As they say in the construction industry, “It’s a small world, but I wouldn’t want to paint it.” The fact is that worldwide hearing health care will always take a backseat to issues like feeding children and eradicating life-threatening diseases in impoverished nations. But that doesn’t absolve hearing care professionals, professional and consumer organizations, government agencies, and others (including editors) of their obligation to promote worldwide hearing care. At the recent Self Help for Hard of Hearing People (SHHH) Convention, Donna Wayner, PhD, moderated a panel that presented a world view on hearing care, summarized in the article starting on page 18. What emerges is that the quality of hearing care and support for hard of hearing people in the different countries ranges from “pretty good” to “nonexistent.” The article also shows that the US, when compared to other countries like Israel, can do a better job at providing resources in the pursuit of caring for its hearing-impaired population. Currently, aid to hard of hearing people in the so-called “Third World” falls chiefly on the noble efforts of various organizations (eg, Starkey Foundation, Lion’s Club, Sertoma, etc), hearing aid manufacturers, and individual dispensing professionals. But it’s evident that there is a great need for supporting larger entities (eg, the World Health Organization) that can help provide worldwide hearing care—and preventing people from having to live their lives in silence.

• A future staple of AR? The individualized care that a patient receives largely shapes the success and satisfaction he/she will have with the hearing device. Working with the patient on overcoming listening challenges is part and parcel of the job confronted by any good clinician. However, practical limitations exist relative to how much time you can spend with patients, as well as how well patients can accurately describe their complex listening needs. I believe the computer-based Listening and Communication Enhancement (LACE) system, developed by Robert Sweetow, PhD, and colleagues at the University of California, San Francisco (p 56) may be a first of its kind in what will become an entire class of vital, interactive training tools that supplement the AR process. With the possible exception of Scientific Learning’s Fast ForWord—a computer program that artificially slows down speech in order to retrain the temporal processing of the brain—LACE is the first interactive program designed (primarily) for the dispensing field that has been developed to retrain the brain to better utilize residual hearing abilities. Although it remains to be seen if LACE is successful, the concept of revitalizing a patient’s “acoustic acumen” and honing listening skills through interactive exercises is a logical one, and it holds great promise as a tool in the future of AR.

If physical therapists can train people to rebuild their muscles and adjust their movements to compensate for physical weakness or injury, why can’t hearing care professionals use interactive exercises to train people to use hearing aids more effectively and adjust their listening habits to compensate for hearing loss? In fact, AR is physical therapy for the ears. This type of approach, if successful, could ultimately present new opportunities, and even help create a hearing care subspecialty (eg, aural rehabilitation therapist). Don’t miss the article on LACE in this issue.

• Why are hearing aids so expensive? Everyone in hearing health care has heard this question. In last month’s HR, veteran dispenser and educator Roy Bain suggested answering a patient’s negative comments about price with an affirmative statement like, “Yes, everything is too expensive these days. I can remember when gas was 19¢ a gallon, but that’s the way life is.” The goal in addressing this issue, according to Bain, is not to turn it into an objection that requires 2 hours of explanation to overcome. Having said that, in this month’s issue, Jay B. McSpaden, PhD, offers an article intended for dispensing professionals that might help to bolster their case further. It shows that, although overall prices have gone up significantly due to the rapid acceptance of advanced technology, today’s hearing aid prices are still in line with historical norms. Further, McSpaden shows that, after adjusting for inflation, you can buy a comparable analog hearing instrument for less than you paid in 1980—and you’ll get a lot more features and benefits from the current hearing aid. Although Bain’s approach may be the practical one for counseling, arming yourself with the facts regarding hearing instrument pricing may also prove to be helpful.

Karl Strom
Editor-In-Chief