Preparing Deaf & HoH Athletes: Assistive Technology & Your Rights

Lexi, a nine-year-old athlete with hearing loss, prepares to bat. Her helmet hides the processors she wears over her ears. Photo by Gina Bailey.

By Jaime Vernon

I knew it would come: the day my daughter, Lexi, faced discrimination in sports related to her hearing loss. A helicopter parent questioned Lexi’s use of a device that allows her to hear on the field—a mask for her real outrage over her child’s strikeout. Awful sounding, right? But it happened to Lexi.

I authored this piece as a blueprint for everyone with hearing loss and deafness. I believe everyone with hearing loss and their family members should know their rights and what to do when something like this happens. And, as always, I want to share the needs and rights of individuals who wear cochlear implants or hearing aids with typical-hearing people.

Lexi Vernon, my nine-year-old daughter, is truly a force to be reckoned with. I'm not saying she's perfect. She is tough to coach. She experiences mental fatigue that sometimes makes her appear "spaced out.” Many times, she can’t hear you during softball practice due to distance or loud noises. She is headstrong and stubborn. However, Lexi is a raw, talented athlete and a fierce competitor. She's strong, tall, and determined. She is a talented basketball player and, more pertinent to her story, a fast pitch softball player.

The coolest part about Lexi's story is that she is 100% deaf. Lexi is a bilateral cochlear implant recipient. She had a surgery in both of her ears in which they implanted a cochlear implant into her cochlea which is located in her inner ear. That implant is also attached to her hearing nerve which sends signals to her brain. Lexi wears processors on the outside of her head (just over her ears) which are the microphones and small computers that send the sound (signals) into the implant. See how a cochlear implant works here.

During athletic games, Lexi needs a small device called a "mini-mic" which is an amplifier for the coach's voice. When she is wearing additional equipment, which can cover her microphones on her processors, or when distance is an issue; this mini-mic allows Lexi to hear her coach better. It’s still not perfect, but it really helps. Learn about a mini-mic device.

This weekend, I had to witness some awful behavior by parents of young athletes. I also had to witness umpires handling it all wrong.

Our team, the Tennessee Bash, of which I’m one of the coaches, was playing in a World Series in Tennessee. We were one of the “teams to beat.” Lexi is a pitcher on the team. During the final game to determine or placement in the Winner’s Bracket, not only did our opponent question Lexi’s assistive technology, but so did the umpires.

I have no problem if anyone asks about her equipment—and I usually disclose it. This tournament, however, only allowed one coach out at pregame, so I didn’t have an opportunity to do so.

The fans started yelling and acting foolishly, thinking I was feeding Lexi information into some mic when they noticed her device. To be honest, I don't even call the pitches. That coach does not wear the mini-mic. She takes the sign from her catcher like everyone else. Then our first base coach uses it when she's up to bat.

The umpire soon raised the questions to our first base coach. Their conversation went like this:

Umpire: “So, is she hearing impaired?”

Coach: “Yes. She is deaf. She was implanted with cochlear implants in both her ears and this mic helps her hear me with all the equipment.”

At that point, it should have been done. Finished. End of conversation.

But no. The umpire wasn’t satisfied. “Can’t she use signs?” she insisted.

Stop. Wait a minute. That is more offensive to us than anything. We fight every day to mainstream Lexi in a spoken language world. Lexi went through five years of intense speech therapy, a special “oral deaf rehab” school and speech tutoring at home three nights a week. She worked hard to be able to hear and speak.

The opposing fans went on about it. Then, an umpire not officiating the game, sitting under a tent, started questioning it. And we’re in the middle of the game! Our coach was trying to coach! Lexi wasn’t even up to bat; she was in the dugout!

Thankfully, Lexi couldn’t hear any of what was going on and Coach Charles took the mini-mic away from his mouth. How would Lexi have felt if she knew half of the people at that game were going on and on about how she shouldn’t be able to use equipment to help her hear?

So, after all the hullabaloo, I went out and spoke to the umpire directly. She seemed satisfied with my explanation. However, the fans didn’t let up. My co-coach handled it sublimely.

So here’s the truth. If our circumstances permit something that stretches our emotions or mind or will, we are supposed to use it. I’m going to use this situation as an example of how to be equipped for this in the future.

Let’s say someone was on the softball team with a prosthetic leg. Do you think anyone would ever be upset that they were playing with their leg on? No, because any human being would be touched by this person’s courage to participate in mainstream athletics!

