What a Hearing Evaluation Measures

A critical part of a thorough hearing evaluation is determining an individual's full range of hearing.  Three "thresholds" of hearing are measured:

• What are the softest sounds that are audible?
• What is the most comfortable level of hearing? 
• What is the most uncomfortable level of hearing?

Threshold testing will help the audiologist determine:

• What consonants will be difficult for an individual to hear
• What vowel sounds will be difficult for an individual to hear
• What sounds in nature and "everyday life" an individual will struggle to hear
• What kind of technology will help enhance an individual's remaining hearing capacity

For more information on hearing evaluations (like how often you should have your hearing checked), click here!

How Audiologists Evaluate Hearing

As we discussed in our last blog, there are major differences between audiologists and hearing aid dispensers.  Audiologists possess a Doctoral degree in audiology and are skilled in the planning, directing, supervising, and conducting of habilitative and rehabilitative counseling programs for individuals who have been diagnosed or are suspected of having disorders of hearing.  Hearing aid dispensers are licensed by the state to test hearing solely for the purpose of fitting hearing aids.  They are not licensed to test for or treat balance disorders or tinnitus.  

Another difference between hearing aid dispensers and audiologists is how hearing is tested.  Audiologists test hearing in an enclosed, sound-proof booth instead of an open table.  The difference between a hearing evaluation performed in an enclosed sound booth and at an open table is accuracy.  Eliminating background noise is a critical component of accurately evaluating a person's remaining hearing capacity.  

At Appalachian Audiology, we test hearing across 8 frequencies depending on the severity of the hearing loss.  A thorough hearing evaluation is also comprised of:

• Otoscopy to ensure the absence of fluid or infection.
• Tympanometry to test ear drum movement, the presence of fluid, and to confirm the absence of eustachian tube dysfunction.
• Acoustic Reflex Testing to check the muscles of the middle ear to see if it contracts in the presence of loud sounds
• Speech and Tone Testing to discover the full range of a patient's hearing
• Air and Bone Conduction 
• Word Discrimination to determine how well speech is understood in noise

These components help an audiologist discover the location, degree, and type of hearing loss an individual has (if any).  Once this is determined, an audiologist must consider three components before deciding on the right course of treatment.  More on this in the next blog...

For more information on what you should expect from a thorough hearing exam, visit our website!

Hearing Aid Warranties and Repair Costs

As we noted in last week's blog series on hearing aid repairs, a hearing instrument usually malfunctions for one of two reasons:  moisture or wax build-up.  If the hearing aid continues to malfunction after it has been dehumidified overnight and all excess wax has been removed, an audiologist should examine the aid to rule out other problems like a damaged receiver or a dead circuit.  In the event the audiologist is unable to repair the hearing aid, the instrument will have to be sent in to the manufacturer for repair.

Warranties and Repair Costs

Two types of hearing aid warranties are included in the purchase price of new hearing aids through Appalachian Audiology.  A Loss and Damage Warranty will allow the wearer to replace each aid once if the instrument is lost.  The manufacturer will usually charge a $200-$350 service fee for replacing a lost hearing aid.  A Repair Warranty will insure the hearing aid in the event it needs a repair the audiologist is not able to perform.  If the hearing aids malfunction for any reason within the warranty period, the manufacturer will repair the hearing aids and return them to the audiologist at no-charge.  Hearing aid manufacturers usually allow patients to extend their warranty coverage up to two years for less than what it takes to repair the hearing aid if it becomes damaged.  Appalachian Audiology offers extended warranty coverage through the hearing aid manufacturer for around $150 per aid.

If a hearing instrument's warranty lapses, hearing aid manufacturers charge a flat repair fee regardless of the type of repair that is needed.  The repair charge usually includes new warranty coverage for 6-12 months.  Repair costs usually add up to roughly $300 while extending a warranty usually costs around $150 through Appalachian Audiology.

Have more questions about hearing aid maintenance, repair, and warranties?  Click here!

