Today's Patient

Facts or Fiction

Facts on Assistive Listening Devices (ALDs):

• ALDs are "binoculars for the ears" and may benefit many people with residual hearing. They are intended to augment standard public address and audio systems by providing signals that can be received directly by persons with special receivers or their own hearing aids.
• A minority of hearing aid owners concurrently use ALDs. About 1 in 4 consumers use a phone amplifier, while less than 10% of hearing instrument owners are users of ALD devices for enhancing their hearing with TV, at movies, in places of worship, or in conferring.
• ALDs "stretch" the performance of a hearing aid by increasing the signal to noise ratio (SNR). This is significant as SNR has to be higher for many people with hearing loss for them to hear speech over background noise
• ALDs reduce the effect of distance between the person with hearing loss and the sound source; override poor acoustics; and minimize background noise.
• There are hard-wired ALDs and three types of wireless ALDs (audioloop, FM, and Infrared). All three types can be used with or without hearing aids, and can be used with an array of receiver attachments for consumers with varying needs and preferences. This includes neck loops, silhouette inductors, headphones, direct audio input and other linkages. Hard-wired ALDs include hand-held amplifiers with microphones, direct audio input microphones, and hard-wired systems.
• Another category of assistive listening devices are the self-contained beam-forming microphone arrays. Some may connect with hearing devices via the telecoil or direct audio input.
• Each type of ALD has advantages and disadvantages. The type of ALD appropriate for a particular application depends on the characteristics of the setting, the nature of the program, and the intended audience.
• ALDs may be installed in large areas, portable for personal use, or in the case of FM systems, built into a hearing aid.
• ALDs are an example of auxiliary aids and services and reasonable accommodations required by the Americans with Disabilities act (ADA) to be provided by public facilities, state and local governments, and employers, to enable people with hearing loss to participate in their programs and services.
• ALDs typically have not been covered by any public or private health insurance plans, and are not available in mainstream retail outlets. Most ALDs must be purchased through catalogs of ALD distributors or from some hearing health professionals. Access, availability and therefore awareness of ALDs by consumers is a limiting factor to their acceptance and use.
• Other assistive technology that can benefit people with hearing loss include alerting devices, such as special smoke detectors, doorbells, telephone ring signalers, telephones, and alarm clocks. These may produce laud signals, visual signals, or tactile signals. Captioning and CART (Computer Assisted Real-time Transcription) also provide great benefit.

Facts on Hearing Aids:

• The hearing aid fitting process typically consists of six stages: assessment, treatment planning, selection, verification, orientation, and validation. The widespread use of computers has made the process of fitting hearing aids more accurate and efficient.
• Over 60% of individuals with hearing loss are fit with two hearing aids (binaural). The benefits of wearing two hearing aids are enhanced ability to (a) hear better in the presence of background noise, (b) determine where sound is coming from, and (c) hear soft sounds at lower levels.
• One state-commissioned study published in 2000 has put the average cost for requiring hearing aid coverage by all insurers, non-profit health plans and health maintenance organizations (HMOs) every 3 years at $16. This is based on a $1,400 contribution per hearing aid (beneficiaries wanting more expensive hearing aids would pay the difference), excluding the cost of batteries and maintenance that is estimated at about $300 per year.
• Hearing aids differ in design, type of circuitry, size, and amount of amplification, but they do have similar components that include a microphone, amplifier circuitry (to make the sound louder), a receiver (to deliver the amplified sound into the ear); and batteries to power the electronic parts.
• Approximately 30% of hearing aids in use today are equipped with a telecoil. This is an optional feature that couples directly with hearing aid compatible telephones and assistive listening devices, improving intelligibility in noisy situations, poor acoustical environments, and at long distances from the speaker.
• There are over 1,000 types and models of hearing aids to satisfy an individual's hearing loss needs.

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Hearing aids vary in terms of the technology that is enclosed in the casing (described above). Types of hearing aids include: conventional analog hearing aids, analog programmable hearing aids, extended hearing devices and digital processing hearing aids. Lower end technology allows limited flexibility in programming the hearing aid for the individual's hearing loss characteristics and environmental characteristics. Mid level technology allows greater flexibility in meeting individual needs and can produce a hearing aid that is fully automatic. This level of technology may include noise reduction which may make listeners more comfortable in noisy backgrounds. The highest level of technology can be completely automatic or user controlled. This level of technology provides the greatest flexibility and many custom features are available to meet the individual listener's need.