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Hearing & Hearing Aid Facts and Research:
Soon after that program, the AARP released their Report on Hearing Aids: User Perspectives and Concerns. The report, which is a summary of data from some 4,000 members and from the shopping experiences of AARP investigators, describes recommendations of items to consider when purchasing a hearing aid. One of its conclusions was that people whose hearing aids were prescribed and fit by audiologists were 13 times more likely to be satisfied with their aids than those who were fit by hearing aid salespeople. One of the main reasons people have been disillusioned with the hearing industry is that they are confused about where to go for responsible, professional hearing care or hearing aids. Many find their way to caring professionals, but many do not. Those who don't, have a very unsatisfactory experience. The Hear for Life® philosophy emphasizes that professional services should be provided by people with advanced training in hearing science and the human ear, not people whose training is primarily in business or salesmanship. Being fit with hearing aids is a process, not a purchase. It is these services, not just the products, that make hearing aid fittings successful. What is the difference between an audiologist and a hearing aid dispenser? About 6 to 7 years of college education in hearing and rehabilitation is Many audiologists also dispense hearing aids. Their rehabilitation and technical training result in a more holistic approach to solving hearing problems. Educating and counseling patients and their families about their hearing losses and providing realistic expectations are essential for success with hearing aids.
In an article in The Hearing Review, Voll and Jones examined the track record of CIC's after five years. Although satisfaction ratings were higher than for conventional models, it did not come without a price. A disturbing statistic is that 25% of CICs ordered were returned for credit, usually after several remakes and modifications. It is very common for CICs to have to be returned to the lab for modifications or shell remakes for comfort or feedback. Estimates of the numbers returned for changes vary from 20 to 64%. The reason for the remakes is that ear canals move, adding an additional complication to an already complicated fitting. For the dispenser, CIC fittings are more labor intensive, requiring an average of 6.5 hours to fit, where a conventional ITE takes 2.3 hours. The main source for these problems is changes in ear canal shape with jaw motion. The importance of the acoustic seal and sensitivity of the deeper bony portion of the ear canal also make the fitting challenging. "Regardless of the performance benefits of these tiny hearing instruments, the fact remains that the ear canal is a hostile environment for electronics. The warm temperature, high humidity and presence of earwax, which characterize the healthy ear canal, threaten the reliability of delicate transducers and circuits. The repair rate is higher for CICs than conventional instruments. A conventional in-the-ear aid can expect to be serviced by the manufacturer three times in five years. A CIC can expect to be returned for service three times more often, 1.8 times per year. Ultimately, the high return for credit, warranty repair and remake rate will keep the price of CIC's high. Both dispensers and consumers must realize that these fittings will require more service, more office visits and more repairs and will probably need replacement sooner." Most users of CIC instruments feel that the cosmetic and performance benefits of CIC's far outweigh the liabilities, but it is important to know the facts before you take the plunge. Excerpts from Mims Voll, L. & Jones, C. H.: CIC's: Five Years Later, What Have We Learned? The Hearing Review, 1998; 5 (4): 8 - 12. Tax deduction for hearing aids. Remember that hearing aids are an IRS approved medical expense. If you'll be claiming a medical deduction this year and are considering new aids, you may want to consider which year the deduction will benefit you more. Medicare and audiograms. Regulations have tightened. We must have a written request from your physician for an "audiogram" or "hearing test" in order to bill Medicare for it. It can be simply written on your doctor's Rx pad, or we can supply a form for your doctor to sign. Remote controls: love 'em or leave 'em. Some people love the idea of a remote control to operate their hearing aids, some don't. For "techies" an extra gadget to play with is an alluring option. For others, it is helpful to be able to see the controls to change volume and settings, rather than having to grope and guess at the ear. The down side is that the remote is an extra thing to keep track of, and you have to have either a pocket or purse to carry it in, or a good memory to recall where you set it down last. People considering higher technology instruments should give some advance thought to how they feel about a remote control. Battery life. Many patients ask why hearing aid batteries must be replaced every one to four weeks, while wristwatch