Hearing intervention

Abstract

Presented herein are techniques relating to a method comprising: obtaining, at a processing device, results of a diagnostic test presented to a recipient of a hearing device; determining from the results that the recipient exhibits a random error or a non-random error with respect to an auditory stimulus presented in the diagnostic test; and selecting between a technical intervention associated with the hearing device or a rehabilitation intervention to be performed by the recipient based on a determination that the recipient exhibits the random error or the non-random error.

Description

background Technical Field

[0001] The present invention generally relates to hearing devices. Background Art

[0002] In recent decades, medical devices have provided a wide range of therapeutic benefits to recipients. Medical devices can include internal or implantable components / devices, external or wearable components / devices, or combinations thereof (e.g., devices having external components that communicate with implantable components). Medical devices, such as traditional hearing aids, partially or fully implantable hearing prostheses (e.g., bone conduction devices, mechanical stimulators, cochlear implants, etc.), pacemakers, defibrillators, functional electrical stimulation devices, and other medical devices, have been successful for many years in performing life-saving and / or lifestyle-improving functions and / or recipient monitoring.

[0003] Over the years, the types of medical devices and the range of functions performed by them have increased. For example, many medical devices, sometimes referred to as "implantable medical devices," now typically include one or more instruments, devices, sensors, processors, controllers, or other functional mechanical or electrical components that are permanently or temporarily implanted in a recipient. These functional devices are often used to diagnose, prevent, monitor, treat, or manage disease / injury or its symptoms, or to study, replace, or modify anatomical structures or physiological processes. Many of these functional devices utilize power and / or data received from an external device that is part of or operates in conjunction with the implantable component. Summary of the Invention

[0004] In some aspects, the technology described herein relates to a method comprising: obtaining, at a processing device, results of a diagnostic test presented to a recipient of a hearing device; determining, from the results, whether the recipient exhibited random errors or non-random errors with respect to auditory stimuli presented in the diagnostic test; and selecting, based on determining that the recipient exhibited the random errors or the non-random errors, between a technical intervention associated with the hearing device or a rehabilitation intervention to be performed by the recipient.

[0005] In some aspects, the technology described herein relates to a method comprising: administering an audiological test to a recipient of a hearing device, the administering comprising: presenting a plurality of speech-speech auditory stimuli to the recipient via the hearing device, presenting a plurality of responses to each of the plurality of speech-speech auditory stimuli to the recipient via a user interface, and receiving a response associated with each of the plurality of speech-speech auditory stimuli from the recipient via the user interface; analyzing the responses associated with each of the plurality of speech-speech auditory stimuli; and determining, in response to the analyzing, that the recipient exhibits a consistent error or an inconsistent error with respect to at least one of the plurality of speech-speech auditory stimuli.

[0006] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media comprising instructions that, when executed by a processor, cause the processor to: obtain results of a diagnostic test presented to a recipient of a hearing device; determine from the results whether the recipient exhibited random errors or non-random errors with respect to auditory stimuli presented in the diagnostic test; and select between a technical intervention associated with the hearing device or a rehabilitation intervention to be performed by the recipient based on determining that the recipient exhibited the random errors or the non-random errors.

[0007] In some aspects, the technology described herein relates to a system comprising a processing device, the processing device comprising a user interface and at least one processor, wherein the at least one processor is configured to: cause a hearing device to present a plurality of speech-speech auditory stimuli to a recipient of the hearing device; present a plurality of responses to each of the plurality of speech-speech auditory stimuli to the recipient via the user interface; receive a response associated with each of the plurality of speech-speech auditory stimuli from the recipient via the user interface; analyze the responses associated with each of the plurality of speech-speech auditory stimuli; and determine, in response to the analysis, whether the recipient exhibits a consistent error or an inconsistent error with respect to at least one of the plurality of speech-speech auditory stimuli.

[0008] In some aspects, the technology described herein relates to a device comprising: a memory; at least one processor configured to initiate delivery of a plurality of speech-speech auditory stimuli to a user of a hearing device; a user interface configured to display a plurality of responses to each of the plurality of speech-speech auditory stimuli and receive a selection of one of the plurality of responses associated with each of the plurality of speech-speech auditory stimuli; wherein the at least one processor is configured to analyze the responses associated with each of the plurality of speech-speech auditory stimuli and, in response to the analysis, determine whether the user exhibited a consistent error or an inconsistent error with respect to at least one of the plurality of speech-speech auditory stimuli. BRIEF DESCRIPTION OF THE DRAWINGS

[0009] Embodiments of the present invention are described herein with reference to the accompanying drawings, in which:

[0010] Figure 1A is a schematic diagram illustrating a cochlear implant system with which aspects of the technology presented herein may be implemented;

[0011] Figure 1B It is wearable Figure 1A A side view of a recipient of a cochlear implant system's sound processing unit;

[0012] Figure 1C yes Figure 1A A schematic diagram of components of a cochlear implant system;

[0013] Figure 1D yes Figure 1A Block diagram of the cochlear implant system;

[0014] Figure 2 is a speech confusion matrix to which the phoneme error-based intervention technique disclosed herein has been applied according to an exemplary embodiment;

[0015] Figure 3 is a first mapping of phoneme errors to interventions according to an exemplary embodiment;

[0016] Figure 4 is a second mapping of phoneme errors to interventions according to an exemplary embodiment;

[0017] Figure 5 shows a speech confusion matrix and misidentifications for a first cochlear implant recipient according to an exemplary embodiment;

[0018] Figure 6 shows a speech confusion matrix and misidentifications for a second cochlear implant recipient according to an exemplary embodiment;

[0019] Figure 7 is a block diagram of an adaptation system configured to implement the phoneme error-based intervention technique disclosed herein, according to an exemplary embodiment;

[0020] Figure 8 is a flow chart illustrating a process flow for implementing the error identification aspects of the phoneme error-based intervention technique disclosed herein, according to an exemplary embodiment;

[0021] Figure 9 is a flow chart illustrating a process flow for selecting an intervention according to the phoneme error-based intervention technique disclosed herein, according to an exemplary embodiment;

[0022] Figure 10 is a flow chart illustrating a process flow for administering audiological testing according to the phoneme error-based intervention techniques disclosed herein, according to an exemplary embodiment;

[0023] Figure 11 is a schematic diagram illustrating an implantable stimulation system with which aspects of the technology presented herein may be implemented; and

[0024] Figure 12 is a schematic diagram illustrating a vestibular stimulator system with which aspects of the technology presented herein may be implemented. DETAILED DESCRIPTION

[0025] Various factors are known to influence outcomes for hearing device users, particularly cochlear implant recipients, who often deal with more severe levels of hearing loss than individuals utilizing other types of hearing devices. Some of these factors include duration of deafness, age at implantation, residual hearing, family involvement, and patient motivation. Even accounting for these differences, outcomes are common and varied among cochlear implant recipients, and even "good candidates" can become "poor performers." These varying outcomes, particularly poor outcomes, can lead to dissatisfaction among cochlear implant recipients and their communication partners, and frustration for clinicians. Such poor outcomes also make it difficult for policymakers to increase resources and funding for cochlear implant surgery and rehabilitation.

[0026] Post-implantation results are typically expressed as clinical speech perception scores in the form of phoneme or word scores, where the outcome is measured as the percentage of phonemes or words correctly identified by the test subject. While these outcome measures provide a high-level overview of the user / recipient's results, they do not provide more detailed information about the types of phoneme perception difficulties and the errors that contribute to this score.

[0027] Therefore, current follow-up care (both fitting and auditory rehabilitation) is broad and does not focus on individual perceptual errors and the patterns of perceptual errors made by the recipient. Therefore, instead of targeted intervention, the recipient is provided with a one-size-fits-all solution. The technology disclosed herein provides a diagnostic battery of tests that parse phoneme error patterns. Such tests can be used to diagnose fine-grained phoneme errors in cochlear implant recipients and users / recipients of other hearing devices. The disclosed technology also includes phoneme error pattern test results into an individualized follow-up care path, which can ultimately improve speech perception outcomes.

