Now That Neurotone Has Put Its LACE Listening Training Software Online, There’s No Excuse Not To Use It

Have you ever had trouble understanding your dinner partners in a noisy restaurant? Neurotone’s new web version of its popular auditory training software, LACE Online, may be just what you need.

LACE is a proven method of training your brain to better understand speech in challenging listening environments. Now that it’s directly accessible on the web, with an attractive $79 retail price ($59 if you take advantage of the limited time introductory offer), it may be the easiest and least expensive investment you’ll ever make to achieve better hearing.

Neurotone has long marketed the LACE software to audiologists, who use it to help new hearing-aid users better cope with their hearing loss. No matter how big a help the hearing aids may be, developing effective listening skills is equally important in understanding speech and keeping up with conversations.

I went through the original DVD-based LACE training a few years ago, and it quickly improved my ability to understand speech in noise. Taking me through a series of listening exercises — tracking conversations in noisy settings, trying to understand one speaker when two people are talking, keeping up with a fast talker, learning to retain key words in sentences to improve contextual understanding — the program tracked and documented my improvement over more than a week of training.

Research at the University of California in San Francisco that led to the development of LACE demonstrated that auditory cognition — your brain’s ability to comprehend speech in noise — can dramatically improve with training. When you couple auditory training with a technical assist from hearing aids, the improvement in hearing is far more dramatic than depending on the hearing aids by themselves.

As a result, audiologists who prescribe LACE along with hearing aids get fewer complaints about the hearing aids not working, because patients are doing their part to make them work. And follow-up visits for programming improvements are more successful, because patients learn to be conscious of the kinds of amplification that will help them most in understanding speech.

Independent researchers have documented improvements of up to 40 percent in difficult listening situations. The latest evidence comes from a Northwestern University study that concluded:

Trained subjects exhibited significant improvements in speech-in-noise perception that were retained 6 months later….We provide the first demonstration that short-term training can improve the neural representation of cues important for speech-in-noise perception. These results implicate and delineate biological mechanisms contributing to learning success, and they provide a conceptual advance to our understanding of the kind of training experiences that can influence sensory processing in adulthood.

LACE training speeds up what works naturally to a greater or lesser degree for all people with hearing loss: over time, your brain learns to compensate for diminished ability to hear by zeroing in on verbal cues that enable you to catch more meaning from less comprehensible sound.

When I got my first pair of hearing aids, my audiologist took me for a walk outside to show me what they could and couldn’t do. In addition to pointing out the sounds I hadn’t been hearing (birds singing), she walked me through the Mass General cafeteria at lunch hour and told me all the things my hearing aids wouldn’t do for me — especially amplifying a noisy environment and thus making it more difficult, not easier, to hear.

But then she said, “Come back in six months, and you’ll be surprised at how much better you hear, not just because you’ll get used to your hearing aids, but because your brain constantly adjusts and helps you get better at understanding.” Sure enough, she was right. Six months later I went to the same cafeteria with a friend, and conversation was much, much easier. My brain really had gradually gotten a lot better at processing speech in noise. However, I’m convinced if LACE had been available then and I’d gone through the program right away, I would have reached the same level of comprehension in days or a couple of weeks instead of six months.

LACE Online makes it a lot easier to access auditory training than earlier versions, which came on DVDs and CD-ROMs, and it performs extremely well. One of the challenges of a highly interactive online site with a lot of audio and video is to deliver response times fast enough to keep up with the user’s pace through the program. LACE Online met all my expectations for immediate response times, not only with my high-bandwidth fiber connection to my desktop, but also when I used the much slower 3G wireless data connection with my iPad2 (LACE Online doesn’t depend on Flash, so all the videos run beautifully on the iPad).

Another challenge with interactive online training sites is the user interface, but LACE Online is intuitive and simple to navigate. Plus they’ve paid special attention to hard-of-hearing customers who depend on speech-reading: in the videos featuring Robert W. Sweetow, PhD, the clinical professor of otolaryngology and director of audiology at UCSF Medical Center whose research provided much of the foundation for LACE, Dr. Sweetow enunciates and shapes his words slowly and carefully enough to be helpful to even the newest speech reader.

