For decades, people have had this thing about hearing aids: They didn't want to wear them and, if they did, they didn't want anyone to know.
"We've been dispensing hearing aids for two decades, and there's always been some resistance to dispensing to someone who's never had one ... [and] the chance of them keeping it or using it is 50 percent," said Dr. Douglas Chen, director of Allegheny General Hospital's division of neurotology and medical director of its Hearing and Balance Center.
"The size of the social stigma is out of proportion compared to that of eyeglasses, canes, walkers and wheelchairs."
Happily, however, Dr. Chen said, that stigma is beginning to dissipate.
"Three years ago things started to change, and I think it was for three reasons," he said. They are:
• Development of the "open canal fitting hearing aid," a smaller and more comfortable device than the old aids, which totally occluded the ear canal, causing an echo. The open canal aids leave part of the canal open; there also is a model that fits in the crest of the ear, leaving the entire canal unobstructed.
• Development of the Bluetooth technology that resulted in colorful wireless receivers for telephones. "People started wearing these colorful devices in their ear, and all of a sudden the stigma was no longer. It became cool to have a Bluetooth thing in your ear," Dr. Chen said. Now the hearing impaired can buy hearing aids in bright shades of green, blue, red and pink or even leopard print. "You don't know whether someone is wearing a Bluetooth or a hearing aid."
• A "younger generation that sees little things that don't look like hearing aids but accepts that," Dr. Chen said. "It hasn't grown up with a stigma of being hearing impaired. My father's generation has the stigma. I'd say [it's] those 60 and above. Anybody who has grown up in the computer age is more [accepting]. With teenagers there's hardly any resistance at all."
Someday there may not be any reason to resist. There are implantable devices both Federal Drug Administration-approved and investigational, and AGH has experience with both, Dr. Chen said.
Meanwhile, hearing aids of all styles have evolved in other ways thanks to developing technology, said audiologist Denise Hoysack, of the Hearing and Balance Center.
Batteries have gotten smaller, allowing aids to be made smaller too, she said. Hearing aids with rechargeable batteries also are available.
But a much bigger development began about a decade ago with the arrival of digital hearing aids, which means they are computerized. Until then all hearing aids were either analog, which increase all sounds at the same rate, or programmable.
"[Digital] hearing aids are now communicating to each other," Dr. Hoysack said. "They're automatic, too. ... They will decide what [sound] needs to come through. They think."
The hearing aids also do data logging and data learning, she said.
Data logging allows audiologists, for example, to track such things as how many hours an aid has been worn, how often they have been worn in loud situations and how often they are switching into noise programs. "Customized adjustments to the hearing aid settings can be made off what I learn from the data logging," Dr. Hoysack said. Data logging has been around about three years.
Data learning has come into use in the last six months, she said. "They learn what your habits are. For example, if you take the volume up two notches for a while, [the hearing aid] will start doing it. That is new. That is very new. Data learning is on the top, top hearing aids. ...
"They're definitely getting more intelligent and sophisticated and giving more hearing help," Dr. Hoysack added. "They're still not as good as natural hearing, but they're very close."