Susan, age 2, has a new pair of hearing aids. Her moderate-to-severe hearing loss was identified at birth due to universal newborn hearing screening (UNHS), and she has now used hearing aids for about a year. In light of the research surrounding the benefits of early intervention,¹ it is easy to understand why her parents have invested in a high-quality pair of digital aids which cost them about $3000.

However, at age 2, Susan isn’t sure about these strange things in her ears. She is too young to reason with, and although her parents have gently tried to get her accustomed to wearing her aids—offering rewards, praise, and even going to the extra expense of having the earmolds made in her favorite color—sometimes Susan has just had enough of wearing the devices and wants them off. Like most 2 year olds, she isn’t very concerned where they end up. Knowing this, Susan’s parents watch her carefully, but today her mom is on the phone and preoccupied when Susan wanders toward the bathroom, casually tosses her aids in the toilet, and—in accordance with her parents’ potty-training lessons—flushes.

A Growing Problem
Although this scenario is not an everyday occurrence, concerns about hearing aid security and protection are clearly increasing. In fact, in light of the cost of hearing instruments and the value they represent to their owners, it might be fair to say this situation is too often overlooked by dispensing professionals and the hearing care field, in general. Although this problem affects ITE and BTE (as well as cochlear processors and the external BAHA component) users of all ages, the first and probably most statistically significant groups dealing with hearing aid protection and loss issues are infants and small children.

Due to the acceptance and success of UNHS programs throughout the US, over 4 million infants were screened last year, with approximately 5000 infants being diagnosed with hearing loss. This has created a situation where there are children as young as 6 months wearing hearing aids. This is obviously good news: Pediatric audiologists are fitting more of these children at earlier ages than ever before. However, many of these children are far too young to understand the need for hearing aids, let alone understand that these aids are not indestructible. This can be the source of all sorts of difficulties and concerns for parents and caregivers.

Further, as these children grow up, FM systems are introduced—again at much earlier ages than ever before. Because the FM unit attaches to the hearing aid (or processor), there are often difficulties in achieving a secure fit. The issue of FM units being lost is becoming a problem for families and schools all over the country. As the hearing care field continues to evolve, this issue will no doubt repeat itself with the new Bluetooth attachments, as well as similar applications that are becoming popular as hearing instruments expand in wireless functionality.^2-5

Both children and adults with hearing loss, want—and often expect—to be able to wear their hearing aids during all sorts of outdoor activities, including competitive sports. These activities can expose hearing aids to sweat, moisture, and dirt, creating potential problems of chafing and irritation for the wearer, and mechanical damage for the hearing aid. Adults who work in dusty, dirty, or high-moisture environments must deal with the same type of problems. There are also ongoing concerns of the effects of insect repellents, hair spray, and other beauty aids on hearing instruments.

Another group who should be considered at high-risk for hearing aid security/protection issues is children and adults with cognitive disorders, such as global developmental delay due to genetic issues or dementia brought on by old age. At great risk for the loss of hearing aids, this group has special requirements for hearing aid security/protection due to their inability to clearly comprehend the need for, and care of, hearing aids.

There are some other factors that are worth noting when discussing the increased concern around hearing aid protection/security. First, the average cost of a hearing aid has increased substantially during the last 15 years.⁶ In the early 1990s when analog aids still held the majority of the market share and CICs had not been invented, the average price of a hearing aid was about $1000 in current dollars. Today, with the advent of digital hearing aids—in models of all sizes with many offering advanced features such as noise reduction circuitry and directional microphones—the average price is about $1900. This makes the loss or repair of hearing aids a much more expensive proposition.

Second, although ITE wearers have often been the focus of the companies offering hearing protection/security devices, BTE users also have the same kinds of concerns. The number of BTE wearers is increasing. For many years BTE’s were about 18% of the hearing aid market, and that has increased substantially over the past 5 years to close to 30%. The reasons for this significant increase include the higher use of directional microphone systems and open-fitting type hearing instruments. It is interesting to note that, in Europe, BTEs have long held the lion’s share of the market at somewhere around 75%, and several industry experts predict that the North American market will see a gradual migration towards the 50% mark.

Special Needs for Special Circumstances
As parents of a daughter with cognitive delays and a mild-to-moderate hearing loss, my wife and I experienced a great deal of difficulty keeping our daughter’s hearing aids on her ears. The initial suggestions from our hearing care professionals were to put the aids on for limited amounts of time, praise her, offer rewards, etc. After finding these solutions to be ineffective, we were offered solutions such as stiffer tubing, two sided wig tape, and it was even suggested that we might want to create some sort of homemade solution with fishing line and a bobby pin that could be attached to a small hook that we could have installed in the base of the BTE. When these approaches did not solve the problem or appeared to be unacceptable, we were finally introduced to a commercial hearing aid security device, which offered a partial solution.

We felt our hearing care professionals did not fully understand the stress we were experiencing as we vainly attempted to keep an eye on our daughter in the house, outside, and while we were visiting friends and family. To make matters even more stressful, we were forced to rely on others to keep track of our daughter’s hearing aids when we sent her off to day care.

We had many close calls. One time, her hearing aids went missing for 3 weeks only to “magically reappear” just as we were about to contact the insurance company to make a claim. It was frustrating experiences like these—as well as the day-to-day pressure dealing with the concern of hearing aid damage—that led me to develop my own version a hearing aid security/protection device.

