The Online-Hearing Test provides a reasonably reliable estimate of hearing loss in the critical speech frequencies from 250 Hz-4000 Hz. The test is available at www.apherma.com/web2004/test.htm. It must be stressed that this test is designed for screening purposes only; it is not intended to replace the more accurate traditional assessment performed in the clinic by a qualified hearing care professional.

The true value of Apherma Corporation's Online-Hearing Test is in creating new opportunities for helping hearing-impaired listeners to recognize their hearing loss. The Online-Hearing test is most useful in getting a reluctant friend or family member to overcome the denial of his/her hearing-related problem and seek professional help. It will also generate referrals for audiologic evaluations and hearing aid fittings. And it does this through an actual listening test rather than through the more conventional “pencil and paper” behavioral based tests.

The Online Hearing Test is available at www.apherma.com/web2004/test.htm. For more detailed information on the test, see the article by Zezhang Hou, PhD, and Huanping Dai, PhD, entitled “An Online Hearing Screening Test” in the October 2004 Hearing Review, pgs 48-49.

Introduced at the AAA Convention in Washington, DC, SwissEar is the intelligent combination of the accuracy of ChannelFree™ digital sound processing with OpenFit™ technology to provide a high-frequency open fitting solution. The new hearing instrument is designed to be unique not only in signal processing and for its directional microphone, but it is also an exceptional solution for the first-time high-frequency hearing loss patient who may need more amplification in the future. Bernafon’s OASIS plus™ software allows the clinician to convert the SwissEar into a full-gain behind-the-ear directional fitting solution in your office via a software setting and a physical ear hook change. SwissEar™ is available this month (July 2005).

Bernafon LLC also announces another innovative hearing solution for your patients with the introduction of Win™ in the basic digital product segment.

Win is the most competitively priced digital hearing solution from Bernafon, allowing hearing care professionals to reach significantly more people—even those with limited budgets. For additional information on all of Bernafon’s products, contact (888) 941-4203, or visit the company’s Web site at www.bernafon-us.com.

Over 45,000 practices across the nation have found that offering their patients financing through CareCredit—instead of billing—is a solution that benefits them in many ways including:

• Increased acceptance of optimal technology.
• A more satisfied patient that starts care immediately.
• Significantly fewer returns.
• Reduced Accounts Receivable.
• Receipt of payment at time of treatment, with no recourse even if the patient delays payment or defaults.

CareCredit has provided convenient payment options to over 3.5 million patients, helping them receive the optimal hearing technology they want and need, without the need to delay care. CareCredit has a plan to fit any budget, including 3, 6, 12, or 18 Month No Interest options and 24, 36, or 48 Month Low Interest Extended Payment Plans.

To get started with CareCredit call (800) 300-3046, ext 4519. Call by August 31, 2005 and you’ll receive 50% off the one-time set-up fee.

With the modulated Digital Speech and steady-state composite signals available on FONIX analyzers, a simple test can be made to determine if the noise reduction feature is working on a digital hearing aid.

The first step is to record the gain response using the steady-state composite signal and obtain a gain response of the hearing aid. In this step, the signal may need to be applied for a period of up to 30 seconds before the noise reduction feature activates. The next step is to switch to another curve and use the digital speech signal, using the same amplitude of drive. This signal, when left on for the same length of time, should not trigger the noise reduction feature. An example is offered below, using the FP 35 analyzer.

With a FP35 analyzer, from the opening screen:

1. Select COUPLER MULTICURVE mode (F3).
2. Select Composite Signal for the Source (with F4).
3. Select a level of 70 dB SPL (UP and DOWN buttons).
4. Connect the hearing aid to the proper 2cc coupler and press START.
5. After 30 seconds, stop the test and press F2 for the next curve.
6. Again, select 70 dB SPL but use the Digital Speech signal (with F3).
7. Repeat the test. The gain should not be reduced with time.

Five Steps to Patient Satisfaction Fitting ReSoundAIR and ReSoundAIR Plus with Aventa 2.0

Step 1. Connect the hearing instrument to the CS63 programming cables and flex strips. Click on the “What’s Connected” button in Aventa 2.0 software to read the model and serial number from the hearing instruments.

Step 2. Reconfigure the hearing instrument, if desired, by clicking the “ReConfigure” button in Aventa 2.0 software. Reconfiguration downloads the algorithms for either ReSoundAIR or ReSoundAIR Plus* into the instruments. When reconfiguration is complete, click on the “What’s Connected” button in Aventa 2.0 to identify the current configuration of the instruments.

