Three Must Have Hearing aid Features for Optimal Performance in 2018
PLUS a few more niche ones for specialist applications. As well as our predictions on what is coming in 2018
Modern hearing aids have many built-in features. It is hard for the layman to know which features actually make a real difference.
Some features, such as multiple channels are easy to implement and look impressive on paper, but in reality don’t make much of a difference in the hearing aid’s actual performance to the average hearing aid user. Interestingly, some smaller manufacturers push these “paperweight” features as they tend to be lacking in the technically difficult features that really matter to user benefit. You often see multiple channels (32, 64 or even 196) advertised as one of the key features in “cheap” online hearing aids as they seem impressive. In reality 6 -8 channels are all you really need for an optimally performing hearing aid.
This article will reveal which features you should consider having in your next hearing aid to achieve the best possible benefit available today. We have filtered out all the fluff, as well as the features such as effective feedback management, open fitting, Impulse Noise management, Noise reduction, Telecoil, electronic wind noise reduction etc., which are already well established. We have selected three universally applicable features that can really make a difference to a hearing aid user’s experience.
Automatic Directional microphones – For better speech understanding in noise
Hearing aids have been able to effectively improve hearing in quiet situations pretty much since their inception. Over the last decade there really hasn’t been much difference between different hearing aid models’ performance in quiet situations.
The only proven way to achieve this is through the use of directional microphones. A modern directional microphone system consists of two microphones on each hearing aid. When the directional microphone system is activated, the hearing aid focusses the direction of sound pick-up forward. This means you hear loudest from the direction you are looking at, while sounds next to and behind you are suppressed.
Directional microphones are most effective when they automatically switch when interfering background noise is detected. Manual systems only get it right when the user remembers to push the button to switch modes, which unfortunately does not happen consistently. Automatic systems get it right 90%+ of the time as they are analysing the sound hundreds of times a second.
There are several levels of directionality, listed below in order of complexity, from least to most complex.
Fixed Directionality – Does Not alter to follow the sound around you. Instead picks up best in front and worst right next to you. Has been available for decades. If you move your head the noise level changes based on the fixed pattern.
Adaptive Directionality – A little smarter in that it follows the one loudest noise behind you as it moves, notching it out. (Many lower end hearing aids have at least this level of directionality). This first became available around 20 years ago.
Multi-Band Directionality – Follows multiple sound sources behind you, suppressing them even if they move or you move your head. The number of bands range from around 4 up to 48 in some more advanced models. This requires more processing has been available for the last decade or so.
Super Directionality (Beam Forming)– This is the most complex level of Directionality and can offer the best hearing in noise in certain situations like at cocktail parties. Here a hearing aid on one ear, wirelessly combines its two microphones with the two on the other ear to form a four microphone array. This is the latest innovation and has been available in limited brands, first released publically around 7 years ago.
This provides maximum pickup in a narrow beam in front of the hearing aid user, while offering maximum suppression behind the hearing aid user. More modern versions of this can automatically trigger and follow the loud noises behind you.
Super Directionality is only available in limited brands, most notably Phonak ( Belong) has 2nd Generation Super Directionality) and Signia (Primax and Nx has 1st Generation Super Directionality). Not all models within the brand has this premium feature.
Oticon has released a new take on directionality, using its new Open Sound Philosophy. This is only available currently in Oticon Opn hearing aids. They claim that directionality as we know it is dead. They do seem to be onto something but clients seem to do well with Super Directionality or Oticon’s Open Sound strategy. We recommend choosing a clinic where both are available.
Note: Directionality requires hearing aid microphones to be spaced about 9mm apart to be effective. For this reason, it tends to be available only in hearing aids with sufficient space to house the microphones. So as a rule, they are not available in Completely-in-the-canal or Invisible in the canal hearing aids. One exception is Signia 7PX CIC, which wirelessly connects the two single microphones in each hearing aid (Left and right) to form a directional microphone with two microphones. The directionality is not as good as with two microphones, but is better than nothing.
NOTE: The better a hearing aid’s directionality, the more expensive it tends to be. Not everyone requires top end directionality to do well however. The only way to know is to undergo a speech in noise test and have your score matched to a hearing aid’s performance in noise. You can read more here about improving your hearing in noise
It is also critical you work with the hearing aid to get the most out of its directional microphones. Basically, keep noise to your back and the person you are listening to, to your front.
Multi-Base Automatic Switching – for best automatic performance and less need for manual program changes
This one is likely to cause a bit of controversy as most manufacturers DON’T offer this feature. The reason for this goes back to the early days of digital hearing aids, when it was technically very difficult to create a multi-base automatic hearing aid without some serious performance issues. Most manufacturers chose single base automaticity as the foundation of their digital strategy. A brave few chose the more complex multi-base automatic system as their foundation.
To understand Multi-Base Automaticity, you first need to understand its counterpart, Single-Base Automaticity. Single-Base Automaticity means that the hearing aid, which is essentially a computer dealing with sound, has a single set of features active for its automatic program based on a few core settings like compression (how it deals with different levels of sound) and frequency response (how it corrects for your hearing at the different pitches).
