House Ear Launches “It’s How You Listen That Counts” Campaign
Los Angeles—The House Ear Institute (HEI) has launched an aggressive consumer awareness campaign aimed at teens and young adults. The campaign uses the theme “It’s How You Listen That Counts” to warn young adults of the potential dangers to hearing posed by listening to loud sound.

The age group sometimes known as “the MTV Generation” is now frequently referred to as the “MP3 Generation” due to the soaring popularity of digital portable music players. Because this generation of consumers tends to play their music too loud for too long, they are particularly vulnerable to permanent noise-induced hearing loss and have become the target audience for the youth-oriented messages delivered by HEI.

Working from extensive market research carried out over several months, the Institute created advisory commercials designed to captivate teens and drive them to the campaign’s Web site (www.EarBud.org) for additional information on safe listening habits. The first phase of the 10-month “It’s How You Listen That Counts” campaign launches in Arizona as a test market with commercial spots featured on MTV, MTV.com, and five Yahoo! Web sites including Yahoo! Music.com.

The goal for phase one is to gather additional market research data and analyze which type of messaging truly impacts behavior in this age group, allowing HEI to then carry the message nationwide. Over the past few years, HEI’s Sound Partners™ hearing conservation program has educated tens of thousands of audio and music professionals about the importance of safe listening practices to a successful career in sound. The Institute recognizes a growing need to expand its program beyond the sound industries to reach young consumer audiences who typically crank up the volume but generally are unaware of the serious risks that loud decibels (exceeding 85 dB) can pose to their hearing.

“This campaign is a vital step to discovering what it will take to reach teens and young adults with a message that motivates them to make smart listening choices to preserve their hearing while still appreciating great sound,” said Marilee Potthoff, marketing director of HEI. “Today, baby boomers who are struggling with hearing loss from the loud activities of their youth regret that they didn’t know enough when they were young to protect their hearing from permanent damage. Our goal is to deliver the warning message to the next generation before it’s too late.”

For more information on the Sound Partners program, see the article “Hearing Conservation for Audio Industry Professionals” by Rachel Cruz, MA, and Potthoff in the October 2005 HR (p 35), or visit www.hei.org.

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Sonomax and Gennum Announce Agreement
Montreal, Quebec—Sonomax Hearing Healthcare Inc, inventor and developer of the SonoCustom® in-the-ear expansion technology and SonoPass® proof-of-performance software, announced that it has entered into a memorandum of agreement relating to a business relationship with Gennum Corporation, Burlington, Ontario, a leading supplier of integrated circuits (ICs) for the hearing industry. The intent of the relationship is for the two companies to combine their respective expertise and technologies in furtherance of Sonomax’s objective of creating and bringing to retail markets new and improved hearing, hearing protection, and communications products centered around Sonomax’s sound-interface technology.

As consideration for the rights granted by Gennum to Sonomax under the agreement, Sonomax has granted stock options to Gennum to purchase up to 3 million common shares of Sonomax. These non-transferable options reportedly may be exercised by Gennum at any time for a period of five years.

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Hearing Industry Makes Small Unit Gains in 2005 Alexandria, Va—According to the Hearing Industries Association (HIA) statistical survey for 2005, the US public dispensing sector saw net unit volume gains of 4.0% while net units dispensed by the Department of Veterans Affairs (VA) fell by 6.23% compared to 2004. In total, the hearing instrument market experienced a 2.53% unit volume gain in 2005, or 2.20 million hearing aids dispensed, which is in line with HR predictions of 2.19 million (December 2005, p 16). VA sales made up 13.6% of all hearing aids dispensed compared to 14.9% in 2004. The 2.5% volume increase in 2005 follows a strong 2004 when sales rose by 7.5%, breaking the 2-million unit mark for the first time in industry history. In 2005, as with 2004, hearing aid sales continued to exceed a half-million in every quarter. Thus, although the industry might have hope for stronger market gains, the year did represent a continuation of positive sales growth—although reports suggest that large gains were realized by a smaller number of hearing aid companies. Digital signal processing (DSP) hearing aids constituted 89.1% of all the hearing aids dispensed in 2005, and now firmly dominate the industry. In fact, HIA chose not to delineate between analog programmable and non-programmable aids in their reporting during 2005, as programmable market percentages had fallen to around 5% in 2004. They are presently estimated by HR to be around 3%. Large increases in the use of behind-the-ear (BTE) hearing aids continued in 2005, with one-third (32.6%) of all hearing aids dispensed in the US being of the BTE style. The trend appears likely to continue at least in the short term: 34.7% of all the aids dispensed in the public sector were of the BTE style, and 37.0% of all aids in the fourth quarter of 2005 were BTEs. Most attribute these increases to the growing use and availability of open-ear instruments, as well as greater use of multi-microphone systems and new “instant fit” product designs.