Step 3. Proceed to the fitting screen by clicking the “Fitting Tab” 2.0 on the far left in Aventa 2.0.

Step 4. Aventa automatically establishes a real-time connection with the hearing instruments upon entering the fitting screen. When prompted to run Stabilizer DFS, choose “Yes.”

Step 5. To program the hearing instrument, click on the “End Session” tab to access the program icon. In the End Session window, click the “Program” button in Aventa 2.0 to save all settings to the instruments.

*Note: To enable the Bass Boost Handles for ReSoundAIR Plus, click on the “Physical Properties” icon to access and select the “on” option for Bass Boost Handles.

With the advancement of digital technology, many hearing aids require advanced stimuli or special test setups to appropriately assess their true performance. The Affinity’s Hearing Instrument Testing software module (HIT440) has a flexible and configurable menu to customize unlimited hearing aid tests as well as current ANSI standardized tests. With this software, you can easily run multiple intensities and/or frequencies for response curves and input/output functions to access all of the possible affects of AGC circuits in multiple bands.

While the HIT440 comes with a standard set of stimuli, including ICRA sound files and speech dialogue using male and female voices, in future applications other test stimuli may be developed by hearing aid manufacturers which can then be imported via WAV files and stored within the test setups. Other special applications allow testing of directional microphones, and you can program hearing aid processing delays as well. A unique “Pause” feature provides the ability to insert a JPG photo with instructions prior to running a section of the test. For example, a reminder can be inserted that would tell the tester to either minimize or maximize the AGC circuit of a hearing aid in order to comply with the new ANSI procedure.

In addition, hearing aid manufacturers may have alternative settings that apply only to a particular model. In this case, a separate test configuration can be designed and named for that specific model, thereby making the test as simple as a choice from a menu and pressing ”Start.” If integrated with NOAH, the HIT440 will permit the simultaneous use of hearing aid fitting software, making it possible to see “real-time” effects of programming changes.

Children in the 3- to 5-year-old range often become frightened or confused during the traditional pure-tone hearing screening that is required by many states. Soft pure-tones can be abstract to preschoolers, whereas conversational speech is a familiar sound.

The fully portable Digital Pilot Test audiometer integrates an automated Speech Reception Threshold (SRT) test into the instrument. This allows an SRT to be quickly obtained in a screening situation for those children who have a difficult time responding to pure-tones. The test is turned into the “Pilot” game in which the child “helps the airplane pilot fly the plane” by pointing out the pictures when prompted. Digitally recorded sentences containing spondee words, such as “Show me the baseball,” play through the earphones. The child identifies the word by pointing to the corresponding illustration on the picture board. Each consecutive sentence is reduced in level by 5 dB, down to 15 dB. Since the test is designed specifically for screening purposes, the entire test can be completed in a small space without a soundroom or microphone to present the speech.

This quick screening can provide fast information regarding the child’s ability to understand speech and an idea of their hearing thresholds, since the SRT score is correlated with certain pure-tone thresholds.

For older children who are comfortable with pure-tones, the Pilot Test audiometer includes a manual air-conduction audiometer for traditional pure-tone screenings.

Syncro 2 offers an important new feature: the Activity Analyzer. This data storage functionality accumulates basic information, including the use of the different programs or the volume control adjustments made by the patient, and also presents the results of advanced environmental analysis.

The advanced analysis includes information such as the distribution of sound levels across the time that the hearing aid has been active, the proportion of the time that speech and/or noise signals are present, and the amount of time spent in the three directional modes (Surround, Split and Full Directional). The professional can access this data any time that the patient is in the office for follow-up. The data storage can be cleared at any point in time and different monitoring periods can be compared.

The data can be used for three major purposes:

1) It can be reconciled with reports from the patient concerning the needs for fine tuning.

2) It can reveal to the professional important aspects about the patient’s auditory life experiences.

3) It can demonstrate to the patient and family members the sophisticated manner in which Syncro analyzes and reacts to the environment.

Accepting a hearing loss and the fact that they need to wear a hearing instrument is a process many first-time wearers find difficult. A hearing aid that is almost invisible and occlusion-free makes it much easier to accept.

Unlike other mini products, miniValeo provides not one, but three fitting options. The two instant open-fitting options are the new Fit’nGo Slim and the Fit’nGo, introduced with Perseo Open. Although the Slim option clearly has the most cosmetic appeal, both allow for instant on-the-spot fittings.

