Hearing Aid Technology Levels & Features
What You Need to know about hearing aids
A plain speaking guide to what they are, what they do and what benefit you can expect in your day to day life.
Let's Talk Hearing Aid Technology
Talk about spatial this and binaural that making your head spin? Damned noise thingy and chipset rubbish talk driving you a little twitchy. Well, we hope we can help you out there. We want to explain what these the features are and why technology levels matter. Except we are going to try and do it so you don't need a masters in physics to understand us.
Once upon a time there was three hearing aid technology levels, what were known in the profession as low end, mid range and high end. Then many of the hearing aid manufacturers introduced four, loosely they are called, basic, standard, advanced and premium and that is the designations I will use here for clarity. Let's take a look at those levels and what you can expect from them in general.
Every couple of years a hearing aid manufacturer releases a new product range, once it was every four years but it seems to have accelerated to every two years. For clarity, a product range may be referred to as a chipset, a platform or a family by differing people within the profession. Each new product range will have four levels of technology.
We said that there used to be three technology levels in hearing aids but that had changed, we kind of feel what the manufacturers have done in most cases is actually split the mid range into two levels. A lower mid range which is what we are calling standard and a higher mid range which is what we are calling advanced. Normally within each technology level there will be every hearing aid type that they produce.
For instance, widex have introduced their new product range the Unique, the Unique product range is based on the new Unique chipset and it has four levels of technology, the 440 which is top of the range or premium technology, the 330, the 220 and the 110 which is the basic level of technology.
Each of those Widex technology levels have a full family of hearing aids including custom, BTE and RICs. Nearly every manufacturer offers hearing aid products in this manner, some use different names to mark different technology levels but most use some sort of name and numeral combination. Phonak like to confuse everyone by giving their hearing aid types different names, but at least they stick to the numeral using the number 90 for their premium top of the range devices, 70, 50 and finally 30 for their basic level.
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How Hearing Aids Work
Before we launch into the different levels of technology, let's talk quickly about what hearing aids are. Hearing aids have changed dramatically over the last few decades with the advent of digital technology. At their core, hearing aids have always been made of the same four basic parts: a microphone, a processor, a receiver (the speaker), and a power source (the battery). In simple terms, the microphone picks up the sounds and passes it to the processor. The processor enhances the signal in accordance with its programming and delivers it to the receiver which delivers the amplified signal to the ear canal.
The power source delivers the power needed to make the magic happen. The introduction of digital technology transformed hearing aids allowing manufacturers to introduce ever more powerful processors in smaller packages. In modern hearing aids, the signal picked up by the microphone is converted from analog to digital before being processed, this allows for a much deeper manipulation and enhancement of the sound. This manipulation is how noise reduction and other hearing aid features work. The signal is then converted back from digital to analog before the receiver delivers the enhanced signal into the ear canal. It is nearly impossible to get an analog hearing aid now, it is a special order, virtually all of the hearing aids manufactured in the world are now digital.
Basic hearing aids
Each manufacturer has a basic level of technology and offers basic hearing aids, they may not call it exactly that but for clarity that is the label it is getting. This level of technology is designed to work for people who are relatively sedentary (don't get out much). As I have said, this might be the basic level but it will still be on the latest chipset available from the manufacturer. Basic level hearing aids are usually just that, quite basic, they will have features such as directional microphones and maybe even some noise reduction, more on both later, but generally they will be basic and they will be manually controlled. However, that is beginning to change, Phonak introduced their latest Venture platform and the basic hearing aid technology the V30 was an automatic hearing aid. It is limited to only two sound situations, but it was an interesting development none the less.
Lifestyle help from basic hearing aids technology
You can expect basic technology to help you in less complex sound situations. That means that you can expect to hear well in one to one conversations, even if the person is talking to you from another room (within reason, if you own a thirty bedroom mansion, all bets are off). You can also expect them to help you with small groups, family around the kitchen table for instance. They should also help you with TV and Radio, although both can be a little difficult because of the quality of audio from different stations. Depending on the car you drive, this level of technology should also help you with understanding conversation in the car.
