10 Myths & 10 Facts

Personal Reactions to Hearing Loss

Hearing Evaluation for Adults

Hearing Evaluation for Seniors

Hearing Aid Types

Hearing Aid Care

Hearing Aid Repair

Ask Alicia

Two Ears are Better than One

World of Sound

Office Tour

Starkey Labs

The World of Sound

Preface

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...

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.

How Our Hearing Works

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

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

Service and Repair

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 ear mold clean.
  
• Never use alcohol or cleaning fluid to clean the ear mold 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.

Types of Hearing Loss

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 Hearing Loss

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

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.

Symptoms of Hearing Loss

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.

Types of Hearing Instruments

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 ear mold by a short, plastic tube. Sound is delivered from the hearing instrument through the ear mold 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®.

Acknowledgments

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

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