Navigating The Latest Technology Options Available To Hearing Aid Users

okay well good morning everybody and
welcome to envy or C's virtual meeting
room I would like to introduce dr. Larry
Midwest II he is an educational
audiologist he was director of audiology
and subsequently was vice president of
clinical services in a large speech and
hearing clinic in Rochester New York he
is presently a professor in the doctoral
audiology program in the department of
hearing speech and language sciences at
Gallaudet University and director of
Gallaudet's peer mentor program dr. mid
wet ski we'll be covering a lot of
information today you can use the chat
feature to ask your questions at any
time but questions will be held until
the end and please don't use the chat
feature for anything other than
questions and so with that I'd like you
to join me in welcoming Larry Midwest
key Larry it's good to have you back and
we're all going to enjoy your program
[Music]
okay can everyone see the screen I hope
so
it's a pleasure to touch base with you
and hopefully at the end I'll get to see
all of you as you hopefully have some
very important question that I hopefully
can answer for you I'm going to start
now and just to let you know I'm not
covering all the options that are out
there but what I believe to be very
important advances that have occurred
that have made a difference in the lives
of everyone who has a hearing loss as
well as the family members who work with
us
by the way please make sure ever you're
all on mute because I hear a little
noise that tells me as someone might be
not in that mute option
bunny can I just make sure can you see
me because when I I kind of minimize the
window so can you can you just maybe
just let me know Bonnie Erbe roots that
you can all see me as well as a
presentation yes we can see you okay
great
up to thank you okay so we're gonna talk
about the latest in hearing technology
options so first before I even start I
just want to share some initial thought
and perhaps there by being an
audiologist for over 40 years
breath I feel not only am I an
audiologist I'm also hard-of-hearing and
I think of it part of hearing since the
age of three and I'm a consumer and so
the thoughts are shared by being at both
a consumer and a professional so the
advent of the digital age Bluetooth
Wi-Fi the miniaturization of computer
chips and now the introduction of cell
phone apps to address the issues you
know that we have to confront it
individuals with hearing loss all of
that has been wonderful and led to
greater access and he's participation in
different settings that used to be so
problematic whatever for the word
hearing loss and I can let you know that
when I was growing up you know even what
a hearing aid I have I struggled in the
classroom in college where some of the
classes were like 500 students so it
used to be very very difficult for me
and now it's so much easier however you
know - there's so much out there
technology that if you don't have the
proper guidance then it can is on
frustration disappointment
and if you're purchasing these devices
it could be a waste of money if you
don't get the type of technology that
best meet your needs
so how does one determine those
listening needs
so to avoid such issued Gallaudet has
developed what did we call as a
communication unit assessment tool and I
want to give credit just Cynthia Compton
Crowley who developed this she's no
longer I gather death but she's the one
who developed this tool and we use it a
Gallaudet and it helps audiologist
determine what might be the specific
listening situations in which an
individual might be struggling in and
what's very important to note and to
often what I read or hear about from
individuals is it's only on a
degree of hearing loss when even more
important than that
it's one's lifestyle for example you can
have a mild hearing loss but yet if
you're someone is going to be in many
settings where there's much noise or you
know all day long then you may have a
lot of trouble on the other hand you may
have a severe hearing loss but almost
all the time being in a settings where
you're doing one-on-one and so you may
not have many issues so it's not degree
of hearing loss only that determines how
much difficult you might be encountering
in your life but your lifestyle and so
this approach that we use in the client
centered approach where it's declined to
guide and help direct intervention
process and with the audiologist it's
not coming I am in this sound
interaction and the expert but as a
collaborator working equally with the
client determine what will best meet the
client's needs and having a knowledge
that the client provides which is then
focus on recommendations that will best
meet the clients daily needs
so here's just an overview of what this
communication needs assessment examines
so in the first slide we have to make
the client factors someone just came in
please mute your mic so that way I'm not
that I get a little distracted thank you
so the class factors we looked at the
touching of gave hearing loss to person
age any health issue that might be
present their cognitive ability to be
able to handle the different types of
Technology the cosmetic concerns they
may have some individuals or fear or
want to ensure that the hearing aid is
small is inside and we have to recognize
that even though at an audiologist what
we most care about is being able to
assist you here but what we can I'd
everybody's emotional well-being at that
point in time may be in a shoe and of
course the budgetary issue but again
that's there will be to the client and
the audiologist responsibility needs to
make best recommendations and then if
for the client to decide what they can
or can't do and but to also let you know
there are ways to assist ur the
different financing plans that are
available out there is that if someone
can't afford technology at one time they
might be able to pay it over time so
these are client factors then what we
look at are the listening environmental
factors we look at the home settings
whether one is still working go to
school or participating community and
their recreational activity that they
may be engaging in and then within each
of these three
environment there are different
listening aspects to it
so one caught face-to-face the ability
to talk to someone one to one or in
groups in relative to media which is how
well they might be hearing a TV
perhaps trying to hear on a computer
going to the movie theater then the
phone whether it be a landline or cell
phone are you having issue than either
those and then being alerted to
important sounds such as a wake-up alarm
or even a cooking you know like on a
stove alarm hearing the door and I can't
see the other one like smoke detector
isomer says them have my captioning over
us and we look at those face to face
media phone and learning in a home or
work or wouldn't go after example if you
don't bowling do you struggle that
setting or you know other kind of places
or in the media like you go to now let's
say the Kennedy Center using your phone
out in different settings so that so
we're gonna ask questions to try to
determine where your need may be in all
the medicine as well I'm looking at the
blind snack just so now I'm going to
start beginning to talk about diem the
various advances that have occurred over
the years and where we are at this point
in time and those advances that I'll
talk about they make it different and an
impact for an individual but how much it
may make depends on how much hearing
loss may be present so when I talk about
these development
be talking to general sense but not all
of them will have equal benefit - they
may depend on a personal hearing loss
and other climb factors but you know the
important thing is that we look at the
concern for accessibility and access to
all consumers even if a certain type of
development doesn't have I haven't
benefits of someone we might be able to
find another alternative so we'll be
able to help everyone to some degree you
know there used to be say oh sorry we
can't help you
that's what doctors used to say there
are their patients well the truth is we
can help everyone now to some degree so
even though I won't talk about cochlear
implants in this talk today I can tell
you the advance of current which C is
since the 1980s and I was actually
involved in some of the initial research
in New York City where I'll do my PhD
where the early implant with quite
primitive actually but now I can tell
you over know many individuals are able
to communicate with me my aslam and they
don't even look at me and I may not even
have captions on at their time and yet
they can follow me easily and I've been
a male I couldn't believe that sometimes
I run back a few years but actually
talking with people in implant fire this
type of mode and it's down the end there
are some people who are ended I attend
youth today who know what I'm talking
about because I'm referring to them so
this slide is showing where we were a
long time ago where after I would come
this is a voice which Larry just real
quick the interpreters are going to
switch thank you thanks
I assume you switched okay so now we're
going so I have a picture of a boy here
wearing like body aides were in like the
19th for years and you could see the
body packs didn't have two body ad were
like large devices that weighed close to
a pound or two and I'm very comfortable
I can imagine that they didn't use these
when they were going to fit then and now
this is like in the 50s and early
sixties the body a tent
remember I said I had a hearing loss
when I was a young child well this is
what it was available when I was like in
