Gesellschaft für Informatik e.V.

Lecture Notes in Informatics

European Conference on eHealth 2007 P-118, 163-176 (2007).

Gesellschaft für Informatik, Bonn


Andreas Hein (ed.), Wilfried Thoben (ed.), Hans-Jürgen Appelrath (ed.), Peter Jensch (ed.)

Copyright © Gesellschaft für Informatik, Bonn


Tele-monitoring and assistant system for people with hearing deficiencies: first results from a user requirement study

M. Meis , J. -E. Appell , V. Hohmann , N. V. Son , H. Frowein , A. -M. Öster and A. Hein


In this paper the concept and architecture of a monitoring and assistant system for people with hearing deficiencies will be described and a first user study will be presented. Core of this concept is the implementation of algorithms that are usually used in hearing aids at a central Home Information and Communication (HIC) platform. This platform integrates formerly separated devices like TV, telephone, and home automation. Thereby, the TV becomes the central human machine interface of the household linking together most of the acoustic inputs listened to by the hearing impaired in his/her home environment. Using the central HIC platform the acoustic inputs can be amplified and adapted according to the specific hearing impairment and the individual thresholds of hearing. These thresholds will be estimated during the initial diagnosis at the audiologist and transmitted to the HIC platform. Supportive Audio Signal Processing (SASP) algorithms are used to fine-tune the amplification according to the acoustic situation of the living room. These fine-tuning, frequent tests of speech understanding and monitoring of the individual adjustment of volume and sound controller are used as a feedback to the audiologist. In this way the transition from mild to moderate or severe hearing loss can be supervised, the use of hearing aids can be motivated and the adjustment of hearing aids can be improved and adapted to the individual situation of the patient. The ideas of this sound processing and alerting system at home, the so called Hearing at Home System (HaH) were presented to 62 hearing aid users and non-users (“young-old” to “old-old”; mean age: 69yrs.) of three countries (Netherlands, Sweden, and Germany) with a different degree of hearing loss (from slight to moderate). The first results of the user requirement study showed, that most of the users will benefit from the HaH environment system, and the results are very useful for further research and development, also in the realm of telemonitoring applications. This project has been funded by the European Commission (FP6-2005-IST-6 project 045089). 163 The increase in the number of persons having hearing deficiencies is strongly connected to the demographic change in the European Union. The sense of hearing begins to degrade from the age of 40 onwards and estimates indicate that more than 50 \% of people over the age of 60 have some degree of hearing loss. The demographic change and age related hearing losses will result in an increasing number of hearing-impaired people in the European Union. Estimates of the number of people in the EU with various hearing disabilities in the early 1990s report a number of 6 \% of hard of hearing and 0.1 \% of deaf people. A study of the Institute of Hearing Research (UK) estimates that 81,536 thousand adults will have a hearing loss in Europe by 2005. By 2015 the figure will increase to be 90,588 thousand. This means that more than 14 \% of adults in Europe will have hearing problems. This makes people with hearing disabilities one of the largest groups facing the challenge that communication is mainly audio-based. Hearing aids are supposed to support the hearing-impaired but the acceptance and use of such devices is influenced as much by psychosocial factors as by the performance of the hearing aid itself. Statistics show that on average people with a hearing deficiency tend to wait seven years before they search for assistance and 75 \% of hearing-impaired who could profit from a hearing aid don't own one. This behaviour cannot be explained with reasonable arguments. Unlike eyeglasses, hearing aids are not considered a fashionable article and the general nonsensical preconception imputes “intelligence” to people wearing glasses and “stupidity” to people with a hearing problem. The latter is the effective outcome of the disability when contributing to a conversation: giving the impression of being an unintelligent individual. Unfortunately this stigma prevents the hearing-impaired from acquiring an ALD (Assistive Listening Device), which would abolish this impression. The remaining 25 \% of users who already own an ALD don't necessarily use it. Users regularly complain that hearing aids are “fragile devices that often do not work properly.” This has multiple causes: Hearing aids need to be fitted. Fitting is the process to parameterize a hearing aid to “fit” a single end user's personal needs for his unique hearing disability. This process usually does not deliver satisfactory results right away resulting in several visits at the hearing aid dispenser for readjustments. Depending on the circumstances (severeness of hearing disability, quality of hearing aid, expertise of hearing aid dispenser, user's readiness to cooperate, distance to travel, etc.) a user may come to the early conclusion, that the device is useless or faulty by design. 2 Approach The used approach aims at integrating hearing support technologies within common digital TV/STB-like Home Information and Communication (HIC) platform devices and connecting this device with a residential gateway for external communication and integration of home appliances. Using this way, the acceptance barrier is lowered to a minimum. At the same time the available TV screen can be used to support speech intelligi- 164 bility by visual support. The description of the approach is divided into two parts: (1) the support system and (2) the tele-monitoring system. 2.1 Support System The support system integrates all relevant audio sources and other information sources to enhance the pure audio signal and extend it by video output. Figure 1: Software architecture of the HIC platform. Figure 1 shows the software architecture of the HIC platform. It combines audio technologies like the Jack framework [JA07] and the Master Hearing Aid (MHA, [GR06]), the Synface visual lip reading support [BE04], a multi-media framework (FFmpeg, [FF07]), a controller running within an OSGi framework [OS07], and a residential gateway. The controller observes the environment (input audio/video channels, remote control, signals form home appliances through the residential gateway) and derives control commands to the other modules depending on the classified scenario (see chapter 3). A datapoint abstraction layer is used to convert the sensor inputs from different modules to a unified format and to convert control commands and parameter settings to the device dependent format. Depending on the detected scenario the video de-multiplexer prioritizes a certain input channel (streams coming from digital TV, DVD player, radio or telephone) and divides it if necessary in separate audio and video streams. 165 The audio stream will be processed by the MHA to improve the audio signals in terms of

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