noise exposure, although it can be caused by
other things as well. Tinnitus is almost always accompanied by hearing loss and is
considered a symptom of hearing loss.
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 Many people can manage the annoyance associated with tinnitus with hearing aids.
A good number of high-tech hearing aids now include integrated “sound therapy”
specifically designed to offer relief from tinnitus.
Unfortunately, teenagers are increasingly experiencing tinnitus, possibly as a result
of frequent noise exposure, according to a study published in Scientific Reports.
5. Explain the principle and working of automatic Bekesy audiometer with block
diagram. (M/J 2016)
AUDIOMETER SYSTEM BEKESY
George Van Bekesy, a Hungarian scientist, designed an automatic audiometric
testing method for plotting the hearing threshold based on the patient’s signal.
A principal feature of the method, differentiating it from conventional pure-tone
audiometric techniques, is the interdependence of the patient’s response and stimulus
intensity: responses govern intensity and are affected by changes they introduce in it.
An audiogram traced by the Bekesy method represents the absolute threshold
values at all frequencies in the range tested. In addition, it shows the difference, in
decibels, between levels at which the patient just hears a signal of increasing intensity and
those at which he just ceases to hear the signal when its intensity is decreasing. ]
This latter characteristic often varies significantly with the type of hearing
impairment, and can aid in establishing the site of lesion within the auditory system. On
the basis of the audiograms, one can easily separate the conduction and perceptive
hearing deficiencies from each other.
Audiometers Bekesy are relatively simple for the patient to operate. The instrument
generates a pure-tone signal, which is presented to him through an air-conduction
earphone. The subject is told to press a switch when the tone is heard and to release the
switch when it is not heard.
This switch controls the motor-driven attenuator of the audiometer: when it is
pressed, signal intensity decreases and when it is released, signal intensity increases.
A pen connected to the attenuator traces a continuous record of the patient’s
intensity adjustments on an audiogram chart, producing a graphic representation of the
subject’s threshold. The test signal may be presented in a variety of ways, each suited to
the investigation of a particular problem.
A block diagram of the audiometer system Bekesy is shown in Figure. It consists
basically of an electrical section and a mechanical section.

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 The electrical section includes an oscillator and modulator circuits for the generation
of the desired test signal, an automatic attenuator linked to the writing system, control
circuits for the drive motors of the mechanical section and a master clock generator for the
control of all timing functions via a logic control circuit.
The carriage drive and the writing system with their separate drive motors constitute
the mechanical section.
Electrical Section
Sine Wave Oscillator:
This oscillator generates test signals with frequencies of 125, 250, 500, 1000, 1500,
2000, 3000, 4000, 6000 and 8000 Hz. This sequence is first presented to the left ear
automatically, each tone for 30 s, and then to the right ear, the shift between the
frequencies being noiseless.
After both ears have been tested, a 1 kHz tone is presented to the right ear to
provide a useful indication of test reliability.
Modulator:
From the oscillator the test signal is fed to the modulator, where the mode of
operation is selected by the ‘Tone’ switch, via the logic control circuit. Two models, ‘Pulse’
or ‘Cont’, are available.
In the ‘Pulse’ mode the test signal is modulated giving a signal, which is easily
recognized by the patient. In the ‘Cont’ mode no modulation is applied, giving a signal
suitable for use, when calibrating the audiometer.
Automatic Attenuator:
The signal from the modulator feeds the automatic attenuator situated on the
carriage together with the writing system. The attenuator consists of a logarithmic
potentiometer which has its wiper attached to the pen drive so that the attenuation of the
potentiometer corresponds to the position (y-axis) of the pen on the audiogram chart.
The potentiometer has infinite resolution. The attenuation range is 100 dB, thereby
covering the range of hearing levels from -10 to +90 dB. When the test is initiated, the
attenuator starts at its top position of -10 dB and then increases the level with a rate of 5
dB/s.
Also, when the test signal switches between the ears and when retesting at 1 kHz,
the attenuator decreases the signal level to –10 dB to ensure that the right ear does not
receive a tone at the elevated level possibly required at 8 kHz.

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 Fig 8. Block diagram of the audiometer system Beskey

Hand Switch:
The pen drive is controlled via the logic control circuit by means of the hand-switch
operated by the patient. Pressing the switch decreases the output from the potentiometer
and thereby the level in the earphones, while releasing the switch increases the output
both ways with a speed of 5 dB/s.
Buffer Amplifier and Calibration Circuit:
From the attenuator the signal is fed via a buffer amplifier to the hearing level
calibration circuit. The buffer amplifier isolates the attenuator from the calibration circuit in
order not to affect its output.

