Hearing

Clear Speech: It’s Not Just About Conversation

By Kathi Mestayer

In the Spring 2018 issue of Hearing Health, we talk about ways to help our conversational partners speak more clearly, so we can understand them better.

But what about public broadcast speech? It comes to us via phone, radio, television, and computer screen, as well as those echo-filled train stations, bus terminals, and airports. There’s room for improvement everywhere.

  This digital oscilloscope representation of speech, with pauses, shows that gaps as short as a few milliseconds are used to separate words and syllables. According to Frank Musiek, Ph.D., CCC-A, a professor of speech, language and hearing sciences at the University of Arizona, people with some kinds of hearing difficulties require longer than normal gap intervals in order to perceive them.    Credit: Frank Musiek

This digital oscilloscope representation of speech, with pauses, shows that gaps as short as a few milliseconds are used to separate words and syllables. According to Frank Musiek, Ph.D., CCC-A, a professor of speech, language and hearing sciences at the University of Arizona, people with some kinds of hearing difficulties require longer than normal gap intervals in order to perceive them.
Credit: Frank Musiek

In some cases, like Amtrak’s 30th Street Station in Philadelphia [LISTEN], clear speech is a real challenge. The beautiful space has towering cathedral ceilings, and is wildly reverberant, like a huge echo chamber. Even typical-hearing people can’t understand a word that comes over the PA system. Trust me; I’ve asked several times.

In that space, a large visual display in the center of the hall and the lines of people moving toward the boarding areas get the message across: It’s time to get on the train. I wonder why they even bother with the announcements, except that they signal that something is going on, so people will check the display.

Radio is very different, at least in my kitchen. There are no echoes, so I can enjoy listening to talk radio while I make my coffee in the morning. The other day, the broadcast about one of the station’s nonprofit supporters was described as: “…supporting creative people and defective institutions…”

Huh? That couldn’t be right. It took a few seconds for me to realize what had actually been said: “supporting creative people and effective institutions.” Inter-word pauses are one of the key characteristics of clear speech. A slightly longer pause between the words “and” and “effective” would, in this case, have done the trick.

In the meantime, I chuckle every time that segment airs (which is often), and wonder if anyone else thinks about the defective institutions!

Staff writer Kathi Mestayer serves on advisory boards for the Virginia Department for the Deaf and Hard of Hearing and the Greater Richmond, Virginia, chapter of the Hearing Loss Association of America.

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Universal Newborn Hearing Screening to Prevail Under EHDI Act of 2017

By Nadine Dehgan

Federal funding for universal newborn hearing screening will prevail until 2022 under the The Early Hearing Detection and Intervention (EHDI) Act of 2017, which officially became law last month. Hearing Health Foundation (HHF) is ecstatic that there was bipartisan support for critical early testing and intervention for children with hearing loss.

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Introduced in March by Representatives Brett Guthrie (R-KY) and Doris Matsui (D-CA) as an amendment to the Public Health Service Act, the EHDI calls for early detection, diagnosis, and treatment of deaf and hard-of-hearing newborns, infants, and young children. Each day nationwide, 33 newborn babies—approximately three out of every 1,000 births—are diagnosed with hearing loss, making it the most common congenital birth defect. Left undetected, hearing loss can negatively impact a child’s speech and language acquisition, academic achievement, and social and emotional development.

HHF, a long-time supporter of universal hearing screening for newborns, applauds the enactment. HHF was instrumental in highlighting the need for similar legislation in the 1990s. In 1993, only 5% of newborns were tested at birth for hearing loss. By 1997, 94% were tested before leaving the hospital, and today 97% of babies are screened before they leave the hospital.

Earlier drafts of the federal budget put the coverage of these crucial procedures at risk, prompting legislators in both the Republican and Democratic Parties to take action quickly. In addition to the bill in the House, a companion measure was introduced in the Senate by Senators Rob Portman (R-OH) and Tim Kaine (D-VA). In early October, the House passed the Act following the Senate’s unanimous approval in September.

