User Manual
Contents
1. previous clients can be easily accessed The client list can be either scrolled or searched using the binocular icons at the top of each client data column Click on the desired client name and continue adding or changing information as required Deleting data Old client data can be deleted by pressing the Delete button on the right hand side of the screen Continuing the test When finished with the Client List continue by pressing the Next arrow at the bottom left of the screen In order to create a full client record we recommend that you fill in all the text fields in the Client List 24 12 Client session Add tester Press the New button on the right hand side of the screen opposite the text fields Write the tester s name into the Tester field and validate by pressing the OK button on the right hand side of the screen The tester s name and date will be entered into the list below Session date The session date is automatically entered into the Date text field You must validate the text by pressing OK The Delete button erases the current record 25 The results can also be accessed in the Reports section in the left hand menu After deleting the record you must restart the diagnostic procedure in all four conditions 13 LiSN S test results Results After the completion of the test in each of all four conditions Different Voices 14 Diagnostic2. 23 23 23 24 24 24 12 13 14 14 1 14 2 15 16 16 1 16 2 16 3 16 4 16 5 16 6 16 7 16 8 16 9 17 FA 17 2 17 3 17 4 17 4 1 17 5 17 5 1 1752 Tba 17 5 4 17 6 Client session Add tester Session date LISN S test results Diagnostic Diagnostic screen graphic Results explanations Reports LISN S PGA How to administer the LISN S PGA test List of clients Client session Quick LISN S PGA session Quick LISN S PGA test results Quick LISN S PGA results explanation Full LISN S PGA session Full LISN S PGA results explanation LISN S PGA reports Background information Environment required for administering LISN S Administering LiSN S The Listening In Spatialized Noise Sentences Test Sentences Correct sentences words and correct responses Scoring The LiISN S test conditions Condition 1 Different Voices 90 Condition 2 Same Voice 90 Condition 3 Different Voices 0 Condition 4 Same Voice 0 LISN S Advantage Measures 25 25 25 26 2 27 28 29 31 31 31 32 dd 36 37 38 oo J3 40 40 40 40 42 42 42 42 43 44 44 44 ie 17 8 17 9 17 10 17 11 17 12 17 13 18 19 20 Normative data Test Retest reliability and critical differences scores Practicing the LISN S test Instructions to client LISN S test summary Presentation Order Presentation Levels Client s task Warning tone SNR SNR adjustment Level
3. a word leaves a word or words out or inserts morphemes such as plural or past tense markers the number of correct words is adjusted For example for the sentence The dog ate the bone a The dog ate the bone 5 words correct b The big dog ate the bone 5 words correct c The dog ate 3 words correct d The dog at the phone 4 words correct e A dog ate the bone 4 words correct f The dog ate the bones 4 words correct 17 4 1 Scoring f the client correctly identifies more than 50 percent of words in the sentence the amplitude of the next sentence Is reduced f the client correctly identifies less than 50 percent of the words the amplitude of the next sentence Is increased The signal to noise ratio SNR is not adjusted if a response of exactly 50 percent correct is recorded 17 5 The LiSN S test conditions LISN S assesses a client s auditory processing in four different conditions In all four conditions the target speech comes directly from the front The listener s score is automatically calculated by the software and represents his or her speech reception threshold in dB 17 5 1 Condition 1 Different Voices 90 high cue SRT In the first condition the competing speech is composed of different voices to that of the target speaker The competing speech is also spatially separated from the target sentences appearing to come from the left and the right This gives the client several aural cues to he
4. and their voices will be very similar to Miss Smith s voice So you will have to listen very hard for the beep and Miss Smith 17 11 LiSN S test summary Presentation Order A client is assessed on four LISN S conditions which must be presented in the following order 1 Different Voices 90 2 Same Voice 90 3 Different Voices 0 4 Same Voice 0 Presentation Levels The competing speech is presented at a constant level of 55 dB SPL The target sentences are initially presented at a level of 62 dB SPL that Is a 7 dB signal to noise ratio SNR Client s task The client s task is to repeat as many words as possible after hearing each target sentence Warning tone A 1000 Hz tone burst is presented before each sentence to alert the listener that a sentence will be presented A silent gap of 0 5 sec separates the tone burst from the onset of the sentence The tone burst is presented at a constant level of 55 dB SPL SNR The SNR is adjusted adaptively in each condition to determine each participant s speech reception threshold SRT For LISN S SRT can be defined as the SNR that yields 50 percent intelligibility SNR adjustment If the client correctly identifies more than 50 percent of words in the sentence the amplitude of the next sentence is reduced If the client correctly identifies less than 50 percent of words the amplitude of the next sentence is increased The SNR is not adjusted if a response of exactly 50