The third fitting option is ideal for patients who need low-frequency amplification and, therefore, are not candidates for an open fitting, or those who prefer the use of an (open) earmold. Any custom earmold can be attached directly to the miniValeo earhook. With a maximum gain of 40 dB and a broad frequency response, miniValeo is also appropriate for up to a moderate hearing loss (for any hearing loss configuration).

This is also important for clients with a progressive hearing loss, who may be candidates for an open fitting now, but require a standard fitting configuration in the future. Knowing that miniValeo can adapt to changing hearing needs means professionals and consumers can feel confident in using miniValeo.

Changes for each fitting option should be entered into the PFG to ensure the best pre-calculation and a high spontaneous acceptance. During the initial fitting, an “Initial Coupling Selection” pop-up supports an easy selection of the actual applied acoustical coupling. Later changes can easily be entered in the “Acoustical Coupling” screen under “Instruments.”

Despite its tiny size, the miniValeo includes a list of features unseen in a miniature hearing system so far. These include multiple signal processing strategies, three memories, active feedback management, and AudioZoom dual microphones. This scope of benefits, particularly for sound clarity and hearing in noise, are very important when meeting the needs of consumers.

Are you looking at ways to increase patient loyalty and grow your practice? Hearing Aid Battery Clubs offer you the opportunity to do both by making batteries part of your patient relationship.

Rayovac ProLine Battery Club programs can be executed in a variety of ways: Battery Club Booklets, Frequent Purchaser Punch Cards, and Frequent Purchaser Battery Coupons.

Battery Club Booklets. These booklets, supplied free by Rayovac ProLine and customized for your office, can be used as either pre-paid or a pay-as-you-go programs. By offering the pre-paid option, you are able to secure battery sales up front with your patient and assure a contact point for future purchases. A pay-as-you-go program gives your patient the option to enjoy the savings of a battery club while being financially flexible.

Frequent Purchaser Punch Cards. Punch Cards, also customized free of charge by Rayovac ProLine, offer a simple battery club option. Handled like many other loyalty programs, patients simply receive a punch on their card when they purchase hearing aid batteries from your office. After a pre-determined amount of purchases, your patient receives a free pack of hearing aid batteries.

Frequent Purchaser Battery Coupon Program. Using a Rayovac ProLine coupon program, patients receive coupons for battery pack purchases and receive a free pack of batteries once they have accrued a predetermined amount of coupons. These programs offer you a variety of ways to stay in contact with your patients and reward them for purchasing hearing aid batteries from your office.

By taking the time to discuss hearing aid batteries with your patients and enrolling them in a battery club program, you can establish that important ongoing link that will bring them back to your office for their next hearing instrument. What an easy way to get repeat hearing aid and battery purchases directed back to you!

The SeboTek PAC style uses the most effective method of reducing or eliminating the occlusion effect—a deep canal seal (Figure 1). This instrument style seals the canal while at the same time letting bone-conducted, low-frequency energy escape from the cartilaginous region like when the ear is entirely open. Using this method overcomes the many challenges and limitations that occur with fully open canals, such as feedback, group processing delays, ambient noise interference, and decreased directional microphone performance. The PAC style creates a comfortable and effective seal at the bony portion of the canal and is clinically proven to eliminate occlusion effects (Figure 2).

The PAC speaker link does not contact the opening of the ear canal in the cartilaginous area. This deeply-fit receiver, when positioned at the bony portion of the canal, is a practical answer to eliminating the occlusion effect without compromise of acoustical benefits.

Extended microphone separation is a key element of PAC designs. PAC instruments separate the microphone(s) and receiver by a far greater distance than with traditional hearing aids. No venting is required, minimizing the most common source of feedback. The receiver is connected to the sound processor by a durable wire speaker link. Since no sound tube is necessary, signal artifacts due to narrow tube plumbing are eliminated.

The physical properties of deep-canal fitting with PAC style instruments require less amplifier gain than other instruments due to the natural increase in canal SPL of up to 18 dB by reducing canal volume. This greater output associated with deep fit means there is less amplifier gain required of a PAC instrument to fit comparable losses with traditional styles. The result is increased headroom, less distortion, increased fidelity, and a broad fitting range. (Figure 3).

