Assistive Technology in Audiology

1
Assistive Technology in Audiology

• Hearing Aids
• Cochlear Implants
• Assistive Listening Devices

2
Various Circuits Available

• Hierarchy of Sophistication and Price
• Analog Digital Programmable
• Options
• Directional
• Remote
• Multi-Memory
• Volume control
• Compression

Ordinarily, any circuit can be put into any size
device!
3
Circuit Options (1)

• Analog Amplifies in a linear fashion, can
  distort sounds, limited means to filter
  background noise, least expensive choice

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Circuit Options(2, 3)

• Digital Programmed via computer
• Has at least 2 channels
• Analyzes incoming sound and adjusts the loudness
  based on preset parameters
• Detects softer sounds of speech, raises loudness
• Does not amplify background noise to same degree
  as primary signal

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Circuit Options(1)

• Programmable Offers fitting flexibility, can be
  used with analog circuits
• Computer programmed processor
• Normally has two channels, controlled
  independently
• Better able to match frequency response of
  hearing loss

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Optional Features

• Directional Uses dual microphones
• Available in analog, compression and digital
  models
• Use of forward facing microphone helps focus on
  desired sounds
• Helps diminish awareness of background noise

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Optional Features

• Multiple Memory
• Increases versatility
• Memories customized
• for various situations
• Remote Control
• Change volume, memory function, directionality of
  microphone

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Hearing Aid Styles
Completely In the Canal CIC In The Ear
ITE Behind The Ear BTE (4)
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Hearing Aid Styles
Behind the Ear
Completely in the Canal
In the Ear
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And the Survey Says

• MarkeTrak V(5)
• Assess user satisfaction by polling 2720 patients
  who had purchased hearing aids
• Devices that are programmable, have a telecoil
  and are fit binaurally provide highest
  satisfaction
• CIC rated highest among styles of aids
• 1/3 users want volume control

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Cochlear Implants(6)

• Biomedical electronic device to convert sound
  into electrical current to stimulate auditory
  nerve
• In use for past 25 years
• Severe to profound bilateral sensorineural
  hearing loss in selected adults
• Severe to profound bilateral hearing loss in
  children

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Cochlear Implants
Childrens with Remote
Two BTE Styles for Adults
Photographs courtesy MED-EL
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Cochlear Implants(7)
Ear level processor
Implant device
Body worn processor
Photographs courtesy Cochlear Corp.
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Cochlear Implant
Drawings courtesy of Cochlear Corp.
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Candidacy for Implant

• Team approach favored
• Team should include
• Audiology, Speech-Language
• Pathology, Otology or Neurotology,
• Social Work or Psychology,
• Educator of the hearing impaired

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Patient Consideration

• Factors considered
• Patient age, general health
• Age at time of hearing loss
• Benefit derived from present amplification
• No medical contra-indications such as absent
  cochlea or VIIIth nerve

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FM Communication Systems(2)

• Enhanced speech perception in noise, at great
  distances
• Used in classrooms
• Greatly increases signal to noise ratio
• New technology reduces size, eliminates cords,
  wires

Receiver/BTE
Transmitter
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Assistive Technology

• Pocket Talker
• One to One Amplifier
• Cell Phone with TDD
• Telephone Amplifier
• Amplified Phone

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Devices for the Home

• Strobe Light Doorbell
• Bed Shake Alarm Clock
• Flashing Smoke Alarm
• Vibrating Wrist Watch
• Television Closed Caption Decoder
• TV Infra-Red Listeners

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Devices for the Home

• Strobe Light Doorbell
• Bed Shake Alarm Clock
• Flashing Smoke Alarm
• Vibrating Wrist Watch
• Television Closed Caption Decoder
• TV Infra-Red Listeners

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Who Can Benefit From This Information?

• Hearing loss one of most prevalent chronic
  conditions in America(8)
• More than 9 million aged 65
• 3/5 in this age group in need of hearing help do
  not have it
• More than 10 million aged 45-64
• 6/7 in this age group who need hearing help do
  not have it

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Effects of Untreated Hearing Loss

• Sadness, depression
• Worry and anxiety
• Paranoia
• Less social activity
• Emotional turmoil and insecurity
• Responses constant across gender, age, income

• Survey by the National Commission on Aging
  reveals older Americans who do not use hearing
  aids are more likely to report the following

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Benefits of Better Hearing

• The same study showed those who use hearing aids
  report
• Better relationships with family
• Better feelings about themselves
• Improved mental health
• Greater independence and security

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Why Not Seek Help?

• Denial
• Hearing isnt bad enough (in those with
  self-estimated moderate to severe hearing loss)
• Can get along without help
• Consumer Based
• Too expensive
• Dont trust hearing specialists
• Heard they (hearing aids) dont work well
• Stigma
• Make me feel old
• What will others think?

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Hearing Aids CAN Help(9)

• Double blind clinical study proved increased
  speech recognition and speech quality
• Benefits found for each circuit tested when
  compared to unaided condition

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Increase Awareness and Referrals

• Be alert for signs of possible hearing loss
• Refer patient for evaluation of hearing

Promote Benefits of Better Hearing
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Some Closing Thoughts

• Numerous circuits, styles and optional features
  of hearing aids allow patient many ways to
  improve hearing
• Cochlear implants available for those with severe
  to profound bilateral hearing loss, as young as
  12 months
• Assistive devices are available for use
  throughout the home and office

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The Last Thought

• Hearing impairment is leading chronic health
  problem in USA
• Quality of life is better for those who use
  hearing assistance
• Discuss potential hearing problems with your
  patients