I’ve just finished the first and second of 11 days of training with LACE Online, and I’m finding it’s a great refresher from my original run through the program. And going through the easy interactive lessons again reminded me that LACE is not just for people with hearing aids. The LACE training can help virtually anyone who’s ever had a problem understanding their companions in a noisy restaurant — which means it could help just about everyone.

Richard Branson Gets Hands-On With Hearing Aids On Starkey Hearing Foundation Mission To South Africa

Media mogul, airline magnate, and high-altitude explorer Sir Richard Branson got hands-on with hearing aids on a recent Starkey Hearing Foundation mission to South Africa that the jet-setting celebrity philanthropist called “one of the most rewarding weekends of my life.”

“Seeing kids who had never been able to hear or speak doing so for the first time. Old men completely deaf dancing with joy at suddenly being able to hear again. Incredible,” Branson said in a post on his Virgin Companies blog entitled “Giving the Gift of Hearing.”

William Austin, founder of Starkey Laboratories and the Starkey Hearing Foundation, led the mission, which set up 500 hard-of-hearing South African citizens with hearing aids.

Check Out This Awesome Video On Why Cochlear Implant Users Can’t Hear Music Well

Kudos to Hearing Review for catching this awesome video of a TED conference talk on why cochlear implant users can’t hear music well. This one hits home for me, because when I lost most of my hearing nine years ago, music suddenly became a discordant jumble of noise that was impossible to enjoy any more. Now I find it’s exactly what cochlear implantees experience.

Dr. Charles Limb describes how devastating the loss of  music can be to his cochlear implant patients while explaining in layman’s terms why it happens. As both a musician and a cochlear implant surgeon, he combines his two passions to study the way the brain creates and perceives music. He is an Associate Professor, Otolaryngology, Head & Neck Surgery, at Johns Hopkins who performs cochlear implantations on patients who have lost their hearing. He is also an accomplished musician on the faculty of the Peabody Conservatory of Music who plays sax, piano and bass.

If you listen to the comparison on the video between “normal” symphonic music and an estimation of what people with cochlear implants hear, you will understand the problem better. Cochlear implantees can’t hear the difference–both sound equally bad (I can’t hear the difference either).

Part of the problem is that neither cochlear implants nor hearing aids are optimized as much for music as for speech. The chart that Dr. Limb displays shows the frequencies and sound levels you need to replicate or amplify for speech, versus the much wider range of frequencies required to convey the richness of music.

But the problem also extends to the brain’s ability to process sound as both music and speech, including the emotional impact music can have. Dr. Limb is fascinated with the idea “that acoustic vibrations in the air can make you feel deep emotion, something that can affect your life.” Music requires a comprehension of pitch, tone and timbre, but cochlear implantees, and people like me with certain kinds of hearing damage, can’t discern warmth in a tone or the timbre of a violin versus a trumpet–qualities that enable music to stir powerful emotions.

The interaction between the mechanical hearing functions and how the brain processes sound and music still is not very well understood. Sound waves are shaped within the ear canal and transmitted through the ear drum and middle-ear bones to the hearing-hair-cell nerves in the cochlea, where they are transformed into electrical impulses carried by the auditory nerve. But then the brain takes over and interprets those sound waves, understanding them as speech, music, a baby’s chatter or cry, random noise or other sounds.

Readers of Musicophilia by Oliver Sacks will be familiar with the mysteries of how the brain processes sound. I found some comfort in the research the book reviewed on the brain’s amazing ability to rewire itself to improve its comprehension of audio inputs after the hearing organs have been damaged. In one of his case histories (and to a lesser degree in my own experience), the brain is able to improve its comprehension of speech over time, and to a lesser extent music as well–to fill in the gaps when the hearing organs are malfunctioning.

But as Dr. Limb makes clear, a lot more is unknown than known at this point. How the brain processes and discerns the quality of music — pitch, tone and timbre — is relatively new territory for researchers. While cochlear implants (and hearing aids) have been wildly successful in restoring the ability of the deaf to hear and understand speech, there’s still a long way to go before they can restore a complete ability to appreciate music.

“If you had a sense to lose, we are furthest along medically and surgically with hearing,” says Dr. Limb, but he adds, “Most implant users really struggle and dislike music because it sounds so bad. So when it comes to this idea of restoring beauty to somebody’s life, we have a long way to go.”

