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The purpose of this booklet is to provide basic information about hearing loss, hearing instruments and the importance of using a Hearing Instrument Specialist® as you make decisions about your hearing instrument. Your professional Hearing Instrument Specialist® has the training and expertise to provide individualized assistance and personal counseling for you and your family as you embark on this new World of Sound. In fact, only qualified professionals approved for membership in the International Hearing Society are allowed to use the registered title Hearing Instrument Specialist®. This booklet is provided as a public service by the International Hearing Society through a grant from the Hearing Aid Foundation and is intended as an informational resource only.
The ability to hear is essential for both the fulfillment of individual potential and the enjoyment of life. As those who benefit from the use of a hearing instrument can testify, you will en joy a "new life" with your new hearing instrument. Having a complete understanding of how your hearing works, and then knowing your options for hearing instrumentation, will help you utilize your hearing instruments to the fullest potential.
As sound passes through each ear, it sets off a chain reaction that could be compared to the toppling of a row of dominoes. First, the outer ear collects pressure (or sound) waves, and funnels them through the ear canal. These vibrations strike the eardrum, then the delicate bones of the middle ear conduct the vibrations to the fluid in the inner ear. This stimulates the tiny nerve endings, called hair cells, which transform the vibrations into electro-chemical impulses. The impulses travel to the brain where they are deciphered into sounds you recognize.
If you suspect a hearing loss, your first step should be a hearing evaluation. This test can be performed by various hearing health professionals, especially a qualified Hearing Instrument Specialist® in your area. Your Hearing Instrument Specialist® is specially trained to help you identify the nature of your hearing loss. The Hearing Instrument Specialist® will also select and fit the proper hearing instrument for you, and will provide support, encouragement, counseling and instruction as you learn to use the hearing instrument to your best advantage. When you choose a Hearing Instrument Specialist®, be sure to select a member of the International Hearing Society (IHS). IHS endorses the National Board for Certification in Hearing Instrument Sciences - the only independent program qualified to certify the competencies of the Hearing Instrument Specialist®. Hearing Instrument Specialists who have passed the rigorous National Competency Exam and are certified by the National Board for Certification in Hearing Instrument Sciences (NBC-HIS) are awarded the designation Board Certified in Hearing Instrument Sciences (BC-HIS). A Hearing Instrument Specialist® with the BC-HIS designation has taken extra measures to show they are committed to helping the hearing impaired by:
- meeting specific continuing education requirements designed to
keep them informed about the latest methods and technical
innovations
- abiding by the NBC-HIS Code of Ethics for professional conduct
- operating at the highest level of professional competency set by
National Standards
Together the International Hearing Society and the National Board for Certification in Hearing Instrument Sciences ensure the highest quality of hearing health care services available.
Selecting
a Hearing Instrument
Hearing instruments come in many types, designs, and styles. Some
provide a variety of special features such as programmability, telephone
pickups, adjustable tone controls, and microprocessors for noise
filtration. Therefore, hearing instrument prices vary greatly, depending
on the type of instrument, the number of special features, and the
services provided by your specialist.
Price should not be the primary concern, except for the limitations of
your budget, when selecting hearing instruments. The objective is to
select hearing instruments that will meet your needs by providing the
most effective assistance for your hearing impairment.
Extensive laboratory and field research has scientifically proven that
people benefit most from wearing a hearing instrument in each ear. This
is commonly referred to as a binaural fitting.
Benefits of binaural hearing include an improved overall sound quality,
clearer speech perception in normal listening environments, increased
understanding in groups and noisy background situations, more relaxed
hearing, no longer straining to use the best ear, and a feeling of more
balanced hearing.
Members of the International Hearing Society have the experience and
expertise needed to assist you in selecting the hearing instrument that
will provide optimal amplification for your individual hearing loss.
The proper selection of a hearing instrument encompasses not only a
person's hearing loss, but other factors, as well. Occupation,
lifestyle, environment and physical limitations (because of the
dexterity needed to adjust the hearing instrument's volume, change
batteries, etc.) must be considered before proper selection of the
hearing instrument can take place.