[0028] For ease of description only, the technology presented herein is primarily described with reference to a specific implantable medical device system, namely a cochlear implant system. However, it should be understood that the technology presented herein can also be partially or fully implemented by other types of hearing devices and implantable medical devices. For example, the technology presented herein can be implemented by other hearing device (e.g., hearing prosthesis) systems, which include one or more other types of hearing devices, such as hearing aids, middle ear hearing prostheses, bone conduction devices, direct acoustic stimulators, electroacoustic prostheses, auditory brain stimulators, combinations or variations thereof, etc. The technology presented herein can also be implemented by proprietary tinnitus treatment devices and tinnitus treatment device systems. The technology presented herein can also be implemented in consumer hearing devices (such as personal sound amplification product (PSAP) devices, headphones, and earplugs, etc.). In additional embodiments, the technology presented herein may also be implemented by, or used in combination with, vestibular devices (e.g., vestibular implants), visual devices (i.e., bionic eyes), sensors, pacemakers, drug delivery systems, defibrillators, functional electrical stimulation devices, catheters, epileptic seizure devices (e.g., devices for monitoring and / or treating epileptic events), sleep apnea devices, electroporation devices, and the like.

[0029] Figures 1A-1D An exemplary cochlear implant system 102 is shown with which aspects of the technology presented herein may be implemented. The cochlear implant system 102 includes an external component 104 / implantable component 112. Figures 1A-1D In the example of a cochlear implant, the implantable component is sometimes referred to as a "cochlear implant." Figure 1A The cochlear implant 112 is shown implanted in the recipient's head 154, while Figure 1B is a schematic diagram of the outer member 104 worn on the head 154 of the recipient. Figure 1C is another schematic diagram of a cochlear implant system 102, and Figure 1D Additional details of the cochlear implant system 102 are shown. For ease of description, the Figures 1A-1D .

[0030] Cochlear implant system 102 includes an external component 104 configured to be attached directly or indirectly to the body of a recipient, and an implantable component 112 configured to be implanted in the recipient. Figures 1A-1D In the example of FIG. 1 , external component 104 includes a sound processing unit 106 , while cochlear implant 112 includes an implantable coil 114 , an implant body 134 , and an elongated stimulation assembly 116 configured to be implanted in the cochlea of a recipient.

[0031] exist Figures 1A-1D In the example of the present invention, the sound processing unit 106 is an outside-the-ear (OTE) sound processing unit, sometimes referred to herein as an OTE component, which is configured to send data and power to the implantable component 112. Generally speaking, the OTE sound processing unit is a component having a generally cylindrical housing 111 and configured to be magnetically coupled to the head of the recipient (e.g., including an integrated external magnet 150 configured to be magnetically coupled to an implantable magnet 152 in the implantable component 112). The OTE sound processing unit 106 also includes an integrated external (head component) coil 108 configured to be inductively coupled to the implantable coil 114.

[0032] It should be understood that the OTE sound processing unit 106 is merely illustrative of an external device that can operate with the implantable component 112. For example, in alternative examples, the external component can include a behind-the-ear (BTE) sound processing unit or a micro-BTE sound processing unit and a separate external component. Generally speaking, the BTE sound processing unit includes a housing that is shaped to be worn on the recipient's outer ear and is connected to a separate external coil assembly via a cable, wherein the external coil assembly is configured to be magnetically and inductively coupled to the implantable coil 114. It should also be understood that alternative external components can be located in the recipient's ear canal, worn on the body, etc.

[0033] As described above, cochlear implant system 102 includes sound processing unit 106 and cochlear implant 112. However, as further described below, cochlear implant 112 can operate independently of sound processing unit 106 for at least a period of time to stimulate a recipient. For example, cochlear implant 112 can operate in a first general mode (sometimes referred to as an "external hearing mode"), in which sound processing unit 106 captures sound signals, which are then used as the basis for delivering stimulation signals to the recipient. Cochlear implant 112 can also operate in a second general mode (sometimes referred to as an "invisible hearing" mode), in which sound processing unit 106 is unable to provide sound signals to cochlear implant 112 (e.g., sound processing unit 106 is not present, sound processing unit 106 is powered off, sound processing unit 106 is malfunctioning, etc.). Therefore, in the invisible hearing mode, cochlear implant 112 captures sound signals itself via an implantable sound sensor and then uses these sound signals as the basis for delivering stimulation signals to the recipient. Further details regarding the operation of cochlear implant 112 in the external listening mode are provided below, followed by details regarding the operation of cochlear implant 112 in the invisible listening mode. It should be understood that the reference to the external listening mode and the invisible listening mode is merely illustrative, and cochlear implant 112 may also operate in alternative modes.

[0034] exist Figure 1A and 1C , a cochlear implant system 102 is shown with an external device 110 configured to implement various aspects of the technology presented. External device 110 is a computing device, such as a computer (e.g., a laptop, a desktop computer, a tablet), a mobile phone, a remote control unit, etc. External device 110 and cochlear implant system 102 (e.g., an OTE sound processing unit 106 or a cochlear implant 112) communicate wirelessly via a bidirectional communication link 126. Bidirectional communication link 126 can include, for example, short-range communication, such as a Bluetooth link, a Bluetooth low energy (BLE) link, a proprietary link, etc. Accordingly, cochlear implant system 102 includes an interface 121.

[0035] Return to Figures 1A-1DIn the example of the OTE sound processing unit 106, the OTE sound processing unit 106 includes one or more input devices configured to receive input signals (e.g., sound or data signals). The one or more input devices include one or more sound input devices 118 (e.g., one or more external microphones, audio input ports, telecoils, etc.), one or more auxiliary input devices 128 (e.g., audio ports such as direct audio input (DAI), data ports such as universal serial bus (USB) ports, cable ports, etc.), and a wireless transmitter / receiver (transceiver) 120 (e.g., for communicating with the external device 110). However, it should be understood that the one or more input devices may include additional types of input devices and / or fewer input devices (e.g., the wireless short-range radio transceiver 120 and / or one or more auxiliary input devices 128 may be omitted).

[0036] The OTE sound processing unit 106 also includes an external coil 108, a charging coil 130, a tightly coupled transmitter / receiver (RF transceiver) 122 (sometimes referred to as a radio frequency (RF) transceiver 122), at least one rechargeable battery 132, and an external sound processing module 124. The external sound processing module 124 may include, for example, one or more processors and a memory device (memory) including sound processing logic. The memory device may include any one or more of the following: non-volatile memory (NVM), ferroelectric random access memory (FRAM), read-only memory (ROM), random access memory (RAM), magnetic disk storage media devices, optical storage media devices, flash memory devices, electrical, optical, or other physical / tangible memory storage devices. The one or more processors may be, for example, a microprocessor or microcontroller that executes instructions of the sound processing logic stored in the memory device.

[0037] The implantable component 112 includes an implant body (main module) 134, a lead region 136, and an intracochlear stimulation assembly 116, all configured to be implanted beneath the skin / tissue 115 of a recipient. The implant body 134 typically includes a hermetically sealed housing 138 within which are disposed an RF interface circuitry 140 and a stimulator unit 142. The implant body 134 also includes an internal / implantable coil 114, which is typically external to the housing 138 but accessible via a hermetically sealed feedthrough ( Figure 1D ) is connected to the RF interface circuit system 140.

[0038] As described, the stimulation assembly 116 is configured to be at least partially implanted in the cochlea of a recipient. The stimulation assembly 116 includes a plurality of longitudinally spaced intracochlear electrical stimulation contacts (electrodes) 144 that collectively form a contact or electrode array 146 for delivering electrical stimulation (electrical current) to the cochlea of the recipient.

[0039] The stimulation assembly 116 extends through an opening in the recipient's cochlea (e.g., a cochlear fenestration, a round window, etc.) and has a ventral ventral vent located adjacent to the cochlea via a lead region 136 and an airtight feedthrough ( Figure 1D 144 is connected to the proximal end of the stimulator unit 142. The lead region 136 includes a plurality of conductors (wires) that electrically couple the electrodes 144 to the stimulator unit 142. The implantable component 112 also includes an electrode outside the cochlea, sometimes referred to as an extracochlear electrode (ECE) 139.

[0040] As described, cochlear implant system 102 includes an external coil 108 and an implantable coil 114. External magnet 152 is fixed relative to external coil 108, and implantable magnet 152 is fixed relative to implantable coil 114. The magnets, being fixed relative to external coil 108 and implantable coil 114, facilitate operational alignment of external coil 108 with implantable coil 114. This operational alignment of the coils enables external component 104 to transmit data and power to implantable component 112 via a tightly coupled wireless link 148 formed between external coil 108 and implantable coil 114. In some examples, tightly coupled wireless link 148 is a radio frequency (RF) link. However, various other types of energy transfer (e.g., infrared (IR), electromagnetic, capacitive, and inductive transfer) may be used to transfer power and / or data from the external component to the implantable component, and thus, Figure 1D Only one exemplary arrangement is shown.

