Technology

Understanding Individual Variances in Hearing Aid Outcomes in Quiet and Noisy Environments

By Elizabeth Crofts

Evelyn Davies-Venn, Au.D., Ph.D.

Evelyn Davies-Venn, Au.D., Ph.D.

More than 460 million people worldwide live with some form of hearing loss. For most, hearing aids are the primary rehabilitation tool, yet there is no one-size-fits-all approach. As a result, many hearing aid users are frustrated by their listening experiences, especially understanding speech in noise.

Evelyn Davies-Venn, Au.D., Ph.D., of the University of Minnesota is currently focusing on two projects, one of which is funded by Hearing Health Foundation (HHF) through its Emerging Research Grants (ERG) program, that will enhance the customization of hearing aids. She presented the two projects at the Hearing Loss Association of America (HLAA) convention in June.

Davies-Venn explains that some of the factors dictating individual variance in hearing aid listening outcomes in noisy environments include audibility, spectral resolution, and cognitive ability. Audibility changes—how much of the speech spectrum is available to the hearing aid user—is the biggest factor. “Speech must be audible before it is intelligible,” Davies-Venn says. Another primary factor is spectral resolution, or your ear’s ability to make use of the spectrum or frequency changes in sounds. This also directly affects listening outcomes.

Secondary factors include the user’s working memory and the volume of the amplified speech. These impact how well someone can handle making sense of distortions (from ambient noise as well as from signal processing) in an incoming speech signal. Working memory is needed to provide context in the event of missing speech fragments, for instance. Needless to say, it is a challenge for conventional hearing aid technology to address all of these complex variables.

Davies-Venn’s highlights two emerging projects that take an innovative approach to resolving this challenge. The first project aims to improve hearing aid success focuses on an emerging technology called the “cognitive control of a hearing aid,” or COCOHA. It is an improved hearing aid that will analyze multiple sounds, complete an acoustic scene analysis, and separate the sounds into individual streams, she says.

Then, based on the cognitive/electrophysiological recordings from the individual, the COCOHA will select the specific stream that the person is interested in listening to and amplify it—such as a particular speaker’s voice. The cognitive recording is captured with a noninvasive, far-field measure of electrical signals emitted from the brain in response to sound stimuli (similar to how an electroencephalogram, EEG, captures signals).

Davies-Venn’s ERG grant from HHF will support research on the use of electrophysiology, far-field or distant (i.e. recorded at the scalp) electrical signals from the brain, to design hearing aid algorithms that can control individual variances due to level-induced (i.e. high intensity) distortions from hearing aids.

The other project involves sensory substitution. This project explores the conversion of speech to another sense—for example, touch—through a mobile processing device or a “skin hearing aid.” For the device to function, a vibration is relayed to the brain for speech understanding. This technology seems cutting edge, but is believed to have been invented in the 1960s by Paul Bach-y-Rita, M.D., of the Smith-Kettlewell Institute of Visual Sciences in San Francisco. Even though it has not yet been incorporated into hearing aid technology intended for mass production, David Eagleman, Ph.D., of Stanford University and others are hoping to make this a reality.

Davies-Venn’s research motives are inspired by a personal connection to her work. “I have a conductive hearing loss myself,” she says. “I had persistent/chronic ear infections as a child that left me a bit delayed in developing speech, and still get ear infections as an adult and have ground accustomed to the low-frequency hearing loss that results until they resolve.” She also has family members with hearing loss and understands the importance of developing more advanced hearing assistance technology.

The projects are in the early stages, and it may take as long as a decade for them to reach the market from the concept. “The goal is to develop individualized hearing aid signal processing to improve treatment outcomes in noisy soundscapes,” Davies-Venn says. “We want to say, this is the most optimal treatment protocol, and it’s different from this person’s, even though you have the same hearing threshold.” Solving hearing aid variances in a precise, individual manner that accounts for variables such as age and cognitive ability will improve communication and quality of life for the millions with hearing loss who use hearing technology.

We need your help supporting innovative hearing and balance science through our Emerging Research Grants program. Please make a contribution today.

