Audiology to Extend a Musicians’ Career | October 2018 Hearing Review

Getting the right sound via the app and creating a specialized Speech/Music program

As a musician with significant hearing loss, I may be one of the more unusual personalities simply because I started my career with my current loss. Most of my musician colleagues were hearing when they began their path to professional music performance and were stricken with their loss somewhere along the way.

Recommendations for a “Musicians’ Package” for Hearing Aid Users

A Smartphone app that has a 5- or even 10-band equalizer to modify music output. It should also be able to enable or disable automatic controls easily, such as feedback and attenuation levels, without a visit to the audiologist.

This doesn’t necessarily make my requirements different than others, but I am not burdened with the concept of restoring what I once had. I have absolutely no idea what my guitar sounds like with normal hearing. This is my own personal quixotic endeavor: to come as close to natural as possible, to be able to perceive my sound the same way an astute musician with normal hearing would.

There is nothing to be done to realize this goal. I practice to the best of my ability, make sure that my tone is clear, projecting well, and that my sound is full and round to my own ear. It is a sound that comes to me amplified of course, but along with it there is an internal feeling of the string and fingertip connection. Then I play for coaches with both perfect hearing and musical expertise, and I take their suggestions very seriously. In this way I cobble together a tone production technique that works for me. However, I never really have known what I sound like; it’s a bitter pill to swallow but I’ve taken this medicine for years and am now accustomed to it.

Along these lines it becomes crucial for me to adopt a baseline of my sound. I have spoken of this often to other musicians with hearing loss, and know we all share this issue to some degree. I have come up with this simple equation: L + C = B, or Loss plus Correction equals Baseline. If either of these variables, Loss or Correction, is altered then so is Baseline—and sometimes quite dramatically. When that happens, I have lost my ability to recognize my sound.

My loss has not changed significantly in 45 years, but if I have a cold, or am plugged up from air travel, loss will become a variable. The correction aspect is, of course, the larger and more typically altered factor. For example: new aids, wax in the earmold, the mold coming out of the ear a millimeter or less, tinkering with the music program settings (either via audiologist input or a telephone application) are just a few possible factors. All affect the baseline result.

A change in actual hearing instruments is the most dramatic baseline change. It can take several days, or even weeks, to adopt to the new normal. If I get this wrong—for example, adopt a deeper low end—my playing can suffer. In this particular case, the mind tells the fingers the sound is rich enough, but indeed it is actually not. It’s a very complex undertaking. Analyzing it, trying to look at it objectively and scientifically, is helpful.

That said, I would encourage hearing aid manufacturers to be open to suggestions from musicians. My most pressing request, if I am not  allowed to program the hearing aids myself, would be for more control over the programs currently allotted via the smartphone application. My current smartphone app allows for switching of programs, creation of favorites, and a 3-band equalizer. Not much else. It appears to me the audiologist can alter 95% of the hearing aid settings during a fitting, while musicians have 5% at their disposal to do on the fly via the smartphone application. Clearly this is out of proportion to most musicians’ needs. For example, we should have a 5- or 10-band equalizer to modify music output. We should also be able to easily enable/disable automatic controls, such as feedback and attenuation levels, without a visit to the audiologist.

I have found that there are three types of programs I use:  1) Speech (in and out of noise); 2) Music (for performing/listening), and 3) Music/Speech (situations where I want music to sound rich but also to be able to understand speech, like when trying guitars with friends, or giving a lesson). In creating my Music/Speech program, I had the audiologist clone my Speech program and remove all automatic features. I then spent time configuring the program via the phone application so I could come up with a way to listen to music and also understand speech. In reality, it’s not very good for either. I am confident that if I had more control over my own settings via the smartphone app, I could come up with a better “hybrid” music/speech program.

It wasn’t long ago that I would travel to the audiology office with my guitar in the hopes of configuring a perfect music program. Since, at the time, I had no control other than volume once I got home, it was essential that I was comfortable with the sound before leaving the office. But oftentimes, when I went back to my practice space, I was disappointed. Today, it is far better because of our ability to tweak via the smartphone app.

Audiologists are well aware that users need to train the brain to accept a change; this is indeed a factor for both the overall sound of new aids and also for music programs. This period of adjustment must be taken into account when considering any change

As a whole, 2018 looks far better than 1998 did for musicians with hearing loss, but I am confident there is a great deal more progress to be made; hearing aid manufacturers need to be willing to listen to us and adopt these changes. Speech discrimination will always be the money shot for hearing aids, but it should become increasingly apparent that music, whether performing or listening, is of extraordinary importance to a large segment of users.


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About the Author: 

Charles Mokotoff holds Bachelor’s and Master’s degrees in guitar performance from Syracuse University and Ithaca College, respectively. He has served on the faculties of numerous colleges and universities in New York and the New England area as a lecturer in classical guitar and lute. He initiated and ran the Guitar Program at Northeastern University in Boston from 1982 to 1991. Mokotoff, severely hard of hearing for a good deal of his life, is an outspoken proponent of making music with hearing loss.

Correspondence can be addressed to: [email protected]

Citation for this article: Mokotoff C. Loss plus correction equals baseline Hearing Review. 2018;25(10)[Oct]:12.

INDEX TO “Audiology to Extend a Musicians’ Career” special October 2018 edition of The Hearing Review:

Keeping it Simple, by Larry Revit, MA

Composing with Hearing Loss, by Richard Einhorn

Rebuilding My Musical Self, by Stu Nunnery

Notes from an Early-Deafened Musician, by Wendy Cheng

How to Use a Bluetooth Streaming Device in Music Performance and Recording at Home, by Rick Ledbetter

OTC: Let’s Get on the Same Page!, by Karl E. Strom