Maybe taking the hearing aids off is not such a good idea after all….

In several previous blogs I wrote about a strategy where a musician, or a person listening to music, should simply remove their hearing aids.  Well – maybe I was wrong.

Here is the story- at least up to now.  Most modern digital hearing aids are limited when it comes to being able to handle the louder inputs associated with music.  They can be wonderful for speech, but speech is a relatively quiet signal, averaging around 65-70 decibels (dB).  Even quiet music can get up around 90 dB with peaks being almost 110 dB.  The analog-to-digital (A/D) converters found in all digital hearing aids – it’s the thing that translates normal analog sound to digital numbers – can typically only handle inputs up to about 95 dB.  This is great for speech but can be problematical for music.

My first article about this issue appeared in 2003 and here it is ten years later, and quite frankly it’s gratifying to see how well the hearing aid industry has responded to this issue.  There are now four commercially available technologies out there that any musician can use to hear and play their music without appreciable distortion.  As a rule of thumb, it generally takes 8-10 years for a manufacturer to bring an innovation to the marketplace.  If it’s done sooner, it may only be an “invention” and not a useful “innovation”.  So, expect some interesting things to be coming down the pipeline from the hearing aid industry over the next 2 or 3 years.

And if you are planning to respond to this blog and ask me the hearing aid names, I will not respond!  There is more to a hearing aid than just technology- the best hearing aid should be chosen in consultation with your local hearing health care professional.  They would know infinitely more about you and your hearing requirements than I do.  And, (although I shouldn’t use “and” to start a sentence twice in a paragraph),  I can assure you that they know about these technologies as well as I do.

I performed an independent double blinded study for one of these hearing aid manufacturers recently and in addition to demonstrating that indeed the technology does work, we also examined a condition where the hard of hearing subjects removed their hearing aids.   Specifically, we asked the subjects to rate on a “Listening at Loudness Difficulty Scale” (where the lower the number, the better was the listening situation) for speech understanding, distortion, and comfort.  The subjects were asked to perform a rating in their real life listening environments with their own hearing aids, and with two experimental hearing aids (X and Y).

However, when the subjects were asked to compare their difficulties for speech understanding, and distortion, there were significantly more difficulties when using their older hearing aids and most importantly, for using no hearing aids at all.  That is, there was the greatest difficulty when they removed their hearing aids.  This is contrary to the strategy of “remove the hearing aids while listening to music”. (There were no statistical differences for a judgment of comfort.)

My reasoning for the strategy of “simply remove your hearing aids” came from several sources. One was a simple calculation of how much amplification someone actually needs when the input to the hearing aid is so intense (as in the case of music).  Another source came from my musician clients who told me that they remove their hearing aids and music sounds better.

Like so many things in life, the bottom line may not be so clear.  Not to make more work for up and coming students, but this is an area that would make a really neat Capstone essay for an AuD student in their final years of study.

Uniaded difficulty

About Marshall Chasin

Marshall Chasin, AuD, is a clinical and research audiologist who has a special interest in the prevention of hearing loss for musicians, as well as the treatment of those who have hearing loss. I have other special interests such as clarinet and karate, but those may come out in the blog over time.