Research shows that hearing loss can affect relationships, school performance, job productivity, and emotional well being. For the estimated 28 million children and adults in the United States who have a hearing loss, selecting the most suitable hearing aids can be the critical factor to enjoying life to its fullest.
Approximately 5% to 10% of adult hearing problems are medically or surgically treatable. The percentage is higher in children if middle ear disease, such as ear infection, is the cause.
If your hearing evaluation indicates that your condition cannot be medically or surgically treated, additional testing may be done to determine if hearing aids will be beneficial.
An audiologist certified by the American Speech-Language-Hearing Association (CCC-A) [use ProSearch to find one near you] specializes in finding the best type and model of hearing aids for you. If you have hearing loss in both ears, the audiologist may recommend that you use two hearing aids. In most instances, wearing two hearing aids helps in localizing the direction of sounds, improves listening in noisy situations, and provides better overall hearing. The audiologist will provide you with the recommended hearing aid(s) and/or other hearing assistive devices and will instruct you in their use.
Do I need medical clearance before buying hearing aids?
Federal and state regulations may require a medical evaluation and clearance from a licensed physician prior to hearing aid purchase. Ask your audiologist about these regulations.
Are all hearing aids the same?
Hearing aids differ in design, size, the amount of amplification, ease of handling, volume control, and availability of special features. But they do have similar components that include:
- a microphone to pick up sound;
- amplifier circuitry to make the sound louder;
- a receiver (miniature loudspeaker) to deliver the amplified sound into the ear;
- batteries to power the electronic parts.
Some hearing aids also have earmolds (earpieces) to direct the flow of sound into the ear and enhance sound quality.
Based on your listening needs, type of hearing loss, and lifestyle, your audiologist will advise you on which of the basic hearing aid styles and features best meet your communication needs and their related costs.
What are the different styles of hearing aids?
In-the-canal and completely-in-the-canal aids: These aids are contained in a tiny case that fits partly or completely into the ear canal. They are the smallest aids available and offer cosmetic and some listening advantages.
In-the-ear aids: All parts of the aid are contained in a shell that fills in the outer part of the ear. These aids are larger than canal aids, and for some people may be easier to handle than smaller aids.
Behind-the-ear aids: All parts are contained in a small plastic case that rests behind the ear; the case is connected to an earmold by a piece of clear tubing. This style is often chosen for young children for safety and growth reasons.
The majority of hearing aids sold today are canal hearing aids and in-the-ear hearing aids.
There are also special hearing aids built to handle very specific types of hearing losses. For example, a bone-conduction hearing aid uses a headband and a bone vibrator for individuals who have no ear canal or outer ear. There are hearing aids that route sounds coming to one ear over to the other ear for use by individuals who have no hearing in one ear. In special cases, hearing aids can be built into glasses for individuals who need that type of fitting. There are hearing aids available that can accommodate virtually any kind of hearing loss!
What types of hearing aid technology are used today?
Hearing aids are distinguished by their technology or circuitry. In the early days, hearing aid technology involved vacuum tubes and large heavy batteries. Today, there are microchips, computerization, and digitized sound processing, used in hearing aid design.
- Conventional analog hearing aids are designed with a particular frequency response based on your audiogram. The audiologist tells the manufacturer what settings to install. Although there are some adjustments, the aid essentially amplifies all sounds (speech and noise) in the same way. This technology is the least expensive and it can be appropriate for many different types of hearing loss.
- Analog programmable hearing aids have a microchip which allows the aid to have settings programmed for different listening environments such as quiet conversation in your home, noisy situations like a restaurant, or large areas like a theater. The audiologist uses a computer to program the hearing aid for different listening situations depending on your individual hearing loss profile, speech understanding, and range of tolerance for louder sounds.
Some aids can store several programs. As your listening environment changes, you can change the hearing aid settings by pushing a button on the hearing aid or by using a remote control to switch channels. The aid can be reprogrammed by the audiologist if your hearing or hearing needs change. These aids are more expensive than conventional analog hearing aids, but generally have a longer life span and may provide better hearing for you in different listening situations.
- Digital programmable hearing aids have all the features of analog programmable aids but use "digitized sound processing" to convert sound waves into digital signals. A computer chip in the aid analyzes the signals of your environment to determine if the sound is noise or speech and then makes modifications to provide a clear, amplified distortion-free signal. Digital hearing aids are usually self-adjusting. The digital processing allows for more flexibility in programming the aid so that the sound it transmits matches your specific pattern of hearing loss. This digital technology is the most expensive, but it allows for improvement in programmability, greater precision in fitting, management of loudness discomfort, control of acoustic feedback (whistling sounds), and noise reduction.
What are some of the special features available in hearing aids?
Many hearing aids have optional features that can be built in to assist in different communication situations. Some options are:
- Directional microphone. Some hearing aids have a switch to activate a directional microphone that responds to sound coming from a specific direction, as occurs in a face-to-face conversation. You can switch from the normal non-directional (omnidirectional) setting, which picks up sound almost equally from any direction, to focus on a sound coming from in front of you. When the directional microphone is activated, sound coming from behind you is reduced.
- Telephone switch. Some hearing aids are made with an induction coil inside. You can switch from the normal microphone "on" setting to a "T" setting in order to hear better on the telephone. (You should know that all wired telephones produced today must be hearing aid compatible). In the "T" setting, environment sounds are eliminated, and you only pick up sound from the telephone. Furthermore, you can talk without your hearing aid "whisting" because the microphone of the hearing aid is turned off!
