As part of a National Institutes of Health-National Institute on Deafness and Other communication Disorders (NIH-NIDCD)-supported project to develop open-source research and smartphone-based apps for enhancing speech rec...As part of a National Institutes of Health-National Institute on Deafness and Other communication Disorders (NIH-NIDCD)-supported project to develop open-source research and smartphone-based apps for enhancing speech recognition in noise, an app called Smartphone Hearing Aid Research Project Version 2 (SHARP-2) was tested with persons with normal and impaired hearing when using three sets of hearing aids (HAs) with wireless connectivity to an iPhone. Participants were asked to type sentences presented from a speaker in front of them while hearing noise from behind in two conditions, HA alone and HA + SHARP-2 app running on the iPhone. The signal was presented at a constant level of 65 dBA and the signal-to-noise ratio varied from -10 to +10, so that the task was difficult when listening through the bilateral HAs alone. This was important to allow for improvement to be measured when the HAs were connected to the SHARP-2 app on the smartphone. Benefit was achieved for most listeners with all three manufacturer HAs with the greatest improvements recorded for persons with normal (33.56%) and impaired hearing (22.21%) when using the SHARP-2 app with one manufacturer's made-for-all phones HAs. These results support the continued development of smartphone-based apps as an economical solution for enhancing speech recognition in noise for both persons with normal and impaired hearing.
School classrooms are noisy and reverberant environments, and the poor acoustics can be a barrier to successful learning in children, particularly those with multiple disabilities, auditory processing issues, and hearing...School classrooms are noisy and reverberant environments, and the poor acoustics can be a barrier to successful learning in children, particularly those with multiple disabilities, auditory processing issues, and hearing loss. A new set of listening challenges have been imposed by the recent global pandemic and subsequent online learning requirements. The goal of this article is to review the impact of poor acoustics on the performance of children with auditory processing issues, mild hearing loss, and unilateral hearing loss. In addition, we will summarize the evidence in support of remote microphone technology by these populations.
Smartphone use has become increasingly prevalent and patients are frequently using this technology to engage in health-related activities. There are a variety of smartphone applications that can be used to assist individ...Smartphone use has become increasingly prevalent and patients are frequently using this technology to engage in health-related activities. There are a variety of smartphone applications that can be used to assist individuals with hearing loss, particularly during extreme situations such as a global pandemic which results in restricted face-to-face interactions. The hearing-related applications can be divided into four categories: (1) screening and assessment, (2) intervention and rehabilitation, (3) education and information, and (4) assistive tools. Several subcategories of applications in the assistive tools category are described that may be of interest to individuals with hearing loss, whether they wear hearing aids or not. Examples of the apps along with links are included for each subcategory.
In this article, we review the current literature assessing the application and benefits of connected hearing technologies, as well as their potential to improve accessibility to and affordability of hearing healthcare....In this article, we review the current literature assessing the application and benefits of connected hearing technologies, as well as their potential to improve accessibility to and affordability of hearing healthcare. Over the past decade, there has been a proliferation of hearing devices that connect wirelessly to smartphone technologies via Bluetooth. These devices include (1) smartphone-connected hearing aids that must be obtained from a licensed audiologist or hearing aid dispenser; (2) direct-to-consumer devices, such as personal sound amplification products; and (3) smartphone-based hearing aid applications (or apps). Common to all these connected devices is that they permit the user to self-adjust and customize their device programs via an accompanying smartphone app. There has been a growing body of literature assessing connected hearing devices in adults living with hearing loss. Overall, the evidence to date supports the notion that all connected hearing devices can improve accessibility to and affordability of amplification. It is unclear, however, whether connected technologies are a clinically effective alternative to traditional hearing aids. Even so, the impact of connectivity is especially pertinent given the sudden disruption caused by the recent global COVID-19 pandemic, whereby connected technologies enable patients to receive treatment through mobile-based, tele-audiology platforms.
