Home

Audioscan Axiom® User`s Guide 1.8

1. 17 Input device OPS PACT iore te n adi etit e snes E cadet uobss sated EHE sds EDIT ERU ee P Rete eta 17 Barcode Iren E H A EE 18 Screen messages andi Help T E R 19 Solare Uap AAU sieneen aa ea Ea ea a Sues E E E cases siden shes E E ENEA a Eede n EEE 19 A General SEDs 20 Dats and time ci anaa E E E TEE E A EE E EAE EE RA 20 Display seting Sirsi rer ET EE NNE E rT E E TE EA E EREE EEEE NE SEERA EESE AERE RNE Res 20 Savine TESE C riea E E AAE EE EEEE EEE EENET TEENE O E E E E EES 20 sanis a i O AE EE EEA TE EEA EE T E E E N E EE 22 Networking requirements C ri ea aa E NEE ASE ENE N ERRE AE i aa RENS 22 acd inean i a E E E E E OE NEE E ENE E ANEA ENE 22 REMIOUS OCURRE Rn 25 Changing the Remote Operation DOE a egere tie Ie entrer eee RU ges Hexe pe ea Sete Ue e ERRARE ke PERI as Re SEEN U E ee doce sii o Soa bag 25 NOAS iU m 26 Changing the NOAH Service port aee rh ee eee to eH E te re OB et uer eee NORD chuehaaecees 26 Testing the INO WE service part z on EH UBER HO IRR RERUREEEO E OE ERE A E A 27 SINGLE COMPULEL CONMECH OM TEM H 28 Automatie connection recommended ener t e rite rir t ree Toe cosas rante reduc rd Reed araoa ened 28
2. RECD RECD RECD coupling Earmold Age Adult Y Rule None Calibrate RECD transducer V gt J sre 65 Axiom User s Guide Version 1 10 November 2015 5 If a valid RECD transducer calibration exists go to RECD on ear response 6 If no transducer calibration exists or the measurement interval has been exceeded connect the RECD transducer to the HA 2 BTE coupler _ Coupler microphone BTE Coupler Tys TEN RECD Tra if nsducer N 7 Click on Calibrate and follow the setup instructions 8 Click on v to generate the coupler response curve green When this curve is stable click on v to save it 9 Click on Daily or Weekly to toggle the measurement interval for the coupler response 66 Axiom User s Guide Version 1 10 November 2015 Measure RECD Connect the RECD transducer to the RECD jack on the underside of the test chamber Prepare the system for on ear tests See Calibration of on ear probe microphone BO N RECD transducer foam tip Probe tub px Click on and select Speechmap from either the Test box or On ear menus Click on the RECD bar to access the RECD setup poster Click on the RECD list button and select Measure from the menu Select the RECD coupling method that will be used on the ear Audioscan software supports both foam earti
3. M 62 Fider show ors dele S isn oa aee ise Sara aeni rE A R e S Ta ESEA E E E E E ASE NEOR E EE AER E EEEn 62 14 On Ear Instrument MEASURES eee neose eE E e PO EO EEEE E EE EEEN Pene A AE aa 64 Orear manual control 5 rode eese a E e R EEN fes aaa Geis S 64 Sound level meter using on ear MICTOPNOMES snsc i N O NEEE EAEEREN 64 ede Die uu Sona snc e e aa a E EA E E S M rH 65 Calibration of RECD transducer aree et EE ENEE bn EE EENEI A EE E REEERE 65 Measure REC D iniciaran HEIN EE IE BT er EE E E eau a EAEAN A ASEE EEE eaa O Ld 69 RECD c eiieeii ia E EEE AST R E O EE E EEEE EE ETE E AA E EERE 70 ANSESSACOOLIIRECD roeines e toI UE Eae aaar Hie TEE Ea EAEE aA AEO RE 71 RECD protocols siccc5 est caasessissarss ch ascaceaieadasdusecnaendeaesaladectasdeauhedusneedsgehdaraueasqadieev us ccuassd sans anadededssaateaGesdeeverbanzubesbaca EA 71 RECD TRC EET 12 AG Insertiob E EORR E E E E T E RE bee 74 DS UO gain MINS d Es 74 Iriserttom gaim n Bee id er icr rer ret beet ett e EH C EE Ie sve to EUH PEEL ERO EV REESE TESORO de OYS VER UI CHEESE G 75 Audiometrie data SM UY EE H M 13 REUR measurement procedure 5 1 nr rei Potente eet Rete Tec e ree ENTE EA TERR LM TER IHE RR ERE Ve E 76 REAR Measurement ertue coin M TI SIbcaleulation tn Insert gaisein oraret se n eret eee teats erre eere Pee Pe ve E te tepore tob Pen ER Eee PE pee pet tex
4. This symbol on the product is a WARNING that failure to follow instructions in this part of the User s and or Quick Start Guides could place the operator or patient at risk Failure to follow the operating instructions for connecting to a network a local printer a keyboard or an external monitor could place the operator at risk Failure to follow the operating instructions for connecting the monitor headphones the mouse or the Audioscan update stick could place the operator at risk This symbol on the product is a WARNING describing a required action The Axiom power supply can only be connected to the mains using the supplied power cord eeooobP PP PPP PbPbE This symbol on the product means that the parts applied to the patient meet the safety requirements of IEC 60601 1 for type BF isolated floating applied parts Axiom User s Guide Version 1 10 November 2015 Environmental safety K This symbol on the product means that this product is not to be disposed of in unsorted municipal waste EH because electrical and electronic waste may contain hazardous substances which could endanger the environment and human health This product and its associated items must be disposed of in accordance with local disposal regulations for electrical and electronic waste Consult your local waste disposal authority regarding applicable regulations The microphone probe tubes and the foam earti
5. Loss simulator c Example of user supplied files user wav user 4 wav and user 42 5 wav 88 Axiom User s Guide Version 1 10 November 2015 18 Speechmap Fitting Procedures The Speechmap fitting screen provides a number of choices for inputing and applying audiometric data for the verification of hearing instrument fittings The procedures in this section assume a familiarity with Test Box Measures Setup On Ear Measures Setup On Ear Measures Screen Setup and Speechmap Speechmap screen choices Speechmap choices are accessed by clicking on Audiometry RECD Verification or Targets which will cause a related selection poster to be presented Changes made on the poster are applied and the poster closed by clicking on v The poster may be closed without applying the changes by clicking X Defaults are the last used choices if test setup memory has been turned on See Saving test setup Audiometry RECD Transducer Headphone a RECD Enter Bone conduction NIA Ll Age Adult UCL Average Rule None Lx Jiv i JJ Lx L 1 L2 1 Transducer Sound source used to obtain the audiogram Select from Headphone Insert Foam or Soundfield If Headphone is selected average adult real ear to dial difference REDD is used to convert entered HL values to ear canal SPL If Insert Foam is selected the appropriate real ear to coupler difference RECD is
6. AGC tests ANSI 1996 Linear and AGC tests 5 Refer to Test Box Measures Setup Coupling the hearing instrument and Positioning the hearing instrument to prepare the instrument for testing Click then click Linear or AGC on the Test box menu Click Start test and follow the test setup instructions which are presented Turn the instrument ON O 9 AD Set the gain control manual or programmable to maximum with all other controls set to provide the widest frequency response greatest gain and highest maximum output AGC controls and or programmable parameters should be set as designated by the manufacturer 10 Click to run the test or to abort the test Note that if required the Axiom will pause during the test to request that the volume control be adjusted to the Reference Test Position RTP Open the test box if necessary and without moving the hearing instrument adjust the user gain control until the large vertical arrow on the screen prompt disappears Click to resume the test If you are unsure which test sequence to run try AGC first If attack and release times are all near zero the instrument is probably linear ANSI 2003 Linear and AGC tests 1 Refer to Test Box Measures Setup Coupling the hearing instrument and Positioning the hearing instrument to prepare the instrument for testing Click then click Linear or AGC on the Test box menu Click Start test and follow the test setup instruct
7. November 2015 Alternate method 2 RECD On ear measurement Audioscan RECD transducer foam eartip Test box Speechmap coupling HA 2 BTE coupler Since the RECD here is measured with a foam eartip an average earmold is added to obtain an HA 2 RECD with earmold effects The error involved will be the difference between the actual earmold and the average used Alternate method 3 RECD On ear measurement Audioscan RECD transducer client s personal earmold Test box Speechmap coupling client s personal earmold HA 1 ITE coupler An average earmold will be subtracted from the measured RECD to obtain an HA 1 RECD without earmold effects The actual earmold will be introduced during test box simulation but error will exist equal to the difference between the earmold measured on the RECD transducer and the average earmold that was subtracted RECD facts Individual RECD values are derived by comparing the SPL produced by a sound source in the closed ear canal to that produced by the same sound source in a 2cc coupler It is commonly assumed that the RECD so measured is a property of the individual ear and is independent of the sound source used to obtain it making it useful for converting HL threshold and UCL obtained using insert phones to SPL values and for simulating real ear measurements from 2cc coupler measures However this assumption is true only if the acoustic impedance of the sound source is significantly higher than t
8. Threshold data and other audiometric parameters may be entered by scanning the barcode s on a previous Audioscan printout or manually using a mouse or an external keyboard See Mouse keyboard barcode scanner and Input device operation To enter data from a barcode see Barcode data input and 1 Press the barcode trigger and center the red line on each barcode from a distance of 6 8 in 15 20 cm The scanner will beep and the Barcode Entry poster will open A green check mark indicates which data have been entered It does not matter in which order the barcodes are scanned or if each is scanned more than once 2 Click on Done to accept the data checked on the poster To enter audiometric data manually 1 On the Threshold UCL or RECD entry screens enter each data point using a mouse or an external keyboard Left click the mouse to enter a point Click again to delete the point On the keyboard the arrow keys change frequency and level and the ENTER key on the numeric keypad enters or deletes a point The keyboard s numeric keypad can also be used to type in data 2 Click on to save the data and exit the entry screen Click on X _ to exit the entry screen without saving the data Fitting to targets for soft speech See Speechmap screen choices for setup and audiometric data entry See Using Speechmap 1 Follow the instructions in Speechmap screen choices to enter audiometric data and select the fitting rule 2
9. To enable disable saving of test levels stimuli and assessment parameters 1 Left click on X 20 Axiom User s Guide Version 1 10 November 2015 2 Left click on Save option on the Setup menu 3 Left click on the Yes No windows to enable disable the save options indicated 4 To exit the Setup menu left click on 21 Axiom User s Guide Version 1 10 November 2015 5 Networking Connection to a computer network allows screen images to be printed on a network printer or on a shared printer on a networked PC Images and underlying data may also be saved to a shared folder on a networked PC See Printing and Storing Results for details The Axiom may also be connected to a single computer using a network router switch or hub Note that sharing data with NOAH is done over this network connection e Failure to follow operating instructions could place the user or operator at risk Networking requirements Connection of the Axiom to a wired computer network LAN requires a Cat 5 RJ 45 cable Connection of the Axiom to a wireless computer network WLAN requires the optional Audioscan Axiom WiFi Adapter part AX 100 Connection speeds will be determined by the type of wireless connection provided and distance from the wireless router The standard 802 11a b g or n wireless networks can be connected to the Axiom The current supported forms of wireless encryption net
10. 60 50 gt 0 ed De DE RT 250 500 1000 2000 4000 8000 The Average REUR used is shown above Measured REUR will vary from this For small children the peak may shift to the right and become sharper Drainage tubes and perforated ear drums will cause large differences usually around 1 kHz REAR measurement procedure 1 9 Click on E and then click on Insertion gain in the On ear menu Referring to On Ear Measures Setup and On Ear Measures Screen Setup prepare the system position the patient and insert the probe tube For tight fitting hearing aids or earmolds the probe tube may be inserted through a vent Without disturbing the probe tube insert the hearing instrument or earmold Referring to Audiometric data entry enter threshold data Click on button 1 2 or 3 in the REAR REIG column This will present a signal from the sound field speaker and display the REAR Setup box Click on the Stimulus button then select either Pink noise or Swept Use pink noise when using the NAL NL fitting formula Use Swept when testing maximum output capabilities Click on the Level button then select a stimulus level from the list box Use the level shown on the target REIG curves if present If no level is shown use the lowest level required to overcome background noise Adjust the hearing instrument so that the REIG curve SPL scale or Aided threshold curve HL scale approximates the dotted target curve
11. 7 Click v to apply your settings Change network address IP Address Netmask Gateway 172 30 w 1 v2 v 255 7 255 w 255 w 0 w 172w 30 w 1 w 1 MAC Address 00 05 67 02 04 00 7 Click on the Test button to check that a connection has been established Change network address IP Address Network Broadcast Netmask vem wi m2 ze wi mo m 172 wi mess 255 ess e 255 0 ivi Test 29 Axiom User s Guide Version 1 10 November 2015 7 Printing and Storing Results The Axiom can print results for future reference as well as store results in computer files for future use Using a web browser you can capture the Axiom s screen image for printing or saving on any computer The Axiom can also store audiometric data and test results in the optional Audioscan NOAH Module Printed output includes the graphical screen image that is showing when you select Print Printed output can optionally include tabular results text notes and printed guidelines for handwritten notes The Printing Setup controls which of these optional components are included in the output as well as whether output is sent to a printer or saved in a file With the Axiom connected to a network you can capture the Axiom screen image through your computer s web browser You can then print or save the screen image using the computer s printer or file system The A
12. For these stimuli the indicat ed level is for the unfiltered Speech std 1 passage and the band levels in all unattenuated bands are the band levels present in the Speech std 1 passage at that level These three signals may be used to deter mine the amount of frequency shift provided by fre quency lowering hearing aids and the sensation level of the lowered components of the speech signal The female and child signals are presented as re corded without any processing and have been cho sen to provide a range of spectra The ISTS was developed under the European Hearing Instrument Manufacturers Association EHIMA which holds the copyright The sound file is available free of charge from the EHIMA website The ISTS consists of 500 ms segments from recordings of 6 female talk ers reading the same passage in American English Arabic Chinese French German and Spanish These segments have been spliced together with appropri ate pauses and filtered to match the average female spectrum from Byrne et al An international compari son of long term average speech spectra J Acoust Soc Am 96 1994 2108 2120 For more details con sult the EHIMA website www ehima com The ICRA distorted speech signal is a recording of an English speaking talker that has been digitally modi fied to make the speech largely unintelligible The resultant signal has many of the properties of real speech but has a harsh sound and lacks harmonic
13. The two Speech std signals are by the same male talker filtered to provide the long term average speech spectrum LTASS recommended by Cox amp Moore 1988 for average vocal effort This is the LTASS assumed in the Desired Sensation Level DSL method of hearing aid fitting In addition one of these passages the Carrots passage has been filtered to suppress the 1 3 octave bands above 1 kHz by 30 dB with the exception of a 1 3 octave band at 4 kHz Speech4000 a band at 5kHz Speech5000 and a band at 6 3 kHz Speech6300 These latter three signals may be used to determine the amount of frequency shift provided by frequency lowering hearing aids and the sensation level of the lowered components of the speech signal The ICRA noise female and child speech signals are presented as recorded with no spectral shaping The ISTS consists of 500 ms segments from recordings of 6 female talkers reading the same passage in American English Arabic Chinese French German and Spanish These segments have been spliced together with appropriate pauses and filtered to match the average female spectrum from Byrne et al An international comparison of long term average speech spectra J Acoust Soc Am 96 1994 2108 2120 The 15 second version of this signal has been provided Live speech may also be used As a result of reanalysis of published data the previous distinction between soft and average vocal effort has been eliminated Consequently t
14. 1 ANSI S3 22 1996 and 2003 tests available absent ea tedzh a Sese vesperi tee e ices Frequency Response ERN Frequency Range E Maximum OSPL90 UE Harmonic Distortion E A o AIME pd Attack amp Release time M Equivalent Input Noise H erecta Coupler SPL Other tests Available scade Speechmap real speech audibility measures Manual measurement of output gain and distortion On Ear Speakers end 1 5 25 x3 75 x3 75 Probe microphone tube Silicone 1 0 mm diameter x 75 mm Probe microphone noise floor 200 8000 Hz 45 dB SPL Frequency Range 200 to 8000 Hz Test Stimuli sese tone tone burst IE pink noise calibrated or live speech Freq modulation sawtooth 3 over 128 ms Stimulus levels for tones 40 85 dB SPL in 5 dB steps Test stimulus accuracy at reference mic for tones 2000 8000 Hz seen 3 dB SPL Equalization Method pressure method ERE Rives tite ene stored for open fittings Frequencies per octave swept tones 12 Frequencies per octave tone burst 3 Analysis bandwidth speech noise 1 3 octave Measurement accuracy at 1 KHz 1 dB Measurement accuracy re 1 KHZ E E PE A E A T 1 5 dB 200 5000 Hz a Ee EN 2 5 dB 5000 8000Hz Measurement Range 30 135 dB SPL 200 2500 Hz CE 30 1
15. 2ab 1 xml Consequently Client IDs starting with numbers appear at the top of the list followed by those that start with uppercase letters followed by those that start with lowercase letters Be consistent to avoid duplicate entries for example use all UPPERCASE in your Client IDs The Axiom prevents you from entering the following characters in session file names I RA amp 4 7 lt gt 40 Axiom User s Guide Version 1 10 November 2015 8 Test Box Measures Setup For linear and AGC tests two completely separate sets of test results labeled A and B may be retained and displayed To switch between A and B test results click on AlB The appearance of these test box measures screens can also be changed to show results in either graphical or tabular format To change the data format click on the Format button Test box screen For most tests two completely separate sets of test results labeled A and B may be retained and displayed To switch between A and B test results press the lt Left Right gt key ANSI 3 22 2003 AGC audioscan 130 Format Graph Scale dB SPL Start test 120 Gain control full on OSPLSO curve 110 Max OSPL90 dB 125 9 1120 Hz Average OSPLSO 120 dB Average gain 50dB 49 dB 100 Gain control at RTS Response curve 60dB Average gain 60dB 43 dB 90 EE od ar MES 2 Frequency range 200 5600 Hz ge 1 Battery drain 1 28 m 4 Equival
16. Hz Figure 14 Level of 30th percentile for Speechmap speech signals at average vocal effort Dynamic Range 99th 30th ile for Speech Signals Average Effort Hanning window 128 ms average 35 00 DYNAMIC RANGE dB 8 8 DYNAMIC RANGE STANDARD 500 9 DYNAMIC RANGE FEMALE DYNAMIC RANGE CHILD X CYNAMIC RANGE ICRA DYNAMIC RANGE ISTS 000 200 25 315 400 500 630 800 1000 1250 1600 2000 2500 3150 4000 5000 6300 8000 BAND CENTER FREQUENCY Hz Figure 15 Dynamic range of Verifit speech signals at average vocal effort 09 01 29 Etymonic Design Incorporated 20 Ludwig St Dorchester ON Canada NOL 1G4 USA 800 265 2093 519 268 3313 FAX 519 268 3256 www audioscan com 12
17. MPO Maximum Power Output the maximum SPL that a hearing aid can deliver in response to a steady narrow band input The stimulus may be pulsed a tone burst to avoid discomfort and to approximate an aided UCL measurement stimulus Modulation the process of varying a characteristic of one signal with another NAL National Acoustic Laboratories Australia NCA National Centre for Audiology Canada Nonlinear Region that portion of the input output function which is not a straight line at 45 degrees OSPL90 output SPL for 90 dB input SPL The SPL developed in a 2cc coupler when the input SPL is 90 dB with the gain control of the hearing aid full on ANSI 3 22 Oscillation in audiology refers to the undesired tonal output of an amplifier behaving unstably as a result of feedback whistling 1 Output Compression a form of AGC in which the signal level is regulated at the output OLC Output limiting Compression compression limiting a form of AGC with a high kneepoint and high compression ratio PC Peak clipping a method of limiting MPO by truncating the electrical signal supplied to the output transducer The resulting acoustic signal may not be truncated but will be distorted PCR Power Concentration Ratio a measure of the degree to which a large amount of power is concentrated at a small number of frequencies in the output of a hearing aid Probe microphone microphone which may include an extension tube having a sound
18. Specification for Audiometers 1996 ANSI S3 22 Specification of Hearing Aid Characteristics revised 2003 ANSI S3 46 Methods of Measurement of Real Ear Performance Characteristics of Hearing Aids 1997 114 Axiom User s Guide Version 1 10 November 2015 23 References AAA Clinical Practice Guidelines Remote Microphone Hearing Assistance Technologies for Children and Youth Birth 21 Years Supplement A Fitting and Verification Procedures for Ear level FM Draft 2007 American National Standards Institute 1997 American National Standard Methods of Measurement of Real Ear Performance Characteristics of Hearing Aids ANSI S3 46 1997 New York American National Standards Institute American National Standards Institute 1996 American National Standard Specification of Hearing Aid Characteristics ANSI S3 22 1996 New York American National Standards Institute Bagatto M Moodie S T Scollie S Seewald R Moodie K S Pumford J amp Liu R 2005 Clinical protocols for hearing instrument fitting in the desired sensation level method Trends in Amplification 9 4 199 226 Bentler R A amp Pavlovic C V 1989 Transfer functions and correction factors used in hearing aid evaluation and research Ear and Hearing 10 10 58 63 Byrne D 1977 The speech spectrum Some aspects of its significance for hearing aid selection and evaluation British Journal of Audiology 11 40 46 Cole W A a
19. While the passage is being presented adjust the hearing instrument s frequency shaping and gain for average sounds so that the middle curve the LTASS falls within the target range shown by the i symbols especially between 500 4000 Hz These target symbols are automatically adjusted for the stimulus level you select 5 Click on to signal average and store a complete passage Repeat as necessary 6 Click on m to stop the test without recording any test data T in pi DART WD SPL threshold Audiometry Headphone UCL Average Bone N RECD Average Age Adult Loss simulator Verification Mode Test box Fitting BTE Targets Rule DSL adult Type Monaural Hide Show aided curves Upon completion of a test recording a colored Aided Audibar beside the gt shows the SII for the aided soft speech signal The difference between the unaided and aided SII score and the associated length of their respective Audibars visually quantifies the speech intelligibility improvement for soft speech likely provided by the hearing instrument being fit To further demonstrate the improvement the unaided speech banana may be displayed by clicking beside the Unaided Audibar 92 Axiom User s Guide Version 1 10 November 2015 Adjusting the Maximum Output Level See Speechmap screen choices for setup and audiometric data entry See Using Speechmap 1 Follow the instructions in Speechmap scree
20. Z Distortion Crosstalk Z Initialize Function Initializing your Audioscan unit will reset it to default factory settings This erases the user preference files stored in internal memory Any custom printer choice network settings test setups will need to be re entered and the user calibrations will also be required 1 To initialize click on Setup then click on Self test 2 Click on Initilize Unit will automatically restart 101 Axiom User s Guide Version 1 10 November 2015 Test box high distortion or noise High distortion and or noise numbers in an ANSI test There may be a leak between the hearing instrument under test and the coupler it is connected to For BTE type instruments check the integrity of the 13 tubing at the end of the coupler where it joins with the ear hook Look for cracks ITE type instruments need to have a good seal between the hearing instrument and the coupler In addition all vents need to be closed from the faceplate side of the hearing instrument Ambient room noise may be leaking into the test chamber Air conditioners computer fans and similar noisemakers can yield artificially high noise figures Check the sealing of the test chamber Try turning off suspected noise sources to identify the cause Vibration may be coupled into the test chamber from other equipment on the same table or wooden floor Computers fans and air conditioners may be the source of the vibration Try t
21. default values for children 1 month to 10 years and adults The UWO child s spectrum has been removed and an own voice spectrum has been added As a result of a re analysis of published data the vocal effort effects for Soft and Average speech levels have been made the same In addition the target symbol has been elongated to indicate that the fit to target is a range not a point The children s LTASSa targets for 70 dB speech are lower than those in previous versions of DSL These differences are functions of the hearing loss and age where average RECDs are used Revisions made in version 5 0a reduce these differences at 250 Hz and for more severe losses The differences will be more significant when the individual RECD values have not been measured for the child being fitted Audioscan assumes no responsibility for the validity of these changes that responsibility rests with the National Centre for Audiology NAL NL1 in Speechmap The NAL NLI procedure seeks to amplify speech such that all bands of speech are perceived with equal loudness while maximizing speech intelligibility and ensuring that the wearer perceives speech to be no louder than that which a normal hearing person would perceive Although NAL NLI states its goals for speech it derives insertion gain targets assuming noise as a verification signal Because it is more accurate to verify a non linear fitting using the signal for which the procedure was developed Audioscan conve
22. j 4 Own FM FM Hz Standard ISTS Female Child Noise Noise Voice Chest Boom 200 56 8 57 0 54 9 32 3 52 9 53 2 2 5 9 0 19 2 250 56 0 57 0 53 1 51 5 55 9 53 3 3 10 7 12 0 22 2 315 53 0 53 8 48 4 57 3 56 9 53 9 6 11 0 16 6 26 0 400 57 0 57 4 55 8 54 1 57 5 53 6 1 10 0 13 3 22 8 500 58 0 57 4 57 3 53 2 57 8 53 7 7 10 1 13 2 25 3 630 55 0 56 4 58 1 61 2 54 3 53 12 4 10 5 21 0 29 1 800 52 5 53 7 54 6 56 5 52 8 53 14 4 10 8 26 4 32 1 1000 51 0 50 0 52 0 52 7 50 4 53 15 0 10 5 26 4 32 7 1250 50 5 48 0 51 0 45 4 51 3 53 14 8 5 5 22 0 33 6 1600 48 0 47 4 51 1 41 1 48 5 53 15 5 4 0 22 1 33 9 2000 45 0 44 9 51 2 39 7 47 0 53 16 2 6 0 21 0 33 0 2500 44 0 42 8 49 3 35 5 44 7 53 14 8 6 0 18 2 31 9 3150 42 5 42 7 46 0 28 8 43 3 53 14 5 2 0 14 4 30 4 4000 42 0 41 0 40 0 31 2 41 1 53 13 2 0 5 11 8 29 0 5000 40 0 40 3 36 1 30 6 39 6 53 9 2 1 0 12 4 27 8 6300 41 5 41 3 43 5 32 6 33 5 53 4 2 0 0 11 4 26 2 8000 41 5 40 4 39 9 35 2 28 2 53 2 7 4 0 11 0 25 8 Overall 65 0 65 0 65 0 65 0 65 0 65 75 0 75 0 84 0 93 0 Microphone location effects Microphone Location Effects Deep insertion Add to all stimuli in test box mode Add to Est Canal SPL Hearing instrument type Frequency BTE ITE ITC CIC BODY CIC 200 0 5 0 3 0 0 0 9 3 0 1 9 250 0 5 0 5 0 3 0 8 3 0 1 9 315 0 8 0 8 0 3 0 7 3 0 2 6 400 1 1 1 0 0 7 0 5 3 0 3 3 500 1 2 1 8 0 0 0 4 4 0 4 0 630 1 1 2 0 0 1 0 4 3 0 4 6 800 0 9 2 0 0 4 0 4 2 0 5 2 1000 0 3 1 5 1 2 0 6 0 0 5 8
23. sjristereonIJoi Mr 28 T Phnt ng and Stocing Results crisisen roh REF PI ERR EO HE d ei UE PER ERE PES SENE E RD ea 30 Storing data in NOAH m 30 urbs M oelaes 30 lus E 30 Printer COMME GU OM MEE 31 Printet TY PES D EEEE RENES 31 BE DEBE nie ea e re TUER E E EST EUR EEEE SE GERE EE OPER EH RETI CEU SERRE E tests EET PUER NND Oye 32 Custom PUUE ST ee ee 32 FileiDULpHL einen en eicere EU Ep D o RED IIo ERR ER ERE Es 33 ruso T DN 33 Windows shadred printers and TOG SIS eo den e teret riter ae n repe IT YE EI downto EES 35 end duci X 37 Web browser screen Caput eninin en coe E eee ue eee IS EE ERIS ERE E SCENES aE O E PER LESE NEAR GR CERES EE ERES Tn 37 SESSIOH SOUU Ps cos ceavezecs rentis ete pde leid vene ERE E PERDE RYE Reel EIER FERNER ER ESO LEER RE FIER e ede Eee EROR E 38 DIOENIE ANG Testurimp SESSIOM TIIGR cs coss dern eee ecrire re ever rip epe tte ve ke ei teer te pev oA USED YER beets 38 6 Test Box Measures Setup eerie turre erret ee eee Pet rete eio Pee eep e nte i ster ties pe eripe ea teb ovre E eces toe ea oE eui ro ceret eres mind aE 41 Test DOR SUTEEI isien renns in a EE