The "T" setting can also be used in theaters, auditoriums, houses of worship, etc., that have induction loop or FM installations. The sound of the talker, who can be a distance away, is amplified significantly more than any backgroundnoises. Some hearing aids have a combination "M" (Microphone) / "T" (Telephone) switch so that, while listening with an induction loop, you can still hear nearby conversation.
- Direct audio input. Some hearing aids have a direct-audio input capability that allows you to plug in a remote microphone or an FM assistive listening system, connect directly to a TV, or connect with other devices such as your computer, a CD player, tape player, radio, etc.
Should I buy mail order or online?
Beware of "discounted" mail order or online hearing aid sales. Purchasing hearing aids through the mail or online often excludes important diagnostic audiologic evaluation, hearing aid orientation and adjustment, and rehabilitation services. These services help to ensure quality care and full benefit from the use of a hearing aid, as well as appropriate referral if medical treatment is warranted.
Do all audiologists dispense hearing aids?
Many people find that they receive the most satisfactory care by using the same professional for all services. The choice is yours. The ASHA-certified audiologist who provides your hearing evaluation most likely dispenses hearing aids as well or may refer you to purchase your hearing aid from a list of audiologists who do specialize in hearing aid dispensing.
Use ProSearch to find an ASHA-certified audiologist near you .
Will hearing aids help me hear better on the telephone or in public places?
Depending on your hearing loss, hearing aids typically help make speech over the telephone clearer. If you are on the telephone a lot, consider getting hearing aids with the "T" (telecoil) circuits described above. Telephone sounds are amplified more efficiently and background noises are better eliminated with this kind of circuit. [Only some cordless telephones work well with hearing aids].
People with hearing loss may also benefit from a telecoil to use with some of the special assistive listening sound systems available in many auditoriums, theaters and other public places as required under federal law. Discuss your option of a "T" switch with your audiologist.
Will hearing aids eliminate all my communication problems?
With hearing aids, you will hear some sounds you have not heard previously or sounds you have not heard in a long time. At first, background noise may seem loud and distracting. Your own voice may sound louder.
It can take several weeks to months to become adjusted to listening with your hearing aids. Your audiologist will provide hearing aid orientation for you as well as audiologic rehabilitation as needed, which will enable you to communicate more effectively with your hearing aids.
Are there other hearing devices that will help me hear with or without my hearing aids?
Hearing aids, very helpful in one-on-one communication, are not the only technology available. for large area events, such as movies, theaters, large meetings, classrooms, or public halls.
Hearing assistive devices (also known as assistive listening devices) are available for use alone or in combination with many hearing aids. These devices provide extra help in specific listening situations, such as the telephone, noisy backgrounds, or small or large group listening settings (e.g., restaurants, concert halls, movie theaters). Your audiologist can advise you about assistive technology that might help with your particular listening needs.
How costly are hearing aids?
Hearing aids vary in price according to selected style, electronic features, and related needs for professional consultation and rehabilitation services. A rule of thumb is that hearing aid costs increase with more complex and sophisticated circuitry and smaller size.
Purchase price, an important factor, should be only one consideration in buying hearing aids. Product reliability can save repair costs as well as the frustration of a malfunctioning hearing aid.
Cost of a particular type of battery used by the hearing aid and the rate at which the battery needs to be replaced also influence the overall cost of owning and maintaining a hearing aid. Batteries may last from several days to several weeks depending on the power requirements of the aid, the type of battery, and whether the aid is used routinely with an assistive listening devices.
Each person's hearing loss presents unique characteristics. The expertise of your audiologist about product quality and the monitoring and follow-up services you will need are important considerations in your purchase decision.
Will my health insurance pay any of the costs of acquiring a hearing aid?
Some private health care plans cover the costs of audiologic tests, a hearing aid evaluation, and even partial or full coverage of a hearing aid. Check with your health insurance company or your benefits manager to find out exactly what audiology services your policy covers. You may wish to advocate for inclusion of audiology services in your plan if not included.
At this time, Medicare does not cover hearing aids; Medicaid often does and must for children.
What else will I need to know about my hearing aids?
- Know how to obtain maintenance and repairs.
- Learn how to use special features ("T" circuit, volume control, and program remote controls).
- Parents will need to know how to determine if a child's hearing aids are functioning properly.
What if I buy hearing aids and I can't adjust to using them?
Laws in almost 2/3 of the states require a trial period for all hearing aid sales. Most audiologists provide a trial period even if it is not required by law. You may choose to try a different make or model if the first choice is not satisfactory. If you decide to cancel your purchase during this trial period, there may be a nonrefundable fitting charge for professional services and your custom earmold. You should discuss these policies with your audiologist prior to purchase.
Hearing aids do not restore normal hearing but do offer substantial benefit to most persons with hearing loss.
Conclusion
Hearing loss doesn't have to restrict life activities. Properly fitted hearing aids with appropriate communication strategies can help in many listening situations. The step-by-step approach below will help you determine if hearing aids can help you to hear better:
- Consult an ASHA-certified audiologist (CCC-A) for an audiologic evaluation and determination of need for medical referral.
- Get a professional hearing aid candidacy evaluation from an ASHA-certified audiologist. Purchase the recommended hearing aids. Pay attention to
- trial period
- sales contract
- warranty information
- features
- Attend follow-up care orientation and rehabilitation.
- Ask about other hearing assistive devices that can be used with the hearing aids to improve hearing in difficult or large area listening situations.
- Report problems you are having with communication. Your hearing aid might need a simple adjustment.
- Receive regular audiologic follow-up care to help you with adjustment to the hearing aid and monitor any changes in your hearing.