“This program exemplifies the importance of early detection and intervention,” said Congresswoman Matsui. “By ensuring that infants have access to hearing screenings at birth, parents can make informed choices about their care management early on. This is critically important, given that so much of a child’s development happens in the first few years of their life. I’m pleased that through the passage of this legislation, the newborn screening and intervention program can continue to improve health outcomes for kids.”

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A Tool to Discover Quieter Restaurants and Voice Concern for Loud Noise

By Gregory Scott

Restaurants and bars are simply too loud. In New York City, restaurants, on average, have decibel levels (77 dBA) that make conversation very difficult.  And bars are even worse with sound levels (81 dBA) that put people in danger of noise-induced hearing loss.  

When you go out, do you strain to hear a friend, family member, date or business partner?  Do you wish venues were quieter to carry a conversation? Looking for a polite way to ask managers to reduce their noise levels? Do you seek a way to find out where the quieter spots are in your city?

These questions have been on my mind the past few years. As someone with hearing loss, I am sensitive to loud venues and have often struggled to hear companions in noisy bars and restaurants.

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I recall many times sitting at a restaurant table feeling completely lost in the conversation while others conversed and connected with each other. I would often nod my head in unison with the conversation, pretending to hear my companions when I could not, and then idly pass the time by entertaining myself with whatever fiction entered my head. At home, I would google “quiet spots,” which was often a fruitless endeavor. A place listed as quiet would often be blasting with music when I arrived with my date. This type of setting was not a great environment to talk in and get to know someone.

To overcome these issues, a free iPhone decibel meter app called SoundPrint has been created primarily for the hearing-impaired community, but even those with typical hearing can benefit. SoundPrint is also helpful for the blind, those with autism, or those who simply prefer quiet environments.

SoundPrint allows you to discover the quieter venues in your city. Using the app’s internal decibel meter, you can measure the actual noise level of any venue, which is then submitted to a SoundPrint database that anyone can access to find out if a certain venue is quiet or loud. A database for your city is created and, with each submission, is enriched and becomes more valuable. In addition, submitting SoundPrint measurements is an effective way to tell venue managers that you and others care about noise levels and that they should mitigate the increasing din.

An initial trial in New York City has begun and to date, 3,000+ venues have been measured, many of which have been measured three times or more. This has resulted in an invaluable curated list of 30 local quiet spots where one can actually hear others! No longer am I just sitting at a restaurant table unable to participate; rather I am engaged in the conversation and able to connect with companions.

The goal is to generate a similar list for other cities and let venue managers know that we care about noise. Join the SoundPrint community by measuring a venue when you are out. By doing so, you are helping each other discover which venues are quiet and noisy.

Gregory Scott is the founder of the SoundPrint app and is involved in the New York City hearing-impaired community. For more information, and to join the newsletter, visit SoundPrint's website and download the app. SoundPrint is only available for the iPhone, but venues are searchable on the app’s website. Greg is looking for SoundPrint ambassadors for other cities outside of New York (greg@soundprint.co).

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Illuminating Usher Syndrome: A Three-Day Event Series to Bring Deafblindness Out of the Dark

By Sophia Boccard

A crowd of people made their way to Lululemon HUB on 5th Avenue in New York City on the evening of September 11 to participate in Day One of a three-day Usher syndrome event series. The cocktail gathering overflowed with wine, cheese, and spectators against the beautiful backdrop of Lululemon’s community space.

  Usher Syndrome Society banner near the portraits in the park. Photo by Rebecca Alexander.

Usher Syndrome Society banner near the portraits in the park. Photo by Rebecca Alexander.

The event, called Rosé in the Dark, was a collaboration amongst four friends, Rebecca Alexander, Peggy Borst, and myself—all of us have Usher syndrome—and Nancy Corderman, a mother to two kids with Usher syndrome. Our objective was to bring insight to life with Usher syndrome through immersive deafblind experiences.

While Usher syndrome itself is quite rare, it is the most common cause of deafblindness—the loss of both hearing and vision. In the United States, the inherited condition affects approximately four babies in every 100,000 births while worldwide, more than 400,000 people are affected with Usher syndrome.

