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Speech In Noise:  Separating Fact from Fiction

2/13/2018

 
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A critique of the article entitled "The Future of Hearing Aids Could be a Video Game" found at...

https://www.weforum.org/agenda/2018/02/your-next-hearing-aid-could-be-a-video-game

New research, technology, and ways of thinking relating to hearing loss and hearing aids are exciting.  This "exciting" article is just one of many examples of cutting edge research that professes to address a real known problem.  I've decided to critique one such article.  Quotes from the article are followed by my responses.

"Roughly 15 percent of Americans report some sort of hearing difficulty; trouble understanding conversations in noisy environments is one of the most common complaints."

TRUE:  The first statement is probably correct, although most studies say 10%, rather than 15%.  Speech in noise complaints are definitely #1.

"Unfortunately, there’s not much doctors or audiologists can do."

FALSE:  While it is true that there is much more hearing professionals CAN and SHOULD do to improve speech-in-noise outcomes for those with hearing loss, (i.e. separating fact from marketing fiction, selecting hearing aids that are proven effective in noise, and using an effectiveness-first fitting approach), to state that there's not much hearing professionals CAN do is false.  

"Hearing aids can amplify things for ears that can’t quite pick up certain sounds, but they don’t distinguish between the voice of a friend at a party and the music in the background."     

FALSE:  Contrary to that statement, the primary purpose of hearing aid research and advanced hearing aid features is just that... to distinguish desired speech from all other sources of sound (i.e. directionality, beamforming, waveform comparison techniques, advanced noise reduction, compression, etc.).  Hearing aid manufacturers have different approaches to tackling this problem.  Granted, some work better than others.  The approach of the hearing professional in terms of the fitting and programming plays a critical role, as well.  Similarly, some fitting approaches work better than others.  

"Most hearing aid users say that even with their hearing aids, they still have difficulty communicating in noisy environments."

TRUE:  It is suggested that about 50% of hearing aid wearers are not satisfied with their hearing solution.  Speech-in-noise effectiveness is a primary "measuring stick" for wearers.  It's not surprising, for reasons stated above, that many do not achieve the desired outcomes.  

"As a neuroscientist who studies speech perception, this issue is prominent in much of my own research, as well as that of many others. The reason isn’t that they can’t hear the sounds; it’s that their brains can’t pick out the conversation from the background chatter."

MISLEADING:  By stating "the reason", this PhD attributes all speech-in-noise problems to neurological degradation.  This is not to say that his approach may not be the solution for some specific cases, but the verbiage is misleading as it suggests his new approach is a comprehensive solution for all with hearing loss.  

"People with hearing aids often report being frustrated with how their hearing aids handle noisy situations; it’s a key reason many people with hearing loss don’t wear hearing aids, even if they own them. People with untreated hearing loss – including those who don’t wear their hearing aids – are at increased risk of social isolation, depression and even dementia."

TRUE, TRUE, and TRUE.

"For many people with hearing difficulties, the problem isn’t in their ears – it’s in their brain. In everyday environments, sound waves emitted from every object around you mix together before they enter your ear. Your brain must then sort out which bits of sound belong to each source in the environment and correctly group these bits of sound together, ignoring some – like the hum of the refrigerator – and focusing on others, like a relative calling out from the next room."

TRUE:  That's why quality hearing professionals use every tool at our disposal to help the brain differentiate between desired and undesired sounds (i.e. high-frequency vs. low frequency adjust, compression, horizontal and vertical sound localization, rapid noise reduction, beamforming, adaptive directionality, frequency lowering, recruitment distortion identification, binaural interference, annoyance noise level measurement and discomfort levels, speech-in-noise testing, careful manufacturer selection, etc., etc.).   

"In their new study, Polley, Whitton and their colleagues created a video game to train players’ brains to distinguish sounds better."

OK:  Sounds exciting.

"In conversations and interviews, Polley admits that he doesn’t know exactly why the game works, but he suspects that the structure of the game is the key...practice seems to be necessary for maintaining the ability to understand speech in noisy backgrounds. Two months after the video game training ended, the researchers tested the participants’ speech understanding abilities again, and found that the benefits of the video game had vanished."

OK:  So, in the future, those with hearing loss will have to play the video game every day?  I guess ruining your social life by playing video games every day is an effective way to avoid noisy settings. LOL.

"So although people should be cautious about claims about training our brains to improve our general intelligence, this study’s results from targeted perceptual training are encouraging."

TRUE:  We should be cautious, yet encouraging.

"One day there might be an iPhone app that can help your mother-in-law follow the conversation at a crowded restaurant or a student with a learning disorder focus on the teacher’s voice." 

MISLEADING:  These apps and hearing aid "add-ons" already exist in various forms in combination with hearing aids.  They work to improve the "signal to noise ratio" or, in other words, promote desired sounds and reduce undesired sounds in various environments.  They can help with the phone, help with the television, help those listening to music, help musicians, help those in classroom situations, and help with focus in noisy situations.  Most work directly with iPhone and some work with Android devices.  

Hearing desired speech in noisy settings is a real problem and there is much more that can and should be done to effectively address it.  Hearing aids, properly selected and fitted, can greatly improve anyone's ability to hear speech in noise.   There is hope with hearing aids.


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    Author

    Jon Elliott is the founder of IHCC, a father, an entrepreneur, a computer programmer, a manager, a classical violinist, a teacher, a hearing aid expert, a consumer advocate, and a hopeless idealist.

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