In bringing this product to market, I discovered there were, indeed, a number of other devices that had been created to address the issue of hearing aid security/protection. In general, these devices can be separated into 1) Products that protect the hearing aid from dirt, dust, and moisture; and 2) Products that are security devices designed to prevent hearing aid loss. The products listed below all appear to represent appropriate solutions for protection and/or security concerns, and—along with the author’s combined protection/security device—are presented here as a starting-point for interested dispensing professionals and their clients/patients.

Protection Devices
Hearing Aid Sweat Band. The Sweat Band is a sock-like cover that slips over a BTE or cochlear processor BTE. It can also be used to keep FM units attached to BTEs. The Hearing Aid Sweat Band is constructed of a specially designed material that is both moisture repellent and absorbent, but does not inhibit sound. It comes in five sizes and six fairly neutral colors, ranging from white to grey. The Hearing Aid Sweat Band does not require any special tools to install and allows operation of the hearing aid controls. The Sweat Band is designed to withstand a few washings (obviously, without the hearing aid!) and then should be replaced. Available from www.vanbenterprises.com.

Super Seals. Super Seals were developed by a parent whose child was experiencing problems from moisture related to rain and sweat. This latex-rubber sock must be installed using a special tool that is included in your Super Seal starter kit. The product comes in three sizes and six colors, including neutral and brighter colors. Available from www.justbekuz.com.

Security Devices
Huggies. Huggies offers a wide range of products that will secure BTEs, ITEs, cochlear processors, bone oscillators, body aids, and more. Huggies will also custom-make hearing aid retainers for specific needs. Huggies is best known for its Huggie Aids, a circular plastic tubing that slips over the ear with two flexible plastic rings attached to it, holding the BTE in place. The ring that fits over the ear is sized in one-quarter inch increments and the circumference of the ear should be measured to get a correct fit. Huggie Aids are available both with and without the cord and clip. Available from Huggie Aids: (405) 232-7848.

Oto Clips. The Oto Clip is a stretchy plastic cord with a loop on the end that slips over the tone hook and, when pulled, tightens to create a firm hold on the BTE. Attached to the cord is a clip which secures the Oto Clip to clothing. The Oto Clip is available in BTE and ITE models (the ITE model requires a small hook to be attached to the ITE) and in both monaural and binaural models. The Oto Clip is available in a wide range of colors, as well as a model called Fun Oto-Clips—clips that have a variety of farm animals, dinosaurs, and sea creatures as part of the clip design to encourage children to wear the product. Available from www.westone.com/kids.html.

Kids Clip. The Kids Clip is a hearing aid security device numerous hearing aid manufacturers distribute as part of the care kits they provide with newly purchased BTEs for children. The device has two flexible plastic rings that the BTEs can be slipped into. These rings are attached to a stretchy elastic cord which has a clip that allows you to secure the product to clothing. Available from audiologists and other dispensing professionals.

Safe N Sound. Safe N Sound was developed by parents who had children with hearing loss and vision problems. This product also uses a flexible plastic ring to hold the hearing aids in place, and can be used with BTEs, cochlear processors, and glasses. The attachment component of the device is provided by both a strap (which is available in multiple colors and with colored beads) that extends from ear to ear and, in the case of younger children, a clip is added which attaches to clothing. Safe N Sound is available in four different sizes. Available from www.getsafensound.com.

Mark Rosal, with his wife, Assunta, and daughter, Shameera, created Ear Gear, a hearing aid security and protection device.

Combination Devices
Ear Gear. Ear Gear is a new hearing aid device designed to combine hearing aid security with protection from moisture, dirt, and dust. As an added bonus, Ear Gear can transform any BTE hearing instrument into a fashion accessory. Ear Gear is a spandex boot that fits snugly over a BTE. It is available by the pair in six different models, and a variety of stylish, fun colors and patterns. The current product line includes: Ear Gear Original (for BTEs up to 1.5 inches), Ear Gear FM (for BTEs over 1.5 inches and those with an FM attachment), Ear Gear Infant (with a shorter cord), and Ear Gear Monaural. The Original and FM models can also be ordered with or without attached cord and clip. Ear Gear is fully washable and comes with a 1-year guarantee. Available from www.gearforears.com.

Conclusion
With the successful implementation of UNHS and better hearing health care, in general, there are more children at younger ages receiving hearing instruments. Similarly, hearing instrument technology has evolved substantially, and some of the technology options available today often represent an investment of several thousands of dollars for parents of these children and young adults. Additionally, security/protection devices are useful for people of all ages who have cognitive impairments or who lead extremely active lives.

The devices discussed here should be “road tested” by the dispensing professional, and those devices that are found to represent good options for a particular patient population should be recommended during the counseling process. Hearing security/protection devices can help relieve the stress hearing aid users—and their caregivers.

References
1. Yoshinaga-Itano C, Sedey AL, Coulter DK, Mehl AL. Language of early- and later-identified children with hearing loss. Pediatrics. 1998;102(5):1161-1171.
2. Ingrao B. Bluetooth technology: Toward more wireless hearing care solutions. The Hearing Review. 2005;12(1):26-27,88.
3. Dietrich S. Roadtest: An FM system in the dental office/educational setting. The Hearing Review. 2005;12(1):38-42.
4. Yanz J, Roberts R, Sanguino J. A wearable bluetooth device for hard-of-hearing people. The Hearing Review. 2005;12(5):38-41.
5. Tchors J. Utilizing bluetooth for better speech understanding over the cell phone. The Hearing Review. 2005;12(2):50-51,80.
6. McSpaden JB. Why are hearing aids so expensive? The Hearing Review. 2005;12(10):30-34,85.