Resources

How to Buy Hearing Aids

By Barbara Jenkins, Au.D., BCABA

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A friend’s mother needs hearing aids. She has a daughter in the hearing industry, she has insurance to cover hearing aids, she holds a Ph.D. in molecular biology, and she is still overwhelmed and confused by where to go, what the options are, and what is best for her.

Sound familiar? There is so much information—and disinformation—available about hearing aids that even some physicians are confused.

As with any big purchase, selecting a hearing aid can be difficult and confusing if you don’t have the right information or know the correct questions to ask. Bring a copy of this checklist with you on your next appointment, and feel confident in your decision to improve your life through better hearing.

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Hearing Healthcare Checklist

1. Where do I go for a hearing test?

Most hearing loss (up to 90 percent) is a result of non-medically treatable issues. But that means as many as one in 10 people will have a medical issue associated with their hearing loss. If this is your first hearing evaluation it would be prudent to see your primary care doctor first, then be referred to a specialist for a diagnostic audiogram (hearing evaluation).

Audiologists have a minimum of seven years of university training (master’s or doctorate level). Hearing instrument specialists can perform hearing tests but do not have the medical training to rule out medical issues—causes for hearing loss such as syndromes, Ménière’s disease, Usher Syndrome, sudden-onset, genetics, ototoxic drugs, etc.

If you know that there is no medically treatable issue associated with your hearing loss, either type of provider should be fine. If you’re in doubt, ask your physician which professional they recommend. They might refer you to an ENT (ear, nose, and throat specialist, or otolaryngologist).

2. Where do I buy my hearing aids?

Typically, once an audiologist or hearing instrument specialist has evaluated your hearing, you should be able to purchase your hearing aids from them. Requirements differ by state, but generally speaking the professional is trained in hearing aid selection, fitting, and care.

Make sure you are comfortable with the quality of care and the options offered by the provider. If only one brand of hearing aid is available, that’s a red flag. Be sure your provider offers a range of choices, in all styles and at all price points.

You can also opt to get a second opinion. This will give you additional provider choices, so you can go with the person with whom you feel most comfortable. After all, you will be starting a relationship that may last for years.

3. What style of hearing aid is best for me?

A hearing aid’s style (shape and configuration) is determined by the severity of hearing loss, manual dexterity and vision ability, comfort, and/or cosmetic appeal. Whether you get a larger, behind-the-ear hearing aid, or one that is nearly invisible in the ear canal, the cost is roughly the same. Discuss options with your provider and ask about the benefits and drawbacks to each type of device. Here is a brief overview of hearing aid styles, categorized from a larger size to smaller:

Behind-the-ear (BTE); receiver-in-canal (RIC) (also known as receiver-in-the-ear, RITE): These are currently the most popular due to durability, comfort, and cosmetic appeal. They may be a bit more difficult to put in the ears at first, but since less of the circuitry is inside the ear, they usually offer more natural sound. Also, RICs can be discreet, with only the speaker wire visible at the top of the outer ear.

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In-the-ear (ITE); in-the-canal (ITC): This category is among the best for ease of use. Just one piece goes into the ear, with a portion of the device visible outside the ear. Many people like ITEs because they are easy to insert into the ear, and the battery
life is better than that of their smaller, ITC cousins.

Completely-in-the-canal (CIC); invisible-in-the-canal (IIC): These typically fit deeper into the ear and are a very good choice for people who wear helmets or use stethoscopes. Since they are deep in the canal (making them less visible), the most common complaint is that they may not feel as comfortable as the BTE styles, and depending on usage you must change the batteries once or twice a week. (BTEs and RICs often use larger batteries for more power, and last longer.)

4. Which fidelity level is best for me?

Once you have chosen your preferred style of device, you must choose the fidelity (technology) level of the computer chip in the hearing aid. This is where the cost differences in hearing aids become apparent.

