Hearing Aids
Research shows that hearing loss can affect relationships, school
performance, job productivity, and emotional well being. For the
estimated 28 million children and adults in the United States who
have a hearing loss, selecting the most suitable hearing aids can
be the critical factor to enjoying life to its fullest.
Approximately 5% to 10% of adult hearing problems are
medically or surgically treatable. The percentage is higher in
children if middle ear disease, such as ear infection, is the
cause.
If your hearing evaluation indicates that your condition
cannot be medically or surgically treated, additional testing may
be done to determine if hearing aids will be beneficial.
An audiologist certified by the American
Speech-Language-Hearing Association (CCC-A) [use
ProSearch
to find one near you] specializes in finding the best type and
model of hearing aids for you. If you have hearing loss in both
ears, the audiologist may recommend that you use two hearing
aids. In most instances, wearing two hearing aids helps in
localizing the direction of sounds, improves listening in noisy
situations, and provides better overall hearing. The audiologist
will provide you with the recommended hearing aid(s) and/or other
hearing assistive devices and will instruct you in their use.
Do I need medical clearance before buying hearing aids?
Federal and state regulations may require a medical evaluation
and clearance from a licensed physician prior to hearing aid
purchase. Ask your audiologist about these regulations.
Are all hearing aids the same?
Hearing aids differ in design, size, the amount of
amplification, ease of handling, volume control, and availability
of special features. But they do have similar components that
include:
- a microphone to pick up sound;
- amplifier circuitry to make the sound louder;
- a receiver (miniature loudspeaker) to deliver the amplified
sound into the ear;
- batteries to power the electronic parts.
Some hearing aids also have earmolds (earpieces) to direct the
flow of sound into the ear and enhance sound quality.
Based on your listening needs, type of hearing loss, and
lifestyle, your audiologist will advise you on which of the basic
hearing aid styles and features best meet your communication
needs and their related costs.
What are the different styles of hearing aids?
In-the-canal and completely-in-the-canal aids:
These aids are contained in a tiny case that fits partly or
completely into the ear canal. They are the smallest aids
available and offer cosmetic and some listening advantages.
In-the-ear aids:
All parts of the aid are contained in a shell that fills in the
outer part of the ear. These aids are larger than canal aids, and
for some people may be easier to handle than smaller aids.
Behind-the-ear aids:
All parts are contained in a small plastic case that rests behind
the ear; the case is connected to an earmold by a piece of clear
tubing. This style is often chosen for young children for safety
and growth reasons.
The majority of hearing aids sold today are canal hearing aids
and in-the-ear hearing aids.
There are also special hearing aids built to handle very
specific types of hearing losses. For example, a
bone-conduction hearing aid
uses a headband and a bone vibrator for individuals who have no
ear canal or outer ear. There are hearing aids that route sounds
coming to one ear over to the other ear for use by individuals
who have no hearing in one ear. In special cases, hearing aids
can be built into glasses for individuals who need that type of
fitting. There are hearing aids available that can accommodate
virtually any kind of hearing loss!
What types of hearing aid technology are used today?
Hearing aids are distinguished by their technology or
circuitry. In the early days, hearing aid technology involved
vacuum tubes and large heavy batteries. Today, there are
microchips, computerization, and digitized sound processing, used
in hearing aid design.
- Conventional analog hearing aids are designed with a
particular frequency response based on your audiogram. The
audiologist tells the manufacturer what settings to install.
Although there are some adjustments, the aid essentially
amplifies all sounds (speech and noise) in the same way. This
technology is the least expensive and it can be appropriate for
many different types of hearing loss.
- Analog programmable hearing aids have a microchip which
allows the aid to have settings programmed for different
listening environments such as quiet conversation in your home,
noisy situations like a restaurant, or large areas like a
theater. The audiologist uses a computer to program the hearing
aid for different listening situations depending on your
individual hearing loss profile, speech understanding, and
range of tolerance for louder sounds.