 
 
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FCC Improves Phone Accessibility for People with Hearing Loss

The Federal Communications Commission on Tuesday, October 24 approved updates to various Commission rules for hearing aid compatibility and volume control on wireline and wireless telephones.

Under the Hearing Aid Compatibility Act, the Commission is required to establish rules that ensure access by people with hearing loss to telephones manufactured or imported for use in the United States. With this action, the Commission continues its efforts to ensure that tens of millions of Americans with hearing loss have access to and can benefit from critical and modern communication technologies and services.

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With the Order, the Commission adopted a revised volume control standard for wireline handsets to provide a more accurate measurement of voice amplification. The Order also implements a provision of the Twenty-First Century Communications and Video Accessibility Act to apply all the Commission’s hearing aid compatibility requirements to wireline telephones used with advanced communication services, including phones used with Voice-over-Internet-Protocol (VoIP) services. Compliance with these provisions must be achieved within two years.

Recognizing the increased reliance on wireless phones, the Order further requires that, within the next three years, all wireless handsets newly certified as hearing aid compatible must include volume control suitable for consumers with hearing loss. It also reminds manufacturers and service providers of existing outreach obligations to ensure that consumers are informed about the availability of hearing aid compatible phones, such as by posting information about wireless phones on their websites.

More information on existing FCC hearing aid compatibility rules is available online at https://www.fcc.gov/general/hearing-aid-compatibility-and-volume-control.

Action by the Commission October 24, 2017 by Report and Order and Order on Reconsideration (FCC 17-135). Chairman Pai, Commissioners Clyburn and Rosenworcel approving. Commissioners O’Rielly and Carr approve in part and dissent in part. Chairman Pai, Commissioners Clyburn, O’Rielly and Carr issuing separate statements.

CG Docket No. 13-46; WT Docket No. 07-250; WT Docket No. 10-254

This press release was republished with permission from the FCC. For additional information, contact Michael Snyder at (202) 418-0997 or michael.snyder@fcc.gov.

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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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With Her Ears On, Sherri Can Enjoy the Sounds of Her Grandchildren

By Sherri Ely

I lived a normal life in the hearing world until about 18 years ago when I started noticing I had a harder time following group conversations and talking on the phone. I discovered I had a moderate hearing loss in all the mid and high frequencies. For several years, I benefited greatly from hearing aids. I had a successful sales career in the Professional Beauty industry and was doing well.

One day, I began noticing that my hearing aids no longer helped with the clarity of speech. I could hear the sound of someone speaking, but had no idea what they were saying.

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A day that is forever etched in my memory is the day I resigned from my job. I pulled up to go into one of my accounts at a noisy salon and literally could not get out of my car. The thought of walking into that business and not being able to understand what was being said to me over the background noise was overwhelming. My employer was wonderful and tried to place me in a position within the company where I didn’t need to rely as much on my hearing, but I just wasn’t able to continue working.

Because my hearing aids were no longer benefiting me, I was evaluated to see if I was a candidate for a cochlear implant (CI). While I met the criteria for a CI, I was concerned about losing my residual hearing. I felt I would be giving up normal hearing in one level to gain hearing in another. So I chose to wait.

In the following years, I lived between two worlds.

I no longer fit into the normal hearing world because I could not have social conversations in a group or talk on the phone, or hear children's voices at all. 

And I didn't fit into the deaf community because I did have some hearing and I could not understand sign language or lip read very well.

About this time we received some great news. Our daughter was expecting our first grandchild! I was overjoyed to be a “Gammy,” but overwhelmed that I would never hear her little sounds, her cry, her little voice!

This sent me on a desperate search for help. This is when I found information about the EAS (electric-acoustic stimulation) implant from MED-EL. I read everything I could find and had hope again for the first time in many years. This new technology sounded perfect for me because it incorporated cochlear implant technology with an acoustic component. At the time, EAS was still being tested, and I was able to enroll in a clinical trial.