Most manufacturers have three levels of fidelity in their newest hearing aids as well as in their economy-priced models. The higher the level of technology, the better and faster the hearing aid can separate noise from speech. This means the speech and sound information passed to your brain is more accurate. Every level will help one-on-one conversations in quiet environments; the more advanced chips will boost clarity and noise reduction even more effectively. In most cases, get the best hearing aid you can afford, but don’t feel pressured into a decision. Take advantage of the 30- to 60-day trial period that is required in most states (in some cases paying a small fee to return the devices).

5. What other special functions do I need for better hearing?

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In the past few years, new features have emerged that have dramatically changed how we can interact with hearing aids.  

Rechargeable batteries: Rechargeable hearing aids are now available, requiring changing the battery only once every one to three years. These devices are recharged by placing the entire hearing aid unit on its charging dock. Not having to frequently manipulate the battery door is very helpful if you have vision or dexterity issues or if you tend to forget your batteries.

Almost waterproof hearing aids: There are now hearing aids that are so waterproof they actually dry themselves when they get wet. They are also dust- and shock-resistant. These are great for people who frequently spend time outdoors or who just perspire a lot. While it is not recommended swimming with them, these devices should survive taking a shower if you forget to take them out.

Bluetooth-enabled hearing aids: Many manufacturers now give you the ability to adjust your hearing aids with your smartphone, using Bluetooth wireless connectivity. You may even be able to stream sound directly to your hearing aids without the use of an additional device like a neck loop. If you’re tech-savvy, this may be for you.

Once you’ve gone through the items in this checklist, I hope you feel more confident about making decisions and improving your hearing.

Staff writer Barbara Jenkins, Au.D., BCABA, serves as Colorado’s professional state commissioner for people with hearing loss and was awarded the 2010 Leo Doerfler Award for Clinical Excellence by the Academy of Doctors of Audiology. Her office, Advanced Audiology, won the Most Humanitarian Hearing Care Office Award at the 2015 Signia Aspire Conference. For more, see advancedaudiology.com. This article also appeared in the Fall 2017 issue of Hearing Health.

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

 
 
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FCC Announces Intent to Automate Phone Captions

By Kathi Mestayer

The Federal Communications Commission (FCC) recently announced in the Federal Register that it intends to allow telephone captions (IPCTS) to be 100 percent provided by automated speech-recognition (ASR) software. I wrote about how it's done currently by a human/software "team."

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The change would save money by making the role of the human captioning assistants optional. But nobody knows what the effect would be on caption quality, as there are no current standards for accuracy or delay in telephone captioning provided under the Americans with Disabilities Act, and regulated by the FCC.

Underscoring that issue is the letter posted by a group of consumer groups, which states:

"The Commission is putting the cart before the horse by allowing ASR-based IP CTS services without developing standards and metrics for the provision of IP CTS to ensure that consumers receive robust service from all providers, regardless of the underlying technologies used to provide the service. Inaccurate and unreliable IP CTS service stand to substantially harm consumers who rely on them for communications with family, friends, employers, and commercial transactions and lack the means to qualitatively compare services in advance."

That document, available online, was filed by the Hearing Loss Association of America, Telecommunications for the Deaf and Hard of Hearing, Inc., National Association of the Deaf, and Gallaudet University’s Rehabilitation Engineering Research Center on Technology for the Deaf and Hard of Hearing.

The public comment period for this proposed change is open until Sept. 17, 2018. You can submit a formal comment at the top of the page in the Federal Register that announces the proposal.

Kathi Mestayer is a Hearing Health magazine staff writer.

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How Nutrition Affects Our Hearing

By Meagan Rowley

Nutrition is fundamental to health, but seldom does one learn about the relationship between diet and the auditory system. Nutrition and hearing ability are, in fact, connected.

There is no specific food that will definitely cause or prevent hearing loss. Likewise, lost hearing cannot be restored through a diet change. However, new research suggests that certain nutrition patterns may actually decrease—or increase—your risk of developing hearing loss.

A 22-Year Diet Study

A Brigham and Women’s Hospital study monitored the hearing health of more than 70,000 women on various diets for 22 years. These diets included the Alternate Mediterranean Diet (AMED), Dietary Approaches to Shop Hypertension (DASH), and Alternative Healthy Eating Index-2010 (AHEI-2010). These diets favor fruits, vegetables, seeds, nuts, legumes, whole grains, seafood, poultry, and low-fat dairy. All three also advise limiting foods that are high in sodium (salt) and LDL (low-density lipoprotein) cholesterol, discouraging consumption of refined and red meats, processed foods, and sugary drinks.