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 The calibration circuit consists of seven potentiometers, one for each test frequency.
During calibration, the potentiometers are adjusted one at a time until the correct level,
measured in a coupler, is obtained in the earphones.
Earphones:
The earphones are a matched pair with distortion, typically less than 1%.
Master Clock Generator:
A stable clock generator supplies the necessary signals for the control of motor
speed, attenuator speed, frequency shift, modulation and other timing functions. This
makes the system independent of variations in line voltage and frequency.
Mechanical Section
Carriage:
The carriage with the writing system is driven by a stepping motor via a toothed belt.
The speed and direction of rotation of the motor are automatically controlled via the logic
control system.
When the test is initiated and the patient indicates that he hears the signal by
pressing the hand switch, the carriage moves along the X-axis (frequency axis) of the
audiogram in agreement with the frequency of the test signal.
When the frequency shifts, the carriage stops until the patient again, by pressing the
hand switch, indicates that he hears the signal. This avoids wastage of recording space on
the audiogram if a patient’s hearing threshold varies from frequency to frequency or from
left to right ear.
When the complete test is finished the carriage and writing system return to the start
position. To prevent carriage over-run, two limit switches are included in the carriage drive
circuit.
Writing System:
The writing system is operated by the pen drive, which is driven by a stepping motor.
The pen drive moves the pen, and with it the wiper of the automatic attenuator, along the
Y-axis (hearing level axis) with a constant speed corresponding to the change in
attenuation of 5 dB/s.
The direction of movement of the pen is determined by the position of the hand
switch operated by the patient. Limit switches are also included with the pen drive.
Audiogram Chart:
The audiogram is printed in standard A5 format (148 ¥ 210 mm). The recording
space is large, 0.8 dB/mm, to enable easy reading.
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 Space is provided on the audiogram side for registration of information on the
patient, audiometer, operator, etc. while the other side has space for recording the
patient’s medical and occupational history.
Four holes in the chart give precise and automatic location of the audiogram on the
chart bed.
In order to establish a more exact diagnosis applying adaptation and hearing fatigue
tests, several other tests besides the pure-tone Bekesy audiometry, have been suggested
and can be performed using the basic Bekesy system. For example, for carrying out the
Fowler loudness balance test, a second channel is provided.
The second channel has a continuously variable intensity over the range 0 to 110 dB
and is calibrated in 1 dB increments.
6. Discuss in detail about an audiogram.
The audiogram is a graph which gives a detailed description of your hearing ability
and which can be described as a picture of your sense of hearing.

Fig 9. An Audiogram – Showing a hearing loss

A hearing test performed by a hearing health care professional comprises a number

of tests which can help to determine whether or not a patient is suffering from hearing loss.
The results from the hearing tests are often displayed in the form of an audiogram.

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 Based on the audiogram, among other things, the hearing health care professional
can tell whether or not you are suffering from hearing loss and, if so, determine how
serious it is.
If you are suffering from hearing loss it is best to have the hearing health care
professional explain the results of the audiogram to you, giving you the best possible
understanding of your particular problem.
The audiogram illustrates your hearing ability by showing your hearing threshold at
various frequencies. Hearing threshold is an indication of how soft a sound may get before
it is inaudible. A hearing threshold of between 0 and 25 dB is considered normal.
How to read an audiogram?
The vertical axis of the audiogram represents sound volume or intensity, which is
measured in decibels (dB). The more one moves down the axis, the louder the sound
becomes. This corresponds to turning up the volume on a radio.
Zero decibel at the top of the axis represents the softest sound a person is normally
able to hear and is not an indication that you cannot hear any sounds at all.
The horizontal axis of the audiogram represents sound frequency or pitch measured
in Hertz (Hz). Sound frequency increases gradually the further one moves to the right
along the axis.
This movement can be compared to playing on the left side of a piano and gradually
moving to the right side where the tone becomes more and more high-pitched.
Frequencies between 500 Hz and 3000 Hz are most commonly used during ordinary
conversation.
During a hearing test the results are recorded on the audiogram by means of red Os
for the right ear and blue Xs for the left one. The resulting red and blue lines show your
hearing threshold for each ear, and the results may well differ.
Generally speaking, the more markings below 25 dB or more, at frequencies which
are normally used in conversation, the more difficult it is to hear what is being said. And in
situations with a lot of background noise it will often be even more difficult to hear properly.
Pure Tone Audiometer
A wave in air, which involves only one frequency of vibration, is known as pure-tone.
Pure-tone audiometry is used in routine tests and, therefore, it is the most widely used
technique for determining hearing loss.