Simply because you cannot see someone’s hearing loss or deafness doesn’t mean it isn’t something very real and very difficult to overcome. That’s Lexi—and hundreds of thousands just like her. They overcome deafness every single day due to amazing technology, but it isn’t human, natural hearing. They do, at times, require special needs.

Resources

• Laws, Rules, and Regulations: These laws state that people with hearing loss and deafness have the right to an “even playing field” figuratively and literally speaking.

• How to Manage the Use of Assistive Technology in Athletics

Whatever you do, prepare yourself or your child for this possible scenario. Remind them that people can be ugly many times and to simply ignore it. Remind them that there are also incredible human beings in this world that fight for these laws to exist, so let’s focus on the fact that they can hear, use spoken language and play sports like every hearing person!

Jaime Vernon is the Founder and CEO of Songs for Sound, a nonprofit organization focused on hearing healthcare and inclusion opportunities for those with hearing loss. This story was republished with her permission. For more on her daughter Lexi Vernon’s cochlear implant story, visit Songs for Sound’s Mission & History page.

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.

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.

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.

Welcome to HHF's New Website!

By Nadine Dehgan, CEO, Hearing Health Foundation

Hearing Health Foundation (HHF) proudly introduced a new website today, August 2. The contemporary design features an engaging storytelling format, clear calls to action, and mobile responsiveness, all of which will enable HHF to better serve and communicate with constituents.

Take a look around to familiarize yourself with HHF’s new virtual headquarters. Below are the site’s most exciting improvements:

Simplified Navigation Bar
We reduced our primary navigation bar to just six categories inspired by user analytics from our old website. Choose from About, How to Help, Research, News, Resources, and Hearing Loss. Between the home page and these six key sections, you will find everything you need.

Streamlined Donation & Partnership Hub
How to Help lists every single action that you can take to advance cures and treatments for hearing loss, tinnitus, and related conditions. The options shown here apply to both individual contributors and corporate partners.

Mobile-Friendliness
Did you ever visit the old HearingHealthFoundation.org on your cell phone? If you did, you probably quickly abandoned the page, frustrated by small text and the need to zoom in and out. Our new website fits perfectly on your smartphone or tablet. Try it!

Consolidation of Research Programs
The Research page provides information on our programs, Emerging Research Grants (ERG), Hearing Restoration Project (RFP), and, the newest, Ménière's Disease Grants (MRG), to keep you informed of our critical investigative work. The reorganization of the Research Programs will also more efficiently attract talented scientists who are researching cures and treatments.

Centralized E-Newsletter and Hearing Health Magazine Registration
Subscribing to HHF is no longer a two-step process. Conveniently opt into to our e-newsletter and free print magazine with fewer clicks on the Subscribe page. The modification will increase viewership and, therefore, hearing health awareness.

More Social Sharing Options
Share useful educational resources or inspiring blog posts with your friends and family seamlessly. Every page includes a sharing sidebar from which you can quickly send information through social media or email.

Ad Space
The new website is more customizable than the previous, allowing for greater advertising capacity. As a result, more organizations will be able to contribute to HHF’s life-changing research and education programs and show commitment to the many Americans with hearing loss, tinnitus, and related conditions.

We welcome your feedback about the new website in the comments section.

Early Detection Improved Vocabulary Scores in Kids with Hearing Loss

By Molly Walker

Children with hearing loss in both ears had improved vocabulary skills if they met all of the Early Hearing Detection and Intervention guidelines, a small cross-sectional study found.

Those children with bilateral hearing loss who met all three components of the Early Hearing Detection and Intervention guidelines (hearing screening by 1 month, diagnosis of hearing loss by 3 months and intervention by 6 months) had significantly higher vocabulary quotients, reported Christine Yoshinaga-Itano, PhD, of the University of Colorado Boulder, writing in Pediatrics.

The authors added that recent research reported better language outcomes for children born in areas of the country during years where universal newborn hearing screening programs were implemented, and that these children also experienced long-term benefits in reading ability. The authors said that studies in the U.S. also reported better language outcomes for children whose hearing loss was identified early, who received hearing aids earlier or who began intervention services earlier. But those studies were limited in geographic scope or contained outdated definitions of "early" hearing loss.

"To date, no studies have reported vocabulary or other language outcomes of children meeting all three components of the [Early Hearing Detection and Intervention] guidelines," they wrote.