Well programmed basic hearing aids will help you somewhat in limited noise. If you take the time to learn coping strategies like turning your back to noise and seating yourself in a way that minimises noise. However, once the noise level rises, they will begin to let you down. This is where our love of wireless accessories comes in, if you use a remote microphone accessory with a basic level of hearing aids it will really help you in noise.
It will give you that extra bit of help you need to hear your companion, it will also open up other opportunities to hear better in different situations. In the car you simply hand the remote mic to your passenger and you will be able to hear them quite clearly. Having issues with the TV? Put your remote mic down by the speaker, or use the cable that comes with it to plug into the audio out of the TV. By no means is it a replacement for higher technology hearing aids, but when you are working within a budget it can give you the extra edge you need.
Standard technology hearing aids
Again, each manufacturer has a standard level of technology which is second from the bottom. These devices are aimed at people who are a little more active. The features in these hearing aids will be slightly better than the basic features and are designed to help you hear in slightly more challenging sound situations. This level of technology is designed for someone who is more active in their life. This level of technology has dramatically improved over the years, to give you an idea, the current hearing aids at this level would easily be as good as flagship models from five years ago.
Lifestyle help from standard hearing aid technology
You can expect all of the help that a basic hearing aid would deliver but better, and on top of that you can expect help in group situations, small meetings, out and about at the shops and in restaurants. Again, this is based on the noise levels present, this level isn't going to help you to hear well in a very noisy restaurant on a Saturday night, think moderate levels of background noise in most situations. Again, wireless hearing aid accessories can make up for any difficulties in different situations and you should also consider them. We believe they are worth the extra expense in most cases.
Advanced technology hearing aids
This level of technology is ideal for active people delivering good sound quality and speech clarity in most situations they will find themselves in. This level of technology has dramatically improved in the last few years, it seems that most of the manufacturers are keeping a lot of their top end technology features in the advanced ranges. They are dumbing them down slightly, but not much, it has been interesting to watch especially over the last year. For instance, the Widex 330 is almost as good as the 440 range and the Phonak V70 is almost as good as the V90 range. There are clear differences between them and there are valid reasons why you would choose the higher end technology but they are close nonetheless.
The main differences between this level and the next up is the binaural processing of hearing aid features. Put simply, hearing aids work exceptionally well when they make decisions as a pair, this extends to the features involved in delivering better hearing. In the flagship models of all brands most of the features are applied by the hearing aids in a combined and consolidated manner because of the communication between both hearing aids. This really does deliver the best and most natural sound and clarity. Advanced technology level hearing aids may have most of the top end features, but they don't work together in that combined way, nevertheless, they are exceptional hearing aids generally.
Lifestyle help from advanced hearing aid technology
Again, you can expect all of the help you get from the two previous levels of hearing technology but better. Advanced hearing aid technology can be expected to assist you in even complex sound situations, especially if you use coping strategies well. Usually at this level you can expect real help with hearing better in situations like large auditoriums, open plan buildings like churches. You should be able to hear quite well at the theatre, music should be a far better experience. In general, speech clarity in noisier situations should be pretty good. So if you are an active individual who likes to socialise, goes to some meetings and gets out and about to social events, these may well be the hearing aids for you. We know we are boring you with our obsession with wireless accessories, but hey good honest advice remember? Yes, wireless accessories that are chosen with the situations you really want to hear in will help you even more.
Premium level hearing aids
This level of technology is where the hearing aid manufacturers deliver all of their very latest features. This level of technology is for people who simply have to hear well in almost every situation. They are designed to handle the most complex sound situations and deliver the best speech clarity and most natural sound. In this level the hearing aids will truly work as a pair, deciding on how the sound is processed to deliver the very best hearing possible. The decision making process and the application of the hearing aid features is undertaken in a binaural manner and because it uses the power of two separate processors these are always the most powerful hearing aids available (in computing power).
