Helping you hear the beauty of Long Islad Sound Audiology by the Sound

Hearing Aids

Help a child with hearing loss learn speech and language.

Help an adult have conversation with family, hear children laughing, hear the birds chirping and music playing.

Help a patient who also has Dementia or Alzheimer's Disease re-connect with the world and loved ones.

Reduce the detrimental effects of hearing loss that may include depression, social anxiety, compromised safety not hearing doorbells, phones or sirens and other cars while driving.

Improve Quality of Life!

Choosing a hearing aid is a big decision that will improve quality of life, safety and communication ability. There are digital hearing aids available now for every hearing loss and every budget. Here are some suggestions and information to consider before buying a hearing aid:

Step One:
See a licensed audiologist to obtain a comprehensive Audiologic evaluation to determine degree and type of hearing loss. An audiologist is the specialist with a graduate degree of a Master's or Doctorate in Audiology. Audiologists are the only hearing health care specialists providing a wide range of Aural Rehabilitation services from pediatric newborn hearing testing to geriatric aural rehabilitation. Audiologists prescribe and monitor the fitting of hearing aids, cochlear implants, and assistive listening devices. They provide balance assessment, aural rehabilitation training, central auditory processing testing, assess, monitor and treat tinnitus, provide hearing conservation/industrial Audiology monitoring and training. Audiologists aretrained to teach communication skills, speech reading, modify acoustics of classrooms and homes to improve hearing ability or fit children and counsel teachers to use assistive listening devices with or without hearing aids. An audiologist is not a physician and does not provide medical treatment, such as surgery or prescriptive medications. An audiologist is trained to determine if your hearing loss may be indicative of a medical condition and will refer you to an ENT if necessary. The FDA recommends you see an ENT once every three years. Children are required to have a medical evaluation by an ENT before being fit with hearing aids. Approximately 80% of hearing losses are treated by aural rehabilitation, assistive listening devices and/or hearing aids; the remaining 20% may be treatable with medical intervention.

Step Two:
All hearing losses are different. Your audiologist will advise you as to restrictions in choice of hearing aid based on your unique hearing loss. Some hearing aid features available may be useful to you but not necessary for others. Assistive Listening Devices may also be an option.

Step Three:
Consider your budget and what you want to get out of the hearing aid. Hearing aids are wonderful tools, but they do not restore hearing, they process and amplify sound to make it as accessible as possible to a damaged auditory system. Many of the proven features, such as Directional Microphones that help you hear better in background noise are available even on entry level priced hearing aids. Also consider the style of hearing aid you want, but bear in mind that your hearing loss also needs to be taken into consideration and discussed with your audiologist before the final decision is made. Here are some pictures of various styles of hearing aids the smallest being the Completely In the Canal (CIC), then there are In The Ear (ITE) hearing aids, and finally Behind The Ear (BTE) hearing aids, such as the baby is wearing:

Baby wearing Behind the Ear Hearing Aid by Phonak. Assorted Phonak Hearing Aids.

Step Four:
Compare Apples to Apples when considering hearing aids and prices. The following is a list of common features and definitions you should become familiar with before you purchase a hearing aid.

  • Channels- Multiple channels are recommended for flexibility and comfort in setting the hearing aid's output to meet each individual hearing loss. For example, one person may need more volume in the high pitches and less in the low. Channels break up the sound into frequency bands and each channel processes a range of sound. Multiple channels also offer an advantage in noise management and feedback management (see below).
  • Directional microphones- Directional microphones are the only proven method to improve speech understanding in background noise. For example, if you are at a table in a restaurant and you want to hear best the person across from you at the table you would turn on the directional microphone and it would amplify the sound coming from the speaker and reduce the amplification from the sounds coming from behind you and other areas in the room. There is great diversity in the sophistication level of directional microphones from different manufacturers but they are available on even the entry level priced hearing aids.
  • Telephone coils & acoustic telephone programs are designed to improve the signal (phone speech) to noise ratio (background noise in the room) when talking on the phone. A telephone coil picks up and amplifies the signal from the magnetic receiver of the telephone. An acoustic telephone program is an acoustic microphone and an adjustment to the sound output of the hearing aid to best work with the phone. Both are designed to minimize the occurrence of feedback when using the phone in background noise.
  • Feedback management- Just like a speaker on a stage has to be careful that they don't point their microphone to the speakers creating that awful squeal, hearing aids are prone to feedback if the sound produced by the hearing aid escapes the ear canal and returns to the hearing aid's microphone. Modern technology has come up with wonderful solutions such as feedback cancellation in which the hearing aid produces the exact mirror image of the frequency of the feedback causing it to become inaudible. Other feedback management strategies may have to reduce the volume of the frequency (frequencies) that are feeding back. Feedback cancellation is more sophisticated because it will not require reduction in the volume of the hearing aid. Other options are reducing the size of the air vent in the hearing aid, but this gives the listener more of a plugged up feeling when talking, or to use a BTE hearing aid which positions the microphone farther away from the sound outlet on the hearing aid.
  • Noise suppression- noise management processing is for use in difficult listening environments and may be facilitated through use of directional microphones or digital signal processing strategies utilized by various manufacturers. Noise management signal processing strategies will make for improved sound quality, clarity, and comfort in a hearing aid, but are not research proven to significantly improve speech recognition ability in background noise like the directional microphones are.
  • FM/DAI compatibility- DAI, or Direct Audio Input enables connection of the hearing aid to external sound sources such as assistive listening devices or FM systems. An FM system is a listening device designed to give the listener an advantage over background noise. A microphone is strategically positioned, either on a speaker's lapel or in another position to pick up desired speech, and then transmits the signal to a receiver by FM signal directly to the hearing aid. In this way the speech is as clear to the hearing aid as it is at the source without the competition of background noise. The FM system may also be plugged into a radio or TV. Telephone coils may also be used to work with DAI systems.