a hard of hearing classroom and a
self-contained out of here classroom and
I did not want to wear these a need
because like this girl is to wear body
aid for me would like wearing a Scarlet
Letter I did not want to go out at the
time and say I'm hard of hearing and
just I wanted to be normal what I did
not know at the time is what I normally
enter me as I want to be perfect but
that I look later on in life but anyway
then I want you to see you see this
hearing aid just what a hearing aid
looked like in the early 1970s well this
is an image of a hearing aid that's
actually being sold now by a a non
hearing and manufacturer and there's not
very appealing to me but because this is
like what hearing aids look like 4050
years ago and that's what's being sold
now but you can get at a low price that
I just want to show you because it
actually represented a hearing aid what
they used to look like and this is like
a picture of the shimmery hearing aid
then of course we have children wearing
behind the ear hearing aids and which
they have to because jump little
children can't wear in the ear hearing
aids because the ears grow and you'd
have to buy new hearing aid all the time
so just up to face mode and this is not
bad but they've got an even smaller
there and then you know the 9090 came
out with these completely in the canal
hearing aid which are very cosmetically
appealing even though they're more
limited than like this type these are
the legs behind the ear technology
license and you can match them to hair
color if you'd like and they're really
small you can't see just a little tubing
there and this person really has
straighter short here and somebody
really cared about cosmetically Jake
adjust brother here a little bit longer
and if no one would see the hearing aid
if that was an issue and then we now
have bluetooth hearing aid you can
control and by you know like a cell
phone and you can talk and we're going
to talk about those and then this is the
latest hearing aids that come out just
past year and I love this picture
because I feel like I'm looking at
speech space-age hearing aids so I just
want to show you evolution advances and
styles even so one of the first features
that was very important that advanced
called hearing aids feedback management
and some of these features you might
wonder what I'm talking about but what
else these advances we wouldn't be able
to do what we're able to do now in terms
of listening so some of you who may have
one hearing aids for many years like I'm
one hearing aids now for 52 years and I
can tell you to have my hearing aid used
to whistle especially I grew up in
Montreal Canada and in a winter is cold
and you have to wear a hat well when I
were a hat over my ears and I had my
hearing aid on they would whistle or
over time when my ear mold started
shrinking you know which can happen and
my ear mom would come loose it would my
start to with lon and the only way I
could stop - whistling was to decrease
the volume so I had a choice not here as
well as I wanted to to listen or
whistling which I didn't want so that
was a major issue also for those
individuals who needed a lot power and
gain once the certain levels reached you
know like trying to set to hearing in in
good fun you couldn't make the hearing
in any louder and begin to feedback and
whistle so that meant individuals would
have profound hearing loss we couldn't
make it loud enough because it would
whistle so in the 2000 hearing
manufacturers because you know we were
able now to have digital chips and we
enter the digital age and instead of the
old analog hearing aid with transistors
we were able use software and with the
software they were able to do in such
way where the detect when the mister was
laying or feedback might just be
beginning and they have ways to just
cancel out the feedback and so what does
that meant for us it means that hearing
aid can now you can increase the volume
without worry of
any whistling so now individual can
sound hearing loss we can have the
volume they need for individual to have
to put the hat on in the winter time no
whistling it live and for those who had
a mild hearing loss or moderate everyone
they don't even need ear molds anymore
they give you just tubing or little
domes that they can put in their ears
and when it allows for them at least
they can be if they're physically more
comfortable even I what I don't have to
wear my hearing aid I take them off good
ear more even though when you're busy
you don't notice that that when I'm
alone by myself I don't need to hear I
take a mask because they're not as
comfortable or not wearing them so I
will take them off and also they fine
for my mother hearing loss when he put
ear mold 8 you just even though the
hearing it could hear others well
the founder of voices sounded like if
they were talking in a barrel and I
can't get into why but without the ear
mode that allows their ears to hear the
low pitches from the environment
directly because they don't need any or
any gain or very little there and so
they could hear their voice naturally so
feedback management was a wonderful tool
that was introduced and it allowed many
things to happen going forward I'm now
going to talk about what called adaptive
directional mic technology but I'll
introduce some concepts first so I need
to first talk about the difference
between an omnidirectional microphone
and directional microphone technology
Omni microphones means omnidirectional
from all directions so it allowed the
microphone to pick up sound from in
front in the back and the side equally
the problem is that if you're in a noisy
environment and you're talking somewhat
maybe in front of you you don't want to
pick up sounds from all directions
because you may be picking up more noise
and making it harder to hear you or if
you're in a car and you're driving
if picking up the motor noise some in
front and you have someone talking about
honey you don't want to be able to pick
up that noise
so directional microphone and when we
talk about direction we're going to talk
about so they're the technology that
used to be around and disseminate out
our way to about 2010 directional mics
have a narrow beam they don't pick up
sound equally from all directions and
normally these microphones were focused
on beaming in front minimizing the
amplification from the side and behind
now up to the 1970s where they're born -
after 2000 before the digital age came
if you've got a directional mic you have
to face the person and actually even
this has been only until the past two or
three years when you use directional mic
DAB salesperson
because they tended to amplify the
signal primarily from in front or at
this and what that meant is that if
someone was on you know like the side of
you you have to turn around to face them
because otherwise directional might be
me and friends will not pick up the side
so that's a problem as I'm saying when
someone's sitting on your side for me
like I'm walking with someone and I'm
hearing it if I'm facing the front in
their direction like the facing forward
then I won't hear the person walking
next to me for a fight if they're
sitting next to me in a car or if I go
to calm a conference or a play and I
want to hear someone next to me I always
would have to turn my head so now in the
past few years I have to say maybe only
two or three years manufacturer
development algorithms that means
software programs that enable hearing
aid to determine what is speech and what
is noise that is sounded not equally and
speech has different characteristics of
noise allow the software it can
determine what is characteristic of
speech I'm wanted more like random noise
and so if they can do that then the
algorithm does direct a microphone to
focus on the speech signal
regards to where the speech may be
coming from somehow they can shift their
the beam to matter what you want to
amplify if no longer has to be in
friends so if someone on the side of you
are behind you the hearing a can shift
to focus on the side or behind wherever
the speech may be coming from and lower
the game from the other direction where
the noise is deemed to be present so
that the will enhance your ability to
speech signal making easier to focus and
listen to the talker because that's
what's going to be more amplified
so - not only can
hearing aid which direction but I can
also now switch from the Omni mode to
directional vice-versa so depends if
there's speech in the environment if
there is then it's going to set the
hearing aid into this directional mode
and find it where the speeches and
directives iam but let's say you're
quiet and you know for most of us we
actually spend ourselves of quite maybe
eighty to ninety percent at a time and
in those situations you don't need it to
be directional because you want to be
able to hear he has three or four of you
sitting around the table but you're just
in someone's home and there is no noise
then you want to be able to hear all the
talkers around you equally
so if switches so that's a wonderful so
adaptive directional microphone
technology here's just analyzing the
environment deciding if there's noise or
not and if there's speech they're
directing the mic tube socks under
talker and if it's quite switching to an
omni mode so that's an amazing
development agenda hearing aid
technology and here it's just a little
figures just showing you so if let's say
someone was talking in front of you so
you see the speech here then if going to
decrease any of the noise to the side
now if let's say if you know let's say
the yes I'm going to just pretend that
yeah someone was talking over here on
the side and pretend they're looking
