Showing posts with label Hearing Aid Users. Show all posts
Showing posts with label Hearing Aid Users. Show all posts

Friday, January 28, 2011

WidexLink


WidexLink
- a New, Industry-leading Technology for Wireless Transmission


In recent years, we have seen a variety of new hearing aids on the market with different wireless communication abilities. Some offer the possibility of transmitting sound to the hearing aid from a mobile phone, a TV, or an MP3 player. Others hearing aids are capable of exchanging coordination data, and a small number are able to transmit sound to one another.

We believe that the key to new achievements in the hearing aid industry lies in the ability to use a sophisticated wireless transmission technology which will facilitate the coordination of dynamic settings between two hearing aids, high quality transmission of audio from external sound sources, and wireless transmission of data between two hearing aids.

We are convinced that wireless technology is the future in the hearing aid industry. However, the success of any given wireless transmission technology will depend on at least three key issues when applied to hearing aids: Sound quality, transmission robustness, and power consumption.

WidexLink is our new proprietary digital radio frequency transmission technology. The new technology has been designed to provide the highest audio quality and efficiency. WidexLink offers new possibilities for extended bandwidth audio transmission between hearing aids (for example, CROS and BiCROS applications),extended bandwidth audio streaming from external assistive listening devices (for example, DEX devices) to hearing aids, and the continuous exchange of synchronisation data between hearing aids and external devices (Inter-ear communication).

The unique, digital wireless link offers an unparalleled low latency (delay) of <10 ms when transmitting audio. This ensures minimum distortion and echo-free audio quality when direct acoustic sound in the room is mixed with transmitted sound.

The need for a new technology


Today, Bluetooth is probably the most popular wireless technology for transferring data and digital sound between devices. The Bluetooth technology is available in a large variety of "plug-and-play" chip solutions. From an engineering point of view, therefore, Bluetooth is the fastest way to a digital wireless design. However, Bluetooth has some drawbacks which create serious problems in hearing aid applications.


First and foremost, Bluetooth is an extremely energy-demanding technology. The Bluetooth chip uses so much power that it has no practical application in the hearing aid industry. Moreover, even if another chip is used, battery drainage is still very high during Bluetooth transmission. Hearing aid manufacturers are therefore forced to find ways to optimise Bluetooth transmission if the power consumption is to be kept at a reasonable level.


Another serious drawback is that standard Bluetooth has a high built-in latency (delay) of 150 ms when transferring audio through the Bluetooth codec. That is, transmitted sound will reach the ear 150 ms later than the direct acoustic sound in the room. In hearing aid applications, this is a serious issue because the time delay between sound sources comprises important psychoacoustic cues about direction and distance to sound sources. The latency can be reduced by switching off some of the technological features while transferring digital audio, but there is a limit to how far this optimisation can be forced. As far as is known, the Bluetooth latency can be reduced no further than approximately 45 ms which is not sufficient to avoid artefacts in hearing aid applications.

Latencies and artefacts



A small delay of 1 to 10 milliseconds is unproblematic. However, when the delay between transmitted and direct sound becomes longer than 10 milliseconds, artefacts begin to occur. The first artefact to occur will be an audible comb-filter effect. It is called "comb-filter effect" because it filters away frequencies like a comb, making notches in the spectrum. The resulting sound will be hollow and metallic. Above 40 milliseconds the streamed sound will be perceived as an echo of the direct sounds. An additional problem can occur when sound is transmitted from for example a TV. When the delay reaches around 150 milliseconds, which is the default delay with Bluetooth, lip movements will begin to appear unsynchronised with the sound. Thus, hearing aid manufacturers who rely on Bluetooth or another technology which introduces a delay above 10 ms will not be able to avoid artefacts in their applications.

Also included on the list of Bluetooth drawbacks are the relatively large chip size and the high current consumption which are obviously essential parameters in a hearing aid design.

The artefacts that can occur as a result of the delay between direct sound and digital audio stream are listed in the figure below:




Figure 1. Psycho-acoustic artefacts due to latency (delay) between direct sound and transmitted sound.


 

The new technology from Widex has un-paralleled low latency of less than 10 ms between the direct acoustic sound and the digital audio stream. And in CROS and BiCROS applications, the delay is even shorter.