It is recommended that you only purchase a hearing instrument in person,
rather than through mail order. Expert, personal assistance is required
in the evaluation of your hearing, the selection and fitting of the
hearing instrument and the follow-up services needed for the successful
use of your hearing system. This can only be accomplished through a
professional relationship between you and your Hearing Instrument
Specialist®. Hearing instruments today come in different styles and
different circuit-types for improved hearing for individual hearing
needs.
Digital and microprocessor technology is a part of the newer hearing
aid designs. The cost of hearing aids reflects differences in size,
advanced technology and professional services. As a result, the range of
prices will vary from $500 to $3000 or more for each aid. Allow your
Hearing Instrument Specialists® to advise you of your options. They
will combine their expertise of fitting hearing instruments with your
personal needs for hearing.
This project was funded by a generous grant from the Hearing Aid
Foundation whose mission is to fund consumer education about hearing
loss and hearing instruments.
Hearing Aid Helpline
HEARING AID HELPLINE (800) 521-5247
UNITED STATES and CANADA 10:00 a.m. - 4:00 p.m. Eastern Time
International Hearing Society
16880 Middlebelt Rd., Ste.4, Livonia, Michigan 48154
734.522.7200
A hearing instrument is a delicate, high-tech, electronic device and
its operating lifespan depends greatly on its proper care. Gentle
handling, occasional preventive maintenance, and a few simple
precautions will result in longer life and less expense to its owner. It
is important that your instrument be serviced by the office where you
purchased it. Hearing Instrument Specialists® who are members of the
International Hearing Society will provide you with continuing service.
Here are a few general suggestions for the proper care of your hearing
instrument:
- Keep the hearing instrument dry and avoid excessive heat.
- Remove spent batteries immediately.
- Do not drop on hard surfaces.
- Protect the hearing instrument from hard knocks.
- Do not use hair spray while wearing the instrument.
- Turn the instrument off each time you take it off.
- Do not attempt to repair the instrument yourself. If it is not
working properly, consult your Hearing Instrument Specialist®.
- Your Hearing Instrument Specialist® can explain the proper
procedure for keeping the earmold clean.
- Never use alcohol or cleaning fluid to clean the earmold or
instrument.
Proper care and maintenance will significantly extend the lifetime of your hearing system. A Hearing Instrument Specialist® uses a video otoscope as part of the hearing aid candidate's evaluation.
A number of conditions can exist that cause a disruption in the hearing process and lead to hearing loss. The two most common types of hearing loss are sensori-neural and conductive.
Sensori-Neural, or "nerve" hearing loss, results from damage to the hair cells, nerve fibers or both, in the inner ear. This is the most common type of hearing loss and is often caused by aging or prolonged exposure to noise. It also can be caused by high fever, birth defects and certain drugs. People with sensori-neural hearing loss can hear speech, but frequently have difficulty understanding it. The problem is usually compounded when background noise is present. Sensori-neural hearing loss is most commonly treated by the use of a hearing instrument, and generally can not be corrected through surgery or medicine.
Conductive hearing loss typically involves an obstruction in the outer or middle ear which reduces transmission of sound vibration through air, bone or tissue to the inner ear. Fortunately, many conductive hearing losses can be treated successfully by medical or surgical procedures. Hearing instruments can also successfully treat conductive hearing loss. Persons with both conductive and sensori-neural hearing loss are commonly referred to as having MIXED hearing loss. Most of these cases can be helped by either a hearing instrument or surgery.
For most people, hearing loss is so gradual that it is hardly noticed - and is usually detected first by family, friends, or a hearing test. You should suspect a hearing loss if you...
- have been exposed to high noise levels, such as tractors, machinery in factories, firearms or power tools, without adequate ear protection
- feel growing nervous tension, irritability or fatigue from the
effort to hear
- are inclined to believe that "every body mumbles" or
"people don't speak as clearly as they used to"
- find yourself straining to understand conversations in social
settings or at work
- frequently misunderstand or need to have things repeated
- find yourself watching people's faces intently when you are
listening
- increase the television or radio volume to a point that others
complain of the loudness
- have a family history of hearing loss
- have diabetes, heart, thyroid or circulation problems
- have been exposed to ototoxic drugs or medications
- have reoccurring ear infections, constant ringing in the ears, or dizziness
There are many other clues to possible hearing loss. The above list provides examples of the more frequent indicators.
