Hearing Aid Technology

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Audiology & Hearing Aid
Services

        Dr. Gabrielle Sadowsky, CCC-A
        Audiologist


         I have a hearing loss!


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Audiologist


   Doctor of Audiology (Au.D), A.T.
    Still University
   Owner of DESERT SOUNDS
    Audiology & Hearing Aid Services
   Contracted with many insurances
    including Medicare
   Helping people hear better for over
    17 years

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    What is an Audiologist?
   Educated health care professionals who
    provide doctors information regarding your
    hearing, and, if you have a loss, the possible
    cause and severity, recommondations for
    further tests, and assistance in managing
    disorders of hearing, balance and other
    neural systems.
   We provide therapy to both adults and
    children who have non-medically treatable
    hearing loss and tinnitus.
   Therapy may include the use of hearing aids,
    cochlear implants, or hearing assitive
    technology (HATs).

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Today’s Topics
   Hearing Health Care Professionals
   Hearing Aids
   Assistive Listening Devices
   Cochlear Implants
   Implantable Hearing Aids
   Bone Anchored Hearing Aids



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…life never sounded so good!



     Hearing Health Care Providers…

     Who are they?

     Where do you go if you need help?


                 DESERT SOUNDS Audiology &
                    Hearing Aid Services     5
     There are three types of hearing health
     care providers:
              Ear, Nose &                             Hearing Aid
                Throat                             Specialist / Hearing
   WHO         Physician          Audiologist        Aid Dispenser
                 (ENT)

EDUCATION     Doctorate          Masters          None
AND           M.D. / D.O.         Doctorate        BC-HIS
CREDENTIALS                      M.S.             Audioprosthologists
                                  M.A.
                                  M.N.S.
                                  Ph.D.
                                  Au.D.
SCOPE OF      Medical         Diagnostic Testing   Free Hearing Tests
PRACTICE      Treatment of    Hearing Aids         Hearing Aid Sales
              Hearing loss    Rehab
              5-10%


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Hearing Test




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FREE HEARING TEST
   For the purpose of selling a hearing aid –
    not covered by Medicare
       If it’s free, it isn’t worth anything!
   Audiologists charge for their hearing
    tests and most are contracted with
    Medicare
   Medicare and most insurances cover the
    cost of the examination if you go to a
    contracted provider
   Medicare requires a script from your
    primary care physician

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Have your Hearing Tested

   If you are here today and you have
    never had an audiological
    evaluation
       First full evaluation should be at 40
        years of age
       By age 60, one out of three people
        have a hearing loss - 30%
       By age 85, one out of two people
        have a hearing loss - 50%

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Most People Look for a Medical
Treatment as the Answer




                            Only 5-10% are
                               surgical
                             candidates




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Hearing Loss is the 3rd Prominent
Health Disorder

   Hypertension
   Arthritis

   Most over-looked health condition
   Only 16% of physicians currently
    screen for hearing loss



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Treatment Via Hearing Aids
   Hearing aids are the only treatment
    available for Sensorineural Hearing Loss
    (Nerve Deafness)
   Takes seven years for a person to get
    hearing aids from the time of hearing loss
    onset
   Less then 7% of the population that need
    hearing aids wear them
   Benefit and satisfaction occurs with earlier
    onset of hearing aid use

     DON’T SHOOT THE MESSENGER!

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Effects of Untreated Hearing Loss

   Depression
   Low Self Esteem
   Frustration
   Anger
   Withdrawal




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Effects of Earning Power

   Decreased earning power
   Get passed up on promotions
   Most people don’t inform others
    they have a loss (self esteem)
       Seen as incompetent
       Lack intelligence
 Be aware that untreated hearing loss negatively
 impacts household income by up to $12,000 per
year, depending on the degree of hearing loss, and
may cost over $122 billion in lost income annually.
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    Effects on Family and Relationships

   High
    divorce
    rate

   Reduced
    Intimacy




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WHY?
   Inability to communicate effectively
   Fatigue
       No energy due to energy trying to hear all day
   Anger from non-hearing impaired parties
    for incorrect communication
       Bluffing or lying that you heard something
       Answering to what you thought you heard




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Who do You Think Of When you Think
of Hearing Aids

   Beltone
   Miracle Ear

 LARGE AMOUNT OF MONEY SPENT IN
     NATIONAL AD CAMPAIGNS




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   Franchised Hearing Aids

        80% of their sales must be from “their
                ADVERTISED brand”.
    FRANCHISE NAME                      RE-LABELED
MIRACLE EAR                   SIEMENS

BELTONE                       GN RESOUND


AVADA                         OTICON


NU EAR                        STARKEY
AUDIBEL
MICRO EAR


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HEARING AID TECHNOLOGY


Not all hearing aids are
“just amplifiers” and not all hearing
aids are alike!