Researchers examined a cohort of 448 children with bilateral prelingual hearing loss between 8 and 39 months of age (mean 25.3 months), who participated in the National Early Childhood Assessment Project -- a large multistate study. About 80% of children had no additional disabilities that interfered with their language capabilities, while over half of the children with additional disabilities reported cognitive impairment. Expressive vocabulary was measured with the MacArthur-Bates Communicative Development Inventories.

While meeting all three components of the Early Hearing Detection and Intervention guidelines was a primary variable, the authors identified five other independent predictor variables into the analysis:

• Chronological age

• Disability status

• Mother's level of education

• Degree of loss

• Adult who is deaf/hard of hearing

They wrote that the overall model was significantly predictive, with the combination of the six factors explaining 41% of the variance in vocabulary outcomes. Higher vocabulary quotients were predicted by higher maternal levels of education, lesser degrees of hearing loss and the presence of a parent who was deaf/or hard of hearing, in addition to the absence of additional disabilities, the authors said. But even after controlling for these factors, meeting all three components of the Early Hearing Detection and Intervention guidelines had "a meaningful impact" on vocabulary outcomes.

The authors also said that mean vocabulary quotients decreased as a child's chronological age increased, and this gap was greater for older children. They argued that this complements previous findings, where children with hearing loss fail to acquire vocabulary at the pace of hearing children.

Overall, the mean vocabulary quotient was 74.4. For children without disabilities, the mean vocabulary quotient was 77.6, and for those with additional disabilities, it was 59.8.

Even those children without additional disabilities who met the guidelines had a mean vocabulary quotient of 82, which the authors noted was "considerably less" than the expected mean of 100. They added that 37% of this subgroup had vocabulary quotients below the 10th percentile (<75).

"Although this percentage is substantially better than for those who did not meet [Early Hearing Detection and Intervention] guidelines ... it points to the importance of identifying additional factors that may lead to improved vocabulary outcomes," they wrote.

Limitations to the study included that only expressive vocabulary was examined and the authors recommended that future studies consider additional language components. Other limitations included that disability status was determined by parent, with the potential for misclassification.

The authors said that the results of their study emphasize the importance of pediatricians and other medical professionals to help identify children with hearing loss at a younger age, adding that "only one-half to two-thirds of children met the guidelines" across participating states.

This article was republished with permission from MedPageToday. 

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. 

More People = Less Noise?

By Kathi Mestayer

Beautiful, open, echoey space.

In the summer, attendance at our church falls noticeably as people go on vacation and spend weekend mornings doing other seasonal things, like birdwatching. After the service on a recent Sunday, we all headed out of the sanctuary, toward the atrium. Normally, this is a time when it’s really difficult for me to talk with anyone because of the reverberant nature of our building. It’s an architectural masterpiece and wonderful for music—and an acoustical nightmare, at least for speech comprehension.

To be fair, our church is not the only one with a large, open worship space where sound bounces around for what can seem like…. forever.  It’s actually becoming more common; when churches get bigger, sound challenges follow. As the authors of a research paper on the topic point out, “We are witnessing a paradigm shift from small church enclosures to very large church auditoriums.  Most of these auditoriums fall short of providing good sound quality and… sooner or later it becomes a very serious problem because such buildings are places for communication to an audience.…”

So, I’ve gotten used to the reverberation, and just try to avoid conversation until we’re out of the sanctuary. That summer day, however, as I worked my way toward the exit, I noticed that the noise level was significantly louder than usual. “That’s weird,” I thought, "fewer people, but more noise?” I checked with a couple of friends, and they had also noticed that the noise level seemed much higher than usual. So it wasn’t just me.

When I got home, I told my (physicist) husband about it, and he asked me how many people were at the service. I said, "Way fewer, less than half the usual number…probably vacations.” He replied, "Oh, that’s probably why it was noisier. People absorb sound.” But at such a noticeable level?

Ask an Acoustician

In search of a second opinion, I contacted Rich Peppin, the president of Engineers for Change, a nonprofit acoustics and vibrations consulting firm. Rich had helped me with a Hearing Health article, “Caution: Noise at Work,” so I knew he’d have the answer. I posited our working hypothesis in my email to him: that a reverberant space would be noticeably noisier if there are fewer people in it.

Rich replied: “Yes. Because people absorb sound and hence reduce reflections. We can calculate the reduction of reverberation if we know before and after numbers of people.” Now, we’re getting somewhere.