5. files such as Word Excel documents 30 The Listening in Spatialized Noise Sentences Test with Prescribed Gain Amplifier or LiSN S PGA assesses the ability of listeners with hearing loss to understand speech when noise is arriving from different directions 16 1 How to administer the LISN S PGA test The LiSN S PGA test is designed to be administrated by professionals such as speech thera pists audiologists or suitably qualified professionals LISN S PGA should be directly administered after the pure tone audiogram and will take just a few minutes The tester will then understand exactly what severity of problems the client has understanding speech in noisy situations The tester and the client will know whether advanced directional hearing instrument micro phone technology or an FM system is recommended to overcome the patient s problems understanding speech in noise With LISN S PGA a virtual 3D acoustic space is recreated under the headphones even in a very small sound booth with the tester sitting outside Therefore there is no need to calibrate a free field test set up LISN S PGA suits all ages Norms are available for all ages from 6 to 60 years patients over 60 years of age are compared to the norms for 60 year olds 16 2 List of clients To add a new client click the New button on the right side Enter the client s information in the text fields provided and then press the Add button If required click Can
6. in the text fields provided and press the Add button If required you can click Cancel to restart Mandatory fields The text fields Last Name First Name and Date of Birth are marked with an asterisk and therefore mandatory In order to continue with LISN S you must fill in these mandatory fields 24 Date of birth If a client is aged under 6 years O months or above 30 years a pop up window opens that reads The diagnostic tests can be run however the normative data is not available for ages under 6 years Preliminary studies have shown it can be used with caution for adults with normal hearing aged 31 to 40 years The normative data was collected for clients aged 6 to 30 years Phonak LiShi S i Tha Ghali ee Ga Eee unt P Pee noire ae a hot ay alate Bor eps rede G yare Prolerraty dadag hae shown Can Ba eed wih caution lor edule with aama hare aged 31 bo 40 yom The namai daba wae cofected for clentsaged fi io 20 yoere To continue click OK The information entered will be added to the client list below A Through upgrades of LiSN S new norms for other ages may become available Renaming a text field The field Other can be renamed Notes field Further information regarding the client such astherapy or diagnosis notes can be added in the Notes box 23 i i e i erja SES Accessing client information after a session has been completed The test results of
7. percent correct is recorded Level adjustment in dB The level of the target sentences is adjusted in 4 dB steps until the first upward reversal in performance is recorded and in 2 dB steps thereafter Number of sentences presented Up to 30 sentences are presented in each of the four LISN S conditions Testing ceases automatically in a particular condition when the listener has either completed the entire 30 sentences in any one condition or completed the practice sentences plus a minimum of a further 17 scored sentences and his or her standard error calculated over the scored sentences is less than 1 dB Thus after 22 to 30 sentences the test finishes and the client s speech reception threshold SRT is calculated 49 Final SRT The listener s final SRT in any condition is calculated as the average SRT over the scored sentences and is displayed in the SRT dB box 17 12 Cut off scores LISN S cut off scores represent the level below which a client is considered to have displayed disordered performance on a particular SRT or advantage measure compared to the normal hearing controls The cut off scores were calculated as 2 standard deviations of the residuals below the mean As there was a trend of improved performance with age across LISN S measures the cut off scores are adjusted for age The cut off scores are calculated automatically by the LISN S software following the completion of each LiSN S condition 17 13 List
8. scored sentences is less than 1 dB While running the test if you consider a client is losing concentration gently prompt the client to listen in front in the case of a condition where the distracters are spatially separated from the target or listen hard for the beep if the stimuli are coming from the same direction If required stop testing reset i e don t save the data give the client a short break and try again 47 17 10 Instructions to client The following explanation is recommended You are going to hear some sentences over these headphones The sentences are said by a lady called Miss Smith Even though you are wearing headphones Miss Smith will sound as if she is standing just in front of you There will be a beep before each sentence so you will know when it is about to start Your job is to repeat back the sentences that Miss Smith says I pretend to be Miss Smith and want you to repeat the sentence you hear The dog had a bone Client repeats The dog had a bone Good that s easy isn t it But there s a trick At the same time as Miss Smith is telling you the sentence there are some very tricky people talking Sometimes the tricky people sound like they are standing in front of you right next to Miss Smith and sometimes they will sound like they are standing next to you No matter where the tricky people are don t want you to listen to them stress this