The iScan will change the way hearing care professionals work. iScan lets dispensing professionals scan impressions right in their office, view 3D images onscreen, and order online with just a click of a mouse. With a seamless electronic integration that enables them to complete a customized and validated order entirely online, iScan™ is designed to eliminate the traditional barriers to productivity. There is no need for order forms, shipping hassles, or waiting. With just a few mouse clicks, an order is transmitted directly to Siemens by either the mySiemens e-business Web site or via the NOAH eTona electronic ordering system. iScan also reduces turnaround time by up to 48 hours for a quick response patients will appreciate.

iScan’s plug-and-play functionality makes start-up easy. Because iScan integrates automatically with Siemens existing e-ordering workflow, hearing care professionals can complete a fully validated order in just minutes. Here’s how:

• Scan. Place the impression into iScan and click “start.” Using high-end optical scanning technology, results are precise to the micron.
• View. In minutes, view the reconstructed 3D scan onscreen to verify the scan from any position or angle.
• Send. iScan integrates effortlessly with mySiemens e-Form and NOAH eTona. With just a few clicks, the order is sent to a Siemens manufacturing facility.

Additionally, with iScan’s digital storage capabilities, hearing care professionals now have the option to order remakes or replacements for lost or damaged instruments without the need for a new impression. 3D impressions are stored at Siemens for up to three years.

Aperson investing $5,000 in state-of-the-art digital hearing aids should not have to be told, “There’s nothing we can do to make your own voice sound more natural, but don’t worry, you’ll get used to it.” Sonic Innovations has developed a method of adjusting the frequency and amplitude characteristics of the wearer’s own voice using the intricate electroacoustic behavior of modern hearing aid fittings in order to move the perceived location of the voice to its natural position. Innova’s nine-frequency control of loud and soft speech sounds in 1 dB increments provides manipulation of perceived location of the wearer’s own voice as well as sound quality.

The “Voice Manager” tab, under “Fit Hearing Aid” in EXPRESSfit, allows the clinician to make these adjustments interactively. Ideally, the perceived location of the wearer’s own voice should be in front of the mouth, with minimized “boominess” and harshness, and no “echo.”

Select “Position” under the “Voice Manager” tab and ask your patient to count to five (preferably with eyes closed), giving the following instructions: “Try to identify where your voice sounds like it is coming from; right to left, up in your nose or down in your throat, in your head or in front of your mouth.” Based on the patient’s response, click the appropriate button. For example, if the patient says that it sounds like his/her voice is in their head and behind their eyes, first click the “Nose” button to “move” their voice downward; repeat as many times as necessary to make it level with the mouth. Next, click the “Inside” button to “move” the patient’s voice outside his/her head. The changes to the actual fitting values are subtle, but have great effect on own-voice perception. The changes can be seen in the fitting curves as small deviations from the targets.

When it comes to hearing loss, most patients want the hearing instrument that is right for them. But all too often, patients are unprepared for the cost and may ask you to recommend less-than-optimal technology. Instead, help them get the best hearing possible by recommending the SoundChoice Credit Card, offered exclusively through the Starkey family of companies and CareCredit®.

Practices have a wide range of payment options to offer patients, with financing available from $1 to over $25,000. All SoundChoice payment plans feature no up-front costs, annual fees, or prepayment penalties. Patients fill out a short and simple credit application, which is submitted by your practice via phone, fax, or online. The whole process takes only a few minutes. You can even pre-approve your patients for SoundChoice before their appointment or the financial discussion so you can present a low monthly payment option at the same time you recommend care.

Offering patients a convenient monthly payment plan through SoundChoice also benefits your practice in many ways:

• No-interest and extended-payment plans motivate the patient to purchase today.
• It is easier for patients to get the best hearing instrument without financial concerns.
• As more patients purchase hearing aids, sales and revenues increase.
• Patients are much more satisfied and less likely to return their hearing instrument.
• Your practice is paid within three business days, improving cash flow and eliminating the risk of non-payment.
• In-statement and collateral marketing and advertising support are available.
• SoundChoice is a revolving line of credit, available to patients for their ongoing care, including batteries, warranties, and maintenance needs.

Enrolling in SoundChoice is easy. Simply visit www.soundchoicefinancing.com for application materials or call SoundChoice at (800) 300-3046, ext 4519 to speak with a representative.

As directional microphone technology has improved in the last several years, hearing instruments featuring directional microphones have become more popular. A recent survey indicated that, for many dispensers, more than one-half of all the hearing instruments they sold in 2004 utilized directional microphones.

However, with new technology comes new challenges. As many hearing care professionals have discovered, a poorly aligned directional microphone may perform no better, and perhaps even worse, than a standard hearing instrument microphone. A number of studies have indicated that even minor misalignments will decrease performance, and a study released late last year confirmed that a misalignment of only 30° will result in a 1 dB decrease in directivity.