Some aids can store several programs. As your listening
environment changes, you can change the hearing aid settings by
pushing a button on the hearing aid or by using a remote control
to switch channels. The aid can be reprogrammed by the
audiologist if your hearing or hearing needs change. These aids
are more expensive than conventional analog hearing aids, but
generally have a longer life span and may provide better hearing
for you in different listening situations.
- Digital programmable hearing aids have all the features of
analog programmable aids but use "digitized sound
processing" to convert sound waves into digital signals. A
computer chip in the aid analyzes the signals of your
environment to determine if the sound is noise or speech and
then makes modifications to provide a clear, amplified
distortion-free signal. Digital hearing aids are usually
self-adjusting. The digital processing allows for more
flexibility in programming the aid so that the sound it
transmits matches your specific pattern of hearing loss. This
digital technology is the most expensive, but it allows for
improvement in programmability, greater precision in fitting,
management of loudness discomfort, control of acoustic feedback
(whistling sounds), and noise reduction.
What are some of the special features available in hearing
aids?
Many hearing aids have optional features that can be built in
to assist in different communication situations. Some options
are:
-
Directional microphone.
Some hearing aids have a switch to activate a directional
microphone that responds to sound coming from a specific
direction, as occurs in a face-to-face conversation. You can
switch from the normal non-directional (omnidirectional)
setting, which picks up sound almost equally from any
direction, to focus on a sound coming from in front of you.
When the directional microphone is activated, sound coming from
behind you is reduced.
-
Telephone switch.
Some hearing aids are made with an induction coil inside. You
can switch from the normal microphone "on" setting to
a "T" setting in order to hear better on the
telephone. (You should know that all wired telephones produced
today must be hearing aid compatible). In the "T"
setting, environment sounds are eliminated, and you only pick
up sound from the telephone. Furthermore, you can talk without
your hearing aid "whisting" because the microphone of
the hearing aid is turned off!
The "T" setting can also be used in theaters,
auditoriums, houses of worship, etc., that have induction loop or
FM installations. The sound of the talker, who can be a distance
away, is amplified significantly more than any backgroundnoises.
Some hearing aids have a combination "M" (Microphone) /
"T" (Telephone) switch so that, while listening with an
induction loop, you can still hear nearby conversation.
-
Direct audio input.
Some hearing aids have a direct-audio input capability that
allows you to plug in a remote microphone or an FM assistive
listening system, connect directly to a TV, or connect with
other devices such as your computer, a CD player, tape player,
radio, etc.
Should I buy mail order or online?
Beware of "discounted" mail order or online hearing
aid sales. Purchasing hearing aids through the mail or online
often excludes important diagnostic audiologic evaluation,
hearing aid orientation and adjustment, and rehabilitation
services. These services help to ensure quality care and full
benefit from the use of a hearing aid, as well as appropriate
referral if medical treatment is warranted.
Do all audiologists dispense hearing aids?
Many people find that they receive the most satisfactory care
by using the same professional for all services. The choice is
yours. The ASHA-certified audiologist who provides your hearing
evaluation most likely dispenses hearing aids as well or may
refer you to purchase your hearing aid from a list of
audiologists who do specialize in hearing aid dispensing.
Use
ProSearch
to find an ASHA-certified audiologist near you .
Will hearing aids help me hear better on the telephone or in
public places?
Depending on your hearing loss, hearing aids typically help
make speech over the telephone clearer. If you are on the
telephone a lot, consider getting hearing aids with the
"T" (telecoil) circuits described above. Telephone
sounds are amplified more efficiently and background noises are
better eliminated with this kind of circuit. [Only some cordless
telephones work well with hearing aids].
People with hearing loss may also benefit from a telecoil to
use with some of the special assistive listening sound systems
available in many auditoriums, theaters and other public places
as required under federal law. Discuss your option of a
"T" switch with your audiologist.
Will hearing aids eliminate all my communication
problems?
