Transcript Introduction to Hearing Aids - Hearing Loss Association of North

Introduction to Hearing Aid Features
A consumer view of some things you
need to know before you buy your first
(or next) hearing aid.
This presentation and others like it are available at www.nchearingloss.org/programs.
Please send corrections or suggestions for improvements to [email protected] .
Opinions expressed are those of the author.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
1
Why Should I Care?
Hearing aids are Expensive.
Hearing aids aren’t like glasses.


You need to be an informed consumer.
You need to know how to use the aid.
There are a lot of misconceptions
about hearing aids.
Hearing better is UP TO YOU!
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
2
What Should I Care About?
Highest Priority: Hearing Better
High Priority: Learning to Use Your Aid
Lowest Priority: Vanity
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
3
All Hearing Aids Are Alike
1. Sound goes in the Microphone.
2. Sound gets amplified.
3. Sound comes out the Speaker into your Ear
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
4
All Hearing Aids Are Different
Style
(Small is best? … not always)
Technology
(Digital is the way to go? … probably)
Features
(More is better? … sometimes)
Settings
(your ‘prescription’ … a starting point)
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
5
Style
Body
Behind The Ear (BTE)
Mini BTE
In The Ear (ITE)
In The Canal (ITC)
Completely In the Canal (CIC)
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
6
Technology
Analog: Settings and Sound are both processed via
analog technology.
Digital Programmable: Settings are processed
digitally, Sound is processed via analog technology.
Full Digital: Both Settings and Sound are processed
digitally.
Opinion: Full Digital is now probably best in most
cases, but not the miracle that some imply. For some
people analog or digital programmables are fine, but
most hearing aids in the future will be full digital.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
7
Features
Volume Control
Telecoil
Multiple Microphone Directionality
Compression
Clipping
Direct Audio Input
FM
Bluetooth
Programmability
Speech Enhancement/Noise Reduction
Frequency Shifting
Earmold/Vent
Remote Control
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
Opinion: Learn
what these
features can do to
help you hear
better so that you
will be a better
consumer.
8
Volume Control
Some aids are preset and you can’t control the
volume.
Some manufacturers and dispensers think you don’t
need it.
Not having a volume control is Ok for a few people
who really don’t need it or can’t manage it.
Very useful to be able to control the volume to
match the situation.
Control may be a wheel, button or lever on the aid,
or a remote control.
Opinion: Usually very important.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
9
Telecoil
Sound
Input
Signal
Magnetic
Input
Signal
Alternate input source
Listens to magnetic signal
instead of (or in addition to)
the sound.
Magnetic signal can be from a
telephone, CD, TV, personal
ALD, headphone, loop
Major advantage is improved
signal to noise
Usually on BTEs; sometimes
on smaller, seldom on smallest
You may have to ASK (or
DEMAND) if you want telecoils!
Opinion: Very Valuable
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
10
Multiple Microphone Directionality
Front Facing Directional Mic
Rear Omnidirectional Mic
Aid Can Focus on Sounds in
Front and Diminish
Background Noise
Selectable Modes


Quiet situations: hear
everything
Noisy situations: block
background noise
Manual or Auto Selection
Opinion: Very Valuable
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
11
Compression
Amplification
100
80
60
40
20
0
quiet
loud
Amount of Noise
Reduces Amplificaton
when it’s Noisy
Helps you hear more
when it’s Quieter
Keeps it from being
Painful when it’s Noisy
Adjustable (manual and
automatic)
Different settings in
multiple frequency
bands
Opinion: Very useful; available
on most aids; may requre
tweaking to set right.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
12
Amplification
Clipping
100
90
80
70
60
50
40
30
20
10
0
Normal
Amplification
quiet
No Amplification
loud
Amount of Noise
Eliminates all
amplificaton above a
certain input volume
Prevents hearing
damage from
excessive
amplification in loud
situations
A setting for most
hearing aids
Opinion: Essential for safety;
available on most aids
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
13
Direct Audio Input (DAI)
Alternate input source
Listens to electrical signal
instead of (or in addition to)
the sound.
Electrical signal can be from a
telephone, CD, TV, or
personal ALD
Major advantage is improved
signal to noise
Boots available only for BTEs
Opinion: Very good signal;
comparable to FM, but requires
the wires.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
14
Booted or Integrated FM
Some Aids have FM receivers
either booted on (as shown) or
integrated into the aid.
Some can be used with handheld transmitters or with fixed
transmitters which can
integrate TV and Telephone.
Clean signal; bridges distance;
improves signal to noise ratio.
Opinion: Expensive but wonderful
if you can afford it.
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter
15
Bluetooth
Some Aids have an optional Bluetooth
pendant that use a proprietary magnetic
interface.
Any aids with a telecoils can use a Bluetooth
pendant that uses an analog neckloop.
Some aids have both (Ask if you want both!)
Bluetooth has some advantages.


