Use of Airpod Pros as Assistive Technology

The goal of this study is to investigate the suitability and effectiveness of the AirPod Pro 2nd and 3rd generation (AP) as hearing assistive technology for individuals with mild-to-moderate hearing loss when listening in noisy environments. Researchers will compare four types of assistive technology: hearing aids (HAs), AP, dedicated wireless remote microphones, and Smartphone wireless remote microphone.

The main questions it aims to answer are:

• Which assistive technology provides the greatest benefit for speech recognition in noisy environments?
• How do these devices impact listening effort, as measured by reaction time in a dual-task activity and changes in pupil size?
• What are participants' preferences for each device based on how easy it is to understand speech and their overall satisfaction? Participants will visit the lab for a single 3-hour session. They will listen to sentences using each device and repeat what they hear. During this task, their reaction times for the secondary task and changes in pupil size will be measured.

Study Overview

• Status: Recruiting
• Conditions: Hearing Loss, Adult-Onset; Hearing Aids
• Intervention / Treatment: Device: Airpod Pro as hearing assistive technology

Detailed Description

A total of 24 participants will be recruited from the Callier Center, local audiology offices, support groups, and senior centers and will first undergo a pure-tone hearing test in a sound booth. The preferred ear tip for the Airpod Pro 3rd generation (AP) will be selected based on participant's comfort, ensuring it passes the ear tip fit test in the iPhone operating system. Similarly, the appropriate ear tip for the receiver-in-the canal Phonak Paradise hearing aid will be selected. The devices will be fit bilaterally and programmed for the individual's hearing loss using the smartphone or computer. Real-ear measurements will be then conducted with both the HAs and the APs to verify that their amplification reaches the The National Acoustic Laboratories non-linear version 2 (NAL-NL2) target level bilaterally (± 5 decibels) for the individual's degree of hearing loss, using Audioscan Verifit 2 (version 4.26.3).

The speech recognition threshold (SRT) at 70.7% will first be measured using the AP and a 2-down-1-up adaptive procedure, adjusting the signal-to-noise ratio (SNR) of babble noise using Hearing in Noise Test (HINT). The sentence will be presented at 65 dBA constant level from Knowles Electronics Manikin for Acoustic Research (KEMAR) with a mouth simulator positioned 1 meter at 0 degrees azimuth. The noise will be presented from the two speakers positioned 1 meter at 90- and 270-degrees azimuth. The participant must repeat the key words correctly. The SNR step size will initially be set to 4 dB for the first three reversals to enable rapid convergence, then reduced to 2 dB to refine the threshold measurement. This procedure will continue until six to eight reversals are obtained to ensure threshold stability. This approach will provide a reliable measurement of the SRT with the AP and allow enough range for improvements to comparison with other assistive technologies.

Next, the participants will complete a dual-task paradigm at the SNR that resulted in 70.7% performance with AP, both without assistive technology and with technology including HA, AP, dedicated wireless remote microphones (DRM), or Smartphone wireless remote microphone (SRM). The target speech will be presented through KEMAR with a mouth simulator positioned 1 meter at 0 degrees azimuth, with babble noise from two speakers positioned 1 meter at 90- and 270-degrees azimuth. The primary task will involve sentence recognition in babble noise using different AzBio sentence lists mentioned above. The secondary task will utilize a working memory task from PALETA (www.paleta.fob.usp.br). While listening to and repeating the AzBio sentence aloud, participants will simultaneously look at the screen, memorize, and click the sequence of colors. Listening effort will be measured by calculating the difference in response time (RT) for the secondary task between the dual-task condition (primary and secondary) and single-task (secondary only) condition.

Following this, the pupil diameter will be measured while participants repeat sentences presented, serving as an additional measure to more reliably assess listening effort under consistent same speaker, SRT and device settings. The AzBio sentence list (Spahr et al., 2012), consisting of 20 sentences, will be used with each assistive technology condition, totaling five sets. Pupil diameter will be captured using the Tobii Pro Lab Analyzer software (version 1.217, Tobii Technology AB, Stockholm, Sweden) positioned 1 meter in front of the participant. This measure will provide two key insights: listening effort and speech recognition ability. We will then compare listening effort and speech recognition with and without each assistive device to determine which assistive technology provides the greatest benefit for speech recognition and listening effort in noisy environments.

Finally, participants will complete a questionnaire to evaluate their experience with each assistive technology. During the pupillometry session, they will rate the difficulty of the sentence recognition task immediately after using each device. At the end of the session, participants will select their preferred assistive technology with the reason for their choice.