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Infant Gaze-Following Correlates to Better Speech Understanding
Seattle—Infants begin pulling off an amazing feat sometime in the final three months of their first year of life; they learn the important social interaction of following the gaze of an adult—a step that scientists believe gives babies a leg up on understanding language, according to the University of Washington (UW).

UW psychologists Rechele Brooks and Andrew Meltzoff have pinpointed this developmental step as beginning somewhere in the 10th or 11th month of life, and have found that infants who are advanced in gaze-following behavior before their first birthday understand nearly twice as many words when they are 18 months old.

Writing in the November issue of Developmental Science, Brooks and Meltzoff provide further evidence for the importance of eyes in human social interactions, and trace how gaze-following develops in infants. Three years ago they reported that 12-, 14-, and 18-month-old infants are much more likely to look at an object when a person turns toward it with open eyes rather than closed eyes.

“Our work shows that babies can look where an adult is looking but that it isn’t easy, particularly at home where there are a lot of distractions,” says Brooks, who is a research associate at the UW’s Institute for Learning and Brain Sciences. “We have found that, at 9 months, babies are beginning to do this by following the movement of the head. At 10 and 11 months, they are following the head and the eyes. The eyes add important information and the babies are more consistently following the head when the eyes are open. It is as if a light is going off in their head. This is a clear shift and an important advance.”

Brooks and Meltzoff refer to the behavior of a baby (or an adult) looking where another has just looked as “gaze-following.” Psychologists have known for some time that among adults detecting the direction of another’s glance is a crucial component of human social interaction. “This line of research is important because following another person’s line of sight is crucial for understanding the emotions of other people and, as we are now showing, learning about language,” said Meltzoff, who is co-director of the institute and a professor of psychology.

The new study is part of an effort by UW researchers to understand the development of gaze-following in babies. To do this, they tested 96 normally developing infants. There were 32 infants at each of three ages (9, 10 and 11 months). Equal numbers of boys and girls in each age group were randomly assigned to eyes open or shut conditions. Each infant was seated in a parent’s lap, across a small table from a researcher. Parents were instructed not to move their head or talk during the experiment. The researcher played with an infant before placing two identical toys on pedestals to the left and right of the table. Then the researcher resumed playing with the child before starting four head-turning trials. In the trials, the researcher made eye contact with the infant before silently turning her head toward either the toy on the left or the one on the right. In the eyes-open condition, the researcher kept her eyes open and turned her head from the child to one of the toys for about seven seconds before turning back to the child. The procedure was the same in the eye-closed trials, except the researcher shut her eyes before turning toward one of the toys and didn’t open them again until she was facing the infant.

In a follow-up interview, when the infants were 18 months old, parents were asked to check off on a list how many words their child understood. There were marked differences in the babies’ ability to gaze-follow based on age. The 9-month-olds turned their heads toward a toy nearly as often in the closed-eyes condition as in the open-eyes conditions. However, the 10- and 11-month-olds looked at a toy significantly more often when the researchers turned with her eyes open than when she turned with her eyes closed.

About one-third of the infants in the open-eyes condition also made simultaneous sounds such as “ah” or “hmm” when they engaged in gaze-following. Babies at this age are unable to speak but can make very simple sounds. Typically developing babies experience a burst of language between 18 and 24 months of age. In this study, the babies who simultaneously followed the eyes of the researcher and made vocalizations when they were 10 or 11 months old understood an average of 337 words at 18 months old while the other babies understood an average of 195 words.

“The sounds they are making are very simple, but some children are looking and making these sounds spontaneously,” says Brooks. “They are creating a social interaction or a link. There seems to be something special about the vocalization when they are looking at the toy. They are using social information to pick out what we are focusing on. They can’t vocalize words, but they are carefully watching where we are looking. We think they are using social information and getting a boost in figuring out the social and language world together.”

Adds Meltzoff: “Although the babies are too young to talk to us, those individual babies who are most attuned to our eye gaze are the same babies who pick up language faster more than half a year later. This is a fascinating connection between the social and linguistic world and suggests that language acquisition is supported by preverbal social interaction.

“To do this a baby has an important social regularity to master: follow mom’s eyes and you can discover what she is talking about,” continues Meltzoff. “This study shows that babies first master this social information between 10 and 11 months of age, and it may be no coincidence that there is a language explosion soon thereafter. It is as if babies have broken the code of what mom is talking about, and words begin pouring out of the baby to the parents’ delight.”

