Is there someone in my town who can work with musicians? Part 2

In part one of this two-part series, I made a call for those hearing health care professionals who are interested in working with musicians and those in the performing arts. In part 2, I suggest a curriculum of topics that would delineate a minimum requirement for working with musicians.

I have listed these under four general categories. This is just a rough outline, but each of these topics can be expanded upon. In many cases, we can “transfer” our knowledge to make it more appropriate to the treatment of musicians. For example, our study of earmold acoustics has taught us a significant amount about how musical instrument work in terms of resonances.

I am contemplating running a series of (Internet-based) workshops in this subject area, and although this is still quite preliminary, the following curriculum is probably a fairly complete overview of what I feel to be the relevant topics.  For more information, please contact me at or through this blog site.



A. Acoustics and psychoacoustics of music and musical instruments
a. Physics of sound transmission (including head shadow and body baffle effects)
b. Psychoacoustics (missing fundamental, dyplacusis, and central processing of music)
c. Acoustic laws of physics- forgotten but still relevant?
d. Quarter- and half-wavelength resonators
e. Helmholtz resonators
f. Similarities and differences between speech and music
g. Sound level, and time-weighted measures
h. Recreational music (ipods and MP3 players, Fligor rule)
i. Room acoustics and measures
j. Real-ear measurement as a tool for spectral analysis

B. Diagnostics of musicians
a. Similarities and differences between musicians and non-musicians
b. Symmetrical and asymmetrical exposure of noise and music
c. TTS as a predictor of PTS and relevant physiology
d. Use of otoacoustic emission testing as an early warning sign
e. Knowledge of limitations of conventional methods of testing
f. Damage risk criteria (DRC); how this varies between occupational and music exposure

C. Assessment of musical instruments
a. Knowledge of typical sound levels of musical instruments
b. Knowledge of the relevant research to date
c. Real-ear measures at various locations (in ear, in situ,…)
d. Tinnitus
e. Dyplacusis
f. Counselling

D. Prevention of hearing loss with musicians
a. Moderation and DRC
b. Uniform and non-uniform hearing protection
c. Custom and non-custom
d. Modifications of hearing protection
e. Active hearing protection
f. Assessment of hearing protection (active and passive)
g. Monitoring improvements (electronic, acoustic, …)

E. Treatment of musicians with hearing loss
a. Amplification parameters
b. Similarities and differences between music and speech as input stimuli
c. Peak input limiting levels
d. Multi- vs. single-channel hearing aids
e. Frequency response
f. Amplitude and frequency compression characteristics
g. Clinical strategies to improve currently existing hearing aids
h. Technical innovations in the field
i. No hearing aids, hearing aids, and PSAPs

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.

1 Comment

  1. Marshall,
    I think what you are doing is very important–and Huge! There are so many things that come into play when working with musicians. No two of them are alike; no two instruments are alike.
    I sold a pair of musicians’ earplugs to a colleague who loves them for tuning pianos, but can’t wear the left one when playing her viola in orchestras, because even the 5dB filter prevents her from hearing how her bow touches the strings–which determines how she finishes the movement of the bow across the strings and enables her to control the quality of the tone she is producing.
    Now I am working with the second pianist who has had another of my colleagues as her piano tuner for 50 years. On my first visit to her home, she played every note of her Steinway rapidly, stopping only to indicate which ones her current hearing aids “distorted.” The problem was, that every note she pointed out was either out of tune, or had poor tonal characteristics. She was making accurate judgments about the piano–not about the hearing aids. When I delivered her new hearing aids, the humidity in her city had suddenly shot up drastically, and her furnace had gone out for three days. Consequently, her piano was now dramatically out of tune. Her new hearing aids were great for voices, but “sounded just awful” for playing her piano. Fortunately, as a piano technician, as well as a hearing instrument specialist, I could demonstrate that the problem was in the piano, not the hearing aids.
    Further problems arise when fitting a pianist with hearing aids. Since a piano has the full range of notes that all the instruments in the orchestra do, has about eight audible harmonics for most of the notes (except those in the high treble), and can play both melody and harmony(usually at the time time), the musical style has effects on how the piano music is heard. Thus a hearing aid, that sounds fine while playing simple melodies, might not sound so fine when the patient is listening to jazz music, or classical; baroque or romantic styles, for example. Concert piano technicians prepare the piano differently according to the repertoire to be performed and the artist performing. They not only tune differently, but are likely to change the tone and touch also.
    When it comes to fitting all musicians with hearing aids, I shudder to think of all the other possible instruments and performing venues that I know nothing about! I love working with pianists though, because it is an extension of the work I have been doing for 35 years; removing barriers so they can express the music that is in their hearts and souls in the world outside.
    Happy New Year!
    Diane Hofstetter

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