At Rosé in the Dark, we began with a three-person panel discussion. The Q&A was very personal, emotional, and informative. Following the panel, guests participated in a deafblind exercise, wearing goggles that replicate tunnel vision, a common viewpoint for a person with Usher syndrome.

On Tuesday for Day Two, we installed a public exhibit of large portraits of people with Usher syndrome in Washington Square Park. Visitors, tourists, and students from nearby universities all absorbed personal information about these individuals while browsing through the photographs and reading their stories.

For Day Three, we concluded the series with an exercise class led by Rebecca Alexander, who is also a Lululemon Ambassador. Admission to the class was donated to Usher syndrome research.

  Sophia Boccard speaks at   Rosé in the Dark. Photo by   Socrates Figueroa

Sophia Boccard speaks at Rosé in the Dark. Photo by Socrates Figueroa

As an individual with Usher syndrome, building awareness is important. Comprehending the invisible condition and knowing how to help or respond to individuals with the condition can be difficult.

We will be continuing to raise awareness and create more experiences to educate everyone on ways they can help and contribute to this rare but damaging condition.

Sophia Boccard sits on Hearing Health Foundation (HHF)’s Board of Directors and is a digital marketing strategist in the hospitality industry with over a decade of marketing experience in the entertainment industry. “As someone who was born with moderate to severe hearing loss, I've always accepted the loss of hearing as a part of who I am. After being diagnosed with Usher syndrome type 2a in 2012, I realized that a cure for both hearing and vision was something I needed to fight for.”

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Don’t Let Swimmer's Ear get in the Way of Your Summer Fun

By Lauren Conte

After a long day spent enjoying the public pool, your youngest child runs towards you clutching one of his ears. You calm him down, and after a few moments he tells you that his ear itches, hurts to the touch, and sounds are muffled.

Unsure of how to treat his pain, you book an appointment with your family's doctor. In the meantime, you try to stop your son from shoving his fingers into his ears as the burning pain worsens.   

At the appointment, the doctor sees the red inflammation in the ear canal and notes the clear, odorless discharge draining from your child's ears. "Yep," the doctor says, "its Swimmer's Ear."

Well, what exactly is Swimmer's Ear, and how does it occur? Swimmer's Ear (also known as acute otitis externa) is an ear infection caused by bacteria, and though instances are rare, sometimes can occur from viruses or fungi.

Long exposure to contaminated water, such as recreational pools or lakes makes individuals susceptible to infections. The water softens the skin inside the ear and allows bacteria to multiply and cause irritation. When people use their fingers, cotton swabs, or other objects to itch their ears, the softened skin is easily broken, spreading the infection further.  

To catch the infection early, some symptoms include:

  • Itchiness in the ear canal
  • Pain when pushing or pulling on the outer ear
  • Clear drainage
  • Swelling and redness of the ear
  • Sensation of fullness in the ear
  • Swollen lymph nodes around the ear, upper neck, and jaw

Treatment options vary, but often your doctor will prescribe an antibiotic or antifungal medication to kill the infection. Your doctor may prescribe a steroid to decrease the inflammation, or an acidic solution to restore the normal pH inside the ear. (When applying the drops, have someone else help you. Also, lie down with the affected ear facing upwards in order to fill the ear completely with medication.) To decrease the pain before and during treatment, over-the-counter pain relievers are effective at helping relieve some of the discomfort in the ears.

Okay, so now we know how it happens and how to treat the infection should it occur, but let's try to avoid getting to that point. Spoiler alert: you don't have to give up the pool, lake, or beach time!

While in the water, keep ears dry by using earplugs or a swim cap.

If that isn't your style, dry the outside of your ears with a towel, drop some drying-aid into each ear, and then tilt your head to the side to help the water drain out.

Pro-Tip: DIY Ear-drying Aid

  • 1 tablespoon white vinegar
  • 1 tablespoon rubbing alcohol
  • (Or however much solution you desire, but keep equal parts vinegar and rubbing alcohol)
  • Mix solution together and add drops into both ears.