24. 1 10 November 2015 ANSI test results In 1996 tests Full on average gain is measured at 50 dB SPL average gain at RTP is usually but not always measured at 60 dB SPL and the frequency response is run at 60 dB SPL for linear aids or at 50 dB SPL for AGC aids In 2003 tests Full on average gain 1 is measured with a 50 dB input SPL average gain at RTS 2 is always measured at 60 dB input SPL and the frequency response curve 3 is always run at 60 dB input SPL 50 Axiom User s Guide Version 1 10 November 2015 10 Other Test Box Measures In addition to the tests of ANSI 3 22 the Axiom also provides the following tests in the test box Manual control Coupler and test box reference mic SPL and coupler mic distortion at selected 1 12th octave frequencies and stimulus SPL of 0 and 40 90 dB in 5 dB steps Can be used as a dual channel sound level meter with 1 12th octave A and C filters Multicurve procedure Multicurve generates 1 to 4 output or gain response curves using either pink noise or swept pure tones at input levels ranging from 40 90 dB SPL and 0 dB off Click then click Multicurve from the Test box column Refer to Coupling the hearing instrument Positioning the hearing instrument use and care to prepare the instrument for testing Turn the instrument ON Click on button 1 2 3 or 4 in the Test column Select the Stimulus window then either Pink noise or Swept from the dr
25. 10 November 2015 12 On Ear Measures Setup For accurate repeatable measurements the Axiom must be properly set up and calibrated the client must be properly positioned and the probe tube must be properly positioned in the ear canal Some common terms Real Ear Unaided Response REUR SPL or band SPL in the open unaided ear canal for a given stimulus Real Ear Unaided Gain REUG Difference in dB between the REUR and the stimulus SPL or stimulus band SPL Real Ear Aided Response REAR SPL or band SPL in the ear canal for a given stimulus with a working hearing aid in place Real Ear Aided Gain REAG Difference in dB between the REAR and the stimulus SPL or stimulus band SPL Real Ear Saturation Response RESR The REAR obtained using a narrow band signal at a level high enough to saturate the hearing aid usually 85 90 dB SPL Real Ear to Coupler Difference RECD Difference in dB between the SPL produced in the ear canal and the SPL produced in a coupler by the same sound source On ear calibration facts The probe microphone and its associated tubing does not have a flat frequency response The on ear calibration process compares this response with the flat factory calibrated response of the on ear reference microphone and compensates all subsequent probe tube measurements for this difference It may be performed as often as desired but will be invalidated at 12 am the following day or at 12 am the
26. 1000 2000 4000 Upon completion of a test recording a colored Aided Audibar beside the gt shows the SII for the aided soft speech signal The difference between the unaided and aided SII score and the associated length of their respective Audibars visually quantifies the speech intelligibility improvement for soft speech likely provided by the hearing instrument being fit To further demonstrate the improvement the unaided speech banana may be displayed by clicking beside the Unaided Audibar Fitting to targets for average speech See Speechmap screen choices for setup and audiometric data entry See Using Speechmap 1 Follow the instructions in Speechmap screen choices to enter audiometric data and select the fitting rule 91 Axiom User s Guide Version 1 10 November 2015 2 Click on 2 to select the second Speechmap test The Test 2 box is outlined to indicate it is active 3 Click on A to start this test Once the test is started click on the Stimulus list button to select the stimulus type as Speech std 1 Speech std 2 or Speech ISTS Click on the Level list button and select a stimulus level of 65 dB The bar beside the 9 shows the SII for the unaided stimulus at 65 dB SPL the Unaided Audibar When you start a new test the speech envelope of the previous test may be automatically hidden See Speechmap Setup to change this behaviour To change the default stimulus type and level see Saving test setup 4
27. Axiom to be used as a sound level meter Sound at the test box reference microphone and the coupler microphone may be analyzed by 1 12th octave A weighted or C weighted filters A and C weighted measurements are limited to frequencies above 100 Hz and the averaging time and update rate are 384 ms 1 Click on and select Manual control in the Test box menu Click on the Level button and select 0 dB stimulus level from the drop down list Click on the Filter button and select 1 12th octave A weighted or C weighted from the drop down list mo ero c9 For 1 12th octave filter click on the Frequency button and select the desired frequency from the drop down list 5 Click on the Start test bar to start the test Start test changes to Stop Test To stop the measurement click on Stop test You may change Level and Frequency without stopping the test 53 Axiom User s Guide Version 1 10 November 2015 Level 75 iv dB Frequency 450 v Hz Start test Distortion 15 0 96 Se Sa a ud 0 10 20 30 40 50 60 70 80 90 100 Coupler microphone 102 5 dB ee aR PL FR DL 0 10 20 30 40 50 60 70 80 90 100110120130 Reference microphone 75 0 dB S SISSE SITES CDI 0 10 20 30 40 50 60 70 80 30 100110120130 Gain 27 5 dB Gye a uem a a 0 10 20 30 40 50 60 70 80 90 100 NOTE Microphone extension cables VA 131 amp VA 133 are available from Audioscan Standard audio e
28. EEE EE NEIRE EE A EE ives E EE AEE N E E EE E 41 lusu aE E E R EIE E Aa E A RS 41 CAS E E E E E E 42 Per SHOW test BOK COVES e 42 Axiom User s Guide Version 1 10 November 2015 ANSI test frequencies e ee e e PR HR Ee EHE Ene FE EYES REV ERREUR MERE cha e aaa EERE E EES aE RESETS 42 Test Dox calibtation LACt sc rr t 43 Calibrating test bak reference MiCrOphOne ocio ete rete rne e e etre etre aree rit ruer eto cto dee RUP EFI Eee ESES 44 Calibration check Tot coupler anierophliopi amp 32 bro de decetero teet eed Pa dnte ee dete Elea desea ed 44 Coupling the hearing instrament TOF ANSI tests inre eric eren eiit eere ee S SaN o a E A S oE S 45 Coupling th hearing instrament for Test box Speechmap 1 ertet teeth torti ere enean e e seessencsanuepnaseeassctesscatend 46 POSIMOMING The hearing ETIQUETA Rm 46 9 AINSI Hearns Ald Vests E ERRES 48 ANSIS322 0996 POS aU REUNIR EIU peas eas eset ad Sl lp eR eee ELEM UR HH 48 ANSI 53 2222003 FAG tS ence ecee dh spc Reto thes aula event esos oh Edi es tea tosal vole isles Oa ae E REE Sr tatters EI aene 48 ANST 1996 Lincar and AGC 8SEs eii iedrosr ptt Dre rre terreat erts Te EHE E SERITUR FU E ai 49 ANSI 2003 Linearand AGC Eests te ts ncivs tert etre Leer errant re eh Peer HE ep cete Lese bee pa eiue cse mn rave 49 WIN EE 50 10 Other Test Box Measutes D 51 INTUPI C
29. If a hearing aid meets certain conditions the manufacturer may choose other averaging frequencies called Special Purpose Average SPA frequencies The current averaging frequencies are indicated explicitly on test results where space permits and also appear as tick marks on the frequency axis of graphs To change the averaging frequencies see ANSI test frequencies This standard also requires some tests with the gain control full on and some with the gain control in the Reference Test Position RTP This requirement applies to both Linear and AGC aids that have a HFA or SPA full on gain greater than the HFA or SPA OSPL90 minus 77 dB Otherwise the RTP is full on If required the Axiom will pause in its testing and guide you in setting the gain control to the RTP All other controls on the hearing instrument should be set to provide the widest frequency response the greatest gain and the highest maximum output AGC controls and or programmable parameters should be set as designated by the manufacturer At full on gain the Linear and AGC test sequences provide a curve of OSPL90 Output Sound Pressure Level for a 90 dB input SPL the HFA or SPA and peak value of this curve the frequency of the peak and the HFA or SPA gain for a 50 dB input SPL With the gain control at RTP these sequences also provide a frequency response curve with an input SPL of 60 dB Linear or 50 dB AGC the HFA or SPA gain for a 60 dB input SPL the frequen
30. Operation application communicates with the Axiom through the Remote Operation network service The Axiom provides the Remote Operation service on a TCP port The Windows computer running the module must be configured to access the same TCP port which is 5900 by default Some Windows anti virus software packages and some network firewalls prevent access to specific ports including 5900 Using the Remote Operation application in the presence of such security settings may necessitate changing the Remote Operation service port 1 Press lt Change gt next to the Remote Operation port 2 Select the appropriate five digits to enter the desired port number entering the same port as the Product web service typically port 80 25 The software will prevent you from Axiom User s Guide Version 1 10 November 2015 Change Remote Service o lS Silo Silo mi o i Port 5900 Ex EV NOAH Service Port Consult your Network Administrator before changing the NOAH service port Changing the port successfully requires understanding the security polices on your Windows PC and computer network The Audioscan NOAH Module communicates with the Axiom through the NOAH network service The Axiom provides the NOAH service on a TCP port The Windows computer running the module must be configured to access the same TCP port which is 8080 by default Some Windows anti virus software packages and some network firewalls prevent access to
31. Review Test 2 Hide Show Speechists Unaided Unaided SII Hide Show SIRRA Aided sii a MPO 28 500 1000 2000 4000 8000 On ear or Test box mode The Speechmap environment provides two hearing instrument verification options On ear Speechmap and Test box Speechmap Using Speechmap in the On ear menu the stimulus is controlled by the on ear reference microphone below the ear and SPL in the ear canal is measured by the probe microphone Using Speechmap in the Test box menu levels measured in the 2cc coupler are converted to estimated ear canal levels using the RECD values age appropriate average entered or measured In addition the stimulus delivered to the hearing instrument microphone is modified to include average microphone location effects for the hearing instrument type indicated The screen display for both modes is the same showing SPL measured or simulated in the ear canal For On ear Speechmap Click and select Speechmap in the On ear menu For Test box Speechmap Click and select Speechmap in the Test box menu Review Calibrating test box reference microphone Coupling the hearing instrument Positioning the hearing instrument It is suggested that hearing instruments be preset in test box mode with fine tuning done in on ear mode Note that on ear mode should be used for vented or open fittings Vent effects depend on the vent the ear and the hearing aid settings and cannot be
32. Screen tour amp Speechmap Fitting Procedures Speechmap Setup Speechmap provides a number of different test stimuli for fitting hearing aids and testing various aspects of their performance Each time you run a test you have the opportunity to select the stimulus from a list You can manage which stimuli appear on this list by doing the following Click and click on Speechmap in the Setup menu Setup Speechmap Hide speech envelopes automatically E Choose Speechmap stimuli MPO J Speech female Speech std 1 Speech child Speech std 2 Speechdive SpeechISTS 7 Speech3150 Speech4ooo 7 Speech5000 Speech6300 V ICRA noise Pink noise V The available Speechmap stimuli are in two columns The left hand column contains the MPO stimulus and speech stimuli that have the specific Long Term Average Speech Spectrum LTASS required when matching prescription fitting targets such as DSL or NAL NL1 The MPO stimulus used to verify that the maximum output SPL of the hearing aid does not exceed the uncomfortable level is always selected You must select at least one of the defined LTASS speech stimuli 1 To select a stimulus click the stimulus you want to add to the list A check mark will be placed next to the selected stimulus 81 Axiom User s Guide Version 1 10 November 2015 2 To remove a
33. You can enter the session file name using an attached keyboard If the data originate from measurements with a client then name the session file after the client that is using a unique Client ID The Axiom will automatically append an increasing number to ensure that the file names are unique and grouped by Client ID Since uppercase and lowercase letters are distinct you should consistently use one or the other e g all UPPERCASE thereby avoiding the frustration of creating multiple Client IDs for the same client If you do not enter a file name the Axiom will use session xml DOE JOHN 1 xml DOE JOHN 2 xml1 DOE JOHN 3 xml session 1 xml session 2 xml session 3 xml NOTE If a printout or session file identifies the printed or saved data as belonging to an individual it becomes Individually Identifiable Health Information and must be protected under the HIPAA Security Rule To store a session file 1 Click Session 2 Select Store session to file 3 Click the Client ID list button This will display a list of Client IDs with the first entry highlighted To add a new Client ID 1 Type the new Client ID The highlight will move to any matching Client IDs as you type then disappear once you have entered a unique one 2 When you finish typing the Client ID click on the Client ID button to keep your entry 3 Click v to store the current session data to the file in the Client ID window To add a sessi
34. analyzer intended to be used by hearing care professionals such as audiologists and hearing aid specialists to verify the electro acoustic performance of a hearing aid connected to a standard earphone coupler or while worn on the ear of the end user It consists of a an integrated acoustically treated test chamber which houses a loudspeaker a reference microphone for controlling the signal from the loudspeaker and a standardized earphone coupler connected to a measuring microphone for the purpose of measuring the sound level produced in the standard coupler by a hearing aid b signal generation measurement and control electronics c two real ear measurement microphone assemblies each housing a reference microphone for controlling the signal from the sound field speakers and a probe microphone connected to a thin silicone tube which may be inserted into the ear canal for the purpose of measuring the sound level in the ear canal produced by a hearing aid d a miniature earphone used to measure the real ear to coupler difference RECD useful in estimating the sound level produced in an individual ear from measurements in the standard earphone coupler There are 4 connectors for USB devices flash drives a QWERTY keyboard mouse printer barcode scanner a LAN port and connectors for the external power supply supplied external loudspeaker supplied and 2 connectors for external HDMI video monitors not supplied Electrical supply in
35. as well as your username and password credentials for the selected domain and server Note that wherever these instructions refer to domain you can substitute workgroup which on many small networks is simply called WORKGROUP Domain and Server In Printing Setup and Session Setup click on Details The Axiom will briefly confirm the network connection If the network connection fails the will Axiom present the Network setup details where you can correct any setup problems before trying again See the section Network Setup for details With a successful network connection the Axiom will automatically scan for the domains and servers available on your network Most networks have only one Windows domain which the Axiom will select automatically Windows shared folder Domain ETYMONICDESIGN Click here to select Computer ds teal ETYFILES Click here for your Windows login Login norman Change Folder CLIENTRECORDS M Windows Login Subfolder pediatric 1 zd Domain ETYMONICDESIGN Share WETYFILESICLIENTRECORDSIpediatri J d Password ee Test connection Windows shared folder setup Windows login If this is the first time that you have set up the Windows share then you will need to enter some details 1 Select the Domain if necessary many networks have only one 2 Select the Computer from the list of available computers 35 Axiom User s Guide Versi
36. between the SPL or BSPL at a specified measurement point in the ear canal and the SPL or BSPL at the field reference point for a specified sound field with the hearing aid in place and turned off ANSI S3 46 REOR Real Ear Occluded Response SPL or BSPL as a function of frequency at a specified measurement point in the ear canal for a specified sound field with the hearing aid in place and turned off ANSI 3 46 The 112 Axiom User s Guide Version 1 10 November 2015 REOR is used to evaluate the seal of an earmold It is not related to the required gain of a hearing aid REUG Real Ear Unaided Gain difference in dB as a function of frequency between the SPL or BSPL at a specified measurement point in the ear canal and the SPL or BSPL at a field reference point for a specified sound field with the ear unoccluded ANSI 3 46 REUR Real ear Unaided Response SPL or BSPL as a function of frequency at a specified measurement point in the ear canal for a specified sound field with the ear canal unoccluded ANSI 83 46 Reference microphone microphone used to measure the stimulus level in the measurement process or to control it in the equalization process Release Time the time required for HA output to fall to within 4dB of its steady state level for an input step from 90 to 55dB SPL ANSI 83 22 REM Real ear Measurement RTG Reference Test Gain the HFA gain for a 60 dB input SPL with the gai
37. can also be used to test behind the ear hearing aids with a custom earmold attached Aka the ITE coupler HA 2 Coupler a coupler having a volume of 2 cubic centimetres with access through a rigid tube When used for testing BTE hearing aids the rigid tube consists of 18 mm of 3 mm tubing plus 25 mm of 2 mm tubing ANSI 83 22 When used for calibrating insert earphones the 2 mm tubing is not used ANSI 583 6 Aka the BTE coupler Harmonic a component of a tone complex that is an integer multiple of the lowest frequency component fundamental Harmonic Distortion the addition of harmonic components to a signal The rms value of a harmonic component of a signal as a percentage of the rms value of the fundamental If less than 2096 the rms value of the total signal may be used instead of the fundamental HFA High Frequency Average the average of values in dB at 1000 1600 and 2500 Hz ANSI 83 22 HL Hearing Level the hearing threshold referenced to the threshold of normal hearing expressed in dB HI Hearing instrument Input Compression a form of AGC in which the signal level is regulated before the volume control Input Output function steady state single frequency plot of the coupler SPL on the ordinate as a function of input SPL on the abscissa with equal decibel scale divisions on each axis ANSI 3 22 ITE In The Ear hearing aid Kneepoint compression threshold the point on an input output curve at which the sl
38. checked stimulus from the list click the stimulus you want to remove You can also choose to have the envelopes of the speech test results automatically hidden leaving only the LTASS when you start another test Click the Hide speech envelopes button to toggle between automatically and manually When you have finished making your selections click to save your selections and exit 82 Axiom User s Guide Version 1 10 November 2015 Screen tour unaided screen Speechmap DSL 5 0a adult Max TM SPL 120 i See Setup Audiometry Verification i to change Headphone Mode On ear UCL Average Fitting BTE Estimated UCL NN dk Bone N A RECD Targets Average Rule DSL adult Age Adult Type Monaural Loss simulator SPL threshold l t Access Test 1 a m SpeechisTS Soto S fw 0 i Hide Show ___ A UID SII D 5 Normal SPL threshold i Access Test 3 83 Axiom User s Guide Version 1 10 November 2015 Screen tour aided screen SEPARO 5 0a adult audioscan 140 Audiometry Verification 130 l Moccia LEN Stimulus level Headphone Mode Test box 120 UCL Average Fitting BTE Bone NIA 110 k ox Fitting rule target f RECD Tames ll II Average Rule DSL adult Age Adult Type Monaural i A e pm uu l p ul M SpeechiSTS Sot isl a timulus type Stimulus level I ETE 8 et fil EL
39. down list RECD results The RECD measurement screen shows the response of the RECD transducer in the real ear pink and in the 2cc coupler green The difference between these curves is the RECD cyan The DSL 5 0 age appropriate average RECD is shown for reference dotted If the RECD curve deviates more than 10 dB from the average in the 4 6 kHz region check for proper probe placement and possible blockage of the tube by the foam tip or cerumen See RECD facts RECD coupler response RECD on ear response 250 904 Max TM SPL 120 3 Scale dB 80 7 Real ear response a 70 i i RECD xdcr cal 60 40 Coupler calibration Real ear 204 Measured RECD HA 1 RECD 500 1000 2000 4000 8000 Measure RECD Avg HA 1 RECD ANSI S3 46 2013 RECD The ANSI 83 46 2013 Real Ear standard advises RECD measurement protocols that make the RECD a property of the ear itself and independent of transducer or acoustic coupling To achieve this accuracy certain conditions must be met in both RECD measurement and Test box Speechmap coupling 68 Axiom User s Guide Version 1 10 November 2015 As earmold tubing effects are dependent on coupled sound source the ANSI protocol accounts for these by making the earmold part of the Speechmap testing in the test box BTE hearing aids are coupled to the HA 1 coupler through the client s personal earmold For similar reasons the on ea
40. facilitate this clip the probe module cable to clothing on the side opposite the test ear and draw the cable snug 5 Hold the front blue cord so that it passes behind the ear canal entrance and pass the end of the probe tube in 60 Axiom User s Guide Version 1 10 November 2015 front of the blue cord and into the ear canal 6 Carefully slide the probe tube into the ear canal until the marker ring approaches the intertragal notch Then let the front blue cord move forward to hold the probe tube in place Use an otoscope to verify that the tube is 2 to 5 mm from the eardrum Probe tube insertion The blue lanyard holds the tube in place and the depth marker is at the intertragal notch 61 Axiom User s Guide Version 1 10 November 2015 13 On Ear Measures Screen Setup To accommodate your working preferences the appearance of On ear measurement screens may be changed in several ways SPL or HL scale In Insertion gain tests you may view results in either dB HL or dB SPL Insertion gain tests view the hearing aid as improving the sound field threshold In Insertion gain the HL scale presents aided results as improved sound field thresholds while the speech region remains fixed To change the scale Click on the Scale toggle button to toggle between a dB SPL and dB HL scale Hide or show on ear curves Hide or show insertion gain curves To hide or show insertion gain curves displayed on the inserti
41. inlet which is small enough to be acoustically unobtrusive when inserted into the ear canal ANSI S3 46 Pure tone a signal containing one and only one frequency a sinusoidal acoustic signal 1 REAG Real Ear Aided Gain difference in dB as a function of frequency between the SPL or BSPL at a specified measurement point in the ear canal and the SPL or BSPL at the field reference point for a specified sound field with the hearing aid in place and turned on ANSI 83 46 REAR Real ear Aided Response the SPL or BSPL as a function of frequency at a specified measurement point in the ear canal for a specified sound field with the hearing aid in place and turned on ANSI 3 46 RECD Real Ear to Coupler Difference difference in dB as a function of frequency between the SPL or BSPL produced by an insert transducer at the eardrum and in a 2cc coupler HA 1 or HA 2 coupler should be specified REDD Real Ear to Dial Difference difference in dB as a function of frequency between the SPL or BSPL measured at the eardrum and the audiometer dial setting that produced it It is specific to the client headphone and audiometer used to generate it REIG Real Ear Insertion Gain difference in dB as a function of frequency between the REAG and the REUG taken with the same measurement point and the same sound field conditions REIG REAG REUG ANSI 3 46 REOG Real Ear Occluded Gain difference in dB as a function of frequency
42. media c Import export ePHI with other systems 4 Mechanisms used for the transmitting importing exporting of ePHI Can the device Display ePHI e g video display Generate hardcopy reports or images containing ePHI esses nennen nennen nennen nnn nnne nnn nnne _ Yes _ Retrieve ePHI from or record ePHI to removable media e g disk DVD CD ROM tape CF SD card memory stick _ Yes _ Transmit receive or import export ePHI via dedicated cable connection e g IEEE 1073 serial port USB FireWire _ No _ Transmit receive ePHI via a network connection e g LAN WAN VPN intranet Internet eS Yes_ Transmit receive ePHI via an integrated wireless connection e g WiFi Bluetooth infrared Yes 3 10 Other ADMINISTRATIVE SAFEGUARDS Yes No N A Note 5 Does manufacturer offer operator and technical support training or documentation on device security features Yes 4 6 What underlying operating system s including version number are used by the device custom build of Linux based on kernel 3 4 47 PHYSICAL SAFEGUARDS Yes No N A Note 7 Are all device components maintaining ePHI other than removable media physically secure i e cannot remove without tools _ Yes _ 8 Does the device have an integral data backup capability i e backup onto removable media such as tape disk cseceeesaeees No _ 9 Can the device boot from uncontrolled or removable me
43. setup applies to both printer and file output 33 Axiom User s Guide Version 1 10 November 2015 Date go Footer go Fil O Barcode Notes Printing page setup NOTE If a printout or session file identifies the printed or saved data as belonging to an individual it becomes Individually Identifiable Health Information and must be protected under the HIPAA Security Rule See Appendix 1 Manufacturer Disclosure Statement for Medical Device Security Ask option To have the Axiom stop and present the page setup options every time you print enable the Ask checkbox Enabling Ask allows you to change the page setup options with each printout for example to include Header text that identifies the patient or to include Description notes that elaborate on the test results With Ask disabled the Axiom generates the output results immediately on the printer or in the file without asking you to change the page setup Header and Date To include custom text in the header enable the Header checkbox and enter the text in the field below it To include the date and time of printing in the header enable the Date checkbox Graph with table Patients often report changes in their hearing instruments performance over time Printed output provides a valuable record for comparing the changes You may wish to include the Table View which includes the precise numeric inf
44. similar to the pink noise signal described previously except that the component tones are presented simultane ously from two speakers half from each The spec trum of the tone complex from each speaker is in dependently controlled with 1 12 octave resolution at the reference microphone Two simultaneous re sponse curves one for each speaker are derived from the measured output of the hearing aid This provides a real time measure ofthe functioning of the directional features of hearing aids that is indepen dent of compression or noise reduction algorithms unlike other methods that sequentially measure re sponse from different directions and work only with these features disabled REM Directional Single view Front signal Back signal TUN Presentation Single view ii Format Graph F Scale dE SPI REAR Stimulus Level Spkr Ajo 2 Q Dual naise 70 F Dual noise 70 H 3 9 aoi fide Show T6 1 Adaptive Directional 5 instrument 20 seconds after signal applied rd Curve 250 S00 T0200 2 2 3 Real speech signals Real speech signals are provided in Speechmap for both On ear and Test box measurement modes Four different digitized speech passages 2 male 1 female and 1 child are provided as well as the International Speech Test Signal ISTS and the single talker In ternational Collegium of Rehabilitative Audiology ICRA distorted speech signal In addition one of the s
45. structure The latter may be significant for hearing aids which use this property of speech to control noise reduction schemes The LTASS is similar to the Speech std signals up to 5 kHz Overall SPLs of 50 55 60 65 70 and 75 dB at the reference microphone are available Soft and Aver age levels 50 70 dB SPL have the same spectrum A Loud vocal effort filter is applied to the 75 dB level signals This is shown in Figure 5 In the Test box mode in Speechmap previously called S REM measurements made in the 2 cc coupler in the test chamber are converted to estimated real ear SPL In this mode the effects of hearing aid microphone location need to be included in the test signals so spectra are further altered to include the microphone location effects shown in Figure 6 Long Term Average 1 3 Octave Spectra LTASS for Speech Signals Average Effort re overall SPL for entire passage Hanning window 128 ms average 0 00 5 00 25 00 BAND SPL dB re overall SPL LTASS re overall SPL FEMALE LTASS re overall SPL CHILD LTASS re overall SPL ICRA amp LTASS re overall SPL ISTS LTASS re overall SPL STANDARD 200 250 315 400 500 630 800 1000 1250 1600 2000 2500 3150 4000 5000 6300 8000 BAND CENTER FREQUENCY Hz Figure 3 LTASS for Speechmap speech signals at average vocal effort 100 LTASS Speech std 1 90 80 70 60 LTAS
46. surements and for Insertion gain and Speechmap on ear measurements It is a pseudo random sig nal composed of 1024 simultaneous tones summed to provide a crest factor of 12 dB The spectrum of the pink noise signal is controlled by the reference microphone in conjunction with a digital feedback loop with a frequency resolution of 1 12 octave and a response time of about 1 3 of a second Pink noise was selected as a test signal because it has equal en ergy per octave producing a flat spectrum when ana lyzed in 1 12 or 1 3 octave bands Figure 1 shows the 1 3 octave spectrum of the pink noise signal and the noise signal specified in ANSI S3 42 1997 Note that the ANSI S3 42 1997 spectrum represents speech peaks not the long term average 1 3 OCTAVE SPECTRA for the PINK NOISE SIGNAL and ANSI 3 42 NOISE re overall SPL 9 00 10 00 11 00 12 00 13 00 BAND SPL dB re overall SPL 16 00 17 00 18 00 200 250 315 400 500 630 4 Band Level re overal SPL Pink Noise Band Level re overall SPL ANSI 83 42 800 1000 1250 1600 2000 2500 3150 4000 5000 6300 8000 BAND CENTER FREQUENCY Hz Figure 1 1 3 octave spectra for the pink noise signal and the noise signal specified in ANSI 3 42 1997 2 2 2 Dual direction pink noise signal Verifit only This unique test signal is available in the dual source Verifit test chamber and for on ear measurements by adding an additional sound field speaker It is
