Can Hearing Aids Make You Smarter? Research On Cognitive Hearing and Listening Fatigue Says They Can — Is The Industry Finally Listening?

Hearing aid manufacturers have finally started listening to ten years of academic research into concepts known as “cognitive hearing,” “listening fatigue” and “cognitive fatigue.” It took them long enough, but I’m not complaining, because at least they are finally claiming to attack the problem of hearing loss at its roots.

In recent announcements of their next-generation hearing aids, industry leaders Starkey Laboratories and Oticon both claimed their new products would ameliorate “cognitive fatigue” and therefore improve not only hearing but also the ability to listen and understand. Since the invention of the hearing aid, the industry has focused mostly on simple amplification that makes noise louder and therefore easier to hear. Too often, hearing aids amplify the noises uses don’t want to hear and actually make it more difficult to comprehend the sounds — speech — they do want to hear. Now the industry is finally trying to address the critical issue of better cognition.

While neither Starkey nor Oticon went so far as to say their hearing aids would make you smarter, that’s really the value proposition the industry should start trying to deliver. No, hearing aids can’t make you smarter all by themselves. But hearing well can enable you to listen well, and listening well can enable you to better understand what you hear, better understanding makes it easier for you to communicate in real time with other people, and intelligent communication lets your brain be as smart as it naturally wants to be. Now think of the same scenario in reverse: no hearing assistance means less listening means less understanding means less intelligent communication. In other words, failure to get a good pair of hearing aids can make you appear to be a whole lot stupider than you really are.

The catch is what constitutes a “good pair of hearing aids.” Dr. Brent Edwards at the Starkey Hearing Research Center in Berkeley, California has been looking at the issue of “cognitive hearing” for years, and his work is finally working its way into the products Starkey is delivering to the marketplace. Instead of looking at the problem from the outside in with the mechanics of replacing lost hearing with amplified sound, Edwards and other researchers have looked at it from the inside out by studying how the brain interprets sounds and uses them to create understanding and intelligence. Critical, previously ignored issues —  such as how the brain processes and then ignores background noise, how it picks up nuances in timbre and tone to make fine distinctions between similar-sounding consonants in speech, and how the mental overhead required to compensate for hearing loss affects overall cognitive performance — are now providing guideposts for product developers deciding on how to use the new wealth of digital technology and software to process sound in helpful ways.

A four-year old presentation Edwards gave at the American Academy of Audiology conference is available here. It’s a good starting point for anyone who wants to understand issues surrounding cognitive hearing and hearing-aid product development better. It also points to the research of others in the field, especially Robert Sweetow, who did pioneering studies on how therapeutic training in hearing and listening can dramatically improve comprehension, a concept embodied in Neurtone’s LACE training software.

Will the new hearing aids from Starkey and Oticon prove to be revolutionary, game-changing breakthroughs in delivering on the promise not just of better hearing but of better cognition? More likely, they will be incremental but important advances in today’s hearing-aid technologies. But I’m more optimistic now that with a new awareness of and focus on the core issue of better hearing — better performance in life through better cognition and understanding — the industry will eventually find ways to deliver on the promise.

Able Planet’s Noise-Canceling Headphones Introduce True Hearing-Aid Technology To Consumer Electronics Industry

Able Planet has been around a long time developing assistive listening products for the hearing-assistance industry based on its Linx Audio sound processing technology. But recently it has taken on a new look with a high-profile branding campaign and a new, broad line of high-end noise-canceling headphones, earphones and accessories attacking the heart of the consumer electronics market. At the AudiologyNOW! conference they stood out with a booth promoting “I Am Able” professional athletes who endorse their products, and they were showing new headphones and headsets that are successfully competing head-to-head with Bose and other popular high-end brands.

I caught up with Able Planet’s CEO Kevin Semcken and Chief Audiology Officer Dr. Christoper Schweitzer. Both have vast experience in the health care, medical device and hearing-aid industries. But what stood out for me is their commitment and savvy about what high-end audio consumers are looking for, and how previously arcane hearing-aid technologies such as digital signal processing will play an essential role in consumer electronics. By integrating Linx Audio into all its headphones and headsets, and promoting the technology as its critical advantage, Able Planet is distinguishing itself as one of the very few companies driving high-end hearing technology into mainstream products.

Able Planet’s noise-canceling headphones are head-to-head competitive with Bose, the gold-standard in noise-canceling headphones. Don’t ask me, ask CNET, which did a review of one of Able Planet’s earliest noise-canceling headphones as long ago as 2007 and said that it provided better noise suppression than Bose and an equally rich if not superior listening experience. The only negative in the review is that Able Planet wasn’t a known consumer brand and therefore would have a difficult time overtaking Bose, even with a better product.

Able Planet will continue to differentiate its products by providing value-added features that enable users to customize their listening experience — with what Dr. Schweitzer calls “chameleon-like” digital platforms that are easily modified based on the user’s unique hearing profile. Things as simple as plug-replaceable cords that can provide volume control, left-right balance and equalization adjustments can make all the difference for a boomer suffering unequal levels of hearing loss in one or both ears. Able Planet is also looking at ear-cup sizes that can accommodate behind-the-ear hearing aids on certain models. And it is working on wireless technologies that will enhance the chameleon capabilities of its products even more in the future.