here that it'll change directions or the
hearing aid will direct to the speech
and now it'll attenuate from you know
even in front we're behind
so it'll consider it but says see in
front it means that to speech if being
directed to the talker even though that
person might be to the side so that's
the adaptive it looks for where the
speech is it might be in front in your
eyes or it'll make a pretend of there
you're facing a person even though that
person actually gee aside another
program that hearing it to do it's
called noise comfort and sometimes for
example and I'm hopefully I'm not
promoting start but by saying this but
if anywhere like that so let's say
individuals you find yourself in a very
noisy place but you're not with anyone
you just by yourself
and so just imagine you're sitting alone
at Starbucks you go there's a cup of
coffee and you bring a book or pretend
you went grocery shopping by yourself
and then a lot of noise Sam well if
you're not talking to anybody
then you don't need to listen to all
that noise because that's actually it's
tiring to the ear then to your brain and
so if the hearing is recognized as much
noise but no speech what I'll do is
automatically reduce the overall volume
and their goal is doing that it's
providing increased listening comfort
they were just listening fatigue
sometimes I notice especially sometimes
when I present like two or three hours
and I don't realize but I find myself
I'm talking loud and then later and
pretend others to be pretend I'm noise
and when I stop talking half to three
hours all of a sudden I find my head is
buzzing well if you go out and very
noisy place and you're out there for an
hour to shopping or whatever and you go
to quite place you might find you your
hands feeling like buzzing that's the
pleasure
you're hearing it or amplify that noise
unnecessarily so the hearing is try to
make it comfortable so that way you know
you don't have to listen to loud noise
finessing and this is what and I'll
explain this graph so on the horizontal
axis it shows frequency like on a piano
go from low pitch to high bridge and
here is called the absolute death that
DB difference it means like how much
change might there be from the initial
situation to after the hearing aids go
to action when you look at this orange
line here that means speech with noise
stimulus so a hearing it a modern
hearing aid with the feature including
that there in term being able to
recognize and adapt to the environment
if it recognizes speech in the noise it
leaves it alone and then do very much
it'll cut out the lows because that's
where you may not need and it making
other heights of someone but it's trying
to maintain the speech alone so it does
not Apple sad does not decrease it much
and then the blue line would mean gee
the hearing aid recognized all noise and
really really suppresses it and so that
way you don't have much sound you don't
have to listen to that by the way if not
exactly if somebody questioned me if the
oldest death not exactly correct and
you're right but I'm just trying to
adjust to ten with me
is that the blue line is representing
what the hearing aid is done and
squashed down while I leaving the speech
and noise alone so that Wake is doing
the speech now the next slide what we're
going to be looking at it would prefer
to as frequency lowering so what does
that refer to
well there is a separate population of
individuals with hearing loss who have
much better hearing a lot of pictures
and actually very poor hearing in the
highs and even if we can make the high
frequencies much louder
because there's a lot of damage in the
inner ear and that region and that's why
you have so much hearing loss that even
when you amplify there are not enough
hair cells and nerve fibers to transmit
a signal with high fidelity and so even
if you amplify them this beats up well
like to not sound clear in the high
pitches and the problem is by making
these sound that enough they're clear or
very sounding Mary stood it it'll
actually make it worse in terms of
lesson to others so what a technique
that we developed has been around for
many many years but initially there were
some issues with the advice and I'll
mention in a second but the goal of
these techniques is to transpose
transpose mean to shift from one area to
another so the technique using software
to transpose the high-frequency speech
sound and shift them actually to lower
frequencies where listener has much
better clarity however there's our
caveat one it can take the listener much
time to adjust it a speech sounds
because you might be listening what the
hearing except many many years and your
dreams or even if you haven't had a
hearing aid
your brain has adjusted to a certain way
of listening and then when you introduce
a whole new different way of trying to
listen it takes a while for the brain to
learn how to adjust this actually if the
learning actually occurs because your
neurons and neural connections have to
change to now be able to process sound
that it hasn't heard in a long time also
one of the things is when you take deep
the sounds that were the high
frequencies that moves to the lows
you're now squishing it from let's say a
region of 250 to 10,000 Hertz you make
now
be shifting that whole range down to 250
to 1000 Hertz so now you're requiring
the brain to process sound in a narrow
region so that is what taken so long to
figure out how do we best do that
without giving too much information in
our region for the plant to be able to
process but now we have new algorithm
and show promise and many individuals
are actually benefiting so where we
would be able to help people before this
technique further people who have very
little hearing or no hearing a high
pictures who actually help many with
this technique but also I just wanted to
mention that without him individuals
rather than using hearing aid in the
past five to ten years we've developed
for called hybrid cochlear implants
where is it individual to fit with
cochlear implant but the the electrodes
that are part of the implant are only
stimulating the high pitches that is the
area where you didn't vigil may not have
any hearing at all but if they have
hearing in the low pictures to actually
to use a hearing aid portion of this
hybrid where the hearing a portion was
transmitted signal to the low
frequencies where the individual
actually still has enough hair cells to
benefit better with the earring a part
than they would with the electrodes so
it's allowing the best of both worlds
here to occur and one of the reasons why
is that electrode or implant themselves
are not necessarily able to transmit
better felt like the pitch of a voice as
well through electrode F to a hearing
aid
what music so when you have this part of
a cochlear implant where you can have
the hearing aid turned many low
frequencies allowing the person to hear
the pitch allowing him hear music and
the high frequencies
the electrons where they provide much
better clarity than they could through a
hearing aid it helps the Mitchells a lot
so this is just a little graph where you
could just want to get so you can see
then this is much better hearing the
lows and it's in closer to the top it
better hearing and anything in the high
frequencies and it decreases means that
the hearing is dropping and so there's
not much hearing certain about it no
hearing above 6000 and very little
between they're doing sweet so the idea
is to shift everything here and move it
over in and map it into the lower
frequencies where the person can hear I
am now just going to take a one-minute
break for everybody to just not have to
hear me for don't go anywhere but I'm
just gonna give you a break for a minute
and that'll just make it easier for you
to process the rest of my talk and I'm
gonna get a drink of water
I thought you could also give a break
for the interpreters as well but just
there sometimes not having to
concentrate so much it gives her an
opportunity to just regenerate a little
bit I have more time we would engage in
breathing exercises to
okay so hopefully that helped a little
bit there okay so we're gonna resume now
so now we're gonna get into some of the
exciting stuff so now the other stuff is
critical and crucial because without
those advances we would not be able to
would you like to hearing aids in ways
that we can't nowadays but now we're
gonna talk about the jump from hearing
aid to now changing ultimately calling
not hearing it anymore but personal
hearing assistance or personal hearing
listening technology I don't know what
to call it do I have to come up with a
name cuz now what I'm gonna share here
not only allows us to do what people
were hearing it was in normal limits can
do but some of these advances allow us
to hear and situation much better than
individual normal hearing allows us to
do so many different things and so we
are now going into an age where wearing
our devices allows them to do things
that other people without hearing aid
can't do so why was he here connectivity
so perhaps just the great hearing aid
advanced ourselves what wireless
connectivity refers to is the ability to
stream to send acoustic signals from
other sources such as telephone sound
system media devices without the use of
hard wired cables to the hearing aid so
sending signals wirelessly from other
devices to the hearing aid I'm going to
talk primarily about two of these
multipliers transmission and the events
are just a Bachelor both and so please
note they're not going to be talking
about induction loops or electromagnetic
fields today which is wireless
technology or infrared I'm going to be
talking about hearing aid connectivity
rather than that other type of hearing