47. tese eque 78 CROS fittn usine Insertion galt ated ee erede eei e tete ote tne Herd Ett e RR Ede EE ea LP eee 78 17 Speechmap teste tert aea eee R e ERE HAERU EVE HEY EOS REESE ERU SERERE RENE E REEL O PEE E ES EET REESE NER RUD 80 PECL PLACES MER 80 Axiom User s Guide Version 1 10 November 2015 18 19 20 2 22 23 24 TSE S 20 im Speec Mma pase she lea 308s aged n E 80 DSL SUG aM SOB JG C HM 81 NALNE aos SEC MGM A esere EEN T E e eite soasanvesdsceearauvansnyccesuetednes tos soassateasaacsevas De ENAR ESERE RNE 81 PEE PEDES un 81 Camhtit 1n Speechimap 22 0 9 neret eet tee p re oe eti tee e re RE REOR ADI EE HE RP ERE etr END H AERE 82 Using Tdi 82 RPS eC MAP SED mene RR 83 Screen tour unaided SCREEN a ne teo rude erento RR EN CO Re NE NE EEE ENNE N IE RE R EAE R AEE OE iE 85 Screentour aided SCIeen usine PEE E A EE GOD REESE suse ssusuasseebsoecpeanseesseouans 86 ono dildo duc 86 SIE calculation TuS PSEC Wd oec irt pear EIER ERI IEEE EE HERE UR A EATER A SERE OM Ust ERE ER CH Pe Ioa ESTE 87 Using Custom Stimuli in Speech a iss eio serere ertet het ree eroe reta cob Gee noted rette dee edo ces deongaats 87 Creating WAV Files for Spee
48. used to convert entered HL values to ear canal SPL values If Soundfield is selected appropriate real ear unaided gain REUG values 45 degrees azimuth will be used to convert HL values to ear canal SPL values 2 Bone conduction Select from N A or Enter If Enter is selected an entry screen will be provided after the air conduction thresholds have been entered 3 UCL Uncomfortable Level Select from Enter or Average If Average is selected UCL will be estimated from entered thresholds If Enter is selected an entry screen will be provided after the air and bone conduction thresholds have been entered If measured UCL values are entered these values will be converted to real ear SPL and used as real ear saturation response RESR targets Note that DSL 5 0 has changed this term to Upper Limit of Comfort ULC Regardless of the acronym it is a narrow band SPL that should never be exceeded 4 RECD Real ear to coupler difference Select from DSL Average Enter Measure if the target rule is DSL child NL2 Average Enter Measure if the target rule is NAL NL2 or Average Enter Measure otherwise The RECD is used to convert entered HL data thresholds and UCL s to SPL values on the Speechmap screen when Insert Foam is selected as Transducer and to convert coupler SPL measured in the test box to estimated ear canal SPL The DSL child and NAL NL2 fitting rules provide differing age appropriate average RECDs which will result
49. 0 Max TM SPL 120 ry Instrument CROS yl 130 Format Graph v Scale dB SPL C 120 Li 110 7 SQ Audiometry 100 Transducer Headphone Probe tube in CROS REUR Average 90 good ear N mic on poor side 80 REAR REIG Stimulus Level SII 70 1 Pinknoise 55 98 60 2 Pink noise 55 99 50 jp REUR Pinknoise 55 100 40 30 Curve Hide Show 20 10 0 a 10 a aa rane Si Dena Sera Diet Din Sire in nial Sinn SET 250 500 1000 2000 4000 8000 77 Axiom User s Guide Version 1 10 November 2015 17 Speechmap Speechmap presents hearing threshold UCL and amplified speech spectra as SPL in the ear canal The fitting goal is to make amplified speech audible and comfortable while avoiding discomfort for loud sounds Speechmap may be accessed from as either a Test box measure or an On ear measure See On ear or Test box mode for details Speechmap facts Speechmap is a trademarked hearing instrument fitting environment introduced by Audioscan in 1992 It presents hearing threshold UCL and amplified speech spectra as SPL in the ear canal The fitting goal is to make amplified speech audible and comfortable while avoiding discomfort for loud sounds Originally speech was simulated using amplitude modulated tonal signals The Axiom replaces these simulated speech signals with real speech both recorded and live For details of the test signals and analysis methods see Speechmap Technical De
50. 10 November 2015 24 Appendix 1 Manufacturer Disclosure Statement for Medical Device Security 118 Axiom User s Guide Version 1 10 November 2015 Manufacturer Disclosure Statement for Medical Device Security MDS Device Category Hearing Aid Analyzer Manufacturer Etymonic Design Inc Document ID Document Release Date Device Model Verifit RM500SL Axiom Software Revision See Page 1 of Users Guide Software Release Date See Page 1 of Users Guide Manufacturer or Titl Representative Contact Information Company Name Telephone tymonic Design Inc Audioscan 800 265 2093 MANAGEMENT OF ELECTRONIC PROTECTED HEALTH INFORMATION ePHI As defined by HIPAA Security Rule 45 CFR Part 164 Yes No N A Note 1 Can this device transmit or maintain electronic Protected Health Information ePHI 2 Types of ePHI data elements that can be maintained by the device a Demographic e g name address location unique identification number cccccceeseeseeeeesseteeeeessenseseeeeseenees b Medical record e g medical record account test or treatment date device identification number Cc Diagnostic therapeutic e g photo radiograph test results or physiologic data with identifying characteristics _ d Open unstructured text entered by device user operator eseeeeeeeeeene eene nennen nnne nennen nnne nnne nnn 3 Maintaining ePHI Can the device a b Store ePHI persistently on local
51. 100 EN Printer 172 30 1 9 9100 Printer test A eae Network printer details Printer test passed Web browser screen capture You can capture the Axiom screen image at any time using a web browser Through the browser you can print or save the image using the computer s printer or file storage Enable the Axiom networking as described above in Network Setup Enter the Axiom network address in the browser address bar e g 172 30 1 57 Select the Capture the screen link shown in the browser window Alternatively enter the direct link to the screen image in the browser address bar e g 172 30 1 57 screen The browser will display the current Axiom screen image Use the browser features to save or print the image In many browsers you can right click on the browser window or open the browser menu 37 Axiom User s Guide Version 1 10 November 2015 a screen 800x600 C fi Setup Software version trunk r11407 eng August 22 2014 Network address 172 30 1 30 Session setup The Axiom itself does not store data All entered and measured data are lost when you turn the Axiom off Also each time you change clients you need to erase the Axiom s session data so that the data and test results do not become mixed or confused among different clients or hearing instruments The Session features allow you to erase data conveniently without turning the Axiom off The Session features also al
52. 1250 0 6 0 3 1 6 1 1 0 0 6 0 99 Axiom User s Guide Version 1 10 November 2015 1600 2 5 0 3 1 9 2 0 4 0 6 1 2000 4 1 3 8 2 1 3 3 4 0 6 1 2500 3 5 5 0 4 8 5 0 3 0 6 4 3150 2 8 3 3 3 5 6 9 2 0 6 6 4000 3 7 4 3 6 4 8 3 0 0 7 7 5000 2 4 3 6 6 7 6 0 0 8 1 6300 1 6 0 4 1 8 4 2 0 0 8 4 8000 3 3 1 0 1 9 5 6 0 0 8 4 Microphone location effects are added after the overall rms level has been set Deep insertion compensation The deep insertion of a hearing aid or ear mold causes the ear canal SPL to be higher than would be estimated by adding RECD to the coupler SPL measured in the test box This most commonly occurs with Completely in Canal CIC hearing aids When this hearing aid type is selected in Speechmap Test box a deep insertion factor is automatically added to the estimated ear canal SPL The factor in the following table is from DSL 5 0 and has been interpolated to 1 3 octave frequencies Speech signal analysis One of the most used measures of a speech signal is the long term average speech spectrum LTASS This is a 1 3 octave spectrum averaged over a sufficiently long portion of the speech material to provide a stable curve In practice a 10 second average meets this requirement and for this reason all Verifit passages are at least 10 seconds long The dynamic nature of speech is often characterized by the distribution of short term levels in ea
53. 4 258 Fikret Pasa S amp Revit L J 1992 Three experiments to validate new probe measurement practices in prescribing customized hearing aids Journal of Speech and Hearing Research 35 384 400 Freed D J amp Soli S D 2006 An objective procedure for evaluation of adaptive antifeedback algorithms in hearing aids Ear amp Hearing 27 4 Hawkins D B Cooper W A amp Thompson D J 1990 Comparisons among SPLs in Real Ears 2cc and 6cc couplers Journal of the American Academy of Audiology 1 154 161 115 Axiom User s Guide Version 1 10 November 2015 Hawkins D B Walden B E Montgomery A A amp Prosek R A 1987 Description and validation of an LDL procedure designed to select SSPL90 Ear and Hearing 8 162 169 Killion M C amp Monser E L 1980 Corfig Coupler response for flat insertion gain In G A Studebaker and I Hochberg Eds Acoustical Factors Affecting Hearing Aid Performance Baltimore University Park Press Lewis D E Feigin J A Karasek A E amp Stelmachowicz P G 1991 Evaluation and assessment of FM systems Ear and Hearing 12 268 280 Martin H C Munro K J amp Langer D H 1997 Real ear to coupler differences in children with grommets British Journal of Audiology 31 63 69 Moodie K S 1996 A practical approach to hearing aid selection BSA News 18 6 8 Moodie K S Seewald R C amp Sinclair S T 1994 Procedure for predi
54. 40 dB SPL 2500 8000Hz ANSI S3 46 1997 tests available ER Real Ear Unaided Response aa Salinas Real Ear Aided Response P E EE a ten seats ee Real Ear Occluded Response 107 Axiom User s Guide Version 1 10 December 2015 V editio ton pea tet St e eet Real Ear Insertion Gain Other tests available hated Speechmap real speech audibility measures EIN E On ear harmonic distortion eit On ear spectral analysis TEET On ear noise reduction verification Manual measurement of output gain and distortion Fitting methods available iod Speechmap with DSL 5 0a NAL NL1 NAL NL2 Insertion gain with NAL RP NAL NL1 Fig6 Pogoll EP Berger Libby Sensory Loss Simulator Simulation types AE A ASS EEN Non linear outer hair cell cochlear loss Simulation band Scincidae i 65 108 Axiom User s Guide Version 1 10 November 2015 109 Axiom User s Guide Version 1 10 November 2015 22 Glossary AGC Automatic Gain Control the means by which gain is automatically controlled by the level of the signal being amplified ANSI 83 22 AGC I input controlled AGC see input compression AGC O output controlled AGC see output compression AGRAM Abbreviation for audiogram ANSI American National Standards Institute Attack Time the time required for HA output to reach 3dB of its steady state level in response to an input step from 55 to 90dB SPL ANSI 3 22 ASP Automa
55. AR measurements Room noise can increase test time cause errors and alter the operation of the hearing instrument being evaluated 1 Choose a quiet location and position the client and the sound field speaker at least 1 5 m 5 feet away from any hard surfaces 2 Position the client directly in front of and facing the sound field speaker at a distance of 45 to 90 cm 18 to 36 in from the center of the head Positioning the probe tube A WARNING Probe tubes are for single patient use only Care is required when sliding the probe tube into the ear canal Be careful not to advance the probe tube further into the ear canal when inserting an earmold or custom hearing instrument into the ear or when inserting the foam tip into the ear 1 Use an otoscope to ensure there is no ear canal obstruction e g cerumen and to get a sense of ear canal length 2 Install a new probe tube on the probe module Set the black marker ring approximately 28 mm from end of probe tube for adult females approximately 30 mm from end of probe tube for adult males and approximately 20 25 mm from end of probe tube for children These positions may be modified based on the otoscopic examination Tip the probe module body is 28 mm long 3 Hang the probe module on the ear as shown The reference microphone should face outwards 4 Adjust the blue cord until the probe module is snug against the head directly below the earlobe cheek level To
56. Audioscan Axiom User s Guide 1 10 November 2015 Table of Contents IE torii M 5 Product description essensie ier ive RH RON EROS GRE ir de qe teo ibis Docs ERREUR EVE E pe epe dee 3 Associated items and SUP IS H 3 SAFETY WARNINGS and NOTICES t tenore et ence eet eroe lect e teneo ond Sa levied nn RE BREED ERA e a E dg tesa dae 5 Enyiranmental Sdbely 5 ner mrt em ee rne tese tee estote ta dle or e Ee ee oe yea eee es ve a reu Gee eee esie xr eee ed 7 Declaration of Electromagnetic Compatibility EMG 2 estne repe Pcr t papeles dee deett ete rnain Ra aaee T Warranty Trademarks Acknowledgments 2 o re refe t pea netter tis ig rr uer EROR RE eA 7 EC Declaration Of Conform 3 ERNST ERR aceon Led ba aad AE Ea aE 9 Electone User s Unde ette tre eere Ueber teet eti eventu ens aee Feed p D erue iive 10 How to Avoid Undesirable Side Bite tess eite eter He een En ttd dtr pta ttes eie 10 2 Getting Started P 12 Unpacking and eom Tou T MR iieri rens AA e EE e SEE EE EA EER AE E a E EE E A A EE EiS 12 Eur care WMS UE ER 15 Microphone CANS T 15 3 General Operation einsi ente te et me RE D bys va RU ava REE dan Ee pede Lie tuae bab eee t e bebeds 17 Switchs ON OFF pH
57. Audioscan version of DSL 5 0 may differ from others in the following ways 1 DSL 5 0 uses RECD values for ages gt 119 months from a different source than for ages up to and including 119 months Audioscan has used the RECD values for a 119 month old for ages gt 119 months so all values come from the same study 2 Input output curve targets and compression threshold targets are not provided Such steady state parameters are of little value in estimating amplified speech levels Matching amplified speech to the LTASS targets at levels from 50 to 75 dB SPL provides much better assurance that fitting goals are being met 78 Axiom User s Guide Version 1 10 November 2015 3 There is no provision to input the number of compression channels This may be useful when the signal used for verification is not the signal for which the targets were developed It is irrelevant when using real speech signals to match speech targets and when using narrow band signals to match narrow band maximum output targets 4 The term Uncomfortable Level UCL is used rather than Upper Limit of Comfort ULC in referring to the ear canal SPL that should never be exceeded 5 Broadband output limiting targets are not provided DSL 5 0 changes The Audioscan version of DSL 5 0 includes provision for bone conduction and ABR threshold binaural targets targets for speech levels from 50 to 75 dB SPL new targets for children targets for adults and new RECD
58. Click on L1 1 to select the first Speechmap test The Test 1 box is outlined to indicate it is active 90 Axiom User s Guide Version 1 10 November 2015 3 Click on gt to start this test Once the test is started click on the Stimulus list button to select the stimulus type as Speech std 1 Speech std 2 or Speech ISTS Click on the Level list button and select a stimulus level of 50 dB The bar beside the M shows the SII for the unaided stimulus at 50 dB SPL the Unaided Audibar To change the default stimulus type and level see Saving test setup 4 While the passage is being presented adjust the hearing instrument s frequency shaping and gain for soft sounds so that the middle curve the LTASS falls within the target range shown by the H symbols especially between 500 4000 Hz These target symbols are automatically adjusted for the stimulus level you select 5 Click on e to signal average and store a complete passage Repeat as necessary 6 Click on m to stop the test without recording any test data audioscan Audiometry Verification Insert Foam Mode Test box UCL Average Fitting BTE Bone NIA RECD Targets Average Rule None Age Adult Type Monaural Loss simulator EN gt Speech ISTS Soft 5t a 26 ds R Be ie a ee i 5 2 50 90 Aided speech banana SPL threshold 70 30 20 10 e c i ots 250 500
59. For multi level targets match each curve using the stimulus level indicated Click on _ to complete the test and capture the data See Insertion gain in SPL and Insertion gain in HL for an explanation of screen curves See SII calculation in Insertion gain NOTE Because it is analyzed in 1 3 octave bands the Noise stimulus produces a REAR up to 12 dB below that 75 Axiom User s Guide Version 1 10 November 2015 produced by the Swept stimulus at the same overall level The REIGs will be similar except at levels which cause non linear operation of the hearing instrument SII calculation in Insertion gain The Axiom calculates a Speech Intelligibility Index SII value for unaided speech at 70 dB SPL REUR the target REIG and for each aided test The calculations use the 1 3 octave band method of ANSI S3 5 1997 without the 160 Hz band and without masking effects with results expressed as a by multiplying by 100 Level distortion effects are included but no hearing loss desensitization is applied An idealized speech region of LTASS 15 dB is used The speech recognition associated with a given SII is a function of the test material and the cognitive abilities of the listener There is considerable individual variability in relating the SII to speech recognition especially amongst impaired listeners The following shows expected nominal recognition scores vs SII for normals on the Connected Speech Test Sherbecoe and
60. HA 2 referenced RECD with earmold effects retained to the HL to SPL transform In Test box Speechmap simulated REM we apply the HA 1 RECD to the coupler measurment for ITE ITC CIC RIC instruments and also to BTE instruments when BTE mold has been selected and personal earmold used in the measurement When the instrument type is set to BTE HA 2 the HA 2 referenced RECD is applied RECD values and are stored displayed and printed referenced to the HA 1 coupler Imported data from software versions 3 10 39 and earlier will be HA 2 referenced and will be converted to HA 1 referenced data for use storage and display Subsequent printing saving or export will show the converted HA 1 referenced values only 70 Axiom User s Guide Version 1 10 November 2015 If you use insert ear phones for audiometry OR if you verify using the test box you should measure RECD preferred or use age related average RECD 71 Axiom User s Guide Version 1 10 November 2015 16 Insertion Gain Insertion gain is the difference between aided and unaided ear canal SPL REIG REAG REUG It inherently assumes a sound field audiogram For non linear hearing aids REIG is stimulus dependent and the dependency is specific to each hearing aid Insertion gain fitting methods ignore these facts Speechmap is recommended for fitting all linear and non linear hearing instruments Refer to On Ear Measures Setup and On Ear Measures Scre
61. LETT PACKARD sDeviceModelz Deskjet D26 sDeviceModelz Deskjet D26 dDEVICEWIDTHPOINTS 612 dDEVICEWIDTHPOINTS 612 dDEVICEHEIGHTPOINTS 792 dDEVICEHEIGHTPOINTS 792 r300 r300 sI jsParams Quality Quality 0 Quality Co sI jsParams Quality Quality 0 Quality Co lorMode 2 Quality MediaType 0 Quality Pe lorMode 2 Quality MediaType 0 Quality Pe nSet 1 nSet 1 dIjslseDutputFD dIjsUseDutputFD s utputFile s utputFilez AL m Custom HP printer File output The Axiom can print results in a file for future printing and viewing You can also include these printed files in documents or display them in presentations In Printing Setup select the File output option To save the output on a USB drive select USB To save the file in a shared folder on a Windows computer select Windows Share See the section below Windows shared printers and folders for instructions about setting up a Windows shared folder File format When printing your output to a file you can select the saved file format as PDF Document PNG Graphic or GIF Graphic The Axiom automatically adds the corresponding extension to the output file name The exact file name depends on the test results you are printing If a similar file already exists the Axiom assigns a unique digit to distinguish the new file e g Test box directional3 png Page setup You can select the components to include in the printed output by clicking the Page setup button The page
62. S Speech40007 40 LTASS Speech6000 uui I LTASS Speech6300 20 i E UEM 10 aa n Tm oe 4000 8000 Figure 4 LTASS for Speech std 1 Speech4000 Speech5000 Speech6300 for the FM boom location effects of Figure 6 Note that curves are 1 3 octave band levels at 1 12 octave intervals which causes the 1 3 octave bands at 4000 5000 and 6300 Hz to appear broader than 1 3 octave For clarity the Speech3150 curve has been omitted LOUD VOCAL EFFORT EFFECT re nominal band SPL 15 00 10 00 BAND SPL dB re NOMINAL un S 0 00 5 00 200 250 315 400 500 630 800 1000 1250 1600 2000 2500 3150 4000 5000 6300 8000 BAND CEN TER FREQUENCY Hz Figure 5 Loud vocal effort effect in dB re nominal band levels Nominal band levels are band levels for an overall SPL of 65 dB This shaping is applied to the 75 dB SPL speech and ICRA signals MICROPHONE LOCATION EFFECTS re nominal band SPL 1 k BTE MIC LOCATION ITE MIC LOCATION ITC MIC LOCATION e CIC MIC LOCATION BODY AID MIC LOCATION FM CHEST MIC LOCATION E FM BOOM MIC LOCATION BAND SPL dB re NOMINAL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 BAND CENTER FREQUENCY Hz Figure 6 Microphone location effects in dB renominal band SPL Nominal band levels are band levels for an overall rms level of 65 dB SPL and average vocal effort in a free sound field In addition to these well controlled and repeatable signals
63. Studebaker 2003 SII 9o Cor Cor Cor IEEE NU6 Sentences Words Digits 8 1 4 1 4 SPONDEES E O 8 fi TNN IEEE WORDS IN 19 i peenest SENTENCES 27 i i i z P KIC NUG WORD Smmm 36 Oo j 3 0 F i i i 87 10 20 30 40 50 60 70 80 90 100 93 SII speech intelligibility index in 9o CROS fitting using Insertion gain See Insertion gain in SPL 1 Place a probe module on each ear and insert the probe tube into the good ear only Position the CROS instruments on in the ears and turn them ON 2 Position the speaker at 45 degrees to the good ear and set Instrument to BTE 3 Select REAR 1 and record a response using Pink noise at 55 It should be like a normal REUR If not the ear may not be fully open 4 Position the speaker at 45 degrees to the poor ear 76 Axiom User s Guide Version 1 10 November 2015 5 Set Instrument to CROS 6 Select REAR 2 and obtain a response using Pink noise at 55 Adjust the response to match that obtained in step 3 7 Position the speaker directly in front of the client Select REAR 3 and use Pink noise at 55 to check for a smooth response Repeat with Instrument set to BTE An irregular response may be the result of reflections from nearby objects including the operator or it may indicate phasing problems in the aids Insertion gain audioscan 14
64. TASS is at threshold approximately depending on test material and the individual 100 Axiom User s Guide Version 1 10 November 2015 20 Troubleshooting This section covers common problems encountered when using the Axiom If you require further assistance note your model and serial number located just behind the test box lid and contact your local distributor or Audioscan at 519 268 3313 800 265 2093 USA only 519 268 3256 fax or service audioscan com PLEASE DO NOT SHIP YOUR UNIT BACK TO THE FACTORY In most cases we can courier you a part that you can quickly and easily replace yourself Self test failures Any failure during power on self test P O S T is indicated on screen and further use of the instrument is denied Try the following steps to resolve the failure 1 To access Self test click on S _and then click on Self test 2 If you received a Max out in or a Routing failure remove any hearing aids from the test chamber and rerun self test 3 Unplug all microphones On ear amp Test box from the test chamber Rerun self test If self test passes reconnect the microphones one by one running self test each time until a failure occurs If the failure returns display and print the test results and contact Audioscan for help Setup selftest EN Routing K Click here to Gain Click here to display rerun selftest Frequency response and print test results Noise floor V Maxout in
65. UE Y PIO doi M 51 IMU CUEY CU E E Ea 51 Spectral analysis in MUlTIGUEVE 3 Ie erste este ooa Pope ere e Eres e RE igen ESQ IEEE euet re EL PASCERE TEX ee ER Tee EE 52 Maniial control proeed ures EM 52 Sound level meter using mantial Control etae rete tete pepe rd ee Eee ege EE E E Ee ERE E ERE Urea eR ERU ED ES s 53 11 Sensory loss gin Dri E 33 Sensory loss simulator descption s M 35 Sensory loss simulator GperattoD ope RR cei eb Pe oer oye boats bed etu Re eue Re R peg EE EEEO 55 12 On Ear Measuttes Setup vec E E EAEE REA ET ONN E ETERS 57 On ear calibrattOD LACUS sas e cot terere eter ee rr UR aE REE EE E E E E TERR E AO NEE EREE a Calibration of opn ear probe Microphone sisses rere tree rre ee decern rne ceret badge paese t te ER ERE EEES iota 57 Calibration check Tor probe module cee cat 2 eri epe erento bien coe pP Td Ye EUER ED Re aaa AS 58 Max TM El EE Too M 59 POSIOMINE the qw MR 60 Positioning the probe tube ec ri I eene terr re EH Ho hee be tdi Y ene Eines ite HE PENES CE Pee ene Ea 60 13 On Bar Measures Screen Setup ite iet rei teatro epe Fe tires LEER ERE URN PEE PERSE TRES UY E ERAS E ES EE EPAE Ea E E RESUME D SOS 62 SPL of HL SCIE
66. a go to Control Panel Network and Sharing Center then select Change Adapter Settings on the left hand panel 2 Right click on Local Area Connection and choose Properties Ensure that Internet Protocol TCP IP or TCP IPv4 is checked Select this and select the Properties button Ensure that Obtain an IP address automatically is selected Static connection A static connection requires an Ethernet hub or switch The Network addresses must be manually entered into the Axiom and PC 1 Connect a Cat 5 RJ 45 cable from one port on the switch or hub to the Axiom network connector 2 Connect a second cable from a switch hub port to the network connector on the PC 3 On Windows XP go to Control Panel Network Connections On Windows 7 8 Vista go to Control Panel Network and Sharing Center then select Change Adapter Settings on the left hand panel 4 Right click on Local Area Connection and choose Properties Ensure that Internet Protocol TCP IP or TCP IPv4 is checked Select this and select the Properties button 5 Check Use the following IP address and enter the following in the IP address box 172 30 1 1 Enter 255 255 255 0 in the Subnet mask box 6 On the Axiom uncheck Auto on the Setup network screen and click the Change button Then set the network addresses as shown below by clicking on the down arrow buttons and selecting from the drop down lists 28 Axiom User s Guide Version 1 10 November 2015
67. and age are encoded In Insertion gain threshold and audiometric transducer type are encoded The type of data and the ear left right is shown below the barcode Only data for the displayed ear are imported Barcodes may be scanned in any order and it does not matter if the barcode is upside down 1 Select Speechmap or Insertion Gain from the Tests menu 2 Hold the printout so that the barcode is flat With the scanner 6 8 in 15 20 cm from the barcode press the trigger on the scanner and center the illuminated red line along the length of the barcode 3 When the scan is successful the scanner will beep the red line will extinguish and a Barcode Entry poster will appear on the screen A green checkmark on the poster shows which data have been accepted A message will advise if the barcode does not contain data for the screen you are viewing 4 When all desired data have been accepted select Done to apply the data 18 Axiom User s Guide Version 1 10 November 2015 See Barcodes tabular data headers and comments on printouts under Printing and Storing Results Screen messages and Help The Title bar top line of the display screen informs you of the selected Test e g Speechmap The Message bar bottom line of the display screen suggests the next step in a test or informs you of the state of the instrument or conditions that could affect your data For example it will inform you if the microp
68. arthed electrical outlet WARNING To allow electrical power to be rapidly disconnected in the event of an emergency position the power supply in an accessible location so that the power cord may be quickly disconnected WARNING To avoid the risk of electrical shock monitors connected to the Axiom must comply with UL IEC 60601 1 OR comply with UL or IEC and ISO safety standards for monitors AND a be operated from an isolating transformer complying with UL IEC 6061 1 OR b be kept at least 6 feet 1 8 m from the patient WARNING To ensure that the operation of this product is not affected by EMC emissions from other products this product should not be used adjacent to or stacked on other equipment If this is necessary its operation should be verified as normal in this configuration Portable and mobile RF communications equipment can affect the performance of this product The Axiom power supply can only be connected to the mains using the supplied power cord oe Failure to follow operating instructions could place the user or operator at risk 1 Carefully unpack the components of the Axiom from the shipping box and check the contents against the enclosed packing list 2 Locate the Axiom on a solid surface in a quiet room and choose a location for the speaker and the client such that they will be about 2 0 6 m apart and both at least 4 1 2 m from any reflective surface If the speaker is to be mounted on a des
69. ayees 106 Techical S PEC ea E 109 oc MM M 109 Hi qr M M 109 n EE eee meti epe DH ORO EN ERR a eia cert i per OR OR RI OI RII RO TE GREEN EE RENE EER 109 Sensory Loss SUM ALON P 110 OS AN E H a 112 se ep T NRX 117 Appendix 1 3 auia e EHE ER REOR RD SED ee EE et EHE EE MERERETUR ERE GER A 120 Manufacturer Disclosure Statement for Medical Device Security esee ener 120 Axiom User s Guide Version 1 10 November 2015 1 About Axiom This section describes the Audioscan Axiom provides contact warranty and trademark information safety warnings and notices and instructions for accessing the electronic User s Guide Note that the User s Guide may be viewed on the Axiom at any time by clicking For long Help pages use the mouse to switch between the Help index and the Help page and to scroll through the page The electronic User s Guide also contains a glossary and additional reference materials and is located on the updater USB flash drive included with the Axiom Product description The Axiom is a hearing aid