The alcohol in the solution combines with the water and because alcohol evaporates at a lower temperature, pulls the water out with it. The acidity of the vinegar lowers the pH of the ear so bacteria cannot grow. Use this solution each time you leave the water, to ensure that infection does not occur.

Also, never use cotton swabs or fingers to try to remove water from ears. Your fingernails can cut up the inside of your ears, cotton swabs can puncture eardrums, and scrape the ear canal as well. Similarly, do not try to use cotton swabs to remove earwax, as the natural substance protects against infection and waterproofs your ears.

There you have it, the signs to look out for, and the ways to avoid putting a damper on your summer.

Lauren Conte is a Communications Intern for Eosera, a biotechnology consumer products company.

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The Path to Funding for Universal Newborn Hearing Screening

By Pranav Parikh

Due to the complexities of a multi-trillion-dollar federal budget, it can often be difficult to understand where all the money ends up. For recipients of Medicaid and their children, part of the government’s longstanding policy is to provide access to quality healthcare low-income communities could not otherwise afford. Medicaid recipients represent approximately 23 percent of the total U.S. population, with an enrollment of 74,550,529 individuals.

According to President Donald Trump’s Fiscal Year (FY) 2018 proposed budget, deemed the “America First” budget, and a nonpartisan CBO report, Medicaid will receive cuts totaling $610 billion USD over the next 10 years. In 2015, the U.S. Government spent $545.1 billion USD on Medicaid services. President Trump alludes to waste and redundancies as his justification of the proposed cuts.

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One of the planned cuts will negatively impact newborn children and be detrimental to the well-being of infants across the country: Universal Newborn Hearing Screening. The terrifying impact is summarized below.
 

What exactly is being removed?
In his FY18 proposed budget, President Trump upheld his campaign promise by cutting what he deems “unnecessary and wasteful spending.” Unfortunately, one program that got the axe was the $18 million USD allocated towards newborn hearing screenings. This earmarked funding has doubled the percentage of newborns receiving hearing screenings before leaving the hospital from 46.5% to 97% just in the last decade. Without early detection, children will be at a distinct disadvantage in tackling hearing loss present at birth.

Why does this matter?
Every day, 33 children are born with some form of hearing loss, designating hearing loss as the most common congenital birth defect in the U.S. Reasons babies may have hearing loss present at birth include an inherited trait, ototoxic chemical, or a viral infection during a mother’s pregnancy. Challenges associated with having hearing loss can be overcome through early intervention, however it is imperative treatment and therapy are started as early as possible. As stated on the U.S. Government Department of Health and Human Services website, “If not identified early, [hearing loss] is likely to delay or impair a child’s development. Hearing problems are difficult to detect through observation alone, so almost all newborns have their hearing checked with special equipment.” 

What types of tests are done?
Aside from behavioral characteristics displayed by infants with hearing loss, there are two main tests conducted by physicians to determine any level of auditory impairment. The first of which is called Otoacoustic Emissions, a test designed to the test functionality of outer hair cells. A negative reading on this test is typically associated with cochlear dysfunction. The second test is called Auditory Brainstem Response (ABR) and determines activity of the auditory nerve through stimulation in the baby’s ear. A negative reading on this test indicates some issue with the vestibulocochlear nerve such as auditory neuropathy, but could also indicate problems with other parts of the ear. Both of these tests can be done while the baby is asleep and offer more concrete evidence to either rule out or diagnose infant hearing loss.

Have studies shown early intervention to be more effectual than later in childhood?
Yes, there are many studies that have shown that early intervention, especially for those receiving treatment within the first six months after birth, increases levels of cognitive function and advanced development. The control group of one study, led by Dr. Christine Yoshinaga-Itano at the University of Colorado-Boulder, showed that those who did not receive treatment or therapy within the first six months after birth had greater difficulty with oral communication and language comprehension.

What happens if children have undiagnosed hearing loss?
Hearing loss as a condition can present a number of symptoms associated with other disabilities, leading to improper diagnoses. For example, when children exhibit a lack of response to loud noise, or don't answer when spoken to, they sometimes are misdiagnosed by professionals as being autistic. If hearing loss is present and detected at birth, doctors will have access to necessary information earlier and children will be better off in the long run in developing their communication and learning abilities.