assistive
so one if car near field magnetic
induction and often record refer to add
near field wireless communication and
then Bluetooth wireless transmission and
Bluetooth we'll talk about is also part
of and kind of a I'll talk about is 2.4
gigahertz transmission and I'll talk
about that too so the first thing I just
want to show you a figure is I have an
example of a device where it uses
near-field we're gonna talk about that
naturally I think I have to slide in the
wrong order here and here the remote mic
that could communicate with this device
and this is what like a car called the
compilot from Phonak and those wires are
not a neckloop they're not accord only
they are when it went around the neck
allow the person to actually be able to
hear this remote mic some 30 feet away
and being sent to the hearing aid and i
thought it was a cute picture of this
person wearing this like kind of
receiving streamer that way and using
their field magnetic induction so what
is it near field magnetic induction
wireless signals have a much lower
frequency transmission in Bluetooth and
the differences until the past year -
computer Bluetooth is that if your
magnetic induction is able to go through
or around objects such as human heads
and so this allowed yeah someone to have
a receiving device where piracy Mia and
then wearing zip like wire around the
head it allows signals to go between a
hearing aid and to talk to each other
and when they talk to each other for
example if you wanted to decrease the
volume
you didn't have to then go to one
hearing aid and that's your other by
just even using a remote control that
sent it to the hearing aid for this
niffle magnetic induction with a remote
control you can just create the volume
simultaneously Mouse ears or there's a
feature called do a phone where if you
had to hear it on your cell set
understand on their hearing aids you
could listen to a cell phone one year
and it could send wirelessly right
through or around your head to the other
hearing aid so you could actually hear a
phone for both hearing aids or you can
stream music on stereo - both hearing
aids the problem with me of your
magnetic induction is that the range of
this is only one meter and that's the
reason why what I showed you the
previous slide that you would have to
wear like a device a receiver and what a
wire around you because if you put it
more than three feet away from you you
no longer could pick up the signal that
would being sent to it from other
devices like a bell like a cell phone or
a remote mic you bear so you have to
wear it so that's why I called
near-field meaning that has a very
limited range from which you can then
pick up two signals from the receiver or
a streamer now and that's why yeah
there's a number of companies have used
a many still continued use a streamer
because
if you just had a originally relied on
just bluetooth and we'll talk about that
a second to bluetooth originally could
not allow it to go through the hearing
aid let them hear near-field users like
called ten megahertz
but the wavelength is longer than the
Bluetooth and a Bluetooth just could not
penetrate through the head or go around
him and so the two hearing aids could
not communicate for speech signals or
any type of sound and so well companies
would do is that they would have a
streamer that could pick up bluetooth
but then it could not allow it to
communicate between the hearing aids and
so the way they overcame that was to use
a streamer to you near-field and then
they could allow the hearing aid to be
able to hear the acoustic signals so we
talked about and I already alluded and I
you know presenting I realized that put
somebody slide in the wrong order so I
apologize so hearing aid streamers are
able to communicate with Bluetooth
devices such as cell phones Bluetooth
transmitter they connected TV in
commuters how this dreamers do so is on
the input side of a streamer like the
device is sure before it has the ability
to communicate what called Bluetooth
classic so that like all these device
cell phones Bluetooth transmitter TV
computers even garage openers it seems
like that here is a what called a
Bluetooth standard that all the devices
dude they're all used the same standard
and you compare a device to them as long
as you're on the same Bluetooth standard
so many companies develop these
streamers that would be on that same
standard so on the input side they
compare with those devices as I said
with what's known as Bluetooth classic
but on the upper side many des streamers
they use near-field magnetic induction
to the hearing games so allow the
hearing to be connected by just streamer
intermediary to Bluetooth devices on the
input the spirit could connect to the
Bluetooth devices but then the signal
that they were sent to the hearing aid
could not be Neptunes because it could
not allow to hearing it to communicate
each other so they used its near-field
magnetic induction and
different motor transmission which then
you can then be able to communicate with
those external devices like cell phones
now I just wanted to mention there is
one device from what car clear sound
which is a company their device Quattro
for is that there are individuals who
have hearing aids that are not near
field magnetic induction compatible they
don't have the software in those devices
these individual might be wearing older
hearing aids that have a t-coil
so clear sounds what they developed was
a device or streaming wear could still
communicate with the Bluetooth devices
but the output was either through a
headset or a neck loop so if you have
hearing of the coils and you could not
connect via n FM I you could still be
able to listen to other devices like
cell phone or TV however you will not be
able to hear and stereo because t-coils
you you hear in a mon or you don't hear
it in a stereo mode so and also some
stream is also function that has a
remote mini mic so I'm gonna show you
and I don't know if you can see but I'm
when what's called the autocrat connect
clip but I'm gonna talk about that in a
little bit so here is a clear sound and
it's a Bluetooth device it can connect
to cell phone and it also you can put a
TV transmitter to comes with the product
and also on the top here is a mini mic
that you can actually take off and
someone can wear it and it is a device
where it's like a regular microphone and
it sends a signal by bluetooth to the
device and then just what looked like
like a cord is actually a neck loop and
if you had t-coil you could wear with
that here is this connect clip this is a
streamer but it's more than just a
streamer it's also a mini mic and so
this device which I'm wearing right now
you can on the input side can be paired
like I do through my cell phone right
now I actually have a little transmitter
connected to my computer so it allows me
to hear anybody talk on the computer and
just random it ascends it to my streamer
and then the output send it to my
hearing it but not by me if your
magnetic induction it has another way of
sending to my hearing aids so now we're
going to go to the other way of
transmission called 2.4 gigahertz
transmission bluetooth is a subcategory
of that Wi-Fi is a subcategory and in
the 2.4 gigahertz that million million
Hertz
microwaves are in there so there's a lot
of different devices that are in this
range now until recently bluetooth to
standard a Bluetooth device of Jews that
I talked about when you try to use that
and we companies were trying to use that
hearing aids for 20 or 30 years but the
problem was with bluetooth the way
communicate cost a lot of battery
changes and hearing aids the batteries
could only last for like 15-20 minutes
so we could not use a pair out hearing
aid with Bluetooth with devices and
that's why we used intermediaries
because those come with much larger
battery that can last a 2 10 12 hours or
more but in the 2010 you know just you
know like 2015 on a new type of
Bluetooth revolved and it's called
Bluetooth 4.0 and now regionally 4.1 has
low-energy developed so it now could be
used in the hearing aids without causing
battery drainage however this Bluetooth
Low Energy is not the same as the
Bluetooth classic so given that we to
use it in hearing aid that did not allow
hearing aid to directly communicate with
various Bluetooth devices like cell
phones now so let me tell you a little
about the properties of Bluetooth Low
Energy instead
here feel magnetic induction which is
only a distance of three feet it can go
up to 36 feet away so originally this
traditionally this signal cannot
propagate through around obstacles like
the low frequency magnetic induction
cables so that's why until enough shared
exciting development but until recently
you could not even though you could
allow hearing aid to pick up a signal
for for 30 60 feet it did not allow to
hearing it to talk to each other though
so meaning that like each hearing aid
separately could pick up a signal being
delivered 30 60 feet but you could not
have one hearing a talk together because
these sound waves the Bluetooth is our
radioing and there's such short waves
they could not penetrate and go around
ahead so you still need as dreamers was
n FM I if you wanted the hearing aid to
be able to communicate with each other
but now
with 4.0 like I said music speech can be
transmitted to hearing aids separately
but through an intermediary I'd like to
connect clip so you can hear actually
and stereo and it's exciting because I
I could put to connect clip 30 45 50
feet away and I don't have to wear that
streamer I don't have to wait a Kinect
clip I can put it down and so when I go
to gym let's say I go on a treadmill I
don't actually have the weird device I