70. c address assignment Ask your network administrator for help in performing the following steps 7 To assign a static network address 1 Disable Auto DHCP 2 Click the Change button 3 Enter the network address details in the Change network address poster 4 Click _ to apply your changes Change network address IP Address 72 fof 30 wll 1 mo ei Netmask 255 fw 255 iepSS O iei Gateway 72 30 mii i1 wj MAC Address 00 05 67 0F 09 07 24 Axiom User s Guide Version 1 10 November 2015 Remote Operation Check Networking requirements and connect the Axiom to your network 1 1 Click amp and then choose Network from the Setup menu Click Remote Operation Change Click Off or On to turn Remote Operation off or on Input a password in the Password field If password is not manually entered the default will be audioscan Click to apply your settings to the remote operation service Remote Operation On oO Password e Li Port 5900 Change TE Note On top mode and Telehealth applications can both be achieved by the Remote Operation feature Changing the Remote Operation port Consult your Network Administrator before changing the Remote Operation port Changing the port successfully requires understanding the security polices on your Windows PC and computer network The Audioscan Remote
71. canal and couple the FM only device to the ear canal as in normal use At maximum volume setting select the MPO stimulus Adjust the receiver settings to meet targets See Adjusting the Maximum Output Level At use volume setting select Speech std 1 2 or the ISTS and choose FM chest 84 dB SPL or FM boom 93 dB SPL for the level Adjust the FM receiver gain volume settings to meet targets in the 1000 4000 Hz range Repeat step 3 at use volume setting 97 Axiom User s Guide Version 1 10 November 2015 19 Speechmap Technical Details Speechmap provides a variety of stimuli for the testing of non linear hearing aids with a range of digital processing features Additional information regarding the stimuli and their analysis is provided in Appendix 2 of the printable User s Guide Speechmap stimuli The Speechmap fitting environment provides a number of well controlled distinctly different stimuli for both On ear and Test box measurement modes Four different digitized speech passages 2 male 1 female and 1 child are provided as well as the International Speech Test Signal ISTS and the single talker International Collegium of Rehabilitative Audiology ICRA distorted speech signal In addition one of the speech passages has been filtered to provide 3 variations for evaluating frequency lowering hearing aids Pink noise at levels of 50 to 75 dB SPL in 5 dB steps and a tone burst at 85 or 90 dB SPL are also available
72. cation 9 4 159 197 Seewald R C 1994a Current issues in hearing aid fitting In J P Gagne and N Tye Murray Eds Research in Audiological Rehabilitation Current Trends and Future Directions Journal of the Academy of Rehabilitative Audiology Monograph XXVII Seewald R C 1994b Fitting children with the DSL method The Hearing Journal 47 9 10 48 51 Seewald R C Moodie K S Sinclair S T amp Cornelisse L E 1996 Traditional and theoretical approaches to selecting amplification for infants and young children In Bess F H Gravel J S amp Tharpe A M eds Amplification for Children with Auditory Deficits Nashville Bill Wilkerson Center Press 161 191 Seewald R C amp Ross M 1988 Amplification for young hearing impaired children In M C Pollack Ed Amplification for the Hearing Impaired Third Edition pp 213 271 Orlando Grune amp Stratton Seewald R C Ross M amp Spiro M K 1985 Selecting amplification characteristics for young hearing impaired children Ear and Hearing 6 1 48 53 Seewald R C Ross M amp Stelmachowicz P G 1987 Selecting and verifying hearing aid performance 116 Axiom User s Guide Version 1 10 November 2015 characteristics for young children Journal of the Academy of Rehabilitative Audiology 20 25 38 Seewald R Moodie S T Scollie S amp Bagatto M 2005 The DSL method for pediatric hearing instrument fitting His
73. ce the risk of contamination hearing instruments should be clean before putty is applied and putty should be replaced frequently The ANSI 83 46 2013 standard specifies RECD referenced to the HA 1 coupler and suggests its use in test box verification for all instrument types Audioscan software allows for BTE coupling to either HA 1 through earmold or HA 2 The appropriately referenced RECD will be applied BTE instruments may be coupled either directly to the HA 2 BTE coupler or to the HA 1 coupler using the client s earmold and blue putty When using the earmold ensure that the mold is well sealed to the coupler and that the medial end is flush with the inside of the coupler opening Putty should not extend into the coupler cavity or block the sound outlet Vents should be sealed at the lateral end Coupling method used for BTE instruments HA 2 or HA 1 must be specified in Instrument type selection on Speechmap screen See Using Speechmap RECD Custom instruments are sealed to the HA 1 coupler with putty so that the end of the eartip is flush with the inside of the coupler opening Putty should not extend into the coupler cavity or block the sound outlet of the instrument Vents should be sealed at the faceplate end It is very important that the instrument be well sealed to the coupler Open fit instruments may not be verified using Test box speechmap RITE Receiver in the ear instruments are coupled to the HA 1 coupler using
74. ch 1 3 octave band These levels are determined by calculating a spectrum for each of a series of short time periods within the passage Historically time periods of 120 125 or 128 ms have been used The Verifit uses a 128 ms time period resulting in 100 levels or samples in each 1 3 octave band for a 12 8 second passage The level in each band that is exceeded by 1 of the samples called L1 or 99th percentile has historically been referred to as the speech peak for that band The curve of the 99th percentile is approximately 12 dB above the LTASS The level in each band that is exceeded by 70 of the samples called L70 or 30th percentile has historically been called the valley of speech for that band The curve of the 30th percentiles is approximately 18 dB below the LTASS The region between these two curves is often called the speech region speech envelope or speech banana The speech envelope when derived in this way has significance in terms of both speech detection and speech understanding Generally speech will be detectable if the 99th percentile is at or near threshold The Speech Intelligibility Index SII is maximized when the entire speech envelope idealized as a 30 dB range is above masked threshold This will not be an SII of 100 or 1 because of loudness distortion factors but higher SII values will not produce significantly higher scores on most test material The speech reception threshold SRT is attained when the L
75. chimap 3 ceci icri rr entere esee EAS EET ez E PERRA HERE EAE Ue pae eee EE edet in aua 88 Speechmap Fitting Procedures E 91 Spesehinap sereenme hole ES 6 c2te circ 3catsnccesecesccsenucicsseeieceets vies e ENE E E o a oi Ree E Ee RENE E e EE 91 DAG CTY E EE tices cdaietsseheagesssasesyiess ba yiagsetanerctvecevacsdensay ance E E 92 Fit ng to targets Tor soft Spee Cli suene HER cesayes E o EA e A a HR HERI E DL be ERE REN AER 92 Fittings t0 targets Tor average SD BOl aue eicere cedere oreteece de eie a tp ones tendere eco Eo E eee AAO LERE NE pE spese aede 93 Adjusting the Maximum Output Level oett eren ertet en e pet sba EENE r a e e EE ERES ERR PEE Este ENER AES 95 Open fitti es I SDee CDD user enin inre rre eret Ir Errant pi tO Dagegen cepe esee dete pesa ee 96 Verifying Frequency Compression Frequency Lowering Hearing Instruments in Speechmap sues 96 FM Titling and VET Catlin RP E ENEE E 98 Speechmap Technical Details set rte LO eter t ee EL HER E eee ERU LRL pas aede ee e Eee Pe ree a steedb alaeves 100 SDSeCHITdD SEPRIU E eee erre eco T tee E ETE E T ER RES ENSE EEE REO E 100 Spin Il TC 100 Mictophete location effects en eddie tertie YER EO Rat CER PETERE Debe ETERNA 101 Deep insertion COMIPENSAR OM E 102 We ee he oy ted AN eA ys os ccc ea cca nas eteti
76. ct your custom stimulus After a short delay your stimulus will begin playing 9 Use your new stimulus with all the features of Speechmap Audiometry Verification Headphone Test box Average BIE NA RECD Targets Average None Adult Monaural Loss simulator Speech std 1 Soft 55 e m MPO Speech std 1 Speech std 2 Speech ISTS Speech female Speech child ICRA noise Pink noise 1khztone click 500 1000 2000 4000 Example of two custom files click wav and Ikhztone wav in the stimulus list To remove custom stimuli from Speechmap close any Test prompts and disconnect the USB stick from the Axiom Notes Files that are greater than 20 seconds in duration will be truncated to 20 seconds e Speechmap will show up to 10 compatible WAV files If you have more than 10 we recommend that you use multiple USB sticks or organize your files into folders moving them into the top level directory of the USB stick as needed Removing the USB stick while a test is running may cause unexpected behavior Stop the test before removing the USB stick from the Axiom Creating WAV Files for Speechmap WAV is a commonly used format for digital audio and can be created edited by nearly all audio editing and 86 Axiom User s Guide Version 1 10 November 2015 recording software A WAV file has many properties that defines the format of the
77. cting real ear hearing aid performance in young children American Journal of Audiology 3 1 23 31 Moore BrianC J amp Glasberg Brian R 2004 A revised model of loudness perception applied to cochlear hearing loss HearingResearch 188 2004 70 88 Mueller H G amp Bright K E 1994 Selection and verification of maximum output In Valente M ed Strategies for Selecting and Verifying Hearing Aid Fittings New York Thieme Medical Publishers 38 63 Pavlovic C V 1991 Speech recognition and five articulation indexes Hearing Instruments 42 9 20 23 Pearsons K S Bennett R L amp Fidell S 1977 Speech levels in various noise environments Project Report On Contract 68 01 2466 Washington DC US Environmental Protection Agency Platz Rainer 2004 SNR Advantage FM Advantage and FM Fitting Proceedings from the Ist International FM Conference www phonak com Scollie S D Seewald R C Cornelisse L E amp Jenstad L M 1998 Validity and repeatability of level independent HL to SPL transforms Ear and Hearing 19 5 407 413 Scollie S D Seewald R C Moodie K S Dekok K 2000 Preferred listening levels of children who use hearing aids Comparison to prescriptive targets JAAA 11 230 238 Scollie S Seewald R Cornelisse L Moodie S T Bagatto M Laurnagaray D Beaulac S amp Pumford J 2005 The Desired Sensation Level Multistage Input Output Algorithm Trends in Amplifi
78. cursor on a graph place the screen pointer on the graph and left click then navigate to the point you want to identify left click again to hide the cursor The scroll wheel may be used to traverse the Help contents multiple Help pages or long menu lists Note that mouse speed can be changed by clicking amp and Display The functions of the screen icons and QWERTY keyboard keys are explained in the following table Screen icon Function QWERTY Key Continue Proceed from current state 4 1 Cancel Revert to previous state Esc Show menu of available tests F3 opu ewe Show on line help F1 17 Axiom User s Guide Version 1 10 November 2015 Show the setup menu F2 Print screen to an external printer or a file Print Screen Show menu for erasing data or exchanging E pre FA data with network files or USB memory F4 Position the screen pointer over the icon Arrow keys button or menu item Activate a screen icon or button or select an Enter on numeric item from a menu mouse left click keypad Barcode data input Failure to follow operating instructions could place the user or operator at risk In Speechmap and Insertion gain tests audiometric data in barcode form on an Audioscan analyzer printout may be entered by scanning the appropriate barcode In Speechmap air and bone threshold UCL RECD audiometric transducer
79. cy range battery drain equivalent input noise harmonic distortion attack and release time AGC only ANSI S3 22 2003 facts ANSI 83 22 2003 has been designated a recognized standard by the FDA and is mandatory for reporting test data The most significant change from the 1996 version is the requirement for the hearing aid to be set in its most linear mode for the setting of the gain control to Reference Test Setting changed from Reference Test Position and for all tests except attack and release and input output I O curves These two tests are to be conducted with the AGC function set for maximum effect The AGC test sequence will pause to allow AGC to be set prior to measuring attack and release time Full on gain is determined with 50 dB input SPL 60 dB was formerly an option and frequency response curves are run at 60 dB SPL for Linear and AGC aids The OSPL90 curve the HFA or SPA and peak value of this curve the frequency of the peak the HFA or SPA full on gain are determined at full on gain setting The response curve frequency range Reference Test Gain battery drain equivalent input noise distortion attack and release times are determined at RTS These changes result in more consistent values for reference test gain equivalent input noise and attack and release time See 1996 or 2003 ANSI standard 8 2 ANSI S3 22 1996 facts and 8 5 ANSI 2003 Linear and 48 Axiom User s Guide Version 1 10 November 2015
80. d 1 Press the barcode trigger and center the red line on the barcode from a distance of 6 8 in 15 20 cm The scanner will beep and the Barcode entry poster opens 2 Click on Done to accept the data indicated on the poster To enter assessment data and parameters manually 1 Click on the Audiometry button 2 Click on the Transducer screen button and then select a choice from the list 3 Click on the REUR screen button to toggle between Average and Measure Measured REUR should be used with a soundfield threshold because individual REUR is part of the threshold Average REUR should be used with headphone or insert phone thresholds because individual REUR isn t part of these thresholds 4 When all selections have been completed click on to save these selections and continue Click on X to exit this selections menu without saving 5 Enter HL threshold values using a mouse or keyboard Left click the mouse on the audiogram form to enter a point Click again to delete the point On the keyboard use the arrow keys to change frequency and level and use the numeric keypad ENTER key to enter or delete a threshold point 6 Click on when all points have been entered The HL for the highest frequency is used for aided targets at higher frequencies Audiometry Ear Left Transducer Headphone v Threshold Entered REUR Average Em we c REUR measurement procedure Perform
81. dB Gain If the stimulus type is Pink noise the analysis is performed in 1 12th octave bands and displayed in real time Pressing Continue captures the displayed spectrum If the stimulus type is Swept a swept filter analysis is performed in 1 12th octave bands and displayed at 1 3rd octave frequencies Pressing Continue causes the swept filter analysis to be performed in 1 12th octave bands and displayed at 1 12th octave frequencies Manual control procedure Manual control displays the reference microphone SPL the coupler microphone SPL their difference in dB gain and coupler microphone signal distortion at any selected 1 12th octave frequency and at a selected input level from 40 to 90 dB in 5 dB steps and at 0 dB off 1 Click on and select Manual control in the Test box menu 2 Click on the Level button and select the desired stimulus level from the drop down list 3 Click on the Frequency button and select the desired frequency from the drop down list Distortion 52 Axiom User s Guide Version 1 10 November 2015 measurement data is available only from 200 4000 Hz 4 Click on the Start test bar to start the test Start test changes to Stop Test To stop the measurement click on Stop test You may change Level and Frequency without stopping the test Sound level meter using manual control When set for a stimulus level of 0 dB off the Manual control mode allows the
82. dia i e a source other than an internal drive or memory component _ Yes_ TECHNICAL SAFEGUARDS Yes No N A Note 10 Can software or hardware not authorized by the device manufacturer be installed on the device cssceseeeseseeseeeeees No _ 11 Can the device be serviced remotely i e maintenance activities performed by service person via network or remote connection _ No _ a Canthe device restrict remote access to specific devices or network locations e g specific IP addresses _ b c Level of owner operator service access to device operating system Can the device owner operator a Apply device manufacturer validated security patches ccscccscccecsseecscescessuseeesseeseuerscscessueuscesesseueesesseeuseeee b Install or update antivirus software cesses C Update virus definitions on manufacturer installed antivirus software eeeeeeeee i d Obtain administrative privileges e g access operating system or application via local root or admin account _ No _ Does the device support user operator specific ID and password iseeeeeeeee eene nennen nnn nnne nnns No Are access sessions terminated after a predetermined length of inactivity e g auto logoff s essssersessrssssrsrenesesse Events recorded in device audit log e g user date time action taken Can the audit log record a Login and logout by users operators b Viewing Of ePHI siescis
83. differences see ANSI S3 22 1996 facts and ANSI S3 22 2003 facts To select the standard to be used 1 Click on t and then click on ANSI 2 Click on the version of the ANSI standard you wish to use 3 Click on Y to save your selections and exit the menu ANSI test frequencies The Frequencies feature allows hearing instruments to be evaluated at the Special Purpose Average SPA frequencies defined by ANSI 3 22 rather than the default High Frequency Average HFA frequencies The choice of SPA or HFA frequencies influences the average OSPL90 average full on gain reference test gain bandwidth and equivalent input noise The frequencies at which distortion is measured are one half the selected SPA frequencies You can also select the frequencies at which attack and release times are measured To change the averaging frequencies 1 Click on amp and then click on ANSI From within the ANSI window click on the HFA SPA pull down menu 42 Axiom User s Guide Version 1 10 November 2015 2 Highlight the desired HFA SPA test frequencies and Click on it to select To change the frequencies for attack and release time measurements In the list of available frequencies click on the frequencies to be used to measure attack and release time Click on Y to save your selections and exit the menu Test box calibration facts Test box microphone calibration establishes a correction cu
84. digital audio When a USB stick is connected to the Axiom Speechmap looks for files in the top level directory that have the following properties File format WAV Data format PCM no compression Sampling Rate 32 kHz Bit precision 16 or 32 bit Channels Mono File name 15 characters or less not including wav extension Existing WAV files can easily be converted to match these specifications using your preferred audio editing software Leveling Options By default Speechmap will automatically level the WAV file so that the Long Term Spectrum matches the level selected for the test The automatic leveling of the WAV file can be modified by inserting a tag in the filename This feature allows you to fine tune the output level of your stimulus The tag must be added at the end of the filename but before the extension Example filename 42 5 wav The tag must consist of an underscore followed by a plus or minus sign followed by the modifier in dB In the example above the tag 42 5 will level the file to be 2 5 dB above nominal There are no restrictions on the magnitude of the modifier there is built in protection against speaker overdrive Precision is limited only by the 15 character limit of the filename 87 Axiom User s Guide Version 1 10 November 2015 Audiometry Verification Headphone Mode Test box UCL Average Fitting BTE Bone NIA RECD Targets Average Rule None Age Adult
85. e replaced Invalid test box calibration Invalid test box microphone calibration This message may be displayed during the test box calibration procedure It indicates that the calibration curve is significantly different from what is expected It may be accompanied by a missing test box reference microphone error e Check that the there is no coupler on the coupler microphone and that the microphones are correctly positioned for test box calibration Check that the coupler microphone is securely plugged into the correct socket Follow the suggestions in No test box reference mic detected No on ear ref mic detected No right or left on ear reference mic detected This message may be displayed when starting an On ear test It indicates that the Axiom is not measuring any sound at the on ear probe reference microphone e Check that a probe microphone assembly is securely plugged into the PROBE socket underneath the test chamber and that the cable has not become damaged Unplug the test box reference microphone in the test chamber and plug the on ear probe microphone in its place Try Test box calibration using the reference microphone of the on ear probe microphone in place of the test box reference microphone If this is fails the on ear probe microphone is defective and must be replaced Invalid on ear calibration Invalid on ear microphone calibration This message may be displayed during the on ear calibration proced
86. e BTE coupler is either obtained from Audioscan or is 13 heavy wall earmold tubing exactly 10 mm in length Probe microphone 15 Axiom User s Guide Version 1 10 November 2015 Debris can alter the probe module reference microphone calibration and frequency response and can permanently clog the probe module port 1 DO NOT reuse probe tubes Probe tubes can be wiped with alcohol wipes for re use with the same patient but must not be used with multiple patients Attempts at ultrasonic cleaning usually result in cerumen becoming lodged in the lateral end which causes irreparable damage to the probe microphones DO NOT attempt to open or repair the probe microphone Attempting to repair the probe module may lead to damage or alteration of the factory calibration DO keep the probe module and probe tubes in a clean area DO stow the probe module when not in use or when transporting the Axiom 16 Axiom User s Guide Version 1 10 November 2015 3 General Operation This section describes the use of a mouse or QWERTY keyboard to control the Axiom and to enter data and the use of the optional barcode scanner to enter data from printouts produced by Audioscan analyzers It also provides instructions for updating the Axiom operating software Switching ON OFF See Getting Started for instructions on connecting the Axiom to its external power supply module the module to an electrical outlet and the location
87. e e irt niri eser p tivi Ter eu e te e toI ME ipe ERR ET AERA 102 MOU DESH O OUI P Y 103 NM NEM EC H M 103 Eoin ETAS ETELE O m 103 Test box Hie b GIStOntlOM Or MOSS esiseinas enaar ae eee a E ce TAE E EE E RE aE SE RE aE 104 Test DOR curyes IDCODSISTeDLU oou oneri Lt Per eter cete E pet nie be eta lees ene qe REE ESENE E aa 104 Test box curves differ from speciticatioris eese reciente t ete ter e eer e Hd e PE ER Hebe etatis 104 Test box sp aket verdrivet TH 104 Noitest box reference mic detected reiri noae edd ss a ud erret Eae etie aa ited eee aoe 105 Iny lid test Dox calibEAHon eed retra reris epe Peer HO e re EEE or eges bres dar OMA ee a 105 N on ear Tel miec detected goo ete te ic eR t MP tai USE HR aera 105 Inyalid on ear calibtatl ofiarne nenioo M 105 Sound Neld spedkero OVerdblVSEs c ceedecee er dr na ER ois PEOR C ans aE E A E EAS E eE este ie Re be ves Eo o E AD eE a te ed tn 106 Invalid RECD transducer coupler callBtatlOh eec tenet ertt rte t ve te iride de etd ete edi aed 106 Invalid RECD real ear measurement sss jase n coeno ro tit ne IR e e ERU e DEP ten been eso cba lem deis 106 Barcode scanner maltunclioti 5 e GE Eu E ita RE pid t D aquataagsieeed eesagebseneceauet
88. e field conditions ANSI 3 22 Equalization process of controlling the SPL or band SPL of the stimulus as a function of frequency at the field reference point ANSI S3 46 Expansion a type of AGC in which an incremental change in the input level produces a larger incremental change in the output level FM frequency modulation a method of transmitting information in which the frequency of a radio wave carrier is varied modulated by the information signal Also a method of reducing standing waves in a sound field in which the frequency of a test tone carrier is varied by a low frequency triangle or sine wave FM System an assistive listening device consisting of a microphone an fm radio transmitter and an fm receiver The microphone and transmitter are worn by the speaker and the receiver is worn by the listener 110 Axiom User s Guide Version 1 10 November 2015 FOG full on gain gain for a 50 dB input SPL with the gain control set to maximum ANSI 3 22 Gain in dB output sound pressure relative to input sound pressure expressed in decibels gain 20log10 output sound pressure input sound pressure also gain output SPL input SPL Gain control a manually or electronically operated control for the adjustment of overall gain ANSI 3 22 HA 1 Coupler a coupler having a volume of 2 cubic centimetres with direct access to the cavity Used for testing in the ear and in the canal hearing aids
89. ed e Check that the RECD transducer is inserted into the HA 2 coupler and the HA 2 coupler is tightly attached to the coupler microphone Check that the coupler microphone is connected Invalid RECD real ear measurement Invalid RECD real ear measurement This message may be displayed during the RECD real ear measurement It indicates that the measurement is significantly different from normal which may cause significant error while fitting e Check that the RECD transducer is connected Check that the probe module is connected Ensure the probe tube is not pinched or blocked e Check that the RECD transducer is inserted to the ear that is currently under test Barcode scanner malfunction If there is no red scanning beam when the trigger is pulled tug on the cable where it enters the scanner If it comes loose easily push it back in until it clicks in place If the scanning beam stays on when the trigger is released or if the barcode scanner fails to read known good barcodes try the following 1 Unplug the scanner from the equipment then reconnect it If the problem persists 2 Print this page on an external printer see External display printer speaker or from the electronic user s guide see Electronic user s guide 3 If your barcode scanner has a PSC logo scan these two barcodes starting with the top one This will reset 104 Axiom User s Guide Version 1 10 November 2015 the scanner to its defa
90. en Setup for terminology and information on preparing the system for use and for proper positioning of the client and the probe tube Insertion gain in SPL Insertion gain audioscan 1404 MaxTM SPL 120 Instrument BTE v 130 Format Graph vi Scale dB SPL 120 LI 110 Audiometry Un Speech Transducer Headphone Intelligibility REUR Average 90 Index SII 80 REAR REIG Stimulus Level SII 70 1 Pinknoise 55 76 60 2 50 nae REUR Pink noise 55 38 40 3443 NAL RP ivl 76 Fitting method gl LJ 30 REIG 1 f Curve Hide Show Target REIG i c M ewe 20 up l 10 SII for target 0 M a E EEEE T E bry EE N E neal E A EI EE E E E T ES TETTE 10 a ee a ee ml Sel e cn J m 3 eel 250 500 1000 2000 4000 8000 1 Click on zl Click on On ear then on Insertion gain 2 Click on the Instrument button to chose from BTE ITE ITC CIC CROS Body This changes the CORFIG used for 2cc targets 3 Click on the fitting method button to chose from NAL NLI1 FIG6 NAL RP POGO II Berger Libby User None 72 Axiom User s Guide Version 1 10 November 2015 Insertion gain in HL See On Ear Measures Setup and On Ear Measures Screen Setup 1 Click on and then click on Insertion gain within the On ear menu 2 Click on the Instrument button to chose from BTE ITE ITC CIC CROS Body This changes the CORFIG used for 2cc targets 3 Clic
91. ent Input noise 23 dB E 500 Hz distortion 970dB 2 926 800 Hz distortion 70dB 1 926 1600 Hz distortion 65dB 0 1 70 Frequency Attack Release E i 500Hz 5 320 ms x Averaging Frequencies qo00Hz B mE 2000Hz 0 380 ms i 4000Hz 0 210 ms 1 50 4 gt HFAISPA 1000 1600 2500 Hz 250 500 1000 2000 4000 8000 Format Except for Speechmap and Manual control screens you have the option of selecting either a graphic or tabular format To change the data format highlight then lt PICK gt Graph or Table 41 Axiom User s Guide Version 1 10 November 2015 Scale Test results are in SPL dB on all screens Hide or Show test box curves To hide or show test curve s On the Speechmap screen 1 Click on the Hide Show buttons located just below each of the Test identifier numbers as shown below Note that the Hide Show aided button has 3 states Curves hidden display LTASS only and display LTASS speech envelope i e the speech banana Hide Show unaided A SpeechtsTs ie is speech region 7 9 Hide Show aided 7 7 LTASS or LTASS speech envelope Hiding a curve does not erase it To erase curves click on D and select one of the Erase options 1996 or 2003 ANSI standard Automated tests of linear and AGC hearing aids may be conducted according to either the ANSI S 3 22 1996 or ANSI S3 22 2003 test standards For