[0041] As described above, the sound processing unit 106 includes the external sound processing module 124. The external sound processing module 124 is configured to convert an input signal received (at one or more of the input devices) into an output signal for stimulating the first ear of the recipient (i.e., the external sound processing module 124 is configured to perform sound processing on the input signal received at the sound processing unit 106). In other words, the one or more processors in the external sound processing module 124 are configured to execute the sound processing logic in the memory to convert the received input signal into an output signal representing electrical stimulation for delivery to the recipient.

[0042] As stated, Figure 1D An embodiment is shown in which an external sound processing module 124 in the sound processing unit 106 generates the output signal. In alternative embodiments, the sound processing unit 106 may send less processed information (e.g., audio data) to the implantable component 112, and the sound processing operations (e.g., conversion of the sound into the output signal) may be performed by a processor within the implantable component 112.

[0043] Return to Figure 1DIn the specific example of the invention, the output signal is provided to the RF transceiver 122, which transmits the output signal (e.g., in an encoded manner) transcutaneously to the implantable component 112 via the external coil 108 and the implantable coil 114. That is, the output signal is received at the RF interface circuit system 140 via the implantable coil 114 and provided to the stimulator unit 142. The stimulator unit 142 is configured to use the output signal to generate an electrical stimulation signal (e.g., a current signal) for delivery to the cochlea of the recipient. In this way, the cochlear implant system 102 electrically stimulates the auditory nerve cells of the recipient, thereby bypassing the missing or defective hair cells that normally convert acoustic vibrations into neural activity in a manner that causes the recipient to perceive one or more components of the received sound signal.

[0044] As detailed above, in the external hearing mode, the cochlear implant 112 receives processed sound signals from the sound processing unit 106. However, in the invisible hearing mode, the cochlear implant 112 is configured to capture and process the sound signals for electrical stimulation of the recipient's auditory nerve cells. Specifically, Figure 1D As shown in , cochlear implant 112 includes a plurality of implantable sound sensors 160 and an implantable sound processing module 158. Similar to external sound processing module 124, implantable sound processing module 158 may include, for example, one or more processors and a memory device (memory) including sound processing logic. The memory device may include any one or more of the following: non-volatile memory (NVM), ferroelectric random access memory (FRAM), read-only memory (ROM), random access memory (RAM), magnetic disk storage media devices, optical storage media devices, flash memory devices, electrical, optical, or other physical / tangible memory storage devices. The one or more processors are, for example, microprocessors or microcontrollers that execute instructions of the sound processing logic stored in the memory device.

[0045] In the invisible hearing mode, the implantable sound sensor 160 is configured to detect / capture a signal (e.g., an acoustic sound signal, vibration, etc.), which is provided to the implantable sound processing module 158. The implantable sound processing module 158 is configured to convert the input signal received (received at one or more implantable sound sensors 160) into an output signal for stimulating the first ear of the recipient (i.e., the processing module 158 is configured to perform sound processing operations). In other words, the one or more processors in the implantable sound processing module 158 are configured to execute the sound processing logic in the memory to convert the received input signal into an output signal 156 that is provided to the stimulator unit 142. The stimulator unit 142 is configured to use the output signal 156 to generate an electrical stimulation signal (e.g., an electrical current signal) for delivery to the cochlea of the recipient, thereby bypassing the missing or defective hair cells that normally convert acoustic vibrations into neural activity.

[0046] It should be understood that the above description of the so-called external listening mode and the so-called invisible listening mode is merely illustrative, and that cochlear implant system 102 may operate differently in different embodiments. For example, in an alternative embodiment of the external listening mode, cochlear implant 112 may use the signals captured by sound input device 118 and implantable sound sensor 160 to generate stimulation signals for delivery to the recipient.

[0047] As described above, the techniques disclosed herein relate to diagnostic test batteries that parse auditory stimulus error patterns (e.g., phoneme or other speech sound error patterns) and to incorporating these test results into personalized follow-up care pathways. As explained in more detail below, these techniques present a diagnostic test battery to a hearing device user (e.g., a hearing / auditory prosthesis recipient), which includes, for example, speech sounds, which in the case of tonal languages are, for example, phonemes or tones. Based on the results of the diagnostic tests, a type of intervention is selected. Certain test results may indicate that a technical intervention (e.g., a cochlear implant fitting procedure) is likely to produce better results. For example, if a recipient is unable to distinguish between two speech sounds, fitting parameters can be adjusted to increase the distinction between the two speech sounds. According to one example, if two phonemes are consistently confused by a recipient, the recipient's cochlear implant can be adapted to focus on the spectral difference between the confused phonemes. Consequently, the upper stimulus level in a channel that represents the maximum difference between the two phonemes can be increased, thereby improving the contrast of the recipient's perception of the confused phonemes. According to other examples, the frequency assignments for each channel of the filter bank of a cochlear implant processor can be altered to ensure that two confused phonemes belong to different frequency bands, thereby enhancing the contrast between the phonemes in the recipient's perception. Alternatively, if the confused phonemes differ primarily in the time domain, the dynamic range of the stimulus can be increased, thereby increasing sensitivity to amplitude modulation and improving the distinction between the phonemes in the recipient's perception. Similar to the previous example, loudness compression in the recipient's cochlear implant can be altered generally or in specific spectral channels to enhance the distinction between confused phonemes.

[0048] Other test results may indicate that a rehabilitation intervention (e.g., personalized rehabilitation) based on the recipient's unique error profile is more likely to produce better results for the recipient. For example, if two speech sounds are distinct but they are confused by the recipient, a rehabilitation training designed to better distinguish between the two perceptually different stimuli can be developed. Based on this determination, the identified intervention can be developed for the recipient. According to a specific example of the disclosed technology, if the recipient exhibits consistent errors (e.g., non-random errors) with respect to a particular speech sound, a technical intervention may be determined to be the best intervention for the recipient. On the other hand, inconsistent errors (e.g., random errors) with respect to a particular speech sound may indicate that a rehabilitation intervention should be developed for the recipient. Other errors or other factors may lead to different conclusions. For example, if the recipient exhibits consistent errors with respect to speech sounds, other factors that prevent the errors from presenting themselves may result in a prescription for a rehabilitation intervention. Similarly, if the recipient exhibits inconsistent errors with respect to speech sounds, other factors that prevent the errors from presenting themselves may result in a prescription for a technical intervention.

[0049] As described above, the disclosed technology can be used with many different hearing devices and / or other types of implantable medical devices. For ease of description only, reference will generally be made to the disclosed technology being used with a hearing prosthesis recipient. Therefore, reference to a hearing prosthesis and / or a hearing prosthesis recipient is merely illustrative and does not limit the scope of the present invention to any particular use.

[0050] The disclosed technology begins with presenting a diagnostic test battery of speech sounds to a hearing prosthesis recipient. According to a specific example, the test speech battery may include consonant and / or vowel phoneme recognition tests. Consonant and vowel phoneme tests may measure a subject's ability to recognize vowels and consonants in a closed set context. For consonants, auditory stimuli of the type "vCv" may be presented, where "v" is the vowel sound and "C" is the consonant being tested. For vowels, stimuli of the type "hVd" may be presented, where "V" represents the vowel of interest and "h" and "d" represent the / h / and / d / phonemes, respectively. Under both test conditions (vowels and consonants), the recipient may be presented with a list of possible choices, and the recipient will select the choice that they think they hear. Because the test subject has limited choices, this type of test is called a "closed set" test. The results of the test may be compiled into phoneme confusion matrices for vowels and consonants, examples of which are provided in Figure 2 The confusion matrix 200 is shown in FIG. The input (the stimulus presented) is shown on the Y axis 205, and the output (the stimulus reported) is shown on the X axis 210. Correct answers are shown on the diagonal axis 215, and errors are shown on the off-diagonal elements. For example, in the diagonal axis 215, the input from the Y axis 205 matches the recipient's output from the X axis 210, so the numbers in the diagonal axis 215 represent the number of correct responses by the recipient. The numbers outside the diagonal axis 215 indicate which phonemes were incorrectly recognized and the number of times they were incorrectly recognized.

[0051] Traditionally, when clinically assessing a subject's performance level, the subject's errors on consonant and / or vowel phoneme identification tests have only considered the overall quantitative results of the test, such as assessing the subject's overall percentage of correct answers. In contrast, the disclosed techniques evaluate specific features of the test results to identify specific error patterns for a particular speech sound. For example, applying the disclosed techniques to confusion matrix 200 allows for the identification of specific error types for a particular speech sound. According to this specific example, confusion matrix 200 can be used to identify and distinguish between non-random error patterns and random error patterns for the specific phonemes illustrated therein.