Advantages of WidexLink


It is no simple matter to design a system which can simultaneously maintain high audio quality, low battery drain, and robustness against transmission errors.
Widex achieved these goals by developing a very efficient audio coding method which is custom-designed for use in a hearing aid platform.


It was considered of the utmost importance that the highest possible audio quality should be maintained with the new wireless technology. In order to achieve this goal, several key components of the wireless system were carefully designed. First, a very efficient and robust audio codec (short for encoding/decoding) and radio frequency (RF) transmission system were developed to ensure fast, stable, and trouble-free transmission of sound and data during normal use.  It was a requirement that the digital audio codec be based on a coding principle which will ensure that the signal is perceived to be as close to the original sound as possible.  Another factor in maintaining a high audio quality was a low audio delay over the wireless transmission system.  To achieve this, the digital coding system was designed in such a way that no data would need to be re-transmitted and consequently slow down the transfer of the audio signal as a result.


Ensuring battery efficiency was also a major concern in the design of WidexLink. This goal was achieved through the employment of a very efficient data compression method, and the invention of a new, highly sensitive radio receiver which permits low transmission power.


Robustness was achieved in multiple ways. In addition to the inherent robustness of the audio codec and the radio receiver mentioned above, robustness was also attained by means of a highly efficient channel coding which detects and handles errors quickly and securely.


How WidexLink addresses the key factors will be discussed in more detail below.



High sound quality


Audio bandwidth


Audio bandwidth is one of the key factors in maintaining a high sound quality. Thanks to the new technology in the Clear product range, we are able to offer an exceptionally broad audio bandwidth in models with a Clearband receiver, stretching from 100 Hz to 11.2 kHz for transmitted sound. This is industry leading.

One area where a broad audio bandwidth makes a clear difference for hearing aid users is when they listen to music. The high frequencies provide ambience and brilliance to the sound. Thus, the sound experience will be somewhat richer with an upper bandwidth of 11 kHz when listening to the crispy sound of a hi-hat or cymbals, for instance. Similarly, an audio bandwidth stretching as far down as 100 Hz will produce a fuller bass.

Codec


Another way to maintain a high sound quality is to develop an efficient codec. Digital audio data as we know them from CDs are extremely bulky. It is therefore necessary to reduce digital audio data in some way as the transmission bandwidth is too narrow to effectively transmit the raw audio signal. This is achieved by means of data compression (not to be confused with the dynamic compression of the audio signal in the hearing aid).

Digital audio data compression is achieved by means of a set of complex algorithms called an audio codec.  An audio codec consists of two parts:  encoding and decoding.  The purpose of the audio encoding is to reduce the size of the digital data representing the original signal. The purpose of the decoding is to reconstruct the encoded audio signal in a manner which ensures that it is as close as possible to the original audio signal. This process is analogous to the shipping of a parcel by mail. If you wished to send an office desk from the U.S. to Europe, you could simply place the assembled desk inside a large box and send it. This shipping method would be quite expensive, though, due to the size of the parcel. A more efficient and less expensive method of shipping the desk would be to disassemble the desk into smaller pieces and package it in a much smaller box. The same principle applies to the transmission of digital audio. The cost of sending digital audio is related to its size. The larger the size of the digital audio data, the larger the transmission bandwidth has to be.


Two different compression techniques are typically used in order to squeeze the audio information into a smaller package.  Both compression techniques rely on the fact that audio signals have a great amount of redundancy.  


One commonly used technique is Redundancy Coding. This technique is similar to the process used when computers compress files into ZIP files. This type of compression can be demonstrated by a simple example:

If we need to send the number 1000000, we may compress it to 10.

The compressed number represents the same digits as the original number, but comprises fewer characters. If each character requires four bits, the uncompressed number would require 28 bits (4 bits x 7 characters), while the compressed number would require 12 bits (4 bits x 3 characters). The technique is effective with data where there is lots of redundant information as is the case with digital audio signals. However, the technique has one major drawback; namely that it is relatively time-consuming. It is therefore not very suitable for hearing aid applications where a minimal delay is of the utmost importance.


Another commonly used technique for achieving a low bit rate is Irrelevance Coding.  It is widely used today to create MP3 and other types of digital audio files.  Widex also uses this technique for analysing and compressing audio data in a special part of the codec. .