The calculations Rich was talking about are based, in part, on how much sound humans absorb. In addition to the sound absorption by human bodies, there are other variables that impact reverberation, such as: what the people are wearing, whether they are sitting or standing, whether there are padded seats in the room, and the size and shape of the room.

In my church example, however, most of the major variables were unchanged between winter and summer: lightly padded seats with metal frames; hard floor, walls, and ceiling; and no drapes. And everyone was standing up, walking out to the atrium, where conversation is a little more possible.

So, how much sound can people absorb? The study Rich shared with me had the results of controlled tests of sound absorption with different numbers of people (zero, one, two, three). The results varied widely for different frequencies (more sound absorption per added person at the higher frequencies tested).  

Human speech, however, was the source of the sound in our church sanctuary, and its frequencies range from an average of 125 Hz (for males) to 200 Hz (for females).  

And the result? Sound absorption increased by about 5 to 20 percent (depending on the frequency) with each person added to the test chamber.

Even though I didn’t know the exact numbers of people at my church, it was a big difference between the winter months, when it’s close to full, and that summer day, with its small attendance.  I estimate at least 75 fewer people. So it was not so surprising that the sanctuary was noisier the day that I, and a few others, noticed it. The bottom line? My husband was right—again. Oh, me of little faith!

Kathi Mestayer is a staff writer for Hearing Health magazine.

An Animal Behavioral Model of Loudness Hyperacusis

By Kelly Radziwon, Ph.D., and Richard Salvi, Ph.D.

One of the defining features of hyperacusis is reduced sound level tolerance; individuals with “loudness hyperacusis” experience everyday sound volumes as uncomfortably loud and potentially painful. Given that loudness perception is a key behavioral correlate of hyperacusis, our lab at the University at Buffalo has developed a rat behavioral model of loudness estimation utilizing a reaction time paradigm. In this model, the rats were trained to remove their noses from a hole whenever a sound was heard. This task is similar to asking a human listener to raise his/her hand when a sound is played (the rats receive food rewards upon correctly detecting the sound).
 

FIGURE: Reaction time-Intensity functions for broadband noise bursts for 7 rats.

The rats are significantly faster following high-dose (300 mg/kg) salicylate administration (left panel; red squares) for moderate and high level sounds, indicative of temporary loudness hyperacusis. The rats showed no behavioral effect following low-dose (50 mg/kg) salicylate.

By establishing this trained behavioral response, we measured reaction time, or how fast the animal responds to a variety of sounds of varying intensities. Previous studies have established that the more intense a sound is, the faster a listener will respond to it. As a result, we thought having hyperacusis would influence reaction time due to an enhanced sensitivity to sound.

In our recent paper published in Hearing Research, we tested the hypothesis that high-dose sodium salicylate, the active ingredient in aspirin, can induce hyperacusis-like changes in rats trained in our behavioral paradigm. High-dose aspirin has long been known to induce temporary hearing loss and acute tinnitus in both humans and animals, and it has served as an extremely useful model to investigate the neural and biological mechanisms underlying tinnitus and hearing loss. Therefore, if the rats’ responses to sound are faster than they typically were following salicylate administration, then we will have developed a relevant animal model of loudness hyperacusis.

Although prior hyperacusis research utilizing salicylate has demonstrated that high-dose sodium salicylate induced hyperacusis-like behavior, the effect of dosage and the stimulus frequency were not considered. We wanted to determine how the dosage of salicylate as well as the frequency of the tone bursts affected reaction time.

We found that salicylate caused a reduction in behavioral reaction time in a dose-dependent manner and across a range of stimulus frequencies, suggesting that both our behavioral paradigm and the salicylate model are useful tools in the broader study of hyperacusis. In addition, our behavioral results appear highly correlated with the physiological changes in the auditory system shown in earlier studies following both salicylate treatment and noise exposure, which points to a common neural mechanism in the generation of hyperacusis.

Although people with hyperacusis rarely attribute their hyperacusis to aspirin, the use of the salicylate model of hyperacusis in animals provides the necessary groundwork for future studies of noise-induced hyperacusis and loudness intolerance.


Kelly Radziwon, Ph.D., is a 2015 Emerging Research Grants recipient. Her grant was generously funded by Hyperacusis Research Ltd. Learn more about Radziwon and her work in “Meet the Researcher.”

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Turning Fourth of July Into a Science Lesson

By Kelly N. Barahona

In most cities if not towns of a certain size in the U.S., a grand display of fireworks for the Fourth of July is part of the celebration of America’s birthday. But just how loud are the fireworks people have come to expect every summer? Unfortunately fireworks can measure from 140 to as high as 165 decibels, easily a hearing-damaging event if you are sitting too close.

