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Assistive Technology in Audiology Hearing Aids Cochlear Implants Assistive Listening Devices Various Circuits Available Hierarchy of Sophistication and Price Analog Digital Programmable Options Directional Remote Multi-Memory Volume control Compression Ordinarily, any circuit can be put into any size device! Circuit Options Analog: Amplifies in a linear fashion, can distort sounds, limited means to filter background noise, least expensive choice (1) Circuit Options(2, 3) Digital: Programmed via computer Has at least 2 channels Analyzes incoming sound and adjusts the loudness based on preset parameters Detects softer sounds of speech, raises loudness Does not amplify background noise to same degree as primary signal Circuit Options(1) Programmable: Offers fitting flexibility, can be used with analog circuits Computer programmed processor Normally has two channels, controlled independently Better able to “match” frequency response of hearing loss Optional Features Directional: Uses dual microphones Available in analog, compression and digital models Use of forward facing microphone helps focus on desired sounds Helps diminish awareness of background noise Optional Features Multiple Memory Increases versatility Memories customized for various situations Remote Control Change volume, memory function, directionality of microphone Hearing Aid Styles Completely In the Canal CIC In The Ear ITE Behind The Ear BTE (4) Hearing Aid Styles Behind the Ear Completely in the Canal In the Ear And the Survey Says… MarkeTrak V(5) Assess user satisfaction by polling 2720 patients who had purchased hearing aids Devices that are programmable, have a telecoil and are fit binaurally provide highest satisfaction CIC rated highest among styles of aids 1/3 users want volume control Cochlear Implants(6) Biomedical electronic device to convert sound into electrical current to stimulate auditory nerve In use for past 25 years Severe to profound bilateral sensorineural hearing loss in selected adults Severe to profound bilateral hearing loss in children Cochlear Implants Children’s with Remote Two BTE Styles for Adults Photographs courtesy MED-EL Cochlear Implants(7) Ear level processor Implant device Body worn processor Photographs courtesy Cochlear Corp. Cochlear Implant Drawings courtesy of Cochlear Corp. Candidacy for Implant Team approach favored Team should include: Audiology, Speech-Language Pathology, Otology or Neurotology, Social Work or Psychology, Educator of the hearing impaired Patient Consideration Factors considered: Patient age, general health Age at time of hearing loss Benefit derived from present amplification No medical contraindications such as absent cochlea or VIIIth nerve FM Communication Systems(2) Receiver/BTE Transmitter Enhanced speech perception in noise, at great distances Used in classrooms Greatly increases signal to noise ratio New technology reduces size, eliminates cords, wires Assistive Technology Pocket Talker One to One Amplifier Cell Phone with TDD Telephone Amplifier Amplified Phone Devices for the Home Strobe Light Doorbell Bed Shake Alarm Clock Flashing Smoke Alarm Vibrating Wrist Watch Television Closed Caption Decoder TV Infra-Red Listeners Devices for the Home Strobe Light Doorbell Bed Shake Alarm Clock Flashing Smoke Alarm Vibrating Wrist Watch Television Closed Caption Decoder TV Infra-Red Listeners Who Can Benefit From This Information? Hearing loss one of most prevalent chronic conditions in America(8) More than 9 million aged 65+ 3/5 in this age group in need of hearing help do not have it More than 10 million aged 45-64 6/7 in this age group who need hearing help do not have it Effects of Untreated Hearing Loss Survey by the National Commission on Aging reveals older Americans who do not use hearing aids are more likely to report the following: Sadness, depression Worry and anxiety Paranoia Less social activity Emotional turmoil and insecurity Responses constant across gender, age, income Benefits of Better Hearing The same study showed those who use hearing aids report: Better relationships with family Better feelings about themselves Improved mental health Greater independence and security Why Not Seek Help? Denial Hearing isn’t bad enough (in those with self-estimated moderate to severe hearing loss) Can get along without help Consumer Based Too expensive Don’t trust hearing specialists Heard they (hearing aids) don’t work well Stigma Make me feel old What will others think? Hearing Aids CAN Help(9) Double blind clinical study proved increased speech recognition and speech quality Benefits found for each circuit tested when compared to unaided condition Increase Awareness and Referrals Be alert for signs of possible hearing loss Refer patient for evaluation of hearing Promote Benefits of Better Hearing Some Closing Thoughts Numerous circuits, styles and optional features of hearing aids allow patient many ways to improve hearing Cochlear implants available for those with severe to profound bilateral hearing loss, as young as 12 months Assistive devices are available for use throughout the home and office The Last Thought Hearing impairment is leading chronic health problem in USA Quality of life is better for those who use hearing assistance Discuss potential hearing problems with your patients