I was implanted with the EAS in 2010, and my granddaughter was born 6 months later. I was there when she was born and HEARD every cry and little sound she made. Today she is a chatty six-year-old that loves to ask me hundreds of questions.  Her favorite question, when I don't answer her quickly enough, is, “Gammy, do you have your ears on?”

Today, because of my EAS, I can say, “I have my ears on and I'm enjoying all the sounds of my new grandson and my very talkative granddaughter.”

EAS implant recipient Sherri Ely, 58, from Charleston, SC, shares her story just in time for Grandparents Day, September 10. A recent survey from MED-EL found that 66% of adults said that a major life event (e.g., marriage, birth of a child/grandchild, health scare) would motivate them to get their hearing checked.

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Small Solution, Large Impact: Updating Hearing Aid Technology

By Apoorva Murarka

For many people, the sound quality and battery life of their devices are often no more than a second thought. But for hearing aid users, these are pivotal factors in being able to interact with the world around them.

One possible way to update existing technology – which has gone unchanged for decades – is small in size but monumental in impact. Apoorva Murarka, a Ph.D. candidate in electrical engineering at MIT, has developed an award-winning microspeaker to improve the functions of devices that emit sound. Murarka sees hearing aids as one of the most important applications of his new technology.

The Current Problem – Feeling the Heat

Most hearing aids have long used a system of coils and magnets to produce sound within the ear canal. These microspeakers use battery power to operate, and lots of it. Valuable battery life is wasted in the form of heat as an electric current works hard to travel through the coil to eventually help produce sound. The more limited a user’s hearing is, the more the speaker must work to produce sound, and ultimately that much more battery is used up. 

As a result, research has shown that many hearing aid users in the United States use about 80 to 120 batteries a year or have to recharge batteries daily. Aside from the anxiety that can accompany the varying dependability of this old technology, the cost of constantly replacing these batteries can quickly add up. 

But battery life is not the only factor to consider. Because the coil and magnet system has not been updated in decades, the quality of sound produced by hearing aid speakers (without additional signal processing) has been just as limited. Even small upgrades in sound quality could make a world of difference for users.

The Future Solution – Going Smaller and Smarter

Apoorva Murarka has invented an alternative to the old coil and magnet system, removing those components completely from the picture. In their stead, he has developed an electrostatic transducer that relies on electrostatic force instead of magnetic force to vibrate the sound-producing diaphragm. This way of producing sound wastes much less energy, meaning significantly longer battery life in hearing aids. Apoorva was recently awarded the $15,000 Lemelson-MIT Student Prize for this groundbreaking development.

The biggest difference? Size. You would need to look closely to even see this microspeaker’s membrane – its thickness is about 1/1,000 the width of a human hair. 

Additionally, the microspeaker’s ultrathin membrane and micro-structured design enhance the quality of sound reproduced in the ear. Power savings due to the microspeaker’s electrostatic drive can be used to optimize other existing features in hearing aids such as noise filtration, directionality, and wireless streaming. This could pave the way for energy-efficient “smart” hearing aids that improve the quality of life for users significantly. 

This invention is being developed further and Apoorva hopes to work with the hard-of-hearing community, relevant organizations and hearing aid companies to understand the needs of users and explore how his invention can be adapted within hearing aids.

You can read more about Apoorva and his invention here

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Telehealth Tools Can Change Your Hearing Care

By Carol Meyers, Au.D.

We continue to benefit from incredible technological advances that assist in the diagnosis and treatment of many health conditions. One rapidly growing technology with the potential to revolutionize hearing care is telehealth, which utilizes telecommunication technologies like smartphone apps to provide virtual healthcare and education services to patients.

Many hearing aid wearers already use apps that serve as remote controls or audio streamers for their hearing aids. As manufacturers develop more ways to leverage smartphone apps, consumers can also expect to change the way they interact with their hearing care professional for the better. Here are some ways telehealth hearing care apps can help you.

Save time and effort.

