Starkey Founder William Austin and Virgin Founder Sir Richard Branson Fit One Of 500 Hearing-Aid Recipients On Starkey Hearing Foundation South Africa Mission That Branson Calls "One Of The Most Rewarding Weekends Of My Life"

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.

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).

To Appreciate Music, You Need To Discern A Much Wider Range Of Frequencies And Amplification Than To Understand Speech

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.”

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.

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!

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!

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!

The Oticon ConnectLine Microphone (Left) Transmits Audio To A Streamer That Sends The Signals Directly Into Hearing Aids

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.

Oticon ConnectLine Microphone Integrates Wireless Transmitter

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.

Rigging your conversation partner with a microphone and transmitter is not a new idea. But earlier solutions required the conversation partner to wear a microphone hooked up to a sizable transmitter, and the hearing aid wearer had to hang a receiver around their neck with a neckloop that transmitted the audio to the hearing aid’s telecoils. I tried several of those solutions, but there was always a snag somewhere along the line–either the transmission rig was too bulky for me to bother asking my partner to use it, or the neckloop didn’t communicate well enough with my T-coils. It was an exercise in frustration, and I gave up on them.

The small, lightweight ConnectLine Microphone gets the equation right on the transmission end by integrating the transmitter into the microphone and sending wireless signals to the ConnectLine Streamer. Then having the body-worn Streamer transmit directly into the Oticon hearing aids (from up to 0.5 meters), rather than depending on a less-than-reliable neckloop-plus-telecoil combination, gets the equation right on the receiving end. It’s not an all-purpose solution to the problem of understanding speech in noise–it would be impossible to dole out microphones to the shifting cast of characters in multiple cocktail-party conversation circles, for instance. And as a pricey add-on to a set of high-end hearing aids that can set you back as much as $3,000 each, the ConnectLine peripherals don’t come cheap.

But they do point to a future of better hearing connectivity and listening comprehension. Like Oticon, leading manufacturers including Starkey Laboratories, Phonak, ReSound, Siemens and Widex have introduced their own wireless connectivity components for their premium hearing aids. We can look forward to seeing more solutions from all of them, like the Oticon ConnectLine Microphone, that complete the end-to-end connection for hearing-aid users in search of better comprehension and a better listening/hearing experience.

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.”

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.

A lot of other people were mad, too, and all the lobbying seemingly has finally paid off. I say “seemingly” because, when it comes to broadcaster and advertiser commitments to provide captions, seeing is believing. It’s not enough to say you’ll provide the captions.You have to actually follow through on your commitment:

• First, you really DO have to provide the captions (that’s right, even after the FCC mandated captions on all broadcast TV several years ago, there are still complaints about many shows that simply don’t have them).
• You also have to provide captions that that are comprehensible (sometimes there are more dropped lines than not in a live broadcast, and I’ve tried to decipher thousands of lines of gobbledygook trying to pass themselves off as dialogue in the captions I’ve followed over the past few years).
• And you can’t cut corners and costs by relying on your speech-recognition software without putting enough humans with brains at the captioning console. (I really did watch that show a few years ago about a “cereal killer” who murdered lots of people but didn’t once eat a bowl of corn flakes).

Therefore, the National Association of the Deaf, in its announcement of the agreement, encouraged everyone to keep score, not of the game, but of how well the NFL and FOX Broadcasting live up to their promise:

The deaf and hard of hearing community has engaged in an annual ritual of counting the number of captioned commercials and network promotions during the Super Bowl. Consumers are invited to join in this celebration by counting along as we reach our 100% captioning goal. The NAD is interested in learning about any technical issues that affect the pass through of captions to consumer’s television sets.

So, three cheers to the NAD and everyone else who brought enough pressure on the powers that be to bring captions to the world’s biggest stage. Let’s all keep score, and let’s let ‘em have it if the broadcaster or the advertisers fumble the ball on providing good Super Bowl captions.

ClearCaptions Offers Real-Time Phone Captioning

Purple Communications, which has been providing voice and video relay services and other assistance to deaf and hard-of-hearing consumers for over a decade, is broadening its portfolio with its new ClearCaptions IP closed captioned telephone service. Captioning of real-time telephone conversations over the Internet is currently available from two other vendors, Sprint Relay and Hamilton Relay, both of whom rely on the WebCaptel service developed by UltraTec. Purple Communications (formerly GoAmerica), which will offer the service under its FCC charter as an approved provider of Telecommunications Relay Services (TRS), is creating some competition and increasing awareness of telephone captioning with its entirely new ClearCaptions service.

ClearCaptions is currently in its beta-test or trial phase but is accepting new users who can register at the ClearCaptions web site. IP captioned telephone service lets you view real-time captions of your phone conversations on your Internet-connected computer (or your Internet-connected handheld phone or tablet). All you have to do is notify your relay service provider that you are making a call, and the service provider monitors both ends of the conversation and, aided by voice-recognition software, provides you with a real-time transcript of the call. That way, if you’re like me and tend to miss anywhere from 20 to 80 percent of a phone conversation depending on the quality of the connection and any background noise that might be present, you get to fill in the blanks with the transcript.

Best of all, these web-enabled services are free, with subsidies provided by the government as part of the effort supported by the original Americans with Disabilities Act (ADA) to provide everyone with reasonable access to public facilities, including telecommunications, regardless of their disabilities. Hamilton Relay and Sprint Relay both also offer additional captioning services that require additional investment, including captioned telephones that display the captions directly on the phone’s LCD display so that you don’t need a computer.

The first neat thing you find with the ClearCaptions service is that you can register and log on through your Facebook account, which means you don’t have to remember a new user name or password. There is also a nice iPhone and iPad app that lets  you get the captions right on your phone. I know Hamilton CapTel and Sprint CapTel both enable their captions on the iPhone, Blackberries and other smart phones. But I love the fact ClearCaptions has an iPad app because that’s the handheld device I use for email and other apps. (The iPhone isn’t hearing-aid compatible, and other smart phones including the Blackberry that meet basic hearing-aid compatibility requirements still don’t have the audio quality I need, so I use the simplest old LG clamshell Verizon offers because it offers the best voice quality, and I use the iPad for all my other hand-held computing and communications needs).

Beyond that I have yet to do a test of the Purple Communications service versus the WebCapTel service to see which provides better captions. As anyone accustomed to watching sports, the nightly news or any other live television programming can attest, quality of real-time captioning can vary tremendously, from near-perfect transcriptions to near unintelligible gobbledygook. So when I’m able to try out both side by side, I will write up a report.