The Importance of Hearing Loss Pre-assessment

Hearing health professionals and hearing aid manufacturers have been using the common-sense "signs of hearing loss" in their public relations and advertising probably since the beginning of the hearing health industry as a method of educating people to seek treatment for their hearing loss with hearing aids.

This continues to be one of the most critical on-going education activities we can do to help people with untreated hearing loss for the following key reasons:

• 6 of 10 new hearing aid users purchased their very first hearing aid because they realized their hearing loss was getting worse. (Source: MarkeTrak VIII)
• 50% of people who admit they have a hearing loss but do not use hearing aids report they chose not to adopt hearing aids because they have never had their hearing checked. (Source: MarkeTrak VII)
• Offering people FREE hearing tests may be effective in bringing in some people into hearing health professional offices, but for the vast majority of people with untreated hearing loss sitting on the fence, they lack insufficient information to make any step toward entering a hearing health professional's office.
• It is our belief that hearing loss problem recognition is a critical precursor to hearing loss problem resolution.

To this end utilizing both objective and subjective information across four databases involving nearly 11,000 subjects, Sergei Kochkin, Ph.D. and Ruth Bentler, Ph.D. have shown in the November 2010 Hearing Review that the BHI Quick Hearing Check has high validity, reliability and utility; it is significantly related to nearly all key quality of life issues; and it demonstrates that standard audiological definitions of hearing loss based on dB loss better ear, may in fact need to be re-thought, since consumers tend to rate their subjective hearing loss much higher than what we state in our text books. The research demonstrates this tool can be used for effectively providing consumers with more information about their hearing loss and moving those with hearing loss closer to seeking a hearing solution.

The availability of this instrument represents a major opportunity for the hearing health industry to strategically attack one of the key barriers to hearing aid adoption; consumer's insufficient information about their hearing loss. There are currently two easy-to-use versions of this test—and both can be used for free and without permission from BHI (www.betterhearing.org). One is a paper and-pencil form in which the test-taker simply circles his/her responses and then uses the instructions on the back of the sheet to obtain a hearing score and recommendation for taking action.  HHP may print this form themselves or purchase them from the BHI in tablet form.

A simpler “no brainer” version that automatically scores the test and presents the results with the click of a button can be found online at www.hearingcheck.org (also a BHI Web site). It’s our hope that hearing care professionals and the hearing industry will instantly see the huge opportunity this test affords us and use it in all hearing-related promotions

The Consequences of Untreated Hearing Loss

Sergei Kochkin, Ph.D., Executive Director, Better Hearing Institute, Alexandria, VA

Many people are aware that their hearing has deteriorated but are reluctant to seek help. Perhaps they don ’t want to acknowledge the problem, are embarrassed by what they see as a weakness, or believe that they can “ get by ” without using a hearing aid. And, unfortunately, too many wait years, even decades, before getting treatment.

But time and again, research demonstrates the considerable negative social, psychological, cognitive and health effects of untreated hearing loss . . . with far-reaching implications that go well beyond hearing alone. In fact, those who have difficulty hearing can experience such distorted and incomplete communication that it seriously impacts their professional and personal lives, at times leading to isolation and withdrawal.

Studies have linked untreated hearing loss to:

• Irritability, negativism and anger
• fatigue, tension, stress and depression
• avoidance or withdrawal from social situations
• social rejection and loneliness
• reduced alertness and increased risk to personal safety
• impaired memory and ability to learn new tasks
• reduced job performance and earning power
• diminished psychological and overall health

Hearing loss is not just an ailment of old age. It can strike at any time and any age, even childhood. For the young, even a mild or moderate hearing loss could bring difficulty learning, developing speech and building the important interpersonal skills necessary to foster self-esteem and succeed in school and life.

If you think you or a loved one suffers from hearing loss, don’t delay another day. Visit a hearing a professional and take the first step toward a world of better hearing.


To receive literature on hearing loss, its treatment and prevention call the Edison Stanford Hearing Center at 801-373-5887 or visit our website at www.edisonstanfordhearing.com.

Hearing Better May Mean Earning More

(NAPS)—People with untreated hearing loss may see their income decrease by as much as $30,000 a year, according to a national survey by the Better Hearing Institute. But hearing aids were shown to reduce the risk of income loss by 90 to 100 percent for those with milder hearing loss, and from 65 to 77 percent for those with severe to moderate hearing loss.

Most of the more than 34 million Americans with hearing loss are either in the workforce or in school. The loss in income for people with untreated hearing problems, due to underemployment, is estimated at $176 billion.

Hearing is critical to effective communication in the workforce. The ability to hear and listen well enables employees to be more productive and understand the work that has been assigned. Poor communication can result in unhappy customers, missed deadlines, poor morale among co-workers and mistakes on the job.

Effective hearing may also be critical to ensure safety on the job.

In the study, those with unaided severe hearing loss had unemployment rates double that of the normal-hearing population, and nearly double that of their aided peers.

“People are losing their hearing earlier and staying in the workforce longer,” says Sergei Kochkin, executive director of the Better Hearing Institute. “In today’s tough job market, hearing your best is essential for career success.”

Hearing aids remain the optimum treatment for the vast majority of people with hearing loss. Yet only 40 percent of Americans with moderate to severe hearing loss, and only 9 percent of those with mild hearing loss, wear them.

Half of all people with untreated hearing loss have never had their hearing professionally checked. To help, the Better Hearing Institute has a five-minute hearing test at www.hearingcheck.org. You can learn more about hearing loss and how to help it at www.betterhearing.org.

People With Diabetes More Likely to Suffer Hearing Loss

(NU) - A new study published by the Annals of Internal Medicine suggests that diabetics are susceptible not only to vision problems, but to hearing problems as well. “For years, physicians who treat people with diabetes have regularly ensured that their patients receive regular vision check-ups,” said Dr. William Luxford, BHI Board member and an Otolaryngologist at the House Ear Clinic in Los Angeles. “This important study underscores the need for physicians now to encourage each of their patients to get their hearing checked as well.”

In the study, National Institutes of Health (NIH) researchers analyzed data from hearing tests administered to 5,140 participants between 1999 and 2004 in the National Health and Nutrition Examination Survey (NHANES). Their findings? Patients with diabetes are more than twice as likely to suffer hearing loss than non-diabetics. More than 40 percent of the patients who participated in the study had some hearing damage.

“People with diabetes should ask their doctors to check their hearing,” said Sergei Kochkin, Ph.D., executive director of the Better Hearing Institute (BHI). “A hearing check can be invaluable in identifying diabetic patients with potential hearing loss, and giving them an opportunity to receive the treatment they need.”

Studies conducted by BHI, a not-for-profit educational organization whose mission is to educate the public about hearing loss treatment and prevention, show that people with untreated hearing loss experience a lower quality of life than people with normal hearing or people who use hearing aids.

The Better Hearing Institute has designed a “Quick Hearing Check” to help people quickly assess whether they have a hearing loss requiring a comprehensive hearing test by a hearing professional. The quick check is available online at www.hearingcheck.org.

Alzheimer’s disease is a women’s issue

As part of National Alzheimer’s Disease Month in November, the Alzheimer's Association and First Lady of California Maria Shriver released The Shriver Report: A Woman's Nation Takes on Alzheimer's. The report is the largest study ever conducted to look at the effect of Alzheimer's disease on American women as caregivers, people with the disease and advocates.

The Shriver Report: A Woman’s Nation Takes on Alzheimer’s demonstrates that women are at the epicenter of the Alzheimer’s epidemic. According to the Alzheimer’s Association Women and Alzheimer’s Poll unveiled in the report, women are almost two-thirds of all Americans with Alzheimer’s. In addition, women compose 60 percent of the unpaid caregivers for family members and friends with Alzheimer’s. This means that there are 10 million women who either have Alzheimer’s or are caring for someone with the disease. The toll Alzheimer’s has on individuals and caregivers is further compounded by the financial burden felt by families and the U.S. government.

“This report gives us a glimpse of Alzheimer’s in a different light. With 10 million women affected, Alzheimer’s is a women’s issue,” said Angela Geiger, chief strategy officer of the Alzheimer’s Association. “One-third of the 6.7 million female caregivers are a part of the ‘sandwich generation’ caring for children and an adult with Alzheimer’s disease simultaneously. The Alzheimer’s Association Women and Alzheimer’s Poll also found that 64 percent of women reported the fact that they had to arrive late, leave early or ask for time off due to caregiving for a loved one with Alzheimer’s, and the majority of respondents found it more difficult to get employer support for elder care than child care.”

In addition, The Shriver Report goes beyond statistics to illustrate the effect Alzheimer’s has on women through original photography and personal essays by well-known public figures and everyday Americans. These individuals share their personal struggles as people living with the disease, caregivers and family members.