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 Pure-tone audiometers usually generate test tones in octave steps from 125 to 8000
Hz, the signal intensity ranging from –10 dB to +100 dB.
Pure-tone audiometry has several advantages, which makes it specifically suitable
for making threshold sensitivity measurements. A pure-tone is the simplest type of auditory
stimulus.
It can be specified accurately in terms of frequency and intensity. These parameters
can be controlled with a high degree of precision. Speech audiometry normally allows
measurements to be made within the frequency range of 300–3000 Hz.
Some patients may have impaired high frequency response due to high intensity
level occupational noise at 4000 or 6000 Hz. Pure-tone measurements at these
frequencies prove to be a more sensitive indicator of the effect of such noise on the ear
than speech tests.
Changes in threshold sensitivity associated with various middle ear surgical
procedures can be monitored more accurately with pure-tone than speech tests.
A pure-tone audiometer basically consists of an LC oscillator in which the inductance
and tuning capacitance are of close tolerances for having a precise control on the
frequency of oscillations.
The oscillator is coupled to an output current amplifier stage to produce the required
power levels. The attenuators used in these instruments are of the ladder type, of nominal
10 W impedance.
The signals are presented acoustically to the ear by an earphone or small
loudspeaker. The available sound pressure levels in a typical audiometer are given in
Table 1.
Speech Audiometer
Besides tonal audiometry, it is sometimes necessary to carry out tests with spoken
voices. These tests are particularly important before prescribing hearing-aids and in
determining the deterioration of speech understanding of patients.
Specially designed speech audiometers are used for this purpose. They incorporate
a good quality tape recorder, which can play recorded speech. A double band tape
recorder is preferred to interface the two channel audiometer units.
Masking noise is supplied by the noise generator. The two channels supply the two
head-phones or the two loud speakers which are of 25 W each.

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 Table 1. Test Tones and Signal Intensity in Audiometers
The tape recorder has a capacity for recording a limitless variety of test material and
a consistency of speech input, which cannot be obtained for live-voice audiometry in
relation to test-retest repeatability.
Another advantage of the tape recorded material is that the test words and
sentences can be selected to cater for the widely differing needs of age, intelligence,
dialect and language.
In speech audiometers, live-voice facilities are incorporated primarily for
communication purposes as the inherent unreliability of live-voice speech tests may lead
to serious errors. The microphone amplifier used for this purpose is a simple two stage
amplifier.
The frequency response characteristics of a live-voice channel should be such that
with the microphone in a free sound field having a constant sound pressure level, the
sound pressure level developed by the earphone of the audiometer in the artificial ear at
frequencies in the range 250 to 4000 Hz does not differ from that at 1000 Hz by more than
110 dB. Also, it shall not rise at any frequency outside this band by more than 15 dB,
relative to the level at 1000 Hz.
7. Write a short note Masking of Audiometer.
Masking in Audiometry

In the presence of monaural and asymmetrical binaural hearing losses, there is

serious difficulty in obtaining accurate measures of hearing for the poorer ear.