It is well-known that raw, uncompressed audio contains more information than the human ear can actually detect. Our irrelevance coding algorithm removes all perceptual redundancies by extracting all of the irrelevant audio information which cannot be heard by the listener due to psychoacoustic masking effects in the cochlea. In other words, the irrelevance coding algorithm uses knowledge of masking to remove audio signal elements which are outside the limits of the human auditory system.  


Irrelevance coding relies on a phenomenon known as the Simultaneous Masking Effect. When listening to a soft and a loud sound simultaneously, it is often difficult to hear the soft sound because it is drowned by the loud sound. The masking effect is largest when the soft sound is in the same frequency range as the soft sound (Moore, 2006: 66). This psychoacoustic phenomenon is very useful vis-à-vis audio data compression. The irrelevance algorithm utilizes knowledge of this psychoacoustic effect to remove softer, less dominant sounds which will be masked by louder, more dominant sounds, from the audio signal.


Basically, our irrelevance algorithm reduces the amount of audio data that needs to be transmitted wirelessly by removing sounds which would not be audible to the listener in any case. And by removing sounds in the audio signal which the listener cannot hear anyway, while preserving the sounds the user can hear, the audio signal can be reduced significantly in size without compromising the high sound quality.

Safe digital transmission


Channel coding


An important aspect to consider when sending any type of digital data over a wireless connection is the potential for errors induced by radio frequency interference.


Errors will occur from time to time with any kind of transmission and especially in wireless transmission. The distance between the devices may change, the orientation of the antenna in the controller might be altered, or interference from radio noise might disturb the connection. Such errors must be handled effectively to minimise the inconvenience caused to the hearing aid user in the shape of crackling, dropouts in the sound, etc. Therefore, in order to prepare the audio data for transmission and ensure the integrity of the transmission with respect to correct receiver as well as the quality of transmitted data, channel coding is introduced.

Error detection and handling


The main task of the channel coding algorithm is to provide a method for ensuring that the digital audio signal which is received is indeed correct and error free. A common and very basic way to do this is to calculate what is called a checksum on the basis of the compressed data. The checksum is enclosed in the shipment alongside the data. When the data are received at the other end, a comparison of the checksum and the data is conducted to determine if any errors have been introduced into the digital audio signal.




Figure 2. The data in the shipment are compared
to the checksum on arrival to determine if any
errors have arisen.


However, a checksum will only establish whether or not an error has occurred. It does not provide a solution to how errors should be handled. A major advantage of Widex' channel coding algorithm is that, thanks to a so-called error corrective code, it ensures that a restricted number of errors can be both detected and corrected.

In a Bluetooth transmission technology, for example, the channel coding will by default ask for a retransmission of data which did not pass the receiver's error checking algorithm (www.bluetooth.com). Since retransmission requests will cause an extra delay whenever the system has to wait for the repetitions of the data to arrive, such a method is not a very good choice in a hearing aid application.

Another method involves the removal of audio data packages which contain errors. This method is for instance used in connection with DAB (Digital Audio Broadcasting). DAB-receivers cannot request a retransmission of signals vitiated by errors. Errors in audio data are simply handled by making dropouts in the sound, resulting in there being no sound playback when errors occur. An error handling method which results in clicks or dropouts in the sound is obviously not very suitable for a hearing aid application either.

Widex rely on a special channel-coding technique which is based on the principle of Graceful Degradation. This technique has none of the unfortunate by-products (long delay and dropouts) mentioned above. Instead, it provides a smooth, seamless listening experience for the hearing aid user.



Figure 3. Widex's channel coding algorithm
can both detect and handle errors.


Widex's channel coding algorithm has been designed to ensure that a small number of transmission errors can be corrected by the algorithm itself. A larger number of errors will be handled by means of the above-mentioned Graceful Degradation-based technique. This technique ensures that a large number of errors will not result in any abrupt changes in the output signal, such as dropout or cracking, heard by the hearing aid user. If the errors are too numerous for the algorithm to be able to correct them, the result will be a gradual fading of the sound. While transmission is interrupted, the HA will switch to the Master program. When the quality of the transmission channel is good enough to allow audio transmission once more, the sound will gradually fade in again to provide a nice, smooth listening experience for the hearing aid user.