Contributors to the report include Barbra Streisand, Terrell Owens, Soleil Moon Frye, ABC News “Nightline” anchor Terry Moran, CBS News Correspondent Barry Petersen, former First Lady Laura Bush, President Ronald Reagan’s daughter Patti Davis, Alzheimer’s Study Group Chairs Newt Gingrich and former Sen. Bob Kerrey, Secretary of Health and Human Services Kathleen Sebelius and Vice President Joseph Biden.

The Shriver Report: A Woman’s Nation Takes on Alzheimer’s will spark a national dialogue around kitchen tables and in communities across the country. To learn more or purchase your copy of The Shriver Report, please visit alz.org.

New Report Addresses Alzheimer Crisis

A new Alzheimer's Association report, Changing the Trajectory of Alzheimer's Disease: A National Imperative, examines the financial cost of the rising Alzheimer epidemic and the moderate advancements that could make a huge difference.


From 2010 to 2050, the total costs of care for Americans age 65 and older with Alzheimer’s disease will increase five-fold, from $172 billion to $1.08 trillion per year. These dollar amounts represent the direct costs of care to all payers, including Medicare, Medicaid, and out-of-pocket costs to people with the conditions and their families, and costs to other payers (such as private insurance, HMOs and other managed care organizations and uncompensated care).

The report also examines the potential cost savings if disease-modifying treatments that delay the onset of Alzheimer's or slow disease progression were available. Currently, for every $25,000 the federal government spends on care for people with Alzheimer’s and dementia, they spend $100 on research.

Support the National Alzheimer's Project Act (NAPA)

By 2050 nearly 16 million Americans will have Alzheimer’s, yet there is no national plan to deal with this looming crisis. NAPA would establish an inter-agency advisory council to address the government’s efforts on Alzheimer research, care, institutional services, and home- and community-based programs.

Find out if your member of Congress is a co-sponsor of NAPA (S. 3036 / H.R. 4689) by visiting alz.org/napa. If not, ask your member of Congress to act now and support NAPA.

Helping Loved Ones Hear Better This Holiday Season

Helping Loved Ones Hear Better This Holiday Season

Salt Lake City, November 16, 2010—Edison Stanford Hearing Center is urging families within the Utah County area to be alert for relatives and friends who seem to have trouble hearing this holiday season.

Hearing loss affects the ability of people to celebrate the holidays with family and friends, often leading to isolation and depression. Hearing loss is one of the most commonly unaddressed health conditions in America today. More than 34 million people in the United States have hearing loss—roughly 11 percent of the population.

“The holidays are a time to gather together with family and friends,” says Paul Lloyd, Edison Stanford Hearing Center. “But for friends and relatives with untreated hearing loss, the holiday season can be bittersweet. By staying alert to the signs of unaddressed hearing loss, and by encouraging those we love to address the problem, we can help them regain their quality of life and strengthen our relationships with them.”

There is a very easy, free and convenient way for people to check their hearing, or encourage loved ones to do so. The Better Hearing Institute (BHI) has made available a simple, interactive, online screening tool where families can check their hearing in the comfort and privacy of their own homes, at www.hearingcheck.org. BHI also has an online discussion forum and information exchange available at www.betterhearing.org, where people can join the dialogue on hearing loss and gain valuable support and information.
Hearing loss occurs at all ages. For example, among people aged 46 to 64, about 15 percent already have hearing problems. Sixty percent of people with hearing loss are below retirement age. Hearing loss can occur due to exposure to loud music or noises.

There is increasing evidence that people with certain medical conditions—such as diabetes, Alzheimer’s disease, kidney disease, heart disease, and even vision loss—may be at an increased risk of hearing loss. And numerous studies have linked untreated hearing loss to a wide range of physical and emotional conditions.

According to a BHI study, family members play a critical role in whether loved ones address a hearing loss. More than half (51%) of new first-time owners of hearing aids said that family members were a key factor influencing their purchase. Fifty-five percent of new hearing aids users sought treatment once they realized through testing how serious their hearing loss was.

In the vast majority of situations, hearing aids can help a person hear better. Studies have shown that hearing aid wearers experience significant improvements in quality of life and decreased depressive symptoms; have significantly higher self-concepts compared to individuals who do not wear hearing aids; and their functional health status improves significantly after three months of hearing aid use.

"Many people decide to get their hearing checked because someone they love suggested it and provided support,” says Sergei Kochkin, PhD, executive director of BHI. “If someone you love appears to have a hearing loss, please urge them to get a hearing screening. With the BHI quick hearing check available at www.hearingcheck.org, it’s easier for people to take that first, critical step in reclaiming their hearing, quality of life, and relationships. What better gift can you give someone you love this holiday season?”

Signs of Hearing Loss

There are several social, emotional, and medical signs of hearing loss that people can watch for this holiday season:

Social:

• require frequent repetition
• have difficulty following conversations involving more than two people
• think that other people sound muffled or like they're mumbling
• have difficulty hearing in noisy situations, like conferences, restaurants, malls, or crowded meeting rooms
• have trouble hearing children and women
• have your TV or radio turned up to a high volume
• answer or respond inappropriately in conversations
• have ringing in your ears
• read lips or more intently watch people's faces when they speak with you

Emotional:

• feel stressed out from straining to hear what others are saying
• feel annoyed at other people because you can't hear or understand them
• feel embarrassed to meet new people or from misunderstanding what others are saying
• feel nervous about trying to hear and understand
• withdraw from social situations that you once enjoyed because of difficulty hearing

Medical:

• have a family history of hearing loss
• take medications that can harm the hearing system (ototoxic drugs)
• have diabetes, heart, circulation or thyroid problems
• have been exposed to very loud sounds over a long period or single exposure to explosive noise

# # #

To take the BHI Quick Hearing Check, visit at www.hearingcheck.org. To participate in the discussion forum, visit www.betterhearing.org, click on “Discussion Forum,” and go to “Welcome!” to register.

# # #

Paul Lloyd is an Audioprosthologist at Edison Stanford Hearing Center in Salt Lake City Utah, and can be contacted at T: 1 (801) 485-5595, F: 1 (801) 467-1125, www.edisonstanfordhearing.com, e-mail: edisonhearing@hotmail.com.

Hearing Loss Affects People with Alzheimer’s Disease

If you or someone you love has been diagnosed with Alzheimer’s disease or is showing signs of dementia, a thorough hearing check is in order.


There is strong evidence that hearing impairment contributes to the progression of cognitive dysfunction in older adults. If not managed, as for example with hearing aids, hearing loss can interrupt the cognitive processing of spoken language and sound.

But when an individual has both Alzheimer’s and hearing loss, many of the symptoms of hearing loss can interact with those common to Alzheimer’s, making the disease more difficult than it might be if the loved one has been treated for hearing loss.

“When left unaddressed, hearing loss can compound the difficulties that people with Alzheimer’s and their families already face,” says Paul Lloyd, Audioprosthologist at Edison Stanford Hearing Centers. “But in many cases, the appropriate use of hearing aids can benefit Alzheimer’s patients.”

Numerous studies have linked untreated hearing loss to a wide range of physical and emotional conditions, including impaired memory and ability to learn new tasks, reduced alertness, increased risk to personal safety, irritability, negativism, anger, fatigue, tension, stress, depression, and diminished psychological and overall health.

“A comprehensive hearing assessment should be part of any Alzheimer’s diagnosis and any hearing loss should be appropriately addressed,” says Lloyd. “By addressing the hearing loss, we can help improve quality-of-life for those who have Alzheimer’s and help them live as fully as possible.”

About Alzheimer’s Disease

(Source: Alzheimer’s Association)

Alzheimer’s disease is a progressive and fatal brain disease that causes problems with memory loss, thinking and behavior. Today, as many as 5.3 million Americans have Alzheimer’s and it is the sixth-leading cause of death in the United States. In fact, from 2000 to 2006, deaths attributed to Alzheimer’s disease increased 47.1 percent. With a rapidly aging population, Alzheimer's will continue to impact more lives in the coming years. (Source: Alzheimer’s Association)

The Alzheimer’s Association has organized an awareness campaign, “Know the 10 Signs: Early Detection Matters,” that identifies the warning signs of Alzheimer’s. Any individual experiencing one or more of the signs should see a doctor to find the cause.

According to the Alzheimer’s Association, the 10 signs include:

• Memory changes that disrupt daily life

• Challenges in planning or solving problems

• Difficulty completing familiar tasks

• Confusion with time or place

• Trouble understanding visual images and spatial relationships

• New problems with words in speaking or writing

• Misplacing things and losing the ability to retrace steps

• Decreased or poor judgment

• Withdrawal from work or social activities

• Changes in mood and personality

For more information about the 10 warning signs of Alzheimer’s disease, early detection and diagnosis, contact the Alzheimer’s Association at 877.IS.IT.ALZ (877.474.8259) or visit www.alz.org/10signs.