can put my cell phone and connect clip
you know on the floor or in a stance
actually earlier before I mean I started
presentation Bruce was talking and I
left he didn't know Bruce and Bonnie
didn't know I walked away I had to get
her to get my bottle of water and I went
30 feet away and I was still able to
hear everything so how I say so the
connect clip it has bluetooth connect to
all the devices are through bluetooth
o'clock but out beside two Bluetooth 4.0
Low Energy can then send the signals
separately to my hearing it so now I can
hear in stereo like a conversation and
hands-free so I use device when I'm in a
car driving and I I do where to connect
with in that case because then it also
has a mini mic so like that's my denied
where I talk into and I could put it
down but then other people want to hear
me so clearly so I wear it only to allow
other people to hear me then
now how exciting development that come
out in 2019 2020 another companies are
going to copy this but we now have the
Phonak Marvell hearing aids and Phonak
engineers have developed technology
including a very very tiny tiny antenna
and an incredible chip with over 30
million transistors Galli like if people
who are my age used to have radio who it
might have like 10 or 15 transistors and
radios in the nineteen sixties
fifteen transistors now compared to 30
million and you put on a chip and what
is the loudest they've overcome these
deficient diseases that were inherent
with the Bluetooth transmission and how
it allows for ear to ear communication
so the new phone ECMO hearing aids the
hearing aid can communicate with each
other the transmission can overcome the
shadow or the the blockage effect and so
what they've done also and I don't know
how but they built-in Bluetooth classic
right into the chip honey hearing aids
what does that mean you don't need a
streamer anymore
that means a hearing aid can communicate
and pair up directly with Bluetooth
devices so you can connect your hearing
aid to the cell phone you can connect it
to other Bluetooth devices let's say you
have a Bluetooth enabled TV and can send
the signal right to the hearing aid and
be paired also because II to him gets to
communicate with each other if you
listen to music you can hear stereo you
can also did you hearing it could work
together as well so again you can unit
director Bluetooth devices there's stuff
on bridges computers you're gonna laugh
a music streaming and hearing it to work
together this chip also uses artificial
intelligence so what does that do it
analyze the acoustic environment and
then by analyzing it it determined okay
what what's going on and then it took
that by through intelligence over time
it's fire in takes certain features in
the hearing aid and it decides what
features the best years for that
particular environment and it takes a
picture optimizes sound in that
environment and over time it actually
learns so that when it comes back into
that environment it will more quickly
grow into those particular settings
so that's what artificial intelligence
is able to do it analyzes undefined
real-time making many minute calculate
many of the calculations to determine
what's best for that environment and so
I supposed to show you but like some of
the technology here that would cut down
and I'm gonna go in a little more so we
have the Marvel hearing aids they're
rechargeable so now you don't even need
batteries no batteries they can charge
and by being rechargeable actually I
think I don't know if they're waterproof
but they're much more water resistant
and then in the past because one you
don't need to have battery battery doors
and use rechargeable you can seal it
better and then we have like you connect
a device to the TV like them said right
to the hearing aid microphones right to
the hearing aids you know have to wear
them paired with the cell phone so it's
amazing what we can do I wanted to talk
now about another type as a hearing aid
called the snarky Livio AI means
artificial intelligence if the first
health about hearing aid that's how they
refer to it
his sensors within the hearing aid yeah
the sensors are computer chips programs
to sense the environment and the person
and uses artificial intelligence
relative to TechNet information using it
so for example it can track body
activity how many steps you take your
movement your heart rate of is getting
high how often you engage in social with
other people are listening and it
derives scores after body and brain
activity and it can use that activity
data through these sensors and you can
then pair it up to various apps that are
available Apple a awesome Google fit
apps and so using information you're
able to dis you know with the D program
determine are you walking enough are you
doing in ourselves you're hardly getting
to where you want it it also has a
sensitive Germany if you might be
falling and if you do fall it can
actually alert other people to come and
help you and what is actually done we
know and I'm sure you but hopefully
you've been to lecture the presentation
to talk about how hearing loss is not a
minor problem but associated with other
major issues such as an increased risk
of falling or any Christmas get dementia
and so or other issues like that and so
the goal is this if not only to help you
hear better but to live better to the
decrease the associated issues that
might come with hearing loss and so as I
said earlier hearing it or not now just
hearing it anymore their personal
listening systems or whatever you want
to call them or it because about hearing
aids so like to hear
so this defining what a hearing aid is
or what it can do so first of all
communicate by the cloud up there the
sky somewhere use artificial
intelligence you can communicate
directly cell phone it can detective
this falls it learns and you know able
to help you all the time by Bluetooth
connectivity accessories so connect to
many other devices the last platform
we're going to talk about and I
estimated what we've done in about ten
minutes and then we'll be able to take
questions yes I want to talk about what
called the Phonak Roger platform and
they're not trying to to plat Phonak but
they in terms of accessories and hearing
since technology they've been a leader
and somebody has a company like Otakon
as well had tried to do with their phone
at them but they've done just maybe a
little ahead of others so I just want to
talk about that so Phonak Roger system
replaced FM systems we tend to use word
FM system a lot but FM technology is
being phased out whatever reasons was
that it was somewhat limited and it
didn't rely so much on digital
technology and the SM or frequency
modulated that's like your radio system
was limited to what called a semi to 276
kilohertz bands I think who's bigger or
might be megahertz a minute screwed that
up here I can't remember now
sorry afraid it been so long that I
can't remember which one it is anyway
Phonak replaced that by using a digital
way of transmission and they created a
Roger remote microphone technology not
using bluetooth but using a different
part of the 2.4 gigahertz transmission
to connect to compatible receiver
gymnast roger direct technology and they
there's no frequency interference that
occurred but so what s emphasis time
remember some time picking up like other
radio
like private kind of radio station that
were in that band and so that should be
mega heard because that so anyway so but
you're not using him to fail number one
it's on it 2 / 4 gigahertz it's a much
wider band but also it does would call
frequency hopping so with a paired Roger
receiver the two together yeah zel they
what they do they analyze the
environment and yeah and they look for a
band that's free and they find it and
they stay in it and then if it appear
and it keeps on analyzing and at any
moment there might be another signal
that started injury it goes to a
different time so many many times a
minute I could not figure out how many
times a dancer's but without make sound
the time the minute calculating where 3
and so you get no interference also
Roger technologies uses adaptive meaning
it can change and it would be software
that continually analyzes the noise
levels in the environment and so the
idea is define and keep do I just ignore
clearly above the background noise oh
and lines and adjusts the the signal to
keep it above that also I'm gonna talk
about there's a certain technology where
multiple rods your microphones that can
link together so that means regardless
of which Roger system a microphone you
use you can have many people talking on
it without interfering with each other
and then like Bluetooth transmitters
where you can like if you have a certain
like transmitter and a Bluetooth the
maximum you can have our three receivers
with a Roger technology can be connected
to infinite number of receivers so it's
adaptive to technology so such that when
you hold a Roger mic in a vertical
position like on your like your chest
the mic entered what called a
directional mode so that's facing the
talker so better pick up the toxic voice
but when you put on a table it becomes
an omnidirectional Mailand so to pick up
speakers around the tables so it splits
vertical direction of to table
omnidirectional three types of Roger
microphone 2 Roger pen do Roger select
and the Roger table Mike
so the Roger pen was the first that
Roger Mike's introduced when it was
introduced they also developed a
compatible Roger receiver called a
MyLink that would that can be sent
directly from Roger pen picked up by
alignment and then you could wear with
your hearing aids also they developed
like a little universal receiver that