[0052] In the non-random error pattern, if you make a mistake for a specific input, these inputs are consistently confused with the alternatives. For example, the test result shown in the confusion matrix 200 shows that the / ada / phoneme input is consistently confused with the / aga / phoneme. As shown by the table item 220 in the confusion matrix 200, the recipient confused the / ada / phoneme input with the / aga / phoneme 188 times. Similarly, as shown by the table item 225 in the confusion matrix 200, the recipient confused the / atha / phoneme input with the / ava / phoneme 555 times. These errors can be identified as consistent errors or non-random errors. In the random error pattern, if you make a mistake for a specific input, the output is inconsistent. For example, the output of the / ana / phoneme is distributed on / ada / , / aga / , / aba / and other phonemes, as shown in row 230.

[0053] As shown by confusion matrix 200, the disclosed technology can analyze the contents of confusion matrix 200 to identify trends in recipient responses and determine appropriate and / or personalized interventions in response thereto. Through such personalized interventions, identified errors can be overcome or compensated for through targeted device settings and / or training.

[0054] The analysis of the confusion matrix 200 can be performed in various ways without departing from the disclosed technology. For example, an individual clinician can analyze the confusion matrix 200 to identify non-random errors shown by entries 220 and 225 and random errors shown by row 230. The analysis of the confusion matrix 200 can also be performed automatically using a statistical data analysis algorithm running on a processing device, which can be the same or different processing device as the device used to administer the diagnostic test. For example, the confusion matrix 200 can be analyzed as a heat map via the processing device, wherein the processing device is configured to identify maximum values as non-random errors and horizontal contour lines as random errors.

[0055] According to other exemplary embodiments, the analysis of the confusion matrix 200 can be performed so that it identifies errors that are unique or uncommon among a particular group of hearing device recipients (e.g., a group of hearing aid or cochlear implant recipients). For example, as shown by entry 225 in the confusion matrix 200, the recipient confused the / atha / phoneme input with the / ava / phoneme 555 times. If this is a relatively common error, no intervention or only generalized intervention may be prescribed for the recipient. However, if this is an uncommon error or an error unique to this particular recipient, this error may be flagged for further analysis during the analysis of the confusion matrix 200 and may result in additional intervention.

[0056] Now turn Figure 3Specific diagnostic test batteries can be designed so that non-random errors in test results can be addressed by technical interventions (e.g., adaptation interventions), while random errors in test results can be addressed by rehabilitation interventions. Figure 3 As shown in FIG, when non-random errors 305 on specific phonemes are identified as technical interventions, a cochlear implant adaptation intervention 310 is prescribed for the recipient in this case. According to a specific example, non-random errors across the frequency range associated with the electrodes of the cochlear implant can be addressed by the adaptation remedy. Random errors 315 on specific phonemes in the same diagnostic test can result in a prescription for auditory rehabilitation intervention 320. On the other hand, Figure 4 Different diagnostic tests are shown, where a technique or adaptation intervention 410 is prescribed for a non-random error 405, and where an auditory rehabilitation intervention 420 is prescribed for a random error 415. Thus, the particular type of intervention prescribed in response to an identified random error or non-random error can be specific to the diagnostic test performed, the auditory stimuli presented during the test, and / or the characteristics of the recipient's hearing or prosthetic abilities.

[0057] like Figure 3 and Figure 4 The disclosed techniques for designing specific interventions for random and non-random errors, as shown in , can also be applied to designing techniques for non-common or unique errors identified for a recipient by analyzing a confusion matrix. For example, analyzing non-common errors, alone or in combination with other common or non-common errors identified for a recipient, can be used to identify and develop specific interventions for the recipient. For example, if the non-common errors indicate an adaptation problem for the recipient, an adaptation intervention can be developed to address the non-common errors. On the other hand, if the non-common errors indicate a behavioral problem for the recipient, a rehabilitation intervention can be developed for the recipient.

[0058] Steering Figure 5, which depicts a confusion matrix 500 showing the results of a diagnostic test administered to a first recipient. According to this specific example, a computer application, such as an application running on a mobile phone, is provided to the recipient. The application can be configured to interface with the first recipient's hearing prosthesis and cause the hearing prosthesis to initiate a battery of hearing tests by presenting a series of target phonemes to the recipient. According to other examples, the mobile phone presents the target phonemes via its internal speaker, without directly interfacing with the hearing prosthesis. After hearing the target phonemes, the recipient is prompted to indicate what they heard by selecting one of several visually presented options on the mobile phone's user interface. In other words, a closed-set or closed-response test is presented to the recipient. Closed-set / closed-response tests can be applied to the technology disclosed herein when the recipient is forced to select an answer. The recipient can ignore responses in open-set tests, making it more difficult to distinguish random errors from non-random errors. It may be beneficial to present a large number of options (e.g., 12 options) to ensure that non-random errors are properly identified. Similarly, each phoneme can be presented to the user multiple times, for example, eight times, to provide sufficient test data to distinguish random errors from non-random errors. Furthermore, the test stimuli can be presented to the recipient in a random order. According to another example, the stimuli can be presented to the recipient based on the output of a machine learning algorithm. This algorithm can determine the recipient's "problem areas" and select and present stimuli to the recipient during the diagnostic test to assess such "problem areas." The use of this algorithm can reduce the length of the diagnostic test, thereby increasing the recipient's satisfaction with their care.

[0059] When the diagnostic test is completed, a confusion matrix 500 is generated. The confusion matrix 500 is related to Figure 2 The difference between the confusion matrix 200 and the present invention is that the values in the confusion matrix 500 have been normalized to 1, while the values in the confusion matrix 200 are non-normalized error numbers. Once the hearing test is completed, the results are analyzed to identify any specific phonemes that are consistently misheard in a non-random manner. Based on the values contained in the confusion matrix 500, the table entries 505, 510 and 520 associated with the consonant phonemes "b", "j" and "v", respectively, are identified as non-random errors because they indicate a large number of answers from the recipient with consistent incorrect responses outside the diagonal axis 502. Therefore, these values are mapped to non-random errors 550. For example, as shown in table entry 505, the recipient consistently misheard the test phoneme "b" as "d". In order to identify such non-random errors, the application can initiate a refitting module that allows the recipient or clinician to make device adjustments to the recipient's hearing prosthesis, specifically paying attention to correcting the misheard phonemes.

[0060] The hearing test results can also be analyzed to identify any test phonemes that are misheard in a random manner. Rows 525, 530, 535, 540, and 545, which are associated with the consonant phonemes "l," "m," "n," "r," and "w," respectively, are identified as random errors 560 because they indicate a large number of answers with inconsistent incorrect responses (i.e., a large number of incorrect responses in more than one column outside the diagonal axis 502) outside the diagonal axis 502. For example, as shown in row 525, the recipient consistently mishears the test phoneme "l," but responds inconsistently by selecting "j," "n," or "r" phonemes at different times. With respect to identifying such random errors, the application can initiate a rehabilitation module that provides the recipient with targeted auditory practice exercises with the goal of helping the recipient hear the "l" phoneme more consistently and correctly.

[0061] Now refer to Figure 6 , which depicts a confusion matrix 600 that exhibits both random and non-random errors, but is less Figure 5 The confusion matrix 500 is less accurate than the confusion matrix 500. Therefore, conventional analysis of the confusion matrix 600 (in which only the total number of incorrect responses is analyzed) may result in the recipient not receiving an appropriately tailored or individualized intervention. For example, because the errors in the confusion matrix 600 are significantly fewer than the errors in the confusion matrix 500, specific errors associated with the recipient may be overlooked using conventional confusion matrix analysis techniques.

[0062] However, by utilizing the techniques disclosed herein, it can be determined that the recipient whose answers populate confusion matrix 600 requires technical intervention to address errors associated with the "l" and "r" phonemes, and requires rehabilitation intervention with respect to the "v" phoneme. As shown in confusion matrix 600, entries 605 and 610 associated with the "l" and "r" consonant phonemes, respectively, are identified as non-random errors because they indicate a large number of answers by the recipient with consistently incorrect responses outside of diagonal axis 602. Therefore, these values are mapped as non-random errors 650. In response to identifying these non-random errors, the application administering the diagnostic test can initiate a refit module that allows the recipient or clinician to make device adjustments with specific attention to correcting the perception and recognition of the "l" and "r" consonant phonemes.

[0063] Utilizing the techniques disclosed herein can also provide the recipient with rehabilitation interventions that might be overlooked using traditional confusion matrix techniques. Specifically, row 615 associated with the "v" consonant phoneme is identified as random error 660 because row 615 indicates a large number of answers outside the diagonal axis 602 with inconsistent incorrect responses (i.e., a large number of incorrect responses in more than one column outside the diagonal axis 602). The application can initiate a rehabilitation module that provides the recipient with targeted auditory practice exercises with the goal of helping the recipient more consistently hear and recognize the "v" phoneme correctly.