Lifestyle help from premium hearing aids
Pretty much what you would expect, everything that the rest can do but exceptionally better. Premium hearing aid technology is designed to deliver the very best possible hearing and speech clarity in even complex sound situations. These type of devices are designed for active people who need to hear well everywhere. Remember though, even at this level of technology you will not be delivered super hearing, hearing aids are designed to give you the best experience with your residual level of hearing. They are not designed to, nor can they give you back your normal hearing or better than normal hearing. Oh and yes, wireless accessories are still an option worth thinking about even at this level.
Let's Talk Hearing Aid Features
Technology levels and hearing aid features are linked, the better the technology level, the better the feature that is used. The feature set of any hearing aid is dependent on the level of technology of the hearing aid and the manufacturer. The flagship or highest technology hearing aids from each manufacturer have the best feature set available from them. First of all, when we speak about features in the profession, we are usually not talking about physical features but hearing aid algorithms or mini programmes that run on the processor. The easiest way to understand is compare it to a smart phone, a smart phone runs on an over all system like Google's Android or Apple's IOS, however within that system there are apps available to you that do different jobs.
Hearing aids and their features are not unlike that concept. Many people get a little snowed under when they try to understand features and we can understand that. Modern digital hearing aids have a ridiculous amount of different features that are designed to deliver differing levels of benefit to hearing aid users. All modern hearing aids will have some mixture of different level of features so we are going to try and investigate them and tell you in plain language what they actually do. Please forgive me in advance, I am a nerd and this stuff excites me.
What are the real world benefits of hearing aid features?
As I discuss the hearing aid features I will try and translate them into real-world benefits for you. Just explaining what they are and what they do is simply not enough. So without further blah, let's have a look.
What are audible indicators in hearing aids?
Right at the basics, an audible indicator informs you of some sort of change in the hearing aids you are wearing. For instance, if you change the programme, or if the volume control has changed or that your battery is running low. In most hearing aids these tones are usually a beep or melody type sound. Widex is one of the only manufacturers that employ real speech to announce the programme that you are on and whether your battery is low. They have even made this feature available in many world languages. These is a clear indication of why Widex is a little different to everyone else, they think clearly about the little details that would help. They are one of the very few manufacturers to use this feature and it is available across their range of hearing aids no matter what the technology level.
What's the advantages of audible indicators for you?
Audible indicators allow you to know what is happening in your hearing aids at any one time, for instance, you enter your favourite restaurant and it is busy. You know that your hearing health professional has set up programme two for just this very situation, so you switch your hearing aids to it. You hear the two audible beeps and you know immediately you are at the right settings. It is still a bit loud though, so you turn down the volume a bit, the sound of the descending beeps let you know it is working. Simply put, audible indicators allow you confidence that you are using the hearing aid properly.
What are listening programmes in hearing aids?
Many hearing aid manufacturers offer listening programmes in their hearing aids. What they are is a differing number of pre-set listening situations that are programmed into hearing aids. Each listening programme has its settings optimised for different listening conditions / sound environments. The different listening programmes can then be selected by the user using a switch or push button on the hearing instrument or via a remote control The listening conditions are usually set as speech, speech in noise, music and acoustic telephone.
What's the advantages of listening programmes to you?
Apart from the obvious one of offering better hearing in differing situations there are other advantages. For instance, your hearing healthcare professional can make adjustments for just one situation in isolation without making global changes to how the hearing aids work. This means that they can target changes to help you hear better in the situation you are having a problem with, without affecting the working of the hearing aids in other situations where you are doing fine. In essence, the more programmes, the better the customisation of the hearing aid for you.
For a real world instance you leave the house in the morning with the children in the back of the car, so you change the listening programme to the one that focuses to the back so you can hear them clearly, all though in fairness after you did it, you wish you hadn't!. After dropping them off you have to meet your friend in the coffee shop, the shop is busy so you use the programme that has been set up for noisy environments so you can hear her clearly. You are really glad you did because she has some great news to share with you and you can hear it clearly. That is the benefit of listening programmes.
What are automatic programmes in hearing aids
Many manufacturers offer differing levels of automatic programmes, what they do is automatically select the optimum instrument settings without the user having to push a button or use a switch. The management systems of the hearing instruments analyse and identify the current sound environment. The management system decided what is the best set of parameters for you to hear better in that sound situation and then automatically switches the parameters within the hearing aids to the appropriate settings. The amount of automatic programmes on any hearing aid is dependant on the manufacturer and the technology level.