9. 47 1 23 2 02 2 5 High Cue SRT 1 14 1 45 2 38 3 5 Talker Advantage 0 86 2 13 3 49 4 4 Spatial Advantage 0 14 1 64 2 69 2 8 Total Advantage 0 67 1 70 2 79 3 5 46 The test retest data was utilized to develop one sided critical difference scores These scores are needed to infer that there has been a genuine improvement in auditory performance on retest taking into account mean practice effects and day to day fluctuations in performance As such the critical difference scores can be used to determine whether a client s LISN S performance has genuinely improved following a period of remediation or compensation with an assistive listening device The critical difference scores for each LISN S SRT and advantage measures for the Australian and North American version of the test are provided 17 9 Practicing the LiSN S test In each of the four LiSN S test conditions the first few sentences a minimum of 5 are considered practice sentences These practice sentences continue until one upward reversal in performance is recorded i e the sentence score drops below 50 percent of words correct Practice sentence scores do not contribute towards a client s final SRT scores Testing in a particular condition automatically ceases when the listener has either a completed the entire 30 sentences in any one condition or b completed the practice sentences plus a minimum of a further 17 scored sentences and his or her standard error calculated over the
10. 90 Same Voice 90 Different Voices 0 Same Voice 0 the client s results are recorded 14 1 Diagnostic screen graphic The diagnostic screen shows the history of the target level as the range of correct The client s results are automatically recorded in the Client Session responses from greater than 50 percent correct to less than 50 percent correct is repeatedly traversed 26 27 The red line indicates the background voice level of the distracters The green line indicates the level of the target sentences as it changes adaptively over the course of the test condition The blue line indicates the patient s average speech reception threshold SRT 14 2 Result explanations If the test has not been completed in all four conditions the results are invalid and the tester is notified When the test is complete recommendations are given in the text field below the table Example recommendations include The client was outside normal limits on the high cue SRT spatial advantage and total advantage measures of the LISN S These results are suggestive of a spatial stream segregation disorder The client was within normal limits on all measures consistent with normal spatial stream segregation 28 15 Reports Client reports are generated automatically by the LISN S software The software indicates clearly for all five measures whether a client is within or outside normal
11. LISN S PGA Listening in Spatialized Noise Sentences Test LISN S Software User Manual Developed by National Acoustic Laboratories Distributed by Phonak Made in Switzerland www LiSN S com www phonak com 029 3094 visu l Phonak AG all rights reserved Content 4 1 4 2 6 1 6 2 6 3 8 1 8 2 8 3 8 4 8 5 Welcome Legal hint The LiSN S package Important information LISN S headphones Phonak soundcard System requirements Installation Installing the LISN S equipment Software installation Calibration information LiSN S configuration Toolbar menus and icons File menu Configuration menu Extra menu Help menu Icons 13 13 14 15 16 17 10 11 How to administer the LiSN S test Select the Test language Add client and tester information Test condition Target sentence Entering the client s score Next target sentence Stopping the test Selecting the Stop button when the score O is marked Final SRT Completion of the condition Completion of the LISN S test Test results Client data Data protection Look fora client Search client Clear search Client list Entering client data Mandatory fields Date of birth Renaming a text field Notes field Accessing client information after a session Deleting data Continuing the test 17 17 18 13 13 19 19 20 20 20 20 21 21 21 21 21 22 22 22 22 22
12. adjustment in dB Number of sentences presented Final SRT Cut off scores List of references Internet software updates Service and warranty List of Phonak LiSN S partners 45 46 47 48 49 49 49 49 49 49 49 49 49 50 50 50 51 92 53 1 Welcome The Listening in Spatialized Noise Sentences Test or LISN S assesses the ability of clients to understand speech when there is noise coming from different directions Understanding speech in competing noise is a problem commonly experienced by clients with auditory processing disorder APD LiSN S uses a totally new and ingenious way of testing these clients auditory skills LISN S will support you in your clinical decisions and help you determine whether a client s listening skills have improved after some form of intervention LISN S was developed by Dr Sharon Cameron a research scientist at National Acoustics Laboratories NAL in Australia along with Dr Harvey Dillon NAL s director Both are highly respected in the international scientific community for their innovative and outstanding contributions The test s inventor Dr Sharon Cameron has applied the highest standards of scientific rigor in designing and validating LISN S It is a model for how tests in this area should be developed Phonak the exclusive worldwide distributor of LISN S is proud and privileged to be associated with NAL Further resources To find out more about LISN S visit ou
13. ate server might not be established These include There is no open internet connection Open or activate your internet connection Your proxy server is not correctly configured In the internet update window click on the Internet Options menu and enter the proxy name and port Optionally a user ID and password can be entered There is a firewall blocking access to the internet add the LISN S application to the firewall s list of exceptions If you don t have internet access to update the software please inform your LiSN S sales contact accordingly 51 Phonak provides a manufacturer s limited warranty for LISN S Please ask your sales contact for full details of this warranty Problems with LISN S arising from improper handling care and adjustments or improper use of material or unauthorized material are not covered by the warranty Sennheiser headphones HD 215 You will receive an original Sennheiser Document of Warranty which needs to be validated by your point of sale This entitles you to 2 years of warranty cover Phonak soundcard The soundcard is your LiSN S security It has a unique serial number Your LISN S sales contact will note the serial number of your Phonak soundcard below This will be required in the event of a warranty claim or repair Phonak soundcard serial number Date of purchase LISN S serial number Protect your Phonak soundcard from theft destruction and loss Legal and
