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.
Monday, November 29, 2010
Monday, November 22, 2010
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.
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.
Tuesday, November 16, 2010
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
- 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
- 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.
Monday, November 15, 2010
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.
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.
Monday, November 8, 2010
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:
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.
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.
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.
Monday, November 1, 2010
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.
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.
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