Hearing instrument manufacturers do their best to properly align the microphones, but since every ear is different, it is difficult to precisely determine the correct alignment once the impression is out of the ear. So what can the hearing care professional do to help? If the outer surface of the ear impression could be marked while it is still curing in the patient's ear, manufacturers would be provided with a physical directional cue for the placement of the microphone.

The new LevelEar from Westone was designed to accomplish just this purpose. This handy tool provides the ability to create a level indentation in the outer surface of the ear impression prior to final curing. The LevelEar is very simple. It consists of a small bubble level secured into a handheld tool that has a marking surface. After the impression is made, but before it can cure, the practitioner can check the position of the patient’s head, align the LevelEar to a level position, and simply press the marking edge into the uncured impression. The manufacturer now has a mic direction indicator on the impression, and can process the hearing instrument with solid knowledge of how it will fit in the ear relative to the horizontal plane of the patient's surroundings. (Note: Allow the patient to assume their natural posture. If they naturally slump, don’t ask them to “sit up straight.”)

This little tool can be quite effective in assisting the manufacturers in getting your patients successfully fitted the first time. And what could be better than that?

1. Start with a perfect ear impression. Make sure that the ear canal is clean before you take the impression. Also make sure the impression material goes beyond the second bend, and covers the tragus and helix areas of the pinna.

2. Ensure comfort. Make sure that the Senso Diva ITC fits comfortably in the ear and that the angles formed by the dual microphones are within 20° of each other in both the horizontal and sagittal planes. Check that the faceplate is not inserted by more than 3 mm beyond the tragus, and that both microphone openings are visible (see figure).

3. Perform Sensogram in a quiet room. An in-situ threshold measure (sensogram) at 500, 1000, 2000, and 4000 Hz is required to specify gain at these and other frequencies. Frequencies within the interoctaves can also be tested for more precise threshold specification. The expanded sensogram may be helpful for atypical audiograms with >20/octave change in hearing thresholds.

4. Conduct feedback test. A feedback test will be needed to estimate the feedback path and to set the gain limit of the Senso Diva. Make sure that the test is performed in a quiet room with no reflective surfaces near the patient. A slight “jaw-open” position is desirable.

5. Voila! You have just fit a Senso Diva hearing aid successfully. This will satisfy the majority of your patients.

Additional fine-tuning may be necessary for a small number of patients. Before fine-tuning, however, remember the following:

• Make sure that your patients have realistic expectations.
• Give the default setting a try (at least 1-2 weeks). In many cases, patients would prefer the default Senso Diva settings over any modifications.
• To understand patient objections, it may be helpful to examine some of the fine-tuning screens (ie, input-gain screen, input-output screen, frequency-output screen at various input levels, and speech spectrum screen).

Hearing aid batteries not only contribute to your revenue, but they also represent an important marketing tool of your practice. By providing your customer with a high quality and affordable battery, you may expect more personal contacts, more exposure for your business, and more loyal satisfied customers.

Unfortunately, the current trend is that more and more batteries are sold by retail outlets than by hearing care professionals. Part of the reason is simple: Consumers can buy the batteries at a much lower cost from retail chains or via the Internet. In many cases, hearing care professionals have not only lost their battery sales, but they have also lost their customers, too. That’s why a battery source like ZeniPower has been provided in order to help you compete and to get your customers back.

The ZeniPower battery is a proven high performance product. For the past 17 years it has been successful in Asia, and the company could be your best profit source for batteries and serve as a powerful marketing tool. The world’s second-highest working voltage makes it suitable for the latest digital hearing aids, as well as for cochlear implants. It is also within the top-three longest lasting hearing aid batteries in the industry, and is a world-leader in terms of economical price.

An alternative brand of batteries has proven to be quite effective for improving customer satisfaction. Providing customers with a choice in power sources makes good business sense. With the alternative of ZeniPower batteries, your customers will find a quality battery at much better pricing than even most mass-merchandising retail stores like WalMart. They will come back to you to buy this battery again and again. And, while it attracts more traffic, it will bring you more business and profits.

By selling ZeniPower batteries, you can maintain a higher margin and pass on your savings to your customers. These batteries also will promote your practice more effectively than traditional private-label batteries, battery clubs, or other rebate programs. The reason is simple: ZeniPower batteries provide top performance at an exceptional price. You will sell more batteries and get more profits, from both the batteries and the other sales that the batteries bring into your practice.

ZeniPower also provides you with private label batteries on request.