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Women following diets similar to the AHEI-2010, DASH, and AMED decreased their likelihoods of hearing loss by at least 30 percent, with DASH and AMED showing the greatest benefits. The researchers found that diets that prioritize fruits and vegetables with minerals like folic acid, potassium, and zinc decreased the risk of hearing loss.

Beneficial Nutrients

Other findings indicate that certain nutrients are associated with positive hearing health outcomes. Potassium—a mineral found in bananas, potatoes, and black beans—plays a large role in the way that the inner ear functions and converts sounds into signals for the brain to interpret. Regular intake can help you maintain your current level of hearing, says Sherif F. Tadros, M.D., of the International Center for Hearing and Speech Research in a Europe PubMed Central published study.

George E. Shambaugh, Jr., M.D., of the Shambaugh Hearing and Allergy Institute reports that the zinc in almonds, cashews, and dark chocolate can be an effective treatment for tinnitus, hearing ringing or buzzing without an external sound source. Magnesium is believed to combat free radicals emitted during loud noises and act as a barrier protecting inner ear hair cells.

Folic acid has also been shown to possibly slow the onset of hearing loss. Blood flow is restricted by homocysteine (an amino acid), so folic acid works to metabolize it to keep blow flow regulated. According to Jane Durga, Ph.D., of the Nestlé Research Center in Lausanne, Switzerland, because the inner ear relies on a regular flow of blood, folate is extremely important. Foods high in folic acid include spinach, broccoli, and asparagus.

Adverse Effects of Malnutrition

Conversely, malnutrition negatively affects the human body. In an examination of 2,193 participants ages 16 to 23, Susan D. Emmett, M.D., and colleagues found that malnutrition not only stunts anatomical development in children, but slows inner ear development. Malnourished children were observed as being twice as a likely to develop hearing loss as young adults compared to their well-nourished peers.

Further, the study acknowledges that that stunting often begins before birth. A malnourished woman who is pregnant or nursing is likely to pass on any deficiency she may have to her child. Hindered inner ear development in utero caused by malnutrition contributes to a higher risk of hearing loss than does malnutrition in vivo.

Diabetes Connection

Individuals with type II diabetes also are more likely to develop hearing loss than their nondiabetic counterparts, according to an National Institutes of Health-funded project by researcher Chika Horikawa, Ph.D., of Japan’s Niigata University. Subjects with prediabetes—those who have elevated blood sugar levels but not elevated enough for a diagnosis of diabetes—also have a 30 percent increased risk The study authors attribute the higher risk to damaged nerves and blood vessels of the inner ear, a consequence of having type II diabetes for an extended period of time.

Though rarely acknowledged, diet has a lot to do with the auditory system. Adding just a few foods to your daily diet and paying attention to the nutrients that your diet is missing may significantly impact hearing over the long term.

As an aspiring doctor currently studying nutrition during my undergraduate years, I understand how important it is to look at an individual's state of health from different angles and perspectives. Nutrition is vital to every aspect of health.

An HHF summer intern, Meagan Rowley is a senior on the pre-medicine track studying human nutrition at Case Western Reserve University in Cleveland.

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

 
 
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ReSound HearSay: Be The Voice of Hearing

By Tom Woods

"A journey of a thousand miles begins with a single step.” For many individuals who know—or suspect—they have a hearing loss, the first step in their journey to better hearing can prove difficult.

It took more than two years for Francine Murphy of Peoria, Arizona to take action. She says, “I was in denial and I was concerned that it would not help, especially if the sound quality was poor. Start with acknowledging that there may be an issue and start with your family doctor. The best resource I found was my audiologist.”

ReSound hearing aid user Francine Murphy.

ReSound hearing aid user Francine Murphy.

Francine is clearly not alone. For many, the delay is due to uncertainty, apprehension, and lots of questions. In the U.S. alone, more than 25 million people who could benefit from hearing aids have yet to take that first step. 

