This article appeared in the July/August 2001 issue of Hearing Loss: The Journal of Self Help for Hard of Hearing People.
What SHHH Members Say About Hearing Aids and Audiological Services
By Barbara Wendt-Harris, Peggy Pollack, and Annekia Lassere
Here are the results of survey in which 261 SHHH members participated. You shared your opinions on hearing aids, assistive devices, and hearing services. Read on to see if you agree with the majority and to see some interesting answers fro your fellow SHHH members.
The following is a report of the preliminary findings of a survey conducted at the 1999 SHHH International Convention held in New Orleans, Louisiana. Thirteen audiology graduate students from the Louisiana State University Medical Center (LSUMC), Department of Communication Disorders, participated in the survey research. Many of you who attended the convention may remember seeing the students dressed in purple hats and shirts. The results of this survey were presented in a session on the last day of the convention. This report is a summary of the preliminary results and of the audience comments from that session.
Tell Me About the Survey
The survey consisted of nine questions. The students conducted the survey in a face-to-face interview and wrote down the respondents’ answers. For the opinion questions, there was no list of answers to choose from. Participants could openly answer the questions and say as much or as little as they desired. During the interviews, many students noticed that SHHH members were assertive in dealing with their hearing loss and had strong opinions that they were more than willing to share. The students and professors compiled and analyzed the data each evening after interviewing, in preparation for the presentation.
Who Participated?
Two hundred sixty one convention attendees participated in the survey. The hearing loss characteristics of the respondents are shown in Chart 1 below.
We noted that the participants in our survey have a much greater degree of hearing loss than those seen most often in our clinic.
Ninety-seven percent (97%) of the respondents reported a bilateral hearing loss while three percent (3%) reported a unilateral hearing loss.
It was surprising to note how many respondents had cochlear implants. Chart 2 indicates the amplification devices used by our survey participants.
Question: “What Do You Like Best About Your Hearing Aid or Cochlear Implant?”
Before conducting the survey, the LSUMC student audiologists and professors tried to predict the answers that the SHHH members would give us. We thought the number one answer to this question would be “I can understand speech”; however, that answer was the third most popular answer. The top answer was “I can hear!”
Table A lists the top five answers, and the number of times each particular response was given as an answer.
Although the number one answer makes sense, it gives the researchers food for thought as we push for speech understanding when fitting hearing aids and cochlear implants. In the population that responded to this survey, many of the hearing losses were severe to profound, and just hearing everyday sounds was an important issue. Comments by participants included the need to hear a dog bark in order to manage a ranch, the desire to hear music, and the desire to hear specific devices such as computers or watches. These responses should alert the audiology profession that there are cases where speech perception is not the only goal in hearing aid fittings.
It should be noted that many formulas used for fitting hearing devices are based on the ability to perceive all sounds within the speech range. Perhaps audiologists need to focus on the client’s ability to hear all sounds, not just speech alone. Clients with little speech understanding due to the severity of their hearing loss would most likely benefit from the ability to hear other sounds in addition to speech.
Answers to this question about what you like best about your hearing aid or cochlear implant were in two major categories: specific hearing aid options (such as t-coil, and programmability) or the ability to hear specific sounds.
Question: What do you like least about your hearing aid or cochlear implant?
The number one answer of “background noise” was not surprising. Even with all the advances in technology in the past few years, there is no listening device better than a normally hearing set of ears. Because background noise is so variable (think of the difference between an air conditioner hum and a cocktail party), no single method of noise-reduction can address all noise issues.
Two common answers to this question were very disturbing to us. A properly fitted hearing aid should not be uncomfortable and should not cause feedback. For the six percent of you who made those comments, we recommend you visit your audiologist immediately! A hearing aid should not cause pain. Earmolds can be remade, and hearing aids can be re-cased to increase comfort and decrease feedback.
Ten percent of the participants complained of problems with moisture. We are unsure if the percentage was so high because the convention was held in the “very humid south” or if excess moisture is truly an all-weather problem. There are several hearing aid drying kits on the market that address moisture problems. We recommend you try several until you find one that works best for you. You must use the kit consistently to get the best results. Many kits are inexpensive.
For those of you who commented that you do not hear as well as you would like to, research scientists are working on that problem as we speak. Look for more and more innovations in hearing aid technology in the next few years. If you are wearing an older hearing aid (five to ten years old or more), we recommend you visit your audiologist to try a new programmable, digital, directional, or multimemory hearing aid. You may find that one of these recent developments may work well for you. Remember to get a trial period when you try out hearing aids so you may find the hearing aids that work best for you without purchasing several pairs.
We were surprised that one answer appeared only a few times on the list of things you like least about your hearing aid or cochlear implant. That answer was price. Evidently when good hearing is the issue, price is not a major factor. (It is possible that because the hearing loss of our participants was mainly severe to profound, it was accepted that remediation would not be inexpensive. The general public, who may not have major hearing difficulties (or may not recognize/accept their hearing difficulties) may be looking for a bargain because they feel not much is needed to “fix” their hearing problem.
The way the hearing aid “looks” was a rare answer to this question, again, to our surprise. In some populations looking “perfect” may not be as important as hearing well.
Question: What was the most helpful information you received from your audiologist?
These answers suggest that audiology professors are teaching the right things to our graduate students, as the major answers to this question are all areas of primary audiology coursework. However, the fact that six percent of you have nothing good to say about what your audiologist told you indicates that there are professionals out there who are in desperate need of hearing aid counseling training. It is a disservice to dispense a hearing aid without explaining proper hearing use and maintenance. Audiologists should always explain results of all tests to the client AND explain all hearing aid options so that the consumer can make an educated decision about which device to obtain.
