How to Ensure Greater Videoconferencing Success for all Hearing Abilities

By: Karyn Voels Malesevic, AuD, CCC-A, Audiologist & Manager of Audiology

Living under the conditions of COVID-19 has many of us becoming more reliant on Zoom, Microsoft Teams, or other video conferencing apps than we ever thought we would be. Between conference calls for work, children learning at home, or catching up with friends or family, it’s apparent that these programs are here to stay. Using these video conferencing tools for an individual with a hearing impairment can be challenging. Below, I have a few headphone and room setup recommendations to make the experience successful for all. 

Considerations for those with Hearing Impairment

Using headphones with hearing aids

If you are the person with hearing loss and you need to videoconference, built-in speakers and mics are generally not going to cut it. When determining what headphones are right for you as an individual with hearings aids, you first need to recognize what type of hearing aids you use. Hearing aids are separated into two main categories, behind the ear (BTE) and in the Ear/Canal (ITE/C) hearing aids. Some ITC aids fit entirely in the ear canal and are known as Completely In the Canal or (CIC). These are the smallest and least visible hearing aid types. 

ITE/C and CIC hearing aids may give you the most flexibility when finding a pair of headphones. According to Audiologist, Brian Fligor from a consumer reports article, “BTEs are especially finicky because the microphone, which picks up outside sounds that are then processed by the hearing aid, is outside the ear canal.” “If you have a headphone that doesn’t sit up and over that, then you’re not going to pick up any sound through the hearing aid itself.” In either case, there should be an option that works for you and your specific style of hearing aids that can be found after some trial and error. 

According to Fligor “the key is to find a pair that’s comfortable and holds the headphone speakers a reasonable distance from the hearing aid microphone in order to avoid feedback. Fligor says a distance of 1 centimeter, if not a little more, is usually a safe bet.” It’s also important to note that some people who wear ITC aids may also comfortably wear on-ear headphones, which are typically lighter and more portable. For some users who wear CIC aids, which are the smallest, they may even be able to wear earbuds depending on the fit of their hearing aid. The end process will likely come down to experimentation as each individual, and their preferences will vary. 

The articles below share more information on the topic of hearing aids and headphone’s and will provide recommendations for specific headphone models.

https://www.consumerreports.org/hearing-ear-care/headphones-and-hearing-aids/

https://www.healthyhearing.com/report/52907-Using-headphones-with-hearing-aids

General Tips for Hearing-Friendly Video Conferences

Setup and Communication Style

Photo by Julia M Cameron on Pexels.com

The Hearing Journal addresses the importance of a successful video conference setup and recognizing communication styles. As a bonus, many of these tips help foster a better video conferencing atmosphere for everyone, not just those with a hearing impairment. The authors share:

1. Secure a strong internet connection and a reliable visual setup to enhance non-verbal communication. Turn on your camera and sit in a well-lit space to brighten your face and avoid backlighting, such as light shining through a window behind a workstation. Sit reasonably close to the webcam with the top of the head to your elbows seen on camera.
2. Foster high-quality audio and eliminate background noise. Use a high-quality microphone, headset/microphone combo, or earbuds. When you’re not speaking, put your microphone on mute to reduce background noise.
3. Practice respectful communication etiquette. Speak in turn and state your name before speaking. Project your voice succinctly and articulately, and avoid fillers such as “so” and “um.” People with hearing loss have a hard time keeping up with spontaneous discussions and details, so try not to sway from the agenda and type your questions or clarifications in the chat feature of the videoconferencing tool you are using.
4. Suggest these communication facilitation tips to the meeting host: Publish and stick to an agenda, request that questions, links, contact information, and other logistics be typed in the chat box that is visible to all participants, inform participants when the topic has changed, and give everyone, including the person with hearing loss, time to process the information and formulate a response.

For individuals with hearing impairment, adding real-time closed captioning can make a tremendous difference in their video conferencing experience. Many videoconferencing providers such as Google Meet, Microsoft Teams and Skype now include an automatic live captioning feature.

Your hearing needs are important and our Audiology Department can help. Hearing loss is one of the most common conditions detected in infants, children, and older adults. We welcome people of every age, from newborns to adults, and offer a wide variety of services from basic hearing tests and evaluations to hearing aids and hearing aid fittings, all using leading-edge technology. For more information on our audiology services for all ages and help for hearing aid , please visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/hearing.html.