If funding for newborn hearing screening is decreased or removed entirely, what does that mean for those suffering from hearing loss?
At the moment, only 67.1% of those diagnosed with hearing loss receive early intervention before six months of age. With lower early detection and screening rates, this percentage will drop further. Without early intervention programs in place, children are at a noticeable disadvantage in developing hearing and speech functionality. After the age of three, it is considerably more difficult for children to develop the speaking and listening skills that are in line with their typical-hearing peers.

Would early intervention actually save money down the road in potential education costs?Some students with hearing loss utilize special education services, such as CART or note-taking, to ensure they don’t miss any of the materials and learnings while in the classroom. Access to the necessary technology and equipment, as well as highly trained teachers, is an expense incurred by school districts across the country.

A recent report released by the National Center for Hearing Assessment and Management states that treatment of hearing loss in children within the first three months of life can save up to $400,000 USD in eventual special educational costs by the time the hard of hearing student graduates high school. By bridging the gap early, and ensuring better interpersonal and cognitive skills in the first years of age, these children will require much less specialized instruction in future years. Essentially, early detection and intervention pays for itself.

Is there any legislation, not including the President’s proposed budget, that addresses this issue?
In March 2017, the Early Hearing Detection and Intervention (EDHI) Act was introduced on the House floor by Representatives Doris Matsui (D-CA-06) and Brett Guthrie (R-KY-02). A companion measure was also introduced in the Senate by Senators Rob Portman (R-OH) and Tim Kaine (D-VA). EHDI reauthorizes funding for Universal Newborn Hearing Screening for the next five (5) years, as well as establishes a database hub to collect information on the results of these tests. If the measure passes, parents will be assured of their child’s hearing health, and one of the nation’s largest public health concerns receives the necessary attention it deserves.


Undoubtedly, funding for newborn hearing screening is imperative. Hearing Health Foundation (HHF)'s Pranav Parikh spoke with Congresswoman Matsui’s staff on the reasons for proposing the legislation, and why she took the lead on tackling such an important issue. “So much of a child’s development happens in the first few years of their life, which is why early detection and intervention is so important,” said Matsui. “This bill will ensure that more infants have access to critical hearing screenings, so parents can be informed about the options for their children’s care.” It is comforting to know children suffering with hearing loss have an ally in our nation’s capital.

As Vickie Glenn, a Medicaid Coordinator for Tri-County Special Education recently stated in a New York Times article, “This isn’t Republicans or Democrats. It’s just kids.” Fortunately, President Trump’s proposed budget appears to be a “purely political document,” according to Peter Coy from Bloomberg BusinessWeek, possibly serving as a trial balloon and nothing more. Congress, even with a conservative majority consisting of many fiscal hawks, will likely reject many of the proposed cuts, as Texas Senator and chairman of the Freedom Caucus John Cornyn remarked, “we know the President’s budget isn’t going to be passed as is.” For now, at least, Universal Newborn Hearing Screening will receive its necessary and deserved funding.

And, finally, an urgent call to action from Nadine Deghan, CEO of HHF:
HHF has strongly supported Newborn Hearing Screening. In the 1990s, we championed legislation to encourage these simple but critical tests for our nation’s babies. For those who feel passionately about newborn screening funding, please contact your Congressional Representative and your Senator to let them know your views.

 

 

 

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My Hearing Is Not Perfect

By Norman Molesko

MY HEARING IS NOT PERFECT


What did you say?
Face me!
Please say it again!
Clearly. Slower. Louder.
I want to understand you.
I know you said something to me.
It may not be what I heard.
May not be what I think you said.
My hearing is not perfect.
Not all sounds are clear to me.
Not all sounds can be heard by me.
Some sounds are difficult to hear.
Some cannot be heard at all.
I don’t want to be unsure of myself.
Please repeat what you said?
Clearly. Slower. Louder.
I need to understand you.
 

By: Norman Molesko, age 86, 

©2011, Ambassador For Seniors

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