With hearing aids, you will hear some sounds you have not
heard previously or sounds you have not heard in a long time. At
first, background noise may seem loud and distracting. Your own
voice may sound louder.
It can take several weeks to months to become adjusted to
listening with your hearing aids. Your audiologist will provide
hearing aid orientation for you as well as audiologic
rehabilitation as needed, which will enable you to communicate
more effectively with your hearing aids.
Are there other hearing devices that will help me hear with
or without my hearing aids?
Hearing aids, very helpful in one-on-one communication, are
not the only technology available. for large area events, such as
movies, theaters, large meetings, classrooms, or public
halls.
Hearing assistive devices (also known as assistive listening
devices) are available for use alone or in combination with many
hearing aids. These devices provide extra help in specific
listening situations, such as the telephone, noisy backgrounds,
or small or large group listening settings (e.g., restaurants,
concert halls, movie theaters). Your audiologist can advise you
about assistive technology that might help with your particular
listening needs.
How costly are hearing aids?
Hearing aids vary in price according to selected style,
electronic features, and related needs for professional
consultation and rehabilitation services. A rule of thumb is that
hearing aid costs increase with more complex and sophisticated
circuitry and smaller size.
Purchase price, an important factor, should be only one
consideration in buying hearing aids. Product reliability can
save repair costs as well as the frustration of a malfunctioning
hearing aid.
Cost of a particular type of battery used by the hearing aid
and the rate at which the battery needs to be replaced also
influence the overall cost of owning and maintaining a hearing
aid. Batteries may last from several days to several weeks
depending on the power requirements of the aid, the type of
battery, and whether the aid is used routinely with an assistive
listening devices.
Each person's hearing loss presents unique
characteristics. The expertise of your audiologist about product
quality and the monitoring and follow-up services you will need
are important considerations in your purchase decision.
Will my health insurance pay any of the costs of acquiring a
hearing aid?
Some private health care plans cover the costs of audiologic
tests, a hearing aid evaluation, and even partial or full
coverage of a hearing aid. Check with your health insurance
company or your benefits manager to find out exactly what
audiology services your policy covers. You may wish to advocate
for inclusion of audiology services in your plan if not
included.
At this time, Medicare does not cover hearing aids; Medicaid
often does and must for children.
What else will I need to know about my hearing aids?
- Know how to obtain maintenance and repairs.
- Learn how to use special features ("T" circuit,
volume control, and program remote controls).
- Parents will need to know how to determine if a child's
hearing aids are functioning properly.
What if I buy hearing aids and I can't adjust to using
them?
Laws in almost 2/3 of the states require a trial period for
all hearing aid sales. Most audiologists provide a trial period
even if it is not required by law. You may choose to try a
different make or model if the first choice is not satisfactory.
If you decide to cancel your purchase during this trial period,
there may be a nonrefundable fitting charge for professional
services and your custom earmold. You should discuss these
policies with your audiologist prior to purchase.
Hearing aids do not restore normal hearing but do offer
substantial benefit to most persons with hearing loss.
Conclusion
Hearing loss doesn't have to restrict life activities.
Properly fitted hearing aids with appropriate communication
strategies can help in many listening situations. The
step-by-step approach below will help you determine if hearing
aids can help you to hear better:
- Consult an ASHA-certified audiologist (CCC-A) for an
audiologic evaluation and determination of need for medical
referral.
- Get a professional hearing aid candidacy evaluation from an
ASHA-certified audiologist. Purchase the recommended hearing
aids. Pay attention to
- trial period
- sales contract
- warranty information
- features
- Attend follow-up care orientation and rehabilitation.
- Ask about other hearing assistive devices that can be used
with the hearing aids to improve hearing in difficult or large
area listening situations.
- Report problems you are having with communication. Your
hearing aid might need a simple adjustment.
- Receive regular audiologic follow-up care to help you with
adjustment to the hearing aid and monitor any changes in your
hearing.