Month: August 2014

Hearing Aids Versus PSAP

hearing aid: noun : an electronic device worn in or on the ear to help a person who has hearing problems to hear better

This is the definition of a hearing aid according to Merriam Webster’s You’ve likely seen Personal Sound Amplification Products (PSAP) advertised on television—small electronic sound amplifiers that allow users to enjoy nighttime TV without disturbing sleepers, or to hear their toddlers from many yards away. At first glance, one might think that a PSAP may have the same definition as a hearing aid. However, according to the Food and Drug Administration (FDA), they are very distinctly different items and they are NOT interchangeable. While these personal sound amplifiers may help people hear things that are at low volume or at a distance, the FDA wants to ensure that consumers don’t mistake them—or use them as substitutes—for approved hearing aids.

The products are different in that only hearing aids are intended to make up for impaired hearing, whereas a PSAP is intended to amplify sound for someone who is not hearing impaired. Consumers should buy a personal sound amplifier only after ruling out hearing loss as a reason for getting one. If you suspect hearing loss, get your hearing evaluated by a health care professional. Choosing a PSAP as a substitute for a hearing aid can lead to more damage to your hearing. It can cause a delay in diagnosis of a potentially treatable condition and that delay can allow the condition to get worse and lead to other complications. Treatments for impaired hearing can be as simple as removal of a wax plug in the doctor’s office or, in rare cases, as serious as a major surgery to remove a tumor or growth in the middle or inner ear.

Both hearing aids and PSAPs acoustically amplify sound. However, the FDA defines a hearing aid as a sound-amplifying device intended to compensate for impaired hearing. PSAPs are not intended to make up for impaired hearing. Instead, they are intended for non-hearing-impaired consumers to amplify sounds in the environment for a number of reasons, such as for recreational activities.

Although it may be tempting to utilize a PSAP in lieu of a hearing aid, especially if you have not been diagnosed with true hearing loss, as a consumer you should be aware of the marketing tactics intended to attract buyers to over-simplified and (possibly) very inexpensive solutions to hearing enhancements. Most PSAP’s look like a Bluetooth device or just a sound amplifier worn as a pendant. But many of the PSAPs on the market are even manufactured to look like top-of-the-line hearing aids and that can be misleading to the average consumer.

The best thing to do before investing any money in a hearing aid (sometimes covered fully or partially by your health insurance) or PSAP (not covered by insurance) is to get a hearing evaluation by a certified audiologist. If you truly do not have hearing loss you still may not need a PSAP. Sometimes you can improve your ability to hear just by cupping your hand around your ear (the author finds this especially useful in situations where there is a lot of background noise while trying to hold a conversation).

If you are diagnosed with hearing loss, go to to find the hearing aid that is right for you and fits your budget. No matter where you are in the country, we have the hearing aid for you and will refer you to an audiologist in your area for personalized fitting and lifetime service and maintenance. When there is true hearing loss, there is no substitute for an accurate evaluation by a credible audiologist and and FDA approved hearing aid.


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What Exactly IS a Hearing Aid?

So what, exactly, is a hearing aid? A hearing aid, also called a hearing instrument, is a highly sophisticated communication device. There are many different types of hearing aids, just as there are many forms of hearing loss, but they share some basic components. All of them work on amplifying sounds to enhance particular hearing range problems but it’s more than just a noise amplifier. The design of each hearing instrument can vary but the overall effect is to empower you to live your life to the very fullest.

A hearing aid works basically like this:

  • A microphone picks up sounds.

  • Sounds are analyzed by a processing chip.

  • Processed sounds are sent to the amplifier.

  • Amplified sounds are sent to the loudspeaker.

  • Sounds are transmitted by the loudspeaker into the inner ear where they are transformed into electrical impulses.

  • Impulses are picked up by the brain where they are processed.

This is a far cry from the early “ear trumpet”!

Hearing Aid Technology

In all hearing aids, sound enters through a microphone. It is then processed, amplified, and delivered to a receiver (loudspeaker). This sends the output either directly to the user’s ear canal, via tubing to an ear mold and into the ear canal, or via a thin wire to a receiver placed directly in the ear.

There are two types of sound processing:

  • Analog

  • Digital

Analog Hearing Aids

Analog sound is like making a photocopy: the sound is registered and you get an overall picture. But the actual processing is analog insidelike recopying a photocopy – it can only be done to a certain extent because it causes a deterioration of the original imprint. Analog hearing aids have a microphone which picks up sound in the environment and converts it to small electrical signals. The electrical signal is then amplified and shaped by transistors and circuits in the signal processing part of the hearing instrument. Shaping and output limiting are performed by manual adjustments usually located on the outside of the hearing aid faceplate. The amplified and shaped electrical signal is then sent to the receiver to be changed back to an acoustic analog signal and sent to the ear of the hearing aid wearer. Analogue hearing aids can have many complex circuits at the signal processing stage but there is a limit to the number and tends to cause interference.

Digital Hearing Aids

Digital hearing aids are much more advanced than analog or programmable hearing aids. In a digital hearing aid the acoustic signal is converted into digits (0, 1), processed within the hearing aid, and then reconverted to an analogue acoustic signal for the listener. A digital signal can be repeated endlessly without affecting the overall quality. It is like making copies of a scanned image: each copy is a perfect duplicate of the original. Because the code also includes information about a sound’s pitch or loudness, the aid can be specially programmed to amplify some frequencies more than others. These programs allow the hearing aid to function differently in different listening situations for example:

  • In a quiet conversation

  • At a concert

  • At a party where there might be a great deal of background noise

Digital hearing aids transform the analog information from the microphone into a binary code then the signal is taken from the microphone and transformed into data that can be manipulated by a tiny computer in the hearing aid. The data can then be tailored and processed very precisely and in ways that are impossible with analog aids. Digital hearing aids can be very finely adjusted to suit an individual’s hearing loss and can include features like noise cancellation, speech recognition and feedback suppression systems.