Audiology Intervention for Children with Down Syndrome

By: Karyn Voels Malesevic, AuD, CCC-A, Manager of Audiology and Family Services

Children who have Down Syndrome can often have hearing loss, so a therapy center that also has an Audiology Department onsite can make coordinating care easier. Their hearing loss may range from permanent and needing hearing aids to having frequent middle ear infections and require consistent hearing tests.

According to the research article Understanding Hearing and Hearing Loss in Children with Down Syndrome, “Children with Down Syndrome are at a greater risk for permanent and transient hearing loss as compared with their typically developing peers. Long-term consequences of late or failed diagnosis, particularly in this population, can significantly affect quality of life, including school performance, speech and language, behavioral challenges, community engagement, and safety. Therefore, ongoing audiologic monitoring and otologic management is highly recommended for this group into adulthood.”

Easterseals DuPage & Fox Valley has Audiologists in our Elgin and Villa Park centers who are experts at working with children that may have been considered “difficult to test” by other clinics.

We are able to fit hearing aids and make repairs and earmolds on children and adults through state programs such as Early lntervention, Medicaid, DSCC, ORS, and via private insurance or private pay options with very competitive pricing.

At Easterseals we work with the local educational Audiologists, who serve children with hearing loss that are in school. That work allows for cohesive coordination between school testing and any hearing aid or other specialized services that may be needed at an outside clinic.

We are also proud that we can continue to see the children in our care as they grow up into adulthood via our audiology clinics.

For more information on our hearing services, visit eastersealsdfvr.org/hearing.

 

Understanding Hearing Loss

By: Cindy Erdos, Au.D., CCC-A

Hearing loss can have serious consequences for individuals who experience it, as well as their loved ones.  We know that hearing loss has a negative impact on social, psychological, cognitive, and physical health.  Hearing is crucial to developing meaningful relationships and fully enjoying life.  People who cannot hear well are often cut off from their family, friends, and community.

According to the Hearing Loss Association of America (HLAA) approximately 48 million American have hearing loss; 30% of adults 70 or older have hearing loss; and 16% of adult 20-60 have hearing loss.  It is estimated that 1 in 5 America teens have some degree of hearing loss.

Based on this information, you should not be surprised to find yourself in a conversation with an individual with some degree of hearing loss.   Many people believe if you have a hearing loss, getting a hearing aid will fix the problem.  But not everyone with hearing loss is a candidate for hearing aids, and not everyone with a hearing loss is ready for hearing aids.  It may be a surprise to learn that hearing aids are not the only solution for individuals with hearing loss.

As an audiologist, I hear these types of comments from patients and family members almost daily:

• “I don’t need a hearing aid, everybody mumbles”
•  “I hear better with my glasses”
• “Everyone yells at me so I can’t understand”

Let’s look at each statement to try understand what might be happening.

“I Don’t Need a Hearing Aid- Everybody Mumbles”

Understanding hearing loss can help us understand this comment.  There are two main types of hearing loss, conductive hearing loss and sensorineural hearing loss.  Conductive hearing loss is often hearing loss caused by a medical problem such as fluid in the ears or even wax in the ear.  Conductive hearing loss mostly affects how loud sounds are heard.  Conductive hearing loss typically can be medically corrected.

Sensorineural hearing loss is often caused by damaged nerve cells in the inner ear most commonly due to age, noise exposure or hereditary hearing loss.  Sensorineural hearing loss typically cannot be medically corrected and is most likely permanent. For many individuals starting to develop a sensorineural hearing loss, the low frequency sounds are heard at normal or nearly normal level (or volume), but they gradually start losing higher frequency sounds.  For understanding speech, high frequency sounds, or consonants provide a lot of meaning.

Besides the Listener’s hearing loss, another key factor that contributes to the “Everybody Mumbles” comment is caused by the speaker.  Many of us speak very quickly during conversations which causes us to blur our speech.  For an individual who is missing key sounds, conversational speech often compounds the difficulty understanding and can make it nearly impossible to follow the conversation.  Here are two examples of how conversational speech is delivered and received.

“The shiplef ona twowecruise.”   (The ship left on a two week cruise)

“We’re lookin for a whitruck tabuy.” (We are looking for a white truck to buy)

One of the most important things we can do when speaking to someone with hearing loss is to slow down a little bit, speak clearly, and pause between phrases or key words. 