92. equency lowering properties of the hearing instrument have been verified use one of the Speech std stimuli to verify aided speech audibility or target match as described elsewhere in this section for frequencies below the isolated band Speechmap audioscan Aided LTASS for Speech5000 R Audiometry Verification Insert Foam Mode Test box 120 UCL Average Fitting BTE Bone NIA 110 RD _ Targets With frequency lowering z RECD Tages s x Entered Rule None Without frequency lowering Age Adult Monaural Loss simulator 130 mm Speech5000 500 1000 2000 4000 FM fitting and verification FM Offset or FM Transparency method in Speechmap after Platz 2004 It is assumed that the hearing aid has been set up for optimal audibility and maximum output See Speechmap screen choices for setup and audiometric data entry See Using Speechmap 1 Before attaching the FM receiver couple the hearing aid to the 2cc coupler in the test box click on and select Speechmap from the Test box menu Click the Verification button and select the appropriate Fitting type typically BTE 2 Click on the Test 1 button and Bi then choose Speech std 1 2 or the ISTS at a Level of 65 dB Click on 96 Axiom User s Guide Version 1 10 November 2015 3 e to run and record the speech passage Attach the FM receiver to the hearing aid and set the FM receiver to the default
93. equired to correct abnormal loudness as modelled by his cochlear hearing loss simulation It provides two approaches to correcting for the hearing loss Camfit restoration aims to amplify sounds that are soft comfortable and loud for a person with normal hearing so that they are soft comfortable and loud for a hearing aid wearer This is the stated goal of the IHAFF International Hearing Aid Fitting Forum fitting method Camfit equalisation aims to amplify speech to produce the same loudness in each critical band It has been argued that this is likely to give the highest intelligibility for a given overall loudness This is the rationale behind the NAL fitting methods and will generally produce similar targets Using Speechmap The Speechmap fitting environment provides a number of distinctly different stimuli Speech and noise are analyzed in 1 3 octave bands and for most speech stimuli data are presented as 3 curves The top curve is the level exceeded 1 of the time speech peaks the lower curve is the level exceeded 70 of the time speech valleys and the middle curve is the average Combined these three curves depict the aided speech banana Starting a test by clicking on causes the signal to be presented continuously the recorded speech signals run in a loop and the curves are updated frequently to show any changes you make to the settings of the hearing instrument Clicking on e restarts the speech passage and the curves are t
94. ermined by the settings of the hearing aid but may reach levels that can produce hearing damage in less than 30 seconds To avoid this possibility 1 hearing aids should be adjusted to limit sound pressure levels to safe levels 2 the maximum TM SPL setting see Max TM SPL Setup should be used to terminate tests if an unsafe level is detected in the ear canal 3 test levels should be limited to 70 dB SPL except when necessary to verify the limiting levels of the hearing aid in which case the test should not last longer than 15 seconds 4 be aware of the test signal and patient reaction during a test and be prepared to respond to any sign of discomfort by reducing the SPL setting switching off the equipment or the hearing aid or removing the 10 Axiom User s Guide Version 1 10 November 2015 patient from the area When using the equipment to measure the Real Ear to Coupler Difference in small ear canals it is possible to induce a hearing loss if the test is allowed to continue for more than 1 hour Since accurate results can be obtained in less than 10 seconds this possibility should never occur in normal practice Power and Grounding This product contains numerous safety features to ensure that the probability of electrical shock is as low as reasonably practicable In order to ensure that all of the safety features work optimally you must ensure that the power cord is plugged into a grounded outlet Any line powered per
95. ess will be reported Click to apply your settings Network Network Wired v M IP Address Auto use DHCP 172 30 1 81 4 Details za Es 5 Connecting to a wireless WLAN network 1 2 3 4 Ensure Audioscan AX 100 WiFi adapter is connected to a USB port on the Axiom Select Change to set Network to the Wireless option Click Scan Once the scan is complete select your wireless network from the list Note wifi networks containing will not be displayed in the pull down menu Confirm the wireless security type for your network If you are unsure of the security type please consult your network administrator Type the security key or pass phrase into the Password text field Click Test connection to test your settings Click to apply your changes 23 Axiom User s Guide Version 1 10 November 2015 Network Network Wireless x SSID Audioscan Scan Signal 74 Security WPA Password orm zi IP Address Auto use DHCP _ 172 30 1 68 Details ET EE 6 To assign a network address automatically using DHCP 1 Simply enable Auto 2 Click Test settings to test your settings 3 If the test is successful your Axiom network address will be displayed e g 172 30 1 44 4 Click to continue Large institutional computer networks sometimes use stati
96. essed in decibels SPL 20log10 rms sound pressure 20uPa SPLITS coupler SPL for an inductive telephone simulator SPL developed in a 2cc coupler by a hearing aid with the gain control at the RTS when the input is the magnetic field generated by a TMFS ANSI 3 22 TMFS Telephone magnetic field simulator a device for producing a magnetic field of consistent level and geometric shape when driven by a specified current ANSI S3 22 THD Total Harmonic Distortion the power in all harmonic components as a percentage of the power in the fundamental If less than 2096 the power of the total signal may be used instead of the fundamental For most hearing aids the inclusion of harmonics above the third will not significantly alter the THD ANSI 83 22 Transducer a device which transforms energy from one form to another For example a microphone or earphone UCL Uncomfortable Listening Level the level for a specified stimulus that is judged to be definitely 113 Axiom User s Guide Version 1 10 November 2015 uncomfortable VGA video graphics adapter VC Volume Control a user operated gain control Warble Tone a frequency modulated sine wave The modulating signal is often a low frequency triangle wave 1 Valente M Strategies for Selecting and Verifying Hearing Aid Fittings New York Thieme Medical Publishers Inc 1994 ANSI S3 5 Methods for Calculation of the Speech Intelligibility Index 1997 ANSI S3 6
97. following Monday depending on the choice of Daily or Weekly calibration interval After the calibration has expired you will be prompted to calibrate whenever you attempt a test that uses the on ear measurement microphones It is suggested that a copy of the calibration curves for the probe modules when new be posted near the Axiom for comparison with daily or weekly curves If there is a drift in calibration with time the module may need replacement See Calibration check for probe module Calibration should be repeated if a probe module is replaced or if a probe tube with different dimensions is installed Switching left and right probe modules after calibration will result in the wrong calibration curve being applied Calibration of on ear probe microphone Ensure the probe microphone assembly to be calibrated is plugged into the appropriate jack See Microphone connection and On ear calibration facts 1 Click on and then click on Calibration within the On ear menu 2 Press the enlarged end of a probe tube as far as it will go into the recessed opening at the top of the probe module 3 Position the open end of the probe tube in front of the reference microphone inlet and press it between the posts as shown 57 Axiom User s Guide Version 1 10 November 2015 4 Hold the probe module 15 90 cm 6 36 inches away from and directly in front of the sound field loudspeaker Orientation of the probe module is no
98. frequency A pink noise signal has a flat spectrum when ana lyzed in fractional octave bands A critical band is a band within which the loudness of a continuously distributed signal of constant SPL is independant of bandwidth 2 1 Narrow band signals 2 1 1 Sinusoidal pure tones Sinusoidal signals are used in the ANSI hearing aid tests in Multicurve 2 cm frequency response tests gain or output in 2 cm and on ear single frequency manual tests in Insertion gain tests and in tone burst maximum output MPO tests The MPO stimu lus consists of a series 128ms tone bursts with 128ms gaps at an SPL of 90 dB SPL in the test box and 85 dB in the sound field Frequencies used are 1 12 oc tave except for the MPO test which uses 1 3 octave frequencies Levels from 40 to 90 dB SPL are available at the reference microphone Control of the level at each frequency is maintained by measuring the fre quency response of the signal path to the reference microphone 256 ms before each test using a 256 ms 50 55 dB SPL multi tone complex or a 256 ms chirp depending on the test to follow Drive levels at each frequency are then set to achieve the desired band levels at the reference microphone For on ear mea surements tones are frequency modulated triangle 396 over 128 ms 2 2 Broad band signals 2 2 1 Pink Noise signal The pink noise signal is available for Multicurve 2 cm coupler gain and output frequency response mea
99. he acoustic impedance of the ear canal or the coupler This is the case for RIC ITE and ITC hearing aids and is approximately true for insert earphones with the supplied foam tips The acoustic impedance of insert earphones drops if the foam tip is replaced by an earmold or the tubing that forms part of the HA 2 coupler At some frequencies for BTE hearing aids with their earhooks and earmold tubing or the HA 2 coupler tubing the acoustic impedance approaches that of an adult ear and falls below that of a child s ear Each of these sound sources will produce a different RECD and if the acoustic impedance of the sound source differs for the ear canal and 2cc coupler measurements further RECD differences will result Audioscan uses the HA 2 BTE coupler for the transducer calibration then our RECD transducer and either a foam eartip or the client s personal earmold for the real ear measurement When a foam tip is used we subtract the two measurements to get an HA 1 RECD When an earmold is used on the ear measurement we first subtract an average earmold referenced to our RECD transducer to obtain an HA 1 RECD then we add the same average earmold referenced to an ER3A to obtain an HA 2 RECD with earmold effects retained When the entered HL transducer is Insert foam we apply an HA 1 foam tip RECD during the HL to SPL transform to correct the thresholds measured in a non average ear canal When the HL transducer is Insert mold we apply the
100. he earhook to the coupler inlet All of the tubing required by ANSI 3 22 is machined into the metal stem of the HA 2 coupler The HA 2 coupler tubing should be inspected regularly for cracks which will cause feedback If the tubing is worn or damaged contact Audioscan for a replacement Alternatively it can be replaced by a 10 mm length of 13 heavy wall earmold tubing Custom instruments are sealed to the HA 1 coupler with putty so that the end of the eartip is flush with the inside of the coupler opening Putty should not extend into the coupler cavity or block the sound outlet of the instrument Vents should be sealed at the faceplate end It is very important that the instrument be well sealed to the coupler Open fit instruments must use the coupler and coupling system specified by the manufacturer This may involve a hook that replaces the open fit tubing or an adapter tube that may be sealed to the opening of the HA 1 coupler with putty RITE Receiver in the ear instruments are coupled to the HA 1 coupler using putty to seal the receiver module or soft tip to the coupler opening Excess low frequency output is usually due to open vents or a poor seal to the coupler For health reasons hearing instruments should be clean before putty is applied and putty should be replaced 45 Axiom User s Guide Version 1 10 November 2015 frequently Coupling the hearing instrument for Test box Speechmap A WARNING To redu
101. he speech ISTS and ICRA signals are presented unfiltered for levels from 50 to 70 dB SPL At 75 dB SPL the spectrum is filtered to represent a loud vocal effort An own voice filter is also available at the 75 dB SPL level This is intended to produce a spectrum and level at a BTE microphone location similar to that produced by the voice of an average wearer A tone burst MPO stimulus provides 128 ms bursts with 128 ms gaps at 1 3 octaves with a level of 90 dB SPL in the test box and 85 dB SPL for on ear mode In test box mode all signals are filtered to include BTE ITE ITC CIC Body microphone location effects The selected overall rms level is established prior to filtering For fitting FM systems the stimuli may be modified to represent the level 84 dB SPL and spectrum at a chest microphone location and the level 93 dB SPL and spectrum at a boom microphone location These are presented in the test box in both on ear and test box modes The overall SPL 1 3rd octave band SPL vocal effort and microphone location effects are given in the following tables for the various broad band signals available Stimulus levels LTASS for standard speech is from Cox amp Moore 1988 Loud spectrum is from ANSI S3 5 1997 Own voice 98 Axiom User s Guide Version 1 10 November 2015 spectrum is from Cornelisse et al 1991 adjusted to a 1 m reference 1 3 octave band SPL Add to band SPL for Speech ICRA Pink
102. hen calculated for the entire passage producing an accurate display of the speech region and LTASS and an accurate SII calculation When using live speech gt changes to m which may be selected to capture short term speech features See SII calculation in Speechmap and Speechmap Technical Details 80 Axiom User s Guide Version 1 10 November 2015 Before starting please see On Ear Measures Setup Speechmap Fitting Speechmap Technical Details and On Ear or Test Box Mode To access Speechmap click on zl then click on Speechmap in either the On ear menu or in the Test box menu To change screen setup see On Ear Measures Screen Setup and On ear or Test box mode To set up hearing instrument type click on Verification then click on the Fitting list button and select from BTE ITE ITC CIC RITE receiver in the ear test box mode Open On ear mode Body CROS On ear mode or FM This changes microphone location effects and the RECD used in test box measures and 2cc targets and the reference microphone used for FM and CROS To enter audiometric data see Assessment data entry To run a test click on oO or or B Then click on gt to start the test Once the test is started click on the Stimulus list button to select the stimulus type Click on the Level list button to select stimulus level Click on e to run the long term average test and display the data Click on m to cancel the test See
103. hen the LTASS is at threshold approximately de pending on test material and the individual These scenarios are shown in Figures 10 12 which follow It should be noted that analysis methods which use shorter time periods produce higher peak levels and significantly different speech envelopes In order to produce results that can be directly compared to mea sures of threshold and UCL the analysis time period needs to approximate the integration time of the ear Although this varies with frequency and individuals a value between 100 200 ms is likely The Verifit and RM500SL use a 128 ms analysis time period as an ap proximation because it also has considerable historic support Because the spectrum of a speech signal varies with time it is necessary to average measurements over several seconds to obtain a stable repeatable result However the effects of adjustments to hearing aid pa rameters need to be seen quickly in order to be useful for optimization To resolve these conflicting needs speech signals are first presented in a repeating loop with a sound field equalization test prior to the start of each passage A running calculation of the short term speech envelope and average is performed on 2 3 seconds worth of data and is displayed in real time so that the effects of adjustments to hearing aid parameters are easily viewed Pressing the Continue key causes the passage to restart and run in its entire ty The envelo
104. hmap from either the On ear or Test box menus 2 Program the hearing instrument so that the frequency lowering feature is inactive 3 Access Test 1 2 or 3 then click on irl to start that test 4 Choose Speech3150 Speech4000 Speech5000 or Speech6300 from the Stimulus pull down menu Choose 65dBSPL from the Level pull down menu Note that only the LTASS is shown for these stimuli and targets f selected have been suppressed 5 Click on to measure and store the long term signal averaged result If the isolated band does not appear in the Test 1 curve it may indicate that the hearing aid has no gain at the selected band frequency This does not mean that the hearing aid will be unable to transpose the band to a lower frequency when frequency lowering is enabled 6 Program the hearing instrument to activate the frequency lowering feature 95 Axiom User s Guide Version 1 10 November 2015 7 Click on another Test button click on Bl and select the same stimulus and stimulus level used in Test 1 8 Click on e to measure and store the long term signal averaged result 9 The isolated band should now appear at a lower frequency and should reach or exceed threshold at its new location as shown below Note that the cavity between 1 kHz and the isolated band may be partially or completely filled in by noise within the hearing aid which will make the isolated band appear less distinct in the test curves 10 Once the fr
105. hones need to be calibrated Context sensitive help is available by clicking on or pressing F1 on a connected QWERTY keyboard The Help index left panel or Help page right panel may be selected by left clicking the mouse on either panel or by pressing the F5 key on a QWERTY keyboard The side sliders on each panel may be used to scroll through the Help index or long Help pages This may also be accomplished using scroll wheel on the mouse or the arrows on a QWERTY keyboard Software updating The software currently running on your Axiom is stored in internal memory A USB flash drive was shipped with your Axiom It will be required to transfer future software updates from a PC to the Axiom STORE IT IN A SAFE PLACE You may download the latest software from www audioscan com or request that a CD ROM be mailed to you Instructions for transferring the software update from your PC to the Axiom will be included with the software download or the CD ROM 19 Axiom User s Guide Version 1 10 November 2015 4 General Setup This section covers Date and Time setup Display settings including mouse pointer speed setting and Saving test setup Date and time setup To set the date and time that appears on printouts and calibration screens 1 2 Left click on 3 Left click on Date amp Time on the Setup menu To change the date left click on the month date or year windows and make your selection from the drop down list
106. ial Number C1267 and Axiom commencing with Serial Number B1954 comply with the legislation regulating certain hazardous substances in electrical and electronic products in the United Kingdom transposing the provisions of the European Parliament and Council Directive 2011 65 EU RoHS2 namely the Restriction of the Use of Certain Hazardous Substances in Electrical and Electronic Equipment Regulations 2012 SI 2012 No 3032 as amended the RoHS Regulations 2012 CE April 15 2015 A T a D B Whitred MAA Ke 0086 Regulatory Affairs Manager Quality System Management Representative 20 Ludwig Street Dorchester Ontario NOL 1G4 www audioscan com Tel 519 268 3313 Fax 519 268 3256 USA 1 800 265 2093 Axiom User s Guide Version 1 10 November 2015 Electronic User s Guide e Failure to follow the operating instructions could place the operator at risk You can download the current User s Guide directly from www audioscan com A printable User s Guide is on the updater USB flash drive supplied with a new instrument This User s Guide will be updated each time you download new software from www audioscan com to the updater USB flash drive Except for some additional reference material this same information is available to you at any time by clicking on the Axiom A pdf file viewer such as Acrobat Reader 5 0 or higher or Foxit Reader is required to view the User s Guide To view the User s Gu
107. ide 1 Insert the updater USB flash drive into a USB port on your PC 2 If your PC does not open the flash drive automatically select My Computer then the Removable Disk drive usually E or F 3 Double click the User Guide folder to open it 4 Double click the english folder and copy the Axiom Users Guide pdf file to an appropriate location on your PC Double click on the file to open it for viewing When you have finished copying the file from the USB flash drive click on the safely remove icon on your PC and remove the flash drive when you are notified that it is safe to do so STORE THE UPDATER USB FLASH DRIVE IN A SAFE PLACE YOU WILL REQUIRE IT TO INSTALL FUTURE SOFTWARE UPDATES How to Avoid Undesirable Side Effects During the development of the hearing aid analyzer Audioscan performed a rigorous Risk Assessment to identify any undesirable side effects that a user could be exposed to during the use of the Axiom and incorporated numerous risk reduction design elements into the Axiom to minimize the risk to users and patients Following are the actions which a user should take to ensure that these risk control measures continue to be effective Loud Sounds The Axiom is designed to produce sound pressure levels as high as 85 dB at the probe reference microphone Exposure to these levels for more than 7 hours can produce hearing damage When such levels are amplified by a hearing aid the level in the ear canal will be det
108. in differing SPL thresholds and differing estimated ear canal SPL If Enter is selected an entry screen will be provided when the poster is closed If Measure is selected the Measure RECD screen is provided when the poster is closed See RECD measurement 5 Age Select from Adult 6 10 years 1 60 months This changes the RECD applied if DSL Average or NL2 Average has been selected when using these target rules 89 Axiom User s Guide Version 1 10 November 2015 Verification Targets Mode Test box Rule NAL NL1 nd Fitting BTE wj Type Binaural X Lv due 6 Fitting Type of instrument or fitting to be verified In Test box mode select from BTE ITE ITC CIC RITE receiver in the ear Body or FM In On ear mode select from BTE ITE ITC CIC Open Body or FM In the case of a CIC a deep insertion factor is applied to the estimated ear canal SPL 7 Rule Fitting rule Select from DSL Adult DSL Child NAL NL1 NAL NL2 or None 8 Type Select from Binaural or Monaural fitting targets if DSL Adult NAL NL1 or NAL NL2 has been selected For DSL child only targets for a monaural fitting are provided 9 Loss simulator An electro acoustic simulation intended to allow normal hearing listeners to hear sounds as if they had the elevated threshold and altered loudness perception caused by outer and inner hair cell damage See Sensory loss simulator Data entry
109. ing a REUR test erases all existing REAR and REIG data associated with the current test ear REUR should be measured only if Transducer Soundfield Otherwise it is more accurate to use average See Audiometric data entry 1 Click on and then click on Insertion gain within the On ear menu 2 Referring to On ear measures Setup and On ear measures screen setup prepare the system position the patient and insert the probe tube 3 If REUR is set to Average click on the Audiometry button then toggle the REUR button to Measure Click on to advance to the Threshold entry poster You may enter threshold data at this time see Audiometric data entry or click on v to proceed with the measurement 74 Axiom User s Guide Version 1 10 November 2015 4 5 Click on the REUR button below REAR REIG test 3 Click on v to accept the default 55 dB SPL Pink noise stimulus and capture the REUR curve OR click on the Stimulus and or Level buttons to select other values These choices have no impact on the resulting REIG If there is a notch in the 4000 to 8000 Hz region try advancing the probe tube 2 mm and repeating step 3 If the notch moves to a higher frequency repeat this step until the notch moves beyond the highest frequency of interest Because it is analyzed in 1 3 octave bands the Pink noise stimulus produces a REUR 12 dB below that produced by the Swept stimulus at the same overall level
110. ions which are presented Turn the instrument ON M amp k 05 rp Set the gain control manual or programmable to maximum with all other controls set to provide the widest frequency response greatest gain and highest maximum output AGC controls and or programmable parameters should be set to minimize AGC action AGC off or threshold high compression ratio close to 1 6 Click to run the test or to abort the test Note that if required the Axiom will pause during the test to request that the gain control be adjusted to the Reference Test Setting RTS If necessary open the HIT chamber and without moving the hearing instrument adjust the gain control until the large vertical arrow on the screen prompt disappears Click to resume the test During the AGC test the Axiom will pause to request that AGC controls or programmable parameters be set for maximum AGC effect If the manufacturer does not provide settings to produce maximum AGC effect use settings that result in the highest gain for soft sounds and the lowest gain for loud sounds This will typically result in the lowest compression threshold a flat I O curve and the longest attack release times These are not typical characteristics but indicate the adjustment range possible for these parameters If you are unsure which test sequence to run try AGC first If attack and release times are all near zero the instrument is probably linear 49 Axiom User s Guide Version
111. ipherals connected to the Axiom must comply with UL IEC 60601 1 OR comply with UL or IEC or ISO safety standards for such equipment AND a be operated from an isolating transformer complying with UL IEC 60601 1 OR b be kept at least 6 feet 1 8m from the patient Ear Infection Probe tubes or RECD foam tips should not be re used on another patient There is a possibility of transferring an ear infection to the other patient Probe tubes and RECD foam tips are for single patient use only Do not attempt to clean or re use Ear Canal Discomfort An otoscopic examination should always be performed prior to inserting a probe tube into the ear canal to ensure that it is healthy and free of obstructions Care is needed when inserting probe tubes into the ear canal Although the probe tubes are made of soft flexible material specially designed for this application it is possible to scrape the ear canal or touch the eardrum causing brief discomfort You should carefully follow the instructions in Positioning the probe tube section of this User s Guide 11 Axiom User s Guide Version 1 10 November 2015 2 Getting Started This section provides instructions for unpacking the Axiom and connecting various components and associated items Unpacking and connecting A WARNING To avoid the risk of electrical shock use only the power supply and power cord supplied with the Axiom and connect it only to a grounded protectively e
112. ital signal processor DSP or played from 16 bit binary audio files stored in the on board flash memo ry In the Verifit these audio files are up loaded from the internal compact disc CD drive at power up In order to provide a repeatable acoustic signal to the device under test a reference microphone is used in conjunction with a digital control loop to maintain the desired band level at each frequency Live audio speech music etc may also be used as a test signal but it is not controlled for spectrum or level Some useful facts about broad band signals Overall SPL is the SPL in a band containing all signifi cant frequency components of the signal Spectrum level is the SPL in a band 1 Hz wide Band SPL is the SPL in a restricted frequency range If the signal is uniform in the band band SPL Spec trum level 10 log bandwidth A spectrum is the band SPL or spectrum level in a series of adjacent bands For a broad band signal the overall SPL is greater than the band SPL and the band SPL is greater than the spectrum level For a pure tone the overall SPL the band SPL and the spectrum level are the same A white noise signal has a spectrum level that is inde pendent of frequency i e constant SPL per Hertz A pink noise signal has a spectrum level that is in versely proportional to frequency i e constant SPL per octave A fractional octave band e g 1 3 octave has a band width that is proportional to
113. k it should be at the edge facing outward A room with sound absorbing floor ceiling and walls is recommended 3 Turn the Axiom over and connect the on ear probe microphones and the RECD transducer as shown 4 Dress the leads out the sides front or rear of the Axiom as appropriate for your work setup and turn the Axiom over placing it on its rubber feet in the place where you will use it 12 Axiom User s Guide Version 1 10 November 2015 f gt es wy 5 Open the lid of the test chamber by using your thumb to roll the rubber roller toward the front of the Axiom This is made easier by placing your fingers under the front lip When sealing the chamber in its closed position place your fingers on top of the lid and use your thumb to roll the rubber roller toward the rear of the Axiom 6 Plug the reference microphone and coupler microphone in to their respective connectors in the test chamber 13 Axiom User s Guide Version 1 10 November 2015 E iT MICROPHON COUPLER MICROPHONE 7 Connect the speaker to the speaker connector on the rear connector panel 8 Connect a video monitor HDMI or DVI with adapter to the PRIMARY MONITOR connector on the rear connector panel This connector must be used if a single monitor is connected An additional monitor may be connected to the second MONITOR connector 9 When connecting both of the Axiom s monitor connectors to TV displays The set