It’s Official: One In Five American Adults Has Hearing Loss

The recent Johns Hopkins survey of hearing loss in the United States, which finds that one in five Americans aged 12 and over suffers from hearing loss, shouldn’t surprise anyone. But it’s still a shocker, especially when you realize that only a small minority of that 20 percent is getting any help for their hearing loss.

Those of us who write about hearing loss usually cite government data putting the number in the range of 30 to 35 million Americans. The Johns Hopkins study says 30 million American adults–about 12 percent–have hearing loss in two ears, and that 48 million, or 20 percent, have hearing loss in at least one ear.

The survey also uses the World Health Organization’s definition of hearing loss: not being able to hear sounds of 25 decibels or less in speech frequencies. So the results are relevant to the hearing health care profession.

The Johns Hopkins hearing-loss survey is important because it’s hard to find current data from an impeccable source. Johns Hopkins is one of the world’s top public-health research institutions, so its count is probably the most accurate new assessment of the prevalence of hearing loss in the U.S. The survey used data from the National Health and Nutritional Examination Surveys (NHANES) conducted by the U.S. Centers for Disease Control, and the painstaking methodology the researchers used provide credibility to their claim that the results are representative of a cross-section of Americans.

The study’s authors say the findings “suggest that many more people than previously thought are affected by this condition,” which isn’t a surprise, as they used more recent data than many of the other studies that are more often quoted. It just reinforces the intuitive conclusion that as the Baby Boom generation ages, the incidence of hearing loss across the population is going to increase at a predictable rate.

But the “one in five” headline is still a shocker. Especially when you realize that only a small minority of that 20 percent is getting any help for their hearing loss. Let’s see if the headlines make a difference.

Nearly Half Of AARP-ASHA Survey Respondents Say Their Hearing Is Getting Worse, But Majority Fail To Take Action

Why do so many people who know their hearing is getting worse fail to seek treatment? That question screams from the remarkable survey results just released by AARP and the American Speech-Language-Hearing Association (ASLH).

There are a number of answers, but according to the survey, the high cost of hearing aids and inadequate insurance coverage for hearing-loss treatment (or lack of health insurance entirely) are high on the list of reasons people don’t seek out help for their hearing problems.

Check out some of the results of the survey of AARP members:

• While 88 percent said they had their vision tested in the past five years, less than half that number, 43 percent, had their hearing checked.
• But in the same period, nearly half (46 percent) said their hearing has gotten worse, with 61 percent saying they have difficulty following conversations in noisy situations.
• And even though 85 percent said maintaining hearing health is of great importance to them personally, 57 percent of respondents with hearing difficulties said they are not seeking treatment.
• Why do they fail to seek treatment? Here’s the kicker: “Nearly two-thirds of poll respondents (63 percent) cite health insurance coverage limitations, concerns about cost, and lack of health insurance as reasons for not getting treatment for hearing difficulties.”

AARP is the world’s biggest organization for people over the age of 50, and when it zeroes in on an issue it can move mountains. What would happen if AARP got on the hearing-loss bandwagon in a big way? Would we see more insurance companies providing coverage for hearing aids? Would we see more pressure on hearing-aid manufacturers to provide more affordable solutions?

Unfortunately, there may be an even bigger problem than high costs and lack of insurance coverage for the failure of people to seek out help. The survey also reveals there’s still a tremendous fear of the stigma that, rightly or wrongly, so many people associate with hearing loss. When you read the full report on the results (click here to download the PDF), you see too many troubling mentions of survey respondents wanting to “cover up” evidence of their hearing loss:

Fifty-seven percent of those with untreated hearing problems say their problems don’t warrant treatment and are easy enough to “cover up.” The foremost reason for not seeking treatment is a perception that their hearing issue isn’t severe enough – that they are getting by without treatment. They seem to have found ways that they believe cover up their hearing issues, and do not see a connection to an improved quality of life that treatment may provide.

Maybe the best result of the AARP focus on the hearing-loss issue will be a reduction in the stigma associated with hearing aids and a greater acceptance by the over-50 Baby Boomer set of the notion that a little help with their hearing could go a long way. But I’m not holding my breath!

Hearing Mojo 2012: My Search For A New Pair Of Hearing Aids Plus A Quest To Understand The World’s Most Mystifying Business

I took a few months away from Hearing Mojo this year for a few reasons. A death in the family, some time-consuming technical web hosting issues that nearly crashed my site for good, and a busy stretch with my other consulting activities all made it difficult to keep my focus on the hearing aid business. But I’m back on the case now and excited about 2012.