The Efficacy of Hearing Aids in the Workplace

The majority of people with hearing loss are under retirement age.  Therefore, it’s crucial that we educate people with untreated hearing loss in the workforce to understand in this tough job market that hearing better could have profound implications for their marketability, success on the job and their earning potential.
In our latest MarkeTrak VIII publication “The efficacy of hearing aids in achieving compensation equity in the workplace” (Hearing Journal, October 2010) we have demonstrated conclusively in a study of 40,000 households that:

• People with untreated hearing loss lose as much as $30,000 annually, depending on their degree of hearing loss.
• For those that use them, hearing aids were shown to mitigate the impact of income loss by 90%-100% for those with milder hearing losses and from 65%-77% for those with severe to moderate hearing loss.
• The loss in income for people with untreated hearing loss due to underemployment is estimated at $176 billion, and the cost to society is estimated to be as high as $26 billion in unrealized federal taxes.
• There was a strong relationship between degree of hearing loss and unemployment for unaided subjects. Those with severe hearing loss had unemployment rates (15.6%) double that of the normal-hearing population (7.8%) and nearly double that of their aided peers (8.3%). Thus, one would expect that the cost to society of unemployment benefit payments is double that for normal-hearing households, depending on degree of hearing loss.

In the coming months we will be promoting this study nationally and developing OpEd and press releases for hearing health professionals to educate the public at a local level. We believe educating consumers about hearing loss and its relationship to job success is an effective strategy for influencing people with untreated hearing loss (and perhaps in denial) to seek hearing solutions earlier in their life.
Earlier this year we issued a Q & A article targeted to Human Resource executives. Hearing Health Professionals are invited to distribute this article to HR executives in their community as a means of introducing their services.

Invisible-In-The-Canal (IIC) Hearing Aids

Dennis Van Vliet, Au.D & Jason A. Galster, Ph.D.

A Completely-In-The-Canal (CIC) hearing aid can be defined by the location of the faceplate, 1-2 mm inside the aperture of the ear canal (Gudmundsen, 1994). For years the CIC has been the benchmark for small, near-invisible hearing aids. Publications have documented the benefits of CIC fittings, including decreased occlusion (Mueller, 1994), increased satisfaction (Ebinger, Mueller, Holland & Holland, 1994), decreased amplification wind noise (Fourtune & Preves, 1994), and improved localization when compared to Behind-The-Ear (BTE) fittings (Best, Kalluri, McLachlan, Valentine, Edwards & Charlile, 2010). All of these benefits were realized as a result of the fitting style.

Advances in digital modeling, laser-shell fabrication and modern microchip packaging techniques have resulted in hearing aids that are smaller and more powerful than those of the past. Today, custom hearing aids that fit deeply into the ear canal can be built on a routine basis. In fact, hearing aids can now be built to fit past the second bend of the ear canal, allowing the faceplate to be seated deeply in the ear, providing an invisible hearing aid fitting. The performance and cosmetic advantages of this fitting style appeal to a wide variety of hearing aid candidates, many of whom may not consider more visible hearing aid options.

A New Category of Hearing Aid

The convergence of hearing-related technologies allows the CIC to be made smaller than ever; small enough that they can be fit past the second bend of the ear canal. These deeply inserted hearing aids are effectively invisible to others. When the hearing aid is fit to the second bend of the ear canal, it may be considered an Invisible-In-The-Canal, or IIC, a new category with respect to size and position of the device. An IIC hearing aid is one in which the faceplate is at or near the second bend of the ear canal, and the medial aspect of the shell is much closer to the eardrum. The deeper position of the hearing aid allows for several technical advantages.

Acoustic Benefits of Canal Hearing Aid Fitting

The ear canal and pinna filter the natural spectrum of sound before it reaches the eardrum. Microphone placement on BTE hearing aids reduces some of these beneficial effects. The loss of these acoustic cues results in degradation of the wearer's ability to localize sounds. Data collected at Starkey Laboratories, Inc. Suggest that canal placement of the hearing aid microphone retains some aspect of the ears' natural filtering as compared to the microphone placement of a BTE style hearing aid. Data supports the expectation that canal placement of the microphone, as provided by the IIC hearing aid, will allow for improved localization ability when compared to a BTE hearing aid fitting (Best et al., 2010).

The reduced residual ear canal volume associated with an IIC fitting also affects the sound pressure level at the eardrum, effectively increasing the overall efficiency of the hearing aid. As Boyle's law states, as volume decreases, pressure increases. Thus, a smaller volume between the end of the hearing aid and the tympanic membrane yields a greater sound pressure level for equal receiver output.

Impressions for the IIC

The key to an accurate and comfortable fit with IIC hearing aids is an ear impression that extends 10-12 mm beyond the second bend. A good understanding of the anatomy and physiology of the ear canal along with deliberate technique make it possible to safely and easily obtain the impressions necessary for building IIC hearing aids. No special equipment is necessary for IIC impressions. However, instrumentation to illuminate and view the ear canal beyond the second bend is valuable. Silicone impressions take with a high flow, low viscosity material will typically fill the entire canal accurately and completely.

After taking a careful patient history and observing clinically appropriate safety procedure, a flattened oto-dam is placed deep in the canal, very near to the tympanic membrane. Lubrication of the oto-dam with Oto-Ease or a similar agent will improve comfort while placing the oto-dam and ease release of the silicone impression from the ear. Starkey as developed a vented cotton oto-dam that can be used to equalize pressuring during the removal of the cured impression. With proper counseling, the patient experience during impression taking and removal is very similar to standard impressions.

Summary

Modern hearing aid processing and laser shell fabrication have made the creation of small, deep-fitting hearing aids a possibility. Existing worries of feedback have been addressed with feedback cancellation and the patient's experience is being improved by advanced directional and noise reduction technologies. The end result is a highly-featured, premium hearing aid that is invisible when worn, meets the needs of the most discriminating patient.

References

ANSI (2004). ANSI S3.35 "Method of measurement of performance characteristics of hearing aids under simulated real-ear working conditions" (American National Standards Institute, New York).

Best, V., Kalluri, S., McLachlan, S., Valentine, S., Edwards, B., & Charlie, S. (2010). A comparison of CIC and BTE hearing aids for three-dimensional localization of speech. International Journal of Audiology, Early Online, 1-10.

Edinger, K.A., Muller, G.H., Holland, S.A., & Holland, J.W. (1994). Assesing the speech-understanding benefit from CIC hearing aids. The Hearing Journal, 47(11), 35-42.

Fourune, T., & Preeves, D. (1994). Effects of CIC, ITC, and ITE microphone placement on the amplification of wind noise. The Hearing Journal, 47(11), 23-27.

Gudmundsen, G. (1994). Fitting CIC Hearing Aids-Some Practical Pointers. The Hearing Journal, 47(11), 10, 45-48.

Muller, G.H. (1994). CIC hearing aids: What is their impact on the occlusion effect. The Hearing Journal, 47(11), 29-35.

Link between Hearing Loss and Depression Highlighted for World Mental Health Day

The Better Hearing Institute (BHI) announced today that it is participating in World Mental Health Day on October 10th by educating the public on the link between hearing loss and depression. This year’s World Mental Health Day focuses on the close association of depression with chronic physical illnesses and calls for integrated care. Depression can be a disabling illness that seriously impacts overall health.

“When left untreated, hearing loss often leads to isolation, depression, and other emotional conditions that can affect both mental health and quality of life,” says Sergei Kochkin, PhD, executive director of BHI. “Yet, hearing loss remains one of the most commonly unaddressed health conditions in America today.”

The link between unaddressed hearing loss and depression is compelling. For example, a large-scale study by the National Council on Aging (NCOA) found that people 50 and older with untreated hearing loss were more likely to report depression, anxiety, anger and frustration, emotional instability and paranoia, and were less likely to participate in organized social activities than those who wore hearing aids. The degree of depression and other emotional or mental health issues also increased with the severity of hearing loss.

A recent survey released by Australian Hearing, part of Australia’s Department of Human Services, found that people who suffer from hearing loss may be at increased risk of developing the debilitating effects of depression. As reported in its 2008 Annual Report, the survey found that 60 per cent of those with hearing loss had displayed some of the symptoms associated with depression. It also found that almost 20 per cent of those with hearing loss demonstrated at least three key symptoms of depression. Specifically, 52 per cent had displayed increased irritability and frustration; 22 per cent had trouble sleeping or experienced restlessness; and 18 per cent showed a loss of interest or pleasure in most activities.

