Hearing Aids: Inquiring Minds Want to Know
Moderated by Scott Bally
This was one strange panel, because seven of the eight scheduled panel
members did NOT show up for the panel! Penny Seacrest from Widex was the
only panelist to share the stage with moderator Scott Bally. In the final
analysis, this may have been a good thing, because the audience soon
dominated the session with a lot of very interesting questions.
In the following discussions, Q is a question, A is an answer from
Penny, and C is a comment from an audience member.
Q. In terms of benefit and value for cost, what are the best features
people can get on their hearing aids?
A. Everyone buys hearing aids for different reasons. Most people want
to hear speech, and hearing in noise is a big issue. Directional mics are
a big help, and today there are very sophisticated adaptive mics that give
a lot of value in noise.
People don't like their hearing aids to whistle, and some aren't able
to hear the whistle. We have a variety of techniques to combat feedback,
and those are great.
Telecoils are very valuable if people want to use them for the phone or
for assistive devices. Some are better than others, and you also have to
consider the quality of the source.
Q. Why don't you put telecoils in every hearing aid, and why don't
audiologists tell clients about telecoils?
A. Not everyone needs a telecoil. Every hearing aid Widex sells today
except the CIC has a telecoil in it. It's up to the audiologist and the
client whether or not to activate it. We don't use an automatic telecoil,
because we don't think they're reliable enough yet.
Most people I work with don't want a telecoil if they don't need it.
Also we are getting some other interface options these days that are
replacing the telecoil.
Q. What happens to the client who needs a telecoil and doesn't have
that option?
A. I can't speak for individual audiologists, because their fitting
philosophy is up to them.
Q. Isn't the orientation of the telecoil in the hearing aid important?
A. Yes, and the orientation depends on the type of aid and how the
telecoil is installed.
Q. If a person has a hearing aid without a telecoil, can one be added?
A. Widex now installs telecoils in all hearing aids that are large
enough to contain them, so this isn't an issue with our new aids. We do
install telecoils in older aids if the client requests and if we are able.
I can't speak for what other manufacturers do.
Q. What is your opinion of the Arizona law that requires audiologists
and hearing aid dispensers to inform clients about telecoils?
A. I think that most audiologists are very dedicated professionals who
are primarily interested in helping people.
Q. Is the information about using telecoil-equipped hearing aids as
personal public address systems getting to audiologists? As inductive
loops become more and more common in public facilities, the benefits of a
telecoil increase.
A. I think audiologists have instigated much of this. They are very
knowledgeable and dedicated people, and are trying to help people.
Scott: I disagree that most are knowledgeable. A lot of them don't want
to deal with assistive technology. As consumers you need to help educate
your audiologist. HLAA and ALDA chapters are great for this. If I want to
know who the good audiologists are in a particular city, I go to one of
the chapters and ask them.
Q. What did you mean when you said that some telecoils aren't very
good?
A. At Widex we make all our own telecoils, because we couldn't find a
manufacturer who met our standards.
Q. I'm a VR counselor and I work closely with the public, and I
strongly recommend telecoils to my clients with hearing loss. I've had
audiologists call me and ask me to stop telling people about telecoils,
because they're such a pain. It seems that the manufacturers, engineers,
and audiologists have these ongoing conversations and come up with new
features without ever looking for input from the consumer. Is anyone
listening to us?
A. I don't know of anything formal that anyone is doing. Some
audiologists do seek feedback. Widex is based in Denmark, and we do quite
a bit of consumer research there, so we do have that research advantage.
Scott: Mark Ross' article "Why People Don't Wear Hearing Aids" mentions
that part of the problem is that consumers aren't proactive about going
back and getting their hearing aids properly adjusted. The other side of
that is that manufacturers and some audiologists get expectations so high
that reality can't possibly live up to them.
Also, there are a lot of people who tried hearing aids 20 years ago and
weren't satisfied with the performance. Those people should give them
another try, because hearing aids have made a lot of progress since then.
Q. Why don't more hearing aids have an M/T switch?
A. One of the main reasons is because you need a separate A/D converter
for each of the circuits (Microphone and Telecoil). In order to have both
active at the same time, the hearing aid needs two A/D converters, and
many don't have two.
Q. Why do telecoils have interference?
A. There's a lot of electromagnetic interference out there, and that's
what causes interference. CRTs (computer monitors and TV sets), some
fluorescent lights, and motors are common interference sources. We do
shield the telecoils, but may need to do more of that.
Q. I much prefer the sound of an analog aid to a digital aid, and I'm
concerned that analog aids are being phased out.
A. People who have used analog aids for a long time tend to prefer
them. An experienced audiologist can adjust a digital aid to sound more
like an analog aid, so it's important to work with an audiologist who can
do that. Digital aids really have a lot more capability and can be better
fit to a person's hearing loss, so I think the transition to digital is a
good thing.
Scott: My aid has a music channel and I almost wept the first time I
used it at a concert, because I could hear the piccolos and high violin
notes, which I didn't even know I was missing.
Q. My question is about clipping. A friend of mine thinks his hearing
aids are clipping at around 6K and would like to know what can be done
about that.
A. Clipping is just chopping off the loudest parts of the sound signal,
and it causes distortion that most people find unpleasant. It can happen
at the input stage or the output stage. I don't think any quality digital
aids clip at the output stage anymore, but some might still clip at the
input stage. The modern alternative to clipping is to compress the signal,
so no part of it is loud enough to require it to be clipped.
C. I know that a lot of elderly people have trouble adjusting to
hearing aids. My audiologist has a great method of overcoming those
problems. She doesn't give clients the full power they need right away.
She has them come back three times and gradually increases the power, and
that seems to be very successful.
Q. Why don't audiologists test our hearing in noise? The real world is
very noisy, and it just makes sense to test our hearing in a realistic
environment.
A. We're starting to see more of that. There are some new tests and
some new standards. But note that no test is meaningful when a person
first gets new hearing aids. Everything will sound different and it takes
some time for a person to adjust. I prefer to wait a month before doing
any really meaningful testing.