“I Hear Better With My Glasses”

Although only 30-40% of the English language is visible on the lips, most people, whether they realize it or not, speech read to some extent.  Relying on lipreading alone can be extremely difficult, but speech reading can be a nice supplement to hearing and understanding a conversation.  And fortunately, a lot of the consonant sounds that are difficult for many hearing impaired individuals to hear can be “seen.”  For example, “death” and “deaf”.  The sounds “th” and “f” look very different on the face.  Speech reading is more than simply lip reading, or using what you see on the speaker’s lips, it involves watching facial expressions and gestures to understand conversation.

When speaking with someone with a hearing impairment, remember they may benefit tremendously by being able to watch your lips as you speak. To assist them make sure you are within 3-6 feet; face them ensuring the visible features of speech are available; do not cover your mouth with your hands other objects; and make sure there is good lighting.  Remember, “I hear better with my glasses on” because I can see your face better.

“Everyone Yells at Me so I Can’t Understand”

Having hearing loss does not mean someone can tolerate sounds louder than someone with normal hearing.  There are a few reasons louder is not always better for someone with a hearing loss.  The first is due to something called “recruitment.”  Related to the damage to the nerve cells, all individuals with sensorineural hearing loss have recruitment.  Very simply, recruitment is when we perceive sounds as getting too loud too fast.   Just as loud sounds can be uncomfortable for someone with normal hearing, loud sounds can be very uncomfortable for someone with hearing loss.

Typically, we yell or speak loudly to someone when we are upset or frustrated.  Speaking very loudly to someone with hearing loss can give the impression that you are angry with them.  No one enjoys being yelled at and it can make the person feel embarrassed about their hearing loss.

If you find yourself in a conversation with someone with a hearing loss, remember it “Takes Two to Tango.”  Your part is to deliver your message in a way to maximize your communication partner’s ability to understand.   Some key points to remember:

1. Make sure you are within three to six feet from the listener
2. Get the listener’s attention before speaking
3. Make your face is visible and look at the listener
4. Speak slowly and clearly, but do not exaggerate
5. Louder is not always better

If you are concerned that you or a loved one may have hearing loss, contact an audiologist at Easter Seals DuPage & Fox Valley for a complete hearing evaluation and more information on communication strategies. For more information, visit: http://www.easterseals.com/dfv/our-programs/adult-services/.

 

How Loud is Too Loud?

May is Better Hearing and Speech Month!

By: Cindy Erdos, Au.D., CCC-A

The Stanley Cup playoffs are underway, and the finals start next week.  I love watching hockey and I am an audiologist, so when I came across an article titled “Can hockey playoffs harm your hearing?”  I had to read it.  The research says,  “YES,”  the level of “leisure” noise present during a hockey game is loud enough to damage your ears and hearing.  If you are lucky enough to get tickets to the Stanley Cup, or any hockey game, you should consider getting some ear plugs or earmuffs for your children.

Most people tend to think that hearing loss caused by noise only happens to adults who work in noisy environments or those who attend lots of rock concerts or elderly adults who have had a life-time of noise exposure.  Exposure to loud noise without proper protection can cause hearing damage to anyone, at any age.  There is a growing concern about noise-induced hearing loss in our children.  We need to protect our children’s ears from noise-induced hearing loss and we need to teach them to continue protecting their hearing throughout their lives.

Our Noisy World

Do you remember that last time you “heard” silence?  We live in a very noisy world.  We encounter sounds every day, all day long.  Traffic, sirens, machinery, lawn equipment, concerts, movie theaters, sporting events are just some of the sounds we encounter on a daily basis. Sound Sense points out that a lot of our children’s activities involve some degree of noise: school lunchrooms, sports and sporting arenas, movies, and electronic media.  As you look around you are likely to see children, and adults, listening to some type of personal listening devices.

Even some children’s toys produce high levels of sound.  The Sight and Hearing Association publishes the Noisy Toys List annually and recommends downloading a sound meter app on your smartphone to help measure noise.  Their rule of thumb is, “if a toy sounds too loud to you, it is too loud for the child.”

