Consumer Reports Rates PSAP’s

Bouton Blog - Consumer Reports
CR looked at hearing devices called PSAP’s – Istock

The February issue of Consumer Reports  magazine took an in-depth look at hearing loss and the hearing aid industry, as well as at the newest “hearing helpers” — less expensive, over-the-counter devices that may help some people with mild to moderate hearing problems.

Titled “No More Suffering in Silence?,” the report included the results of a fall 2015 survey of more than 131,000 of CR‘s subscribers. Nearly half reported they had trouble hearing in noisy environments, yet only 25 percent had had their hearing checked in the past year.

This isn’t surprising, as anyone who follows the hearing-healthcare business knows. The National Institute on Deafness and Other Communication Disorders (NIDCD) reports that among adults 20 to 69, only 16 percent of those who could benefit from a hearing aid has one.

Consumer Reports, however, with a subscription base of 7 million, reaches far more people than an NIDCD statistic does. When CR tells its readers about the dangers of untreated hearing loss, it is sending a message to millions who might not otherwise hear it.

The Consumer Reports article begins with an overview of hearing loss, noting the recent changes in understanding of the consequences of hearing loss. Once dismissed as “part of getting older” or a “nuisance,” we now know that untreated hearing loss is a “significant national health concern, one that’s associated with other serious health problems, including depression and a decline in memory and concentration. Several studies even suggest a link between hearing loss and dementia,” the article says.

Cost could be a big reason for this, the magazine notes. The National Academy of Sciences reports that hearing aids cost an average $4,700 per pair in 2013 and can climb to almost twice that price. Plus, hearing aids are usually not covered by health insurance or Medicare.

This is where OTC hearing helpers — also called PSAP’s, for personal sound amplification products — come in. They cost a fraction of the price of an average hearing aid. But do they really work?

The magazine had three of its employees with mild to moderate hearing loss try four devices priced from $20 to $350, wearing them for three to seven days to see how well they could help with hearing in a noisy environment. CR‘s audio labs also tested the devices for amplification, batteries, microphone function and sound distortion.

The most important finding: Pinching pennies can hurt you. The two lowest-priced devices — the Bell & Howell Silver Sonic XL ($20) and the MSA 30X ($30) – were found not only inadequate, but also potentially dangerous. Both overamplified sharp noises, like a siren, to the point where hearing damage could occur.

A hearing-aid researcher who assessed the devices recommended avoiding those under $50. “They don’t seem to help much, if at all, and could actually further diminish your ability to hear,” the magazine reported.

The two PSAPs that fared better were the SoundWorld Solutions C550+ ($350) and the Etymotic Bean ($214 each, $399 for a pair). CR reported on the pros and cons of each device, offering overall “device advice” for each one.

In general, The C55+ and the Bean seem useful for people with mild to moderate loss. The Bean was found to be especially helpful for those with hearing loss in the higher frequencies rather than the lower. For complete details, click here.

If your hearing loss is serious enough to warrant a hearing aid (and much hearing loss is, so have your hearing checked by an audiologist first), the article offered some suggestions for ways to pay less. I’ll write about these in my next post.

 

A version of this post first appeared on AARP Health on March 6, 2017.

Would You Ask for Help With Hearing Problems at Work?

Accommodations for Hearing Loss at Work Dealing with the stigma of both hearing loss and aging at work can keep some employees from asking for accommodations — Thomas Barwick/Getty Images

Older workers with hearing problems face a double whammy: They’re dealing with the stigma not only of hearing loss but also of age. If they ask for accommodations on the job for hearing loss, they fear attention will be drawn to their age as well.

The Americans with Disabilities Act protects the rights of workers to ask for accommodations at work to help them hear more easily. However, research out of Oregon State University has found that older workers are less likely to feel there’s support for them to ask for that kind of help, because of worries they’ll be perceived as old by coworkers and managers.

Other research has shown that people with disabilitiesrefrain from requesting accommodations if they think coworkers would find the request “normatively inappropriate” — meaning not in keeping with the office culture. For instance, an office environment with a focus on maximizing profits like that in The Big Short or The Social Network is perceived as being much less likely to understand and tolerate a disability than would a nonprofit that prides itself on a more inclusive culture.