I’ve used headphones from Sony, Sennheiser, Bose and others. Each has its advantages and all provide pretty good sound. But none of the brands has ever made me feel they are focused enough on people with mild or severe hearing impairments to give me any comfort that they are developing products that will continue to meet my needs better and better as new hearing-enhancement technologies become available.

The traditional hearing-industry leaders are no better, by and large choosing to focus on a narrow market of hearing-impaired patients served by audiologists rather than aggressively pushing new products into consumer channels. There is no doubt that within the hearing-aid industry there is enough mind-blowing new technology which, if packaged and promoted properly, could change the landscape of consumer electronics. It continues to amaze me that, as the baby boomer generation continues to lose its hearing at predictable rates, so few manufacturers are positioning themselves to meet the needs of high-end consumers of electronic products who need better and more intelligible sound. By showing up at AudiologyNOW! positioning itself to serve that broad space between high-tech hearing aids and high-end consumer electronics, Able Planet is showing that it “gets it.” Let’s see how many others in the industry follow their lead.

Feel Good Department: Super Bowl Heroes Drew And Brittany Brees Give Big Assist To Hearing Protection Advocacy

Credit Super Bowl MVP Drew Brees and his wife and partner-in-parenting Brittany with the biggest assist of the year for hearing protection advocacy. The feel-good story of the afternoon was when the future Hall-of-Fame quarterback shared a special moment with his year-old son Baylen just before hoisting the Lombardi trophy in front of 70,000 fans and millions of TV viewers. The first question out of many viewers’ mouths was, “What’s with the headphones?” Drew and Brittany let everyone who asked know that the huge hearing-protection headset covering little Baylen’s ears has been standard issue since their son attended his first game at the tender age of three weeks. The New York Times parenting blog captured the moment beautifully, giving both parents an A+ for putting their son’s precious hearing first. Now here’s a question: who was the manufacturer of that hearing-protection headset? I can’t tell the brand or model from the pictures. Whoever it is now has the world’s most valuable product endorsement!

02/11/2010 UPDATE: This just in–a Hearing Mojo reader named bob has identified Peltor as the maker of Baby Baylen’s hearing-protection headset. Inc. Magazine got on the story quickly. Peltor, located in the home town of the Indianapolis Colts, apparently had no idea their Peltor Junior Earmuffs would be getting such a great endorsement. For more on Peltor see our previous story on Peltor’s hearing protection headsets.

Rock & Roll Icon Stephen Stills Talks About How Hearing Aids Alleviate His Lifelong Hearing Loss

Oticon USA has used the 40th anniversary of the Woodstock concert to do a nice PR piece on Crosby, Stills & Nash player Stephen Stills, who uses Oticon Dual hearing aids. The group’s performance at Woodstock was a centerpiece of the film made about the event and kept their music at the top of the charts for years.

Unlike many rock musicians whose first deafness was a direct result of constant exposure to too-loud music, Stills was diagnosed at nine years old with a slight hearing loss in one ear. In the interview published on the Oticon web site, he shares some good insights on what it’s like to gradually accept your hearing loss and do something about it. He’s also a good example of someone who’s managed to cope with his hearing loss and continue doing what he loves:

“Now when I perform, I am able to hear the top end of the music and get back in tune….Now I can hear the subtleties of the music. This has improved my playing and my singing.”

Opinion: Hearing Aid Pricing Should be More Transparent

The recent Consumer Reports survey of hearing-aid pricing and fitting practices highlighted a growing problem for the hearing-aid industry. Increasingly, consumers are starting to wonder why a few small digital components that can be purchased individually from wholesalers for tens of dollars each (digital signal processor, microphone, amplifier and software) end up in a set of hearing aids that can cost thousands of dollars. It’s time for more transparent pricing in the hearing-aid industry. Digital technologies are becoming standardized, and the cost of components continues to decline.

And there are good alternatives to the established brands now for cost-conscious, tech-savvy do-it-yourselfers: America Hears, which builds top-quality digital hearing aids and sells them online, programs them to your audiogram at the factory, sends you the software to make your own adjustments, and has licensed audiologists at the end of the phone to give you as much help as you need. All for under $1,000 a hearing aid. But most other comparable top-quality digital hearing aids still cost two to three times that much. Why? The answer is in the cost of the service required to get a custom fit. If you don’t dare do it yourself, a good audiologist truly is worth his or her weight in gold, especially if your hearing profile is complex. Getting a comfortable fit and programming assistance tuned to your audiogram usually requires multiple tries and is seemingly as much art as science. An audiologist who will stick with you through multiple adjustments is worth a significant mark-up. But it’s fair to question the value of the markup above and beyond the wholesale price of the basic hearing instrument components.