We believe that hearing is fundamental to life. When it starts to decline, it’s imperative that everyone understands, and has access to, the best hearing technology.

That’s why we created ReSound HearSay, an online resource that gives people who are successfully managing their hearing loss an opportunity to lend their voice to educate and inspire others to seek care.

We think that peer-to-peer information sharing is critical in this learning process.

“Get your hearing tested now,” urges John Chynoweth from Orlando, Florida. “Determine exactly what your hearing is like now (get a baseline). Work with a hearing specialist to determine the environments where you struggle to hear. Try different types of hearing aids to find the right ones for you.”

I’m reaching out to readers of this blog to share their hearing journey. Just like Francine and John, you can help those who are just starting to realize hearing loss or considering a hearing aid, and may be hesitant or unsure where to start.

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Through posts, you’ll encourage others into action by addressing common concerns and questions, giving them practical advice to help navigate the process, from diagnosis to hearing aids. And you’ll help them understand the important role of the hearing care professional.

Be the “Voice of Hearing” and help others on the path to better hearing. Please take time today to visit ReSoundHearSay.com to share your insights and experience.

Tom Woods is President, ReSound North America.

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How One Institution is Changing South Africa’s Approach to Pediatric Hearing Loss

By Vicky Chan

Carel du Toit Center (CDT) has been at the forefront of hearing loss education for the past 45 years—offering a mainstream education and speech development programs for children aging from infancy to 10 years old in Cape Town, South Africa. Although an estimated 6,000 babies are diagnosed annually with permanent bilateral hearing loss in the country, early detection and intervention programs are extremely uncommon. CDT is one of the only institutions in the area that offers an early intervention program for children with hearing loss and their parents.

A young student with hearing loss. Credit:    Carel du Toit   .

A young student with hearing loss. Credit: Carel du Toit.

Because the damaging effects of hearing loss are widely dismissed by South African legislation, 72% of the nation’s hospitals do not offer any form of hearing tests and fewer than 1% plan to implement newborn hearing screenings. Consequently, 90% of newborns do not have access to a hearing test and families do not receive information about pediatric hearing loss.

Hearing loss is usually detected only after the child’s caregiver notices unusual behavior or speech and language delays. The average age of diagnosis for a child with hearing loss in South Africa is 31 months old, and the typical age at which one is first fitted with hearing aids is 39 months. This is well beyond the critical time period for a child's speech and language development, which depends immensely on the brain’s responses to hearing in the first two years of life.

To help parents understand their child’s hearing loss, the school provides a family-centered early intervention program in their CHAT (Children Hear And Talk) Centre. Coaching families about how to cope with hearing loss is a key component in teaching a child to talk. Parents are encouraged to attend weekly sessions at the CHAT Centre where they are taught to incorporate speech into their family’s daily routine so their child can continue to develop language and social skills at home. The CHAT also provides weekly sessions for children who are too young for school so they can be enrolled in an early intervention program as soon as possible.

“This is your journey with your child and you are absolutely equipped to teach your child to talk through listening,” one teacher says of CHAT. “It may not have been what you were expecting—but embrace it.”

The school employs more than 60 staff, including teachers, early interventionists, social workers, audiologists, psychologists, and speech therapists, who strive to create a natural environment that promotes listening experiences and intensive speech training. Students are fitted with the appropriate hearing technology and learn with the support of the school staff and their parents.

“I had a passion for special needs children and ended up in deaf education,” reflects an CDT educator. Echoing this sentiment, another teacher comments, “Teaching a child a new word or concept everyday makes it very rewarding. You are changing their lives on a daily basis.”

CDT understands that early diagnosis and intervention is the cornerstone for obtaining the best outcome for infants with hearing loss, which is why the center also partners with social services and South Africa’s State Health Department to provide equipment and personnel to test high-risk babies in the largest hospital in West Cape. With a mission to ensure all children in South Africa can function optimally in a hearing world, CDT is making strides to change outcomes for those with hearing loss nationwide.

For more, visit http://careldutoit.co.za/.