114. k on the fitting method button and chose from FIG6 NAL NL1 NAL R POGO II BERGER LIBBY USER NONE An estimated aided threshold curve is calculated by shifting the unaided threshold curve upward by the REIG This estimate assumes a the unaided threshold is a sound field threshold and b a linear aid i e REIG doesn t depend on level The REUR curve uses the right hand SPL scale and is shown for reference only Insertion gain audioscan 30 f TS Instrument Scale dB O Cu KM PEE 55 Audiometry 16 Target Estimated Speech Transducer Headphone S ut T Risa i Intelligibility REUR Average 20 nresno N Index SII Sa 7 REAR REIG Stimulus Level SII 40 1 Pink noise 55 76 50 BE f 60 mcd REUR Pink noise 38 70 NP Macs ANE bed Unaided Threshold Fitting method NAL RP iv 76 80 Curve Hide Show 30 SII for target 100 Aided Threshold 110 120 Max TM SPL 120 Koaccoalitencoatan sive PERIPXRERABHAVDNATPABUEIBSNRRUXOSEERWAVEREIDHEUETIVLLITTERRSPORENAPEERONOROIRADGRM 250 500 1000 2000 4000 8000 Audiometric data entry Threshold data and parameters may be entered by scanning a barcode on an Audioscan printout manually using a mouse or the numeric keypad on an external keyboard See Mouse keyboard barcode scanner and Input 73 Axiom User s Guide Version 1 10 November 2015 device operation To enter data from a barcode see Barcode data input an
115. live speech may be used as a test signal It will of course be unequalized and at an uncontrolled level 3 Analysis of broad band signals Broad band signals contain energy at many frequen cies simultaneously Such signals are usually analyzed in a series of narrow frequency bands to produce a spectrum The auditory system functions on a loga rithmic frequency scale and analyzes broad band sig nals in critical bands which approximate 1 3 octave bands Figure 7 Using 1 3 octave bands for analysis of broad band signals allows measured levels to be compared more readily to narrow band behavioral measures such as threshold For this reason analy sis of broad band signals in all On ear measurements including Speechmap Test box mode is in 1 3 octave bands Other analyzers use narrower analysis bands sometimes having constant bandwidth As shown in Figure 7 this can result in significantly underestimat ing the audibility or comfort or discomfort of a com plex signal It should be noted that in all On ear measurements 1 3 octave band SPL is displayed and reported when saving data to a file at 1 12 octave frequencies which provides curve smoothing and causes the spectrum of narrow band signals to appear broadened When calculating overall rms from these data the SPL at 225 Hz and subsequent 1 3 octave increments should be used Analysis of broad band signals in all Test box tests except Speechmap is in 1 12 octave bands a
116. low you to store data permanently in Session files which you can later restore to the Axiom To access the Session features click the Session button and select one of the erasure or storage options You can store the Axiom data in session files on a USB drive or on a Windows shared folder You can later restore the session files to the same Axiom or to other Audioscan equipment Since the files use an XML data format you can also view session file contents through a web browser and you can load them in a spreadsheet program such as Microsoft Excel To enable and configure file based data exchange 1 Click Setup then select Session a 2 Click Enable file based data exchange 3 Click the storage file location USB drive or Windows share 38 Axiom User s Guide Version 1 10 November 2015 Storing session files on a USB drive requires that you simply insert the drive into any of the Axiom s USB ports Storing session files on a Windows shared folder requires that your Axiom be connected to the local area network and that you create a shared folder to store the files on one of your computers See the section above Windows shared printers and folders for instructions about setting up a Windows shared folder Storing and restoring session files You can save a session file at any time by clicking Session from the Axiom home menu and then by selecting Store session to file
117. map Single view DET 146 TEE instrument BIE T _ Mode S REM 30 Presentation Single view 30 Format Graph ne Seale dB SPL 20 i Pe 3 Ol Bprech shape Avg 5 79 10 ES oc o EE E apr T T l Unalded 23 T Curve Hide Show Figure 12 The highest SII is obtained when the entire speech envelope is above threshold 99th Percentile of 1 3 Octave Band SPLs for Speech Signals Average Effort re LTASS for entire passage Hanning window 128 ms average 14 00 12 00 6 00 BAND SPL dB re LTASS 4 00 7 99th 9oile re LTASS STANDARD 2 00 99th ile re LTASS FEMALE 99th ile re LTASS CHILD 99th ile re LTASS ICRA k th ile re LTASS ISTS 0 00 200 250 315 400 S00 630 800 1000 1250 1600 2000 2500 3150 4000 5000 6300 8000 BAND CENTER FREQUENCY Hz Figure 13 Level of 99th percentile for Speechmap speech signals at average vocal effort 20 Ludwig St Dorchester A 30th Percentile of 1 3 Octave Band SPLs for Speech Signals Average Effort re LTASS for entire passage Hanning window 128 ms average 0 00 5 00 8 8 BAND SPL dB re LTASS a 8 25 00 30th ile re LTASS STANDARD 9 30th ile re LTASS FEMALE t 30th ile re LTASS CHILD 30th ile re LTASS ICRA kk 30th ile re LTASS ISTS 200 250 315 400 500 630 800 1000 1250 1600 2000 2500 3150 4000 5000 6300 8000 BAND CENTER FREQUENCY
118. mp Sinclair S T 1998 The Audioscan RM500 Speechmap DSL fitting system Trends in Amplification 3 4 125 139 Corliss E L R 1990 The ear as a mechanism of communication Journal of Audio Engineering Society 38 9 640 652 Cornelisse L E Gagne J P amp Seewald R C 1991 Ear level recordings of the long term average spectrum of speech Ear and Hearing 12 1 47 54 Cornelisse L E Gagne J P amp Seewald R C 1991 Long term average speech spectrum at chest level microphone location Journal of Speech Language Pathology and Audiology 15 3 7 12 Cornelisse L E Seewald R C amp Jamieson D G 1994 Wide dynamic range compression hearing aids The DSL i o approach The Hearing Journal 47 10 23 29 Cornelisse L E Seewald R C amp Jamieson D G 1995 The input output I O formula A theoretical approach to the fitting of personal amplification devices Journal of the Acoustical Society of America 97 3 1854 1684 Cox R M amp Moore J N 1988 Composite speech spectrum for hearing aid gain prescriptions Journal of Speech and Hearing Research 31 102 107 Dunn H K amp White D S 1940 Statistical measurements on conversational speech Journal of the Acoustical Society of America 11 278 288 Feigin J A Kopun J G Stelmachowicz P G amp Gorga M P 1989 Probe tube microphone measures of ear canal sound pressure levels in infants and children Ear and Hearing 10 4 25
119. n Listeners should be within 1m of the sound field speaker and in a quiet room 1 Click on and select Speechmap in either the Test box menu or the On ear menu 2 If an audiogram has previously been entered in Speechmap or Insertion gain go to step 5 Otherwise click on the Audiometry button 3 Enter HL threshold values using the mouse Left click the mouse on the audiogram form to enter a point Click again to delete the point 4 Click on to return to the Speechmap screen when all points have been entered 5 Click on the Loss simulator button E Birds fe 70dB PK m m Hearing Entered loss _ 12 Entered loss S Normal sir Type ofloss Sensorineural 6 Click on Bi Sound processed to simulate the entered hearing loss will be presented via the sound field speaker 7 Click on list button next to the play button for a list of sounds to play and click on one of them 55 Axiom User s Guide Version 1 10 November 2015 8 Click on one of the Hearing buttons to simulate the Entered loss 1 2 Entered loss or Normal hearing 9 Click on m or m to stop the demonstration and freeze the stimulus speech banana on the screen 10 Click on X to exit from the Sensory Loss Simulation screen 11 Click on toggle button next to the Type of loss toggle between Sensorineural and Conductive hearing loss simulations 56 Axiom User s Guide Version 1
120. n 1 10 November 2015 the Postscript printer language Otherwise you must select a Hewlett Packard printer model See HP printer described below Test your selection by clicking the Print test page button You will get results only if the printer successfully prints the page which can follow some delay For example it takes about fifteen seconds for a USB connected HP printer to start printing the test page Otherwise check your settings and try again Alternatively you may prefer to use a web browser to capture the Axiom screen image and to print from the browser using the computer s printer See Web browser screen capture for details HP printer If you use an HP printer then you must select the specific product model From Setup printing click the button that shows the printer model name The Axiom will show almost all available HP printer models Find and click on your printer model then click v to accept your choice HP printer Click on your printer Deskjet d2600 Deskjet d2600 Deskjet d2660 Deskjet d2645 Deskjet d2663 Deskjet d2666 Deskjet d2666 Deskjet d2660 Deskjet 2640 Deskjet Ink Advantage 2645 All in one Deskjet Ink Advantage 2646 All in one Deskjet 3000 j310 Deskjet 3000 j310 Deskjet 3050 j610 Deskjet 3050 j610 Deskjet 3050a j611 Deskjet 3050a j611 Deskjet 30553 E all in one j611n Deskjet 30573 E all in one j611n Deskjet 3059a E all in one j611n Deskjet 3055a E all in o
121. n choices to enter audiometric data and select the fitting rule 2 Click on 3 to select the third Speechmap test The Test 3 box is outlined to indicate it is active 3 Click on gt to start this test Once the test is started click on the Stimulus list button to select the stimulus type as MPO When you start a new test the speech envelope of the previous test may be automatically hidden See Speechmap Setup to change this behaviour To change the default stimulus type and level see Saving test setup 4 In Test box mode while the 90 dB sweep is being presented adjust the hearing instrument s high level gain and or output limiting e g MPO PC so that the curve matches the REAR90 targets DSL or approaches but does not exceed the UCL estimates at all frequencies 5 Click on e to run and store a complete sweep Repeat as necessary 6 In On ear mode advise the client to point to the screen if a sound becomes too loud during the test see Max TM SPL setup Click on le to run and record a single sweep Adjust the gain and output for loud sounds as for test box measures factoring in client response Speechmap DSL 5 0a adult audioscain Audiometry Verification 130 j Headphone Mode Test box 120 DSL REAR90 target UCL Average Fitting BTE Estimated UCL Bone N A 0 EM 11 3 i 109 Measured MPQ A 4 l RECD Targets i _ Rule DSL adult 90 Age Adut Type Mo
122. n control at RTS ANSI 3 22 Reference Sound field the calibration point of a sound field measurement RSETS Relative Simulated Equivalent Telephone Sensitivity difference in dB between the HFA SPLITS SPA SPLITS and the RTG plus 60 in the M microphone mode RSETS HFA SPLITS RTG 60 RTS Reference Test Setting of the gain control for a 60 dB input SPL the setting of the gain control required to produce an HFA gain within 1 5 dB of the HFA OSPL90 minus 17 dB If the full on HFA gain is less than the HFA OSPL90 minus 17 dB the RTS is the full on setting of the gain control ANSI 83 22 Saturation in a hearing aid the limiting of output caused by the output circuitry and transducer reaching their maximum capability SPA Special Purpose Average the average of values in dB at three third octave frequencies separated by 2 3 of an octave ANSI S3 22 See also HFA Spectrum the BSPL as a function of frequency for a broad band signal SII Speech Intelligibility Index a quantity calculated from measures of speech noise and hearing threshold that is highly correlated with the intelligibility of speech ANSI 83 5 Speech Region a statistical range of short term spectra present in a speech passage The short term spectra are typically 120 130 millisecond averages in 1 3 octaves The statistical range is typically from the 70th to the 99th percentile SPL Sound Pressure Level rms sound pressure relative to 20 uPa expr
123. n each rr band that is exceeded d by 70 of the samples Fa called L70 or 30th per centile has historically l been called the valley i of speech for that band Yq The curve for these L70 levels is approximately 18 dB below the LTASS t The region between i these two curves is of Too OO OD ono ten called the speech re gion speech envelope or speech banana The speech envelope when derived in this way has significance in terms of both speech detec tion and speech under standing Figure 8 Output left and Gain right curves for a linear hearing aid generated using a swept tone 1 and pink noise analyzed in 1 12 octave bands 2 Dual view not available in RM500SL 3 2 Real speech signal analysis One of the most used measures of a speech signal is the long term average speech spectrum LTASS This is a 1 3 octave spectrum averaged over a sufficiently long portion of the speech material to provide a sta ble curve In practice a 10 second average meets this Generally speech will be detectable if the L1 level is at or near threshold The Speech Intelligibility Index SII is maximized when the entire speech envelope idealized as a 30 dB range is above masked threshold This will not be an SII of 10096 or 1 because of loudness distor tion factors but higher SII values will not produce sig nificantly higher scores on most test material g The speech reception threshold SRT is attained w
124. n of Conformity Manufacturer European Authorized Representative CE marked Products Products Classification Certification Declaration Date of Validity audioscam A Division of Etymonic Design Incorporated EC Declaration of Conformity Etymonic Design Incorporated operating as Audioscan 20 Ludwig Street Ontario NOL 1G4 CANADA PC Werth Ltd Audiology House 45 Nightingale Lane London SW 12 8SP UK Model Verifit VF 2 Real Ear Hearing Aid Analyzer Commencing with Serial Number C0900 Model RMSOOSL Real Ear Hearing Aid Analyzer Commencing with Serial Number A1715 Model Axiom Real Ear Hearing Aid Analyzer Commencing with Serial Number B1000 Model Verifit VF 1 Real Ear Hearing Aid Analyzer Commencing with Serial Number 3879 Class lla after MDD Annex IX Rule 5 EC Certificate CE 543241 issued by the British Standards Institution for compliance with Annex V section 3 2 of European Union Council Directive 93 42 EEC as amended by Directive 2007 47 EC concerning medical devices We hereby declare that the above mentioned devices comply with the legislation regulating medical devices in the United Kingdom transposing European Medical Devices Directive 93 42 EEC namely Statutory Instruments 2002 No 618 Consolidated legislation and the Medical Devices Amendment Regulations 2008 No 2936 which transpose Directive 2007 47 EC into UK law Further we also declare that Verifit VF 2 commencing with Ser
125. naural 80 i i Loss simulator BEBE j Speech sts 40 LTASS 50 Em Speech std 1 30 4SPL threshold E 28 5 EM o ee 250 500 1000 2000 4000 Open fittings in Speechmap On ear mode should be used for open and vented fittings There are no special real ear SPL targets for open 95 Axiom User s Guide Version 1 10 November 2015 fittings it doesn t matter how the sound reaches the TM the perception is the same However the sound that escapes from a vent or open fitting may be detected by the on ear reference microphone interfering with the sound field equalization For this reason the hearing instrument must be muted during sound field equalization 1 With Speechmap in the On ear mode click on the Verification button and select Open from the Instrument pull down menu 2 Position the client and probe tube and enter audiometric data See On Ear Measures Setup Speechmap and Fitting to targets for soft and average speech and Adjusting the Maximum Output Level 3 Place the open fit hearing instrument on the ear with the probe tube in place making sure to mute the hearing instrument 4 Access Test 1 2 or 3 If this is the first test since selecting Open you will be prompted to mute or turn off the hearing instrument and click on the Equalize button on the setup poster After equalization unmute or turn the instrument on and follow the fitting procedures presen
126. nclude the effects specific to the client s earmold otherwise an average earmold is assumed The following describes acceptable RECD measurement protocols and Test box Speechmap coupling combinations for BTE instruments and the implications of each in the test box simulation ANSI 83 46 method RECD On ear measurement Audioscan RECD transducer foam eartip Test box Speechmap coupling client s personal earmold HA 1 ITE coupler With this method RECD is a property of the ear only and not dependent on the transducer or sound source coupling The earmold effects will be part of the measurement in the test box Measured RECD is appropriate for coupler simulation and error is minimized Alternate method 1 RECD On ear measurement Audioscan RECD transducer client s personal earmold Test box Speechmap coupling HA 2 BTE coupler This method utilizes the client s personal earmold for the on ear RECD measurement The HA 1 RECD is converted to HA 2 reference with earmold effects retained and is applied in Testbox Speechmap The error introduced is the difference between the earmold effects when connected to the hearing instrument receiver and earmold effects when connected to the RECD transducer If the total earmold tubing length is less than 35mm it is recommended that Foam tip be selected in the RECD Coupling field This will bypass the correction and increase accuracy for small earmolds 69 Axiom User s Guide Version 1 10
127. nd the band SPL is displayed at 1 12 octave frequencies Analysis Bandwidth Used by Various Analyzers To Analyze Complex Signals 35 e Verifit RM500SL Speechmap E 1 24th Octave Analyzers 30 1 G The Normal Ear Critical Bands 100 Hz band analyzers N on 20 amp 10 Log Analysis Bandwidth Hz 0 E T T T T T T T 200 250 315 400 500 630 800 1000 T T T T T T T T 1 1250 1600 2000 2500 3150 4000 5000 6300 Band Center Frequency Hz Figure 7 Analysis bandwidths of some real ear analyzers and critical bands for a normal ear If the analysis bandwidth is less than a critical band aided response curves shown to be at threshold or UCL will actually be well above it 7 3 1 Pink noise signal analysis All band levels are calculated with an averaging time of 128 ms For a linear hearing aid a pink noise stimulus will re sult in a response curve that has the same shape as one obtained using a swept pure tone However it must be remembered that while a swept tone has the same band SPL as overall SPL the band SPL for a noise signal is significantly lower than the overall SPL Consequently for a linear aid output curves obtained using 1 12 octave analysis will be about 18 dB lower than the output curves obtained using a swept tone at the same overall SPL As long as the hearing aid is linear the gain obtained will be the same for both sig nals Figure 8 show
128. ne Deskjet 30514 E all in one j611h Deskjet 3052a E all in one j611e Deskjet 3052a E all in one j611f Deskjet 3052a E all in one j611g Deskjet 3054a E all in one j611c Deskjet 3054a E all in one j611d Deskjet 30544 E all in one j611j HP printer Custom printer Occasionally your HP printer might not appear on the list or the selected model might not operate as supplied In this case you need to define a Custom printer Please contact Audioscan for assistance We can help define 32 Axiom User s Guide Version 1 10 November 2015 the custom settings and will integrate your changes into future updates of the Axiom software for use by everyone In the HP Printer selection dialog shown above click the Custom button In the Custom dialog shown below click the HP Printer button and select the model that most closely matches your desired printer To copy its definition click the gt gt button Make changes then click v The most common changes needed are to the DeviceModel and to the PenSet To change the selection back to a standard printer simply select the desired printer model again in the HP Printer dialog shown above Custom HP printer Deskjet d2600 gs gs dBATCH dBATCH dPARANOIDSAFER dPARANOIDSAFER dQUIET dQUIET dNOPAUSE dNO PAUSE sDEVICE ijs sDEVICE ijs sIjsServer hpijs sIjsServer hpijs sDeviceManufacturerz HEWLETT PACKARD sDeviceManufacturerz HEW
129. ng Custom Stimuli in Speechmap Custom digital sound files can be used as stimuli in Speechmap If you connect a USB stick with WAV files on it to the Axiom Speechmap will make those files available as stimulus selections This feature provides the freedom of using any stimulus in Speechmap with all the features that Speechmap offers Please note that fitting targets are not available for custom stimuli A USB stick is required for this feature It is highly recommended that the USB stick is formatted for data using the Audioscan Updater prior to using this feature The Audioscan Updater comes with any current Audioscan software download or Cd Visit www audioscan com to obtain software updates To use digital sound files as stimuli in Speechmap 1 Connect a USB stick to your PC 2 Format the USB stick for data using the Audioscan Updater 3 Create digital sound files that are compatible with Speechmap see Creating WAV files for Speechmap 85 Axiom User s Guide Version 1 10 November 2015 Copy the WAV files from the PC to the top level directory i e not in any folder of the USB stick Disconnect the USB stick from the PC and connect it to the USB port on the Axiom Run a test in Speechmap see Using Speechmap SL v Me e Click on the Stimulus list button Compatible WAV files will appear as selectable options in the stimulus list below the default stimuli You may need to scroll down to see all the stimuli 8 Sele
130. ntrol in the Test box menu 6 Click the Level button and click on 0 on the drop down list 7 Click the Frequency button and highlight and click the frequency of the calibrator e g 1000 Hz on the drop down list 8 Click the Filter button and click on 1 12th octave from the drop down list 9 Click Start test which changes to Stop test 10 Check that the Coupler microphone level is within 1 dB of the calibrator level setting the calibrator accuracy For a 94 dB calibrator with 0 3 dB accuracy the indicated coupler microphone level should be 94 1 3 dB 11 To stop the measurement click Stop test Coupling the hearing instrument for ANSI tests N WARNING To reduce the risk of contamination hearing instruments should be clean before putty is applied and putty should be replaced frequently The Axiom is supplied with 2 metal couplers a type HA 1 ITE and a type HA 2 BTE Note that an ANSI standard coupler for CICs does not exist These must be tested in the HA 1 coupler When threading the couplers onto the coupler microphone if is very important that they be firmly tightened to ensure a good acoustic seal Avoid twisting the coupler microphone cable turn the coupler not the microphone or unplug the microphone while tightening the coupler BTE instruments are coupled to the HA 2 coupler by means of a 9 mm length of black Viton tubing The only purpose of this tubing is to seal the tip of t
131. of the standby switch To start the Axiom set the standby switch U to its ON position The green light on the right rear corner will light and the instrument will begin its start up sequence which will take a few seconds To shut down the Axiom switch the standby switch ly to its OFF position Note that the Axiom receives low voltage electrical power from the external power supply module The standby switch U on the rear of the Axiom disconnects this electrical supply but the power supply module is always on as long as it is connected to a live electrical outlet The green light on the power supply module indicates that it is receiving electrical power from the outlet Input device operation Failure to follow operating instructions could place the user or operator at risk The Axiom is operated by using a USB mouse included or a QWERTY keyboard not included to select icons and menu items operate on screen buttons and to enter audiometric data To activate an on screen icon or button or to select an item from a menu use the mouse to place the screen pointer over the icon button or menu item and left click To enter a data point on a chart such as an audiogram place the screen pointer over the desired point on the chart and left click To move the data point place the screen pointer near the new location and left click To delete a data point place the screen pointer on the data point and left click To summon a
132. on 1 10 November 2015 3 Click Change to enter your Windows username and password 4 Click to accept the Windows Login details Note that your Windows login details are stored separately for each of the printer share the printing folder share and the session folder share You will need to enter your username and password details separately for each even if the details are the same for all of them Share name entry The Axiom automatically scans for the available domains computers and shares To enter the share name directly disable the checkbox then type the printer or folder share name into the text field Test connection Once you have selected or entered all required details click the Test connection to test the Windows shared printer or folder Any detail showing a red X indicates some error or omission which you need to correct before saving the details M clientRecords E Windows shared folder GO i ms ome Bl nan cmon Domain TYMONICDESIGN _ a x i Server ETYFILES w Sk Favorites Login norman Change A pun Folder CLIENTRECORDS w Jj Downloads 3 Recent Places Subfolder Doe John 1 Share METYFILESYCLIENTRECORDS Doe John al Libraries Daa Windows shared folder example Missing subfolder The following table indicates the possible causes of each failure and the corrective steps Failure Cause Correction Server The server cannot be fo
133. on REAR targets is less than 1dB 5 There is no requirement to input hearing aid experience An Experienced user is assumed The reduction in NAL NL2 REAR targets for an inexperienced user is less than 4 5 dB 6 There is no provision to generate targets for tonal languages The REAR targets for tonal language differ less than 2 5 dB from those for non tonal languages 7 There is no requirement to input the number of compression channels This may be useful when the signal used for verification is not the signal for which the targets were developed It is irrelevant when using real speech signals to match speech targets and when using narrow band signals to match narrow band maximum output targets 8 There is no requirement to input compression speed It has no impact on REAR targets 9 There is no requirement to input earmold tubing type It has no impact on REAR targets 10 There is no requirement to input vent size or fitting depth They have no impact on REAR targets 11 For sound field threshold the speaker is assumed to be at 45 degrees For on ear measurements the speaker is assumed to be at 0 degrees and the reference microphone is assumed to be on the head surface 12 The SII calculation is per ANSI S3 5 1997 and is the same for all fitting fitting methods Camfit in Speechmap Camfit is an approach to fitting hearing aids developed by Brian Moore at the University of Cambridge UK It specifies the level dependent gain r
134. on for an existing Client ID 1 Select the client in the list using the mouse or a connected keyboard The Axiom will highlight the closest match as you type 2 Click on the matching Client ID 3 Click v to store the current session data to a new file To restore a session from a file 1 Click Session 2 Select Restore session from file 3 Click the Client ID list button This will display a list of Client IDs with the first entry highlighted 4 Use the mouse or the arrow keys to select the Client ID or start typing the Client ID on a connected keyboard The highlight will move to the closest match as you type 39 Axiom User s Guide Version 1 10 November 2015 5 Click on a session file name 6 Click v to load the session data View a session file You can view session files on any computer using a web browser or a spreadsheet program such as Microsoft Excel To view a session file Excel right click on the file and select Open With Choose a browser program or Microsoft Excel When prompted for a style sheet select the audioscan xsl from the same folder which the Axiom saves alongside any session data files Session file name rules You may need to consider the following rules when naming the session files Uppercase letters are distinct from and precede lowercase letters Digits precede all letters 1AB 1 xml 1Ab 1 xml 1aB 1 xml lab 1 xml 2AB 1 xml 2Ab 1 xml 2aB 1 xml
135. on gain screen 1 Click on the Hide Show button located on the lower right side of the insertion gain screen NOTE the REUG curve display defaults in the Show position 2 Click on the desired test result to toggle between the Hide or Show options The curves will toggle on or off when selected 3 Click v within the Curve Display poster to return to the test screen Curve display Ear Right REAR1 Hide REAR2 Hide REARS Hide REUG Show Ll EXE gj Hide or show Speechmap curves To hide or show unaided and aided curves on the Speechmap screen 1 Click on the Hide Show buttons located just below each of the Test identifier numbers as shown below Note that the Hide Show aided button has 3 states Curves hidden display LTASS only and display LTASS speech envelope i e the speech banana 62 Axiom User s Guide Version 1 10 November 2015 Hide Show unaided Speech ISIS Son 50 speech region Ea 1 2 Hide Show aided A i LTASS or LTASS speech envelope Hiding a curve does not erase it To erase curves click on c and select one of the Erase options 63 Axiom User s Guide Version 1 10 November 2015 14 On Ear Instrument Measures A number of the tests covered in Test box measures can also be performed with the hearing instrument coupled to the ear of a client rather than to a 2cc c
136. onnection The Axiom can be networked to a single computer with two methods depending on the network hardware available The computer must be running Windows XP professional or higher Vista Windows 7 Windows 8 and have an available functioning network port Note The single computer connection instructions assume the PC is not on any other network including wireless If your PC has a network or internet connection see 5 Networking Networking Requirements Automatic connection recommended Automatic connection requires a small network router It may be wireless or not but must have at least two hardware Ethernet connections Most routers have DHCP address assignment active by default and do not require installation of software on the PC to establish a simple connection with a Axiom 1 Connect a Cat 5 RJ 45 cable from one router port to the Axiom network connector 2 Connect a second cable from a router port to the network connector on the PC 3 On the Axiom press Setup and then choose Network from the Setup menu 4 Select Enable Ensure the Auto checkbox is checked and choose Test A network address will be provided by the router and should show up in the Network address window By default Windows 7 8 Vista and XP computers have networking and DHCP enabled so at this point your connection should be complete To check your PC settings 1 On Windows XP go to Control Panel Network Connections On Windows 7 8 Vist
