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As printed in Hearing Health, volume 20:1,
Spring 2004
By Margie littell Ulrich, CCC-A
Practicing in a busy clinic as I do, I see many clients
and hear some pretty outlandish allegations about what
hearing aids can and cannot do. Many of them are attributed
to digital models because people often have high expectations
of the “latest and greatest” technology.
These claims are sometimes based on truth that has
been distorted or exaggerated by word of mouth and through
inaccurate or lack of information. Other times they
are based simply on wishful thinking, flights of fancy
or pure fiction.
Perhaps not surprisingly, I hear most of the mythical
statements from people walking into my office carrying
hearing aids in their hands instead of wearing them
in their ears, indicating right away that their expectations
have not been met.
Here are the ones I hear most frequently and the truth
that debunks them.
These hearing aids are supposed
to reduce background noise.
Background noise translates as any sound that is not
what the listener wants to focus on. No hearing aid
is smart enough to know what you do or do not want to
hear. For example, if I come to your house to visit
and the television is on and you want to hear me, the
television is background noise. On the other hand, if
you want to hear the television, I am background noise.
Some of the new top-of-the-line digital hearing aids
do have the ability to recognize and enhance the speech
signal and detect steady noise, such as motors or fans,
and reduce it before it clutters up the speech signal.
But if more than one person is talking, hearing aids
cannot tell which one you want to understand. They will
make the speech of the person closest to you, the speaker
you are looking at, the clearest signal.
These hearing aids are supposed
to give me normal hearing.
I do wish we had a device that could restore hearing
to the normal range. But nobody has been able to duplicate
the precise functioning of the human ear; it is just
too complex and too well-engineered. That is why we
call these devices – little marvels that they
are notwithstanding – hearing “aids!”
Hearing aids enhance the speech signal, making it
clearer though not necessarily louder, which is actually
quite amazing.
The world is too noisy and too complex for any of us
to understand speech all the time, even if we have “normal
hearing.” Ever notice how yelling passes for conversation
at football games, rock concerts, construction sites,
etc.? That’s because in noisy environments we
can hardly hear ourselves think, much less hear anybody
talking to us.
All hearing aids are the same.
I heard this myth from a man as he handed me a hearing
aid that he had purchased in a mail-order catalog. Good
hearing aids are surprisingly complex and can be made
to reflect individual patterns of hearing. Everybody’s
hearing is different just like everybody’s vision
is different. We can’t exchange each other’s
glasses so why would we think we could use just any
hearing aid?
Your audiogram, which is not generally consulted in
mail-order hearing aid purchases, gives specific information
about the frequency range(s) of your hearing loss. A
programmable aid can be set to provide optimal benefit
specifically for you whereas many mail-order hearing
aids and other non-programmable aids are preset to address
losses in the high frequencies.
Also, although the price you pay isn’t always
directly correlated to your achieving satisfaction with
your aids, there is some truth to the old adage “You
get what you pay for.”
Manufacturers group digital hearing aids into categories
and price them accordingly. “Good” or “basic”
digital aids have fewer programming choices and less
features than “moderate” or “better”
models. The “premiere” digital aids can
recognize speech and noise, have more than one memory
and use directional microphone technology (see “focus”
myth) as standard equipment.
Taking advantage of this range of technology and depending
on your particular lifestyle and specific hearing loss,
you can be more certain than ever that you will get
hearing aids that are customized to meet your needs
and are most definitely not the same as all the others.
These hearing aids are supposed
to pick up far-away quiet sounds.
Hearing aids are like a tiny public address system.
For example, in church, if the preacher speaks into
his microphone, his voice is loud and clear. But if
he turns and walks away from the microphone, his voice
floats up into the air and sounds like it disappears.
The same is true with hearing aids: if the person speaking
moves away from the microphones on your hearing aid,
the sound will float away and become unintelligible.
Some digital hearing aids can be programmed to enhance
“soft sounds” but the problem of hearing
distant soft sounds is best resolved by using an assistive
listening device (ALD), either along with or built into
the hearing aid.
These hearing aids are
supposed to “focus” on speech so I don’t
hear everything else.
This claim is based on the fact that some aids have
multiple microphones. If yours is so equipped, its microphones
team up, each collecting sounds from a different direction
and delivering them for analysis. The aid’s processor
enhances the sounds coming from the front because the
basic assumption is that most people want to hear what
they are facing.
Only hearing aids with a directionality feature and
more than one microphone work this way. If the hearing
aid has only one microphone, it cannot be made directional.
Some of the newer digital hearing aids can be set to
be “directional” automatically. I have found,
however, that most people want to be able to select
that mode with a button on the hearing aid or a supplied
remote control.
What happens when the hearing aid wearer is driving
the car and wants to hear the person speaking in the
back seat?
Although some aids can be programmed to help in noisy
situations where the speech signal is behind the listener
or in an unusual place, the best way to deal with these
special communication dilemmas is to use an ALD that
will work with a hearing aid.
Digital hearing aids sound better
than regular hearing aids.
To some hearing aid wearers, this statement is true.
Others cannot tell the difference in sound between a
digital and an analog hearing aid. In many cases, the
inner ear is injured and has lost most of its ability
to make fine distinctions in sound.
However, there are many advantages to digital aids simply
because the sound undergoes digital processing rather
than analog and because they feature more sophisticated
programs for different listening environments.
The smaller the hearing aid,
the better it is.
One man handed me his tiny hearing aid and with a sheepish
grin admitted, "I spent a great deal of money to
get the smallest hearing aid I could so it would be
invisible when I wore it. But the first thing I do is
pull it out and show it to people!” Ironic, isn’t
it?
All hearing aids, no matter what size, have advantages
and disadvantages. But smaller isn’t always better.
For some people, the very opposite may be true. People
who have dexterity problems or low vision often find
it very difficult to manage changing the battery in
tiny completely-in-the-canal aids or even to turn them
off and on.
Bigger hearing aid cases can hold more electronics.
Sometimes simply a bigger microphone makes a substantial
difference in the sound quality.
Truth is … a well-fitted aid will make speech
easier to understand most of the time. Hearing aids
improve interpersonal relationships and research is
delivering mounting evidence that they positively influence
the overall health of the individuals wearing them.
So don’t let myths obscure the truth about the
availability of hearing help from hearing technology,
whether analog, programmable or digital.
Margie Littell Ulrich, CCC-A, is a
clinical audiologist at the Mid-East Tennessee Regional
Speech and Hearing Center in Dayton and a frequent contributor
to Hearing Health and area newspapers and publications.
Readers may contact her by
writing to MUCCCA@aol.com.
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