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Hearing Better Through the Ages

By Rebecca Huzzy, Au.D.

Chances are, you visit your doctor for an annual physical, wear a seatbelt, and use sunscreen. These are just a few small efforts we regularly make to stay healthy and injury-free.

Tending to the health of our hearing is another important, simple way we can maintain our overall physical and emotional well-being. Supporting hearing health begins at birth, when we test newborns for hearing loss, and continues into our elder years, when assistive technology can vastly improve overall health and quality of life.

Diagnosing Newborns & Infants

According to the Centers for Disease Control and Prevention, hearing loss is one of the most common congenital conditions, impacting approximately 12,000 infants per year. About half of these cases are linked to certain genetic syndromes, such as Down syndrome, Treacher Collins, and Usher syndrome.

But with the advent of universal newborn hearing screening programs in the early 1990s, hearing loss can now be identified and treated very early. According to what we call the “1-3-6” EHDI (Early Hearing Detection and Intervention) national goals, infants should be screened by age 1 month; diagnosed by age 3 months; and in an early intervention program by age 6 months.

“The effects of providing acoustic stimulation to the immature neurological system, including the brain, and combining the input with a rich and meaningful environmental experience, allows children to develop sufficient auditory skills to learn spoken language at a very young age,” says Janice C. Gatty, Ed.D., the director of Child & Family Services at Clarke Schools for Hearing and Speech.

This means families should expose their infants to sound frequently and consistently—talking to them, naming objects, narrating actions, singing, and reading books. With access to sound and an early intervention program at this young age, a child with hearing loss can begin learning to listen, babble, and eventually talk.

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Common Risks for Adolescents & Teens

Since the prevailing cause of hearing loss in young people with typical hearing is noise exposure, we need to educate kids early, as many begin listening to music on personal devices, playing in bands, and attending concerts at a young age.

According to the American Speech-Language-Hearing Association, exposure to sound that is higher than 85 decibels (the volume of a blender, hair dryer, or siren) for an extended period of time can cause permanent hearing damage. And the maximum output of most MP3 players is a powerful 110 decibels!

Fortunately, there are options for volume-limiting software that can mitigate unhealthy sound levels. Many devices offer parental controls and volume-controlling apps that limit noise levels, and there are various kid-friendly, hearing-healthy headphones available.

Follow the 80/90 rule: Set the maximum headphone volume to be 80 percent (not 100 percent), and listen for up to 90 minutes daily. If you listen for longer, lower the volume even more.

How Sound Exposure Catches Up With Us in Middle Age

“Adult onset hearing loss typically progresses slowly over the course of a number of years,” says audiologist John Mazzeo, Au.D., the audiology supervisor at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.

Noise-induced hearing loss (NIHL) can have a sneaky, cumulative effect, similar to the impact of years of exposure to the sun. The people at the highest risk for NIHL work in noisy professions and include musicians, farmers, dentists, airport workers, and military service members. For those who spend time in loud environments, wearing hearing protection is the best way to guard against NIHL.

Ototoxic drugs (drugs harmful to hearing) and certain conditions, such as Ménière’s disease, can also contribute to progressive hearing loss over time. Regular screenings, prior to the recommended age of 50, are especially important if hearing loss runs in the family, or if you have symptoms associated with hearing loss, such as tinnitus, dizziness, or a perceived decrease in hearing.

Caring for Seniors as Hearing Abilities Change

Hearing loss becomes much more prevalent with age, affecting more than 30 percent of people over age 65, and 80 percent of adults over 80.

Hearing loss in seniors is linked to serious health conditions, including dementia. When communication is difficult, many people will avoid social situations, and research shows that social isolation is linked to cognitive decline, a key symptom of dementia. Additionally, difficulty hearing can impact the effectiveness of our other neural processes.

The risk of falls also becomes more likely with age, due to both decreased spatial awareness and increased cognitive load. A 2012 Johns Hopkins study found that older adults with mild hearing loss were nearly three times more likely to have a history of falling.