[0064] As indicated above, the technical interventions described herein may include cochlear implant fitting interventions. Figure 7 A block diagram of an exemplary adaptation system 770 configured to perform the techniques presented herein is shown in . The adaptation system 770 is typically a computing device that includes a plurality of interfaces / ports 778(1)-778(N), a memory 780, a processor 784, and a user interface 786. The interfaces 778(1)-778(N) can include, for example, any combination of network ports (e.g., Ethernet ports), wireless network interfaces, Universal Serial Bus (USB) ports, Institute of Electrical and Electronics Engineers (IEEE) 1394 interfaces, PS / 2 ports, etc. In Figure 7 In the example of FIG, interface 778(1) is connected to cochlear implant system 102 having components implanted in recipient 771. Interface 778(1) can be connected directly to cochlear implant system 102 or to an external device that communicates with the cochlear implant system. Interface 778(1) can be configured to communicate with cochlear implant system 102 via a wired or wireless connection (e.g., telemetry, Bluetooth, etc.).

[0065] The user interface 786 includes one or more output devices for presenting visual or auditory information to a clinician, audiologist, or other user, such as a display screen (e.g., a liquid crystal display (LCD)) and a speaker. The user interface 786 may also include one or more input devices, such as a keypad, keyboard, mouse, touch screen, etc.

[0066] The memory 780 includes hearing capability profile management logic 781 that can be executed to generate or update a hearing capability profile 783 of a recipient stored in the memory 780. The hearing capability profile management logic 781 can be executed to receive a hearing capability profile 783 from a user, such as an imaging system, via one of the other interfaces 778(2)-778(N). Figure 778(N) from an external device (not shown). In some embodiments, the memory 780 includes subjective assessment logic 785 that is configured to perform a subjective assessment of the recipient's cognitive hearing ability and provide the results for use by the hearing ability profile management logic 781. Thus, the hearing ability profile management logic 781 may include logic configured to perform and analyze diagnostic tests according to the techniques disclosed herein. In other embodiments, the subjective assessment logic 785 is omitted, and the hearing ability profile management logic 781 is executed to obtain the results of the objective assessment of the recipient's cognitive hearing ability from an external device (not shown) via one of the other interfaces 778(2)-778(N). Figure 7 (not shown) to obtain the results of the subjective assessment of the recipient's cognitive hearing ability. Similarly, diagnostic tests according to the technology disclosed herein can be performed and analyzed from an external device.

[0067] The memory 780 also includes profile analysis logic 787. The profile analysis logic 787 is executed to analyze the recipient's auditory profile (i.e., the relevant results of the objective and subjective assessments) to identify relevant stimulation parameters optimized for the recipient's cognitive auditory abilities. The profile analysis logic 787 can also be configured to identify stimulation parameters based on analysis of diagnostic tests according to the techniques disclosed herein.

[0068] The memory 780 may include read-only memory (ROM), random access memory (RAM), magnetic disk storage media devices, optical storage media devices, flash memory devices, electrical, optical, or other physical / tangible memory storage devices. The processor 784 is, for example, a microprocessor or microcontroller that executes instructions for the auditory ability profile management logic 781, the subjective assessment logic 785, and the profile analysis logic 787. Thus, in general, the memory 780 may include one or more tangible (non-transitory) computer-readable storage media (e.g., memory devices) encoded with software including computer-executable instructions, and when the software is executed (by the processor 784), it is operable to perform the techniques described herein.

[0069] The relevant stimulation parameters identified by the execution profile analysis logic 787 are sent to the cochlear implant system 102 to be instantiated as the current relevant stimulation parameters for the cochlear implant. Thus, the adaptation system 770 can implement a cochlear implant adaptation intervention determined according to the techniques disclosed herein. However, in some embodiments, the relevant stimulation parameters identified by the execution profile analysis logic 787 are first displayed at the user interface 786 for further evaluation and / or adjustment by the user. Thus, the user (e.g., an audiologist or a cochlear implant recipient) has the ability to refine the relevant stimulation parameters before sending the stimulation parameters to the cochlear implant system 102.

[0070] Now refer to Figure 8, which depicts a flowchart 800 illustrating a generalized process flow for implementing the phoneme error-based intervention technique of the present disclosure. Flowchart 800 begins at operation 805, where the results of a diagnostic test are obtained. The diagnostic test was presented to a recipient of a hearing prosthesis. According to a specific example, the diagnostic test may be based on a diagnostic test battery in which speech-speech auditory stimuli are presented to the recipient. The speech-speech auditory stimuli may have included phonemes or tones of a tonal language. The diagnostic test presented to the recipient may have been a closed-response diagnostic test in which a plurality of possible responses are presented to the recipient and the recipient is asked to select a response that corresponds to the speech-speech auditory stimuli presented to them. The results may have been compiled into a speech confusion matrix. In other words, the results obtained in operation 805 may be embodied as described above with reference to Figure 2-6 Describes the results of one or more different types of diagnostic tests.

[0071] In operation 810, it is determined from the results whether the user exhibited random errors or non-random errors with respect to the auditory stimuli presented in the diagnostic test. Figure 2-6 For example, operation 810 may be implemented as described above with reference to Figure 2 、 5 and 6 as described in the confusion matrix to identify random errors, non-random errors, or both.

[0072] Finally, in operation 815, a selection is made between a technical intervention associated with the hearing prosthesis or a rehabilitation intervention to be performed by the recipient. The selection is based on determining whether the recipient exhibits random errors or non-random errors. For example, the selection of operation 815 may be in response to determining non-random errors in operation 810 to select a technical intervention, as described above. Figure 3 Alternatively, the selection of operation 815 may be in response to the determination of a random error in operation 810 and the selection of a technical intervention, as described above. Figure 4 Similarly, operation 815 may select a rehabilitation intervention in response to determining a random error in operation 810, as described above. Figure 3 Alternatively, the selection of operation 815 may be in response to the determination of a non-random error in operation 810 to select a rehabilitation intervention, as described above. Figure 4 As shown in .

[0073] As shown by the above discussion, flowchart 800 can implement the error identification and intervention selection aspects of the disclosed technology. Figure 9 Flowchart 900 illustrates a process flow for implementing the diagnostic test administration and analysis aspects of the disclosed technology.

[0074] Flowchart 900 begins at operation 905, where an audiological test is administered to a recipient of a hearing prosthesis. Thus, operation 905 may be embodied as described above with respect to Figure 2-6 The administration of the diagnostic kit described. Briefly turn to Figure 10 , depicts a flowchart 1000 illustrating a process flow for implementing a specific example of administering an audiological test. Flowchart 1000 begins at operation 1005, where a plurality of speech sound auditory stimuli are presented to a recipient of a hearing prosthesis. The auditory stimuli are presented to the recipient by the hearing prosthesis. Operation 1005 should be broadly interpreted such that presenting auditory stimuli in operation 1005 can encompass presenting auditory stimuli generated by the hearing prosthesis itself or presenting auditory stimuli generated by another device and transmitted to the recipient by the hearing prosthesis.

[0075] In operation 1010, a plurality of responses to each of a plurality of speech and audio stimuli are presented to the recipient via a user interface. For example, operation 1010 may be embodied as presenting the responses as part of a closed-response diagnostic test. The user interface of operation 1010 may be a screen of a personal computing device, including a touch screen of a smartphone or tablet computing device. When implemented via such a personal computing device, the recipient has the opportunity to conduct an audiology test at their own pace. The user interface of operation 1010 may also be a user interface as described above with respect to Figure 7 Finally, in operation 1015 , a response to each of the plurality of speech sound auditory stimuli is received from the recipient via the user interface.

[0076] Steering Figure 9 , the process flow of flowchart 900 begins with operation 905 (whether via Figure 10 Whether implemented by flowchart 1000 or via another process, the process proceeds to operation 910. In operation 910, the responses to the audiology test are analyzed. Thus, operation 910 may be embodied as editing the responses to the audiology test as described above with reference to FIG. Figure 2 、 5 and 6 described in the language confusion matrix.

[0077] Finally, in operation 915, it is determined whether the recipient exhibits a consistent error or an inconsistent error with respect to at least one speech sound in response to the analysis of operation 910. As described above, the speech sound can be a phoneme, a tone, a consonant-vowel-consonant speech sound, a vowel-consonant-vowel speech sound, a syllable, a word, or a combination thereof.