14. cel to restart PHONAK Fit e 31 Mandatory fields The text fields Last Name First Name and Date of Birth are marked 16 4 Quick LISN S PGA session with an asterisk and therefore mandatory 16 3 Client session Press the New button on the right hand side of the screen If you wish to use a Prescribed Gain Amplifier select Yes If you wish to re use a previous Prescribed Gain Amplifier for this session select User Last PGA If you do not want to use Prescribed Gain Amplifier select No Enter Audiogram data for Prescribed Gain Amplifier Enter the client audiogram data by Write the tester s name in the Tester field or select a tester in the drop down list and clicking data directly on the chart validate by pressing OK Press the AC button to activate the air conduction value red and O for Right Ear blue Session date The session date is automatically entered into the Date text field You must and X for Left Ear If you wish to use the bone conduction value press the BC button to validate the text by pressing OK activate the bone conduction value grey and lt for Right Ear grey and gt for Left Ear 32 33 Save press this to continue the test and save the audiogram data If Bone Conduction values has to be used tag the Use Bone Conduction values for Right Ear and or Left Ear Cancel resets audiogram data Delete erases the current record Remar
15. displayed in the SRT dB box Seq Phrase 30 The soccer team is losing Comect Corect Completed S 1 5 Number of Standard E reversals 9 of Mean dB n weet 3 9 Completion of the test The Quick LISN S PGA test is completed after its final sentence has been scored A pop up window opens signaling the completion of the test in Different Voices 90 condition Press OK to continue a oe S J Test Different voices 90 deg has been completed OK 16 5 Quick LISN S PGA test results Results after the completion of the test the client s results are automatically recorded in the Client Session When the test is complete the client s soeech understanding in noise score is displayed on the screen and recommendations are given for each score s zone green yellow red me z Sad lt ae PHONAK so rt a EEE T Hraste amp s ou _ ow he al s e lt ere eerie o Mt me 8 ee Se a cme CFE Ge ae et tee et oe F be sem cere amp 4 gees te eee oer he ae amp s lt lt e s 2 our s wet ia p i d ti d i J 4 36 The results and recommendations can also be accessed in the Reports section in the left hand menu 16 6 Quick LISN S PGA results explanation The results are displayed and the tester can add his her own comments or explanations in the free text field These comments will also be includ
16. ed in the printed client reports e O SS pm PHONAK gt H Le a CN Plawults tel aed 4 ne Le ie manm una ta maiman f 37 16 7 Full LiSN S PGA session To complete the Full LISN S PGA test the client must be assessed in all four LISN S conditions different voices 90 same voice 90 different voices 0 same voice 0 The first LISN S test condition different voices 90 has to be done in Quick LiSN S PGA By click ing Full LISN S PGA the remaining three LiSN S test conditions same voice 90 different voices 0 same voice 0 will be tested Results after the test is complete the client s results are automatically recorded in the Client Session When the test is complete the client s score for Quick LISN S PGA is dis played on screen in addition to the Full LISN S PGA graph These results can also be accessed via the Reports section in the left hand menu 38 16 8 Full LISN S PGA results explanation The results for Quick LISN S PGA and Full LISN S PGA are displayed on the screen The tester can add his her own comments or explanations in the free text field These comments will also be included in the printed client reports e a p o a n te ee _ PHONAK oF 2H teweeees o as om M _ 16 9 LiSN S PGA reports Client reports are automatically generated by the LISN S PGA software The content of t
17. ent publications etc Guidelines and background information provides insights into the research and development of LISN S Chia miih iai te eis Professional articles provides a list of LISN S related publications Licence Agreement provided in Adobe PDF format Movie LISN S in detail the concept LISN S Internet provides a direct link to www LiSN S com 8 4 Help menu What s new the latest helpful LISN S information Help topics find the answers you need by topic User Manual an electronic version of this User Manual in Adobe PDF format Internet upgrade service view internet update information 16 Mo new update required LISN S application provides general info about the LISN S test program 8 5 Icons Print Back up of user data Edit the list of professionals Search for a client 9 How to administer the LISN S test Select the Test language This needs to be done when first using LISN S and whenever a change of test language is required a Phonak LISH 5 C T ar gece a ey u E Add client and tester information Type the client s name and details click Add and then Next To add the tester select New type in the tester s name then select OK followed by Next 18 Test condition Highlight the first LISN S condition Then press the Start button on the very right hand side The competi