"Hearing loss is not a harmless condition to be ignored or left untreated,” says Kochkin. “It has tremendous impact on your life. And if left unaddressed, it can have serious emotional and social consequences."

It’s important to understand that in the vast majority of situations, hearing aids can help the individual hear better and thereby alleviate the conditions that may lead to depression when hearing loss is left unaddressed. Studies have shown that hearing aid wearers experience significant improvements in quality of life and decreased depressive symptoms; have significantly higher self-concepts compared to individuals who do not wear hearing aids; and their functional health status improves significantly after three months of hearing aid use.

In fact, the NCOA study found that those who used hearing aids to address their hearing loss had a reduction in depression and depressive symptoms; improved interpersonal relationships, including greater intimacy; experienced less anger and frustration; enhanced emotional stability; decreased paranoid feelings; reduced anxiety symptoms; reduced social phobias; greater belief that they were in control of their lives; reduced self-criticism; improved cognitive functioning; improved health status; reduced incidence of pain; and enhanced group social activity.

Today, there are more than 34 million people in the United States with hearing loss—roughly 11 percent of the U.S. population. And over the last generation, hearing loss has increased at a rate of 160 percent of U.S. population growth.

“More Americans than ever before are suffering with hearing loss,” says Kochkin. “That means greater numbers are leaving their hearing loss unaddressed—simply because they don’t understand how significantly it affects their quality of life and mental health.

“Unaddressed hearing loss has become an entrenched public health issue that is closely linked to depression, especially in older individuals. World Mental Health Day is an extremely important acknowledgement of the inter-relatedness of physical and mental health. We need our healthcare gatekeepers to recognize the importance of addressing both in an integrated healthcare setting.”

The World Federation for Mental Health established World Mental Health Day in 1992 to provide an annual opportunity for public education about current issues and improving well being. It is the only annual global awareness campaign to focus attention on specific aspects of mental health and mental disorders.

The World Federation for Mental Health encourages local, national and regional authorities and organizations to observe World Mental Health Day on October 10th with events and programs that focus on “Mental Health and Chronic Illness: The Need for Continued and Integrated Care.” Campaign materials prepared by the World Federation are available for download on its website at www.wfmh.org.

You may need a hearing aid if...

• Your hearing frustrates you when you converse with family or friends.
• Your spouse tells you they often have to repeat what they have said to you.
• Your hearing problem embarrasses you when you meet strangers.
• You have difficulty hearing the television or radio at a normal volume level.
• Your hearing causes you to have arguments with family members.
• You feel that hearing difficulties hinder your social life.
• You attend church services or other group activities less often because of your hearing problem.
• It is difficult for you to hear or understand when someone speaks to you in a whisper.
• You feel that you are impaired by your hearing problem.
• Your hearing creates difficulties when you visit a restaurant with friends or family.

What You Should Expect From Hearing Aids

If your hearing loss has progressed to the degree that you need hearing aids, a critical factor in their success is your understanding and acceptance of realistic expectations of their capabilities. Hearing instruments, regardless of brand or type of technology, can never replace normal hearing in all listening situations.
Expecting results that cannot be achieved will only lead to frustration and dissatisfaction. If you know what to expect, you'll be free to enjoy the improvements that hearing aids can make in your life. Here are some guidelines which should help you and your provider agree on a set of realistic expectations for you.

• The extent to which the lost hearing function can be restored through amplification is based on the severity and duration of your hearing loss. The degree and extent of hearing loss is determined by using calibrated equipment called an audiometer.
• The more sever your hearing loss, the larger the hearing aid must be to provide room for a larger amplification and components.
• Crowded social gatherings and restaurants are examples of noisy conditions where even a person with normal hearing has trouble hearing conversation. As a person's hearing deteriorates, so also does the ability of a hearing aid to correct for hearing loss in these situations. Your provider's goal is to select an appropriate circuit for your hearing aid that will deliver a natural loudness throughout your entire listening range without getting too loud or too quiet.
• In difficult listening situations normal hearing listeners rely on using speech reading cues and focusing their attention on the speaker. These listening skills are even more important for the hearing aid user when faced with these circumstances.
• In quiet, many hearing aid users can achieve a performance level equal to normal hearing. But as the difficulty of the listening task increases, the gap between a person with normal hearing and a person with hearing loss widens. The more severe the hearing loss, the wider the gap.
• With properly fitted hearing aids you should be able to hear many normal sounds that you may not otherwise be able to hear clearly, such as the voice of your client or the words of a loved one. You may also begin to hear sounds you have forgotten were a part of your world, such as the hum of the motor on your refrigerator or the buzz of your fluorescent lights.
• Hearing aids in the advance, programmable and digital categories should prevent normally loud sounds from becoming uncomfortable.
• Depending on the degree and severity of your loss, hearing aids may allow you to hear speech more clearly in some noisy situations.
• You'll need time to get used to your new hearing aids to learn how to achieve maximum performance from them.
• Hearing aids will not restore your hearing to normal. Science has not been able to match the human hearing mechanism.
• Hearing aids will not "filter out" background noise, despite some advertising claims. Some hearing aids have circuitry that will avoid boosting the volume of some types of background noise, but this can also remove some of the speech you want to hear. This is usually a benefit, however, providing a more comfortable listening experience and better sound quality in some types of noisy situations.
• Hearing aids should allow you to understand speech more clearly, with less effort, in a variety of listening situations.
• Hearing aids should keep others from noticing your hearing loss.
• Your hearing health care provider should have the same goal as you: to find a way to help you reach the best possible hearing improvement. Using the best testing and assessment equipment science has to offer, and the availability of hearing aids from more than 30 national manufactures.

Conventional Hearing Aids

Hearing aids which use conventional electronics have been the mainstay of the hearing aid industry for 35 years. Conventional hearing aid electronics use basic analog Class A technology to provide quality, linear-type amplification to patients with a wide range of hearing losses. Class A amplifiers have as their defining feature the characteristic of adding the same amount of amplification to all levels of sound intensity. Thus, low bass-type sounds will be amplified with the same amount of volume as high treble sounds. For this reason, some patients may find that conventional electronic hearing aids provide either too little sound or too much sound to comfortably reach a listening level for the particular hearing loss. When this is the case, the patient should consider a prescription circuit instrument of the advanced, programmable or digital technology type. Priced at the lower end of the cost pyramid, conventional electronics represent the most basic type of amplification and are a good choice when finances are the major concern.

User benefits:

• Lowest cost
• Often ordered as a spare or backup set
• Comfortable low-distortion sound
• Available in all shell sizes: larges sizes needed to hold larger amplifier for patients with severe losses

Digital Hearing Aids

Digital Technology:

Hearing aids which are fully digital process sound mathematically bit by bit. In place of electronic components, digital hearing aids contain millions of tiny electrical parts micro-manufactured into a single silicon chip. The computer programmed silicon chip within the aid applies continuous digital processing to incoming sound. Here's how these digital hearing aids work:

1. The hearing aid microphone turns sound into an analog electrical signal.
2. A filter removes inaudible frequencies.
3. This filtered analog signal goes to the analog-to-digital converter which changes it to a numerical digital signal (0s and 1s) so it can be manipulated by the hearing aid's internal computer (DSP chip).
4. This chip is programmed to perform many numerical operations (filtering, noise reduction, loudness compensation, and feedback cancellation) depending on the algorithm used.
5. The digital signal is converted back into an audible sound for the patient to hear. These functions are performed instantly and continually.

The five most important questions regarding digital hearing instruments:

1. How many channels does it have? How many do I need?
2. What type of Automatic Signal Processing compression does it use? What type would best fit my lifestyle?
3. How many memories does it have? How many various listening situations do I encounter?
4. Does it come with a remote control? Do I need a remote control?
5. Does it offer multiple or directional microphones for hearing in noise?

User Benefits:

• The preciseness of digital computer technology.
• Availability of Automatic Signal Processing circuits which are not available with nonprogrammable instruments.
• Remote control (available on some models).
• Multiple memories for various listening situations.
• Multiple circuit options within a single instrument which achieve different sound qualities.
• Automatically achieves more volume for the soft, high frequency sounds and less volume for the more intense, low frequency sounds.
• Capable of retaining the patient's complete audiometric file and preferred listening program for various environments.
• Ability to readjust your prescription should your hearing loss change.

Advantages Beyond Cosmetics Of Deep Canal Hearing Aids

1. Acoustic advantages: The deep canal aid fits deep within the ear canal which allows your ear's natural acoustic features to work their greatest efficiency. This improves the performance achieved by the instrument.

2. Elimination of the volume control: The special features of a deep canal aid eliminate the need for a volume control wheel common to most hearing aids.

