Can Miracles Really be Bought?

For those hearing aid wearers who may have only achieved mixed results from their hearing aids, it is only natural for them to wonder whether a premium priced set of devices would change the outcome.

There is no shortage of older hearing aid wearers who complain about difficulties hearing in crowds and other noisy environments.

Equally there is no shortage of claims from manufacturers that they have the answer to these longstanding concerns.

It seems there is nothing quite like desperation in the market place to produce optimistic claims.

No matter how advanced the hearing device, the level of benefit will ultimately be determined by the state of the individual’s central nervous system.

A factor often downplayed in marketing, is that our central auditory pathways change throughout our lives. The way in which auditory signals are encoded in the ear and brain undergoes gradual but relentless change as we age.

These changes include a decline in temporal processing, such as gap detection between syllables, which is an important factor in our ability to focus our hearing on an individual voice in a crowded room. A decline in temporal processing is also accompanied by declines in pitch analysis and loudness damping.

It is no wonder most seniors complain that conversation in noisy environments loses some of its pleasure. Not only does it become harder to focus on the voice of interest, but extraneous noise may jar the senses. Deafness and over-sensitivity are unfortunately paradoxical partners for many aging ears and brains.

Today’s hearing aids do incorporate features designed to shelter wearers from the worst effects of these changes in auditory processing. Compression limiting buffers the ear from uncomfortable increases in volume and directional microphones focus the wearer’s attention toward the signal of interest. Noise suppression circuits may also increase tolerance of noise while improving overall listening comfort.

However, what sophisticated processing cannot overcome, is the individual’s biology. If the person’s central auditory processing is degraded by aging or disease processes, outcomes with hearing aids will always be less impressive, than for those with better neural processing.

Provided that the fundamentals of a hearing aid fitting are correct, chances are that a person who is not doing well with a moderately-priced set of hearing aids, will probably not do much better with a premium set of hearing aids. Equally, someone who perceives good benefit from a premium set of hearing aids, will probably also do quite well with a more moderately-priced set of devices. In fact there is substantial evidence to support this correlation.

Most independent studies have shown little difference in speech comprehension performance among different price levels and brands of hearing aids. This is not to say there are no differences at all, but they tend to be more of a qualitative nature, such as listening comfort and ease of listening, rather than outright speech comprehension.

Prospective hearing aid wearers would do well to turn to motivated and experienced hearing aids wearers for advice. It is best to talk to someone in your own age bracket, as there is little sense in basing one’s expectations on a 35 year old’s experience if you are 85. The exact type of hearing loss (neural versus mechanical) should also be factored in when comparing individual outcomes. Consumer groups may also be a source of valid advice. If you do turn to a manufacturer’s website for information, you may receive information geared somewhat more towards the positive aspects of today’s hearing aid technologies.