Nothing will ever completely replace face-to-face interactions with your healthcare providers. However, some issues can be resolved with a brief conversation. Telehealth apps offer text, voice, and even video calls so that you can consult your hearing care professional without making a trip to the office. Furthermore, apps can store useful information, such as care and usage instructions and troubleshooting guides, so you can use them to solve problems at your convenience. This is particularly advantageous if you live in a remote area, cannot take time off work, or have difficulty getting around.

Adjust to wearing new hearing aids.
Getting used to wearing new hearing aids involves actually retraining your brain to process all the sounds that you were missing before amplification. Hearing care apps can assign you simple daily exercises to complete, such as rustle a newspaper or have group conversation during a family meal. These exercises encourage your exposure to a variety of listening situations. As you complete these tasks, you can rate your satisfaction with the experience, which is then transmitted to your hearing care professional.

Let hearing care professional monitor your hearing needs.

Your hearing care professional wants to ensure your satisfaction and success just as much as you want your questions and concerns about your new hearing aids resolved. Your ratings and feedback regarding new listening experiences can be transmitted via the app to your hearing care professional, who can then contact you if necessary.

Have your hearing aids adjusted remotely.

Not only can your hearing care professional interact with you via apps, they can also access your hearing aid settings directly without your needing to visit the office. Based on your feedback (via a text or call) they can adjust your hearing aid settings and send the update through the app to your hearing aids. Once you accept the change, those adjustments take effect so you can try them out immediately.

Finally, telehealth apps are safe. They are secured via end-to-end encryption so that interactions and conversations between you and your hearing care professional remain private. The next time you visit your hearing care professional, ask how a hearing aid telehealth app can help you.

With more than 25 years of clinical practice, Carol Meyers, Au.D., is an educational specialist for Signia responsible for the training and education of staff and hearing care professionals in the U.S. on the company’s products, technology, software, services, and audiology-related topics.

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Celebrating Hearing Innovations

By Frankie Huang

On Feb. 25, Hearing Health Foundation is celebrating International Cochlear Implant Day to raise awareness of this life-changing technology. Cochlear implants greatly enhance the lives of individuals with severe to profound hearing loss and individuals who don’t benefit from the use of hearing aids. Did you know that as of November 2012, there are 324,000 cochlear implants in use worldwide, and that number is growing daily!

Cochlear implants (CI) are electronic medical devices that are implanted via a surgical procedure. Although implants replace the function of the damaged inner ear, it is important to remember that CIs do not restore normal hearing but work by bypassing damaged structures in the inner ear and stimulating the auditory nerve. This sends signals to the brain, allowing the user to perceive sounds.

Researchers found that children 5 years or older with bilateral severe or profound hearing loss who are implanted with CIs have better speech perception and development over time than children treated with hearing aids. In addition, children with profound hearing loss who used CIs showed greater development of preverbal behavior than those using hearing aids.

Other researchers found that children receiving CIs before 24 months of age greatly benefit in terms of their overall language development. Levels of spoken language in children implanted before age 24 months were on par with their typical hearing peers by age 4.5, but those implanted after age 24 months did not “catch up” with hearing peers by age 4.5. It’s important to note the study didn’t evaluate language development or ongoing delays after age 4.5.

HHF is proud to have supported research in the 1970s that led to the development of cochlear implants. Since then the technology has continued to evolve and improve in order to increase the benefits yielded from having a cochlear implant and to reduce risks associated with an invasive surgical procedure. By further improving the design and the function of CIs, researchers may find a way to maximize all the possible benefits for the patient, to preserve residual hearing, and to improve the health of the inner ear.

If you’re interested in funding research related to hearing loss technology,
please consider donating today at hhf.org/donate or contact us at development@hhf.org.

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Real-Time Text: The FCC Makes It Official

By Kathi Mestayer

This will be the standard symbol for real-time text, from the RTT    website   .

This will be the standard symbol for real-time text, from the RTT website.

Have you ever been on a phone call, slowly spelling out the word you just used? And finding out how very similar fifteen and fifty sound? Or how tough it is to communicate a word such as “impingement,” even if you do spell it?