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 The answer to the problem is to eliminate responses from the better ear by masking
in order, to shift the threshold to a higher level, permitting greater intensities to be
presented to the poorer ear without any danger of cross-over.
If the difference in air conduction acuity between the two ears is 50 dB or more, then
it is advisable to place a masking noise over the better hearing ear while determining the
threshold in the other.
Masking efficiency depends upon the nature of masking sound as well as its
intensity. A pure tone can be used to mask other pure tones. However, over a range of
test frequencies, masking efficiency of a pure tone is low as compared to a noise
composed of many frequencies, as usually provided in commercial audiometers.
Saw-tooth noise and white noise have been most commonly used for masking in
clinical audiometry, but narrow band noise, i.e. a restricted frequency bandwidth of white
noise is also often used.
Saw-tooth noise is a noise in which the basic repetition rate (fundamental frequency)
is usually that of the mains voltage and contains only those frequencies that are multiples
of the fundamental.
The intensity of these multiples decreases as their frequencies increase. Noises
referred to as ‘complex’ or square waves are similar in that they are composed of a
fundamental frequency and components that are multiples of it.
White noise is a noise containing all frequencies in the audible spectrum at
approximately equal intensities. However, the spectrum is limited at the ear by the
frequency response of the earphone, which may essentially be flat to 6000 Hz and may
drop rapidly beyond.
An excellent complex masking noise can be obtained by using the thermal or
random electronic emission from a semiconductor diode, since it generates all frequencies
simultaneously and with equal amplitude over a frequency range wider than the response
of the ear.
Narrow-band noise has been used by a number of investigators in audiometric
studies. It is produced by selectively filtering white noise. It has been found that narrow
band noise is the most efficient masking noise in pure-tone audiometry.
The masking audiograms for normal hearing subjects and the clinical results for
hearing-impaired subjects show that for equal intensity levels, narrow band noise
produces greater threshold shifts than do either of the other two types and thereby
provides greater protection from false responses due to cross-over of the test tone.
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8. Explain About Speech Trainer Device
DEFINITION
Speechifi is a digital Speech trainer device using advanced digital sound processing
technology based on Sound-X-Engine.
It is noninvasive, portable battery operated device. Speechifi is assistive
communication devices that assist and prepare educators and therapists to perform
systematic and effective speech and language training for child with Autism, Delayed
Speech and language, Hearing impairment, Low I.Q., Expressive & receptive
developmental language disorder and learning disability.
It also provides auditory training for child with hearing impairment. The advance
Sound-X-Engine technology differentiates it from app based speech instruments. The
enhance feature of Speechifi acts as a catalyst to child speedy recovery.

Fig 10. Speechifi

Clinical purpose

Speechifi is helpful improving receptive and expressive language skills. Speechifi

designed to continuously enhance the learning capability of children by using its three
modality approach i.e Visual, Audio and tactile modality.
Speechifi store and deliver high quality sound with full acoustic energy which
enables a user to listen properly and differentiate between two distinct sounds. User can
get Live and recordable speech stimulation both in native language.

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Used by
Device can be used by Special Educator, Therapist, individual at classroom, clinic and
home.

Fig 10. Audio visual tactile modality

Overview of functionality
Operates from internal rechargeable battery. Operator can give live or recorded speech
stimulation through headphone or inbuilt speaker output. Volume can be controlled by
keypad.
Operator can record own voice in any language in two different section and recorded
output can be play repeatedly for speech stimulation to child. There is inbuilt light within
device which is helpful in enhancing attention and eye-contact of child.
Flash cards are provided with devices which are categorized into vowels, words,
sentences, story selling. These cards cover all lexical categories, syntax, semantic and
pragmatic for speech and language development of child.

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Speechifi enhances child’s receptive & expressive skills with following benefits:
 Speechifi device works as a digital speech & language developmental trainer.
 Emphasis on listening ability.
 Avoid lip reading.
 Combination of auditory & verbal stimulation.
 Step wise development of speech & language vowels, words, sentences, initiations,
conversation, story telling.
Speechifi is a complete solution for speedily development of your child’s speech &
language at home. Speechifi device provides full solution and gives systematic effective
speech & language training to child for development of words, sentences, conversation,
story telling & narration without doing any lip reading.Child maximally uses listening skills.
Speechifi System Inculdes :
 Speechifi Device
 Microphone
 Headphone
 Charger
 360 Flash Cards
 Vocabulary Book
 DVD
 Carry Bag
Speechifi Covers
 Autism
 Delayed speech and language
 Hearing impairment
 Low IQ, slow learning
 Adult Neurological speech disorder: Aphasia, Stroke, Memory loss
 Expressive and receptive developmental language disorder
 Learning disability
Features
 Capability to do 1:1 Therapy
 Visual, Audio and tactile modality.
 High Sound quality with full acoustic energy
 Live and recordable speech stimulation
 Portable
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  3 days battery backup
 Easily user interface
Benefits
The enhanced technology of the product makes it a device full of advantages. It
caters to the need various speech complexities in the society. It culminates pre-linguistic
skill by stimulating sitting attention and eye-contact.
It serves the need of Linguist skill by enthusing a sense of understanding and
expression into the minds of people. Also, it operates in providing supra-linguistic skill by
enhancing the cognition level. With the range of benefit it provides, it also assists at home
mingle with the main-stream.
Working
Speechifi is an assistive communication devices that assist and prepare parents,
educators and therapists to perform effective speech therapy. The working of speechifi
hinges upon the three-modality principle, namely, auditory, visual and tactile principle.
Speechifi store and deliver high quality sound with full acoustic energy which
enables a person to listen properly and differentiate between two distinct sounds. The
functionality of light system enhances attention and eye-contact. The device operates to
use original voice in speech stimulation, which in turn works towards speedier recovery.

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