batteries last a year or longer. Hearing aids draw more current from batteries than wristwatches do. A watch battery ticks off the seconds, minutes and hours day in and day out, with no variation. A hearing aid battery, however, functions continually and must power a mini amplifier, microphone, speaker, and in the case of programmables, a computer chip. Although the two devices may use the same type of batteries, like zinc air, a hearing aid uses much more energy each day. Hearing aids which look alike and use the same size battery may get much different battery life. The type of aid circuitry inside, as well as the power of the instrument, determine how long the battery lasts. Hearing Aid Technology: What Consumers Need to Know. By Harriet Kaplan Reproduced with permission from Self Help for Hard of Hearing People, Inc., Copyright 1999 SHHH. During the past few years, much new hearing aid technology has become available. We now have digital hearing aids, compression technology, telecoils, multiple channels, multiple memories, remote controls, and new microphone technology. These innovations come at increased cost. However, it is common for a top-of-the-line hearing aid to sell for $2,000 [to $3000] or more, including, of course, the services of the audiologist. Many consumers are asking whether these features are worth the money. The answer to that question must be based on the communication needs of the individual hearing aid user. It is the responsibility of the consumer working with the audiologist and/or hearing aid specialist to determine which features are worth the investment. In order to participate in the decision-making, however, consumers need to understand the function, advantages and disadvantages of the new technology. Does everyone need programmable hearing aids? Definitely not! There are certainly other good choices available today. If your instruments are over four years old, many circuit improvements are available which you can expect to hear better with. The one that's right for you depends on your hearing loss, the types of environments you spend your time in, and your expectations. For your hearing aid consultation appointment, first you need an accurate, up-to-date audiogram. Then your audiologist can discuss your particular situation and suggest the alternatives which make the most sense for you. In some cases, the best solution will be programmable instruments, but other good alternatives will often meet you needs. Once your options and the trade-offs are laid out for you, it will be easy to make the right personal choice. The truth about background noise. Few subjects in hearing care generate more confusion than background noise and our attempts to eliminate it with technology. No fixed, objective definition is possible, because background noise is any sound that competes with the signal (sound) you want to hear. As the following example illustrates, the very same sound can be signal or background, depending on what you choose to listen to. If you treat yourself to a new pet canary, you may want to listen for hours to its uplifting song. When your grandson's television is blaring in the background, you tell him to turn down the "background noise" so you can hear your bird's virtuoso performance more easily. Later, when you tire of the bird, and want to listen to the news, you may have difficulty hearing the newscaster because your canary continues its solo in the background. Now the bird song is "background noise" and the TV is the desired "signal". So you see, unless the hearing aid can read your mind, it will never be able to "eliminate background noise" as some advertisements suggest hearing aids can. So what's wrong with having hearing aids filter out the noise? You can filter out speech cues at the same time. Filtering out low-frequency noise is popular in certain widely advertised types of circuits, but they filter out low-frequency speech cues at the same time. Most circuits can't separate low-frequency speech from low frequency noise, only the brain can. This deprives the brain of some of the speech cues it needs to do its job properly. Despite its limitations, technology has made some wonderful breakthroughs in hearing aids. Binaural (both ears) amplification, broader range high fidelity circuits, and circuits designed to maximize ability to understand speech, all can help hearing-impaired listeners make better use of their remaining hearing. These hearing aids make almost everything audible - speech and noise - so your brain can do its job. The 100% digital processing aids have made great progress toward separating speech from noise. So, what's the catch? High fidelity circuitry is not the instant solution everyone hopes for. With new hearing aids, you may need to go through a relearning period of four to six weeks. That seems to be the time required for the brain to learn (relearn) how to recognize common interfering sounds and put them into the background. At the end of this adaptation period, you will still hear the noises, but they will interfere much less with your ability to carry on a conversation at a restaurant, party or baseball game. Amplification cannot replace