I think most readers with hearing loss should be able to relate to my two immediate goals:

1. My old America Hears hearing aids, which have served me extremely well, are wearing out after nearly four years of use. In 2012 I will conduct a disciplined search for a new pair of high end hearing aids. The search will include comparison shopping. Writing about this extended shopping expedition should be fun and illuminating.
2. As I shop for hearing aids I will be striving for a deeper understanding of the world’s most mystifying business. I’ve been writing about hearing products and technology for more than six years, as well as about how I cope with hearing loss. In 2012, I will start writing more about how the hearing aid industry works (and doesn’t work). Wouldn’t it be nice to find some answers to that question everyone asks: “Why don’t the tens of millions of consumers who need hearing assistance (more than 30 million in the U.S. alone) have more products to choose from, at a broader range of price points, from a bigger competitive field than five or six global manufacturers?”

So, I’m excited about 2012 and expect to write a lot more than I did in 2011.

A note about my technical problems: last year I set up a hearing aid comparison chart showing the flagship products of the top six global manufacturers. It quickly became one of the most popular attractions on Hearing Mojo. Unfortunately, the WordPress plug-in I used to create the chart crashed my site. (Google the phrase WordPress White Screen of Death and you will get an idea of the extent of the problem).

I finally got the site up and running again, without the chart, and am revamping my approach to hosting and managing what has become a much bigger production than the small blog I started six years ago. I hope to make Hearing Mojo even bigger and better in 2012, and I will revive the product comparison chart(s) once I’ve sorted out the technical issues.

Stay tuned!

W.L. Copithorne, RIP — He Left A Pile Of Unused Hearing Aids In The Dresser Drawer

My 94-year-old father died recently, and as we were going through his things we discovered a collection of unused hearing aids sitting in his drawer. So it can happen to anyone, even someone whose son has spent the last five years writing a blog about the wonders of hearing aids.

In recent years I had spent a lot of time helping Dad search for solutions that would alleviate his mild hearing loss, but I never knew how many times he had tried hearing aids in the past. Last year, I got him an over-the-counter Songbird Ultra hearing aid that used replaceable Number 10 hearing aid batteries, and a couple of years before that, I had gotten him a Songbird disposable hearing hearing aid that he never replaced after its battery ran out. Though he heard better with both these lower-cost products, he never got comfortable with them and they ended up in the drawer.

At that time, I knew there was already another pair of hearing aids in his drawer. Shortly after my mother died 10 years ago, he went to an audiologist for a full workup and came home with a nifty pair of completely-in-the-canal (CIC) hearing aids that set him back several thousand dollars. But he stopped using that pair, complaining about feedback and discomfort. But it wasn’t until I cleared out his home that I found yet another pair of hearing aids he had purchased a number of years earlier and never used.

In spite of the fact that he had a son who’d long gotten past the stigma of wearing hearing aids, and who was a walking example of how helpful hearing aids can be once you get up the learning curve with them, he never found a pair that did the trick for him.

You would think that in this day and age of comfortable, open-fit hearing aids with sophisticated sound processing and advanced feedback cancellation, the unused-hearing-aids-in-the-dresser-drawer syndrome would be a thing of the past. But it’s not. I chalk it up to the fact that until you really, really need hearing aids, you’ll often find it easier to cope with poor hearing on your own than going through the learning curve required to use hearing aids effectively.

It takes a while for your brain to adjust and get used to the amplified sound coming into your ears, and a lot of users don’t realize that the brain eventually filters out the distracting sounds of your feet sliding on the carpet or the keys jangling in the ignition that you first experience with a new pair of hearing aids. And even with today’s much easier-to-use hearing aids, older users like me father in their 80s and 90s still often have some dexterity issues getting the hearing aid placed correctly in their ear and the volume adjusted to their liking.

In the final decade or more of his life, my father, like so many others, suffered with less than adequate hearing and never found a pair of hearing aids that he liked. It’s too bad, as it’s been shown time and again that users of all ages who make the effort and get up the learning curve end up with much better hearing and a higher quality of life.