Support for the research comes from the National Institute of Child Health and Human Development, the Tamaki Foundation, the Virginia Merrill Bloedel Hearing Research Center, the Talaris Research Institute and the Apex Foundation, the family foundation of Bruce and Jolene McCaw.

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Sebotek and Lotus Agree to End Patent Dispute
Tulsa, OK—SeboTek Hearing Systems LLC announced that it has reached an agreement with Lotus Technology Inc, Mooresville, NC, in connection with a lawsuit filed against Lotus for infringement of patented designs and technology used in the SeboTek PAC™ digital hearing instrument.

As part of the agreement, Lotus has agreed to cease manufacture and promotion of its Isis product. Lotus’ cornerstone product line is the Legacy Digital Series, and the company also offers full lines of digital, programmable, and analog instruments in all styles.

Sebotek’s patented design utilizes a linkage from a miniature sound processor to a deep-fitting receiver that is encapsulated within a soft tip. “The SeboTek PAC hearing instrument continues to grow in popularity, and is gaining wide-spread acceptance worldwide,” says SeboTek President Jim Feeley. “And while it is unfortunate that we were forced to file this suit, we’re pleased that Lotus has agreed to withdraw the Isis product from the market. We take matters such as these very seriously, and will not hesitate to pursue all appropriate legal channels to protect our intellectual property rights.”

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AuDNet Signs Private Label Contract with Siemens Burnsville, Mn—AuDNet has signed an agreement with Siemens Hearing Instruments to manufacture hearing aids under the AuDNet brand. America’s Audiology Network (AuDNet) is the nation’s only national network and buying group whose membership is 100% audiologists. Consistent with AuDNet’s mission and efforts to brand and create demand for audiology care, the full line of Siemens products will be private labeled under “AuDNet” effective February 1, 2006. AuDNet CEO Kathy Foltner (left) and Vice President of Marketing John Zeigler (right) meet with Siemens Vice President of Sales Joseph Lugara. “Recent reports indicate there are 31.5 million Americans with some degree of hearing loss,” says AuDNet CEO Kathy Foltner, AuD. “That number could reach 78 million by 2030, affecting almost one-third of the US population. At issue: Where do consumers find quality hearing care? At AuDNet, we believe the answer is an audiologist! It is time audiologists unite nationwide to achieve brand recognition and create demand for audiology care. We are pleased to add Siemens to our family of quality vendors who are helping brand audiology care under AuDNet.” “We regularly survey our members and prospective members in order to better understand their needs,” says AuDNet President David Smriga, “and one of the issues we’ve been addressing is the development of a greater variety of larger suppliers from which our members can choose.” Smriga says that, although AuDNet previously privately labeled its ITEs (eg, the shells carried the AuDNet branding), the agreement with Siemens includes the transactional experience of packaging and other materials typically associated with branded hearing aid products. “In the past, when we’ve marketed our member practices using the AuDNet-branded strategies, we’ve experienced a lot of success, even in areas that have a lot of corporate dispensing competitors. This speaks to the strength of our message of comprehensive quality care.” He reports that, as a buying group, AuDNet doubled its net unit volume in 2005 compared to 2004, and that the organization would be open to other private-labeling contracts. “The new AuDNet has evolved to the point that Siemens believes it is the perfect time to establish our relationship,” says Joseph Lugara, Siemens’ vice president of sales. “AuDNet’s member benefits provide quality support, marketing, and business management tools to audiologists. And, now these tools will be combined with Siemens’ resources and technologies to support our common mission of helping the hearing impaired with the best solutions possible.” AuDNet, Inc audiologists reportedly meet strict educational and quality standards, and provide only the best in hearing care and rehabilitation. For information, visit http://www.aud-net.com.

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Children’s Hearing Loss from Chemotherapy Underestimated
Portland, Ore—A new study published in the December edition of the Journal of Clinical Oncology found that ototoxicity’s frequency and severity, as well as its long-term effects on development, have long been underreported by the medical community. The research found that a well-known classification system doctors use for reporting toxicities in patients, the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE), doesn’t consider high-frequency hearing loss, allowing the magnitude of ototoxicity in children treated with platinum agents to be miscalculated.