Figure 4. Summary of three methods for error handling in connection with digitally transmitted data.

Digital Audio Transmission by WidexLink


 

The WidexLink technology makes it possible to minimise the amount of data that needs to be transmitted in order to ensure a high quality output signal. This is essentially possible thanks to the identical audio generators in the encoder and the decoder. More specifically, because the WidexLink encoder and decoder both contain identical synthetic audio generators, it is not necessary to transmit the original signal, or even the synthetic signal. All that needs to be transmitted is information about the discrepancy between the original sound signal and the synthetically generated signal. A more detailed discussion is included in the sections below.


The WidexLink encoding procedure can be divided into five main stages. In the first stage, the original audio signal is compared with a synthetic signal generated by a Synthetic Audio Generator. A Discrepancy Analyser generates information about how close the synthetic sound is to the original. A perceptual model is then applied to determine if discrepancies are audible or not (irrelevance coding). To keep the amount of data to a minimum, only audible discrepancies are allowed to influence the sound generation process. Next, the best approximation to the discrepancy between the original sound and the synthetic signal is retrieved from a large number of synthetic sounds stored in a Sound Sample Archive. And finally, information about which sample is the best approximation to the discrepancy between original and synthetic signal is transmitted to the decoder.


Figure 5. The WidexLink encoder principle.


With WidexLink, the sampling rate is 25.44 kHz, which means that the above procedure is repeated 25,440 times for each second of sound. This enables us to exploit the fact that there is typically not very much variation from one sound sample to the next to generate an increasingly accurate synthetic representation of the original signal.


The first time a discrepancy analysis has been conducted, information about the best approximation is used to create a Sound Model with information about the discrepancy between original and synthetic sound. This knowledge about the discrepancy between synthetic and original sound contained in the model is permitted to influence the generation of the next synthetic sound, whereby the difference between the new synthetic sound and the original sound sample can be reduced. By updating the model every time a sample has been processed by the encoder, the system is able to reduce the difference between original and synthetic signal to a minimum very quickly.


The decoder in the hearing aid contains an exact replica of the synthetic audio generator module in the encoder. Thus, information about the discrepancy-based best approximation is sufficient to provide all the necessary information for the synthetic audio generator in the hearing aid to be able to generate an exact copy of the synthetic signal in the encoder. In other words, the output signal generated by the hearing aid is a 100% synthetic sound identical to the synthetic sound generated in the encoder. The decoding sequence is presented schematically below.




Figure 6. The WidexLink decoder principle.

Transmission Robustness


A new, highly accurate and robust receiver has been developed for the Widex Clear product range to ensure safe transmission and low battery drainage. The accuracy of this new, patent-pending receiver enables us to operate with a low transmission power, which in turn contributes towards extending battery life.

Moreover, the modulation technique employed to send digital data over the wireless system also contributes to maintaing a high degree of robustness.

When sending digital data over a wireless system, a modulation scheme must be used. Modulation essentially determines how the digital information is sent through the radio frequency spectrum. One very commonly used digital modulation technique is Frequency Shift Keying(FSK). In an FSK modulation system, two frequencies are used to represent a binary "0" or a binary "1", respectively (see figure 7 below). So once the audio has been digitised, i.e., turned into a series of 0s and 1s, it can be transmitted by means of two different transmission frequencies which represent either a 0 or a 1. The receiver has to detect which of these two frequencies is being transmitted in order to determine if the transmitter is sending a 0 or a 1. The receiver then demodulates the signal by interpreting the frequencies received as either a 0 or a 1.


Figure 7. Illustration of the Frequency Shift Keying principle. In an FSK modulation system, two frequencies represent a binary "0" or a binary "1", respectively.


Traditional methods of wireless demodulation employ a simple two point sampling of the received wireless signal. This means that, in effect, the receiver relies on only two measurering points when it has to determine if the received signal is a "1" or a "0". Figure 8 below contains a model of the demodulation of a signal without noise.


Figure 8. Model of the demodulation of a signal without noise. Traditional methods of wireless modulation employ two points of sampling. In the example, the sample points indicate a rise. The signal will therefore be interpreted as a 1.


 

The demodulation method described above works very well with a clear signal and no noise. However, as illustrated in figure 9 below, using only two sampling points to determine if the transmitted signal is a 1 or a 0 can result in mistakes if noise is also present in the signal.


