Hearing Informed

Since 1989, Knowles Electronics has conducted seven Marke Trak surveys of the US hearing loss population. In one of the most recent surveys from 2007, some disturbing statistics were unearthed. It was determined that there were 1.2. million children ages 0 to 17 in the United States: 1) whose parents admitted that their children had “hearing difficulties” and that 2) that children did not use amplification. That leaves out the estimated 300,000 dependents aged 18 to 21 with unamplified hearing loss. In some of these cases a hearing aid wouldn’t be the answer. But a vast majority of these children are being left behind by going without hearing aids. It goes without saying that these children are denied a basic right to communication; its effects are like cascading dominoes that lead to mental health problems, social ineptness, lack of self confidence, poor academic performance, and overall broken dreams.

In Marke Trak VII, a targeted survey was sent to 3,000 parents of these dependents that have hearing loss but don’t wear any kind of hearing device. They were asked to discuss four major issues: 1) the nature of the dependents loss; 2)the treatment sought; 3)impact of hearing loss on dependents life, and 4)reasons why dependent does not use hearing aids. Almost 90% of the parents responded in some form to the survey.

These responses shed light on haunting levels of ignorance and denial. Many the letters are downright flippant. There is usually a glaring discrpency between the subjective reporting of their child’s hearing loss level and the realities that are espoused in the letter. In fairness, some of these parents want the best for their children but can’t afford hearing aids or don’t get qualified advice. So many important questions are raised by these letters:

Minimization, Denial, or Neglect?…

“Kept saying ‘what’ at a young age of 4. Doctor said it may get worst or better not sure, but so far stayed the same. She was in special education so school was OK most of the time. At school she sits up close. Music, TV and games she turns up loud. Did not get hearing aids because doctor said it wasn’t bad enough.”—Parent of 20-year-old female described as having a moderate hearing loss in one ear

“The hearing loss was discovered from my daughter’s speech. She doesn’t talk as well as she should. The family doctor has her going to Easter Seals for speech. Hearing testing was mild but not real bad hearing loss.”—Parent of 4-year-old female with mild hearing loss

“When you talked to him, he wouldn’t answer you or he would say, huh? You have to repeat what you say to him. The teacher sets him closer up front of the class. He does not have hearing aids because his hearing isn’t that bad yet.”—Parent of 8-year-old child, with hearing loss described as moderate and inability to hear normal speech across a room

“She has requested seating at the front of the room in school in some classes. She will turn the TV up to a point where it is almost uncomfortable to others. Surgery repaired the rupture to her ear drum and she just lives with the mid to moderate hearing loss. Her hearing loss is not severe enough to warrant hearing aids.”—Parent of 14-year-old female with infection as a child, ruptured eardrum, and subsequent scarring from surgery, described as having a moderate hearing loss

“If she is in a room next to the room I am in, I have to shout or use the phone to call her. If she is in the same room, I have to speak loud and slow. I do not think her hearing is bad enough to warrant hearing aids.”—Parent of 15-year-old female with mild hearing loss and inability to hear normal speech across a room

Professional Recommendations…

Many of the parents in the survey make decisions not to to explore hearing aids for their children based on “professional recommendations” from pediatricians, audiologists, family physicians, or ENTs. Some of the parents received conflicting information from two or more professionals. Most of the information seems to either be egregious misinformation or a severe misunderstanding of competent information. Some of these “professional recommendations” that follow are completely perplexing…

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A typical earplug from Walgreen’s squelches so much sound that I don’t really enjoy concerts with them. Most earplugs are made of high density foam that muffle speech and music- they reduce sound more in the high frequencies (that I really need) than the mid and low frequencies, which makes the sound unnatural and unclear.

Hearing loss is a function of exposure time, average sound level, and the peak level of very loud sounds. To make things more complex- every person reacts a little differently to loud sounds and some people are more susceptible to hearing loss than others. However, most earplugs, when used for concerts, are overkill. They kill a lot more sound than necessary for hearing protection. The solution? I love my musicians earplugs from Etymotic Research. I can switch out little replacement buttons that change the amount of decibel protection to suit the situation. I find that the 25 decibel button works great for loud concerts and and I can hear a LOT more than I did with the typical store bought ones. The cost of $150 might be considered a bit steep- but its not all that much when you consider your protecting your hearing and having a great sound experience. Also- buying replaceable earplugs all the time will surely add up.