• Study Type: Interventional
• Enrollment (Estimated): 24
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Linda Thibodeau, Ph.D.; Phone Number: 972-883-3108; Email: thib@utdallas.edu
• Study Contact Backup: Name: Seeon Kim, Ph.D.; Phone Number: 4806164403; Email: Seeon.Kim@utdallas.edu

Study Locations

• United States
  • Texas
    • Richardson, Texas, United States, 75080
      • Recruiting
      • Callier Center for Communication Disorders
      • Contact: Kim, Ph.D.; Phone Number: 480-616-4403; Email: Seeon.Kim@utdallas.edu
      • Principal Investigator: Linda Thibodeau, Ph.D.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Adults aged 18 to 60 years.
• Fluent English speakers.
• Mild-to-moderate hearing loss confirmed by a pure-tone hearing test (average hearing threshold screening 25 to 55 dB HL across octave frequencies from 250 to 8000 Hz).
• Individuals with no prior hearing aid experience for a year.

Exclusion Criteria:

• Normal hearing.
• Hearing loss worse than moderate.
• Neurological, psychiatric, or ophthalmological conditions that might alter the pupil response.
• Non-fluent English speakers.
• Individuals with prior hearing aid experience more than a year.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment group; AP, HA, ... (Randomized)	Device: Airpod Pro as hearing assistive technology; All participants will use and evaluate four types of assistive technology: hearing aids, Airpod pro 2nd and 3rd generation, dedicated wireless remote microphones, and Smartphone wireless remote microphone.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reponse time of secondary working memory task	It refers to the amount of time it takes for a participant to react to and complete the secondary working memory task, performed alongside the primary task (speech recognition). This measurement reflects the participant's cognitive processing speed and listening effort. It is measured in seconds (s). Faster values indicate better performance.	The measurement will be conducted immediately following the intervention within the 2-hour single session.
Pupil diameter	Pupil diameter reflects the motivation to exert effort through physiological mechanisms that maintain homeostasis, making it a reliable indicator of listening effort. It is measured in millimeters (mm). Larger pupil diameters typically indicates greater exerted effort.	The measurement will be conducted immediately following the intervention within the 2-hour single session.
Questionnaire	Participants are asked to rate how easy it was to understand the speaker with each device. This scale ranges from "Very easy", "Easy", "Ok", "Hard", to "Very hard". They are also asked to select their most preferred device.	The measurement will be conducted immediately following the intervention within the 2-hour single session.
Speech recognition threshold at 70.7%	Speech recognition threshold (SRT) at 70.7% is the noise level at which a person can correctly repeat 70.7% of sentences. Determine the appropriate dB SNR to measure sentence recognition with assistive technologies. It is measured in decibels (dB). Lower values indicate better performance.	The measurement will be conducted immediately following the intervention within the 2-hour single session.

Collaborators and Investigators

• Sponsor: The University of Texas at Dallas
• Investigators: Study Director: Linda Thibodeau, Ph.D., The University of Texas at Dallas; Principal Investigator: Seeon Kim, Ph.D., Callier Center for Communication Disorders

Publications and helpful links

General Publications

• Spahr AJ, Dorman MF, Litvak LM, Van Wie S, Gifford RH, Loizou PC, Loiselle LM, Oakes T, Cook S. Development and validation of the AzBio sentence lists. Ear Hear. 2012 Jan-Feb;33(1):112-7. doi: 10.1097/AUD.0b013e31822c2549.
• Nilsson M, Soli SD, Sullivan JA. Development of the Hearing in Noise Test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am. 1994 Feb;95(2):1085-99. doi: 10.1121/1.408469.
• Levitt H. Transformed up-down methods in psychoacoustics. J Acoust Soc Am. 1971 Feb;49(2):Suppl 2:467+. No abstract available.

Helpful Links

• Platform to Assist in the Execution of Dual Task Tests

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2025
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: December 18, 2024
• First Submitted That Met QC Criteria: February 17, 2025
• First Posted (Actual): February 21, 2025

Study Record Updates

• Last Update Posted (Actual): May 11, 2026
• Last Update Submitted That Met QC Criteria: May 7, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Hearing Loss; Hearing Aids; AirPod Pro (AP)
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Otorhinolaryngologic Diseases; Sensation Disorders; Ear Diseases; Hearing Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Hearing Loss
• Other Study ID Numbers: IRB-25-148

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Don't have plan to share IPD.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: Yes