Figure 9. Model of the demodulation of a signal with noise. Signals can be wrongly identified when noise is present in the signal.


 

Consequently, Widex has developed a more secure variety of the FSK-method for the reception of wireless transmissions with a high degree of noise in the transmitted signals. The new method introduces a larger number of measuring points than the traditional two, which means that the receiver is able to determine with a much higher degree of certainty whether a received signal should be interpreted as a 0 or a 1.

Application


The new digital transmission technology is a central element in our new Widex CLEAR product range. It is used for the transmission of both data and audio signals in a large number of situations.

Transmission of audio


WidexLink is used for the transmission of audio signals from external devices to the hearing aids when the user watches TV, talks on his mobile phone, or listens to music.



























Transmission of Audio via WidexLink


Typical Situation: Sender and recipient:
TVTV-Dex – Hearing aids
Hi fiTV-Dex – Hearing aids
Mobile phoneM-Dex – Hearing aids
Personal audio device (Ipod, mp3 player, etc.)M-Dex – Hearing aids

 

Transmission of data


WidexLink is also the employed in the transmission of data between remote control (RC-Dex) and hearing aid, and in the exchange of synchronization data between hearing aids (Inter-ear communication).



























Transmission of data via WidexLink


Sender and recipient:Feature:
RC-Dex - hearing aidRemote control
Hearing aid - hearing aidHA synchronisation

  • Volume control

  • Program shift


Hearing aid - hearing aidIE coordination

  • Compression

  • Feedback cancellation

  • Noise reduction


Hearing aid - hearing aidWidexLink Surveillance


  • Lost partner alarm



 

References:


Moore, B. C. J. (2006). An introduction to the psychology of hearing. Elsevier Publishing Company

www.bluetooth.com

 


 


 

Friday, October 1, 2010

The Audibility Extender and how to individualise it

This bulletin describes the Audibility Extender program, the default settings in Compass, how to fine tune the Audibility Extender program as well as how to individualise it. The descriptions in this bulletin refer to the Graphics panel and the Audibility Extender settings panel in the Fine tuning window of the program in  Compass. Please refer to Compass in order to see the details of the screen. References will be found in the final section.

Audibility Extender default setting in Compass 


The Audibility Extender program uses linear frequency transposition and is developed for clients with little or no hearing in the high frequency area. Compass uses Sensogram data to set the start frequency of the transposed signals where normal aided speech cannot be made audible by normal amplification. The frequency range of the transposed signals is, by default, set to three frequency bands.

image

In the Fine tuning window in Compass you can see how the start frequency is automatically set, based on the Sensogram.

Fine tuning the Audibility Extender program


In the Fine tuning window, you can fine tune the Audibility Extender program. The elements that can be changed are:
The start frequency o • f the transposed signal
• The loudness of the transposed signal
• The frequency range of the transposed signal (Basic or Expanded)
image

Individualising the Audibility Extender program


Proper fine tuning ensures that the client is able to detect and discriminate relevant sounds. If a client
fitted with the Audibility Extender in the default setting has not benefitted from the program after a period of acclimatisation, it is recommendable to fine tune the start frequency and the Audibility Extender gain. One way to find the optimal setting is to make sure that the hearing aid user can hear the/s/ sound at normal speech level (approx. 30 dB HL). The energy of the /s/ sound lies in the range between 4 KHz and 6 KHz and is of great importance in speech understanding in many languages. It should therefore be in the transposed signal and be audible with the appropriate settings.

A simple method, based on this, is described below:


  1. Increase The start frequency three steps


  2. Check the audibility of the /s/. If audible end, if not audible proceed


  3. Adjust AE gain in steps


  4. Check the audibility of the /s/ after each step. If audible end, if not audible proceed


  5. Lower start frequency one step (reset AE gain to 0


  6. Repeat from step 2       


For clients who cannot hear the /s/ sound even at lowest start frequency, use the /sh/ sound (the energy
of this sound lies in the range from 2 KHz to 4 KHz). Be aware that it will normally take some time for the client to get used to the new sound. Several clinical trials have shown that benefit of the Audibility Extender improves over time (Kuk et al. 2008)

Frequently asked questions:


Who are candidates for the Audibility Extender?
Candidates for the Audibility Extender are both children and adults with an unaidable high frequency hearing loss. Clients who have hearing loss that is greater than 70 dB at and above the start frequency can often benefit from the Audibility Extender.

image Verified fitting range for the Audibility Extender. From Kuk et al 2008

Is fine tuning always necessary?
If the client is satisfied with the Audibility Extender in the default setting, fine tuning is not necessary. If the client cannot get used to the sound in the Audibility Extender program after an acclimatisation period, fine tuning is necessary.