3. Wind noise: A hearing aid contained completely within your ear canal reduces the problem of wind noise.

4. Sleeptime wear: The fit, comfort and reduced feedback of a deep canal aid makes it possible to wear during sleep. This allows you to continue to hear important sounds such as speech or alarm signals.

5. Less distortion: A deep canal aid produces greater real-ear output which means that less sound amplification is needed. This reduces the likelihood of sound distortion.

6. A fit for active people: The sureness of a deep canal aid's fit makes it ideal for use during exercise and vigorous work.

7. Less feedback: This aid's position close to the eardrum, secure fit, and minimal venting work together to minimize acoustic feedback.

8. Comfort: A shell precisely made from a mold of your ear usually results in a deep canal aid that is very comfortable to wear.

9. Telephones: With a deep canal aid, you will experience less acoustic feedback. You will also find that this instrument's deep fit helps eliminate the discomfort of placing a telephone to your ear.

10. Easy removal: The permanently attached cord and small size of this aid make it easier to remove from your ear than most in-the-ear instruments.

11. Appearance: This may be the most popular feature. A deep canal aid is virtually invisible when worn.

12. Circuitry: Because of the reduction in the size of electronics, today's deep canal hearing aids are available in 100% digital signal processing.

Seven Reasons You Hear Better With Two Ears

It is called binaural listening: bi for two; and aural for ears. The human hearing mechanism is the most advanced stereophonic wonder known to man. With all of its amazing accuracy and versatility, it provides the listener with space perception, depth perception and balance.

Hearing does not happen in your ears, it happens in your brain. Your brain requires reliable information from your ears in order to decipher sound. Using just one hearing aid when hearing test results indicate that two are needed reduces your brain's chances of hearing and understanding by 50 percent, as well as removes your ability to perceive depth and space. Here are seven reasons to wear two hearing aids if indicated by your hearing test:

1. Less power needed when two hearing aids are worn. When your ears work together, lower volume settings are required for comfortable hearing. You will experience greater efficiency and clarity with two hearing aids as compared to monaural listening. The reduced need for power saves your hearing from damage caused by excessive amplification. The benefits are that loud sounds are more comfortable and listening is less stressful.

2. Stereo listening gives depth perception. Anyone who has enjoyed music in stereo, compared to mono, knows the difference. Mono makes all sounds seem shallow, flat, and unnatural. Your brain has the ability to hear in stereo but to do so requires that sounds be delivered by both ears. Not only are sounds more natural, they can also be understood more clearly.

3. Detecting sound direction saves embarrassment and saves lives. A one-eared listener is always wondering "where is that sound coming from?" when someone speaks. He can also never tell from which direction the screeching automobile is coming, unless he sees it. Hearing with two ears gives you the ability to know sound direction. Binaural listening gives the listener a sens of location and the ability to locate sounds not only horizontally but also but also vertically, 360 degrees in all directions.

4. Good manners takes two ears. One-eared listeners may be considered rude because they tend to ignore the speaker on their unaided side. In business and social situations binaural hearing aids can be your best ally for being the best listener possible.

5. Give your brain what it needs for auditory intelligence. The two halves of your brain work in harmony to give you an auditory image. Just as your brain converts the two images your two eyes see into a single picture, the same special perception happens with your two ears. It is the different signal each ear sends to your brain that makes this perception possible. The ears' sound signals travel up the brain stem via complicated pathways. Some cross over and eventually stimulate the opposite side of the brain. Other stimulate the same side. These complex patterns of stimulation make up auditory intelligence. If the two halves aren't sharing their signals, auditory intelligence is reduced. Binaural hearing aids help the ears get the messages to both sides of the brain, thus increasing your auditory intelligence.

6. Two ears hear better in noise. Whenever several people are talking at the same time, such as in a restaurant, it becomes more difficult to understand the one person at the table with you. The one-eared listener hears all of the voices blending together. Voice discrimination in noise is difficult with two ears and becomes impossible with only one. Binaural hearing aids give the best advantage to hearing in noise.

7. Quality of sound is better quality of life. The majority of hearing aid users who have worn both binaural and monaural hearing aids report a significant difference in sound quality. The vast majority of people who now use binaural hearing aids will tell you that listening with two aided ears is the only way to fully enjoy the 3D world we live in. The advantages of superior sound over the burden of persistently poor sound should not be underestimated. Seize the opportunity to enhance your listening quality, should your test results indicate two hearing aids are needed.

Having trouble hearing? Listen to the truth behind hearing loss myths

Sure, you sometimes have to ask people to repeat themselves, and the volume knob on the car stereo is set much farther to the right than it used to be. But you can't be experiencing hearing loss - you're not a senior citizen. Hearing loss only affects the old, right?

Not necessarily. Only 40 percent of people with hearing loss are older than 64. The largest age group with hearing loss is people between 18 and 64 - about 19 million people compared to 14 million at retirement age. More than 1 million school-age children have hearing problems, as well.

The idea that hearing loss only happens to the aged - and is an unavoidable circumstance of aging - is just one of many commonly believed myths about the issue. The truth is that hearing loss affects all age groups. If you want to avoid hearing loss, it pays to know the truth behind the myths and the basics of hearing loss prevention .

Here are some common myths about hearing loss, and the truth behind the myths:

Myth: If I had hearing loss, my family doctor would have told me.

Truth: Only 15 percent of doctors routinely screen for hearing loss during a physical exam. Even when a doctor does screen for hearing problems, the results may be suspect since most people with hearing problems hear pretty well in quiet environments - like a doctor's office. Without special training on hearing loss, it may be difficult for your family doctor to even realize you have a hearing problem.

Myth: Nothing can be done about my hearing loss.

Truth: People with hearing loss in one ear, with a high-frequency hearing loss, or with nerve damage may have been told by their family doctor that nothing can be done to help. Modern technology has changed that. Now, nearly 95 percent of people with hearing loss can be helped, most with hearing aids.

Myth: Only people with serious hearing loss need hearing aids.

Truth: Your lifestyle, your need for refined hearing and the degree of your hearing loss will determine whether you need a hearing aid. If you're in a profession that relies on your ability to discern the nuances of human conversation - such as a lawyer, teacher or group psychotherapist - even mild hearing loss can interfere with your life.

Myth: Hearing aids are big and ugly. Wearing one will make me look old or disabled.

Untreated hearing loss is far more noticeable than today's hearing aids. If you miss the punch line of a joke, or respond inappropriately to a comment or question, people may wonder about your mental capacity. Hearing aid makers realize people are concerned about how they will look wearing a hearing aid. Today, you can find miniature hearing aids that fit totally within the ear canal or behind your ear, making them virtually invisible.

Myth: Hearing loss is an inevitable part of growing older and there's nothing I can do to prevent it from happening to me.

Truth: You can take steps to prevent hearing loss. Noise is one of the most common causes of hearing loss; 10 million Americans have already suffered irreversible damage to their hearing from noise. Yet a third of all hearing loss could be prevented with proper ear protection.

Myth: I cannot afford hearing aids

Truth: There is a wide price range in hearing aids on the market just like there is for other consumer products. In addition the BHI has identified close to a 100 sources for financial help in their eGuide "Your Guide to Financial Assistance with Hearing Aids"

If you work in a high-risk profession, make sure your hearing is protected according to OSHA regulations, and wear hearing protection such as foam or silicone plugs or earmuffs. At home, lower the volume on the TV, radio, stereo and any device that uses earbuds or headphones. Wear ear protection while mowing the lawn or blowing leaves or snow. Buy quieter products (compare decibel ratings) and reduce the number of noisy appliances running at the same time in your home. Before taking a new medicine, be sure to ask the doctor about any possible side effects on your hearing.

Republished from Better Hearing Blog by Sergei Kochkin

Tips for Communicating With Persons With Hearing Impairment

1. If necessary, speak louder, but don't shout.
2. Speak clearly and slowly.
3. Speak at a distance of between 3 and 6 feet.
4. Stand in clear light facing the person with whom you are speaking for greater visibility of lip movements, facial expressions, and gestures.
5. Do not speak to a person with hearing impairment unless you are visible to him or her (e.g. not from another room or while he or she is reading or watching TV).
6. Move away from background noise.
7. If a person with hearing impairment does not appear to understand what is said, rephrase the statement rather than repeat only the misunderstood words.
8. Do not over-articulate. Exaggerating your pronunciation not only distorts the sound of speech, but also the speaker's face making the use of visual cues more difficult.
9. Do not cover your mouth with a cigarette or hands and do not chew food while speaking.
10. Arrange the room (living room or meeting room) where communication will take place so that no speaker or listener is more than six feet apart and all are completely visible; communication for all parties involved will be enhanced.
11. Include the hearing-impaired person in all discussion about him or her. Individuals with hearing impairment sometimes feel quite vulnerable and left out; this approach will aid in alleviating some of those feelings.
12. Ask what might make conversation easier.
13. In meetings or any group activity where a speaker is presenting information (church meetings, civic organizations, etc.) make mandatory that the speaker use the public address system.

