May 2021 PCMag.com
Many adults who would benefit from hearing aids don't use them, thanks in part to cost and stigma. But less-expensive, over-the-counter solutions, as well as the popularity wireless earbuds, are helping accelerate adoption.
Electronics manufacturers are increasingly producing software and products that address hearing loss. Smartphone apps, earbuds, and soundbars help people understand real-time, in-person conversations, phone calls, and streaming media. "It's remarkable that so many more tech companies are even thinking about people with hearing loss," says Joe Montano, a New York City audiologist and professor at Cornell University's Weill Medical College. Montano was pleasantly surprised to learn that big box retailer BJ's is now selling a "dialogue clarifying" soundbar that makes it easier for people with hearing loss to understand movies and TV shows by reducing the prominence of music and sound effects in the soundtrack.
Zvox AV157 soundbar
The Zvox AV157 sells for just under $200 and has a dozen settings that reduce sounds other than dialogue. Swampscott, MA-based Zvox, which also makes low-cost hearing aids and noise-cancelling Bluetooth headphones, has been in the soundbar business since 2004. The AV157 has been a godsend for Dick DeBartolo, the 75-year-old MAD Magazine writer and gadget reviewer who describes his hearing as "not tremendous.” "I just found the Zvox AV157 really amazing at clearing up the dialogue," said DeBartolo. He described watching a scene in a movie recently involving someone who was about to be hung in an old Western town. The crowd that had turned out to witness the hanging was screaming, at which point DeBartolo hit 12, the most extreme of the dozen dialogue clarifying settings. "The crowd basically vanishes," said DeBartolo. "You just hear the people who are going to do the hanging talking, which is more important to me than hearing the crowd yelling."
My wife, who has severe to profound hearing loss, has found Caption Calls, a recently enabled accessibility feature on Google's Pixel phone, to be a huge help in her struggle to understand people on the telephone. The one drawback is that the recipient of her calls hears a short pre-recorded advisory that the conversation will be captioned and some recipients promptly hang up, thinking it is a robocall. But Google's accessibility team has been advised of this shortcoming.
Among adults 70 and older who would benefit from hearing aids, only 30% have ever used them according to the National Institutes of Health, and that number drops to 16% among people aged 20 to 69. Two factors figure into that phenomenon, advocates say: stigma and cost. But recent legislative and technological developments promise low-cost and stigma-free solutions.
This includes substantially cheaper over-the-counter hearing aids approved by the federal government (but still caught up in bureaucratic red tape), as well as the emergence of wireless earbuds as an affordable way to compensate for mild to moderate hearing loss. These earbuds are usually controlled by apps on smartphones.
Asked whether there was widespread awareness of the apps and earbuds in the hearing loss community, Lise Hamlin, director of public policy for the Hearing Loss Association of America (HLAA), said, "I've been hearing some good chatter about it… People like the idea of using something that looks like what everybody else is wearing."
"Fifteen to 20 years ago, nobody would be caught dead with anything sticking out of their ears and now, of course, it's a fashion accessory," noted Richard Einhorn, the former chairman of HLAA's board. "AirPods were designed to not only be visible but really visible. You're really making a statement when you walk around with these sticks in your ears. From the standpoint of people with hearing loss, this is fantastic news because it means that people are no longer embarrassed putting things in their ears in order to hear. It's a small step now to put something in your ears to hear better."
Einhorn is a composer and record producer who suddenly lost much of his hearing in 2010. He is now a US consultant for Jacoti, a Belgian company whose key executives have spent 30-plus years working on hearing technology like cochlear implants. Jacoti's technology—and that of its competitors—will turn wireless earbuds into de facto hearing aids with a self-administered hearing test and the ability of consumers or a professional audiologist to tweak settings to compensate for hearing loss in individual patients.
"It's going to enable millions of people to hear better for the first time," said Einhorn, who notes that the frequency range for wireless earbuds is far greater than that of hearing aids. The result is that music will sound much better on the earbuds than on hearing aids, which are optimised for speech.
Jacoti signed a deal with Qualcomm in October to include its software on the chipmaker's QCC5100 Series Bluetooth Audio SoCs. Jacoti's software will be licensed by headphone and earbud manufacturers, who will load it onto the chip during the manufacturing process. Consumers will then be able to run a hearing test app on iPhones and Android phones, after which Jacoti creates a profile for each ear so the earbuds can adjust noise levels. "For example, in a busy restaurant or even in an open plan office their technology is designed to deliver assistive listening for live conversations so that those with mild to moderate hearing loss can more easily participate in conversations around them," according to Qualcomm.