[0078] As previously mentioned, the technology disclosed herein can be applied to any of a variety of situations and used with a variety of different devices. Figure 11 and 12An exemplary device that may benefit from the techniques disclosed herein is described in more detail in Figure 7 Adaptation system 770 Adaptation system configuration reference Figure 11 and 12 For example, the techniques described herein can be used to prioritize clinician tasks associated with configuring operating parameters of a wearable medical device, such as a wearable medical device. Figure 11 The implantable stimulation system described in Figure 12 The vestibular stimulator described in [ 1 ]. The technology disclosed herein can be applied to other medical devices, such as neurostimulators and vestibular stimulation devices, as well as other medical devices that deliver stimulation to tissue. In addition, the technology described herein can also be applied to consumer devices. These various systems and devices can benefit from the technology described herein.

[0079] Figure 11 1 is a functional block diagram of an implantable stimulator system 1100 that can benefit from the technology described herein. The implantable stimulator system 1100 includes a wearable device 100 that acts as an external processor device and an implantable device 30 that acts as an implanted stimulator device. In an example, the implantable device 30 is an implantable stimulator device that is configured to be implanted beneath the tissue (e.g., skin) of a recipient. In an example, the implantable device 30 includes a biocompatible implantable housing 1102. Here, the wearable device 100 is configured to be percutaneously coupled to the implantable device 30 via a wireless connection to provide additional functionality to the implantable device 30.

[0080] In the example shown, the wearable device 100 includes one or more sensors 1112, a processor 1114, a transceiver 1118, and a power supply 1148. The one or more sensors 1112 can be one or more units configured to generate data based on the sensed activity. In the example where the stimulation system 1100 is an auditory prosthesis system, the one or more sensors 1112 include a sound input sensor, such as a microphone, an electrical input for an FM hearing system, other components for receiving sound input, or a combination thereof. In the case where the stimulation system 1100 is a visual prosthesis system, the one or more sensors 1112 can include one or more cameras or other visual sensors. In the case where the stimulation system 1100 is a cardiac stimulator, the one or more sensors 1112 can include a cardiac monitor. The processor 1114 can be a component (e.g., a central processing unit) configured to control the stimulation provided by the implantable device 30. The stimulation can be controlled based on data from the sensors 1112, a stimulation schedule, or other data. In the case where the stimulation system 1100 is a hearing prosthesis, the processor 1114 can be configured to convert the sound signal received from the sensor(s) 1112 (e.g., acting as a sound input unit) into a signal 1151. The transceiver 1118 is configured to transmit the signal 1151 in the form of a power signal, a data signal, a combination thereof (e.g., by interleaving the signal), or other signals. The transceiver 1118 can also be configured to receive power or data. The stimulation signal can be generated by the processor 1114 and sent to the implantable device 30 using the transceiver 1118 for providing stimulation.

[0081] In the illustrated example, implantable device 30 includes a transceiver 1118, a power source 1148, and a medical device 1111 including an electronics module 1110 and a stimulator assembly 1130. Implantable device 30 also includes a hermetically sealed biocompatible implantable housing 1102 that encloses one or more of the components.

[0082] The electronic module 1110 may include one or more other components to provide medical device functions. In many examples, the electronic module 1110 includes one or more components for receiving a signal and converting the signal into a stimulation signal 1115. The electronic module 1110 may also include a stimulator unit. The electronic module 1110 can generate a stimulation signal 1115 or control the delivery of the stimulation signal to the stimulator assembly 1130. In an example, the electronic module 1110 includes one or more processors (e.g., a central processing unit or a microcontroller) coupled to a memory component (e.g., a flash memory), the memory component storing instructions that, when executed, cause an operation to be performed. In an example, the electronic module 1110 generates and monitors parameters (e.g., output voltage, output current, or line impedance) associated with generating and delivering stimulation. In an example, the electronic module 1110 generates a telemetry signal (e.g., a data signal) comprising telemetry data. The electronic module 1110 can send the telemetry signal to the wearable device 100 or store the telemetry signal in a memory for later use or retrieval.

[0083] Stimulator assembly 1130 can be a component configured to provide stimulation to the target tissue. In the example shown, stimulator assembly 1130 is an electrode assembly comprising an array of electrode contacts arranged on a lead. The lead can be arranged near the tissue to be stimulated. In the case where system 1100 is a cochlear implant system, stimulator assembly 1130 can be inserted into the cochlea of the recipient. Stimulator assembly 1130 can be configured to deliver the stimulation signal 1115 (e.g., electrical stimulation signal) generated by electronic module 1110 to the cochlea so that the recipient experiences auditory perception. In other examples, stimulator assembly 1130 is a vibration actuator, which is arranged inside or outside the housing of implantable device 30 and is configured to generate vibrations. The vibration actuator receives stimulation signal 1115 and generates a mechanical output force in the form of vibration based on the stimulation signal. The actuator can deliver vibrations to the recipient's skull in a manner that generates movement or vibration of the recipient's skull, thereby generating auditory perception by activating the hair cells in the recipient's cochlea via cochlear fluid movement.

[0084] The transceiver 1118 may be a component configured to transcutaneously receive and / or transmit signals 1151 (e.g., power signals and / or data signals). The transceiver 1118 may be a collection of one or more components that form part of a transcutaneous energy or data transmission system to transmit signals 1151 between the wearable device 100 and the implantable device 30. Various types of signal transmission, such as electromagnetic, capacitive, and inductive transmission, may be used to effectively receive or transmit the signals 1151. The transceiver 1118 may include the coil 20 or be electrically connected to the coil.

[0085] As shown, the wearable device 100 includes a coil 108 for transcutaneously transmitting signals with a concave coil 20. As described above, transcutaneously transmitting signals between the coil 108 and the coil 20 may include transmitting power and / or data from the coil 108 to the coil 20 and / or transmitting data from the coil 20 to the coil 108. The power source 1148 may be one or more components configured to provide operating power to other components. The power source 1148 may be or include one or more rechargeable batteries. Power from the battery may be received from the power source and stored in the battery. The power may then be distributed to other components as needed for operation.

[0086] It should be understood that although the Figure 11 Although specific components are described, the technology disclosed herein can be applied to any of a variety of situations. The above discussion is not intended to imply that the disclosed technology is only suitable for use in situations similar to those in Figure 11 In general, the methods and systems herein may be practiced using additional configurations, and / or some aspects described may be eliminated without departing from the methods and systems disclosed herein.

[0087] Figure 12 An exemplary vestibular stimulator system 1202 is shown that can be used to implement the embodiments presented herein. As shown, the vestibular stimulator system 1202 includes an implantable component (vestibular stimulator) 1212 and an external device / component 1204 (e.g., an external processing device, a battery charger, a remote control, etc.). The external device 1204 includes a transceiver unit 1260. Thus, the external device 1204 is configured to transmit data (and possibly power) to the vestibular stimulator 1212.

[0088] The vestibular stimulator 1212 includes an implant body (main module) 1234, a lead region 1236, and a stimulation assembly 1216, all configured to be implanted beneath the recipient's skin / tissue (tissue) 1215. The implant body 1234 generally includes an airtight sealed housing 1238 in which an RF interface circuit system, one or more rechargeable batteries, one or more processors, and a stimulator unit are disposed. The implant body 134 also includes an internal / implantable coil 1214, which is generally external to the housing 1238 but connected to a transceiver via an airtight feedthrough (not shown).

[0089] The stimulation assembly 1216 includes a plurality of electrodes 1244(1)-(3) disposed in a carrier member (e.g., a flexible silicone body). In this particular example, the stimulation assembly 1216 includes three (3) stimulation electrodes, referred to as stimulation electrodes 1244(1), 1244(2), and 1244(3). The stimulation electrodes 1244(1), 1244(2), and 1244(3) serve as an electrical interface for delivering electrical stimulation signals to the vestibular system of a recipient.

[0090] The stimulation assembly 1216 is configured so that a surgeon can implant the stimulation assembly near the recipient's otolith organ via, for example, the recipient's oval window. It should be understood that this particular embodiment with three stimulation electrodes is merely illustrative, and the techniques presented herein can be used with stimulation assemblies having different numbers of stimulation electrodes, stimulation assemblies having different lengths, etc.

[0091] In operation, the vestibular stimulator 1212, the external device 1204, and / or another external device can be configured to implement the techniques presented herein. That is, the vestibular stimulator 1212, possibly in combination with the external device 1204 and / or another external device, can include an induced bio-response analysis system as described elsewhere herein.

[0092] It should be understood that while specific uses of the present technology have been illustrated and discussed above, the disclosed technology can be used with a variety of devices according to many examples of the present technology. The above discussion is not intended to indicate that the disclosed technology is only suitable for implementation within systems similar to those shown in the accompanying drawings. In general, the processes and systems herein can be practiced using additional configurations and / or some of the described aspects can be excluded without departing from the processes and systems disclosed herein.