Republished from: Better Communication and Hearing Aids, D.S. Wayner, PhD and J.E. Abrahamson, MA

Types of Hearing Loss

Spotlight On Hearing Loss

Effects of Hearing Loss

Assisting Employees with Hearing Loss

By Sergei Kochkin, Ph.D.

Question: What can organizations do to plan for and address the impact of employee hearing loss?

Answer: Employers can take a number of simple steps to educate employees about hearing loss and to facilitate the use of hearing aids, where needed.

In a 2009 survey of 46,000 U.S. households, the Better Hearing Institute (BHI) determined that over the past generation hearing loss grew at 160 percent of the U.S. population growth— primarily attributable to the aging of the American population. Yet the study found that 60 percent of people with hearing loss are below retirement age, meaning that 16.3 million people with hearing loss were in the U.S. workforce in 2010.

Previous research at BHI has shown that 50 percent of people with untreated hearing loss have never had their hearing checked by a professional and lack sufficient information to know whether they need to take action to correct it. Human resource professionals can help employees understand if they need treatment by:

Educating employees on the impact of untreated hearing loss on quality of life.

Encouraging employees to take valid online hearing tests such as the five-minute hearing evaluation offered by BHI.

Encouraging local hearing health professionals to conduct on-site hearing screenings.

In many cases hearing aids can help protect employees from being at a competitive disadvantage with peers. Organizations can encourage the use of hearing aids, when needed, by ensuring that health insurance covers such devices and by recommending that employees purchase hearing aids using pretax medical flexible spending account funds.

In addition, employers can:

• Create a corporate climate where hearing loss is recognized so those with hidden hearing loss feel more comfortable.
• Avoid noisy restaurants as meeting locations. 
• Summarize meeting minutes in writing to be sure that those with hearing issues are clear on the outcome of the meeting.
• Provide easy accommodations, such as moving an employee's desk away from noisy hallways, machines, or air conditioning and heating vents, or installing a phone that amplifies high frequencies.
• Build work environments that facilitate better hearing by choosing cubicles with noise-absorbent materials and equipping meeting rooms with an inductive loop that creates a wireless zone for hearing aids with telecoils, headsets or microphones.

By encouraging employees to treat hidden hearing loss rather than hide it, an employer creates a win-win situation by ensuring that the loss of hearing does not interfere with job performance, productivity, safety, or the employee’s career or quality of life on or off the job.

Sergei Kochkin, Ph.D., is executive director of the Better Hearing Institute, a not-for-profit that educates the public about hearing loss, prevention and treatment.

Reprinted from: The Society for Human Resource Management (www.shrm.org)

Hearing loss hits 1 in 5 U.S. teens

By Liz Szabo, USA TODAY

One in five American teenagers now suffers from some type of hearing loss, an increase of 31% since the mid-'90s, new research shows.

Most cases of hearing loss are slight, affecting only one ear and involving mostly high-frequency sounds, according to a study in today's Journal of the American Medical Association. Many teens may not even notice the hearing change. About one in 20 have "mild or worsening" hearing loss, which can make them struggle to follow conversations or teachers at school.

ON THE WEB: NIH tips on protecting kids' hearing

"It's very concerning," says study author Josef Shargorodsky, an otolaryngology/head and neck surgery resident at the Massachusetts Eye and Ear Infirmary in Boston.

Other studies show that even a small hearing loss can harm a child's school performance, language development and social interactions, he says.

Parents may have trouble spotting the change as well, given that teens often tune their parents out, says Shargorodsky, whose research was conducted at the Channing Laboratory at Brigham and Women's Hospital, also in Boston.

Parents may notice other changes — such as an unexplained drop in grades — that could signal hearing loss, he says.

Because hearing loss is cumulative, these teens are at high risk for significant hearing problems as adults, says Brian Fligor, director of diagnostic audiology at Children's Hospital Boston, who wasn't involved in the study. Instead of developing noticeable hearing problems at age 50 or 60, these teens may have trouble hearing beginning at age 40.

Researchers based their findings on records of and interviews with nearly 4,700 kids ages 12-19, led by the Centers for Disease Control and Prevention.

They found no link between hearing loss and ear infections. Kids who reported being exposed to loud noise for at least five hours a week were no more likely to have hearing problems than others, says Shargorodsky, although he notes that teens usually aren't very good at accurately keeping track of their noise exposure.

Children living below the poverty level were much more likely to have hearing loss, possibly because poor kids have worse health in general, Fligor says.

Shargorodsky says his research doesn't explain why hearing loss is becoming more common. But doctors say the study points out the need to do more to protect children's hearing.

"Kids are growing up in a noisier world," Fligor notes.

An Australian study of kids with "mild to moderate" hearing loss found that using a portable music player, such as an iPod, was linked to 70% increased risk of hearing loss. And in a study of New York college students, Fligor found that more than half were listening to an MP3 player above the recommended exposure levels, which are 90 minutes a day at 80% of the maximum volume.

But iPods and rock concerts aren't the only source of noise in a child's world. Kids are also at risk if they fail to protect their ears when mowing the lawn, hunting with a rifle or attending noisy events, such as NASCAR races, Fligor says. Kids can protect their hearing by wearing headphones or inexpensive foam earplugs, Fligor says.

Other health trends also may be harming kids' hearing. Both high blood pressure and obesity can increase the risk of hearing problems, Fligor says. The number of children with diabetes has increased significantly in recent years, and a third of children are now overweight.

"What is scary is that these kids are setting themselves up for earlier hearing decline," says Mark Brown, an Austin otolaryngologist who treats a lot of children. "We will see the consequences of this down the road."

Originally published on USA today: http://www.usatoday.com/news/health/2010-08-18-hearing18_st_N.htm

Even Minor Hearing Loss Puts Kids at Risk for Learning Problems, Better Hearing Institute Warns

Washington, DC, August 9, 2010 - Children with even a mild hearing loss are at risk for learning and other social, emotional, and behavioral problems, the Better Hearing Institute (BHI) warned today.

BHI is urging classroom teachers to be alert to the needs of children with unaddressed hearing loss, which is often overlooked or attributed to other learning and behavior-related issues, such as Attention Deficit Disorder (ADD/ADHD). BHI also is urging schools to incorporate hearing health education into the curriculum and to adopt hearing protection policies.

The warnings came as schools across the country are opening their doors for the start of the school year.

“Too many children with hearing loss aren't getting adequate help and are being put at risk”,   says Sergei Kochkin, PhD, executive director of BHI and co-author of the national study, Are 1 Million Dependents with Hearing Loss in America Being Left Behind?  “Educators, pediatricians, and other healthcare providers underestimate the impact of mild hearing loss. And sadly, it’s the kids who are suffering.”

The scientific literature is clear that untreated hearing loss affects nearly all dimensions of the human experience. And the pediatric literature demonstrates that even children with "minimal" hearing loss are at risk academically compared to their normal hearing peers.

Hearing loss of any type or degree in a child can present a barrier to “incidental learning.” Up to  90 percent of a young child's knowledge is attributed to incidental reception of conversations around him or her. Hearing loss poses a barrier to the child's ability to overhear and to learn from the environment, as well as miss a significant portion of classroom instruction.

Hearing loss also frequently causes a child to miss social cues. Not surprisingly, many of the symptoms of unaddressed hearing loss in children overlap those of Attention Deficit Disorder (ADD/ADHD).

A large part of the problem is that many parents today either don't recognize their child's hearing problem, minimize it, or have been given misinformation regarding the ability to treat it.  At least 50 percent of parents don't seek additional professional testing when their infant fails an initial hearing screening.

According to Eileen Rall, AuD CCC-A, an audiologist from the The Center for Childhood Communication of The Children's Hospital of Philadelphia, teachers can help children with undiagnosed hearing loss.  She said:

"First and foremost, teachers can pay attention to the listening environment of the classroom and how the students are functioning in it. There are many low cost, creative ways to improve the acoustics of a classroom including something as simple as teaching children to create good listening environments—make eye contact, reduce distance, taking turns speaking and reducing the noise the students are making themselves. Some schools install sound field systems in their classrooms. Sound field systems amplify the teacher's voice and deliver his/her voice through speakers placed strategically in the classroom. Most importantly, teachers who suspect that a child is having difficulty hearing should bring it to the attention of the child's parents and school administrators so the child can undergo a thorough hearing assessment by an audiologist."