The hearing industry for the most part remains stuck in a very old distribution model which has restricted growth and shut off affordable options for a large segment of potential buyers in need of hearing assistance. Today most hearing aids are sold by audiologists who charge a single price for the hearing instrument and the service they provide. They give you a hearing test and fit you with hearing aids that meet your specific needs. Their invoice most often does not include line items for the cost of the hearing test, for the ear molds, for the hearing instrument, or for follow-up service. If it did, you would see there’s a lot of cost built into the time they put into helping you out. If you don’t need much help, they make a lot of money. If you are a difficult case requiring a lot of adjustments, they make less. This model worked well until recently. But now, digital technologies are making many more options available for people with different kinds of hearing loss. Open-fit designs mean many consumers don’t need an earmold fitting, and good digital amplification is making it possible for many people to get the hearing assistance they need from low-cost manufacturers selling direct, over the counter. One manufacturer, Songbird Hearing, is even offering disposable hearing aids that you can buy direct from their web site to address mild hearing loss, without a hearing test if you sign a medical waiver. Read more

Consumer Reports Survey Finds Resellers Routinely Double Wholesale Prices of Hearing Aids

A Consumer Reports Magazine investigation of hearing-aid sales and fitting practices found that resellers commonly mark up the prices of new hearing aids more than 100 percent over the wholesale prices paid to manufacturers. In a major report published in the magazine’s July issue, Consumer Reports editors followed a dozen hearing-impaired patients for 6 months as they shopped for and used hearing aids, lab-testing the features of 44 hearing aids. The magazine’s National Research Center also conducted a survey of 1,100 Americans who had bought a hearing aid in the last three years.

“Consumer Reports verified the wholesale price of several of the hearing aids tested, finding on average a markup of 117 percent,” the magazine said in a news release. “This means that there is room to bargain,” said Consumer Reports Senior Editor Tobie Stanger, who added that only 15 percent of survey participants negotiated for a lower price.

Consumer Reports also found that most hearing-aid purchasers they tracked got what it called “mediocre” fittings. “Two-thirds of the 48 aids purchased were misfit: They amplified too little or too much,” the news release said. However, even with substandard fittings, the survey indicated that the hearing-aid industry has started to overcome past problems with customer satisfaction by finally delivering hearing assistance that actually helps users hear better: 73 percent of the users who bought hearing aids were highly satisfied.

The prices of the hearing aids in the Consumer Reports investigation ranged from $1,800 to $6,800 per pair. Currently most hearing aids are sold by manufacturers to audiologists, who resell the products while providing essential services such as a hearing test, fitting, programming the amplification settings to match the patient’s unique hearing profile, and providing warranty repair service. Audiologists justify the mark-up over the manufacturers’ wholesale prices by providing service as part of a set price for the hearing aids.

More Courts Should Provide ‘CART’ Real-Time Video Transcription Services

I was excused from jury duty today after I told the officer at the reception desk that none of their amplification schemes, even the portable listening devices they provide as an accommodation for people with hearing loss, would work for me. I told him I’d be happy to serve if they could provide CART service–communications access real-time transcription–where they wheel a TV monitor into court and provide real-time video captioning of the proceedings. But they still don’t provide that service in the Massachusetts Superior Court House where I was called to serve.

CART systems have been around for many years and have long been recognized by the federal government as a “reasonable accommodation” under the Americans with Disabilities Act (ADA). So it’s disappointing and a little surprising that CART service isn’t yet a standard accommodation for hard-of-hearing people called to jury duty. Read more

It’s Better Hearing and Speech Month

Better Hearing and Speech Month is a 75-year-old tradition celebrated every May. The American Speach Language Hearing Association website has some nice ideas on how you can promote it, along with materials you can download and/or buy. Enjoy.

Back in Business, After a Long Break

I’ve been letting people know I’m re-booting my Hearing Mojo hearing-loss blog after having taken a long break from posting new entries. In the past year I’ve let this blog lie dormant as I’ve gone completely “mainstream” with my communications consulting business, Aquarius Advisers. We have been successful, with a number of happy high-technology clients, but it’s been an education in coping with hearing loss in the business world. During my blogging hiatus, I’ve stayed current with the new developments in the world of hearing loss and hearing aids, including time spent consulting with America Hears, Inc., the leading online manufacturer and marketer of premium digital hearing aids. However, I’ve sorely missed writing about this industry and all the issues involved with it, so I intend to start doing so again. I’m still managing a transition to a new blogging platform (the new look and feel are enabled by the WordPress open-source content management system, as opposed to the Moveable Type platform I used in the past). So it might take me a while to get the new platform exposed to the search engines. But I’m starting to write again as of now. A lot has happened in my absence, and I intend to catch people up with all I’ve seen and heard, starting with my visit earlier this month to the American Academy of Audiology Audiology Now 2009 conference.

It’s Official: Bilateral Cochlear Implants Improve Quality Of Life

What people like Michael Chorost have long-suspected appears to be true: hearing in stereo is good for your health. A study by the Indiana University School of Medicine found “cochlear implants in both ears significantly improve quality of life in patients with profound hearing loss and that the cost of the second implant is offset by its benefits.” Read more

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