What's the advantages of automatic programmes to you?
Automatic programmes deliver real advantages, in essence the hearing aids are always working to deliver the best possible sound quality no matter where you are. They do so seamlessly and without any input from you, which means you can just concentrate on getting on with your life. In most manufacturer's hearing aids these automatic programmes can also be individually altered or fine tuned for your preference. Most hearing aid manufacturers would also offer manual listening programmes along side their automatic function. Again this delivers the benefit that your professional can deliver the exact customised settings you need for just one situation.
Binaural synchronisation is something that has only recently entered the lexicon of hearing aid terms with the advent of wireless communication between hearing aids.In essence it means that the hearing aids communicate wirelessly to ensure that the settings are synchronised.
What's the advantages of binaural synchronisation to you?
It is a hugely useful feature that was introduced several years ago. At it's most basic, this feature ensures that the current user settings are synchronised across the two hearing aids. So if you make a change on one hearing aid, such as the changing the listening programme or volume control setting by touching the button. It is automatically changed on the other to reflect this. This means that the two devices are always in the same programme and at the same volume level.
However, it is at it's most advanced where it dramatically improves the lives of hearing aid users. Binaural synchronisation at it's most advanced makes sure that every feature of the hearing aid is working in a combined manner to deliver the very best listening experience. This really is exciting stuff because it is responsible for the huge advances in hearing aids in the last few years. It is also the reason why hearing aids have become more natural sounding (told you I was a nerd). When someone speaks about this technology to you, be sure to be clear exactly what it synchronises.
Again the advent of this feature was enabled because of the advances in wireless communication in hearing aids. Widex were first to introduce it in their flagship Clear hearing aids in 2009. Most of the manufacturers have followed suit in more recent times introducing the feature under differing names. Hearing aids that use binaural compression work as a combined system to deliver enhanced sound as naturally as possible. This is achieved by using both hearing aids to assess the surrounding sound environment. This information is then shared between and used by the hearing aids in a combined manner. This mass of information allows the hearing aids to make decisions on sound output as a true pair or system.
What's the advantages of binaural compression to you?
The system uses natural sound cues such as temporal effects (time differences in sound) and the head shadow effect (differences in sound from one ear to the other) to assess exactly what is going on in the sound environment. It then re-produces those sound cues in the enhanced sound you receive to deliver the most natural sound experience. All of this happens instantaneously without time lag. Because the natural sound cues are preserved, your brain gets the optimum information possible in order that it can do, what it does naturally. Remember, the ears just carry sound, it is the brain that makes sense of what you are actually hearing. I really think that this is the most exciting feature that has been released in recent times. As this feature evolves, it will make hearing aids better and better, achieving benefits for most users that were un-imaginable.
Compression channels have kind of fallen out of favour in the recent past as a sexy talked about feature because of two reasons. The first is that they are actually hard to explain without resorting to gobbledygook and the second being that sexier more understandable features have come about. However, they are still fantastic features and it is worth me trying to explain what they are. Okay, this is pretty technical stuff, but I will give it a go to make it intelligible. Compression channels are designed to change how different frequencies of sound are amplified. Compression channels are divided into a number of channels that are used to restrict or change differing levels of amplification within one sound frequency. For instance, you may have problems hearing sounds below 40dB in one channel.
However, the amount of amplification we need to deliver to you to hear those sounds clearly is radically different to the amount of amplification that we may have to add to a sound of 65 dB. Compression channels allow us to add varying levels of amplification to the varying volume of sounds. The feature is used to programme the hearing aid to amplify or reduce the range of noises that you hear. This feature simply allows us to customise the hearing aids to your hearing loss in a better manner. Some hearing aids have more channels/bands than others.
What's the advantages of compression channels to you?
Simply a better customised hearing aid which is the foundation that everything else relies upon.
