Pediatric Fitting Mode

Oticon safari Fitting guide

The Complete Guide to Fitting Oticon Safari using Genie 2010.2

Genie 2010.2

The Pediatric Fitting Mode was developed based on input from audio- logists from all over the world with the aim to help simplify the fitting process of children with hearing loss.

The goal is to offer:

• Intuitive pediatric features Genie • Pediatric default settings – and the option to personalize them

• More time for counseling – with less time spent on programming Pages marked with indicate steps that • Greater certainty – hence more confidence in the fitting should always be carried out.The other pages deal with optional steps.

2 How does the Pediatric Fitting Mode help?

Fitting Counseling • Pediatric Default Settings – pediatric appropriate • Parent counselling support incorporated with the option to define own settings and age into Genie brackets • Child-oriented sounds and pictures • Settings Overview – quickly verify that the instrument settings are set as you wish • Dedicated instructional videos

• Compression Ratio – ascertain the CR of the fitting with one click

• Visual Indicator (LED) – visual confirmation can be enabled or disabled as desired

• Improved FM flexibility – change or maintain program button settings

• Volume Control Reserve Gain – information is readily available 3 Table of Contents

Table of Contents 4 Fitting Controls 38 Connecting Safari to Genie 5 Automatics 40 Personalize Genie 9 More Tools Feedback Manager 41 Fitting Step 10 REM 42 Graph Format 11 Live Demonstration 43 Pediatric Default Settings 12 Activity Analyzer 44 Default Rationale 13 Fitting Assistant 45 Measurement Modules 14 In-situ Audiometry 46 Navigation 15 End Fitting Buttons and Indicators 48 Pediatric Settings Dialog 17 Operate Pushbutton and VC 49 Counseling 22 Beeps 50 Select Family 24 Visual Indicator (LED) 51 Selection Select Instrument 26 ConnectLine 52 RECD, REUR and Audiogram 27 TV 53 Program Manager 30 Phones 54 Telephone Options 31 Music/ Audio 55 Acoustics 32 More Tools Phone and DAI/FM 56 COW, CHILD, ELF 33 Phone Programs 57 Links 34 DAI/FM 58 Pediatric Instruction Videos 35 Save, Program and Exit 59 User Instructions 60 Connecting Safari to Genie

It is just as easy and quick to fit Safari instruments as other Oticon hearing instruments.

Safari is programmed using programming shoes and Oticon programming cable #3 (right and left).

You can also use nEARcom to fit Safari instruments without cables.

5 Connecting the Programming Shoe

1. Open the battery door on the instrument and slide the programming shoe into the guide as 1 shown. (Make sure the battery is fresh).

2. Close the battery door and attach the HI-PRO or NOAHlink cable. 2

6 nEARcom

For greater flexibility and comfort use nEARcom to Detect the instruments fit Safari instruments without cables. 1. Switch on the instruments using fresh batteries.

2. Lay nEARcom on the table and place the instruments in the middle of the neck loop.

3. Click Detect for cordless programming.

Note: make sure the instrument volume control is set to position 3 during detection.

Cordless programming

Wired programming 7 nEARcom

Instruments which have never been programmed To identify the instrument place it in the middle of must be assigned to the correct side the neck loop and click BEEP. The instrument will – left and right – in Genie. beep for 6 seconds.

Use a BEEP test as follows: While the instrument is beeping, remove it from nEARcom and listen to it.

If the instrument does not beep, return it to the middle of the neck loop, click Change side 1 and click the same BEEP. Listen to the instrument again.

Click Continue and proceed with the programming.

8 Personalize Genie

In Genie Preferences you can Personalize the user interface and settings for pediatric fittings.

Go to Preferences g Specific Preferences:

• Fitting Step

• Graph Format

• Pediatric Default Settings

• Default Rationale

• Measurement Modules

Changes in Preferences apply to all products. The new settings will be applied when you restart Genie.

Personalize Genie Preferences – Fitting Step

Select All channels plus MPO to access more controls in the fitting step.

When fitting Safari SP, the MPO is available in the control panel by default.

10 Preferences – Graph Format

To view the SPLogram as the default graph in the Fitting step, select SPLogram.

To simplify verification, the SPLogram allows you to compare the fit to target with results from external real-ear measurement equip- ment.