Hearing aids are often not sufficient for optimal communication between a listener and a talker. Therefore, numerous options for wireless connectivity between the listener and the talker designed to improve communication...Hearing aids are often not sufficient for optimal communication between a listener and a talker. Therefore, numerous options for wireless connectivity between the listener and the talker designed to improve communication have become widely available. From the original wireless option of the induction loop system, most of the current solutions involve a digital signal with high quality and limited interference. Many are proprietary and only operate with a given manufacturer's devices, while others are more universal as long as the digital receiver can be connected to the listener's personal device. In addition, connectivity options to assist those with hearing loss are now readily available on the smartphone which can be used as a remote microphone. Therefore, it is paramount that the available wireless protocols be considered relative to the listener's experience with wireless technology so that solutions may be offered that are efficient, economical, and effective.
Individuals with severe to profound hearing loss are likely to present with complex listening needs that require evidence-based solutions. This document is intended to inform the practice of hearing care professionals wh...Individuals with severe to profound hearing loss are likely to present with complex listening needs that require evidence-based solutions. This document is intended to inform the practice of hearing care professionals who are involved in the audiological management of adults with a severe to profound degree of hearing loss and will highlight the special considerations and practices required to optimize outcomes for these individuals.
Hearing loss is a pervasive global health care burden affecting up to one in every seven persons of whom 90% reside in low- and middle-income countries. Traditional service-delivery models are unable to support and promo...Hearing loss is a pervasive global health care burden affecting up to one in every seven persons of whom 90% reside in low- and middle-income countries. Traditional service-delivery models are unable to support and promote accessible and affordable hearing care in these setting. Major barriers include a severe shortage of hearing health care professionals, costs associated with equipment, facilities and treatments, and centralized service-delivery models. Convergence of digital and connectivity revolutions are combining to enable new ways of delivering decentralized audiological services along the entire patient journey using integrated eHealth solutions. eHealth technologies are allowing nonprofessionals in communities (e.g., community health workers) to provide hearing services with point-of-care devices at reduced cost with remote surveillance and support by professionals. A growing body of recent evidence showcases community-based hearing care within an integrated eHealth framework that addresses some of the barriers of traditional service-delivery models at reduced cost. Future research, especially in low- and middle-income countries, must explore eHealth-supported hearing care services from detection through to treatment.
Healthcare services in the United States are difficult to access for at least 10% of our population. Moreover, hearing healthcare services, including hearing aids, are largely inaccessible even for those individuals who...Healthcare services in the United States are difficult to access for at least 10% of our population. Moreover, hearing healthcare services, including hearing aids, are largely inaccessible even for those individuals who may have health insurance and access to healthcare. Humanitarian audiology has been recognized as a means of supplying hearing services and devices to underserved populations around the globe. However, little has been publicized about humanitarian audiology projects taking place in local communities within the United States. This article describes one such project that has been in place in Pittsburgh, PA, for the past 4 years. This service results from collaboration across a collection of healthcare, community service, charitable, and educational organizations. The resources necessary to create similarly sourced services in other U.S. locations are described. Challenges and solutions for this local form of humanitarian audiology are discussed.
International humanitarian programs are one way for individuals within low-income countries to access hearing health care. Faculty and students from the Idaho State University (ISU) Audiology Program have traveled to sev...International humanitarian programs are one way for individuals within low-income countries to access hearing health care. Faculty and students from the Idaho State University (ISU) Audiology Program have traveled to several locations within less developed countries over the past 15 years. Most recently, the ISU Audiology Program has partnered with Idaho Condor Humanitarian to provide hearing health care services to Peruvian indigenous people. The humanitarian expedition provides medical, dental, and audiology services to rural villages surrounding Cusco, Peru. Each year the ISU Audiology team gathers data on the hearing health care needs of the Peruvian people and fits donated hearing aids. The ISU Audiology team navigates a variety of barriers associated with limited resources to provide quality hearing health care focused on best practice guidelines for the people of Peru. This article highlights the specific needs of the people served, which the team identified and prioritized, as well as initiated a plan for continuing to develop follow-up care and sustainability.