[0093] This disclosure describes certain aspects of the present technology with reference to the accompanying drawings, which illustrate only some possible aspects. However, other aspects may be embodied in many different forms and should not be construed as limited to the aspects set forth herein. Rather, these aspects are provided so that this disclosure will be thorough and complete and will fully convey the scope of possible aspects to those skilled in the art.

[0094] It should be understood that the various aspects (e.g., parts, components, etc.) described herein with respect to the figures are not intended to limit the systems and processes to the specific aspects described. Therefore, additional configurations can be used to practice the methods and systems herein, and / or some of the described aspects can be excluded without departing from the methods and systems disclosed herein.

[0095] According to certain aspects, a system and non-transitory computer-readable storage medium are provided. The system is configured with hardware configured to perform operations similar to the methods of the present disclosure. One or more non-transitory computer-readable storage media include instructions that, when executed by one or more processors, cause the one or more processors to perform operations similar to the methods of the present disclosure.

[0096] Similarly, where process steps are disclosed, these steps are described for the purpose of illustrating the present methods and systems and are not intended to limit the present disclosure to a particular sequence of steps. For example, the steps may be performed in a different order, two or more steps may be performed simultaneously, additional steps may be performed, and disclosed steps may be eliminated without departing from the present disclosure. Furthermore, the disclosed processes may be repeated.

[0097] In summary, by having cochlear implant recipients first undergo diagnostic testing to determine their user-specific phoneme perception errors and error patterns, personalized interventions targeting these errors and error patterns can be achieved. Based on these errors and error patterns, personalized follow-up care is developed. This targeted, personalized follow-up care is intended to improve outcomes for cochlear implant recipients, particularly adult recipients. These techniques are particularly beneficial for cochlear implant recipients in the "poor performer" group. By implementing the disclosed techniques, long-term goals of rehabilitation can be facilitated, including reintegrating the recipient into society, providing the recipient with skills and training that allow equal opportunities compared to normal hearing individuals, and improving the recipient's overall quality of life.

[0098] Thus, in some aspects, the technology described herein relates to a method comprising: obtaining, at a processing device, results of a diagnostic test presented to a recipient of a hearing prosthesis; determining from the results whether the recipient exhibited random errors or non-random errors with respect to auditory stimuli presented in the diagnostic test; and selecting, based on determining that the recipient exhibited the random errors or the non-random errors, between a technical intervention associated with the hearing prosthesis or a rehabilitation intervention to be performed by the recipient.

[0099] In some aspects, the technology described herein relates to a method wherein the selecting comprises selecting the technical intervention in response to determining that the recipient exhibits the random error.

[0100] In some aspects, the technology described herein relates to a method: wherein the hearing prosthesis comprises a cochlear implant; wherein the non-random errors comprise non-random errors across a frequency range associated with electrodes of the hearing prosthesis; and wherein the technical intervention comprises fitting of the cochlear implant.

[0101] In some aspects, the technology described herein relates to a method wherein the selecting includes selecting the rehabilitation intervention in response to determining that the recipient exhibited the non-random error.

[0102] In some aspects, the technology described herein relates to a method wherein the auditory stimulus comprises a phoneme.

[0103] In some aspects, the technology described herein relates to a method wherein the auditory stimulus comprises a tonone.

[0104] In some aspects, the technology described herein relates to a method wherein the diagnostic test comprises a closed response diagnostic test.

[0105] In some aspects, the technology described herein relates to a method wherein the diagnostic test comprises an audiological test.

[0106] In some aspects, the technology described herein relates to a method wherein the audiological testing includes a speech test.

[0107] In some aspects, the technology described herein relates to a method comprising: administering an audiological test to a recipient of a hearing prosthesis, the administering comprising: presenting a plurality of speech-speech auditory stimuli to the recipient via the hearing prosthesis, presenting a plurality of responses to each of the plurality of speech-speech auditory stimuli to the user via a user interface, and receiving a response associated with each of the plurality of speech-speech auditory stimuli from the recipient via the user interface; analyzing the responses associated with each of the plurality of speech-speech auditory stimuli; and determining, in response to the analysis, whether the recipient exhibits a consistent error or an inconsistent error with respect to at least one of the plurality of speech-speech auditory stimuli.

[0108] In some aspects, the technology described herein relates to a method further comprising selecting a technical intervention in response to determining that the recipient exhibits the consistent error with respect to at least one of the plurality of speech-speech-auditary stimuli.

[0109] In some aspects, the technology described herein relates to a method wherein the consistent errors include non-random errors.

[0110] In some aspects, the technology described herein relates to a method wherein the technical intervention comprises a cochlear implant fitting intervention.

[0111] In some aspects, the technology described herein relates to a method that also includes selecting a rehabilitation intervention in response to determining that the recipient exhibits the inconsistency error with respect to at least one speech-speech-auditary stimulus of the plurality of speech-speech-auditary stimuli.

[0112] In some aspects, the technology described herein relates to a method wherein the inconsistency errors comprise non-random errors.

[0113] In some aspects, the technology described herein relates to a method wherein the plurality of speech sound auditory stimuli comprises a plurality of phoneme stimuli.

[0114] In some aspects, the technology described herein relates to a method wherein the plurality of speech sound auditory stimuli comprises a plurality of tonal stimuli.

[0115] In some aspects, the technology described herein relates to a method in which the user interface includes a personal computing device.

[0116] In some aspects, the technology described herein relates to a method in which the personal computing device comprises a smartphone or a tablet computing device.

[0117] In some aspects, the technology described herein relates to a method in which the personal computing device is configured to interface with the hearing prosthesis to cause the hearing prosthesis to deliver the plurality of speech sound auditory stimuli to the recipient via the hearing prosthesis.

[0118] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media, comprising instructions that, when executed by a processor, cause the processor to: obtain results of a diagnostic test presented to a recipient of a hearing prosthesis; determine from the results whether the recipient exhibited random errors or non-random errors with respect to auditory stimuli presented in the diagnostic test; and based on determining that the recipient exhibited the random errors or the non-random errors, select between a technical intervention associated with the hearing prosthesis or a rehabilitation intervention to be performed by the recipient.

[0119] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media, wherein the instructions that cause the processor to select the technical intervention associated with the hearing prosthesis or the rehabilitation intervention to be performed by the recipient include instructions that cause the processor to select the technical intervention in response to determining that the recipient exhibits the random error.

[0120] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media: wherein the hearing prosthesis comprises a cochlear implant; wherein the non-random errors comprise non-random errors across a frequency range associated with electrodes of the hearing prosthesis; and wherein the technical intervention comprises fitting of the cochlear implant.

[0121] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media, wherein the instructions that cause the processor to select the technical intervention associated with the hearing prosthesis or the rehabilitation intervention to be performed by the recipient include instructions that cause the processor to select the rehabilitation intervention in response to determining that the recipient exhibits the non-random error.

[0122] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media, wherein the auditory stimulation includes phonemes.

[0123] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media, wherein the auditory stimulus includes a tonoid.

[0124] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media, wherein the diagnostic test comprises a closed response diagnostic test.

[0125] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media, wherein the diagnostic test comprises an audiological test.

[0126] In some aspects, the technology described herein relates to one or more non-transitory computer-readable storage media, wherein the audiological test includes a speech test.

[0127] In some aspects, the technology described herein relates to a system comprising: a hearing prosthesis; and a processing device comprising a user interface and at least one processor, wherein the at least one processor is configured to: cause the hearing prosthesis to present a plurality of speech-speech auditory stimuli to a recipient of the hearing prosthesis; present a plurality of responses to each of the plurality of speech-speech auditory stimuli to the recipient via the user interface; receive a response associated with each of the plurality of speech-speech auditory stimuli from the recipient via the user interface; analyze the responses associated with each of the plurality of speech-speech auditory stimuli; and determine, in response to the analysis, whether the recipient exhibits a consistent error or an inconsistent error with respect to at least one of the plurality of speech-speech auditory stimuli.

[0128] In some aspects, the technology described herein relates to a system wherein the at least one processor is further configured to select a technical intervention in response to determining that the recipient exhibited the consistent error with respect to at least one of the plurality of speech-speech-auditary stimuli.

[0129] In some aspects, the technology described herein relates to a system wherein the consistent errors include non-random errors.

[0130] In some aspects, the technology described herein relates to a system wherein the technical intervention comprises a cochlear implant fitting intervention.