In the bay area I really appreciate the small concert halls that give a nice full sound without hurting my ears. My favorites: Yoshi’s in Oakland and San Francisco and The Kuumbwa in Santa Cruz.

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Call me a little sick, but I enjoy listening to (and reading!) the oral arguments given in Supreme Court cases. We can thank Jerry Goldman, who created Oyez in 1994 in an effort to share details about the Justices and their cases. He’s taken thousands of reel-to-reel tapes of the Supreme Court proceedings stored in the National Archives and converted them to streaming audio (with captions) and MP3’s on his website. This is an unprecedented look inside a notoriously mysterious institution. Justice David Souter once said, in regards to allowing cameras to broadcast it’s proceedings,”the day you see a camera come into our courtroom, it’s going to roll over my dead body.” That didn’t stop Jerry Goldman from providing an excellent website with audio and transcripts of the court’s oral arguments.

Oyez is extremely accessible for the hearing impaired: the transcripts are excellent and intuitive. Unlike a lot of captioned television out there, these transcripts follow along with the speech with precise timing- beginning a line just as the speaker starts. Not only do we get the text- but the speaker is identified with a name and picture. Also, I like that they underline the text that is being spoken. The transcript is especially pertinent here because the audio quality is poor- high quality digital recordings are not a priority for the Supreme Court. They use reel to reel. Jerry Goldman is pushing for high quality digital recordings.

What I really love: I can listen to the personalities of the Judges- the anger, irony, humor, and utter frustration that comes forth. The tension between the judges is quite apparent at times, even though they go to great lengths to hide it. All these things I could sense before (I’ve got that skill down)- but now I can also follow exactly what they are saying. That is very valuable. I hope that more websites follow this transcript model and dare to improve on it.

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From the point of view of a hearing impaired person, the iPhone sucks. The features that would make the phone more accessible to the hearing impaired are within the internal chip’s capabilities but they have been purposely crippled by the software that runs the phone.

Paula Rosenthal at Hearing Exchange has this to say,

Apple’s new iPhone is not hearing aid compatible on microphone or telecoil settings. Complaints have been filed with the FCC because HLAA believes that Apple, when designing the phone, could have tested it for hearing aid compatibility implemented standards to make it accessible to hearing aid and cochlear implant users.

A hearing aid like Oticon’s Epoq is Bluetooth enabled: it’ll take sound from an MP3 player or phone (or both) and route the sound wirelessly right into the ears. No headphones, no interference, and because they are tailored to fit, they sound great too. However, Steve Jobs has decided to cripple the iphones nascent features so that the iPhone supports mono, call only Bluetooth. i am not part of the “i” in iPhone.

Thanks to David at Hearing Mojo for bringing this to my attention. Check out this forum discussion at MacRumors and go to the iPhone discussion area and tell them what you think. Also see this locked up thread at Apple’s iPhone discussion area.You can also call Apple’s PR Department at (408) 974-2042 or write Steve Jobs.

For the more technically inclined check out Live Journals “Hearing Aid Hacking”.

A new privately held, venture backed company named Insound Medical has developed a very interesting new “hearing solution” called the Lyric (its funny that they avoid “hearing aid” at all costs- most companies are doing this in one way or another). Developed by ENT physicians and audiologists, this new hearing aid rests very close to the tympanic membrane. No surgery is required for this invisible hearing aid. It’s placement minimizes occlusion (like talking inside of a barrel) and feedback. When the battery dies the device dies- usually about 120 days. The user can control the volume or turn it on and off via a magnetic adjustment tool. The Lyric can fit the ear canals of about 75% of the people out there.

Downsides to this hearing aid: these aids aren’t waterproof, limited frequency range and power, and the pricing information, which is really a subscription based fee, is opaque.

Things I like:

1) invisible hearing device

2)minimizes the effect of sounding like I’m “talking inside of a barrel”

3)new, creative idea from a small company when consolidation seems to be the trend.

4)built with lots of input from hearing impaired users. The device uses analog sound which might prove itself over digital.

5)uses your own ear to naturally draw the sound toward the hearing aid

Who can Wear Lyric?