Staying Fit

If you’re diagnosed with a hearing loss, remember: Hearing loss is not only very common, it’s also very treatable! A licensed audiologist or hearing healthcare professional can discuss options with you, including hearing aids and assistive listening devices.

When it’s a loved one struggling to hear, or being stubborn about getting help, be patient. Gain their attention before talking, rephrase sentences instead of repeating them, and encourage trying out some kind of amplification.

Think of your hearing health as essential to your body’s complete performance. Our bodily systems are all interconnected; neglecting to protect our ears or refusing helpful interventions can have cascading health effects. When you take even small steps to protect your hearing health and that of loved ones, such as through regular hearing screenings and using earplugs in noisy environments, take heart in knowing you have bolstered your overall well-being.

Rebecca Huzzy, Au.D., CCC-A, is an educational audiologist at Clarke Schools for Hearing and Speech at its Philadelphia location and a clinical audiologist at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware. For more, see clarkeschools.org. This article also appeared in the Spring 2018 issue of Hearing Health magazine. For references, see hhf.org/spring2018-references.

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

 
 
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Why So Many Can’t Afford to Hear Better

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Only about 14 percent of Americans with hearing loss use hearing aids. For many others, this vital, life-changing treatment that facilitates participation in meaningful conversations with friends and family is out of reach financially.

Hearing Health Foundation (HHF)’s 2017 hearing loss survey, created to better understand our constituents’ opinions related to hearing loss, was cited by a WBUR-FM Here & Now radio segment highlighting the barriers to hearing loss treatment that Americans encounter.

The news story opens with commentary from retiree Betty Hauck, 72, who was shocked when her first pair of hearing aids cost her $5,600—with no assistance from Medicare.

“A price tag like that is often a surprise to people buying hearing aids for the first time. Four states—Arkansas, Connecticut, New Hampshire and Rhode Island—require health plans to cover hearing aids for children and adults,” explains reporter Peter O’Dowd.

“But those benefits are rare. A 2017 survey by the Hearing Health Foundation, a group that funds research and advocates for treatments and cures for hearing loss, found that 40 percent of the people they asked had no hearing aid coverage through health insurance.”

Kevin Franck, director of audiology at Massachusetts Eye and Ear, among other experts, are hopeful that the Over-the-Counter Hearing Aid Act of 2017 will reduce barriers—cost, stigma, and hassle—encouraging greater adoption.

You can access the full WBUR segment, here.

Note: The audio segment is not captioned but is summarized in print.

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On a Quest

By Sue Baker

From his earliest days, the concept of sound consumed musician and inventor Les Paul. How did sound work? Why did the record player produce sounds different from the player piano? Why does the sound of the train change as it moved down the tracks? Why did the body of his acoustic guitar vibrate when he plucked the strings? How could he make just the strings vibrate?

Although best known for his solid body electric guitar and industry-changing recording inventions, for Les the quest always came back to sound, even in his later years. “I’ve spent my life looking for the perfect sound, trying to build the perfect guitar to play the perfect note,” he wrote in his 2005 autobiography, “Les Paul in His Own Words.”

One of Les Paul's hearing-related inventions.

One of Les Paul's hearing-related inventions.

In the 1960s, Les’s eardrums were ruptured due to playful roughhousing. The resulting infection and, later, mastoidectomy surgery, left him with a hearing loss. He wasn’t happy about the hearing aids’ sound quality for music.

I met Les when I was the executive director at a museum in his hometown of Waukesha, Wisconsin. We were creating an exhibit about his career. Over the course of what would be the last decade of his life, our friendship grew. Two years after Les passed away at age 94 in 2009, his business manager Michael Braunstein asked me to work at the Les Paul Foundation.

During one of my visits to Les’s home in 2001, I asked him about an unusual piece of equipment in a corner. “Oh, it’s just an experiment I was doing,” he said. “I was trying to replicate how the human ears work.” He was a tinkerer by nature and necessity, always wanting to invent something to fill a void or to improve what was available.

Musician Jon Paris says Les’s audiologist (whom he met at New York City’s Iridium Jazz Club, where Les performed every Monday night) told him that Les “drove him nuts—in a good way—constantly demanding better quality from his hearing aids.”