the natural function that has been lost. But the breakthroughs offered by today's technology combined with the skills of a trained hearing health care professional and the cooperation of a determined hearing aid user, can offer immeasurable benefits. But nothing will ever be as good as the "original equipment". Research Supports Binaural Hearing Aids Binaural hearing also gives you a broader listening range. A voice barely heard at 10 feet with one ear can be heard up to 40 feet away with two ears. Stereo fittings require less effort to hear soft spoken words and quiet environmental sounds. Balanced hearing improves overall speech clarity and allows the listener to appreciate all the full rich dimensions of sound and to localize the sound source. A surprising 1992 study suggested an even stronger reason for wearing two aids when both your ears have a hearing impairment. Specially constructed word lists were used to measure people's word understanding. For those people with bilateral hearing losses who wore aids in both ears, speech discrimination (understanding) scores remained stable over time. For patients who had a loss in both ears, but chose to wear only one aid, researchers found an "auditory deprivation effect." Over a period of 4 to 17 years, the speech understanding in the aided ear remained stable, while the discrimination score in the unaided ear decreased significantly. Each individual is different, but this research makes a strong case for at least trying two aids, rather than just one. If it means that you can communicate better over a longer period of your life, it at least deserves a 60 day trial to see how it works for you personally. If you're one of those people with two bad ears who chose to try just one aid, you may be cheating yourself out of better present and future hearing. Foreign Accents Particularly if English is your native language, you've learned a set of rules about how sounds of American English should be pronounced, how they flow together into words, and the natural phrasing and intonation of your native language as it is used in conversation and sentences. This knowledge, called redundancy, is one of the crutches you use to help fill in the blanks any time you miss a sound or a word in a conversation. It helps you make an educated guess about what you missed. The advantage of redundancy is completely lost when someone speaks with an unfamiliar accent or an unusual way of combining words or constructing sentences. An unexpected difference as simple as pronouncing observatory "ob-ser-VAT-ory" can throw you completely off kilter, even with normal hearing. You are denied the familiar redundant information you normally use to fill in the blanks. British TV programs can be particularly frustrating. Instead of "come on in" or "in the hospital," they'll say "do come in" and "in hospital". These little unexpected turns of phrase can befuddle your hearing and make it too much work to untangle the conversation. The extra time it takes you to catch on, or catch up, leaves you in the dust on the next two sentences. Earwax and hearing aids. The human ear canal is completely lined with skin and is kept healthy by being lubricated with cerumen (wax) and sebaceous oil. The canal continually renews itself with skin which grows out radially from the center of the outer surface of the eardrum. This skin is sloughed off along with cerumen and sebaceous oil. These are usually unconsciously wiped away from the ear with a light touch of a finger. When your ear is closed off with a hearing aid, the natural cleansing process is blocked. This often results in wax, oil, and/or skin debris accumulating in the sound tube of the hearing aid. Skin debris in the sound bore can be especially troublesome because, unlike earwax, it can swell with moisture and shrink with dryness, causing intermittent "power loss" in your hearing aid. Over 50% of all hearing aid failures are caused by wax and skin debris. Unfortunately, patients don't assume that it is their own body causing the problems. Rather, they conclude that their hearing aids are "lemons" and they blame the hearing professional who fit them. Naturally, they share this bad news with their friends, and as a result, many hearing impairments go untreated. |
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one difference. A dispenser is licensed to testhearing solely for the purpose of selecting and fitting hearing aids. The audiologist is educated and trained to prevent, identify, and assess hearing disorders, as well as to provide treatment including hearing aids and other assistive listening devices. More that any other hearing care professional, the audiologist understands how the degree of your hearing loss affects your communication with others and your quality of life. 
For years, scientific hearing research has illustrated benefits of wearing two hearing aids, versus one. When you receive signals on both sides of the head, you are receiving a certain amount of redundancy or repetitive information. Both sides of your brain can use these additional clues to help decipher speech in noisy situations. What one ear misses, the other may catch. 