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Our hearing ability decreases naturally over time. Prolonged exposure to loud noise often worsens hearing loss, especially high frequency hearing loss. Human speech recognition occurs in the mid to higher frequencies which is why those with high frequency hearing loss cannot hear conversations that occur in a crowded room. They cannot distinguish between the voice of the person speaking to them and the background noise. This can be especially frustrating for someone with high frequency hearing loss as all they can do is nod their head at conversations directed at them at a party because they cannot hear what is being said to them.

Hearing aids can be very helpful to improve hearing loss but must be prescribed by a professional and can be quite expensive. The mean cost for two hearing aids is $4700, which is not covered by Medicare. Nationally representative estimates are that only 20 percent of adults with hearing loss report using hearing aids. But there are less expensive alternatives to hearing aids – personal sound amplification products or PSAPs. PSAPs are over the counter products not specifically labeled for hearing loss treatment, but some are technologically comparable to hearing aids and may be used to treat mild to moderate hearing loss. Recently a study was done at Johns Hopkins School of Medicine in Baltimore that compared hearing aids to PSAPs. They compared the Oticon Nera 2 hearing aid ($1910) to 5 PSAPs – Sound World Solutions C550+ ($349), Soundhawk ($349), Etymotic BEAN ($299), Tweak Focus ($269), and MSA 30X Sound Amplifier ($29.99). Study volunteers repeated sentences in the presence of background noise under 7 conditions: unaided, with the hearing aid, and with the 5 PSAPs. The testing was conducted by an audiologist using a sound booth. The sentences were presented via a speaker directly in front of the participant with another speaker creating background noise directly behind the participant.

The change in accuracy in speech understanding varied by device. The hearing aid improved speech understanding by 12 percent while the Sound World Solutions C550+ improved it by 11 percent and the Soundhawk by 10 percent. Two other PSAPs showed less improvement in speech understanding while one device, the MSA 30X Sound Amplifier, made speech understanding 11 percent worse. Although this was a small study it was the first one to compare PSAPs to a hearing aid. The authors note that had the users been able to self-program the PSAPs, as can be done with these devices, the improvement in speech recognition might have been even greater. The results of this study lend support to current national initiatives from the National Academies, the White House, and bipartisan legislation requesting that the FDA create a new regulatory classification for hearing devices meeting the appropriate specifications to be available over the counter. (This article was written several months ago. Since then, Congress passed this law and the and President Trump signed it). PSAPs may be less expensive alternatives to expensive hearing aids for those with hearing loss.

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