137. op down list Click on the Level window for the selected Test then select a stimulus level from the drop down list Click on to run a sweep or to capture a pink noise curve press to abort the test To measure another response curve click on another test button to overwrite a curve click on its test button To change scale from dB SPL to dB Gain highlight amp lt PICK gt the Scale window Multicurve results 1 Output curves for the noise signal are in 1 12th octave bands They will be approximately 18 dB lower than pure tone curves for a linear instrument Gain curves for a linear instrument will be the same for both swept and pink noise test signals For compression instruments both gain and output curves may be expected to differ for the two test signals See Test Box Measures Setup to change screen appearance 51 Axiom User s Guide Version 1 10 November 2015 Multicurve audioscain 100 90 80 70 60 50 30 A Presentation Single view LI Scale dBSPL Format Graph Lil Test Stimulus Level 1 Pink noise 60 2 Swept 60 3 aj Curve Hide Show a ul ee Se Lae eel rl 250 500 1000 2000 4000 8000 Spectral analysis in Multicurve Selecting a stimulus level of 0 dB off in Multicurve presents a spectral analysis of the coupler microphone signal Scale dB SPL or the difference between the coupler and reference microphone spectra Scale
138. ope digresses from unity indicating the signal level at which a non linear process begins to take effect 1 LCD liquid crystal display A thin planar information display Linear Region that portion of the input output function which is a straight line at 45 degrees Linear Amplification amplification having the same gain for all input levels until the maximum output of the device is reached LTASS Long term average speech spectrum the rms level of a speech passage in l 3rd octave bands averaged over the entire passage Loop System an assistive listening device that uses magnetic induction to carry a signal from a microphone amplifier to a wire loop The signal is picked up from the loop by a hearing aid set to the telecoil position or by a receiver with built in telecoil volume control and earpiece Loops are either worn around an individual s neck or can encircle a room such as a classroom providing an excellent signal to noise ratio 1 MAF minimum audible field SPL of a tone at the threshold of audibility measured in a free sound field for a subject listening with both ears and facing the sound source The SPL is measured with the subject removed from the field at the midpoint of an imaginary line joining the centers of the ear canal openings MAP minimal audible pressure SPL of a tone measured or inferred at the tympanic membrane at the threshold of audibility 111 Axiom User s Guide Version 1 10 November 2015
139. or session file identifies the printed or saved data as belonging to an individual client it becomes Individually Identifiable Health Information and must be protected under the HIPAA Security Rule See Appendix 1 Manufacturer Disclosure Statement for Medical Device Security Printing results The Axiom can print results on a printer or save results in a file for future printing and viewing Printing Setup allows you to select the printer or file location as well as to select the file output format The Page Setup options allow you to select the content to be printed or saved Results are printed as graphical images of the Axiom screen and can optionally include the tabular view for tests that define it Additional printed elements include informational headers and footers as well as typed notes and guidelines The following sections describe how to set up printers and files Printing setup Use Printing Setup to control the output and page setup options for printed output To enable printing check Enable To send the output to a printer select Printer To save the output to a file for printing or viewing later 30 Axiom User s Guide Version 1 10 November 2015 select File In either case to select the optional components to include in the output click the Page setup button To test your selected options click the Print test page button Setup printing ANSI Printing Enable MIL Date amp Time O
140. ormation required to repeat the original test under the same conditions Table View provides the required numeric data To include a Table View along with any printed Graph view enable the Graph with table checkbox Footer To include a footer showing the Axiom model serial number and Audioscan software version enable the Footer checkbox Barcode The date and a header such as a facility name may be added to printouts Barcodes representing hearing threshold UCL and RECD where applicable may be added to printouts of Speechmap and Insertion gain tests Tabular data where applicable may be appended to printouts Lines for hand written notes or typed comments may also be added 34 Axiom User s Guide Version 1 10 November 2015 Notes To include notes text with the printed output enable the Notes checkbox and enter the text in the field below it Enabling Notes will also include blank guidelines for handwritten notes Print test page To test your selected options immediately click the Print test page button The test page includes all of your selected printing options using sample screen images Results are generated on the printer or in a file according to your selected options Windows shared printers and folders In Printing Setup and Session Setup you can click the Details button to enter details for accessing Windows shared printers or folders The details include the domain server and share names
141. oupler The on ear results may be expected to differ from the test box results because of the different acoustic environment and the different acoustic load On ear manual control 1 Refer to On Ear Measures Setup to prepare the system for use and for proper positioning of the client and the probe tube Click on and then click on Manual control in the On ear menu Click on the Level button and select the desired stimulus level from the drop down list Click on the Frequency button and select the desired frequency from the drop down list Distortion measurement data is available only from 200 2500 Hz Click on the Start test bar to start the test Start test changes to Stop Test To stop the measurement click on Stop test You may change Level and Frequency without stopping the test Sound level meter using on ear microphones The manual control feature enables the Axiom to be used as a sound level meter to perform C weighted A weighted or 1 12th octave analysis of sound as measured by the probe and reference microphones A and C weighted measurements are limited to frequencies above 100 Hz and the averaging time and update rate are 384 ms 1 Gy sexe oer tS Refer to On Ear Measures Setup to prepare the system for use and for proper positioning of the client and the probe tube Click on and then click on Manual control in the On ear menu Click on the Level button and select 0 dB stimulus level from
142. pe and average are calculated over the full passage to provide stable and repeatable data When using live speech as a test signal a Freeze curve function is available to capture the short term spectra for examination and counseling purposes 55th Percentile L1 30th Percentile L70 00 1000 Figure 9 Example of speech envelope and LTASS Fei instrument BTE O Mode REM JO Presentation Single view OJ Format Graph rel Scale dH SPL He Audiometry Oi Age Adult Transducer Headphone UCL Average RECD Average REDD Average REAR Stimulus Level Sil 1 O Speech shape Avg 60 92 3 9 4 9 Unaided 160 Curve Hidef Show Q Speechmap Single view audicscan 140 DTE instrumen mE iol 130 Mode S REM 30 Presentation Single view C 120 xo ok Format Graph 1716 a i x Seale dB SPL 4 Aud bometry el Age Adult Transducer Headphone UCL Average RECD fwerage REDD Average REAR Stimulus Level Sii A OlSpeech shape Avg 60 4 E instrument 196 i f Mode E Presentation Single view 30 120 i i Format Graph Tol 116 x S x Seale dE SPL 20 2 O speech shape Avg 60 35 n i ajal m 10 iuc cA P uic s aep T T Unalded Ez a Curve Hide Show O Figure 11 When LTASS is at threshold SII 33 which corresponds approximately to SRT Speech
143. peech passages has been filtered to provide 3 varia tions for evaluating frequency lowering hearing aids Each has a duration of 10 15 seconds and may be presented as a single passage or in a continuous loop In order to provide a repeatable speech signal to the device under test the signal path must be equalized prior to the presentation of the speech signal This is accomplished by presenting a 896 ms pink noise burst at the selected speech level 256 ms prior to the start of each speech passage and adjusting a digital filter to provide a flat response at the reference mi crophone The two Speech std signals are by the same male talker filtered to provide the long term average speech spectrum LTASS recommended by Cox amp Moore 1988 for average vocal effort This is the LTASS assumed in the Desired Sensation Level DSL method of hearing aid fitting In addition four spe cial versions of the Speech std 1 test stimulus are provided in Speechmap to assist in the adjust ment of frequency lowering hearing aids These are called Speech3150 Speech4000 Speech5000 and Speech6300 The Speech3150 stimulus has had the bands at 1000 Hz and above attenuated by 30 dB ex cept for the 1 3 octave band at 3150 Hz which is un attenuated Similarily the Speech4000 stimulus has an unattenuated band at 4000 Hz the Speech5000 stimulus has an unattenuated band at 5000 Hz and the Speech6300 stimulus has an unattenuated band at 6300 Hz Figure 4
144. ps and personal earmold however this choice must be made prior to measurement Click on to continue If RECD transducer has not been calibrated or the measurement interval has been exceeded go to Calibrate 67 Axiom User s Guide Version 1 10 November 2015 RECD transducer If a valid RECD transducer calibration exists then click on Measure real ear eardrum Refer to Positioning the probe tube and insert the probe tube into the ear canal to within 2 5 mm of the Insert the foam tip into the ear being careful not to advance the probe tube further into the ear canal Insertion depth should be as used with insert phones Allow the foam tip to fully expand in the ear Click on Y to generate the real ear response curve pink and the RECD curve cyan If the RECD curve is negative and unstable in the low frequencies check the seal of the foam tip Increase the tip size and or apply a lubricant to the foam tip to improve the seal If the RECD curve deviates more than 10 dB from the average in the 4 6 kHz region check for proper probe placement and possible blockage of the tube by the foam tip or cerumen 9 When these curves are stable click on v to save them For comparison purposes the DSL 5 0 age related average RECD is shown as a dotted curve on the screen You may change this by clicking the Age list button on the RECD setup poster step 2 above and selecting a different age from the drop
145. ps used with the RECD transducer are for single patient use After use they may be disposed of in unsorted municipal waste or as required by your facility s waste management policy Declaration of Electromagnetic Compatibility EMC Medical electrical equipment needs special precautions regarding EMC and needs to be installed and put into service according to the following information The Axiom should not be used adjacent to or stacked on other equipment If this is necessary its operation should be verified as normal in this configuration Portable and mobile RF communications equipment can affect medical electrical equipment and may affect the performance of the Axiom Performance degradation due to electromagnetic disturbances including electrostatic discharge is considered normal and acceptable The compliances listed in the following table are met with the supplied RECD transducer microphones speaker and mouse connected with 2 LCD monitors connected and with a terminated Ethernet cable and unterminated USB cables 3 connected The connection of other devices may result in increased emissions Guidance and manufacturer s declaration electromagnetic emissions The Axiom is intended for use in the electromagnetic environment specified below The user of the Axiom should assure that it is used in such an environment Emissions test Compliance Electromagnetic environment guidance The Axiom uses RF energy only for inte
146. put requirement 100 240 Vac 47 63 Hz 1 35A A hospital grade grounded outlet is required Associated items and supplies VA 120 Barcode scanner for reading barcoded audiometric data on printouts from Audioscan analyzers VA 201 NOAH module allows a networked PC running NOAH to exchange data with Audioscan analyzers RE367 36 Probe microphone tubes for single patient use 36 per bag SAFETY WARNINGS and NOTICES For purposes of IEC 60601 1 this product is Class I with Type BF applied parts The applied parts are 1 Probe tube 2 Foam eartip Axiom User s Guide Version 1 10 November 2015 3 Probe microphone This device complies with Part 15 of the FCC Rules Operation is subject to the following two conditions 1 this device may not cause harmful interference and 2 this device must accept any interference received including interference that may cause undesired operation This Class A digital apparatus complies with Canadian ICES 003 This symbol on the product is a WARNING describing a foreseen risk WARNING To avoid the risk of electrical shock use only the power supply and power cord supplied with the Axiom and connect it only to a grounded protectively earthed electrical outlet WARNING To allow electrical power to be rapidly disconnected in the event of an emergency position the power supply in an accessible location so that the power cord may be quickly disconnected WARNING To avoid the ri
147. putty to seal the receiver module or soft tip to the coupler opening Excess low frequency output is usually due to open vents or a poor seal to the coupler For health reasons hearing instruments and earmolds should be clean before putty is applied and putty should be replaced frequently Positioning the hearing instrument 1 The hearing instrument should be coupled to the appropriate coupler See Coupling the hearing instrument 2 Place the instrument and coupler in the test chamber so that the front microphone opening of the instrument is on the crossbar within the test zone 3 Position the test box reference microphone as close as possible to the microphone opening of the hearing instrument without touching it 4 Close and seal the test chamber 46 Axiom User s Guide Version 1 10 November 2015 47 Axiom User s Guide Version 1 10 November 2015 9 ANSI Hearing Aid Tests These tests follow the procedures of ANSI 3 22 1996 or ANSI 83 22 2003 as selected in Setup See 1996 or 2003 ANSI standard Linear An automated test sequence for linear hearing aids per ANSI S3 22 AGC An automated test sequence for AGC hearing aids per ANSI 83 22 ANSI S3 22 1996 facts The Axiom performs selected hearing instrument tests in accordance with ANSI S3 22 1996 This standard expresses some outputs and gains as High Frequency Average HFA values The HFA is the average of values at 1000 1600 and 2500 Hz
148. r RECD measurement is performed with a foam eartip rather than the earmold This minimizes the error that arises from unknown lengths of tubing added to the RECD transducer These tubing effects can now be accounted for during the simulation on the coupler The ANSI RECD protocol can pose certain challenges in clinical implementation so alternate methods of RECD measurement are possible Test box Speechmap allows the selection of coupling for BTE instruments HA 1 or HA 2 so the more traditional HA 2 BTE coupler can be utilized RECD protocols A measured RECD is used both for simulation in the coupler Test box Speechmap and for correcting HL thresholds measured with insert phones For threshold corrections in the HL to SPL transform the Axiom uses an HA 1 RECD or an HA 2 RECD including tubing effects based on whether the stated HL transducer is Insert foam or Insert mold respectively If the RECD was measured with an earmold these tubing effects will be specific to the client s earmold if it is measured with a foam tip they will be based on average earmold tubing For Test box Speechmap involving BTE instruments the earmold tubing must be considered If the BTE is coupled to the HA 1 coupler using the personal earmold the tubing effects will be part of the measurement If the HA 2 BTE coupler is used the HA 1 referenced RECD will be converted to an HA 2 RECD As with the threshold correction above the use of the earmold in RECD will i
149. r by tightening the latch at the front of the lid Click on then click on the Calibration option within the Test box menu Click on Daily or Weekly to select the calibration interval Click on Calibrate See Test box calibration facts It is recommended that you print a copy of the initial calibration curve and compare it with your daily or weekly curve Any change in this curve indicates a drift in either the coupler or the reference microphone which needs further investigation See Calibration check for coupler microphone for an additional check REFERENCE MICROPHONE Calibration check for coupler microphone Accuracy of test box measurements depends on the calibration of the coupler microphone This should be checked regularly using a microphone calibrator with an adapter ring The RE780 1 1 8 in and RE781 1in rings are designed for Quest CA22 and QC 10 20 respectively To verify the coupler microphone calibration 1 Calibrate the test box reference microphone See Calibrating test box reference microphone 44 Axiom User s Guide Version 1 10 November 2015 2 Screw the appropriate calibrator ring onto the coupler microphone 3 Insert the coupler microphone with the attached calibrator ring into the calibrator opening 4 Turn the calibrator on and adjust it to present one of the available frequencies and levels e g 94 dB SPL at 1000 Hz 5 Click on and click on Manual co
150. read 70 2 dB 8 Repeat with the frequency at 250 Hz 9 To stop the measurement click on Stop test The probe module should be replaced if it fails this test Max TM SPL setup The Max TM SPL safety feature allows you to set a limit on the SPL measured by the probe microphone above 59 Axiom User s Guide Version 1 10 November 2015 which a test terminates The MAX TM SPL limit is shown on all on ear measurement screens The default limit is 120 dB To choose a different Max TM SPL setting 1 Click on 3 then click on Max TM SPL in the Setup menu 2 Click on the Max TM SPL pull down menu 3 Click on the desired Max TM SPL setting from the drop down list 4 Click on to exit Setup This Max TM SPL setting will be in effect until you change it If the limit is exceeded during an on ear test the Axiom will terminate the test and display the message MAX TM SPL EXCEEDED You must then decide to either reduce the maximum output limit of the hearing instrument or increase the Max TM SPL setting following the steps above If the MAX TM SPL limit has been disabled a notice will appear on each real ear screen Also a message reminding you that the MAX TM SPL limit has been disabled will appear when you select an on ear test Positioning the client Sound reflections from nearby surfaces including the operator can cause large measurement errors especially if the client moves between REUR and RE
151. ref mic 3 5mm st EBEE E 1 coupler microphone 3 5mm st 1 External speaker RCA 2 real ear mic 3 5mm st Test box Working Space Re niet este 60in Speaker 5 eed 1 30 5mm Round Test box isolation 1KHz gt 25 dB Frequency Range sssss 200 8000 Hz Coupler microphone noise floor 200 8000 Hz 40 dB SPL Test Stimuli tone tone burst pink noise PEN calibrated or live speech Test stimulus levels 40 to 90 dB SPL in 5 dB steps Test stimulus distortion lt 2 at 90dB SPL EDD IEEE 0 596 at 70 dB SPL Test stimulus accuracy at reference mic for tones 200 2000 Hz sene 1 5 dB SPL 2000 8000 Hz eene 2 5 dB SPL Equalization method pressure method Analysis frequencies per octave 12 Analysis filter bandwidth 1 12 octave Measurement accuracy at 1 KHz tidb Measurement accuracy re 1 kHz 1 dB 200 5000 Hz solio a 2 5 dB 5000 8000 Hz Measurement range 30 140 dB SPL Harmonic distortion measurement 2nd 3rd seit cfe toed vetet ve stt iced re cbe dep nen or 2nd plus 3rd Harmonic distortion range 200 to 4000 Hz Harmonic distortion accuracy
152. reliably predicted from 2cc coupler measurements 84 Axiom User s Guide Version 1 10 November 2015 SII calculation in Speechmap The Axiom calculates a Speech Intelligibility Index SII value in 96 for unaided speech and for each aided test The calculations use the 1 3 octave band method of ANSI S3 5 1997 without the 160 Hz band and without masking effects with results expressed as a by multiplying by 100 Level distortion effects are included but no hearing loss desensitization is applied An idealized speech region of LTASS 15 dB is used The speech recognition associated with a given SII is a function of the test material and the cognitive abilities of the listener There is considerable individual variability in relating the SII to speech recognition especially amongst impaired listeners The following shows expected nominal recognition scores vs SII for normals when using a variety of speech stimulus conditions Killion and Mueller Hearing Journal January 2010 pp 10 15 SII Cor Cor Cor Dieits IEEE NU6 m 9 12 15 18 21 24 Sentences Words Toast len 0 0 H H H 5 4 Sij i i C 5 im maine ae L5 m 5 Foy M mwn 20 19 Hefjde 4 f isENTENCES 25 27 LE 6 X 30 36 WORDS 3 35 45 40 56 45 63 50 70 55 76 60 81 0 F f i 70 87 10 20 30 40 50 60 70 80 90 100 80 93 SII speech intelligibility index in 90 96 Usi
153. rnal function Group 1 Therefore RF emissions are very low and not likely to cause any interference in nearby electronic equipment RF emissions CISPR 11 RF emissions CISPR 11 Harmonic emissions IEC 61000 3 2 Voltage fluctuations flicker emissions Complies IEC 61000 3 3 Class A The Axiom is suitable for use in all establishments Class A other than domestic and those directly connected to the public low voltage power supply network that supplies buildings used for domestic purposes Warranty Trademarks Acknowledgments The Audioscan Axiom is manufactured by Etymonic Design Inc 20 Ludwig St Dorchester Ontario Canada NOL 1G4 Web site www audioscan com Phone 800 265 2093 USA only 519 268 3313 Fax 519 268 3256 Axiom User s Guide Version 1 10 November 2015 Email info audioscan com or service audioscan com The authorized representative for this product in the European Community is P C Werth Audiology House 45 Nightingale Lane London UK SW12 8SP Phone 44 0 181 675 5151 Fax 44 0 181 675 7577 Warranty The Axiom is warranted against defects for two years from date of purchase Within this period it will be repaired without charge for parts labor or return shipping when returned prepaid to your authorized Audioscan service agent This warranty does not apply to equipment that in our sole judgment has been subject to misuse or unauthorized alteration or repair Trademark
154. rts the NAL NL insertion gain targets to LTASS targets for amplified speech in the Speechmap environment resulting in Speechmap NAL NL1 The conversions use the same adult average RECD and REUG as used in DSL The RESR targets are from Hearing Aids Dillon Thieme Publishing 2001 p274 An insertion gain version is available by selecting Insertion gain from the on ear measures test menu The pink noise stimulus should be used NAL NL2 in Speechmap Fitting targets default age related RECD and REUG are provided by a software library used under license from Hearworks Pty Ltd which is solely responsible for their derivation This revision of NAL NL1 has many more input parameters and output target formats than its predecessor In implementing NAL NL2 Audioscan has made the following simplifications and clarifications 1 NAL NL2 targets are provided as REAR targets in Speechmap Insertion Gain targets are not provided 2 There is no provision to select Insert earphones earmold as the audiometric transducer since this invalidates the audiometer calibration and correction for this error is problematic 79 Axiom User s Guide Version 1 10 November 2015 are of little value in estimating amplified speech levels Matching amplified speech to the LTASS targets at levels from 50 to 75 dB SPL provides much better assurance that fitting goals are being met 4 There is no requirement to input client gender The impact of gender
155. rve for the uncalibrated test box reference microphone by comparison with the factory calibrated coupler microphone It may be performed as often as desired but will be invalidated at 12 am the following day or at 12 am the following Monday depending on the choice of Daily or Weekly calibration interval After the calibration has expired the message window will turn blue and you will be prompted to calibrate whenever you attempt a test that uses the test box microphones Your calibration curve should be similar to the one shown but may be at a different level It should remain stable over time Irregularities in the calibration curve may be the result of not properly aligning the microphones See Calibrating test box reference microphone Test box calibration audioscan 40 Scale dB SPL Calibrate 30 Last Fri Oct8 2 18pm 20 Interval Weekly Expires Mon Oct 11 12 00am 10 1 Position reference microphone tip near coupler microphone inlet 2 Close test chamber 3 Select Calibrate a o a oh a oe X cb a ok g 250 500 1000 2000 4000 8000 Calibrating test box reference microphone 43 Axiom User s Guide Version 1 10 November 2015 Remove any coupler from the coupler microphone before calibration 1 4 5 Position the test box reference microphone opening concentric with the coupler microphone opening and about 1 2 mm from as shown below Close and seal the test chambe
156. s Audioscan Axiom Speechmap Verifit and Viewport are registered trademarks of Etymonic Design Inc DSL is a registered trademark of Western University All rights reserved HP LASERJET is a registered trademark of Hewlett Packard Company NOAH is a registered trademark of the Hearing Instrument Manufacturer s Software Association QUEST is a trademark of Quest Technologies Inc PostScript is a registered trademark of Adobe Systems Inc Acknowledgments DSL 5 0 is used under license from Western University which is solely responsible for its content We acknowledge the support received from past and present staff at the National Centre for Audiology at Western University in implementing the DSL method CAMFIT is used under license from Prof Brian C J Moore University of Cambridge UK We are indebted to the University of Memphis Hearing Aid Research Laboratory for permission to use some of their recorded speech material NAL NLI is used under license from the National Acoustics Laboratories Australia NAL NL2 is used under license from Hearworks Pty Ltd Australia Software licenses Audioscan distributes selected software components under various open source licenses These licenses generally give you the right to copy and change the affected component s software source code For details see the license files distributed with the software or contact Audioscan Axiom User s Guide Version 1 10 November 2015 EC Declaratio
157. s by left clicking on an item To change the time left click on the hour or minute window and make your selection from the drop down lists by left clicking on an item Left click on am pm window to toggle between am and pm To exit the Setup menu click on Display settings To change the screen language screen saver timing and the background color for charts 1 2 Left click on 3 Left click on Display on the Setup menu To change the language used on the screen left click on the Language window and select from available languages Deutsch English Espa ol Fran ais Portugu s To change the idle time before the screen saver blanks the screen to prolong display life left click on the Screen saver window and make your selection from the drop down list by left clicking on a time To change the background color for charts left click on the Color window to toggle between Black and White In this screen you can also click on the Mouse pointer speed button and select the response speed from the drop down list To exit the Setup menu left click on Saving test setup This feature lets you retain the last used stimulus type and level for most tests when the power is turned off and the last used target method and transducer type in Speechmap and Insertion Gain tests This feature also lets you determine how assessment parameters test levels and stimuli are treated when you click on and select Erase data
158. s output A and gain B for a lin ear hearing aid obtained using a swept tone 1 and pink noise 2 with a 60 dB overall SPL IMulticurva Dual view Ps n 120 f UN B ii ol OT T M 5n M m 1 Pi d 1 100 a on f TE an 2 M ba P i pl 1 P Md o uM 7 ra M i L 1 fa 1 L East S00 TOo00 2000 AD BO eo S00 Dual view Q Test Stimubus Level Dualwiew Graph ojl UO Swept eo Graph 50 Seale dB SPL O ZLO Pinknolse Seale dE Gain 2j 3 Swept B 4 9 Curve Hides Show Cu 20 requirement and for this reason all Soeechmap pas sages are at least 10 seconds long The LTASS curves displayed in Speechmap are 1 3 octave band levels at 1 12 octave intervals It should be noted that this results in smoothing and the apparent broadening of the spectrum of a narrow band signal For example a 1 3 octave band of speech will exhibit a spectrum 2 3 octave wide The dynamic nature of speech is often characterized by the distribution of short term levels in each 1 3 octave band Historically time periods of 120 125 or 128 ms have been used In Speechmap 1 3 octave band levels at 1 12 octave intervals are derived ev ery 128 ms The level in each band that is exceeded by 1 of the samples called L1 or 99th percentile has historically been referred to as the speech peak for that band The curve for these L1 levels is approxi mately 12 dB above the audioscsry LTASS The level i