Research by David C. Baldridge and Michele L. Swift of Oregon State University’s College of Business, published in the journal Human Resources Management, studied the effect of age on such requests. Workers’ fear of seeming old, they found, may trump their fear of seeming to have a disability. Their findings were based on an email survey of 242 workers ages 18 to 69. Most had moderate to severe hearing loss.

Age itself has a negative stereotype in many workplaces, including the perception of “lower productivity, resistance to change, reduced ability to learn, and greater cost,” the authors wrote. “These stereotypes are often associated with fewer promotions, less training, lower performance ratings, and lower retention.”

But add disability to age and the stereotypes multiply. The older the person with a disability, the more likely they are to fear that others will attribute the request not to the disability, but to their age.

“Simply put,” the authors wrote, “people with disabilities appear to face a straightforward yet troubling question, ‘If I ask for a needed accommodation, will I be better or worse off?'”

In their discussion, the researchers advised managers and human resources personnel to realize that while many older employees may be eligible for and would benefit from disability accommodation, “these employees might also be particularly reluctant to make requests,” especially if they work in for-profit organizations or if the organization appears not to have others with disabilities.

When the disability is hearing loss, managers should make sure telephones have adjustable volume (and, I would add, be telecoil compatible). Large meetings should routinely include open captioning, which can also help employees with normal hearing follow what’s being said.

In an email interview, Baldridge said managers should think about the inclusion of persons with disabilities as “a normal aspect of diversity management.”

As the workforce ages, disability increases. The Bureau of Labor Statistics reports that about 26 percent of those ages 65 to 74 are in the workforce, and the majority are full-time workers. It’s in a company’s interest to have employees working at full capacity. If people are reluctant to ask for accommodations for a disability, their output and effectiveness are likely to suffer.

Please share your workplace experiences in the “reply” section below.

For more information about David Baldridge’s studies of disability and the workplace, email him at David.Baldridge@bus.oregonstate.edu.

For suggestions on workplace accommodations for hearing loss see HLAA’s Employment Toolkit. 

 

This post first appeared on AARP Health on June 3, 2016

Living Better jpegshoutingwonthelp

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

What’s With the Purple?

Why purple?

I like it, for starters.

But it’s also part of the color scheme of the logo of the Hearing Loss of Association of America. I’m a fan of HLAA, and a member, and a member of the board. I’m grateful to it for advocacy and support on the national and local levels. And for the many friends I’ve made through the organization.

For more information, and for the location of chapters, go to Hearing Loss Association of America.imgres

You might also want to look at the websites for The Association of Late Deafened Adults (ALDA), The National Association of the Deaf (NAD), AG Bell, and Gallaudet University. They all have useful information, local chapters, and many resources to offer to the deaf and hard of hearing.

Good News! For a change.

Good news for people with hearing loss.

Last week CMS, which runs Medicare and Medicaid, reversed itself on an earlier proposal to eliminate coverage for bone-anchored cochlear implants, like Cochlear’s Baha and Oticon’s Ponto.

This is good news for two reasons.

First, it preserves coverage for an important and expensive technology. People with certain kinds of hearing loss, including that resulting from acoustic neuroma, can’t be treated with hearing aids or conventional cochlear implants. The bone-anchored devices, which have been implanted in 40,000 Americans since they were approved by the FDA and accepted for Medicare reimbursement in January 2006, affect people of all ages. Only 20 percent of these 40,000 procedures was covered by Medicare, according to the Hearing Industries Association. And in fact when CMS made its original proposal to end coverage it noted that it wouldn’t save Medicare a substantial amount of money.

Medicare’s decision not only ensures that these devices will continue to be available on Medicare but also will have a so-called ripple affect. Private insurance companies often follow Medicare’s lead in coverage guidelines.

And these devices are expensive (although not as expensive as conventional cochlear implants, which both Medicare and private insurers generally cover). Cochlear Americas estimated that the national average “bundled” rate (which includes physician and audiologist services), is $9732 if the surgery is done on a hospital outpatient basis.