Some basic steps that teachers can take on their own to help a child with a confirmed or suspected hearing loss include the following:

• Arrange the child's seating away from the heating and cooling system, hallways, playground, and other sources of noise. If the child's hearing loss affects only one ear; if it's greater in one ear, seat the child in front of the room with his better ear toward the teacher.
• Allow the child to move around in the classroom to clearly see the speaker.
• Assign a helper, or notetaker, for the child.
• Try to speak clearly and not too fast.
• While you are speaking, don't turn away to write on the board or cover your mouth.
• Write key words or visual aids for the lesson on the board.
• Write assignments on the board so the child can copy them down into a specific notebook used for this purpose.
• If the child does not understand something, rephrase what you have said rather than repeat the same words again and again.

"Children need to be able to hear, not just in the classroom, but also because hearing affects language competence, cognitive development, social and emotional well-being, and academic achievement" says Kochkin. "Children who cannot hear well—that is, when their hearing loss is untreated or under-treated—could face a life of underperformance and broken dreams."

According to Kochkin:

• Only 12 percent of children under the age of 18 with hearing loss use hearing aids; yet an estimated 1.5 million youth (including adult dependents) under the age of 21 have hearing loss that may be improved with amplification.
• The study found no evidence of the use of any form of hearing assistance in the classroom (e.g. FM systems, hearing aids, speakers), other than front-row seating.
• Hearing loss leaves children vulnerable to other problems, according to three out of four parents of children with hearing loss. Common problem areas include:
• Social skills (52%)
• Speech and language development (51%)
• Grades in school (50%)
• Emotional health (42%)
• Relationships with peers (38%)
• Self-esteem (37%)
• Relationships with family (36%)

Compounding the problem is the increased use of portable media devices such as MP3 players, which children are listening to at high volume levels for long periods and putting their hearing at risk. According to the Centers for Disease Control, an estimated 12.5 percent of children and adolescents aged 6 to 19 years—or approximately 5.2 million youth—have permanent hearing damage from excessive exposure to noise.

"Parents, healthcare providers, and educators need to come together to thoroughly address a child's hearing loss if we are to allow that child a fair and equitable opportunity for success," says Kochkin. "As schools gear up for the start of the new academic year, I strongly encourage all educators to do their part to recognize the problem of unaddressed hearing loss in the classroom and to advocate for these children.”

Republished at www.EdisonStanfordHearing.com

MP3s 'to blame' for hearing loss

By Sima Kotecha a  BBC Newsbeat US reporter

Up to six and a half million teenagers in America struggle to hear whispered conversations or leaves rustling in the wind.

That's according to researchers in Boston, Massachusetts who say a growing number of 12 to 19 year olds have suffered slight hearing loss.

Doctors are putting the blame on MP3 players causing damage to the hearing of young people.
The study used data from a nationwide health survey.

It compared hearing loss in 3,000 teenagers from 1988-94 and then compared it with similar data from 2005-06.

The researchers say hearing loss has increased by 19% during that time, meaning one in five teenagers now has some sort of hearing damage.

Listen carefully

Some experts say it means teenagers should turn down the volume on their MP3 players and listen for less time.

But there's no absolute proof that the apparent hearing loss is a direct result of MP3 players or earphones.
"Our hope is we can encourage people to be careful", said the study's senior author, Dr. Gary Curhan of Brigham and Women's Hospital in Boston.
Most of the hearing loss was "slight", defined as inability to hear at 16 to 24 decibels.

A teenager with slight hearing loss might not be able to hear a tap dripping or their partner whispering "good night."

Those with slight hearing loss "will hear all of the vowel sounds clearly, but might miss some of the consonant sounds" such as t, k and s, according to Doctor Curhan.

He added: "I think the evidence is out there that prolonged exposure to loud noise is likely to be harmful to hearing, but that doesn't mean kids can't listen to MP3 players".

Each new generation of teenagers has found new ways to listen to loud music.

Brian Fligor, an audiologist at Children's Hospital Boston, said: "Today's young people are listening longer, more than twice as long as previous generations".

New Hearing Loss Forum

BHI Launches Discussion Forum July 23, 2010 The Better Hearing Institute (BHI) announced today that it has launched a discussion forum to help people and their families cope with hearing loss. This unique online forum covers a wide range of hearing health topics. It is designed as the go-to place for people with mild-to-severe hearing loss who are looking for a peer support community where they can chat and exchange information on hearing loss, treatments, tinnitus, hearing loss prevention, and other related topics. To participate in the discussion forum, visit www.betterhearing.org, click on “Discussion Forum,” and go to “Welcome!” to register. Moderated by BHI, the free discussion forum will have quick and convenient access to a wealth of accurate and valuable hearing health information found on the BHI web site. “Hearing loss is challenging for many people to deal with because it can be so isolating,” says Sergei Kochkin, PhD, BHI’s executive director.  “Unaddressed hearing loss can affect virtually every aspect of a person’s life. Even when someone with unaddressed hearing loss is surrounded by loved ones, the impaired ability to hear and actively participate in conversation can leave the individual feeling cut off.” Kochkin said that connecting with others with hearing loss grappling with the same issues can provide great comfort and support. The BHI discussion forum index includes topics such as Hearing Loss 101; Hearing Loss Treatment: Hearing Aids; Hearing Loss Treatment: Alternative/Supplementary Options; Tinnitus (Ringing in the Ears); Financial Assistance; Hearing Loss Prevention; Childhood Hearing Loss; Family and Relationships; and Hearing Loss Technology. According to a BHI study, the number of Americans with hearing loss has grown to more than 34 million—roughly 11 percent of the U.S. population. Over the past generation, hearing loss has increased at a rate of 160 percent of U.S. population growth and has remained one of the nation’s most commonly unaddressed health conditions. "Unaddressed hearing loss silently erodes one's quality of life, undermining family relationships, interfering with short-term memory, and creeping into virtually every aspect of daily living," says Kochkin. "But hearing loss can be easily diagnosed, and there are modern-day solutions that can help people hear better—so they don’t need to draw back in silence. “BHI is offering this forum so we can better help the large numbers of people with mild to severe hearing loss. We urge anyone with hearing loss—or anyone who cares about another with hearing loss—to join the online forum and share their questions and experiences. We want anyone with hearing loss or other hearing health issues, no matter how mild or severe, to find the support and help they need.”

Are You Aware of Your Hearing Loss?

Patricia B. Kricos, Ph.D. - University of Florida, Gainesville, Florida
“What? You think I have a hearing loss?” If you are like many people, you may be surprised when friends and family suggest that you have a hearing problem. You may think to yourself “I hear what people say. I don’t know why they think I have a hearing loss.” Many times, you probably do hear them when they are talking, but you may be missing some of their conversation with you, or you may not realize that what you think you heard is not exactly what they were saying. This can lead to your loved ones accusing you of not listening or of not paying attention. There may actually be times when you do not realize that someone is speaking. In this case, you may appear to be ignoring the person, or you may start talking, causing your communication partner to view you as quite rude. Faux pas such as this can lead to annoyance, resentment, and/or exasperation on the part of your communication partner.

You are not alone! Many people experience this, because hearing loss usually comes on very gradually. If you woke up one morning and suddenly could not hear your alarm clock, or the coffee brewing, or your neighbor’s lawnmower, you would probably know right away that you had a hearing problem. The hearing loss experienced by most people is not sudden, but instead comes on little by little. Even when people’s hearing losses have advanced to the point where they are missing the punch line during a joke, or failing to hear the tea pot whistle, they still are likely to know when someone is talking and to understand much of what is said, especially in an ideal listening situation where there is only one talker and no background noise.

Although your spouse, children, coworkers, and friends may nag you to do something about your hearing difficulties, you yourself may not realize how much you are missing in every day conversations. Even if a full hearing evaluation confirms that you have a significant hearing loss, you still may insist that even if you do, it is not causing any problems.

If this sounds like you, it may be helpful to start consciously monitoring situations in which you may be experiencing communication problems due to hearing loss. It is importance to realize that hearing loss not only affects your ability to understand what people are saying, it can also have other consequences. For example, you may not realize that lately you feel tense in social situations, that you become tired more easily, especially after a busy day at work or during a social situation, and that you want to bow out of previously enjoyed activities such as bowling. These changes may be occurring because, without realizing it fully, you may be straining to understand your communication partners and experiencing communication situations as stressful. Again, these experiences may happen so slowly over time that you do not even realize the connection between hearing difficulties and your emotional response to these difficulties.