11 Preferences – Pediatric Default Settings

Three panels are available:

• Age brackets Click + or – to customize the age bracket

• Automatics Change the Noise Management and Directionality for each age bracket above

• Buttons A default setup is available from Oticon. Provide access to the Volume Control for each age Personalize Genie by choosing your preferred default bracket setting. My Voice is not a Safari feature. Setting will apply to pediatric fittings of Agil Pro, Chili SP9, Epoq XW, Dual XW, Epoq XW and Dual XW.

12 Preferences – Default Rationale

The default rationale for children is DSL v5.0a.

• Select product Family

• Choose your preferred rationale for each hearing instrument

13 Preferences – Measurement Modules

• When fitting Safari through Noah, you can select a preferred REM or HIT module

• If selected, the REM module will open automatically when going to the REM tool in the Fitting step

14 Navigation

Horizontal navigation – organizer steps: • Client: Appears only when running Genie outside Noah

• Counseling: Appears only if Gateway is installed

• Family: Selection of all hearing instrument families

• Selection: Selection of instrument style, features, and entry of pre-fitting measures (e.g. RECD)

• Fitting: Feedback measurement, verification and fine tuning of settings

• End Fitting: Setting of user buttons and indicators, ConnectLine, FM, save, program and exit

15 Navigation

Vertical navigation – task pane: • For each organizer step there is a Task Pane providing access to tools and links related to where you are in the fitting process

16 Pediatric Settings Dialog

In a new Safari fitting, an overview dialog lists the default settings based on the child’s age.

• Age bracket and age of the child

• Setting of Directionality and Noise Management

• Volume Control status

• Available program and rationale

Select Show Pediatric Settings to view the dialog during the fitting.

17 Pediatric Settings Dialog

• The dialog box will always reflect the current settings of the hearing instrument

• When children enter a new age group, Genie will alert you via this dialog box. Use the ‘Apply’ button to accept the new age group settings

Fitting Steps Overview

Counseling g Family g Selection g Fitting g End Fitting Select Family Select Instrument Controls Button and Indicators – Operate pushbutton RECD, REUR Automatic Features and VC and Audiogram – Beeps Feedback Manager – Visual Indicator Program Manager – Telephone Options REM ConnectLine

The Ear Evaluation Acoustics Live Demonstration Phone and DAI/FM

Learning Your Child’s COW – CHILD – ELF Activity Analyzer User Instructions Language Hearing Links Fitting Assistant Recommendations Pediatric Instruction In-situ Audiometry Videos Counseling

The Ear Evaluation

Learning Your Child’s Language Hearing

Recommendations

Counseling Counseling

The Pediatric Counseling tool has been developed to support the counseling process. It offers a suite of dynamic visual and audio modules within the following areas:

• Evaluation

• Your Child’s Hearing

• Recommendations

• Learning Language

• The Ear Audiogram will be automatically imported into the Pediatric Counseling tool from Genie. Installation of Oticon Gateway CD version 2.0 or later is required to run the counseling tool properly from Genie.

22 Family

Select Family

Family Select Family

Detect the instrument after connecting to NoahLink, HiPro Box or nEARcom or

Select the Safari family and then select Safari style (Safari 312/ 13P or Safari SP) and model (900, 600 or 300).

24 Family Selection

Select Instrument

RECD, REUR and Audiogram

Program Manager – Telephone Options

Acoustics

COW – CHILD – ELF

Links

Pediatric Instruction Videos

Selection Select Instrument

If the instrument is not connected, choose the appropriate style:

• An overview of the different hearing instrument styles is presented

• The fitting range is reflected for each style selected

Oticon Streamer can be selected if part of the fitting.

The correct style and model is automatically detected in a live fitting. Select whether Streamer will be part of the fitting. To simulate a fitting select the style and model you want to simulate. To select Safari SP, go to Family step

26 Selection RECD, REUR and Audiogram

In order to most accurately prescribe hearing instrument settings, Genie needs information on the measurement methods used to obtain the audiometric thresholds. By entering this data, Genie will determine whether to apply corrections or not. See examples on the following pages.

Choose the tab you need and enter the appropriate values:

• RECD

• REUR If you do not want Genie to apply any corrections to • Audiogram the audiometric information entered, you do not need to visit this area. By default, no corrections are applied.

27 Selection RECD

Enter the measured RECD values in the appropriate boxes.