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Build it Yourself




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Mail Order Hearing Aids




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Cost of Hearing Aids

   Expensive (range from $800 to
    $3500 per aid – digital)
   Cover the cost of the device –
    affected by supply and demand
   Cover the cost of the professional
   Cover the cost of programming and
    service and on-going care


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Price Ranges
   Studies show there are no price
    differences between an audiologist
    and a hearing aid dispenser
   Historically, hearing aid dispensers
    in franchises charge more due to
    territorial rights and name branding
    (Beltone, Miracle Ear)
   Multi-line dispensers compete for
    prices and differ in services offered

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Patient Satisfaction
Hearing Aid Services and Satisfaction: The Consumer
  Viewpoint     Carren J. Stika*, Ph.D. & Mark Ross**, Ph.D.

   Most consumers (76.6%) indicated that they were “definitely
    satisfied” or “satisfied” with the services they received,
    regardless of where they purchased their aids (i.e.,
    audiologist or hearing instrument specialist)

   However, they found a significantly greater percentage
    of people who received hearing aids from audiologists
    reported higher levels of satisfaction compared to
    those who received their aids from hearing instrument
    dispensers (81.4% versus 66.8%).




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Patient Dissatisfaction
   More folks who purchased their aids from
    hearing instrument specialists expressed
    dissatisfaction than those people who
    obtained hearing aids from audiologists
    (21.5% versus 9.6%).

   Would they recommend their hearing aid
    dispenser to friends or relatives. People
    who saw audiologists said, “yes” (8l.3%)
    compared to those who saw hearing
    instrument specialists (62.7%).


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Which Hearing Aid is Best?
                          Depends on severity
                           of hearing loss
                          Depends on dexterity
                          Depends on your
                           memory
                          Depends on life style
                          Cost
                          Services




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Major Brands – TOP 7

   GN Resound (Beltone)
   Oticon (Avada)
   Phonak
   Siemens (Miracle Ear)
   Starkey (Audibel, NuEar)
   Sonic Innovations
   Widex


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Each Hearing Aid Company Makes
Different Models

WIDEX                     Inteo      $$$$$
                          Diva        $$$$
                          Senso        $$$
                          Flash         $$
                          Bravissamo     $




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Hearing Aid Satisfaction

  Patients expect that because they
   paid top price for their hearing aid
  they should hear better than ever;
      however, there may be little
   difference between a top-end and
    mid-line hearing instrument for
             overall benefit.



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Evidence Based

   All manufacturers are part of
    Hearing Instrument Association
   Use Evidence Based Design for
    improved benefit
       Unfortunately sometimes the evidence
        lags months if not years behind the
        design – unlike pharmaceuticals
   Peer Review


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Hearing aids can’t…
   give you 20/20 hearing like glasses
    give you 20/20 vision due to hair
    cell damage and a distorted
    auditory system
   get rid of all the noise
   help you hear people in another
    room
   translate from English to Spanish


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Hearing aids do…

   improve your quality of life and
    relationships
   help you maintain greater earning
    power
   Improves your self esteem
   improves relationships
   help with Memory Problems


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Not All Hearing Aids Are Alike!
HEARING AID FEATURES & BENEFITS

   Digital – Programmable Analog - Analog
   Noise reduction – adds comfort and
    reduces fatigue
   Feedback reduction
       Notch Filtering
       Adaptive Feedback Cancellation
   Dual Microphone – the only proven
    technology to help you hear better in
    noise
   Telecoil
       Automatic
       Acoustic
       Push Button
   Automatic Program Switching or Manual
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Not All Hearing Aids Are Alike!
HEARING AID FEATURES & BENEFITS


   One band, one channel – like making
    music with one key on a piano – one tone
    can make the volume go up or down
   Twenty bands – better sound matching
    and fidelity, fine reduction of noise with
    minimal effect on speech
   Open ear acoustics- large vents
   Frequency Transposition vs Compression
   Remote control access

    LOTS OF FEATURES TO CHOOSE FROM
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LIFESTYLE
   On the phone a lot
       Cell Phone
       Home or Work
        Phone
   Television
   Music/Theatre
   Family Gatherings
   Travel
   Church Functions
   Home body


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Hearing Instruments




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Open Fit Instruments
                                 Designed for people
                                  with near normal low
                                  frequency hearing
                                 No Earmold
                                 Very Discreet
   Oticon Delta
                                 Telecoil or No
                                  Telecoil?
                                 Expandable with loss?