Let’s say that your family and friends have suggested that you have a hearing loss, and a hearing health professional has confirmed that test results indicate a significant hearing loss. You, however, are still doubtful. Try monitoring your hearing for a few weeks so that you may become more aware of how your hearing loss may be affecting you, as well as your family and friends. When you realize not just that you have a hearing loss, but that it is affecting your family, social, and work place, you may be a better candidate for hearing assistive technology. When you monitor your conversational experiences, you will probably become more aware of everyday communication problems that you are experiencing. Your awareness of difficulties, such as hearing female voices, understanding in background noise, and participating in conversations when multiple speakers are talking, may help your hearing health care provider choose hearing assistive technology that would be most helpful for your particular problems.

To increase your awareness of how hearing loss might be affecting you, try periodically (e.g., every week) looking at the sample communication situations below and answering the question “How often does this happen to you?” using one of the following answers:

1. Never
2. Once or twice a week
3. Several times each week
4. Many times
5. All the time

Self-monitoring may help you realize that your family and friends are not just picking on you, but rather, that you do have hearing difficulties. These difficulties can cause problems not only for you, but also for family members, coworkers, and friends. If you scored 3 or more on these items you may have a hearing loss. For further information about your treatment options, go to the Edison Stanford Hearing Center web link titled Hearing Solutions or take the online hearing check by clicking here.

Is There Tinnitus Relief Through Herbal Treatments?

Richard E. Carmen, Au.D. – Auricle Ink Publishers, Sedona, AZ

In the past many years there have been a number of herbal remedies claiming benefit for tinnitus. As a clinical and research audiologist, I reviewed the literature on herbal treatments in 2004 and was unable to substantiate that any of the product manufacturers’ claims were backed by U.S. evidence-based research. As a former human studies researcher in the area of tinnitus during the 1980s, I’ve remained interested in this subject matter. In that it had been six years since I last looked at the literature, in June-July/2010 I ran a Medscape search that revealed 174 articles mentioning the word tinnitus. However, none of them were scientific studies on herbal treatments for tinnitus. On a Medline search for “tinnitus,” 7,078 articles were cited. But when I refined the search to “herbal treatment for tinnitus,” 24 articles were cited, almost all of which were useless because they only mentioned the word tinnitus or herbal treatment, but were not related to a study. Only one was an actual study (article in Chinese), and based on the abstract in English, there are serious flaws in the design of the study, not the least of which was the study lasted only 5 days.



I think Enrico and his research team in 2007¹ aptly sum things up regarding herbal treatments and tinnitus. It “ . . . lacks substantial scientific support, and . . . these substances are probably not clinically effective either.” Furthermore, they stated that, “. . . in view of the potential harm that may occur from inappropriate use of CAM products [complementary and alternative medicines, such as herbs], physicians need to be aware of their principal characteristics with particular emphasis on toxicity and possibilities of interaction with prescription drugs.”



In addition, in June-July/2010, I contacted two companies with over-the-counter tinnitus remedies using herbs, nutrients or a combination, for treatment of tinnitus. My inquiry to them was, “What U.S. evidence-based research is your claim based on?”



One company’s representative claiming tinnitus relief through their product (now seen all over television and print media) replied, “We’ve done extensive research over five years and the product works!”


I asked, “Where can I find this published study?”

She replied, “It’s not for public viewing.”



It defies common sense. If you have a proven relief for tinnitus, you’d want to be sharing this news with the world. Yet, they could provide nothing to me other than a claim and their word. The other company I contacted basically said the same thing – admitting there was no tinnitus research the company conducted to back the claim - BUT – I was told that the ingredients in the bottle were effective for a variety of things related to increasing blood flow, maintaining cognitive health, or relaxing the body.



On July 7, 2010, I ran an online search, “herbal treatment for tinnitus,” at The New England Journal of Medicine and the search turned up only one result, unrelated to the question. The same search at The Journal of the American Medical Association cited many articles isolating the word tinnitus in an article, but in the top 100 results, not a single article reported conducting such a study.



Here are the conclusions from an abstract that Morris and Avorn3 offer: “Consumers may be misled by vendors' claims that herbal products can treat, prevent, diagnose, or cure specific diseases, despite regulations prohibiting such statements. Physicians should be aware of this widespread and easily accessible information. More effective regulation is required to put this class of therapeutics on the same evidence-based footing as other medicinal products.”



It’s probably worth noting that the single most touted ingredient in some of these purported remedies is Ginkgo biloba. My general review of the literature in 2004, and again in June/2010, failed to uncover a single U.S. scientific study that supported the notion that any herbal treatment, including Ginkgo biloba, was of any more benefit for tinnitus than a placebo (sugar pill). Even company executives of tinnitus relief companies could not provide the data. What’s more, researchers can’t even agree that Ginkgo biloba is of benefit to health unrelated to tinnitus (see a December/2009 report on Medscape regarding a study on Ginkgo in Journal of the American Medical Association: www.medscape.com/viewarticle/714476).



Now then, in fairness as a reporter and quite in contrast to U.S. studies, some European research showed there was a link between herbal treatment and tinnitus. This is the basis for U.S. product claims. The problem is, as I said earlier, that results from these foreign studies have not been replicated in U.S. studies, so the methodologies in these foreign studies should be challenged. The reason there may be no studies conducted on herbal treatment for tinnitus is because there are far stricter guidelines in the U.S. than most other countries. We cannot know the flaws in research without knowing how the studies were designed, and exactly what the data showed. Here are only a few examples how tinnitus research can be so flawed and biased as to make the study itself worthless:

• scant case history details and “fact gathering” make for unreliable or biased results;
• not isolating and identifying variables (those things that could contaminate a study like having one patient privately taking a prescribed drug for stress or depression, for example, at the same time being assessed for the value of the test herb);
• not considering duration of tinnitus may be an influential factor (someone who just developed tinnitus last week versus a subject suffering for 20 years);
• not objectifying rating scale questions (how a researcher measures relief can influence outcome);
• not using standardized scales and measures in order to determine what comprises improvement or relief;
• failing to use randomized, blind or double-blind, placebo-controlled methodology;
• not taking into consideration the “unknowns,” for example, if most subjects report subjective tinnitus loudness about 1-4 (on a scale of 1–10 where 10 is loudest tinnitus), it may well be easier to shift tinnitus from 4 to 1 than from 8 to 5;
• failing to perform a physical exam at baseline to rule out potential factors that could influence the test result;
• failing to rule out obvious causes of tinnitus that could result in spontaneous recovery from tinnitus even after many months or years – and there are such known recoveries with cause and effect (for example, tinnitus caused by pressure or fluid in the middle ear can be resolved when the medical cause is treated; or something as simple as an ear canal hair touching the eardrum can set off a sound emission through conductance, with tinnitus immediately gone upon removal of the hair).

Linde² and a group of researchers in 2003 reviewed clinical trials on herbal medicines including their effects on tinnitus, requiring what they felt were specific stringent methodology, and concluded, “From a total of 79 potentially relevant reviews pre-selected in the screening process, 58 met the inclusion criteria. Thirty of the reports reviewed Ginkgo (for dementia, intermittent claudication, tinnitus, and macular degeneration), hypericum (for depression) or garlic preparations (for cardiovascular risk factors and lower limb atherosclerosis). The quality of primary studies was criticized in the majority of the reviews.”



If you’re a person who regardless of the evidence seeks to try anything, then it should at least be done under medical supervision. It’s worth mentioning that in most people there are apparently few side effects using Ginkgo biloba (oral administration of Ginkgo special extract EGb 761, typically 24% ginkgo-flavonol glycosides, 6% terpene lactones). However, there can be side effects including gastrointestinal disturbances, headaches, dizziness, intracerebral hemorrhage, and allergic skin reactions. Most importantly perhaps is that it does function as a vasodilator (opens the blood vessels more). For people already on vasodilators it can increase the risk of bleeding; for example, when used in conjunction with histamines, anticoagulants (like Coumadin or Warfarin), vitamin B3 (variations of niacin), Alpha blockers (such as Phenoxybenzamine), antiplatelet agents (like aspirin), and even other herbs.



I would suggest to anyone searching for tinnitus relief no matter the treatment: be vigilant, discerning, demand to see the evidence that the product works, and don’t throw good money away on testimonials alone. That’s not science.

1. Enrico P, Sirca D, Mereu M., Antioxidants, minerals, vitamins, and herbal remedies in tinnitus therapy. Prog Brain Res. 2007;166:323-30.
2. Linde K, ter Riet G, Hondras M, Vickers A, Saller R, Melchart D; Systematic reviews of herbal medicines—an annotated bibliography. Forsch Komplementarmed Klass Naturheilkd 2003; Apr,10 Suppl. 1:17-27.
3. Morris CA and Avorn J. Internet marketing of herbal products. JAMA 2003;290:1505-1509.

Republished from www.EdisonStanfordHearing.com