The good news is that the FCC has now enacted the long-awaited transition to providing real-time text (RTT) by cellphone providers. "Real-time text allows characters to be sent as they are created without hitting ‘send,’” according to the Dec. 15, 2016, FCC press release. “This allows text to be sent at the same time as voice communications, permitting a more conversation-friendly service.”

People with hearing loss will now be able to clarify (or receive clarification) of spoken content by quickly texting the word(s) to the other party, without interrupting the ongoing conversation (or hitting “send”).

This action is discussed briefly in Hearing Health’s Winter 2017 issue here (before the official adoption of the rules by FCC had been completed).  

The new FCC rules require large phone carriers to make RTT available by the end of this year. The first phase would require users to download an app, but RTT would eventually be built into phones.  

According to Christian Vogler, the director of Gallaudet University’s Technology Access Program, AT&T worked closely with Gallaudet at various stages of planning for RTT. In one case the testing made it possible to show “how well it held up under network conditions that can be too poor even for voice calls.”

“Too poor for voice calls”—who hasn’t been there? Very soon we’ll have another option. For more information, see the RTT website.

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Your Cell Phone Can Save Your Hearing

By Murray Grossan, M.D.

As a ear, nose, and throat specialist I treat patients with hearing loss and tinnitus. Did you know that by simply by using your smartphone, you can help prevent these hearing conditions?

Loud noises damage the ear. But how loud is too loud? When a guest attends a wedding and sees children seated in front of eight-foot speakers, are the speakers too loud? Your phone knows.

When a parent yells to his teenagers to lower the volume of their music, is it truly too loud? Your phone knows.

There are many smartphone apps available to Apple and Android operating systems. A simple search for the terms “sound meters” or “decibel meters” will bring up  different apps, including many of which are free!

Hearing sounds at 115 decibels for more than 15 minutes can cause permanent hearing loss. With hearing loss you may also develop tinnitus. Chronic tinnitus can be so distracting that it can disrupt daily life, including the loss of sleep.

It is not essential to know all the ins and outs of sound measurement in order to protect your hearing. (For technical details, see the Occupational Safety and Health Administration’s report.) A sound meter is all you need.

Why? It may be hard to realize how loud a sound really is, how close you are to it, and how long you are exposed to it. One person says the sound is too loud; another says it seems fine. A smartphone sound meter can measure the volume level. Recent research by National Institute for Occupational Safety and Health scientists shows the apps’ accuracy is approaching that of professional sound meters. And once you know the danger, you can limit your exposure: Block, walk, and turn.

We know that many older people have hearing loss. But science is not sure if age causes the loss or if it is an accumulation of years of hearing loud noises, just as the cumulative effects of sun exposure are evident decades later. I have an 88-year-old patient with perfect hearing. She never used a noisy lawnmower.

If sound meter use becomes common, and we are all fully aware of the danger of noise exposure, you won’t see children seated in front of giant speakers at a wedding. And I sincerely hope that I will see fewer people at my office because they can’t hear and have tinnitus.

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Conference Calls-Now With Captions

By Kathi Mestayer

That’s right, it’s not a typo! Where I live, Virginia Relay has just announced availability of captions for conference calls. No more worrying about that caller who is always multitasking and talking into their speakerphone from two feet away. Virginia Relay’s new Remote Conference Captioning service provides the captioning free of charge to Virginia residents, who can view the internet-based captions on their laptop during the conference call.

I learned about this new service from Clayton Bowen, the director of Virginia Relay, a program of the Virginia Department for the Deaf and Hard-of-Hearing (VDDHH). Virginia Relay provides communications access to people who are deaf, hard-of-hearing, and deaf-blind, through a number of traditional and high-tech programs.

If you live in Virginia, visit the Virginia Relay website, where there’s also more information on the conference-call captions.

Which other states offer conference-call captioning? So far, it’s just a handful, but these states do:

…and the federal government, for their employees.

To learn more about captioning, read my story on real-time captioning, which benefits from a blend of human input and voice recognition, in the Spring 2016 issue of Hearing Health.

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