Hearing healthcare outreach in developing countries is ill defined and inundated with sustainability challenges. One method to facilitate sustainable efforts is by training local personnel on certain aspects of hearing h...Hearing healthcare outreach in developing countries is ill defined and inundated with sustainability challenges. One method to facilitate sustainable efforts is by training local personnel on certain aspects of hearing healthcare. The purpose of this descriptive study was to identify the challenges and successes of an audio-technician training program conducted in various regions throughout Guatemala. A collaboration was created between Healing the Children, Centro de Audicion, the University of Washington, and Gallaudet University to create a learning environment for Guatemalan audio-technicians and audiology graduate students. Administration of the audio-technician training component of this program began in 2008 and continues today. Challenges and successes were identified around five themes: (1) audio-technician recruitment and skills upon entering training program; (2) practical and logistical components of clinical training; (3) collaboration and resources for ongoing care; (4) funding for travel, time, and accommodation for personnel involved in training sessions; and (5) cultural differences surrounding our approach to hearing healthcare and training. Approaches to overcome the barriers identified and future directions are discussed.
The goal of humanitarian healthcare is to improve health outcomes and patient quality of life in under-resourced areas. One avenue for improvement may be via interprofessional collaborative practice, which allows provide...The goal of humanitarian healthcare is to improve health outcomes and patient quality of life in under-resourced areas. One avenue for improvement may be via interprofessional collaborative practice, which allows providers from multiple specialties to work together to promote positive interventions for the communities they serve. The purpose of this article is to provide a general framework for incorporating interprofessional collaborative practice within a humanitarian audiology project.
As the travel industry continues to grow, so does the creation and proliferation of voluntourism opportunities offered to individuals who want to impact the lives of populations due to adversities or misfortunes of war,...As the travel industry continues to grow, so does the creation and proliferation of voluntourism opportunities offered to individuals who want to impact the lives of populations due to adversities or misfortunes of war, weather, or poverty. A more popular form of tourism for individuals to volunteer professional or personal expertise in a chartable manner is often termed "voluntourism." Unquestionably, there is a lure to volunteer for a short-term experience in exotic lands with the hopes of improving living conditions. This article aims to identify how an individual can move from being a well-meaning voluntourist to an engaged and dedicated humanitarian by following professional ethical principles and etiquette behavior.
One of the areas MarkeTrak has explored is the customer journey through hearing health care. The survey has asked question regarding how long they had a hearing loss before they took some type of action, where did they s...One of the areas MarkeTrak has explored is the customer journey through hearing health care. The survey has asked question regarding how long they had a hearing loss before they took some type of action, where did they start their journey, why did they obtain hearing instruments or not, and what the hearing instruments cost. To put that journey in perspective, this article looks at the journey of one specific individual and explores their attitudes about their hearing loss through the eyes of a psychologist.
Reimbursement for hearing aids in the present time has become as complicated, if not more so, than any other area of health care. For many years, hearing aids were a noncovered item where insurance was concerned. The pre...Reimbursement for hearing aids in the present time has become as complicated, if not more so, than any other area of health care. For many years, hearing aids were a noncovered item where insurance was concerned. The predominant model of bundling costs into a single dollar amount was copied decades ago from hearing instrument specialists. However, insurance companies and federal agencies are increasingly covering the cost of the diagnostic hearing evaluation and at least some of the costs associated with hearing aid purchases. One operational question is whether the bundled charge model is still appropriate, or should audiologists follow more closely the example of optometry whereby professional services are charged separately from the cost of goods sold? The models that have evolved constitute a broad mixture of bundling, partial bundling (i.e., partial unbundling), and complete unbundling. There exists no uniformity for which charge method is best. But, with greater frequency, insurance requirements are forcing a movement toward partial or complete unbundling of associated costs. Regardless of which charge model is adopted, calculation of the cost of service delivery for each audiology practice is an essential business component to justify charges and make educated decisions regarding participation in various insurance, cooperative, or network plans.