Data logging is a feature which records different sets of information during the hearing aid’s use. Most hearing aid manufacturers offer data logging of one type or other with differing levels of data captured. This information is available to be analysed by the hearing professional when they connect to the hearing aids. This type of information allows a professional a deeper understanding of your experiences.
What's the advantage of data logging to you?
It can assist in the fine-tuning of the aid to your preferences. The data recorded includes the hours of use, the types of listening environments you were in, the listening programmes you used and any volume control changes during that period. Data logging delivers information that helps the hearing professional to programme the hearing aid to your specific requirements. Anything that helps the programming of your hearing aids to better suit you, has to be seen as a good thing.
Feedback cancellation in hearing aids
Feedback is the horrible whistling that is most associated with older hearing aids and used to be the one of the biggest complaints of hearing aid users. Feedback is caused by amplified sound being re-processed, in other words sound emitted from the receiver (speaker) is re-processed through the hearing aids and it shrieks. This is exactly the same thing that happens when a microphone is put too close to a speaker.
The underlying cause of feedback is the escape of sound from the ear canal. There are many reasons for that, it can be due to a poor fitting of an ear mould or in-ear hearing aid, which allows amplified sound to escape. Earwax blockage is another frequent culprit for hearing aid feedback. Another cause of feedback is close proximity of the hearing aids to something, for instance if you place anything over your ear, a hand or hat or a person hugging you.
Feedback cancellation is a feature that identifies and stops feedback, how it does it changes from manufacturer to manufacturer and within technology levels. Suffice to say, each feature identifies the feedback and which frequency or frequencies it is occurring in. It then removes the feedback from the signal and stops the whistling. Different features do this in different ways, I won't bore you with the technical details, but if you really want to know, drop us a line and we can explain.
What's the advantages of feedback cancellation to you?
Simply put, your hearing aid doesn't whistle, you don't get embarrassed and your hearing aids work better.
Adaptive feedback cancellation
This is feedback cancellation on steroids, it is able to automatically adapt its speed of operation to improve it's performance, for example it can change how it works when you are using a telephone, listening to music and suddenly hear alarm beeps. The telephone needs strong feedback cancellation, the music situation needs very little feedback cancellation because musical notes can sound like feedback and alarm beeps is a similar concept.
Directional microphones completely changed how hearing aid users can hear in noise. Directional microphone features use the sound information supplied by two microphones, to allow the computer brain of the hearing aid to identify sound that is coming from the rear and sound that is coming from the front.
This allows the processor to reduce the level of sound coming from the rear and concentrate on the sound coming from the front. Modern directional microphone features actually enable you to change the direction of hearing as you require. You can change the focus of the hearing aids from all-round sound to being more focused on a single person or object to the front side or rear.
What's the advantages of directional microphones to you?
Simply put, directional microphones are a proven method for hearing well in noise. So they are an invaluable feature for you to have.
Adaptive directional microphones
Yes, you guessed it, directional microphones on steroids! This feature allows the null of the directional microphones to adapt, the null is where the noise source is. So the microphones detect the location of the strongest noise source and adapt the sound to reduce your perception of that noise. If the noise source moves the the system adapts to keep that noise source reduced. Most of the modern adaptive systems work in more than one frequency band, meaning that they can help to reduce your perception of several different noises at one time, even if they are all moving at different positions once they are at differing frequencies.
What is the advantage of adaptive directional microphones to you?
Bigger, better, proven method to help you hear in noisy environments!
Automatic directional microphones
This is feature just automates the directional microphones completely, it allows the processor to select how it will use the directional microphones according to the sound situation you are in. In a quiet situation they will operate in an omni-directional mode (taking in sound from all around) and directional mode or adaptive directional mode if available, when a noise source is introduced.
What's the benefit of automatic directional microphones to you?
Complete automation of what is an outstanding feature, you get to hear well in every situation without any input. It just happens automatically. each manufacturer has its own flavour of directionality, where possible we will explain what it is clearly.