This doesn’t mean you can’t enjoy the festivities. With the abundance of decibel-reading apps for smartphones it’s easier than ever before to learn how much noise is in the world around us. Most apps use the smartphone’s microphone to give a reading of the decibel level. As with a professional-grade meter, most apps can also show how the noise fluctuates over time, in real time, and provide numerical reference points that users can compare to their own sound levels. Some apps even let you geo-tag the decibel level to a specific location, like your local coffee shop or favorite restaurant.

Parents, camp counselors, and teachers can turn the Fourth of July into a science lesson. On the night of the fireworks show, Hearing Health Foundation recommends staying at least one block away from where the fireworks are being displayed and using a smartphone app to measure the decibel level.

If you want to be closer to the action, protect your hearing by using foam earplugs or over-the-ear earmuffs for the youngest children. A fun but loud activity like this can be a good segue for conversations about how listening to music at too loud a volume and participating in noisy recreational activities may be harmful, as well as how to incorporate better hearing health practices in your daily life.

Fourth of July should be a time of fun and enjoyment, but as with anything, it is necessary to take precautions to make the holiday safe as well. Teach your loved ones about the noises and sounds around them to hopefully encourage everyone to take active measures to protect their hearing on a regular basis. Remember, noise is the most preventable cause of hearing loss.

Some 1 Like You

By Makayla Allison

Our 6-year-old daughter, Lily, was recently diagnosed with Ehlers Danlos Hypermobility (EDS-HT). We received this diagnosis only after she acquired more than three dozen symptoms and diagnoses of uncertain significance, ranging from global joint pain and muscle weakness to tinnitus, and over the course of nearly five years.

It was a long and isolating time for our family as we tried to figure out what was going on. We so badly wanted to connect with someone who understood what our little one was going through, and when I asked Lily’s specialists if they could connect us with anyone, the answer was never yes due to privacy laws. Without a diagnosis it is nearly impossible to find groups of people in the same situation to talk to. And it can be even more frightening when the uniqueness of your symptoms isolates you even more.

The discovery of how Lily’s condition affected her hearing was both transparent and innocent. When Lily was 4 years old she asked me if the invisible bumblebees were going to sting her. She was so confused why she couldn’t see the bees that buzzed around her ears. It was shortly after she was referred to an ENT that we learned about tinnitus and that the sounds she hears come from inside her head.

Our daughter had a big desire to find a friend like her, but looking for someone else experiencing the same health challenges online, without posting them in great detail, was proving to be an impossible task. Her dreams inspired us to create Some 1 Like You (S1LY), an organization that connects people privately based on whatever health conditions they are experiencing, regardless of whether or not they’ve received a diagnosis.

According to the documentary film Undiagnosed: Medical Refugees, “The total number of undiagnosed patients is unknown but considered to be vast.... It takes an average of 7.6 years in the U.S. to uncover a rare disease diagnosis. Worldwide there are an estimated 350 million people living with a rare disease; add to [that number] patients still waiting for a diagnosis, patients who have been misdiagnosed, and adults and children who have diseases not yet named or recognized. Being ‘undiagnosed’ is not commonly considered to be an identity, but it should be. Helping people who are ill to feel that others are supporting and advocating for them, and know that they exist, can make all the difference in the world.”

Our mission for S1LY is to privately connect people across symptoms and diagnoses to empower the individuals facing these complex challenges. S1LY is unique because we can perform that search for people, while also keeping their health information private: To make these matches we take only their email address, as well as the health qualities, or groups of qualities they possess and are looking for in someone else.

Once a match is made, the email addresses of those members are shared with each other, and communication is then done only between members. It is our hope that this vast sharing of knowledge and resources among patients will make its way back to physicians and impact treatments as a whole across diseases.

S1LY has developed a Gifted Membership program to cover the lifetime membership fee to Some 1 Like You for constituents of qualifying organizations. 100 gifted memberships have been donated to the Hearing Health Foundation community. The first 100 people to submit their Connect Contact Forms to S1LY with the code “HHF100” will receive lifetime memberships to privately connect with Some 1 Like You members.

If you would like to explore gifted memberships for your patients or members at no cost, please email Makayla at gifted@some1likeyou.com. A portion of the proceeds of every S1LY membership goes to funding research on Ehlers Danlos Syndromes.