What to Do When Your Hearing Aids Stop Working

Your hearing aid has suddenly stopped working.  You placed it in a dehumidifier overnight.  You have removed all wax and replaced the wax trap (if your hearing aid is equipped with one).  However, it's still not working....what's next?
It's time to see an audiologist.  There are several reasons a hearing aid can cease to function.  These include: 

• A dead receiver.  Many times a hearing aid will cease to function because the wiring in the receiver has stopped working.  This is an easy repair that an audiologist must perform.  Please do not attempt this repair on your own!  Manufacturers differ in how the receiver is removed and placed on the hearing aid.  If you pull the wrong way, the receiver can break off into the hearing aid.  If your hearing aids are still under warranty, a receiver can be quickly replaced at no charge.  Receivers typically cost around $75-$100 to replace for out-of-warranty hearing aids.   
• Debris.  Debris can clog the microphone ports or other parts of the hearing aid.  To fix this, an audiologist must use a suction device to remove the debris and then put the microphones back into phase.
• Battery contact decay.  Overtime, moisture can cause the battery contacts to rust or decay.  This is a repair that the hearing aid manufacturer must make.  The hearing aids are shipped overnight to the manufacturer who then replaces the contacts.  Most of the time, hearing aids are returned to the patient within a week.
• Dead circuit.  A less likely cause of a hearing aid malfunction is a dead circuit.  Overtime, hearing aid circuits can cease to function due to moisture exposure, age, debris, or lack of proper maintenance.  If your hearing aids are still under warranty, a manufacturer will replace the circuitry at no-charge.

Most of the time an audiologist can repair hearing aids on site in a matter of a few minutes.  Appalachian Audiology includes lifetime service, adjustment, and maintenance for all hearing aids purchased through our clinic.  If your hearing aid has stopped working, please don't hesitate to consult with one of our clinical audiologists.

If your hearing aid must been sent in for repairs, how much will it cost?  How important are hearing aid warranties?   Next blog...

2 Main Reasons Hearing Aids Malfunction...and How to Fix! Pt. 2

Has your hearing aid suddenly stopped working?  Usually, a hearing aid that suddenly "goes dead" is easy to repair.  In most cases, these simple repairs can be performed by the hearing aid wearer without the help of an audiologist or assistant.  Hearing aids usually stop working for one of two reasons.  As we noted in our last blog post, one cause for malfunction is moisture.  Another common cause for hearing aid malfunction is ear wax build-up.  Wax can clog or cover parts of the hearing instrument causing it to shut off.  Each hearing aid should come with common tools like a brush and wire used to keep the aids minimally clean. A brush and cloth can be used to gently remove the wax from the end of the receiver, a tip, and a dome.  A small wire can be fed through the slim tube to clean out any loose wax particles.  If the hearing aid is equipped with a wax trap that becomes filled with wax, the hearing instrument will usually resume normal functioning once the wax trap is replaced.  The tool included with each wax trap is used to plug into the wax trap on the hearing aid and remove it. Once removed, the new wax trap can easily be inserted using the same tool.  Our office is equipped with more complex tools used specifically to clean hearing aids, remove excess wax build up, and change wax traps.  If you are uncomfortable changing out the wax trap, we would be glad to do it for you.  Lifetime service is included with all hearing aids purchased through Appalachian Audiology.

What if the hearing aid still doesn't work after it's been in the dehumidifier overnight and all wax has been removed?  Next blog....

For more information on hearing aid maintenance, click here.

2 Reasons Hearing Aids Malfunction...and How to Fix!

Has your hearing aid suddenly stopped working?  Usually, a hearing aid that suddenly "goes dead" is easy to repair.  In most cases, these simple repairs can be performed by the hearing aid wearer without the help of an audiologist or assistant.  Hearing aids usually stop working for one of two reasons.  One cause for malfunction is moisture.  Moisture is the number one enemy of hearing aids.  As hearing aids are exposed to sweat during yard work or outdoor activities, moisture can build up inside the casing and cause the aids to stop working.  To avoid moisture build-up, place the hearing aids in a dehumidifier on a nightly basis.  If your hearing aid suddenly stops working, the aids should be placed in a dehumidifer overnight to ensure that all moisture is eliminated.

There are many types of dehumidifiers.  A Dry Spot dehumidifier is perhaps the most cost-effective solution.  The Dry Spot dehumidifier is a plastic container that includes a removable dessicant.  At Appalachian Audiology, a Dry Spot dehumidifer is automatically included in the purchase price of hearing aids.  The dessicant should be golden in color.  As the beads absorb moisture, they will turn green.  Once the beads begin turning green, place the dessicant in the microwave for thirty second intervals until the golden color is restored.  This will evaporate the moisture the beads have collected overtime.  There are also electric dehumidifiers.  The Dry and Store Zephyr can electronically absorb moisture while the Dry and Store Global II can both absorb moisture and perform a sanitization function.