Personal connectivity to TV, Phone, iPods,
Tablets
Clean signal; bridges distance; improves signal
to noise ratio.
Proprietary versions have advantages


True 2-channel stereo
No EMI (interference)
Bluetooth has some disadvantages:

Opinion: Not terribly expensive,
and nice to have if you want
that connectivity.



A bit “techie” for some
Requires a pendant/neckloop
Some delay in audio
Personal: Doesn’t do “broadcast”
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
16
Programmability
The ability of an aid to have several different sets of settings
Hearing aid dealer/audiologist chooses and sets up the programs
User can switch among the programs
Examples of useful programs
 for quiet situations
 for noisy situations
 for music
 telecoil or DAI with or without microphones
 FM
May be controlled with a switch or button on the aid or with a
remote control
Opinion: Very valuable, but you must understand,
choose and learn how to use the options.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
17
Speech Enhancement and
Noise Reduction
Speech Enhancement

Enhance certain speech sounds (like consonants)
Noise Reduction Processing

Identify speech in the signal and separate it from noise
Opinion: May be useful in some situations but these are
not miracles and their benefit may not be obvious in
many situations.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
18
Frequency Shifting
dB
2k
0
10
20
30
40
50
60
70
80
90
100
4k
Can Hear
6k
8k
Can’t
Hear
Only one aid, so far (AVR
ImpaCT)
Lowers the frequency of
sounds you can’t hear into a
range where you can hear
them.
Does some speech
enhancement, too
With practice those new
sounds start to sound
realistic.
Opinion: Most likely useful
for steep ski slopes
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
19
Ear Mold Design
Adaptor
Bore
The shape and
smoothness of the bore
The size and
smoothness of the vent


Depth
Vent
Too small: Drum Feeling
Too Large: Feedback
Depth of the mold
Smoothness of the
adaptor
Opinion: Very important,
and much ovelooked.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
20
Open Fitting
People with mild or
moderate hearing
losses can consider an
“open fitting” instead of
an full ear mold.
An open fitting is
common on mini-BTE
aids like the one shown.
Not suitable for more
serious losses.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
21
Remote Controls
Let you control your aids
conveniently
Some simple; some powerful
Some people like them; some
don’t
Control:



Volume
Program
Mode
Opinion: Very convenient;
especially if it allows direct
access to individual programs.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
22
Feature Availability By Type
Feature / Type
BTE
ITE ITC CIC
Telecoil
Most
Some
???
???
Directional Mics
Some
Rare
No
No
Compression/Clipping
Yes
Yes
Yes
Yes
DAI
Some
No
No
No
FM
Some
Few
???
No
Bluetooth
Some
???
???
???
Programmability
Most
Most
Some
Some
Power
Plenty
Less
Less
Less
Remote
some
some
few
???
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
23
Summary
Put hearing better as the top priority.
Put vanity at the bottom of your priorities.
Be a savvy consumer; know what
features might help you.
Watch out for people trying to sell you
what they THINK you want.
Choose a provider that lets you try
multiple aids/settings.
Small is not necessarily better (and
usually isn’t).
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
24
Summary (cont.)
Watch out for sales pitches; if it sounds too
good to be true; it probably is.
Get professional help from someone you
trust.
New is not necessarily better (but
sometimes is).
Use the trial period. Try the aids in different
situations and make notes. Work with your
provider during the trial period by
explaining what things sound good or bad
to you.
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
25
Final Opinion
Knowing about features is important.
Hearing loss isn’t a “spectator sport”.
Hearing better is up to you.
Learn to be a better consumer.
Join Hearing Loss Association of
America at www.hearingloss.org
Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter
26