Frequency bands in hearing aids
Again, like compression bands or channels this one is a little bit in depth. Frequencies, as we will discuss them here, are the way that sound is split. The total frequency range of a hearing instrument is divided into a number of bands or channels in which the gain that is provided can be customised to your hearing loss. A quick but worthwhile side note here, the frequency band width of hearing aids can be very different. What that means is that the amount of sound frequencies that a hearing aid can process can be very different from manufacturer to manufacturer.
Some hearing aids can only process sound frequencies between 200 Hz and 6 kHz, others can process between 100 Hz to 11.5 kHz. Why is this important I hear you ask, while human speech is normally between 200 Hz and 4 to 6 kHz, for the full and rich enjoyment of music, a much wider bandwidth is more desirable. Hence, if you are an audiophile, you might well appreciate the wider bandwidth.
Back to frequency bands, each manufacturer is different, some hearing aid manufacturers call them bands and some call them channels and some manufacturers offer more than others. The bands allow your professional to programme the hearing aid in a more customised way for your hearing loss. The more frequency bands that the aid has, the finer the programme can be, so you end up with crisper, clearer hearing.
Most features of hearing aids work within the bands, so the more bands there is in the instrument the more bands that the features in the hearing aid work across. How many bands are best? There is a lot of debate about that, but it is generally agreed that any amount between fifteen and twenty is optimal, that's why you will find most flagship hearing aids have numbers of channels or bands in that range. For instance Widex flagship hearing aids have fifteen channels, however GN ReSound believe have seventeen channels.
What's the advantage of frequency bands to you?
The more frequency channels or bands a hearing aids have the better, although after twenty the benefit starts to fade. The more channels or bands, the better the customisation and the better experience that other hearing aid features will supply. Simply meaning that you will receive optimal benefit from your hearing aids.
Hearing aid noise reduction
This is probably the feature that drives most interest, it is often discussed as a feature that makes speech clearer in noise. Generally, it actually doesn't quite do that exactly. Only one manufacturer, Widex, have actually ever produced a noise reduction feature that affects signal to noise ratio. Signal to noise ratio or SNR to geeks like me, is used to measure the ratio of signal (speech) to noise. So the actual measure of any feature that helps you to understand speech should be SNR.
What most noise reduction features actually do is to reduce the amplification of non-speech sounds in an effort to allow better understanding of speech sounds. This tactic makes it more comfortable for a user in noisy conditions by reducing the background noise, for example in traffic noise in the street, a busy pub or restaurant. There is a lot of evidence that this reduces fatigue, reduces the amount of concentration you have to have and therefore actually does help you hear speech a little clearer. As with all features, not all noise reduction is the same and the more high end technology has better strategies to deal with noise.
What's the advantages of noise reduction for you?
A better chance for you to understand speech in noisier environments, in combination with a good directional microphone system it will dramatically improve your experience.
Speech enhancement is another feature designed to help you hear speech clearly in noise. It is used in combination with noise reduction to better help you to hear those important speech sounds. The processor in the hearing aids identify speech signals and enhance or amplify them. It analyses sound signals and, where most noisy maximises the speech signal.
What's the advantages of speech enhancement for you?
In combination with noise reduction and directional microphones, it allows you the best opportunity to hear speech in noisy sound situations.
Transient noise reduction
This is simply a noise reduction feature that concentrates on identifying and suppressing impact or sudden sounds, such as shutting doors, clattering dishes and glass breaking. The feature is designed to do it without affecting the speech clarity. It is known by many names across different hearing aid manufacturers. No matter what it is called, it allows the hearing aid to process sudden or loud noises in a more comfortable way for the user.
What's the benefit of transient noise reduction for you?
A much more comfortable listening experience for you as you go about your daily life.
Wind noise reduction
It is exactly what it sounds like, it is a noise reduction system that reduces the sound of wind cavitation on the hearing aid microphones. This feature is particularly useful for people who like to be in the outdoors. So if you are a golfer or a hiker, it is something that you should consider.
What's the benefit of wind noise reduction for you
It will make it mush easier for you to tolerate being outdoors if you are an outdoorsy type, golf and such things, it is an invaluable feature.
I have covered much here and I hope I have made it clear and easy to read, however, if I have not, or if you are looking for more information, don't hesitate to contact us with your questions.