for other systems you can connect their
like a certain port that you could
connect on Phonak FM system through all
those other companies systems that can
change those systems rather than being
an FM that could become Roger compatible
now the roger pen has three manual
microphone modes on it omni so so 360
degrees directional so can zoom in a
certain angle or ultrazoom or auto zoom
that must be Mike and it also has the
adaptive Mike feature that we talked
about in the last slide and here's a
picture of the Suraj Japan were the
three different mic settings now with
the introduction a Marvel hearing aids
you no longer need an external like
receiver such as the my link or a little
device that you attached garage you
might consume right to the hearing aid
directly because there's a software
program aside there erogenous of a
computer grille that you can activate in
the Marvel hearing aids and all study
recently the Roger pen in was introduced
where you can put the pen into a docking
station and you can connect the docking
station to a cell phone to an mp3 player
TV etc and then it allowed to roger pan
to send a signal to any of the roger
compatible unions
allowing you to hear the cell phone or
other that way
or you can connect these devices
directly to the web they're like DBT
devices Val you have to be capable to
the roger pen or with the marvel hearing
as I said you can connect directly to
the device and even without you has been
so here's a picture of the Roger pen and
darkness station the Rogers select
actually if not just like the Roger pen
with one mic gonna have six microphones
and they create beams like narrow beams
as to the signals they're going to
listen to in six directions so they
covered that whole circle so each of
these might cover 60 degrees I've asked
360-degree circles and in noises
settings and actually to calculate and
determine and analyze the signal to
noise ratio for all six directions an
automatically selected beam with the
best clarity for the speech signal so
now so when placed on a table
automatically select a person who's
talking and it can switch from one
talking to another so oh somebody and a
different microphone being picked up
better so I switch it to that up another
talking begin and it switches to which
one that's gonna listen to so now when
multiple conversation play take place
like a lot of people talking now they're
on just select doesn't know who would
want to listen to you can also manually
override and you could decide oh I want
to listen person forget about the other
people so here's a picture - Roger
select so each of these like little
curvatures are different microphones and
so it picking up and I'll decide oh I
want to hear the person in this
direction or this way or you can
actually press on and decide I want to
listen to one person this has a docking
station as if I like you out of pen so
you can connect this to different new
chip devices and with the Rogers select
send a signal right to your hearing aids
the last devaraja system logic briefly
talk about the Roger cable - which is
dedicated for working situation when one
practices when one goes to a different
meeting now some little Roger selected
also has six months each be me in a 60
degree angle but you compare and network
what you gather to create a multi
talking network so rather like garage
it's like great and a mic if you have
like four people around but if you have
a table that's 20 feet long
one Roger select cannot deal with that
but if you put maybe three or four Roger
table mics one every like four or five
feet down the table then they connect to
each other and then it can decide or
pick up the person nearest to it so the
rods table might select the person who's
talking and they switch automatically
between a meeting participants so here's
an example of the rod tip of mic
networking in action so you have one
octave of mic here one here one here and
then if someone over here is talking
that's suppose that's the ones gonna
pick up or someone else begins to talk
it's sent to the person who have like
here that's wrong and all this thing
with the my link for example them which
they had that near-field and the person
was able to hear and hear again but now
you could send it right to your Martha
hearing aids and so here's example it's
just in the Roger touch dream mic so you
could actually see and press other ah
just select this is a Roger clip-on mini
mic so if you someone like a spouse was
wearing it to send ya the mic
transmitted right to the hearing aid or
to a MyLink Roger pen so the last thing
I want to talk about quickly our
cellphone app for just as young
assistive technology so there are
actually voice to text that drift voice
to where you can see it once the system
is live transcribe from google it free
download there's actually developing
Google and Gallaudet and you can
download it and use it but it's only for
Android phones because Google's and
Android products or worked with Android
just the caveat is that I've had some
difficulty in a lot of noise my
if you attach a highly directional
microphone you could cut out some of the
noise and still use in those settings
another develop like that for use with
Android and iPhones called live caption
and things only $2.99 to pay for it so
with here the kicked your life
transcribe you see the word appear in
the phone when has it spoken and
actually autocorrect so for example you
see I'd like a table for two at 2:00
p.m. so direct yourself and etc there's
also live transcribe is good for less
than one person at a time there's an app
called Ava which is for grift
conversations so each person in who
wants to participate in a group they
would download the app so they would all
have a burr on their cell phone and it
would be a color code and each person
when they would just talk normally just
be near the phone and the speech-to-text
would be trans you know scented it all
the cell phones linked and you get a
message and then anyone talks there
would be a college over that would let
you know who's talking
and you would see the voice and so you
can use Avon group meetings and
restaurant one-on-one Church etc and it
actually does quite well with moderate
background noise and I read somewhere
that indicated it was more accurate than
the Google I've transcribed so
compatible for Android iPhones now if
you use it after think like five hours a
month I think that's what I understood
it for free but if you want to use them
more often then you pay $29 a month so
if you're a person who goes through a
lot a lot I mean 29 a month since for
success so here and I just a picture of
aim of being used let's go different
color if you want to join a group
conversation now even though it's not a
cell phone app I just want to briefly
mention doom and Google me so these two
software program you can download it to
a cell phone or to your computer you not
only get em free I communicate last
night every Friday now I communicate now
my friend in Australia
and have excellent voice to text
software and you can do that without any
training hopefully you can see if so
they using them today to capture the
quite accurate most of the time so it
has an autocorrect feature I'm not sure
about Google mean if it has that or not
and it also has embedded closed
captioning as you can see I think but
I'm not a hundred cents sure that
playback you just have to hear CC and
you can see the caption so we'll find
out out there still trying to see if I
can do that or not and you can also have
three size fonts so I'm right now I'm
using the smaller side because otherwise
they don't interfere maybe in the
presentation when you could adjust you
can use a mobile devices remote mic so
as I said you you can either use you put
down your cell phone and then send a
signal right to your hearing aids if
them if you be the source dreamer or
blue or like Marvel hearing aid for
example but if you're a noisy place you
might want a high quality directional
mic and then I think autumn IQ there are
different prices but you just play the
spy for close to talk to stand up to
forty five feet away and the mic you
microphone can be used however only on
iPhone and I don't know why that would
be the case but there are other mics I'm
sure available you can attach to Android
phone so here's like just attaching like
the Bluetooth Mikey to the phone place
it down on the table so let's say you go
to a lecture a small room like 30 feet
away put it down right on the way to
person talking anderson director you're
hearing it so you don't need an FM
anything just meet yourself on set or
your own remote mini mic whatever you
want to use you can also use a mobile
device as an alerting system so they're
apt to pick up environmental sounds door
knocks smoke alarm telephone ring and
you can even have it such where you can
you know let's say someone calling you
it'll have a different vibration
patterns and ecology by vibration or
flashing light and like the learning
devices so they can be triggered and you
can have
there's a problem in terms of
sensitivity but you can adjust it so
they don't trigger unnecessarily Chuck
strain yourself onto the cell that you
want and here is just different apps
here like showing you how you can be
alerted to smoke alarm or doorbell or
you know a lot of clock cetera so it's
wanted to show you that and different
ways number of vibrations you need tap
tap for door knock et cetera I think
this the last divided by you it's called
the visor saver is a strong vibration
best shakers much life on
after I download an app I said on my
after days of time that want the alarm
to go off I couldn't use it for myself
or I could actually put the library
saver in my son's room