[0131] In some aspects, the technology described herein relates to a system wherein the at least one processor is further configured to select a rehabilitation intervention in response to determining that the recipient exhibits the inconsistency error with respect to at least one speech-speech-auditary stimulus of the plurality of speech-speech-auditary stimuli.

[0132] In some aspects, the technology described herein relates to a system wherein the inconsistency errors comprise non-random errors.

[0133] In some aspects, the technology described herein relates to a system wherein the plurality of speech sound auditory stimuli comprises a plurality of phoneme stimuli.

[0134] In some aspects, the technology described herein relates to a system wherein the plurality of speech sound auditory stimuli includes a plurality of tonal stimuli.

[0135] In some aspects, the technology described herein relates to a system wherein the user interface includes a touch screen.

[0136] In some aspects, the technology described herein relates to a system in which the processing device comprises a smartphone or a tablet computing device.

[0137] Although specific aspects are described herein, the scope of the present technology is not limited to these specific aspects. Those skilled in the art will recognize other aspects or improvements within the scope of the present technology. Therefore, specific structures, actions, or media are disclosed only as illustrative aspects. The scope of the present technology is defined by the following claims and any equivalents therein.

[0138] It should also be understood that the embodiments presented herein are not mutually exclusive and that various embodiments can be combined with another embodiment in any of a variety of different ways.

Claims

1. A method comprising: obtaining, at a processing device, results of the diagnostic test for presentation to a user of the hearing device; determining from the results whether the user exhibited random errors or non-random errors with respect to auditory stimuli presented in the diagnostic test; as well as Based on determining that the user exhibits the random error or the non-random error, a selection is made between a technical intervention associated with the hearing device or a rehabilitation intervention to be performed by the user. 2 . The method of claim 1 , wherein the selecting comprises selecting the technical intervention in response to determining that the user exhibits the random error.

3. The method according to claim 2: wherein the hearing device comprises a cochlear implant; wherein the non-random errors comprise non-random errors across a range of frequencies associated with electrodes of the hearing device; and wherein the technical intervention comprises fitting of the cochlear implant.

4. The method of claim 1, wherein the selecting comprises selecting the rehabilitation intervention in response to determining that the user exhibits the non-random error.

5. The method of claim 1, 2, 3 or 4, wherein the auditory stimulus comprises a phoneme.

6. The method of claim 1, 2, 3 or 4, wherein the auditory stimulus comprises a tonone.

7. The method of claim 1, 2, 3, or 4, wherein the diagnostic test comprises a closed response diagnostic test.

8. The method of claim 1, 2, 3, or 4, wherein the diagnostic test comprises an audiological test.

9. The method of claim 8, wherein the audiological test comprises a speech test.

10. A method comprising: Administering an audiological test to a user of a hearing device, the administering comprising: presenting a plurality of speech sound auditory stimuli to the user via the hearing device, presenting a plurality of responses to each of the plurality of speech sound auditory stimuli to the user via a user interface, and receiving, from the user via the user interface, a response associated with each of the plurality of speech-speech-auditary stimuli; analyzing the response associated with each of the plurality of speech-speech auditory stimuli; and In response to the analyzing, it is determined that the user exhibits a consistent error or an inconsistent error with respect to at least one of the plurality of speech-speech-auditary stimuli.

11. The method of claim 10, further comprising selecting a technical intervention in response to determining that the user exhibits the consistent error with respect to at least one of the plurality of speech-speech-auditary stimuli. The method of claim 11 , wherein the consistent errors comprise non-random errors.

13. The method of claim 10, 11 or 12, wherein the technical intervention comprises a cochlear implant fitting intervention.

14. The method of claim 10, 11 or 12, further comprising selecting a rehabilitation intervention in response to determining that the user exhibits the inconsistency error with respect to at least one of the plurality of speech-speech-auditary stimuli. The method of claim 14 , wherein the inconsistency errors comprise non-random errors.

16. The method of claim 10, 11 or 12, wherein the plurality of speech sound auditory stimuli comprises a plurality of phoneme stimuli.

17. The method of claim 10, 11 or 12, wherein the plurality of speech sound auditory stimuli comprises a plurality of tonal stimuli.

18. The method of claim 10, 11 or 12, wherein the user interface comprises a personal computing device.

19. The method of claim 18, wherein the personal computing device comprises a smartphone or a tablet computing device.

20. The method of claim 18, wherein the personal computing device is configured to interface with the hearing device to cause the hearing device to deliver the plurality of speech sound auditory stimuli to the user via the hearing device.

21. One or more non-transitory computer-readable storage media comprising instructions that, when executed by a processor, cause the processor to: obtaining results of a diagnostic test for presentation to a user of the hearing device; determining from the results whether the user exhibited random errors or non-random errors with respect to auditory stimuli presented in the diagnostic test; as well as Based on determining that the user exhibits the random error or the non-random error, a selection is made between a technical intervention associated with the hearing device or a rehabilitation intervention to be performed by the user.

22. One or more non-transitory computer-readable storage media according to claim 21, wherein the instructions causing the processor to select the technical intervention associated with the hearing device or the rehabilitation intervention to be performed by the user comprise instructions causing the processor to select the technical intervention in response to determining that the user exhibits the random error.

23. The one or more non-transitory computer-readable storage media of claim 21 : wherein the hearing device comprises a cochlear implant; wherein the non-random errors comprise non-random errors across a range of frequencies associated with electrodes of the hearing device; and wherein the technical intervention comprises fitting of the cochlear implant.

24. One or more non-transitory computer-readable storage media according to claim 21, wherein the instructions causing the processor to select the technical intervention associated with the hearing device or the rehabilitation intervention to be performed by the user comprise instructions causing the processor to select the rehabilitation intervention in response to determining that the user exhibits the non-random error.

25. The one or more non-transitory computer-readable storage media of claim 21, 22, 23, or 24, wherein the auditory stimulus comprises a phoneme.

26. The one or more non-transitory computer-readable storage media of claim 21, 22, 23, or 24, wherein the auditory stimulus comprises a tonone.

27. The one or more non-transitory computer-readable storage media of claim 21, 22, 23, or 24, wherein the diagnostic test comprises a closed response diagnostic test.

28. The one or more non-transitory computer-readable storage media of claim 21, 22, 23, or 24, wherein the diagnostic test comprises an audiological test.

29. The one or more non-transitory computer-readable storage media of claim 28, wherein the audiological test comprises a speech test.

30. A system comprising: a processing device comprising a user interface and at least one processor, wherein the at least one processor is configured to: causing a hearing device to present a plurality of speech sound auditory stimuli to a user of the hearing device; presenting to the user via the user interface a plurality of responses to each of the plurality of speech sound auditory stimuli; receiving, from the user via the user interface, a response associated with each of the plurality of speech-speech-auditary stimuli; analyzing the response associated with each of the plurality of speech-speech auditory stimuli; and In response to the analyzing, it is determined that the user exhibits a consistent error or an inconsistent error with respect to at least one of the plurality of speech-speech-auditary stimuli.

31. The system of claim 30, wherein the at least one processor is further configured to select technical intervention in response to determining that the user exhibits the consistent error with respect to at least one of the plurality of speech-speech-auditary stimuli.

32. The system of claim 31 , wherein the consistent errors comprise non-random errors.

33. The system of claim 30, 31 or 32, wherein the technical intervention comprises a cochlear implant fitting intervention.

34. A system according to claim 30, 31 or 32, wherein the at least one processor is further configured to select rehabilitation intervention in response to determining that the user exhibits the inconsistency error with respect to at least one of the plurality of speech-speech auditory stimuli.

35. The system of claim 34, wherein the inconsistency errors comprise non-random errors.

36. A system according to claim 30, 31 or 32, wherein the plurality of speech sound auditory stimuli comprises a plurality of phoneme stimuli.

37. A system according to claim 30, 31 or 32, wherein the plurality of speech sound auditory stimuli comprises a plurality of tonal stimuli.

38. The system of claim 30, 31 or 32, wherein the user interface comprises a touch screen.

39. The system of claim 30, 31 or 32, wherein the processing device comprises a smartphone or tablet computing device.

40. An apparatus comprising: Memory; at least one processor configured to initiate delivery of a plurality of speech sound auditory stimuli to a user of the hearing device; a user interface configured to display a plurality of responses to each of the plurality of speech speech auditory stimuli and receive a selection of one of the plurality of responses associated with each of the plurality of speech speech auditory stimuli; Wherein the at least one processor is configured to analyze the response associated with each of the plurality of speech-speech auditory stimuli and, in response to the analysis, determine whether the user exhibits a consistent error or an inconsistent error with respect to at least one of the plurality of speech-speech auditory stimuli.

Images