RECD values differ greatly between infants and adults. They change during early childhood, and can be expected to reach adult values by the time the child is about seven years old. If no values are inserted, Genie will automatically use the predicted values for the appropriate age.

28 Selection Audiogram

Select the appropriate:

• Measurement method

• Test signal transducer

• dB measurement unit

Genie will make the necessary audiogram corrections based on the information entered.

Thresholds are dependent on the transducers used: – Headphones – Insert earphones Genie does not apply any corrections unless you – Insert earphones (with own earmold) alter settings in the screen and represcribe settings. The grey curve shows the corrected audiogram. – Free Field

29 Selection Program Manager

By default, one program is available: P1: General (M).

To add extra programs: Click ‘Add‘ and select additional program from the options menu.

The default rationale is DSL v5.0a, pediatric. When an FM receiver or DAI shoe is connected, the DAI/FM+M program is automatically on, and the program switch is deactivated (see page 58 Important: for more information). To change this default If you want to provide access to more than one program when using FM and/or DAI, remember to setting, go to Phone and DAI/FM in End Fitting. uncheck ‘‘Automatically deactivate program switch when attaching DAI/FM shoe’’ in Phone and DAI/FM.

30 Selection Telephone Options

Phone programs available: Phone (T): The telecoil input in Phone (T) has increased gain within the telephone bandwidth compared to the Telecoil (ALD) program. Phone (M/ MT): Omni mic. with increased gain within the telephone bandwidth. Safari SP also has telecoil input.

Programs can be set: • Manually activated in P2/3/4 – Phone (T) and Phone (M/ MT) • Automatically activated Auto Phone – Auto (T) or Auto (M/ MT) (No separate program is required)

The Auto Phone program is automatically acti- Adjustments made in P1 are transferred to all the Phone vated when the instrument is held close to a programs. The non-phone ear listens in P1 or “reduced telephone receiver with a magnet. This gives P1” with Binaural Broadband. You can disable the reduc- the child an optimized telephone program with- tion in the End Fitting step, Phone and DAI/FM. out having to use the program switch.

31 Selection Acoustics

Verify the settings of Vent, Hook and Tubing.

Note: Very small ears preclude the use of an open vent. The following defaults will apply: Genie automatically selects a vent size according to the – 0-3 years: 0 mm vent child’s age and audiogram. – 4-7 years: ≤ 2 mm vent – >7 years: audiogram-based vent suggestions

32 Selection COW – CHILD – ELF

• Access the COW database to fill in information for child, teacher and parents

• Access the ELF or CHILD pdfs to print handouts for parents to fill out, and forms for you to fill out.

Functional assessment tools can be used to: - Help family and caregivers understand the COW (Children’s Outcome Worksheets): hearing loss and the specific difficulties Ages 4 and up involved. CHILD (Children’s Home Inventory for Listening Difficulty): 3 – 12 years - Establish a collaboration among the people involved in the process. ELF (Early Listening Function): 4 months – 3 years

33 More Tools Links

• Product information for the specific model

• Product Overview to facilitate product comparison and finding the product needed

• Cable Overview to facilitate finding the cable needed

• DAI/FM Overview to facilitate finding adaptors and FM receivers needed

• View the audiogram in the Pediatric Counseling

• Access pediatric Instruction Videos

34 Links Pediatric Instruction Videos

Can be used:

• During counseling of parents and clients

• As a visual support tool for the professional

Scroll down to ‘P’ for pediatrics to locate pediatric In- struction Videos.

35 Links

Fitting

Controls

Automatic Features

Feedback Manager

REM

Live Demonstration

Activity Analyzer

Fitting Assistant

In-situ Audiometry

Fitting Controls

• Review and verify the prescribed settings

• Make changes using +/- for the appropriate frequency region and input level

• View Volume Control Reserve Gain for each ear

• To view Compression Ratio for independent fitting bands press

• To make the correction binaurally press

The VC Reserve Gain displays the volume range between the preferred level and the instrument’s possible maximum gain in the range of 0-10 dB, at 2.5 dB steps. Adjust the instrument’s gain or change the feedback limit to modify the reserve gain. The volume control range is 30 dB: -20 dB to maximum + 10 dBvel. Position “3” is the preferred level on the Safari SP VC wheel.