Another friend, Chris Lentz, says that Les worked with Marty Garcia of Future Sonics to improve his hearing aids. In a note to Chris, Marty wrote, “Throughout our years together, Les validated just about every voice coil transducer Future Sonics developed.”

In a 2008 interview in Audiology Today, Les talked about how he wanted to improve hearing aids for music. He cited the importance of extending the audio range to capture more of the harmonic structure than what is needed for speech. Les also wanted hearing aids that could be worn in the shower and would work optimally when using the telephone.

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Les Paul’s 103rd birthday would have been this June 9. He would have been gratified to see how far hearing aid technology has come.

Sue Baker is the program director for the Les Paul Foundation. For more, see lespaulfoundation.org.

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Making Entertainment Relatable and Accessible for More

By C. Adrean Mejia

Films, plays, and television series have long served as platforms to create awareness of important topics that have otherwise been kept out of the spotlight. Hearing loss is one example of such a topic.

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As an organization that seeks to inform the public about the prevalence, prevention, and treatment of hearing loss, Hearing Health Foundation (HHF) applauds the growing prioritization of this issue in entertainment. We are pleased to know that the number of films featuring characters with hearing loss—played by actors with hearing loss—has risen with the years, generating greater public awareness of the third most common health condition in the United States. Complementing this trend of an increased presence of hearing loss on screen is the introduction of recent legislation to make entertainment more accessible to viewers with hearing loss.

Actors and characters with hearing loss expand society’s understanding of the condition. Hearing loss empowers abilities, emotions, and experiences unlike those of people with typical hearing. Some recent works with characters with hearing loss include the following:

The Silent Child tells the story of a profoundly deaf four-year-old girl who is about to attend a mainstream school with minimal support—until a social worker teaches her American Sign Language (ASL). The film communicates the disappointing statistic that over 78% of deaf children attend mainstream school without accommodations. A final comment that states that the creators “hope this film contributes in the fight for sign language to be recognized in every school across the globe.”

Children of a Lesser God, a play written in 1979, made its Broadway debut last April. The piece focuses on the professional and romantic relationship between a deaf janitor and a typical hearing teacher and shows the contrasting worlds off sound and silence. To Sarah, the janitor, deafness is an identity, not a defect.  

This Close is a TV series by two deaf writers and actors that narrates the true story of their lives. The show provides a close look of the everyday day life of two best friends, emphasizing their challenges and frustrations while highlighting the positive and beautiful things that their hearing loss brings to their existence.

HHF commends these and the artists behind similar works for the awareness their creations have generated. Likewise, the organization is proud to witness the introduction of new laws and procedures to make entertainment more accessible to the hearing loss community.

Credit: Naugatuck Patch

Credit: Naugatuck Patch

The American with Disabilities Act (ADA) first broke barriers by advocating for the requirement that all video program distributors close caption their TV shows. But it wasn’t until recently, with the help of technology, that these rules have expanded. On November 2016, the Final Rule on the ADA Title III was signed, requiring all American movie theaters to provide accessibility for captions. Large cinemas now offer assistive listening, closed captions, and descriptive audio.

Broadway, too, has made tremendous improvements. In 2016, the Theater Development Fund (TDF) and The Broadway League, launched www.theatreaccess.nyc, a website with information about tickets prices, dates and accommodations for theatergoers with disabilities. In addition, TDF now provides accessibility programs with open captioning and/or ASL at select Broadway performances.

Entertainment has made progress in becoming more inclusive for people with hearing loss since the implementation of these programs, but additional work is needed. Though mandating captioning at movie theaters represents great progress, other entertainment settings, including sports arenas and concert halls, must follow suit.

To optimize the listening experience for audience members with hearing loss, more must adopt the use of hearing loops, which transmit sound from a PA system to hearing aids and cochlear implants. In December 2017, the state of Minnesota passed a bill requiring hearing loops in public meeting spaces, taking after similar New York City legislation from earlier in 2017.

HHF looks forward to a day where no one must live with hearing loss. As long as hearing remains out of reach for tens of million Americans, fair accommodations are the most ethical choice.

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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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