18. er information about these headphones please visit www sennheiser com No other headphones can be used with the LiSN S software without invalidating the results of the test 4 2 Phonak soundcard Connect the Phonak soundcard to your computer The LISN S software will not run unless the Phonak soundcard is connected to the computer via USB The output of the Phonak soundcard in dB SPL is automatically set to the correct level by the LISN S software No other soundcard can be used with the LiSN S software without invalidating the data and affecting the spatial qualities of the speech stimuli LiSN S is protected and can only be run with the Phonak soundcard supplied Protect this soundcard from theft destruction and loss Windows 2000 XP Vista Hard disk space Minimum 20 MB Recommended 100 MB CD ROM drive Minimum RAM 64 MB 6 1 Installing the LiSN S equipment You need a personal desktop computer or laptop that is capable of playing audio An attached printer is recommended for printing out the LiSN S reports as is Adobe Acrobat Reader 5 0 or higher available for free from www adobe com Remove the LISN S hardware equipment from the packaging material Make sure your Phonak soundcard is recognized by your PC Connect the Phonak soundcard to your computer s free USB slot Do not extract the soundcard until it has been recognized by Windows Unscrew the large jack from the end of the Sen
19. eted after its final sentence has been scored A pop up window opens signalling the completion of the test in the specific condition e g Different Voices 90 Press OK in the pop up window to continue with the next LISN S condition 20 Completion of the LiSN S test The patient must be assessed in all four LISN S conditions presented in the following order Different Voices 90 Same Voice 90 Different Voices 0 Same Voice 0 Test results The results are automatically recorded in the Client Session 10 Client data Data protection Client data information in the Client List is stored in the client database See the lower section of the Client screen outlined in red below The tabs and buttons associated with this client database list are described below Look for Enter client details either first or last name to pull up a particular client s records All The full client list can be viewed via the All tab Look for Last clients All 21 Search client when clicked this button displays client search results in alphabetical order Clear search clears the client search entry in the client database A search can also be performed by typing a client s First or Last name into the blue marked textbox 11 Client list Entering client data To add a new client press the New button on the right side of the frame Enter the client s information
20. g a PC A three dimensional auditory environment is created by pre synthesizing speech stimuli with head related transfer functions HRTFs This offers an alternative to free field testing which is limited by factors such as listener head movement which can affect the sound at the eardrum by several dB as well as replication of loudspeaker and listener placement between clinics and the effects of reverberation between clinics Output levels are directly controlled by the software using an external Phonak soundcard A simple repetition response protocol is utilized to determine a listener s speech reception threshold SRT for sentences presented in competing speech looped Clients s stories The target sentences are perceived as coming from directly in front of the listener 0 azimuth whereas the maskers relative to the targets vary according to their perceived spatial location 0 vs and 90 azimuth the vocal identity of the speaker s of the stories same as or different to the speaker of the target sentences or both 40 The competing speech is presented at a constant level of 55 dB SPL The target sentences are initially presented at a level of 62 dB SPL The signal to noise ratio SNR is adjusted adaptively in each condition by varying the target level to determine each participant s speech reception threshold SRT Up to 30 sentences are presented in each of four conditions of distracter location and voice different vo
21. handling issues should follow our recommendations 52 Australia Phonak Australasia Pty Ltd Baulkham Hills N S W 2153 Canada Phonak Canada Limited Mississauga Ontario L5WOB3 New Zealand Phonak New Zealand Ltd Takapuna Auckland 9 Singapore Phonak Hearing Systems Indomed Singapore Pte United Kingdom Phonak UK Limited Warrington Cheshire WA1 1PP USA Phonak LLC Warrenville IL 60555 3927 Manufacturer Phonak Communications AG Laenggasse 17 CH 3280 Murten Switzerland 53
22. hese reports can be tailored by clicking the desired check boxes 88S SSL ESS S qqqqQqQqq___ F o et PHONAK aF ot A z_ _ _ E___ SS See o a Mr deeem a o n ue o ee Se ewe te ee e te t meee S 4 wad ee amt E he cee amp me ee 39 17 1 Environment required for administering LiSN S A sound treated room is required as all the LISN S norms were gathered in such sound treated rooms 17 2 Administering LiSN S The LISN S test should be administrated by audiologists or suitably qualified professionals in a sound treated environment The licence warrants that you and any person that you permit to use the software are Suitably qualified or are legally entitled to give the test and are competent to use the software 17 3 The Listening In Spatialized Noise Sentences Test LISN The Listening in Spatialized Noise Sentences Test or LISN S was developed to assess auditory stream segregation skills in clients with suspected auditory processing disorder APD Auditory stream segregation is the process by which a listener is able to differentiate the various auditory signals which arrive simultaneously at the ears and form meaningful representations of the incoming acoustic signals Auditory cues such as the location of the sounds or the pitch of the speakers voices help this process of segregating the total stream of sound LISN S is presented over headphones usin