said it for him and I can wake him even
though he's not in the same room so you
can use a remote but what I love about
just is that can go away to a convention
on vacation I don't have to bring in a
live clock I don't have to rely on a
hotel all I have to do is be my cell
phone and this fiber saver and I'm able
to use it to wake up when I need to not
worry about him so here the vibra saver
under a pillow and he had to sit on and
you consider just Brown and Ronald
cetera oh shoot this again the last
thing you're over the county hearing aid
I'm just gonna say some quickly and I'm
just gonna go quickly on this because I
I don't I know I need to have questions
throughs what should I do
I see if five more minutes here should I
would how do I do this
I think you know we should probably try
to finish with your slides and then take
a short break
okay great and then because I think
it'll be just a few minute ake a break
and then hopefully answer questions if
people get asked if the interpreters are
not available I think we have the
captioning on - there will be okay but
yeah we need to finish up here
okay thank you okay I was asked to talk
about over-the-counter hearing it so I'm
going to do that and just society so
overcome to hearing is that supposed to
become available this year but they are
not yet on the market the FDA is still
finishing their guideline they are
supposed to be published by August 2020
and then they'll promote the guideline
for input from medical community and
potential uses so just be aware until
these guidelines are made official
consumers have to be aware that if any
ad you see said oh there's an OTC
hearing aid that be aware of that
because they've not received FDA
approval and a lot of times I don't see
like I saw Walmart saying about hearing
aid just we can add I want to check into
and know I would notify it about Seth
though they're not OTC hearing aid
they're actually hearing aid I guess
Walmart went through FDA approval but
they're not oh to see hearing aid just
because you can get them online or
through Walmart doesn't make them
over-the-counter hearing aids and
they're gonna be regulated medical
devices to the US Food and Drug
Administration you'll be able to
purchase them with our medical
prescriptions but just be careful that
if you're new if never one hearing aids
you really should check to make sure you
have no underlying medical issue but hey
it's like buyers beware that's your
problem if you don't get them at a
prescription then just beware there
gonna be available for adult children so
18 and older and only Fred's own was a
mild to moderate hearing loss so if you
have a severe profound hearing our feed
devices will not be made for you
they will not be strong enough for you
and your own you'll be able to purchase
them directly from retail or online now
they're obviously be cheaper as those
bundled cost hearing aids ones a bunch
of cup hearing aids that not only is
device it includes the fitting visit to
fit the devices and any service warranty
for example Gallaudet if someone buys
hearing it for us and we we kind of have
a hybrid models bundle at number though
but when you get hearing it to else you
not only let's say surprise Spencer
party we have a three year manufacturer
of surf launch it so for three years if
you come back to us any visit to get you
don't have to pay for so if you buy
hearing aid and you need to get visit my
brother you always have to pay for
Miller do not do it pictured modeling in
a moment caveat as I said earlier they
only be available to individual amount
amount of degree a hearing loss the
maximum input will be the output will be
limited to prevent damaging hearing in
these types of individuals so it's not
going to be strong enough for those with
severe to profound hearing lots of
you've been waiting for these OTC
hearing and after your hearing loss
don't wait they won't meet your needs
now also know the primary problem for
those with mild to moderate hearing loss
is not hearing the quiet but it's
hearing in noise so what these devices
what's gonna be important is that the
hardware and software included it's
somehow going to have to make sure
they've just don't know is it soon
they'll have to have directional mics
they're gonna have to be able to cancel
noise out not knows I'd hate to somebody
lose their nose out of this now they'll
have to have programming flexibility
that is you be able to set the hearing
aid for when you're listening quiet when
in noise listening on a telephone
listen to music have to be able to adapt
to that
and the questions are what happened if
there are some issues that
yeah I might work well quite but it
doesn't work well annoys or works well
annoyed but it doesn't work well for
music and telephone what happens if the
sound quality is not so good it sounds
you tinny what happened it's too loud
what happened if it's not loud enough in
different settings how will that be
addressed if you buy it over the counter
I heard some people think oh I'll just
buy them then I'll go to the audiologist
that way I could spend money however the
problem is I left the audiologist
somehow carry those devices we may not
have the software and if we don't have
the software which we let it that comes
and unlike me when I give to us then how
we gonna be able to adjust those device
so we may not be able to help them also
I went to Walmart recently as I said and
they're selling FDA approval yet but
when I went I tried to get information
each area didn't know nothing except for
like 120 posts from the club people
about them but I have no idea what those
hearing is actually do and this wasn't
going to be a problem if you don't if
you don't get information or you can't
understand so my thoughts about it is
that I believed in seeing it will be
useful for people not made of matter
hearing loss if they live in a nursing
home if they're listening facility or
those who don't go out very much but I
may appear there certain devices that
may also be able to adjust noise related
issues but the question is will they be
cosmetically appealing both has actually
got approval for a both hearing aid
goodnight 2018 but they're not out yet
but in their the way they're describing
it sounds like it's gonna look like is
it device like here where you're gonna
wear a black band around your neck and
you're gonna have to wear these very
sick ear about to these excellent
quality devices and they work well this
device but will people with montemagno
hearing loss who didn't want to get
hearing aid because of Winnie look and
they're gonna wear this so I don't know
I don't think some there's no hearing
test required so that way y'all get self
hearing test yourself fitting will they
all be incorporated into it or you just
gonna have to body hearing it and hope
that it meets your hearing needs how
would those fitting adjustment issues
repaired be addressed will they be
trained staff available to meet with
customers if they're being purchased
online for example you won't if you buy
in a store you gotta go to Walmart and
they're gonna have somebody trained to
serve you I don't think so
whether it be individuals who purchase
the hearing aid will actually have
underlying medical issues such as
certain types of tumors and they've
nothing neurologists at all they don't
seek treatment until very late when just
started to have other issues last thing
is body asked me to talk about this so
doctor audiology training aided students
undergo a very intensive period earning
or training I want you to just know what
is required to be an audiologist
nowadays it's three or four-year
programs not only to the courses they
take they get on-site training for the
first and possibly a second year and
then they go to internships where they
work for like a year with different
providers and the clinics or hospitals
and usually they're in the same city of
the University and then they spend a
whole year
five days a week when they're being
supervised by an audiologist the focus
of training at least for Gallaudet is
client centered care the audiologist
seek to ascertain is but the fish is
listening and client the goals and
together a client audiology was worked
to determine what intervention best
meets client's needs how the
intervention successfully met the need
or do we have to alter the plan maybe
try different hearing aid or do we need
maybe assistive technology because
hearing aid by themselves were not
necessarily address all the listening
needs of that person they might need
other technology such as waking up to an
alarm could you have to take off your
hearing aids hearing a door knock when
you're in a shower that's all you know
to get out to this do you need to
and at Gallaudet what else didn't taught
professional integrity respect
compassion culture awareness these are
all things that dr. students need to
learn it's not about making money it's
about helping people so committed to
serve the best interest of the client as
dr. Matthew Bakke stated at our Waco
ceremony yesterday now celebrate our
doctoral audiology student it is all
about our clients not about you
so suffering I hope I provided some
information new to you
some pathway avenues to explore going
forward and I hope you have questions
they may be able to answer I'm now done
so okay there we go on one second um let
me turn my video on you can go ahead and
yeah turn off you're sharing your screen
if people can just wait if they have
questions we're going to go to the
questions in the chat first please turn
off your video so we can stay focused on
the speaker all right
I wish I'll tell you I wish I can make
my finger now I have oh if you turn off
your chaired screen we would be able to