When an environment is encountered requiring an automatic change, those underlying strategies stay the same, but adaptive features like noise reduction or directionality are increased or decreased.
A big advantage with this approach was that it was relatively easy to do without causing any noticeable switching effects to the end user. The big disadvantage is that if a setting required any underlying changes to the core processing, such as those required for music, then a manual program would need to be used for optimal performance.
Another limitation to the clinician would be that if a client has issues in one situation that is automatically adapted for eg. background noise, they were left with one of two choices. They could either change the noise settings and hope that all the other situations will remain acceptable or they would have to create a manual program to address that single situation. This essentially means that the hearing aid is semi-automatic.
Multi-Base automaticity essentially switches the hearing aid automatically from one set of core features to another (Automatic program switching). So not only can the adaptive features change, but the frequency response and core compression characteristics can change automatically. This approach is much more automatic than single-base systems.
In the past, the biggest disadvantage was that hearing aid users could hear the hearing aid switch from one program to another, which was quite unsettling. With each generation, hearing aids became ever faster and new strategies like the blending of programs gradually got rid of the side effects all together. Today you can experience smooth transitions with optimal automatic functioning without compromise.
The biggest advantages of modern Multi-Base Automatic hearing aids are that each automatic program can be changed independently of any other. This means, if you have difficulties in noise, the clinician can confidently change only that program without any concern of changes to programs that are working well. The clinician also has very little need to add manual programs, which in turn means less manual fiddling from you, the user.
Availability of Multi-Base Automaticity:
Hansaton (Post Sonova Acquisition models)
Why don’t other manufacturers just switch to Multi-Base automaticity?
Most manufacturers tend to build on features from their previous generation hearing aids. This means that the next generation has all the features of the previous one PLUS MORE. To change to a completely new core digital strategy would mean that much of what was done previously would have to be discarded and they would likely have to start everything, from scratch. They basically have too much to lose as they have to learn or licence what they don’t know about making Multi-base automaticity work effectively. They also run the risk of alienating the clinicians who are used to the way things have always been done.
Some manufacturers like Siemens (now Signia) have tweaked their single-base automatic system to allow a change to the frequency response and a few other criteria in its automatic settings, which is an improvement on other Single-Base Automatic systems. They do not however allow the full flexibility of a true Multi-Base automatic system and manual programs are still required at times.
Exceptional Sound Quality – Improved speech clarity, better music enjoyment and less distortion in loud environments
Digital Hearing aids have always had pretty good sound quality, but over the last 24 months we have seen some impressive advancements in how sound is captured and processed in these miniature computers.
In the past, limitations in size, power usage and processing ability, limited the range of sound input that could be processed in a hearing aid. The limited resources available then, were focussed on speech audibility at the cost of sound quality.
This is all starting to change however. Big manufacturers have gradually been updating their hearing aid ranges with much more powerful processing, allowing them to deal with a wider range of incoming sound. This greatly improves their sound quality, especially for music. It also means less distortion in very loud environments.
The top rated manufacturers regarding sound quality are:
- Widex (Unique)
- Starkey (Synergy)
- Phonak (Belong)
- Unitron (North, Tempus)
- Hansaton (Post Sonova Acquisition models)
- Oticon (Opn hearing aids)
- Signia with their new Nx range
That covers the top three features I believe one should consider as must haves in your next hearing aid. A combination of the features is better than any single one on its own through. Saying that, most modern hearing aids are far removed from their older siblings in terms of performance and quality. Beware, there are still plenty of hearing aids using old chips delivering sub-optimal sound quality.
That’s not all folks…..
The three features above are certainly key features that can make or break a hearing aid in today’s competitive market. They are Universally beneficial and would apply to any hearing aid user. There are however a range of features which, are very helpful, but apply to only a certain hearing aid users. These are listed below:
Features to reduce tinnitus:
Widex, Siemens, Oticon, Phonak, Starkey, Unitron
Powerful Features to dramatically improve hearing in Wind noise:
Phonak, Widex, Starkey, Siemens, Oticon (Opn), Unitron
Features to address severe or greater hearing loss in the high frequencies
Phonak, Unitron, Widex, Bernafon, Siemens, Starkey, Oticon (Opn)
Features to improve Phone use: (Allows you to hear landline calls in both ears)
Phonak, Unitron, Starkey
Features to greatly assist with single Sided Deafness (Wireless CROS)
The Ability to upgrade to a higher level of hearing aid later on by upgrading the hearing aid software
Wireless connectivity for hands-free mobile phone use, access to remote microphones and better television enjoyment.
Phonak, Unitron, Hansaton, Siemens, Oticon, Bernafon, Sonic, Widex, Starkey
Direct Connectivity to mobile phones:
iPhone and Android: Phonak Direct
What is likely coming later in 2018:
- Direct to Android and iPhone streaming will become more prevalent
- Full featured remote assistance – where your clinician can access your hearing aids and adjust them via your smart phone. This means less clinical visits and the possibility of adjustments in the situations you are having trouble in. Phonak and Signia appear to be first in line to release this functionality
- More rechargeable hearing aid options from various brands
- New chipset releases from selected brands
- New Power Hearing aids from Phonak