The purpose of the study is “to make people aware that this is more common than people think and we need to follow this issue,” says Kristy Gilmer Knight, MS, a pediatric audiologist at the Oregon Health and Science University’s (OHSU) Doernbecher Children’s Hospital and the study’s lead author. Knight says a major problem for doctors is that the chemotherapy drugs affect mostly the high frequencies, and “kids won’t complain about not understanding what was said when they’re [young].” This can lead to development issues for children. A 1998 study that evaluated the educational performance and social-emotional functioning of about 1200 children with minimal hearing loss found that 37% failed at least one grade in school compared with the normal rate of 3%. They also had more problems with behavior, energy, stress, self-esteem, and social support.

OHSU researchers tested the hearing of 67 patients, ages 8 months to 23 years, who received platinum-based chemotherapy. Data was analyzed to determine the length of time to hearing loss using criteria from ASHA, and the effects of treatment and patient characteristics on the incidence and severity of ototoxicity. According to the study, hearing loss was found in 61% of patients, with average onset beginning 135 days after chemotherapy. This included 55% of children treated with cisplatin; 38% of children treated with cisplatin’s less-toxic derivative, carboplatin; and 84% of children treated with both agents.

Researchers say many of these children are falling through the cracks. The study found that, while the ASHA criteria and CTCAE grading scale were similar in how they defined hearing loss progression, results from clinical trials often focus only on CTCAE grade 3 toxicity, which represents hearing loss requiring therapeutic intervention, and grade 4, which requires a cochlear implant and additional speech and language development services. The study said agreement between the CTCAE and ASHA criteria was “inadequate.”

“By tradition, many published clinical trials report only grade 3 and 4 CTCAE toxicities,” reports the study. “In the case of hearing loss, this would leave grades 1 and 2 ototoxicity unreported, thereby underestimating the magnitude of ototoxicity in children treated with platinum agents. We believe that CTCAE grade 1 and 2 hearing losses are significant in children and should therefore be considered and reported.” Over one-third (36%) of patients who were examined would not have been reported as having ototoxicity if only CTCAE grades 3 and 4 were considered.

Scientists want to boost awareness of ototoxicity because it may soon be preventable. Nancy Doolittle, PhD, associate professor of neurology at the OHSU School of Medicine, and a researcher in the Blood Brain Barrier Program which studies methods for breaching the brain’s natural defense system to deliver chemotherapy compounds to tumors, has shown that sodium thiosulfate (STS) decreased hearing loss in patients with malignant brain tumors who were treated with carboplatin chemotherapy, which is given with the blood-brain barrier disruption technique. When STS was given 4 hours after carboplatin, ototoxicity decreased from 84% of patients to 29%.

The OHSU study team is developing protocols for a clinical trial of a second potential chemo-protectant called N-acetylcysteine, or NAC. The drug—typically used to treat people with Tylenol poisoning—prevented platinum-induced ototoxicity in rats in a study published in mid-2004. NAC may prevent hearing loss by binding to cisplatin’s platinum molecules, thereby inactivating them. And as a free-radical scavenger, it hunts down highly reactive atom clusters believed to cause similar hearing loss caused by noise trauma. The goal is to determine a safely tolerated dose of NAC in humans. Once the safe dose is determined, Phase 2 efficacy testing begins to see if NAC, combined with STS, will protect hearing.

“One of the strategies for improving survival is increasing doses of chemotherapy,” Doolittle says. “Because larger doses may cause more toxicity, we have to be able to address the toxicity. Maintaining quality of life by maintaining hearing is really important.” The study was funded by the National Institute of Neurological Disorders and Stroke, NIH, and the US Department of Veterans Affairs. (Disclosure Notice: Dr. Neuwelt, OHSU, Portland Veterans Affairs Medical Center, and the VA have a significant financial interest in Adherex, a company that may have a commercial interest in the results of this research and technology. This potential conflict was reviewed and a management plan, approved by the OHSU Integrity Program Oversight Council and the Portland Veterans Affairs Medical Center Conflict of Interest in Research Committee, was implemented.)

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Britain Battles Hearing Loss with New Hearing Care Campaign
London—The Royal National Institute for the Deaf (RNIF) launched its “Breaking the Sound Barrier” campaign Christmas Day to change attitudes towards hearing loss and hearing aids. It follows a specially commissioned survey similar to the US MarkeTrak study (see the July 2005 HR) examining barriers to hearing aid adoption.

Similar to MarkeTrak findings in the US, 70% of people in the UK survey who reported hearing loss minimized their hearing loss. Nearly half indicated embarrassment over their hearing loss and concerns that people would treat them differently or view them as getting older if they wore hearing aids.

On Christmas Day, RNID attempted to screen 4 million people over the phone and had television commercials which showed people getting hearing aids and reconnecting with their families and society.