Chris Havell, Qualcomm's senior director for voice and music product marketing, said the company wants to see Jacoti technology in as many earbuds as possible. "If you're going to focus on hearing enhancement and have hearing tests on the phone and make adjustments in the earbud, you want to make sure that that is done correctly," said Havell. "That's why we're engaging with Jacoti, because as a medical devices company, that's their strength.” Jacoti's hearing test apps, though they are software and not hardware, are certified as medical devices in the European Union, and are registered with the FDA in the US.
Which Apps and Devices Actually Work?
Jacoti is not the only company whose mission involves using a smartphone app and wireless earbuds to help consumers with hearing loss. Search the iPhone and Android app stores and you'll find dozens of apps, including Ear Booster, Ear Scout, HearMax, Miracle-Ear, Hear Boost, Mobile Ears, Hearing Helper and Rogervoice. Some don't claim to be dedicated to ameliorating hearing loss but simply characterise their function as hearing personalisation or amplification. Many are free but Petralex, the product of a Moscow-based company, requires a $12-per-month subscription. A company spokesman says Petralex is installed on about 7,000 devices globally.
Mimi software, the product of Berlin-based Mimi Hearing Technologies, was used to test the hearing of more than 1.7 million people last year, according to CEO Philipp Skribanowitz. Like Jacoti's technology, Mimi can be used on Qualcomm's SOC and its hearing test apps are certified as medical devices in Europe. Mimi, which means ear in Japanese, licenses its hearing-assistance algorithms to smartphone and headphone manufacturers. The software is also available on a streaming app used by Rundfunk Berlin-Brandenburg, a German public broadcasting network.
Skribanowitz estimates that Mimi technology is currently on about a million devices and projects that in five years that number will grow to 100 million.
The irony that earbuds, which are believed to be a significant cause of hearing loss in the young, are now being used to cope with hearing loss is not lost on Skribanowitz. "Twenty, 30 years ago, occupational [exposure] was a major cause of hearing loss but today consumer electronics is one of the biggest drivers of hearing loss," he noted. In the last several years, earbuds manufactured specifically for people with hearing loss have entered the market. This product line has been referred to as smart earbuds or hearables and, with the addition of sensors, can be used for medical monitoring and fitness tracking.
Olive Smart Ear
Tokyo-based Olive Union makes a $300 single earbud known as the Olive Smart Ear. It is classified as a personal sound amplifying product (PSAP), which exempts it from FDA regulation as a hearing aid.
Nuheara, an Australian company, makes the IQbuds2 MAX, a set of $319 "hearing buds" that have an algorithm used by audiologists to calibrate high-end hearing aids. The algorithm is licensed from the Australian government's National Acoustic Laboratories. But Nuheara is careful not to bill itself as a hearing-aid alternative. Perhaps that's a semantic splitting of hairs because the company does say it is focused on individuals with mild hearing loss.
"Our primary target customer is a 55-year-old person who recognises they have a little bit of hearing loss but aren't prepared to get a hearing aid," said David Cannington, Nuheara's chief marketing officer. "We're not trying to replace a hearing aid and we're not trying to replace the audiologist's role in helping people that have moderate to severe hearing loss. They have to go to see an audiologist. But we're using some of the technology that is typically found in a hearing aid in a consumer device."Cannington believes there will come a day when people wear a hearable for a good part of their day. "Whether it's to hear better or do biometric readings, that day will come," he said. "There's no doubt that there's going to be massive growth in this category."
The company also makes IQstream TV, a Bluetooth box that allows wearers of Nuheara's hearing buds to independently control the volume of TV content. The device may appeal to couples in which one partner needs more volume due to hearing loss while the other partner does not.
As electronics manufacturers cater more to consumers looking to ameliorate their hearing loss or personalise their listening experience, we can expect all sorts of new products that will prove true that line in Paul Simon’s song "The Boy In The Bubble"—"These are the days of miracle and wonder." Expect this sort of innovation to move beyond personal devices to systems that deliver customised sound to people wherever they may be, from concert halls to sports stadiums. Miracle and wonder, indeed.