The second piece of good news is that this was accomplished as a result of a public campaign against the proposed changed. Cochlear Americas got it started but CMS received more than 4,070 comments, and 11,300 signatures on a petition, according to the Acoustic Neuroma Society. The people’s voices were heard!

Let’s all remember that the next time CMS or some other seemingly behemoth government agency proposes to cut back coverage of an essential device or procedure.

Scientists Meet the Consumers

SCIENTISTS MEET THE CONSUMERS.

Yesterday I was the guest speaker at the 14th annual Forum on Hearing and Hearing Loss, co-sponsored by the Massachusetts Eye and Ear Infirmary Department of Audiology and the Boston Chapter of the Hearing Loss Association of America.

Sharon Kujawa, who originated the event and has organized it for 14 years, is an Associate Professor of Otology and Laryngology at Harvard Medical School, director of the Department of Audiology at Mass Eye and Ear, and Senior Researcher at the Eaton Peabody Laboratories at Mass Eye and Ear. Her lab focuses on noise and age induced hearing loss, and is currently investigating how noise exposure alters the way ears and the auditory system age. By understanding the underlying mechanisms, the lab hopes to develop a drug that could result in treatment or prevention.

Specifically, the Kujawa lab is involved in a biomedical and engineering research partnership that is looking to develop an implanted drug delivery system that could help prevent hearing loss. Given to vulnerable populations — those exposed to unavoidable loud noise, for instance active-duty military, as well as those with a genetic predisposition to hearing loss  — the drug might help offset the effects of the noise exposure.

Dr. Kujawa spoke first. Her talk was a detailed discussion of what we now know about the causes of hearing loss, and about the  underlying systems. She also talked about the lab’s current work. Her talk covered a lot of technical material but it was crystal clear.

I spoke next, about hearing loss from a personal perspective, about the need to educate people about hearing loss, about the general misunderstanding of adult-onset hearing loss (most of us are not Deaf and we don’t use sign language). I also spoke about the need for reforms in Medicare and private insurance, which currently do not cover hearing aids or diagnostic hearing tests. I urged those in the audience to write to their congressional representative and ask for support for HR3150, which would overturn the statute that currently prohibits Medicare from reimbursing for hearing aids or diagnostic hearing tests.

HR 3150 would be an immensely important corrective to the existing policy. The consequences of untreated hearing loss, are enormous — not only personally but on a public health level as well. Untreated hearing loss is strongly associated with depression and isolation (both known risk factors for dementia), anxiety, paranoia, with a three-fold greater risk of falls — and an alarmingly greater correlation with the onset and severity of dementia.

This is a power-point talk that I frequently give to hearing loss groups as well as academic audiences. For a list of upcoming appearances, you can go to my website: katherinebouton.com and look under events. Most are open to the public, and most have multiple kinds of hearing accessibility. CART — simultaneous captioning on a screen on stage — is always available. Many venues are also looped, and sometimes there is an ASL intepreter.

Dr. Charles Liberman was the third speaker. Dr. Liberman is the Harold F. Schulknecht Professor of Otology and Laryngology and Vice Chair of Basic Research in that department, which is part of Harvard Medical School. He and Dr. Kujawa collaborate on much of their work. Dr. Liberman’s current research focuses on noise: “acoustic overexposure.” His talk was also highly technical but also very clear to his mostly lay audience. He discussed the ways the inner ear connects to the brain — through two kinds of sensory neurons and and two neuronal feedback systems — and how those pathways can be affected by noise exposure.

Neither Dr. Kujawa nor Dr. Liberman spoke down to the audience, and the audience members responded with their own detailed technical questions. People with hearing loss are often well versed in the science of hearing loss, and the Mass Eye and Ear annual forums bring cutting edge science to the lay public.

Mass Eye and Ear has made a commitment to sharing its research with the public. Does anyone know if such public forums exist at  other academic hearing centers? It’s a generous gesture from the scientific community to the population their research may eventually benefit.