23. ices at 90 DV 90 same voice at 90 SV 90 different voices at 0 DVO and same voice at 0 SVO resulting in a maximum of 120 sentences presented The first few sentences played a minimum of 5 are considered practice sentences This practice testing continues until one upward reversal in performance is recorded i e the sentence score drops below 50 percent of words correct Practice sentence scores do not form part of a client s final SRT scores Testing stops in a particular condition when the listener has either a completed the entire 30 sentences in any one condition or b com pleted the practice sentences plus a minimum of a further 17 scored sentences and their standard error calculated automatically in real time over the scored sentences is less than 1 dB A listener s performance is measured as two speech reception threshold SRT and three advantage measures The advantage measures represent the benefit in dB gained when either different talkers spatial cues or both talker and spatial cues combined are incorporated in the maskers The use of difference scores to measure performance in the LISN S test minimizes the influence of higher order language learning and communication functions on test performance For example as such skills affect both the SRT when the distracters are presented at 0 and the SRT when they are spatially separated at 90 these Skills will have minimal effect on the difference be
24. ith APD score very poorly in the spatial advantage measure To assess how well a client can differentiate between different speaker voices and so understand speech in noise LISN S also calculates the difference between a client s scores for conditions 3 and 4 The resulting figure is known as the client s talker advantage The difference between a client s scores in conditions 1 and 4 is referred to as his or her total advantage Like the high cue SRT total advantage is a measure of how well a client uses the cues in the environment to filter the noise coming from different speakers and different directions As mentioned previously by measuring performance as a difference between the scores from two LISN S conditions the influence of higher order language learning and communication skills on test performance is minimized This unique LISN S approach to measurement allows clearer evaluation of a client s ability to use spatial and voice cues LISN S automatically calculates whether a client has displayed a disordered performance on any of the SRT or advantage measures by comparing performance to normal hearing controls 17 7 Normative data Normative data exists for North American English and for Australian English North American English should be used in the United States and Canada Australian English should be used in Australia and New Zealand Norms are currently also being developed for the United Kingdom In North Ame
25. ks the maximum gain has been reached will be displayed if the maximum gain available from the sound card is reached Test condition the sound files for the Quick LISN S PGA condition are automatically con verted according to the audiogram data CEE p a s tes Then press the Start button The competing speech will now commence 34 Target sentence Press the blue colored Next sentence button to present the first test sentence _ aaaaaaiiaaaasasaui i p oe a m E lt i Cr 8 an a i i p Seunen eet Ag Pm e e Rn s gt r i o e Sa gt eee Hie y uM 3 js Oe ia o M When the target sentence is playing the E icon will be shown This icon disappears when the target sentence is finished Entering the client s score enter the number of words the client repeated correctly using the number button panel on the right of the screen If the client repeated all the words cor rectly click AH Select actual corect Next target sentence After you have entered the client s score you can move on to the next sentence by pressing Next on the right Stopping the test If for any reason you need to stop the test just press Stop on the right hand side 35 Final SRT The client s final SRT Speech Reception Threshold in any condition is calcu lated as the average SRT over the scored sentences and is
26. limits Client reports can be viewed mid way through the testing process However only the performance measures that can be calculated from the conditions completed will be tabulated in the Client s score table and variable standard deviation columns of the report and displayed on the graph 29 The horizontal line on the graph shows the various LISN S SRT and advantage measures The vertical axis indicates the variation from the mean normative data score in standard deviations The blue line on the graph represents the mean normative data scores for a client of the same age as the client that is zero standard deviations from the mean The green line represents the client s results in standard deviations from the mean normative data score The red line represents the cut off score below which performance on the various LISN S SRT and advantage measures is considered outside normal limits These results are tabulated above the graph along with details of whether the client is within or outside the normal limits for a particular measure In the table a green field is considered a Pass and a red field a Fail Client reports can be previewed printed and e mailed from this menu Clicking Report preview opens an Adobe PDF file which provides the following information General LISN S background Client test results Suggestions for further steps Further client information can be imported from other client