38 Fitting Controls

The Overall Loudness Trimmer (OLT) is available for Super Power fittings only.

The OLT changes both gain and MPO to protect speech intelligibility. The steps are reversible, which means that if returning to a previously tested step, the values in this step will still remain the same.

The Adaptation Manager is available for Safari 312 and 13P and will default to level 3.

The analog VC in Safari SP is temporarily disabled when connected to Genie.

39 Fitting Automatics

Click on this tab to change the settings of the following automatic features:

• Directionality

• Noise Management

• Binaural Broadband

By default, automatic features are turned OFF for the age 0-3. You can define default automatic settings by age bracket through the Genie Preferences feature (see page 12 in this guide). Safari SP offers the choice between Moderate If you disable Binaural Broadband all binaural func- (default) and Maximum Noise Management. tionalities; Binaural Processing (compression, Binaural Maximum allows up to 3 dB more attenuation. Noise Management, DFC2), Synchronization and Coor- dination (pushbutton and VC), are disabled. 40 Fitting Feedback Manager

It is recommended to run the Feedback Manager for all Safari SP fittings.

It is important to be in a quiet environment while mea- suring feedback limits.

It is only necessary to run the Feedback Manager for 13P and 312 models if feedback is present.

Genie prescribes a suitable feedback limit to prevent feedback for Safari SP. It is recommended to measure the feedback limit of the individual fitting to ensure that maximum gain can be provided. The feedback Raise or lower the feedback limit if required. limit can be displayed in the Insertion Gain and Gain 2cc graph views in the Controls screen: Press the Feedback Limit button.

41 More Tools REM

The Genie REM tool lets you verify the prescription without you having to disable Automatic features beforehand.

The preferred REM module will also open automatically through Noah if selected in Preferences. If not, a Tool Selection dialog will appear that lets you select the desired REM module.

42 More Tools Live Demonstration

Use the Live tool to demonstrate features such as:

• Amplification

• Directionality

• Noise Management

Using the Live tool with parents can help them better understand how hearing instrument features work.

43 More Tools Activity Analyzer

This feature provides an overview of the types of environments the child encounters in daily life and the use of various hearing instrument features. This information may be useful to determine whether fine-tuning is needed.

Available overviews:

• Average usage

• Volume control usage

• Signal processing

• Configuration

44 More Tools Fitting Assistant

If fine-tuning should be needed, the Fitting Assistant can be helpful.

Select a tab:

• General perception

• Speech perception

• Own voice

Select the control that matches the child’s complaint or the parents’ observation. Click to access different sound samples including Sounds for Children, to assist in the fine-tuning process. Click left or right to adjust (the initial setting is indicated by an arrow in the middle).

45 More Tools In-situ Audiometry (Safari SP only)

In-situ audiometry is available and can be used to measure the audiogram between 125 Hz - 6 kHz using the client’s own earmolds and hearing instruments.

• Hearing thresholds are measured directly in the child’s ear with the instrument

• Measurements can be conveniently made in various quiet environments such as child’s home or a room in the clinic

• In-situ audiometry can be used to make a better instant fitting for demonstration purposes

Note: In-situ audiogram is based on the actual instrument and acoustics. In-situ audiometry is not recommended if the child has a mixed or conductive hearing loss.

46 More Tools End Fitting

Button and Indicators – Operate pushbutton and VC – Beeps – Visual Indicator

ConnectLine

Phone and DAI/FM

User Instructions

End Fitting Buttons and Indicators

The “Buttons and Indicators” task is used to con- figure the function(s) of the hearing instrument control button. Beeps and Visual indicators can also be enabled or disabled.

48 End Fitting Operate Pushbutton and VC

On the “Operate Pushbutton and VC” tab the following pushbutton functions can be activated or deactivated:

• Program switch

• Volume control

• Mute function

By default, the Program Switch, Volume Control and Mute function are turned OFF.

A binaural pushbutton function is available for both Volume Control and Program Switch (Safari 900 & 600). Safari SP has a binaural Program Button (900, 600 & When fitting small children and infants, it is 300). The analog VC wheel is not binaurally coordi- recommended to disable the VC, program switch nated. and muting to avoid accidental changes.