How long is the acclimatisation period in general?
Studies indicate that clients still improve in a speech discrimination test 6 weeks after being fitted with the Audibility Extender (Auriemmo et al 2008, Kuk et al 2007).

Can I make an objective evaluation of the settings of the Audibility Extender?
It is possible to make an objective evaluation of the settings in the Audibility Extender program by using SoundTracker: Say the /s/ sound and look at the bars of the transposed signals in SoundTracker. If the bars of the transposed signals exceed the thresholds, the sound should be audible. This is also a method that can be used if the client cannot provide a verbal response.

References and other relevant literature


Auriemmo, J., Kuk, K., & Stenger, P. (2008). Criteria for evaluating the performance of linear frequency
transposition in children. Hearing Journal, 61(4), 50, 51-54
Auriemmo, J., Thiele, N., Marshall, S., Quick, D., Pikora, M., & Strenger, P. (2008). Effect of linear
frequency transposition in school-aged children. AAA. American Academy of Audiology 2008, 1
Kuk, F, Keenan, D., Peeters, H., Korhonen, P., & Auriemmo, J. (2008). 12 Lessons learned about linear
frequency transposition. Hearing Review, 15(12), 32, 34, 36-38, 40-41
Kuk, F. (2007). Critical factors in ensuring efficacy of frequency transposition. Part 1: Individualizing
the start frequency. Hearing Review, 14(3), 60, 62-64, 66
Kuk, F., Keenan, D., Peeters, H., Lau, C., & Crose, B. (2007). Critical factors in ensuring efficacy of
frequency transposition part 2: Facilitating initial adjustment. Hearing Review, 14(4), 90, 92, 95-96.
Kuk, F., Korhonen, P., Peeters, H., Keenan, D., Jessen, A., & Andersen, H. (2006). Linear frequency
transposition: Extending the audibility of high-frequency information. Hearing Review, 13(11), 42,
44-46, 48.

Friday, September 24, 2010

Widex Ireland Clean & Care Kits for Hearing Instruments

Widex Cleaning & Care Line

Widex Ireland is well aware of the current economic climate and the difficulties that our customers face. We strive to support our customers with our innovative product line and the introduction of campaign offers that truly assist our customers to preserve their margin and increase their market penetration. Widex believes in the complete hearing solution concept, with this in mind we would like to re-introduce our Cleaning & Care line and explain why we think it can truly benefit your business, increase your margin and introduce ancillary revenue flow.

The advantages of supplying a Cleaning & Care kit to your Patient

  • Your customer will have a more hygienic, safe and reliable hearing instrument
  • You increase your own value as a service supplier by providing a complete hearing solution service
  • Your Patients will return to your clinic to purchase refills which will improve your Patient relationship, aid Patient retention and provide you with an added source of ancilliary revenue.

How Widex can assist you

Widex offer  well branded and attractively packaged Cleaning & Care kits for both ITE and BTE hearing instruments, along with refills. The Cleaning & Care kits come complete with everything the Patient needs to take care of their hearing instruments on a daily basis. We think the addition of the line to your offerings will assist you in several ways,

  • Enforces the perception of you as a premium hearing care provider
  • Increases your Patients awareness of the primary causes of instrument breakdown
  • Build your Patient’s trust in you, your care package and your concern for them
  • Creating satisfied customers with decreased breakdowns
  • Increasing and consolidating the relationship with your Patient by repeat visits not associated with problems

The Cleaning & Care refills should over time become a valued noncore additional revenue stream.

The ITE Clean & Care Kit and it’s contents

The BTE Clean & Care Kit and it’s contents

Sunday, June 13, 2010

Reasonable expectations of success with digital hearing instrumentation.

Treatment with Hearing Aids will have a positive effect on your quality of life but they will not restore your normal hearing.