27. lp him or her to filter out the background noise and identify the target speech 42 The result of this condition is called the client s high cue speech reception threshold or high cue SRI In condition two the competing speech is composed of the same voice as the target speech and again comes from the left and right 43 17 5 3 Condition 3 Different Voices 0 With condition three the competing speech is composed of different voices than the target Speech and comes from the front the same direction as the target speech 17 5 4 Condition 4 Same Voice 0 Low cue SRT In condition four the competing speech uses the same voice as the target speech and comes from in front of the client the same direction as the target speech This fourth condition is the most difficult of the four as there are no spatial cues available and the target and competing speech is very similar The result of this test is referred to as the client s low cue speech reception threshold or low cue SRT 17 6 LiSN S Advantage Measures Moving distracting voices from the front to the sides allows a client to make use of spatial cues How much an individual client benefits from this movement is easily calculated by measuring the difference in scores between conditions 2 and 4 4A This spatial advantage is calculated automatically by LISN S and is a highly sensitive indicator of auditory processing disorder Clients diagnosed w
28. ng speech will now commence Target sentence Press the blue colored Next sentence button to present the first test sentence When the target sentence is playing the icon is shown This icon disappears when the target sentence Is finished Entering the client s score Enter the number of words the client repeated correctly using the number button panel on the right of the screen If the client repeated all the words correctly click the large AIl button Select actual conect Next target sentence After you have entered the client s score you can move to the next sentence by pressing the Next button on the right Stopping the test If for any reason you need to stop the test just press the Stop button on the right hand side Selecting the Stop button when the score O is marked If the score of O appears in the Actual Correct box and the Stop button is selected a pop up window opens You are asked if you want to save this value and stop the test If you press Yes the pop up window closes and you can either choose to continue Continue or reset Reset the test Both buttons are on the right hand side Final SRT The patient s final SRT Speech Reception Threshold in any condition is calcu lated as the average SRT over the scored sentences and is displayed in the SRT dB box fag PT Dia Corea 10 The ducks quacked loudly o 4 no am 10 Completion of the condition The condition is compl
29. nheiser headphone cable Connect the Sennheiser HD215 headphones to the green headphone input socket of the Phonak USB soundcard The software will not run unless the Phonak soundcard is connected to the computer In case of soundcard recognition problem make sure your Phonak soundcard is set as default soundcard Go to Start gt Configuration panel gt Sound 6 2 Software installation Insert the LISN S CD ROM in your PC s CD ROM drive The CD ROM will autoplay In case of no autoplay go to My Computer click the CD DVD drive icon then double click on the LISN S exe installation file Enter your User Name and Company Name T oe ri yek ia ae Eanes kane Click Next and follow the on screen prompts to complete the installation Copying of the LISN S files and software registration will only begin after you have read and accepted the LISN S licence agreement wipke camee dp iha Rete shee fl igand dad Tera LENS Thee Fial patel aa rll rial Pl E ar Pee Met wt ei 10 Re start the LISN S software via the desktop icon provided or the Start Programs menu Make sure your soundcard is inserted Click Licence and scroll down to read the licence agreement f you agree press OK lale E n The LISN S program will now start 11 8 1 File menu r m J aii Seg e a 6 3 Calibration information The output of the Phonak USB soundcard and the headph
30. of references Cameron S Brown D Keith R Martin J Watson C amp Dillon H 2009 Development of the North American Listening in Spatialized Noise Sentences Test NA LISN S Sentence equivalence normative data and test retest reliability studies Journal of the American Academy of Audiology 20 2 TBA Cameron S amp Dillon H 2008 The Listening in Spatialized Noise Sentences Test Comparison to prototype LISN test and results from Clients with either a suspected central auditory processing disorder of a confirmed language disorder Journal of the American Academy of Audiology 19 5 377 391 Cameron S amp Dillon H 2007a Development of the Listening in Spatialized Noise Sentences Test LISN S Ear and Hearing 28 2 196 211 Cameron S amp Dillon H 20076 The Listening in Spatialized Noise Sentences Test LISN S Test retest reliability study International Journal of Audiology 46 145 153 Detailed references are given in the guidelines background information and articles listed in the software 50 Once you have purchased LISN S you are entitled to download further software updates directly from the internet The software checks to see whether internet updates are available on start up This feature can be deactivated in the menu Help Internet Upgrade Service just uncheck the Check the version on start option There are several reasons why communication with the upd
31. ones is automatically set to the correct dB SPL level by the LISN S software 7 LiSN S configuration The LISN S software is configured into 3 main modules Client Diagnostic and Reports Client module this contains information about clients The list of clients is protected Client session results are included in this module Diagnostic This module is used to assess the four LISN S conditions Different Voices 90 Same Voice 90 Different Voices 0 Same Voice 0 Section results and explana tions are included Reports These are generated automatically Reports can be viewed during a test or at the end of the test Reports can be easily printed and e mailed 8 Toolbar menus and icons Page setup is possible Exit LISN S 12 13 The Configuration menu is activated as soon as you open a client in the List of Clients 8 2 Configuration menu Edit button Click Edit to configure your lists of schools teachers and testers Phonak LISM S Test language Highlight the test language you require and confirm by pressing OK You can choose or change the test language only at the beginning of a LISN S session 14 im ae a a og a E j E E Information regarding the headphones and Phonak soundcard is also listed under the Configuration menu 8 3 Extra menu New provides latest LISN S information such as announcements new versions and updates rec