Analog/Digital Hybrid (also called Digitally Programmable Hearing Aids)

These aids use analog signal processing at the amplifier stage. However, they also have a digital chip at the amplifier stage that allows shaping of the frequency response and output-limiting to be altered by a computer rather than a screwdriver. Unlike a strictly analog hearing aid, a digitally programmable hearing aid allows for the choice of different programs from the internal memory to suit different listening conditions.

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A Brief History of Hearing Aids

The very first hearing aids were invented in the 17th century. They were external and known as ear trumpets. Ear trumpets were useful for directing sounds into the ear canal. Ear trumpets were hand held, acoustic, and only raised the amplification level modestly.

Ear trumpets were hand held acoustic devices used for capturing sound and feeding it directly to the ear.

Ear trumpets were hand held acoustic devices used for capturing sound and feeding it directly to the ear.

This type of hearing aid was used almost exclusively for over two hundred years but the move towards modern hearing aids began with the invention of the telephone in the late 19th century. The telephone was the first electrical device that could transmit speech. Hearing-impaired persons often found that they could hear a conversation better through the telephone than in person as the sound was subtly amplified directly into their ear. Thomas Edison, who was hard of hearing, didn’t benefit from improved hearing through the telephone so was interesting in improving on the Alexander Graham Bell’s telephone invention. In 1878, Mr Edison invented the carbon transmitter for the telephone which, unlike Bell’s device, amplified the the electrical signal. Some tried to adapt telephones for use as hearing aids but the results were cumbersome, heavy and only offered sound amplification of about 15 decibels. Considering that normal speech is about 60 decibels, this wasn’t much improvement. These early hearing devices were of limited usefulness and really had no commercial viability.

Weighing less than 10 lbs, this type of device was considered portable but was not popular with the hearing impaired.

Weighing less than 10 lbs, this type of device was considered portable but was not popular with the hearing impaired.

Then came the introduction of the vacuum tube and Western Electric Co. started producing technically superior hearing aids in 1920. These offered sound amplification at 70 decibels and more frequency response. However, these “hearing aids” were as large as a filing cabinet and weight over 200 lbs. Four short years later and Western Electric created hearing aid weighing in at less than 10 lbs and fitting in a small wooden box…still not portable and very conspicuous. These were still not popular with the hearing impaired population due to their unwieldiness and the stigma attached to be visibly pegged as hearing impaired.

By 1938, Aurex Corp. out of Chicago, developed the first wearable hearing aid. The earpiece was connected to a thin wire that lead to the amplifier-receiver clipped to the wearer’s clothes. The battery pack was strapped to the wearer’s leg. Around the same time, 1937 to be precise, Raytheon developed sub-miniature vacuum tubes which allowed for amplifiers that were smaller and required less power. The amplifiers were marketed to hearing aid manufacturers and gained market share even though they still relied on the strap-on battery pack.

By the late 1940s manufacturers combined sub-miniature vacuum tubes with two innovations that rose from WWII; printed circuit boards and button batteries. They were able to produce more compact and reliable models. The battery,

This hearing aid, although more discreet, still required an attached amplifier and battery pack.

This hearing aid, although more discreet, still required an attached amplifier and battery pack.

amplifier, and microphone were combined into one unit that could fit in a person’s shirt pocket or even a woman’s hairdo! The unit was connected to an earpiece by a wire. The device was not invisible by any means but the manufacturer did try to camouflage them by hiding the microphones in the hair or on some clothing accessory like a tie tack or brooch. What the hearing impaired really wanted was a truly one-piece, nearly invisible unit that was worn in the ear. So far, this was not possible even with the smallest sub-miniature vacuum tubes.

A solution came in 1948 with the invention of the transistor and by 1952, Raytheon was manufacturing and selling transistors to hearing aid manufacturers. More than 200,000 transistorized hearing aids were sold in 1953. By the late 1950’s Otarion Electronics in Chicago, introduced the first hearing aid worn entirely at the ear….no wires leading to amplifiers and battery packs. This was accomplished by putting all the electronics in the temple pieces of a pair of eyeglasses. By 1959, this type of hearing aid,

These "hearing glasses" were the first type of hearing device with all the components at the ear.

These “hearing glasses” were the first type of hearing device with all the components at the ear.

known as “hearing glasses” had captured half the market and were even worn by people with near perfect vision. It was a big step towards modern hearing aids but the leap was made in 1964 by Zenith Radio, a longtime hearing aid manufacturer in Chicago who sold a behind-the-ear model using integrated circuit amplifiers and a 1.2 volt button battery. It weighed a mere 7 grams and about 500 times more reliable than hearing aids built with discreet transistors. The microphone was placed inside the ear and was connected by a wire to the amplifier and battery which were clipped to the ear.

In the late 1980s, several companies were applying digital signal-processing chips (DSP) to hearing aids in which digital signals controlled and analog compression amplifier. These were known as hybrid models. The fully digital models debuted in 1996 and a few short years later, programmable models allowing for greater flexibility and fine tuning according to patient’s needs became available.

This hearing aid is all digital and completely self contained.

This hearing aid is all digital and completely self contained.

By 2005, digital hearing aids captured 80% of the market. Despite how far hearing aids have come, there is still room for improvement and manufacturers are still working on some of the issues that face hearing aid wearers. Modern hearing aids excel at amplification and acoustic feedback but researchers are still working on devices to filter out background noise and extraneous sounds that can obscure a conversation.

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