159. s that come into contact with patients the probe module body cable and blue lanyard should be regularly wiped down with alcohol wipes Hearing instruments should be cleaned prior to introduction to the test chamber due to the difficulty of sanitizing the acoustic foam Custom hearing instruments must be cleaned with disinfectant towlettes i e audiowipes prior to placing in the test for this reason and to minimize contamination of the blue putty used with the HA 1 coupler The acoustic foam in the floor of the test chamber is easily removed and should be replaced if badly worn or soiled Audioscan recommends periodic replacement of the blue putty used with the HA 1 coupler to ensure cleanliness Both couplers and coupler mic can be wiped down with alcohol wipes as needed Ensure that all safety and usage recommendations on cleaning product packages are followed Microphone care Coupler microphone 1 DO NOT twist the cable when attaching a coupler to the coupler microphone Turn only the coupler or unplug the coupler microphone before turning it 2 DO NOT leave the coupler microphone plugged in when transporting 3 DO make sure that the 2cc coupler is tightly screwed to the coupler microphone when performing hearing instrument tests Coupler leakage can cause feedback and erratic response curves 4 DO make sure the tubing on the BTE HA 2 coupler is free from any cracks tears 5 DO make sure that any replacement tubing used on th
160. scsccccsssncpdsncasssacieses C Creation modification or deletion of ePHI d iImportfexport or transmitial recelpt of ePEL 2i eese itbabva a Ress aea an su e kane Re saeE o Does the device incorporate an emergency access break glass feature that logs each instance of use Can the device maintain ePHI e g by internal battery during power service interruptions sssessrseesssererenesenee Controls when exchanging ePHI with other devices a Transmitted only via a physically secure connection e g dedicated cable seenm b Encrypted prior to transmission via a network or removable media as C Restricted to a fixed list of network addresses i e host based access control list eeee Does the device ensure the integrity of the ePHI data with implicit or explicit error detection correction technology _ tRecommend use of ECRI s Universal Medical Device Nomenclature System UMDNS Adapted from Information Security for Biomedical Technology A HIPAA Compliance Guide ACCE ECRI 2004 ACCE the American College of Clinical Engineering ECRI formerly the Emergency Care Research Institute MDS v 1 0 2004 11 01 Side 1 2004 HIMSS All rights reserved 119 audionote 2 Verifit amp RM500SL Test Signals amp Analysis Bill Cole BASc PEng 1 Introduction The Verifit and RM500SL are full duplex dual chan nel audio measurement systems designed for the te
161. setting The FM transmitter should be ON and set to MUTE Repeat step 2 but use Test 2 instead of Test 1 If the results of Test 1 amp Test 2 are not similar the presence of the FM receiver has changed the intended performance of the hearing aid Where possible make programming adjustments to compensate being careful not to make adjustments that will change Test 1 results Move the hearing aid attached to the coupler and microphone outside the test box at least 12 in 30 cm away from the FM transmitter Put the FM transmitter microphone set to Omni within 2 mm of the reference microphone in the test box Close the lid of the box With the FM transmitter unmuted repeat step 2 Note that the hearing aid is outside the test box during this test Quiet please The results should be within 2 dB of the results from step 3 If not change FM settings and repeat A coupler mic extension cable is available See Microphone connection Real ear verification of FM only open fittings in Speechmap based on AAA Clinical Practice Guidelines Remote Microphone Hearing Assistance Technologies for Children and Youth from Birth to 21 Years April 2008 Open fittings must be verified in On ear mode See Speechmap screen choices for setup and audiometric data entry See Using Speechmap 1 2 Enter Audiometry data and select FM from the Fitting list box Position the transmitter microphone as in step 4 above Place the probe tube in the ear
162. sk of electrical shock any line powered peripheral equipment connected to this product must comply with UL IEC 60601 1 OR comply with UL or IEC and ISO safety standards for such equipment AND a be operated from an isolating transformer complying with UL IEC 60601 1 OR b be kept at least 1 8m 6 ft from the patient WARNING This equipment is not suitable for use in an oxygen rich environment or in the presence of flammable anesthetic mixtures with air or with oxygen or nitrous oxide WARNING To ensure proper operation of this product no modification of this equipment is permitted WARNING Probe tubes are for single patient use only Care is required when sliding the probe tube into the ear canal Be careful not to advance the probe tube further into the ear canal when inserting an earmold or custom hearing instrument into the ear or when inserting the foam tip into the ear WARNING Foam eartips are for single patient use only WARNING To ensure that the operation of this product is not affected by EMC emissions from other products this product should not be used adjacent to or stacked on other equipment If this is necessary its operation should be verified as normal in this configuration Portable and mobile RF communications equipment can affect the performance of this product WARNING To reduce the risk of contamination hearing instruments should be clean before putty is applied and putty should be replaced frequently
163. specific ports including 8080 Using the NOAH module in the presence of such security settings may necessitate changing the NOAH service port Note that changing the NOAH service port requires restarting the Axiom software Changing the NOAH service port 1 Press lt Change gt next to the NOAH service port 2 Select the appropriate five digits to enter the desired port number The software will prevent you from entering the same port as the Product web service typically port 80 Change NOAH service e mis mio miis mio vi Port 8080 Lx J Lv 7 3 Click v 4 You will be prompted to restart the equipment Click v to restart or to enter a different port number 26 Axiom User s Guide Version 1 10 November 2015 Restart required Changing the NOAH service port requires restarting the equipment Testing the NOAH service port The Axiom provides the NOAH service using the HTTP protocol Communication between the Windows PC and the Axiom can be tested using an ordinary web browser 1 On the Windows PC enter the Axiom network address and port number into a web browser following this example http 172 30 86 8080 noah 2 If the communication is successful the web browser will display NOAH data formatted in XML lt noah gt Example XML lt noah gt 27 Axiom User s Guide Version 1 10 November 2015 6 Single computer c
164. sting and fitting of all types of hearing instruments and many assistive listening devices They provide an acoustic test chamber for the testing of devices coupled to standard 2 cm couplers as well as sound field speaker s for on ear measurement of hearing aid performance The Verifit test chamber contains two loudspeakers for the functional testing of direc tional hearing instruments Test signals are deliv ered to the device under test via the test chamber loudspeaker s the test chamber telephone mag netic field simulator TMFS the test chamber mag netic field test loop Verifit only or the sound field loudspeaker s Device output signals are measured in the 2 cm coupler via the coupler microphone or in a real ear via the probe microphone Data from the 2 cm coupler may be viewed as coupler SPL coupler gain or as estimated SPL in the ear canal simulated real ear measurements S REM Data from the probe microphone may be viewed as ear canal SPL as ear canal SPL re normal hearing threshold i e dB HL as insertion gain or as ear canal SPL in the context of an auditory area Speechmap 2 The test signals Sinusoidal pseudo random noise and digitized real speech signals are provided Two signals derived from real speech the International Speech Test Signal ISTS and the single talker International Collegium of Rehabilitative Audiology ICRA signal are also pro vided Test signals are generated in real time by the dig
165. t critical 5 Click on the Calibrate button The resulting curve should be similar in shape to that shown but may be shifted 5 dB 6 Click on and repeat steps 2 5 for the second probe module 7 To change the calibration interval click to choose Daily or Weekly 20 10 o poeson 10 Calibration check for probe module The calibration curve for the probe module is a comparison of the response of the probe microphone with tube to the response of the on ear reference microphone Any change in the curve indicates a change in one of these microphones or the probe tube See Calibration of on ear probe microphone As part of a regular calibration schedule or to investigate changing calibration curves the on ear reference microphone may be checked against a high quality sound level meter 1 Click on then click on Manual control in the On ear menu 2 Click on the Level pull down menu arrow and then select 70 from the drop down list 3 Click on the Frequency pull down menu and then select 2000 Hz from the drop down list 58 Axiom User s Guide Version 1 10 November 2015 4 Click on the Start test bar which changes to Stop test 5 Hold the probe module about 18 in 0 5 m in front of the sound field speaker 6 Hold the microphone of a calibrated sound level meter next to the on ear reference microphone as shown Set the sound level meter to C weighting and slow 7 The sound level meter should
166. tails Speechmap departs from insertion gain target methods in presenting amplification goals in the context of the residual auditory area not as an isolated target line and in the use of real speech not tones or broad band noise This is extremely important for non linear hearing aids analog or digital because their processing is signal dependent It also makes provision to correct audiometric data and 2cc coupler measurements for age related or individually measured acoustic differences between real ears and the couplers used for calibration and testing The Speechmap environment provides two hearing instrument verification options on ear measures and test box measures See On ear or Test box mode for details DSL 5 0 in Speechmap n zd DSL jo Copyright DSL 2004 Version 5 0 The Desired Sensation Level DSL method is a systematic eardrum sound pressure level SPLogram approach to hearing instrument fitting that seeks to ensure amplified speech will be audible and comfortable while loud sounds will not be uncomfortable It takes into account individual acoustic factors in audiometric and electroacoustic data DSL was developed by the National Centre for Audiology NCA London Ontario Audioscan has implemented DSL within its Speechmap fitting system since 1994 In 2005 DSL underwent an extensive revision resulting in DSL 5 0 It was further revised in 2007 to version 5 0a See DSL 5 0 changes for details of the changes The
167. ted previously in this section It is necessary to repeat the Equalize procedure whenever the client or nearby objects are moved Verifying Frequency Compression Frequency Lowering Hearing Instruments in Speechmap Frequency lowering is used when it is not possible to amplify the high frequency components of speech sufficiently to raise them above threshold In this case the high frequency components may be shifted to a lower frequency with a better hearing threshold where the available gain will render them audible Four modified versions of the Speech std 1 test stimulus Speech3150 Speech4000 Speech5000 and Speech6300 are provided in Speechmap to assist in verifying and adjusting frequency lowering devices In each of these modified test stimuli the 1 3 octave band levels above 1000Hz are reduced by 30dB except for an isolated 1 3 octave band centered at the frequency indicated in the selected test stimulus name With these reduced band levels the resulting LTASS produces a distinct cavity between 1000Hz and the selected high frequency band as seen below for the FM Boom test signal 94 Axiom User s Guide Version 1 10 November 2015 Speechmap 140 R 130 120 110 100 LTASS Speech std 1 90 80 70 60 50 30 20 A SG 10 Lo M afte sais En IT cR ITE Io ek oe a eo c TIT FE 1 250 500 1000 2000 4000 8000 To test frequency lowering 1 Click on and choose Speec
168. that the test box is sealed tightly Ensure that the test box microphone calibration was performed correctly Check that the coupler is screwed tightly onto the coupler microphone Test box speaker overdriven Test box speaker overdriven This message indicates that the test chamber speaker is unable to produce the SPL required for a test Check that the test chamber lid is closed and sealed Check that the test box calibration looks normal Check that the hearing instrument under test is not feeding back Try running an On ear test 102 Axiom User s Guide Version 1 10 November 2015 No test box reference mic detected No test box reference mic detected This message may be displayed when starting a hearing instrument test It indicates that the Axiom is not measuring any sound at the test box reference microphone The test box reference microphone is the white microphone located in the test chamber Ensure that the test box reference microphone is secure Unplug the white test box reference microphone Plug the microphone back in again ensuring that it clicks into place Try the calibration procedure again Unplug the test box reference microphone and plug the on ear probe microphone in its place Try test box calibration using the reference microphone of the on ear probe microphone in place of the test box reference microphone If this is successful the test box reference microphone is defective and must b
169. the drop down list Click on the Filter button and select 1 12th octave A weighted or C weighted from the drop down list For 1 12th octave filter click on the Frequency button and select the desired frequency from the drop down list Click on the Start test bar to start the test Start test changes to Stop Test To stop the measurement click on Stop test You may change Level and Frequency without stopping the test 64 Axiom User s Guide Version 1 10 November 2015 15 RECD measurement The RECD real ear to coupler difference may be individually measured to improve the accuracy of hearing aid fittings The measurement procedure may be accessed by clicking on the RECD button located on the Speechmap screen Calibration of RECD transducer WARNING Foam eartips are for single patient use only RECD values are stored and expressed as referenced to the HA 1 ITE coupler however for ease of measurement we calibrate the RECD transducer in the HA 2 BTE coupler 1 Connect the RECD transducer to the RECD jack on the underside of the test chamber Prepare the system for test box tests See Microphone connection Calibrating test box reference microphone 2 Click on and select Speechmap from either the Test box or On ear menus 3 Click on the RECD button to access the RECD setup poster 4 Click on the RECD list button and select Measure from the menu Then click on
170. tic Signal Processing In hearing aids level dependent frequency response shaping AVC Automatic Volume Control slow acting AGC that attempts to maintain a constant average signal level BSPL Band Sound Pressure Level the SPL within a restricted frequency band BTE Behind The Ear hearing aid Compression a type of AGC in which an incremental change in the input level produces a smaller incremental change in the output level CR Compression Ratio the ratio of incremental change in input SPL to the resulting incremental change in output SPL Used to characterize steady state AGC action can be a function of input level duration and frequency CROS Contralateral Routing Of Signals a type of hearing aid in which the microphone is at the ear opposite to the one receiving the amplified sound CORFIG coupler response for flat insertion gain the transformation added to real ear insertion gain to Obtain 2 cc coupler gain Assumes linear amplification Coupler a device used to acoustically couple an earphone or hearing aid to a measurement microphone and to provide an acoustic load DSL Desired Sensation Level Method a systematic eardrum SPLogram approach to the hearing aid fitting process that seeks to ensure amplified speech will be audible and comfortable while loud sounds will not be uncomfortable Directional hearing aid a hearing aid for which the gain is dependent on the direction of sound incidence when measured under fre
171. torical perspective and current issues Trends in Amplification 9 4 145 157 Seewald R C amp Moodie K S 1992 Electroacoustic considerations In M Ross ed FM Auditory Training Systems Characteristics Selection amp Use Timonium MD York Press Sherbecoe R L amp Studebaker G A 2003 Audibility Index predictions of normal hearing and hearing impaired listeners performance on the Connected Speech Test Ear and Hearing 24 1 71 88 Sinclair S T Moodie K S amp Seewald R C 1997 Pediatric Hearing Instrument Fitting Phonak Video Focus 2 Booklet Stofa Switzerland Phonak A G Sinclair S T Seewald R C amp Cole W A 1996 A new real ear fitting system Because no two ears are alike Hearing Review 3 6 46 48 Skinner M W 1988 Hearing Aid Evaluation Englewood Cliffs Prentice Hall Inc Smith D A 1990 Technological report Acoustometry Hearing Instruments 41 11 40 44 Valente M Potts L G Valente M Vass W amp Goebel J 1994 Intersubject Variability of real ear sound pressure level Conventional and insert earphones Journal of the American Academy of Audiology 5 390 398 Valente M Strategies for Selecting and Verifying Hearing Aid Fittings New York Thieme Medical Publishers Inc 1994 Zelisko D L C Seewald R C amp Whiteside S 1992 Comparing three procedures for predicting the ear canal SPL at LDL ASHA 34 10 117 Axiom User s Guide Version 1
172. ult settings If your scanner has a Unitech logo scan the following barcode to reset the scanner to its default settings 105 Axiom User s Guide Version 1 10 December 2015 106 Axiom User s Guide Version 1 10 December 2015 21 Technical Specifications Specifications subject to change without notice Environmental conditions STORAGE amp TRANSPORTATION Temperature 20 C to 60 C Relative humidity non condensing 5 to 95 OPERATING Temperature eeeseses 15 C to 30 C Relative Humidity sssssse 20 50 Atmospheric Pressure 81 106 kPa Altitude Anche eps below 2000 m General Power source 100 240 V 47 63Hz 1 35A Overall dimensions 12 5 x12 25 x4 25 81 75cm x 31 2cm x 10 8cm Weldglit itin ERU 7 6 Ib 3 45kg Display type eeeeseessssss User supplied Resolution eeeesssss 800x600 SVGA Printer tyPe cesscecessseeesereeetensseceeeeees User supplied Power amplifiers eee 1 Stimulus Channels seen 1 Measurement channels eee 2 ConrieClors iic e eerte eee dne 4 USB NADA CHOR OU NADIE 1 Ethernet RJ45 icu ibn els eM oM Mo oh cha teats 2 HDMI MU oeste iis sala 1 RECD transducer 3 5mm st E E ieu 1 test chamber
173. und in the specified domain Change the server Change the domain Login The username and or password are not authorized for the server Change the server Change the username and or change the password Printer The printer cannot be found on the selected server Change the printer Folder The folder or subfolder cannot be found on the selected server 36 Axiom User s Guide Version 1 10 November 2015 Change the folder Change the folder permissions on the server Change the subfolder Create the subfolder on the server Change the subfolder permissions on the server Once you have selected or entered all of the required details click to save the Windows Share settings Network printer If your chosen printer connects directly to the local area network through its own network interface and cable then select the Network connection option Ask your network administrator for the network printer s IP address and port that you enter in the Network printer details In Printing Setup select Network for the connection and click the Details button Enter the address e g 172 30 1 9 and the port e g 9100 To test the Network printer details click the Printer test button If the test fails the Printer entry will be marked with a red X If the test passes the Printer will be marked with a green check and the printer will print the setup details on a sheet of paper Network printer Address 172 30 1 9 Chl Port 9
174. up procedure should be as follows 1 2 3 4 5 Connect both HDMI cables Power on TV s amp assign proper input on both Power on Axiom amp Wait 45 sec for boot up until splash welcome screen would appear Power cycle TV if video isn t displayed If video does not appear on either TV first try power cycling the TV then try re booting the Axiom 10 Connect a USB mouse included to one of the USB connectors on either side of the Axiom 11 Connect the Axiom power supply included to the power connector on the rear connector panel 12 Connect the power cord included from the Axiom power supply to a GROUNDED electrical outlet In the USA and Canada this outlet should be marked Hospital Grade 14 Axiom User s Guide Version 1 10 November 2015 USB 2 USB 2 ON OFF Power Second Primary Network Sound field Supply Monitor Monitor Speaker General care instructions Probe tubes are for single patient use only They may be wiped with alcohol wipes for re use with the same patient but must not be used with multiple patients Attempts at ultrasonic cleaning usually result in cerumen becoming lodged in the lateral end which causes irreparable damage to the probe microphones The case can normally be cleaned dusted with a damp cloth however if it is soiled we recommend wiping with a mild solution of water and detergent or with alcohol impregnated wipes deemed safe for use on electronic equipment Part
175. ure It indicates that the calibration curve is significantly different from what is expected It may be accompanied by an on ear reference microphone error e Check that a probe microphone assembly is securely plugged into the PROBE socket of the side Right or Left you are trying to calibrate and that the cable has not become damaged 103 Axiom User s Guide Version 1 10 November 2015 Try using a new probe tube Ensure it is correctly attached and positioned Try switching right and left probe microphone assemblies Sound field speaker overdriven External sound field speaker overdriven This message may occur in on ear unaided or aided tests if The external sound field speaker is improperly connected The test environment is too reverberant for the distance between the client and the speaker Move the on ear speaker and client away from walls and hard objects Move the client closer to the speaker The speaker or connecting cable is defective If this is the case you should not hear any sound coming from external speaker during any test Try a different speaker or cable Invalid RECD transducer coupler calibration Invalid RECD transducer coupler calibration This message may be displayed during the coupler calibration for the RECD transducer It indicates that the calibration is significantly different from normal which may cause significant error while fitting Check that the RECD transducer is connect
176. urning off suspected sources to identify the cause Relocate the source or the Axiom on a foam pad Test box curves inconsistent The test box curves keep changing from test to test The battery may be close to end of life or starved for air zinc air cells because of a tight seal on the battery compartment Try using a fresh battery The test box reference microphone the white one in the sound chamber is incorrectly positioned In order to control sound pressure levels precisely at the microphone inlet of the hearing instrument the test box reference microphone must be positioned as close as possible to the hearing instrument s microphone without actually touching it The noise or feedback reduction features are attempting to reject the test signal These need to be disabled prior to tests with tones or noise The instrument is on the verge of feedback due to a poor seal to the coupler unplugged vent or a crack in the tubing on the BTE coupler Test box curves differ from specifications The OSPL90 and response curves don t look like the manufacturer s Check that all controls or program settings are the same as those used by the manufacturer Check that vents on earmolds or ITE instruments are plugged at the faceplate Check that ITE instruments are well sealed to the coupler When puttying a hearing instrument into the ITE coupler be sure to keep the canal portion of the instrument flush with the inside of the 2cc volume Ensure
177. utput Printer Ll Display Connection Network E Details Max TM SPL 172 30 1 9 9100 Network Printing Save option Self test Session Speechmap PostScript wlPostscript Type Printing setup Printer connection Failure to follow operating instructions could place the user or operator at risk When using the Printer output option you must also select the printer Connection and Type If the printer connects directly to your Axiom through a standard USB cable select USB If the printer is accessible on a local area network LAN then select either Windows Share or Network Choose Windows Share if the printer connects through a Windows laptop PC or server computer Windows shared printers are common in both small and large offices See the section below Windows shared printers and folders for instructions about setting up a Windows shared printer Choose Network if the printer connects directly to the network through its own interface and cable See the section below Network printer for instructions about setting up a Network printer Both Windows Share and Network printer connection options require that your Axiom be connected to a local area network See Network Setup for details Printer types You must select the printer type for the connected printer Many laser printers and large office printers support 31 Axiom User s Guide Versio
178. work security are as follows e WPA WPA2 using pass phrase for authentication most common e WEP 10 or 26 digit hex key None open network The Axiom can connect to a local area network LAN or WLAN using either automatic or static internet address assignment Most home and small office networks use automatic addressing These networks have a DHCP server Dynamic Host Configuration Protocol Special purpose networks might use static address assignment provided by the network administrator Remote Operation of the product requires a valid network connection whether it be wired or wireless the Axiom must have an active network connection Networking setup Check Networking requirements and connect the Axiom to your network 1 Click 3 and then choose Network from the Setup menu 2 Click Network Change 3 To turn networking off select the Off position in the Network drop down 22 Axiom User s Guide Version 1 10 November 2015 Setup network ANSI s Network off change Date amp Time Display Max TM SPL Network Remote Operation On nHL to eHL Printing 4 Connecting to a wired LAN network 1 2 Select Change to set Network to the Wired option In most cases your network will support automatic address assignment DHCP and you need to only enable Auto Click Test connection to test your settings If the test is successful your Axiom s IP addr
179. xiom can store its input data and test results in session files Restoring a session file restores the patient assessment data and test results as the Axiom was when the file was saved The Session Setup controls where session files are stored Session files can be stored locally on a local USB drive or in a Windows shared folder on a network Storing data in NOAH The Axiom can store data using the optional Audioscan NOAH Module that runs in the NOAH framework on a Windows PC Using the Module requires that both the Axiom and the Windows NOAH PC be connected to the same network The NOAH Module allows you to store the client assessment data such as HL UCL and BCT audiograms and the WRECD for use in future client visits Since the assessment data are stored in the HIMSA NOAH public data format then they can also be obtained from or exchanged with other NOAH modules that comply with the public standard For example the Axiom can restore audiograms from another manufacturer s audiometer The data are stored as actions in NOAH client records The Axiom can later restore the assessment data from the Module as the starting point for follow on measurements with the same client The Module stores Axiom test results as screen images The NOAH Module can display or print the stored screen images for comparison with the future test results Contact Audioscan or visit www audioscan com for details about the Audioscan NOAH Module NOTE If a printout
180. xtension cables should not be used They will substantially increase noise levels 54 Axiom User s Guide Version 1 10 November 2015 11 Sensory loss simulator Sensory loss simulator description A pure conductive loss attenuates loud and soft sounds equally and is easily simulated by just turning down the volume or inserting an earplug Losses of a sensory nature are more complex and more difficult to simulate The most common sensory loss is caused by outer hair cell damage and results in loss of audibility for soft sounds but near normal loudness for loud sounds nner hair cell damage elevates threshold and reduces loudness for both soft and loud sounds possibly somewhat more for soft sounds This sensory loss simulator SLS is intended to allow normal hearing listeners to hear sounds as if they had the elevated threshold and altered loudness perception caused by outer and inner hair cell damage It is based on the cochlear hearing loss model described in Moore amp Glasberg 2004 In this simulation losses less than 58 dB SPL are considered to be due entirely to outer hair cell damage Any loss greater than this is considered inner hair cell loss This SLS does not simulate broadening of the auditory filters or other distortions that may accompany cochlear hearing loss To properly experience the simulation listeners should be within 1m of the sound field speaker and in a quiet room Sensory loss simulator operatio

Audioscan Axiom® User`s Guide 1.8

Contents

Download Pdf Manuals

Related Search

Related Contents

Audioscan Axiom&reg; User`s Guide 1.8

Contents

Download Pdf Manuals

Related Search

Related Contents

Audioscan Axiom® User`s Guide 1.8