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Phonak MicroPower




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Cochlear Implants
   Designed for
    people who do not
    benefit from
    hearing aids or
    hearing aids with
    assistive
    technology




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Bone Anchored Hearing Aid
   For people with a
    significant
    air/bone gap –
    conductive or
    mixed hearing loss
   For people with
    single sided
    deafness




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Sound Bridge
   For people with a
    sensorineural
    hearing loss who
    can’t tolerate
    hearing aids, up to
    a severe loss

   Problems with
    rejection rate,
    viability and
    future services

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Assistive Listening Devices




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Many Reasons for the Use of Assistive
Devices

   The hearing aid alone is insufficient
    for understanding speech
   Especially in difficult listening
    situations such as: noise, distance,
    reverberation, speaker
    characteristics
   They can be used alone, with
    hearing aids, cochlear implants, or
    Bone Anchored Hearing Aids

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Excellent for Difficult Communication
Situations

   Small Groups
   Large Groups
   Conference Rooms
   Places of Worship
   Watching TV
   In a Restaurant
   Riding in a Car
   In noisy situations

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Study

 Communication   Performance
 items from Communication
 Profile for the Hearing Impaired
 [Demorest & Erdman, 1986]
 Five Subscale Scores: Social, Work,
 Home, Average, Adverse




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             Efficacy
                          CPHI Results: the 5 subscales

             5


             4
                                                                HA
Mean Score




             3

                                                                FM 6
             2                                                  weeks

                                                                FM 1-year
             1


             0
                 Social   Work     Home     Average   Adverse




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Coupling




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Assistive Devices
SOUND ID

Combination:
 Hearing aid with
  directional
  microphone
 Blue Tooth
  Technology
 Companion mic
  mode


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CROS/BICROS SYSTEMS




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  CROSLink & FM: 3 microphone pick up
      FM improves signal to noise ratio
                                                  1.      SmartLink (distant) microphone
                                                          sends signals to ML8S receiver
                                                          attached to CROSLink

  3                                       2               transmitter




                                               ML8S receiver
                                                                     1
                                                  2.           CROSLink transmitter
                                                               (offside) microphone picks
                                                               up signals at unaidable ear
                                                               and both are sent via
                                                               CROSLink wireless to aided
                                                               ear
CROSLink picks up sound from all directions       3.           Aided ear microphone picks
                                                               up signals on aided (better)
                                                               ear
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Amplified Telephone


 Arizona Telecommunications
      Equipment Program

      FREE TELEPHONE



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Other Devices

   Alerting Devices
   Telephone Aids
   Television Aids
   One-to-one communication devices
   Large area listening devices
       Church
       Theatres
       Conference

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TV Loop System




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Blue Tooth Technology
     Advantages                  Disadvantages

   Connects directly           Compatibility
    to telephone                Price
   Connects directly           Battery Drain
    to television and
    other public
    venues



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Cellular phone with integrated wireless Bluetooth link
                                                                               Listen



                                                     Speak                                           Ringing is heard


                                                                                                        M
                                                                                                      FM+M
                        SmartLink switches on
                        automatically                                                   For remote-enabled HI, switches
                                                                                         HI switches to correct FM
                                                                                        back to previous program
                                                                                           program

                                                                       For non-remote control hearing instruments this
                                                                       feature is not automatic. The user must manually
                                   Bluetooth                           select FM+M


    Phone is ringing and sent to                                Note Bluetooth symbol in
                                                                Accept the call
    SmartLink via Bluetooth                                     display
                                                                End the call



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Training
   The hearing aid fitting is only as good as
    the person who is fitting it.
   This applies to audiologists as well as
    hearing aid dispensers
   It is more costly to purchase the wrong
    aid then it is to purchase a hearing aid
    you will enjoy wearing!
   Life of a hearing aid, if purchased well,
    is 5 years (unless you have a dramatic
    life change or hearing shift) – get more
    bang for your buck with a BTE


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Questions to Ask
   Provider’s Credentials
   Contracted with your insurance –not we accept
   Stability of the providers in the office
   What hearing aid companies do they work with
   Trial Period
   Return Fee
   Verification Techniques
       Real Ear – good
       Sound Field – speech is good
       Does it sound good? Bad!!!
   Warranty and Loss and Damage Coverage
   Follow up services – fee for service or included in the
    hearing aid
   Loaners


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Real Ear




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Questions?




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THANK YOU!
Hearing is a precious gift that allows us to live in the
  community and interact socially with other
  people.

If you live in the East Valley, we hope you will
   consider DESERT SOUNDS for your future
   audiological needs.

We are located at 6124 E. Brown, Ste 102, Mesa
        (just east of N. Recker on E. Brown)

                www.desertsounds.net


                   DESERT SOUNDS

				
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