The most advanced and expensive hearing aids available today will not restore your normal hearing, that appears to be a stark and contrary statement, however it is true. That does not mean that hearing aids of all technology levels will not assist you with your problems. They will assist you to hear in a more satisfactory and clearer manner in the areas that you wish if you have purchased a level of technology that is suitable for the task. The following is a list of things that you should think about and I hope will make it easier for you to set out reasonable expectations for you and your chosen instruments.   

  • Restore hearing. No matter how technically advanced, in most cases hearing aids cannot restore your hearing to normal, except in some very mild hearing losses.
  • Types of hearing aids. Not all hearing aids perform the same with every type of hearing loss.
  • Hearing in noise. No hearing aid has been designed that will filter out all background noise. Some hearing aids can reduce amplification of some types of background noise or make you more comfortable in the presence of noise. The most effective solution for improving speech intelligibility in noisy situations is hearing aids with directional microphones. When directional hearing aids are coupled with digital signal processing, you can be assured that your hearing aids are optimized for improving your quality of life in noisy environments.
  • Fit and comfort. Since you are purchasing custom hearing aids, you should expect the fit to be comfortable; ideally you should not even know they are in your ears. There should not be any soreness, bleeding, or rashes associated with your wearing hearing aids. If there is go back to your hearing healthcare provider.
  • Sounds. Hearing aids should allow you to: (1) hear soft sounds (e.g. child's voice, soft speech) that you could not hear without amplification; this is part of the enjoyment of hearing aids; (2) prevent loud sounds from becoming uncomfortably loud for you-but very loud sounds that are uncomfortable to normal hearing people may also be uncomfortable for you.
  • Whistling and feedback. It is normal for hearing aids to squeal or whistle when you are inserting them into your ear (if you do not have a volume control to shut it off). If it squeals after the initial insertion, then most likely you have an inadequate fit or your canals may be full of wax, and should tell your hearing healthcare provider.
  •  Your friend's hearing aid. Do not expect your friend's hearing aid brand or style to work for you.
  • Your family doctor. Do not expect your family doctor to be knowledgeable about hearing loss, brands of hearing aids and whether or not you need them. Data shows that only 13% of physicians screen for hearing loss.
  • Expect benefit. Expect your hearing aids to provide benefit to you during the trial period. By benefit, I mean that your ability to understand speech has demonstrably improved in the listening situations important to you (within realistic expectations though). This is what you hoped for, and you should expect benefit. If you do not experience an improvement, then work with your hearing healthcare professional to see if the instrument can be adjusted to meet your specific needs. Never purchase a hearing aid that does not give you sufficient benefit.
  • Satisfaction guarantee. Expect to be satisfied with your hearing aids; expect the quality of your life to improve due to your hearing aids.
  • Trial period. Expect a 30-day trial period with a money-back guarantee if your hearing aids do not give you benefit (there might be a small non refundable portion for some services rendered).
  • Adjustment period. Give your hearing aids a chance, being sure to follow the instructions of the hearing healthcare provider. Most people need a period of adjustment (called acclimatization) before deriving the maximum benefit from their hearing aids (even up to four months).
  • If you bear the preceding in mind you should begin to have realistic expectations about what your aids can and will do for you.

    Tuesday, June 8, 2010

    Recognising a Hearing Loss

    Recognising a hearing loss is not necessarily easy for the person who suffers it. The problem and blessing, is that a hearing loss is rarely sudden, it is a slow and basically insidious process. Because of this process, a person loses their term of reference, they are no longer aware of what normal is or should be. The other confusing thing about hearing loss is that usually a person can hear some sounds perfectly well, while other sounds are un-clear at best and not present at worst. The cultural norms that are accepted for hearing loss is that somebody is deaf, shout loud enough and you will be heard.

    This is not the case, a person with hearing loss may have exactly the same ability to hear some sounds as a normal hearing person, but a radically reduced ability to hear other sounds. Shouting at them just brings discomfort and embarrassment. The issue is that most hearing impaired people have a problem hearing high frequency sounds, the consonants in speech. The consonants in speech are relatively soft sounds but they carry all the intelligibility of speech. Without them I am afraid most speech is about as intelligible as Beaker from the Muppets, or the Swedish Chef. I am showing my age here, if you don’t know who either of those are search the net for the Muppet Show and Beaker, you will understand immediately.