32. r website www LiSN S com The following symbol appears in this user guide A Important note for all users 2 Legal hint Use this software only after reading and accepting the Licence Agreement The system requirements and LiSN S test specifications need to be strictly followed Before starting LISN S read the Licence Agreement to make sure you are permitted to run the LiISN S test software LiSN S software is protected and can only be administered with the LiSN S specific Phonak soundcard installed Any unauthorized installation of software and or soundcard and or calibration of the USB soundcard and or headphones which could damage your computer system or cause you hearing problems are prohibited Phonak declines any responsability for any consequences 3 The LiSN S package LISN S is a combined hardware and software package It comprises LISN S PC software program High quality headphones Phonak soundcard The package also includes the Document of warranty which should be validated by your LISN S sales contact LISN S features automatic internet updates The user is notified when new updates are available and these can be then downloaded free of charge These upgrades comprise new features such as new language support new norms new reports or extended database functionalities A See chapter 17 Internet software updates 4 1 LiSN S headphones LISN S uses Sennheiser HD 215 headphones For furth
33. rica the normative data was collected from 192 normal hearing clients aged 6 years 2 months to 30 years 3 months Brown Cameron Martin Watson amp Dillon submitted for publication In Australia the normative data was collected from 70 normal hearing clients aged 6 years O months up to 11 years 11 months Cameron and Dillon 2007 The results of the LiSN S test are invalid for clients outside the age range stipulated in the software 45 17 8 Test Retest reliability and critical difference scores Retest reliability data was obtained for LISN S Re testing was carried out between 2 months and 3 months after initial testing Differences in mean SRT advantage score be tween the initial test and retest were small across performance measures Test retest dif ferences did not vary significantly with age Full details can be found in Cameron amp Dillon 2007b and Cameron Brown Keith Martin Watson amp Dillon 2009 Correction Factor SD of Critical 7 Mean Test the Mean Difference Condition Retest Difference Test Retest 1 64 x SD Including Difference Correction dB dB dB dB Low Cue SRT 0 49 1 51 2 47 3 High Cue SRT 0 44 2 4 3 99 4 4 Talker Advantage 0 31 2 46 4 03 4 3 Spatial Advantage 0 05 2 21 3 63 3 6 Total Advantawge 0 06 2 35 3 85 I e Correction Factor SD of Critical 7 Mean Test the Mean Difference Condition Retest Difference Test Retest 1 64 x SD Including Difference Correction dB dB dB dB Low Cue SRT 0
34. to the client Just listen for the beep and the sentence Miss Smith always starts out louder than the tricky people so you shouldn t have any trouble hearing her But sometime the tricky people get loud f you only hear a bit of the sentence want you to tell me all the words that you hear because give you a mark for each word you get right stress this to the client So if you just heard dog and bone what would you say Client repeats dog and bone Great If you don t hear Miss Smith at all just shake your head and I ll go straight on to the next sentence Once you ve heard the sentence tell me what you ve heard straight away so you don t forget it n the first few sentences the tricky people will be standing right next to you Don t listen to them stress this to the client Just concentrate on what Miss Smith is saying in front The tricky people start first and then Miss Smith starts a few seconds later Ready Describe where the tricky people are before each listening condition i Same Voice 90 Condition Now the tricky people will be next to you again but their voices will be a bit different Ignore them and just listen for Miss Smith ii Different Voices 0 Condition Now the tricky people will be next to Miss Smith Just listen for the beep and the sentence 48 iii Same Voice 0 Condition Now the tricky people will be next Miss Smith
35. tween the SRTs in these two conditions Thus the differences that inevitably exist between individuals in such functions can be accounted for allowing for clearer evaluation of their abilities to use spatial and voice cues to aid speech understanding LISN S SRT amp Advantage Measures Same Speaker Different Speaker Rely on SNR Low Cue SRT Same Voice 0 Talker Advantage gt Different Voices 0 TS is Same D Location gt S Use tonal and spatial cues gt a Same Voice 90 Different Voices 90 chen High Cue SRT Location 41 LISN S studies have shown that there is a trend of decreasing SRT and increasing advantage as age increases No significant differences were found on any performance measure as a consequence of data collection site or gender Inter and intra participant variation is minimal Test retest differences are not significant on any measure Full details of the LISN S test s development sentence equivalence studies normative data studies and test retest reliability studies can be found in the Professional Articles section in the Extra menu 17 4 Sentences Correct sentences words and correct responses The client s task is to repeat as many words as possible heard in each target sentence A word is considered correct if it is repeated exactly as it appears on the playback screen If the client includes an extra word there is no penalty If the client substitutes
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