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Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter 1

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 is available for SHHH Chapters to use at www.nchearingloss.org/programs.Please send corrections or suggestions for improvements to [email protected] .Opinions expressed are those of the author.


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!


What Should I Care About?

Highest Priority: Hearing Better High Priority: Learning to Use Your Aid Lowest Priority: Vanity


All Hearing Aids Are Alike

1. Sound goes in the Microphone.

2. Sound gets amplified.

3. Sound comes out the Speaker into your Ear


All Hearing Aids Are Different

Style (Small is best?)

Technology (Digital is only way to go?)

Features (More is better?)

Settings (your ‘prescription’)


Style

Body Behind The Ear (BTE) In The Ear (ITE) In The Canal (ITC) Completely In the Canal (CIC)


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: 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.


FeaturesVolume ControlTelecoilMultiple Microphone DirectionalityCompressionClippingDirect Audio InputFMProgrammabilitySpeech Enhancement/Noise ReductionFrequency ShiftingEarmold/VentRemote Control

Opinion: Learn what these features can do to help you hear better so that you will be a better consumer.


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 on the aid, or a remote control.

Opinion: Usually very important.


Telecoil Alternate input sourceListens to magnetic signal instead of (or in addition to) the sound.Magnetic signal can be from a telephone, CD, TV, personal ALD, headphone, loopMajor advantage is improved signal to noiseUsually on BTEs; sometimes on smaller, seldom on smallestMagnetic

Input Signal

Sound Input Signal

Opinion: Very Valuable


Multiple Microphone Directionality

Front Facing Directional MicRear 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 SelectionOpinion: Very Valuable


Compression

0

20

40

60

80

100

quiet loud

Amount of Noise

Am

plifica

tion

Reduces Amplificaton when it’s NoisyHelps you hear more when it’s QuieterKeeps it from being Painful when it’s NoisyAdjustable (manual and automatic)Different settings in multiple frequency bands

Opinion: Very useful; available on most aids; may requre tweaking to set right.


Clipping

0102030405060708090

100

quiet loud

Amount of Noise

Am

plifica

tion

Eliminates all amplificaton above a certain input volumePrevents hearing damage from excessive amplification in loud situationsA setting for most hearing aids

Normal Amplification

No Amp-lification

Opinion: Essential for safety; available on most aids


Direct Audio Input (DAI)Alternate input sourceListens to electrical signal instead of (or in addition to) the sound.Electrical signal can be from a telephone, CD, TV, or personal ALDMajor advantage is improved signal to noiseBoots available only for BTEs

Opinion: Very good signal; comparable to FM, but requires the wires.


Booted or Integrated FMSome Aids have FM receivers either booted on (as shown) or integrated into the aid.Some can be used with hand-held 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.


Programmability

The ability of an aid to have several different sets of settings Hearing aid dealer/audiologist chooses and sets up the programsUser can switch among the programsExamples 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 controlOpinion: Very valuable, but you must

understand, choose and learn how to use the options.


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.


Frequency Shifting

0102030405060708090

100

2k 4k 6k 8k

dB

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, tooWith practice those new sounds start to sound realistic.

Can Hear Can’t Hear

Opinion: Most likely useful for steep ski slopes


Ear Mold DesignThe shape and smoothness of the bore The size and smoothness of the vent

Too small: Drum Feeling Too Large: Feedback

Depth of the mold Smoothness of the adaptor

Vent

Bore

Depth

Adaptor

Opinion: Very important, and much ovelooked.


Remote ControlsLet you control your aids convenientlySome simple; some powerfulSome people like them; some don’tControl:

Volume Program Mode

Opinion: Very convenient; especially if it allows direct access to individual programs.


Feature Availability By TypeFeature / Type BTE ITE ITC CICTelecoil Most Some No No

Directional Mics Some Rare No No

Compression/Clipping Yes Yes Yes Yes

DAI Some No No No

FM Some Few ?? No

Programmability Most Most Some ???

Power Plenty Less Less Less

Remote some some few ???


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).


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.


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 SHHH at www.hearingloss.org

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