But there’s good news to this story, too. Alongside my dad’s unused hearing aids were two pairs of my long-deceased mother’s hearing aids as well. When she hit her late sixties she decided to do something about the mild hearing loss that she had suffered for years. She went to Sears and got a pair of inexpensive Miracle Ear in-the-canal hearing aids and wore them at church and dinner parties. Among the collection I also found a nicer, and newer, set of Phonak hearing aids that were clearly hers as well — she must have graduated to a more expensive set along the way without my having noticed.

So while Dad never got the hang of his hearing aids, they seemed to work well for Mom. Maybe she had more patience than he did. Or maybe she was just a better listener!

Oticon’s New ConnectLine Microphone Completes End-To-End Connection Between Hearing Aids And Your Conversation Partner

Oticon’s ConnectLine communication devices have made it easier for users of hearing aids to listen to their Apple iPods and personal MP3 players, their TVs, and their Bluetooth mobile phones for a while now. But with yesterday’s introduction of the Oticon ConnectLine personal microphone, you’ll finally be able to hear your dinner companion as well, even in a noisy restaurant.

The new wireless Oticon ConnectLine Microphone clips to your conversation partner’s lapel and picks up his or her voice while filtering out unwanted background sounds. It transmits the audio directly to the ConnectLine Streamer, which you wear on a loop around your neck, and the streamer transmits the unadulterated audio signals directly into your Oticon Agil hearing aids. It can also be adjusted to transmit at frequencies most compatible with the listener’s hearing-loss profile and hearing aids.

Ever since the big hearing aid makers began incorporating communication receivers directly into hearing aids, there’s been a not-so-quiet revolution in people’s ability to connect to more of the sounds of the modern world. But strangely enough, it’s taken some time for the major manufacturers to come up with workable assistive-listening solutions for the most common complaint of hearing-aid wearers–comprehension of speech in noisy surroundings. The ConnectLine Microphone is one approach to the speech-in-noise problem that is small and easy enough to actually be useful in the real world. When you add to the Oticon ConnectLine solutions for your TV, phone and personal listening system, you end up with a complete, end-to-end listening and comprehension system. Read more

Study Linking Hearing Loss To Dementia Raises More Questions Than It Answers

When Johns Hopkins researchers demonstrated a strong correlation between hearing loss and dementia, they confirmed previous research on the same subject but failed to answer what the study’s author termed “the 50-billion-dollar question”—whether hearing aids or cochlear implants correcting hearing loss could serve to prevent the onset of dementia.

The new study, published in the Archives of Neurology, used data collected by the Baltimore Longitudinal Study on Aging to follow more than 600 dementia-free adults between the ages of 36 and 90 for an average of 12 years. Those who had hearing loss at the start of the study were significantly more likely to develop dementia: those with mild, moderate, and severe hearing loss had twofold, threefold, and fivefold, respectively, the risk of developing dementia over time.

But according to the principal author of the study, ear surgeon Frank Lin, M.D., Ph.D., the results do nothing to answer the most obvious questions it raises: Might hearing loss be a cause of dementia? Or does hearing loss simply accompany dementia, without any cause or effect? Can diagnosed hearing loss can be used to predict onset of dementia? And that 50-billion-dollar question: can hearing correction enabling seniors to communicate better actually fend off onset of dementia? Additional research will be required to answer any of these questions, let alone understand why there is a connection at all. Two earlier studies, one in 1989 and another in 2008, came to a similar conclusion but left open the same questions.

“We really need to begin studying what the exact mechanism is,” Lin told Fox News. “And we need to begin studying whether hearing aids could have an effect on the onset of dementia.”

It’s About Time: Entire 2011 Super Bowl Broadcast AND All Its Advertisements Will Have Closed Captioning

After years of intense lobbying by the entire hard-of-hearing community, the National Association of the Deaf (NAD) has gotten a commitment from the National Football League (NFL) and FOX Broadcasting to provide closed captions for the entire Super Bowl XLV broadcast this Sunday—including all advertisements that will be aired.

Everyone knows the Super Bowl is more than a football game. In fact, in the Madison Avenue circles where I used to move, it’s more a Super Bowl of advertising than an athletic contest. It’s where the most creative minds in media and entertainment show off their best and brightest ideas every year. That’s why when I lost most of my hearing, it enraged me that so few of the ads had captions. Read more

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