do that so all right we're going to take
just a minute or two here for a short
break so with some eyes can rest about
reading captions or watching the
interpreter we're going to have Debbie
Jones come on and read the few questions
that we can cover in the time remaining
so give us a minute here and we'll come
and answer some of the questions in the
chat we're not going to have time to
share screens and chat with our speaker
today so just one second
Debbi would you like to come on screen
and prepare to read the questions and I
will go off alright and we're just gonna
take a two-minute break
give the interpreter time to get some
hands down and we'll be right back all
right thank you everybody we're gonna go
ahead and come back and we'll go ahead
and start working on some of the
questions that we have here in the chat
Christine was asking about the Gallaudet
communication needs assessment is that
available to the public or is that only
for audiologists Larry
okay the Gallaudet communication needs
assessment can be shared it's just you
know like a PowerPoint to her that I can
share but it's just a tool so I just
share that easily if somebody wanted
email me I put on the first slide
I don't know hopefully Bruce if
everybody who came today
exactly email we can send a PDF and they
can have this presentation so they can
have my email address as well and again
it's a tool so people can look and they
can put the information in what the
audiologist does and why do you re ology
is important and you need someone who is
aware of all the different technology is
to know okay now that I know where you
have listening difficulties the next
thing I want to know what are the
priority what are the three or four area
they're most important that you want
help in then I then turn my attention a
now that I know what the issues are with
my knowledge of your hearing loss your
lifestyle what your prioritize needs and
a knowledge of what's available or where
to look or who to contact
I can then think of the technologies
that will best match with who you are
for example if you have a severe hearing
loss and let's say you're visually
impaired I need to get technology
recognizing that aspect on the other
hand if you have different physical
capability or you have arthritis or
something for example or visual
impairment let's say I want to get you a
certain type of telephone I'm going to
know I need large buttons and let's say
you're the early onset dementia then I'm
going to get where I have memory button
with pictures on it so by having the
knowledge of what's available and
matching it up to the person's need I
can then come up with the best solution
that are cost-effective that will make
the
individual get the access that they need
okay is there if somebody wanted to get
access to that tool is there a link that
they can follow or should they get in
touch with you to find out how to get
that needs assessment tool well if in
the presentation that's what I put there
is actually the tool it has the
different you know applied factors it
shows you the different settings it's
all there all you would have to do is
print it out and then put in okay when
I'm in the settings okay I have trouble
talking at the dinner table you know at
home or I have trouble hearing on the
phone at work you can put those things
in and then you can take that tool and
maybe bring it to the audiologist that
you go to and say you know I got this
tool I've identified either my issues
here I would like help in these areas
getting it help me great thank you so
much
Russell was asking his impression is
that directional mics are of limited
value in that it diminishes noise but
not enough to be of any real value is
there any work going on to improve that
with directional mics okay Thank You
Russell for asking that and it's like as
I was talking I wanted to say certain
things and it looks like I may not have
but as you already know I went longer
than I was hoping to so first even the
highest quality directional mics and can
improve what's called the speech to
noise ratio by about four to five
decibels that's the maximum improvement
you could get so it does help on the
other hand for those who wear what I
call domes oh by the way so the four to
five is if you wear like your mom's if
you wear domes it may only get two to
three decimals so there's a limited
amount but three decibels of improvement
speech still have quite a breath
but if nowhere at all close to what you
can get with remote mic which can give
you up to 50 - 25 gb of improvement so
that's the first thing
the problem with directional mic says oh
yeah now if you use like the autism
feature you know like Roger pen you can
actually enhance the signal-to-noise
ratio but we don't have the microphone
capability like that in the hearing aids
you have this very very time you make
them they're only limited to a certain
amount you can do another problem which
is that the type of noise that the most
difficult to address are other people
talking it's not like if the noise would
purely such that it was like dishwashers
or you know the car noise then like the
Bose type of noise cancellation system
would work they rolled north just both
translation and I need to read more
about it I don't I'm sure it can handle
party noise but let's say you only have
one or two people talking that's an
issue so it is a limit to what we can do
with direction of technology and even if
we could you know determine a speech
signal the problem is the brain doesn't
know okay if you have see people talking
the brain doesn't know what you're
talking to one you want to listen to
they're not from a hearing aid to in
order to listen to a talker and ignore
that people talk unless you have no more
hearing when you're in a party you have
many people talking and when you have
two good ears it can actually separate
all the different sounds and your brain
makes a decision as to what you want to
attend to and attenuate so hearing a
dental have that ability and that's one
of the reasons why you can only do so
much so when you have a remote mic or a
microphone that can zoom you
you're acting then at the human brain
and picking on who you want and that's
how you can set that really help so did
O'Neill there's a certain limit or we
can do it hearing aid alone okay thank
you
April is asking do you recommend an FM
system for group interactions where
folks are willing to take turns when
they're talking in the past that's what
I would recommend however with the FM
system do you either head has like one
microphone or you have to daisy chain it
and as well and as long they're willing
to pass it around but i can tell you
that when you're if you have you're in a
meeting with many hearing people even
when they're willing to pass around they
forget and they you know they'll start
talking and then you have to remind them
to have systems such as the roger table
mike or there are other system reading
get into that are much more expensive
where you have certain types of
technology welcome to terms like sealing
my chair or gooseneck mics and it can
determine which from which mic if the
speech is coming from though their
specimen if you have roger table mics in
place for a five and you allowed the
technology to figure out what the main
talker at that point in time you don't
have to worry about passing around it's
automatically doing for you so again if
you're an HLA a meeting yes sm systems
can still be done because most people
remember but if you go into a meeting
where the two or three hard-of-hearing
people on fifteen hearing people they
are going to forget so but a roger table
mic system which was that that expensive
that's gonna meet the needs of the heart
is given person the best my mind
great great David was asking what do you
mean by artificial intelligent software
yeah and you
now the old definition of artificial
intelligence to me used to mean
learnings from the situation and then
making changes so that when it comes to
that situation again it doesn't have to
keep on learning it so it does all these
calculations learn from it like a us
basically artificial intelligence in
some ways was to simulate the human
brain we were coming to situations
we get exposed we learn and then when we
come to that situation again we have
that now where storage and so we don't
have to learn again we recognize what it
is and we can move forward I've learnt
artificial intelligence can mean other
things as well which is it can it has an
end goal that in the software it
analyzes in the environment all the you
know and then like number crunching or
data analysis to determine which
possible scenario from all their
informations is that it coming to it it
picks a scenario that best will handle
it so that's another way of artificial
intelligence but I'm hoping that for one
day it's not only and I've read that
some many types of artificial
intelligence usages okay they not only
adapt and do it sin but then they store
that so when the same situation comes
again it doesn't have to do all this
analysis that's already done is
recognize that setting has endorsement
and implemented so that's artificial
intelligence in being able to analyze
learn from it and then implement great
thank you so much I'm sorry that's all
we have time for today I know that there
are more questions that we didn't get to
we do have dr. Mike wets keys contact
information that we can share with the
folks who attended today so that we can
you can rather we can share that so that
you can ask more questions thank you all
for joining us today Larry thank you so
much this was a lot of information and I
know
it'll take us some time to process it
but thank you for joining us this was
great