Introduction to Hearing Aid Features

A consumer view of some things you need to know before you buy your first (or next) hearing aid.
This presentation is available for SHHH Chapters to use at www.nchearingloss.org/programs. Please send corrections or suggestions for improvements to steve.barber@earthlink.net . Opinions expressed are those of the author.
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Why Should I Care?

Hearing aids are Expensive. Hearing aids arent like glasses.

You need to be an informed consumer. You need to know how to use the aid.

There are a lot of misconceptions about hearing aids. Hearing better is UP TO YOU!
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

What Should I Care About?

Highest Priority: Hearing Better High Priority: Learning to Use Your Aid Lowest Priority: Vanity

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

All Hearing Aids Are Alike

1. Sound goes in the Microphone. 2. Sound gets amplified. 3. Sound comes out the Speaker into your Ear

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

All Hearing Aids Are Different

Style Technology Features Settings
(Small is best?) (Digital is only way to go?) (More is better?) (your prescription)
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Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Style
Body Behind The Ear (BTE) In The Ear (ITE) In The Canal (ITC) Completely In the Canal (CIC)

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Technology
Analog: Settings and Sound are both processed via analog technology. Digital Programmable: Settings are processed digitally, Sound is processed via analog technology. Full Digital: Both Settings and Sound are processed digitally.
Opinion: Digital is now probably best in most cases, but not the miracle that some imply. For some people analog or digital programmables are fine, but most hearing aids in the future will be full digital.

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Features
Volume Control Telecoil Multiple Microphone Directionality Opinion: Learn what these Compression features can do to Clipping help you hear Direct Audio Input better so that you will be a better FM consumer. Programmability Speech Enhancement/Noise Reduction Frequency Shifting Earmold/Vent Remote Control
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Volume Control
Some aids are preset and you cant control the volume. Some manufacturers and dispensers think you dont need it. Not having a volume control is Ok for a few people who really dont need it or cant manage it. Very useful to be able to control the volume to match the situation. Control may be a wheel on the aid, or a remote control.
Opinion: Usually very important.
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Telecoil
Sound Input Signal

Magnetic Input Signal

Alternate input source Listens to magnetic signal instead of (or in addition to) the sound. Magnetic signal can be from a telephone, CD, TV, personal ALD, headphone, loop Major advantage is improved signal to noise Usually on BTEs; sometimes on smaller, seldom on smallest
Opinion: Very Valuable
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Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Multiple Microphone Directionality

Front Facing Directional Mic Rear Omnidirectional Mic Aid Can Focus on Sounds in Front and Diminish Background Noise Selectable Modes

Quiet situations: hear everything Noisy situations: block background noise

Manual or Auto Selection

Opinion: Very Valuable
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Compression
100
Amplification

80 60 40 20 0 quiet loud Amount of Noise

Reduces Amplificaton when its Noisy Helps you hear more when its Quieter Keeps it from being Painful when its Noisy Adjustable (manual and automatic) Different settings in multiple frequency bands
Opinion: Very useful; available on most aids; may requre tweaking to set right.
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Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Clipping
100 90 80 70 60 50 40 30 20 10 0

Normal Amplification

No Amplification

quiet

loud

Eliminates all amplificaton above a certain input volume Prevents hearing damage from excessive amplification in loud situations A setting for most hearing aids
Opinion: Essential for safety; available on most aids
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Amplification

Amount of Noise

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Direct Audio Input (DAI)

Alternate input source Listens to electrical signal instead of (or in addition to) the sound. Electrical signal can be from a telephone, CD, TV, or personal ALD Major advantage is improved signal to noise Boots available only for BTEs
Opinion: Very good signal; comparable to FM, but requires the wires.
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Booted or Integrated FM
Some Aids have FM receivers either booted on (as shown) or integrated into the aid. Some can be used with handheld transmitters or with fixed transmitters which can integrate TV and Telephone. Clean signal; bridges distance; improves signal to noise ratio.
Opinion: Expensive but wonderful if you can afford it.
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Programmability
The ability of an aid to have several different sets of settings Hearing aid dealer/audiologist chooses and sets up the programs User can switch among the programs Examples of useful programs for quiet situations for noisy situations for music telecoil or DAI with or without microphones FM May be controlled with a switch or button on the aid or with a remote control
Opinion: Very valuable, but you must understand, choose and learn how to use the options.
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Speech Enhancement and Noise Reduction

Speech Enhancement

Enhance certain speech sounds (like consonants)

Noise Reduction Processing

Identify speech in the signal and separate it from noise

Opinion: May be useful in some situations but these are not miracles and their benefit may not be obvious in many situations.

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Frequency Shifting
2k 0 10 20 30 40 50 60 70 80 90 100 4k 6k 8k

Can Hear

Cant Hear

Only one aid, so far (AVR ImpaCT) Lowers the frequency of sounds you cant hear into a range where you can hear them. Does some speech enhancement, too With practice those new sounds start to sound realistic.
Opinion: Most likely useful for steep ski slopes

dB

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Ear Mold Design

Adaptor
Bore

The shape and smoothness of the bore The size and smoothness of the vent

Too small: Drum Feeling Too Large: Feedback

Depth Vent

Depth of the mold Smoothness of the adaptor

Opinion: Very important, and much ovelooked.
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Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

Remote Controls
Let you control your aids conveniently Some simple; some powerful Some people like them; some dont Control:

Volume Program Mode

Opinion: Very convenient; especially if it allows direct access to individual programs.

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Feature Availability By Type

Feature / Type
Telecoil Directional Mics Compression/Clipping DAI FM Programmability Power Remote

BTE
Most Some Yes Some Some Most Plenty some

ITE ITC CIC

Some Rare Yes No Few Most Less some No No Yes No ?? Some Less few No No Yes No No ??? Less ???

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Summary
Put hearing better as the top priority. Put vanity at the bottom of your priorities. Be a savvy consumer; know what features might help you. Watch out for people trying to sell you what they THINK you want. Choose a provider that lets you try multiple aids/settings. Small is not necessarily better (and usually isnt).
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Summary (cont.)
Watch out for sales pitches; if it sounds too good to be true; it probably is. Get professional help from someone you trust. New is not necessarily better (but sometimes is). Use the trial period. Try the aids in different situations and make notes. Work with your provider during the trial period by explaining what things sound good or bad to you.
Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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Final Opinion
Knowing about features is important. Hearing loss isnt a spectator sport. Hearing better is up to you. Learn to be a better consumer. Join SHHH at www.hearingloss.org

Introduction to Hearing Aid Features by Steve Barber, SHHH Wake Chapter

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