    With the preceding in mind, it becomes easier to understand why many people are confused about their hearing, while some people can be in denial about their loss, you can see why other people just think it is everybody else who is at fault. To get a clearer idea about whether or not you or a partner or friend have a hearing loss, there are several key questions that you should ask yourself or them.

  • Do you or they have a problem hearing over the telephone?
  • Do you or they have trouble following the conversation when two or more people are talking at the same time?
  • Do people complain that you or they turn the TV volume up too high?
  • Do you or they have to strain to understand conversation?
  • Do you or they have trouble hearing in a noisy background?
  • Do you or they find yourself asking people to repeat themselves?
  • Do many people you or they talk to seem to mumble (or not speak clearly)?
  • Do you or they misunderstand what others are saying and respond inappropriately?
  • Do you or they have trouble understanding the speech of women and children?
  • Do people get annoyed because you or they misunderstand what they say?
  • If you have answered yes to more than a few of these questions, I would advise you to take a hearing test, it is better to be informed than not. If you find that you indeed have a loss try reading the following before moving forward.

     

    Modern Hearing Aids

    Maintenance of Hearing Aids

    Thursday, May 27, 2010

    WOULD YOU SPEND TWO AND A HALF GRAND ON A FLAT SCREEN TV AND WHEEL IT INTO YOUR SAUNA EVERY DAY AND RUB BABY OIL INTO IT?Taking care of your Hearing Aids and why you should choose carefully.

    After parting with probably a large chunk of your hard earned cash for hearing device, it makes real sense to take care of them to the best of your ability. The daily care for hearing instruments, whether BTEs or custom ITEs is relatively similar. At the end of every day, take the aids off and open the battery door, opening the battery door allows the battery breathe and conserves power.

    In the case of a BTE, wipe the Aid case and the mould with a dry cloth. Check the sound bore of the mould and the tubing to see if any cerumen (wax) detritus or moisture has built up during the day. If you notice some, separate the mould and the aid and use a puffer ball to dislodge any foreign object. This should also force out any large beads of condensation. The mould and tube can then be placed in a soak box. A soak box is a small tub that can be filled with warm water and a wash tab. This will remove any bacteria or stubborn cerumen. When you remove it the next morning, it is important to dry the mould and tubing thoroughly, again the puffer ball will help here.

    It is a good idea to place the BTE instrument in a dry box overnight. A dry box is a small tub which will hold a drying Pastille and your aid, overnight it will remove any moisture that has built up over the days use. Moisture is your enemy, while manufacturers take every pain to ensure that hearing aid circuits are protected, nothing and I do mean nothing is foolproof. A build up of moisture can wreak havoc with the working of an aid. It can cause weakened amplification and the failure of components within the aid.

    With an ITE just wipe the case with a dry cloth to clean it off, then check the wax cap. With the brush supplied and holding the ITE with the wax cap facing the floor, gently brush the wax cap area. Then gently brush the microphone covers. These actions will remove any detritus that has gathered during the day. It is a good idea to place the aid in a dry box overnight particularly during the summer. Moisture again is a huge issue, particularly for a custom aid, because of its placement in the ear they are prone to moisture build up in susceptible ears.

    Whilst I understand the emotional choice that is made when a Patient picks an ITE, in practice I always advised them to go for a BTE. You are about to spend a large amount of money on a sensitive electronic device that will change your life for the better. Although Manufacturers take every pain to try and protect it, it can not be hermetically sealed, it needs to remain open to the ear to work. The ear is a hostile place, it is warm wet and oily, I ask you this question and I appeal to you to answer it honestly and think about the ramifications.

    WOULD YOU SPEND TWO AND A HALF GRAND ON A FLAT SCREEN TV AND WHEEL IT INTO YOUR SAUNA EVERY DAY AND RUB BABY OIL INTO IT?

    I would assume most of you have answered no, so why do you do it to your hearing aid, your one link to a more normal lifestyle? The one thing that allows you a fuller enjoyment of your day to day life? Go for a BTE, they get smaller and smaller every day, with thin tube applications they are almost more discreet than an ITE. Make the right choice for you, but make it knowing all the facts.

    Geoff