Question: Is the information your audiologists provides useful to you?
The good news is that almost half of the respondents (46%) stated that all information received from their audiologist was helpful. Eleven percent (11%) indicated that none of the information was useful or that you were provided with incorrect information. Four percent (4%) of the respondents felt there was too much technical information provided.
Answers to this question indicate that audiologists must keep up on the latest developments in hearing aids and cochlear implants so they can present all information correctly to their clients. Some clients do not want to hear information that is too technical. The audiologist needs to determine the level of information that is appropriate for each client. As consumers, you should not be afraid to tell your audiologist that you are overwhelmed by information or that the information presented is too simple.
Question: What additional information would you have liked to receive from your audiologist?
Because the survey was completed at the SHHH Convention and most attendees are avid supporters of SHHH, it is not surprising that respondents felt information on this organization is important. Looking at all the answers given (including those not in the top five), 22% of the respondents wanted more information on rehabilitation and coping with their hearing loss. We were pleased to see that 10% of the respondents felt they received all the information they needed from their audiologist.
However, we were surprised and dismayed to see that the number one and number three answers indicated that consumers were not told about assistive listening devices and t-coils (which you need in your hearing aid to in order to use some assistive devices). Students are taught about t-coils, and assistive listening devices are reviewed in class, but they do not receive as much emphasis as the engineering of hearing aids and hearing aid fitting formulas. Many professors in audiology education have been saying for a long time that there has not been enough emphasis on rehabilitation of the individual with hearing loss. Many programs seem to just emphasize hearing aid dispensing. The answers to this question definitely point out that the entire person needs to be addressed not just their inner ear.
Question: Are there any social situations you avoid because of your hearing loss? If so, which ones?
The answers to this question were predictable. The one pleasant surprise was that 14% of the respondents said that there was not a single situation they avoided because of their hearing loss.
Hooray for those people who have really appropriate hearing devices or enough self-confidence that they will not let less-than-perfect hearing interfere with the enjoyment of life!
The other answers to this question fell into two main categories. Sixty-six percent of the responses indicated difficulty in social situations due to excessive noise (parties, bars, etc.). Twenty-nine percent of the answers pinpointed situations where there was an inability to hear the speaker most likely due to poor acoustics or sound transmission (such as in a church, at a play, or at a movie). This information is important for any service company that wants to attract customers with hearing loss.
Question: What are the most common assistive or alerting devices (ALDs) that you use?
Responses to this question brought a few issues about ALDs to the surface. The first is that while audiologists know about some of the more common devices, not all audiologists are familiar with all of them. This fact was highlighted when the graduate students visited the exhibits at the SHHH convention and were amazed at the wide range of devices available. The other interesting finding was the list of items used that we do not consider “typical” assistive listening devices. This includes items such as family members, and e-mail. One respondent listed caller ID as an assistive device because when she recognizes the phone number on the caller ID machine she knows who is calling her, is familiar with the caller’s voice, and she knows what the possible topics of conversation could be.
The response of dogs as an assistive listening device was of interest. While some participants had trained “hearing dogs,” many participants use the family dog as an alerting device. Many of us with normal hearing use our barking dogs to alert us when someone is at the door or when there are strange noises outside the house, but do not realize that the pet is acting as an assistive listening device. This comes into play when fitting amplification devices because, as mentioned earlier, the ability to hear a dog bark (an everyday sound) is not usually the goal of a hearing aid fitting. Maybe it should be for some clients.
While giving these results in a presentation on the last day of the SHHH Convention in New Orleans, comments from the audience again reinforced their desire to be informed about assistive listening devices and support groups. This topic must receive more emphasis in graduate education.
It was noted that the amount of information clients wanted about their amplification devices varied. Some clients want to know about all the technology; others just want to know how to use and maintain their device.
Many attendees were unsure of how to find an audiologist for services. The two primary audiology organizations and their addresses, websites and telephone numbers are listed below.
The most rewarding part of the research study for the students, professors, and participants was the interaction. There is so much we can learn from each other. The audiology community needs to keep in touch with its clients so we can truly meet their needs and tailor the education of students (future audiologists) to do so. The community of people with hearing loss must tell the audiology community their wants and needs. Many decisions about audiology services are made using our “best guess” as to what services the community of people with hearing loss need. As the results of this survey pointed out, our best guess is good, but definitely lacking in some areas.
We appreciate the comments and suggestions gathered from this survey and plan to use them to improve our own academic program at LSUMC. We will share this information with our audiology peers to try and enlighten and educate them about the needs of people with hearing loss.
Barbara Wendt-Harris, Ph.D., and Peggy Pollack, M.C.D., are assistant professors of clinical Audiology at Louisiana State University health Sciences Center (formerly LSU Medical Center). Annekia Lassere, M.C.D., graduated in May 2000 with her graduate degree in audiology.
Sources of Information
These organizations are great sources for any information about hearing and hearing loss. They provide information for consumers and for audiologists. Of course, contact SHHH for information for consumers about living well with hearing loss (www.shhh.org).
American Academy of Audiology (AAA)
8300 Greensboro Drive
Suite 750
McLean, VA 22103-3611
800/AAA-2336
http://www.audiology.org
American Speech-Language-Hearing Association(ASHA)
10801 Rockville Pike
Rockville, MD 20852-3279
800/498-2071
http://www.asha.org
