Assisted Listening Devices and Hearing Aids
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The following is a continuation of our interview posted on November 16, 2016. It includes Dr. Lynn Sirow’s insight on hearing aids and assisted listening devices as well as recent research findings. Dr. Sirow is an audiologist with over thirty years of experience in her field. Among her many accomplishments, she founded the Port Washington Hearing Center in New York.
On reasons a hearing aid may be needed and the impact:
Hearing aids sort of got a bad rap not so long ago. People equated them with people who were deaf or couldn’t hear, because the hearing aids would amplify all sounds equally. When the sound got very loud, the hearing aids didn’t really cut out, so the sound just became kind of intolerable. It got to a point where it cut out and distorted everything, so hearing aids didn’t perform particularly well. This meant people wearing them also didn’t perform particularly well, and hearing aids were equated with people who couldn’t hear.
Now that there are digital hearing aids, we are able to overcome most of those problems, although it should never be construed that the hearing aid is going to cure the hearing loss. It’s going to bring the sound in where the individual has the hearing loss at the appropriate level and frequency for that person. In terms of how important they are, there’s a fair amount of research coming out of Johns Hopkins. Dr. Frank Lin has looked at the correlation between the development of cognitive problems, as you age, and loss of hearing. There was a correlation between development of cognitive problems and individuals with untreated hearing loss, so we know that cognition and hearing seem to be tied together.
On the difference between a hearing aid and an assisted listening device:
An assisted listening device is not easily wearable. They’re not designed to be hearing aids or worn all the time, only for certain situations or settings. Hearing aids can be worn continuously during the day. Some assisted listening devices are analog or not digital devices. They’re a lot less sophisticated than hearing aids, generally. (An FM system is an example of an assisted listening device.)
On new advances in hearing aid technology:
There are always new hearing aids coming out. Are they always advancements? Not necessarily. Sometimes, it’s just new bells and whistles, and it allows them to raise the price on a hearing aid. It’s not necessarily a better hearing aid. I guess the most recent true advancement is in what’s called connectivity. Hearing aids can now be connected to your blue tooth, to cell phones, to television sets, and landline telephones, if they happen to be connected to blue tooth. You can get the input from that device directly in the hearing aid.
There are 3 manufacturers who now have a blue tooth connection to the iPhone. When your hearing aid is connected to the iPhone, you’re able to use that phone as a remote microphone. This means you can put your iPhone on the table in a noisy restaurant, and it will pick up the individuals at the table somewhat louder than the surrounding background sounds.
There are several facets to each manufacturer’s app on the iPhone, and they do different sorts of things. Some of them have a feature where you can set the hearing aid differently for different situations. For instance, if you want very little amplification, maybe when you go on public transportation or when you go somewhere rather noisy, you don’t want a whole lot of amplification. They can geographically tag the hearing aid to soften when you get to that position, so it’s read by GPS.
On amplification and research:
For years, clinically, we saw that we would fit a hearing aid on an individual, come out with really nice test results, and the individual would take it home and tell us that they really couldn’t hear. Then we’d change the hearing aid, set it exactly the same way, but a different manufacturer, and suddenly, that individual would be performing better. We questioned what it was about each hearing aid, where one was more appropriate for one individual than another. We started looking at auditory processing, specifically, the ability of the auditory system to respond to the pauses in between letters or sound in a word and in the pauses between the words themselves or the pauses in clean speech. That’s called gap detection. We found people with poor gap detection had a lot of difficulty when they used a hearing aid that altered the characteristics of sound a lot.
We came upon a group at Northwestern University who was looking at the same correlation, but using cognitive tests and looking at working memory as an indicator of whether an individual needed fast or slow acting compression. Our group ran a study where we looked at both central auditory processing and cognitive measures. And we actually found that the cognitive measures were more sensitive. People with good working memory tend to be able to tolerate a signal with some distortion in it. People with poor working memory have a lot of difficulty when you distort the signal. In our work, we look at the individual’s working memory. And on that basis, we select hearing aids for testing and assess speech discrimination in noise, to see which hearing aids give us the best results.
On the one thing that’s important people understand about audiology:
Audiology is not a retail business. It’s a diagnostic and therapeutic medical field. You cannot just slap rehabilitation or a hearing aid on an individual randomly. These things have to be evaluated, so that the individual can function to the best of technology’s ability. And it has to be matched to the individual.