Summary:
Audiologist Hunter Gerhart reflects on how things have changed since his grandparents’ experience with hearing loss and explores the evolution of assistive listening systems—from hearing loops to Bluetooth-enabled devices and the promising future of Auracast—showing how innovation continues to transform patients’ lives.
By Hunter Gerhart, AuD
I became an audiologist because my grandparents experienced the effects of hearing loss. They were both struggling to participate in social events, and as a result, they withdrew. After support from the family, my grandparents eventually got hearing aids, and we could notice the massive difference it made, not just in their lives, but also in ours.
This story is one that many of my colleagues and I see every day. Hearing aids are powerful tools that can make significant differences in our patients’ lives. That’s why advancements in the technology we provide our patients are so important to creating the best outcome possible.
In the 20 years since my grandparents received hearing aids, the technology has advanced from the clunky models of years ago to being small and barely noticeable. Even more impactful are the additional capabilities within hearing aids. But what I believe has made the biggest impact on patients so far is the simplicity and ease with which hearing aids work with assistive listening systems and devices. Here’s a look at the evolution of these devices, how they impact patients, and a look ahead to the next revolution.
The Past
When I began studying audiology over a decade ago, the primary assistive listening system in public spaces was the hearing loop.
It was and remains a useful tool to amplify sounds in crowded places like movie theaters, churches, and public meeting spaces. It’s a simple concept—the event spaces have a copper loop that surrounds the room and is connected to an audio source. This creates a magnetic field that connects to small copper wires within hearing aids, called telecoils, which act as antennas to receive the sound directly to the hearing aids (or cochlear implant processors). It was a significant development for its time and made it much easier for those with hearing loss to attend events and participate in them.
However, while the hearing loop remains popular in other parts of the world, like Europe, it struggled to gain steam in the United States. Today, just about half of hearing aids are equipped with a telecoil, and it’s most useful in public spaces.
While a hand-held hearing loop receiver is capable of plugging directly into your phone through a headphone jack (for phones that still have headphone jacks), the technology is not seamless and can be difficult for some people to use. This is particularly an issue for the older population, who make up a significant portion of hearing aid users.
In addition to hearing loops, devices like infrared receivers and FM systems are solutions used in classrooms or small work environments. However, they either require one person to wear a specific microphone connected to the hearing aid or involve an additional piece of equipment to attach to the hearing aids. Extensive education is needed from an audiologist and its use typically involves advocacy from the user ahead of time to provide the proper equipment.
The Present
In the age of smartphones, there was a need for a seamless device that was easy for everyone to use. The previous devices made it easier to communicate in public spaces, but they are also lacking when talking on the telephone. Bluetooth technology has filled that gap.
When the first standalone Bluetooth hearing device, the ReSound Linx, entered the hearing aid market in 2014, it was limited. It was only compatible with iPhones and could be used to control basic hearing aid functions, like volume and changing the programming. However, it was easy to connect to the phone, and has since developed into a powerful tool that can connect to iPhones as well as Androids.
Bluetooth is now a mainstay in hearing aids, creating a direct connection from the phone to the hearing aids in a much more seamless way than the telecoil. It has also allowed users to hear much better on the phone. I’ve heard from patients who can talk on the phone for the first time in their lives. Through their Bluetooth-compatible phones, they can also listen to music, monitor their physical activity, or change the programming to their hearing aids.
Beyond speaking on the phone, Bluetooth has opened the door to teleaudiology. Through a simple video call, a hearing care professional can do a remote fitting program for the hearing aid to the user’s liking, or even provide hearing lessons for the user. For example, a patient could have a monthly meeting in a busy, loud restaurant and have difficulty hearing. It’s difficult to simulate that environment in a quiet office, but Bluetooth allows us to connect to a patient’s hearing aids remotely while they’re at the restaurant, visualize the different sound classes they’re around, and program the hearing aid to their liking.
One downside to this technology is the drain on your battery. There are two types of Bluetooth: Classic and Bluetooth LE (low energy). The main difference between the two is the energy consumption. Classic Bluetooth is on as long as your hearing aid is on, consuming more energy and requiring a larger charge on your hearing aids. Bluetooth LE can intermittently turn off while the hearing aid is on, using less energy.
However, while hearing aids used to rely on disposable batteries, most hearing aids are now rechargeable. Many hearing aids available on the market today boast longer battery life than ever before, with some models even providing up to 51 hours of battery life per charge. As long as the user can recharge them at the end of each day, the drain is typically not an issue.
Bluetooth technology, either classic or LE, is a standard feature in many hearing aid models, and I consider it one of the most revolutionary advancements in audiology.
The Future
With that being said, even though Bluetooth has created a new world of possibilities, it isn’t a replacement for hearing loops or the other devices of the past. Unlike telecoil, it’s limited to your phone and can’t connect to public sound systems, and its range is typically around 30 feet. It’s not a reliable solution to hearing in public spaces—yet.
The next step in Bluetooth, Auracast, could solve these issues. Auracast has the potential to combine the capabilities of telecoil in large gathering spaces while using Bluetooth’s ease of access. It allows smart devices to cast audio to multiple hearing devices like headphones, earbuds, and hearing aids.
This means if you or one of your patients is working out in a gym or sitting in an airport terminal, you can connect your phone to what you want to hear, like the gym’s TVs or the airport’s intercom, and that audio is transmitted directly into the device in your ear.
Think of the possibilities with this technology. It could be used at conference centers, for museum tours, and even in concert halls. Better yet, it could be adjusted to speak the language of your choosing if public venues adapt. The hearing aids would look the same, and wouldn’t need any additional piece of equipment to use aside from already being Auracast compatible.
Auracast is still relatively new and isn’t widely available, even outside of hearing aids, amongst mainstream hearing devices like headphones. However, hearing aid models like Starkey’s new Edge AI Hearing aids and Signia’s IX hearing aids are equipped with built-in Bluetooth Low Energy Audio, which makes them capable of connecting to Auracast, while ReSound’s Nexia is already enabled. These advancements for hearing aid users are coming.
It’s remarkable to look at how far we’ve come in just a short amount of time, and at the same time, feel excitement for the future of our industry. And patients, just like my grandparents did 20 years ago, are benefiting from it.
About the Author:
Hunter Gerhart, AuD, began his career in audiology more than a decade ago. He earned his Bachelor of Science degree from Texas Tech University Health Sciences Center and his Doctor of Audiology degree from Washington University School of Medicine in St. Louis. Now, as director of audiology for Livingston Hearing Aid Center in Texas, he manages operations across several office locations, working closely with each office to support patients along their hearing health journey.
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