By Gail Hubbard, Aud. Doctor of Audiology
As everyone knows, hearing aids are any devices that help you to hear more than you do without them! They may be over the counter amplifiers that make everything a little louder, electronic earphones that attach to your Smart Phone with adjustable volume and tone control and can even tell you where they were the last time they were functioning, attachments to make it easier to hear television or on the phone, or sophisticated devices that can focus the microphones on sounds coming from where you are facing. Oticon’s newest devices, the receiver in the ear style OPN hearing aids are so advanced they can even send an email to a caregiver to let them know when your hearing aid battery needs changing! No, modern hearing aids are not at all like the hearing aids your mother complained about!
Modern hearing aids are not at all like the hearing aids your mother complained about!
Hearing aids have come a long way!
When I was growing up, my grandmother wore a hearing aid that was housed in a box the size of a flip top cell phone with a heavy wire extending from the case to a button receiver attached to a large molded ear piece worn in her ear. She wore the device in a pocket in her bra with the wire running under her clothing up to the receiver. Although the device was very powerful, it amplified all sounds, even the scratching sound of her clothing rubbing against the microphone. The only adjustments on the hearing aid were a large rotary volume control and an on-off switch, which my grandmother would use to turn off the noise of our shouting when it became too much for her. Later hearing aids became smaller and were worn in cases behind the ear reducing clothing noise, but still amplifying all environmental noise. While smaller than the larger body-worn hearing aids, they were still fairly bulky and noticeable.
In the late1970’s custom molded hearing aids with nothing behind the ear were developed for people whose hearing loss was less severe. To help reduce background noise, some hearing aids had a switch to reduce low pitched sounds. To make hearing aids more discrete, some devices were built into the back of the heavy temples in eyeglasses.
Each advancement provided an improvement over prior styles, but with each advancement, some benefits were lost. As instruments became smaller, the controls became more difficult for stiff fingers to adjust and batteries became smaller requiring more frequent replacements.
Computer technology was applied to hearing aids in the middle to late 1980s, providing the hearing aid fitter with greater control for finer adjustments of the tone quality. In addition, as computer chips became smaller, so did hearing aids, with instruments molded small enough to fit inside the ear canal. Unfortunately, the technology required more power to operate with even shorter battery life. Miniaturizing the hearing aids required ever smaller batteries.
Today the hearing aid user has a myriad of choices in hearing aid styles and technological capabilities! There are one size fits all devices that can be ordered directly from television or computer retailers. There are instruments designed to be worn 24 hours a day for two or three months before being replaced with new ones. There are discrete instruments molded to fit inside your ear or hidden behind your ear. There are devices sold by licensed dispensers in big box stores, from manufacturer owned retail outlets ( Accuquest, Connect Hearing, Sonus, among others), private practitioners, and ENT physician offices. There are telephone amplifiers, television amplifiers with earphones, special listening systems for theaters and churches. Each vendor and each device has its own assets and liabilities.
So How in the world does the consumer determine what is BEST for them?
Seek Professional Advice
Although it is common to lose hearing as you age or from exposure to loud sound, there are many other causes of hearing loss and many are medically treatable. It stands to reason that having your hearing professionally evaluated to determine the degree and nature of your hearing loss is the best first step to finding a solution to decreased hearing.
Licensed audiologists are trained to evaluate how you hear and to refer you to a physician when medical treatment is necessary. Hearing aid dispensers are trained to test you for the purpose of fitting and selling a hearing aid. While some of the same tests are performed by both professionals, the analysis of the results may be different.
After you are medically cleared for hearing aid use, your test results serve as a starting point for determining which style and power of hearing instrument is best for you. Physical concerns such as visual acuity and manual dexterity and lifestyle preferences such as whether you spend most of your time enjoying quiet activities or are actively involved in social activities must also be explored. Your audiologist may further evaluate your ability to understand speech in noise and how well you tolerate loud sound. You may be asked to complete questionnaires exploring your listening preferences and needs. Finally, measurements to verify that the hearing instruments are adjusted to your needs will be taken.
Because your audiologist must understand your needs, it is important that you feel comfortable with her as your professional advisor and can be forthright in sharing your listening experiences. Only when the two of you work together can the audiologist recommend the best hearing aid style, features, and level of technology to meet your needs.