    Photograph of a Direct Audio Input system.

  • Multiple memories- multiple memories, or programs are different settings on the hearing aid for different listening conditions. For example you may need a certain sound output for listening at home in quiet to hear best, and a different setting to understand speech in background noise, like when out shopping. Perhaps the directional microphone will be active in one program and turned off in the other program. Or you may like to listen to music with a slightly different frequency response (consider how different people like more bass and some more treble). Some hearing aids now have signal processing that enables them to anticipate when the environment dictates the use of a certain program and they will switch settings automatically.
  • Warrantees- Typically hearing aids come with one or two year warrantees and the option to extend these warrantees up to five years with some manufacturers. The warrantee is typically through the manufacturer and may include repair or repair, loss and damage coverage. Review the terms and conditions of each warrantee to know when it expires and if there is a deductible to pay if the hearing aid is lost or damaged.

HEAR BEST WITH TWO EARS:
Unless there is a reason NOT to amplify both ears always wear two hearing aids. God created you with two ears and your brain needs the input from both to listen and perceive the sounds of your environment the best. The natural capabilities of the brain when receiving a signal from both ears are better than any advancement in technology. It is better to use two less expensive hearing aids rather than one very expensive hearing aid. The benefits of listening with two ears include the following:

  • Sound localization ability- you cannot tell what direction a sound is coming from unless you hear it with both ears. This is an important safety consideration but also usefull when someone calls for you and you want to know where they are.
  • Speech in noise- research has proven that it is easier to understand speech in background noise when listening with two ears instead of one. The brain is able to process out environmental sounds that are distracting or coming from a different location than what you are concentrating on if you use two ears!
  • If you use only one hearing aid that hearing aid may need to be up to 10dB HL louder to give you the volume you desire. Wearing two you do not need to make the hearing aids as loud.
  • And as important as the safety considerations is the risk of neural atrophy not using a hearing aid in both ears. Over time your ability to process speech may decrease even if your hearing threshold remains the same.

Step Five:
Consider and write down your personal goals. This will help you measure and take notes on your progress with the use of hearing aid. It will also help you identify the features you want in your hearing aid. Consider some of the following examples:

  1. I want to hear my favorite TV program or music better and without raising the volume so high.
  2. I want to hear my grand-daughter when she comes over to visit.
  3. I want to be able to hear better when I go out to eat with my friends.
  4. I need to hear on the phone for work.

List specific goals in the order of importance and then consider how you do without hearing aids by putting a score on them, for example 1= very difficult 5= no difficulty hearing. You can refer to this list and reconsider your difficulty levels once you are wearing hearing aids to track improvement or inform your audiologist of specific areas that need more attention.

Step Six:
Make an appointment with a licensed audiologist. Audiology by the Sound provides appointments for listening to demonstration of select hearing aids. We are proud to offer the following manufacturers chosen by proven quality, research investment and technological advancement, as well as customer service.

Visit their websites:

REMEMBER:

  • Hearing Aids do not restore normal hearing nor do they prevent further hearing loss.
  • FEDERAL LAW requires a medical evaluation of your hearing loss by an Otolaryngologist (ENT), or if none is available, by another licensed physician. You have the right to waive this requirement, you must sign a statement of waiver of your rights.
  • The FDA recommends that you see an ENT every three years.
  • NY State law protects your investment. You have the right to a 90% refund on hearing aids purchased if they are returned within 45 days in proper working order, normal wear and tear excluded. Specific statements must be made regarding this law in the purchase contract you sign when you buy hearing aids. See the NY State website for more information on your rights, specifics about this law, and for their consumer's guide to hearing aids: www.dos.state.ny.us and www.dos.state.ny.us/lcns/guides/hearingaids.html
  • Aural Rehabilitation goes beyond hearing aids. We also offer assistive listening devices, speech training, communication counseling for family and care takers, as well as communication strategies training and advice on modifying the acoustics of your home for best comfort and listening ability. Sometimes hearing aids aren't even the best solution—there are other and some very inexpensive devices to help those who cannot or choose not to use hearing aids.
  • Aural rehabilitation takes time. Hearing loss often occurs gradually and others may realize you have it before you do! After years of progressing hearing loss you should expect a process to learning to hear again through the use of hearing aids or other intervention. Don't delay in seeking help and you will minimize the effects of atrophy from lack of sound stimulation.

Disclosure:
The above are just tidbits on hearing aids... spend some time researching for yourself, and contact Jennifer Auer, Au.D., F-AAA, CCC-A for more information. While the manufacturers listed are carefully selected, the statements made on their websites do not necessarily reflect the opinions or recommendations of Dr. Jennifer Auer, audiologist, Audiology by the Sound PLLC.