THE MISTAKE IN HEARING AID DESIGN
IS PRESIDENT REAGAN WEARING THE RIGHT HEARING AID?
©1985 The Anstendig Institute
Text by Mark B. Anstendig
Idea and Technical Information
by Mitchell A. Cotter
Edgar Villchur, the noted writer, teacher, and designer of audio components, once pointed out that nobody thinks twice about dealing with eye-glass wearers, but most people who wear hearing aids are avoided. It is assumed that people wearing eyeglasses have had their sight problems corrected and can see quite respectably. But not so with people who wear hearing aids. They are shunned as difficult to deal with because they usually cannot hear even with their hearing aids.
Most hearing disorders are of two types. Either the subject hears all frequencies, but in a more limited than normal volume range (recruitment), or the subject does not hear all the frequencies equally well (presbycusis, when sensitivity is lost in the higher frequencies). Today, people with these two most often encountered problems, and their many variations, could be helped to hear quite acceptably. But, the popular hearing aids that fit into the ear or on the stem of a pair of eye glasses, besides providing poor sound quality, allow no room for the sound compensation and controls needed to adequately correct individual hearing disorders.
The problem has become a vicious circle. The first hearing aids usually made things worse because of poor sound quality and lack of experience in using them. These conditions caused extreme embarrassment for the self-conscious users, who consequently sought the smallest, least noticeable hearing aids, preferably without cables that would give their presence away. Manufacturers went to extremes to make them smaller in an attempt to completely hide the fact that they were being worn. Sound-quality had to be sacrificed because these devices are not large enough to have good, individually corrected sound-reproduction. With larger devices, the bulk of hearing-impaired people could be provided with a degree of individual hearing correction that would enable them to hear so normally and comfortably that there would be absolutely no inconvenience conversing with them. But people have now become so used to thinking of hearing-aids as a stigma that they do not want to wear a hearing aid large enough to really help. The public is not being educated to this problem by audiologists and the hearing aid industry has no interest in pointing it out because, even though they have poorer sound quality, the smaller devices are much more expensive and more profit can be made on them.
Miniaturization does not belong in the priorities of hearing aids; only sound-quality does. It should not be forgotten that, besides having to provide adequate hearing compensation for everyday situations, hearing aids are worn even at the finest of live music programs as well as in situations that demand hearing the utmost differentiation in nuance (even everyday speech contains subtleties worth hearing). Nothing less than the sound quality of the finest hi-fi studio components will do.
Miniaturization increases the price in geometrical proportion to the decrease in size. People are paying huge sums for tiny hearing aids that have poor sound-quality and unsophisticated, inexact sound compensation, if any, when they could have excellent sound-quality and precise sound-compensation tailored to their individual needs for a lot less. A device the size of a pocket calculator, carried comfortably in a shirt or blouse pocket connected to an ear-piece in either or both ears (for better physical balance) could be as effective in helping these people hear as eyeglasses are for those with visual problems.
While the publicity surrounding President Reagan's tiny hearing aid may encourage many people who never would have worn hearing aids to wear them, it will, in the long run, have a negative effect by fostering the use of inappropriate, ineffective devices that will only increase the stigma of wearing them. As a result of the publicity, tiny hearing aids have become so fashionable that no one wants anything else. The President should be setting an example for the public by showing that the best sound-quality comes before appearances. The situation is doubly sad because it is much more important for a man in as critical a position as the President of The United States to have the very best possible sound-quality than it is for him to worry about appearances. He should be a shining example of the benefits of a hearing aid that is precisely tailored to the hearing disorder. The President is also the one who would best convince us that there is nothing wrong with anyone noticing that you are wearing a hearing aid.
Audiologists have failed to set the correct priorities in helping the hard of hearing. They should energetically resist the trend towards ever tinier instruments and concentrate on the right priorities: highest quality sound and precision-tailoring of the frequency response (equalization) to the patient's hearing defects. With real success in helping the hard of hearing to hear normally, the need to camouflage hearing aids would subside. Clearly, if hearing aids were as effective as eyeglasses, no one would pay them much notice.
The Anstendig Institute is a non-profit, tax-exempt, research institute that was founded to investigate stress-producing vibrational influences in our lives and to pursue research in the fields of sight and sound; to provide material designed to help the public become aware of and understand stressful vibrational influences; to instruct the public in how to improve the quality of vibrational influences in their lives; and to provide research and explanations for a practical understanding of the psychology of seeing and hearing. The institute maintains an outreach program utilizing and demonstrating the results of its research.