If the hearing aids continue to malfunction after being placed in a dehumidifier overnight, there is one more maintenance procedure that should be performed.  More on this later...

For more information on hearing aid maintenance, click here.

3 Solutions for Hearing Better in Noisy Places Pt. 3

After an audiologist has determined how well an individual is able to hear speech in noise, tolerate loud sounds, and understand rapid speech, three potential solutions for hearing better in noisy places can be explored.  These solutions are:

• Digital hearing aids with highly developed digital noise suppression
• Bluetooth accessories
• FM Systems   

FM Systems are designed to help people with or without hearing loss understand speech more clearly in noisy environments.  Some FM systems wirelessly transmit volume directly to an individual's hearing aids.  Other types of FM systems are used by people with normal hearing who struggle to accurately identify speech due to ADD or ADHD-related issues. 

Phonak (a major hearing aid manufacturer) describes how FM systems work the following way:  

The person you are speaking with wears or holds a transmitter microphone (or places this in the middle of  your group).  This transmitter picks up their speech and uses harmless radio waves to send this to one or more FM receivers, which are worn behind the ear or connected to hearing aids.

For more information on FM systems, click here.

Three Solutions for Hearing Better in Noisy Places Pt. 2

After an audiologist has determined how well an individual is able to hear speech in noise, tolerate loud sounds, and understand rapid speech, three potential solutions for hearing better in noisy places can be explored.  A hearing loss that makes it difficult to discern speech in noise can be treated using digital hearing aids with highly developed digital noise suppression and bluetooth accessories.   Bluetooth accessories for hearing aids make it possible to wirelessly stream the volume of a phone, portable music device, mini-microphone, and television directly to both hearing aids usually through the use of a remote.  Bluetooth connection to a cell phone or land line often improve the clarity of the caller's voice simply because the caller is heard in both hearing aids.  More than that, certain bluetooth circuits will deliver a stereo signal again enhancing the clarity for TV listening, computer streaming, and music comprehension.  Bluetooth compatible hearing aids are available at all three levels of technology and generally require an accessory to access the bluetooth capabilities.  This is customized based on the individual's lifestyle and comfort with the technology.

For more information on bluetooth accessories and how they improve speech clarity, microphone sophistication and directionality, and solutions for hearing in noise, click here.

More later on the third solution for hearing better in noisy places...

Three Solutions for Hearing Better in Noisy Places Pt. 1

After an audiologist has determined how well an individual is able to hear speech in noise, tolerate loud sounds, and understand rapid speech, three potential solutions for hearing better in noisy places can be explored.  While it is possible to have normal hearing and yet have difficulty understanding speech in noisy environments, it is often the case that an individual with speech-in-noise problems also has an accompanying hearing loss.  A hearing loss that makes it difficult to discern speech in noise can be treated using digital hearing aids with highly developed digital noise suppression.  Major hearing aid manufacturers produce hearing aids at three different technology levels (Level 1, 2, and 3).  These three technology levels are differentiated by the sophistication of the microphones within the hearing aids and the number of adjustable channels.  The directionality of the hearing aid microphones differs between each level and makes hearing in noise more possible.  For example, a hearing aid with multi-directional, adaptive microphones will focus on and amplify speech from its source- whether it be from the side, behind, or in front of the individual.  In general, the noisier your world, the better you will do with more advanced hearing aids.

For more information on digital hearing aids, microphone sophistication and directionality, and solutions for hearing in noise, click here.

More later this week on the other two solutions for hearing better in noisy places...

How to Hear Better in Noisy Places

Understanding speech and participating in conversations in noisy environments like restaurants and church can be difficult.  However, improving an individual's ability to hear in noisy environments is now possible.  Before suggesting a real solution to the problem, an audiologist must test, measure, and quantify three factors that influence an individuals speech-in-noise difficulty:

• The level of difficulty of understanding speech in noise
• An individual's level of intolerance to loud sounds
• The level of ability to understand rapid speech

For a detailed explanation of how these three factors influence the ability to understand speech in noisy environments, click here.

Once these factors have been tested and measured, the audiologist can propose solutions to improve the individual's ability to participate in conversations in noisy places.  More on solutions next week...