49 End Fitting Beeps

On the Beeps tab the following beeps can be configured:

• The beep signal’s frequency and level (can be tested during programming)

• Startup jingle

• Volume Control indicators

• Battery Low indicator (can be tested during programming)

The startup jingle and the Change Battery Warning are active by default. Beeps may be deactivated, as these can be confusing to younger children.

50 End Fitting Visual Indicator (LED)

On the Visual Indicator tab the following visual indications can be configured:

Program Indicator • Blink to indicate program number: 1 blink - P1, 2 blinks - P2 etc.

• Volume Control indicator

• Blink at preferred volume level: 5 rapid blinks

Battery Low indicator • Battery low warning: Continuous rapid blinking For small children and infants the Visual Indicator (LED) should be activated to give parents and caregivers assur- ance that the instrument is ON.

51 End Fitting ConnectLine

Adjust the three ConnectLine applications; TV, Phones, and Music /Audio, in the following dimensions:

• General perception

• Power Bass

• Music Widening (not Phones)

To make the correction binaurally press

It is always possible to activate either Power Safari 900 SP offers Power Bass and Music Widening. Bass or Music Widening when available. It is not The prescribed/selected vent size determines whether Power Bass is default set to On or Off. Music Widening is possible to activate both features in a single default set to Off. application.

52 End Fitting TV

General Perception • The level of TV alone and relative to the hearing instrument microphone (M) level is set

• Use the ‘sound quality’ trimmer to correct the emphasis of the audio response by adjusting the tonal balance according to the child’s preferences

Power Bass • For improved TV experience it might be beneficial to set Power Bass to High or Safari 900 SP offers Power Bass and Music Widening. Music Widening • For TV listening it might be beneficial to set Music Widening to Off to optimize speech understanding

53 End Fitting Phones

General Perception • The level of Phone alone and relative to the hearing instrument microphone (M) level is set

• Use the ‘sound quality’ trimmer to correct the emphasis of the audio response by adjusting the tonal balance according to the child’s preferences

Power Bass • It might be beneficial to set Power Bass to Medium

Microphone (M) relative to Phone: Normally, the level for the hearing instrument Safari 900 SP offers Power Bass. microphone should be lower (softer) than the phone to enhance the phone conversation.

54 End Fitting Music / Audio

General Perception • Music Level, microphone (M) relative to music can be adjusted

• Use the ‘sound quality’ trimmer to adjust the tonal balance of the audio signal

Power Bass • For improved music experience it might be beneficial to set Power Bass to High or

Music Widening Safari 900 SP offers Power Bass and Music Widening. • It might be beneficial to set the Music Widening feature to Medium

55 End Fitting Phone and DAI/FM

In this section, an overview of current phone and FM settings is provided. By selecting the “Phone Programs” or “DAI/FM” tabs, the default settings can be modified.

56 More Tools Phone Programs

The Auto Phone program is automatically activated when a telephone receiver with a magnet is held close to the hearing instrument.

Auto Phone can be selected for one or two ears and set to either Auto (T) or Auto (M/ MT).

• Specify whether the Auto Phone program should use telecoil or microphone input or, in Safari SP a combination (MT)

• The gain reduction on the non-phone side can be disabled. This option applies both for Auto Phone and Manual Phone programs Instruments with binaural synchronization have reduced gain in P1 on the side not using a Phone program.

57 More Tools DAI/FM

When an FM receiver or an DAI/FM adapter shoe is connected, the program automatically changes to FM/ DAI+M.

Important: If you want to provide access to more than one When an FM audio shoe is connected and the program when using FM and/or DAI, remember to program switch is deactivated, only FM+M uncheck ‘‘Automatically deactivate program switch (default) or FM only program is available. when attaching DAI/FM shoe’’.

58 More Tools Save, Program and Exit

Remember to press ‘Save, Program and Exit‘ when the fitting is completed before the hearing instrument is disconnected.

59 End Fitting User Instructions

The User Instructions provide information about pushbutton, volume control and visual indicator settings.

This information can be printed for the client to take home.

A detailed “Addendum for Instructions for Use” can be printed.

Printing out the instructions can help parents remember how the hearing instrument is programmed. Example of the Visual Indicator printout

60 End Fitting It takes a truly dedicated approach to help children with hearing problems achieve their full potential. That’s why we deliver the solutions and services that professionals and caregivers need to provide children the opportunities they deserve. This is what child-friendly hearing care is all about. 106327US / 09.10