Top 3 Noisiest Toys via Sight & Hearing Associations Noisy Toy List 2016

 

WWE 3-Count Crushers: Roman Reigns
Ages 6+
104.4 dB(A)

 

 

Road Rippers Rush & Rescue
Ages 3+
103.9 dB(A)

 

 

My First Tonka Wobble Wheels
Ages 1+
103.2 dB(A)

 

The Center for Disease Control (CDC) recently published an article titled, “Too Loud!  For Too Long!” The article reports that hearing loss is the third most common chronic health condition and a major cause of hearing damage is noise exposure.  The World Health Organization (WHO) estimates that a billion-young people worldwide could be at risk of hearing loss due to unsafe listening practices.

How Loud is Too Loud?

First thing to keep in mind is noise does not need to be unpleasant, or even physically uncomfortable to cause damage to your ears or hearing.   The intensity (loudness) of the sound and the time spent (duration) listening to the sound are critical. Intensity of sound is measured in decibels (dB).  Conversational speech is around 60 dB; a soft whisper is around 30 dB and a shouting directly into someone’s ear can be as high as 110 dB.  Your dishwasher probably runs about 70 dB and the sound of your hair dryer is around 90 dB.  City traffic (inside your car) is around 80-85 dB, but when riding a motorcycle, you are listening to around 95 dB of noise.  Watching your favorite sports team live may expose you to as much as 100 to 120 dB – depending on if your team is winning.

So how much is too much and how long is too long?  85 dB is the “magical” number. Occupational Safety and Health Administration (OSHA) recommends any employee who is exposed to 85 dB of noise be included in a noise conservation program to ensure their hearing is monitored and they are instructed on hearing protection practices.  The American Academy of Audiology recommends any time you are exposed to 85 dB or louder you should use hearing protection.   In addition to how loud the sound, you need to be concerned about the length of time you spend listening to the sound.

The chart below gives more examples of typical sounds and the maximum recommended duration:

Leaf blower:                                       90 dB (2 hours can cause damage)

Sporting event:                                 100 dB (14 minutes can cause damage)

Rock concert:                                     110 dB (2 minutes can cause damage)

Siren:                                                    120 dB (1 minute can cause damage)

SOURCE: CDC Vital Signs, February 2017

Unless you have a sound level meter app on your phone, you may not know if a sound is 85 dB, 70 dB, or 110 dB.  Here are some signs that a noise may be too loud:

• You need to raise your voice to be understood by someone standing nearby
• The noise hurts your ears
• You have a buzzing or ringing in your ears, even temporarily
• You don’t hear as well as you normally do until several hours after you get away from the noise
• When listening to music through your headphones you cannot carry on a conversation without shouting

Prevention & Protection

Most of us rely on hearing to communicate and stay connected to others.  As we know hearing is critical to speech and language development, speech and language are critical for learning and academic progress.  Even mild hearing loss can affect a child’s academic success.  The damage from noise not only causes hearing loss, but it can cause tinnitus (buzzing or ringing in the ears) and/or hyperacusis (increased sensitivity to sounds).

The good news is ear damage due to noise exposure is almost completely preventable.  With a little knowledge, you can protect your child’s ears, as well as your own.  You can also teach your child to recognize when sounds are dangerously loud and how to protect their ears and hearing for a lifetime.  It’s a Noisy Planet has activities and suggestions for encouraging children to protect their ears.

More tips for safer listening are:

1) Turn the noise down

2) Walk away or avoid the noise

3) Take breaks from the noise

4) Block the noise or use hearing protection

5) Use the 60:60 Rule:  listen to music at 60% maximum volume for no more than 60 minutes a day.

Putting cotton or tissue in your ears may make you feel like you are protecting your ears, but most likely you are not providing appropriate protection against sound and possibly causing more damage as you may feel like you can stay longer in the noise because you have “protected” them.  You should use products that are made specifically for protecting your ears from noise.  You can purchase disposable earplugs from a pharmacy.  You can order earmuffs for you or your children.  You can even have customized earplugs made which are often more comfortable as they fit your individual ears.

Damage due to noise is completely preventable.  First you need to recognize when a noise could potentially be dangerous, and then take step to prevent the sound from damaging the delicate structures or your ear.

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If you are concerned that you or a loved one may have noise induced hearing damage, contact an audiologist at Easter Seals DuPage & Fox Valley for a complete hearing evaluation and more information on how you can keep the hearing that you have. Visit our website here.