Hearing health care is rapidly changing through innovation in technology, services, business models, and product categories. The introduction of hearables and over-the-counter (OTC) hearing aids in particular will change...Hearing health care is rapidly changing through innovation in technology, services, business models, and product categories. The introduction of hearables and over-the-counter (OTC) hearing aids in particular will change the market for hearing help and the role of the hearing care professionals (HCPs). This article focuses on how these products will be differentiated from HCP-fit hearing aids through their ability to address the unmet needs of different consumer segments within the population of people with hearing dysfunction. The unmet hearing needs of each segment are discussed, and the size of each segment estimated, demonstrating a large potential market for hearables and a smaller potential market for hearing aids than has been previously mentioned in the literature. The results from MarkeTrak 10's survey of consumers' attitudes toward an OTC model are reviewed, showing that approximately half of both hearing aid owners and nonowners are uncomfortable doing hearing- and hearing aid-related tasks on their own without the assistance of an HCP and would be unlikely to purchase OTC hearing aids if available today. MarkeTrak data are also shown that demonstrate that the majority of hearing aid and personal sound amplification product owners believe that the HCP helped or would have helped with their hearing devices. Finally, challenges to OTC hearing aids becoming successful are discussed.
The purpose of this article is threefold. First, it is to evaluate current rates of hearing aid satisfaction, in addition to the examination of factors that influence satisfaction rates. A second purpose is to evaluate t...The purpose of this article is threefold. First, it is to evaluate current rates of hearing aid satisfaction, in addition to the examination of factors that influence satisfaction rates. A second purpose is to evaluate the effects of hearing aid use on mental health and quality of life, from the consumer perspective. The third purpose of this article is to review the current status of the market in terms of usage and ownership. The usage statistics from MarkeTrak 10 answer questions such as what is the most common type of hearing aid style. And what types of hearing aid features are popular? The results of the usage statistics provide not only insight into the satisfaction and quality-of-life metrics but also information about marketplace trends. By fulfilling these purposes, strengths and weaknesses of the current hearing aid marketplace can be determined, guiding future technological and clinical practice developments. Survey results demonstrate the continued dominance of mini-BTE (behind the ear) hearing aids and high popularity of features, including wireless capabilities. Overall satisfaction rates are encouragingly high, driven by satisfaction with BTE instruments, especially those acquired in the past 5 years. Noted areas for improvement continue to be related to listening in noise and patient understanding of their hearing aids. Given the high levels of noted satisfaction, it is not surprising that the sample revealed significant hearing aid benefits, notably in a lower risk for depression, higher satisfaction listening in almost all environments, and improved quality of life on a regular basis. Together, these data provide insights into the factors that drive satisfaction, encourage industrial and scientific advancements in the identified areas of weakness, and paint a bright picture of the hearing aid market from the consumer perspective.
In the field of audiology, change is inevitable: changes in technologies with hearing devices, changes in consumer knowledge, and changes in consumer-driven solutions. With these changes, the audiologist must adapt to me...In the field of audiology, change is inevitable: changes in technologies with hearing devices, changes in consumer knowledge, and changes in consumer-driven solutions. With these changes, the audiologist must adapt to meet the needs of the consumer. There are potential predictors that the audiologist could use to determine who is more likely to pursue and use amplification; by using these data, the audiologists may increase their productivity and increase patient satisfaction. The goal of this article is to investigate the MarkeTrak 10 (MT10) data to determine the trends in adoption and use of hearing aids as well as examine predictive factors that can be used to determine hearing aid adoption.
MarkeTrak has been conducted on a regular schedule for over 30 years to take the pulse of the hearing health care market and of consumers with hearing loss. The current version, MarkeTrak 10 (MT10), builds on the success...MarkeTrak has been conducted on a regular schedule for over 30 years to take the pulse of the hearing health care market and of consumers with hearing loss. The current version, MarkeTrak 10 (MT10), builds on the successful completion of MarkeTrak 9, with the same two objectives: to estimate hearing difficulty, hearing aid usage, and adoption of hearing aids in the United States and to gain insights into the consumer's journey through the hearing health care delivery system. In addition, MarkeTrak 10 added additional questions regarding use and satisfaction with Personal Sound Amplification Products (PSAPs) by both owners and nonowners of hearing aids.