There is no single hearing instrument that is suitable for all types
of hearing loss. The type you need depends on your individual hearing
loss and the nature of that loss.
The Completely-In-the-Canal (CIC) type of hearing aid fits deeply within
the ear canal and is barely visible. Though small, this instrument is
very powerful and fits a variety of hearing loss needs.
The Canal Model fits within the canal portion of the ear and is barely
visible in the bowl of the ear.
The In-The-Ear (ITE) model fits within the outer ear, extending into the
ear canal. This model accommodates a wide variety of hearing losses.
The Behind-The-Ear (BTE) model is a small hearing instrument housed in a
curved case that fits securely behind the ear. It is attached to the
earmold by a short, plastic tube. Sound is delivered from the hearing
instrument through the earmold and into the ear canal. BTE models will
fit the widest range of hearing losses. The Body Worn hearing
instrument, though powerful, with easy to manipulate controls, has been
replaced by the more powerful smaller models of hearing instruments
Using Your
Hearing Instruments
Now that you have your new hearing instruments, you may notice sounds
you haven't heard in a long time. Background street noises, a chirping
bird, children playing ... these are all sounds that gradually faded out
of your life as your hearing worsened. It will take some time to adjust
to your new world of sound. Eventually, you will get used to these
noises and to unconsciously use the same selective hearing process that
people with normal hearing use each day.
The key is to remain optimistic. Except in rate cases, hearing loss
occurs over an extended period. You must give yourself time to adjust to
better hearing. Daily use of your hearing instruments will be essential
to that process. Through it all, your Hearing Instrument Specialist®
will be there to:
- instruct you on the proper insertion of your new hearing instruments
- show you basic care and maintenance for your instruments
- provide an individualized program to help you adjust to your newfound ability to hear
- consult with your family and others to help them better
communicate with you and help you adjust to your new hearing system
Circuit
Design and Capabilities
The technical choices in current hearing aids allow the consumer a
variety of options. There are approximately 600 models of circuit
designs with digital programming and digital processing capabilities, in
addition to many non-digital circuit designs. These circuit choices can
be categorized into seven technologies.
1. LINEAR CIRCUITS - These make all sounds louder.
2. TRADITIONAL COMPRESSION - These soften some loud sounds when they
occur.
3. ADVANCED COMPRESSION - There are many special circuits to make
hearing aids more comfortable. Your specialist will guide you.
4. ADVANCED DESIGN NON-DIGITAL - These are unique newer more complex
circuits that may be "automatic" (i.e. no volume wheel
necessary).
5. DIGITAL PROGRAMMABLE - These higher technology circuits have 1-13
adjustable bands of compression. Often they are automatic and use
computers to program different listening environments. Some models use
remote controls to provide more direct client control.
6. 100% DIGITAL (DSP) - DSP stands for Digital Signal Processing, audio
sounds are digitized and then processed. These types of hearing aids use
computers for the fitting process. They contain computer chips within
the hearing aid for further processing.
7. DEEP CANAL CIRCUIT - For maximum benefit this circuit depends upon
the placement of the hearing aid near the eardrum, which changes the
performance of this type of hearing aid.
Remember your Hearing Instrument Specialist's® role is to correct your
hearing problem with the most effective hearing instruments for you.
Listen to their advice and discuss your options.
For hearing help see your local Hearing Instrument Specialist®.
A special thank you to Joel Mynders, BC-HIS, for his editorial contribution to the World of Sound project. The Society gratefully acknowledges Starkey Laboratories, Inc. and Beltone Electronics, Inc. for contributing photographs for use in this brochure. Copyright, 1998, International Hearing Society
Copyright 1998 International Hearing Society
Blue Bell Hearing Aid Center, Inc.
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