Introduction to Hearing Aid Features

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 and others like it are available at www.nchearingloss.org/programs. Please send corrections or suggestions for improvements to steve.barber@earthlink.net . Opinions expressed are those of the author. Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

2. 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

3. 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

4. All Hearing Aids Are Alike • Sound goes in the Microphone. • Sound gets amplified. • Sound comes out the Speaker into your Ear Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

5. 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

6. 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

7. 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

8. 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 Opinion: Learn what these features can do to help you hear better so that you will be a better consumer. Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

9. 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

10. Telecoil Sound 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! Magnetic Input Signal Opinion: Very Valuable Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

11. 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

12. Compression • 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

13. Clipping • Eliminates all amplificaton above a certain input volume • Prevents hearing damage from excessive amplification in loud situations • A setting for most hearing aids Normal Amplification No Amp- lification Opinion: Essential for safety; available on most aids Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

14. 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

15. Some 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. Booted or Integrated FM Opinion: Expensive but wonderful if you can afford it. Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

16. 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: A bit “techie” for some Requires a pendant/neckloop Some delay in audio Personal: Doesn’t do “broadcast” Bluetooth Opinion: Not terribly expensive, and nice to have if you want that connectivity. Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

17. 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

18. 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

19. Frequency Shifting • 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. Can Hear Can’t Hear Opinion: Most likely useful for steep ski slopes Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

20. Ear Mold Design Bore Adaptor • The 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 Depth Opinion: Very important, and much ovelooked. Vent Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

21. 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

22. Let you control your aids conveniently Some simple; some powerful Some people like them; some don’t Control: Volume Program Mode Remote Controls Opinion: Very convenient; especially if it allows direct access to individual programs. Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

23. Feature Availability By Type Introduction to Hearing Aid Features by Steve Barber, HLAA-Wake Chapter

24. 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

25. 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

26. 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