Tech Topic/Hearing Airs for the Active Kid | May 2014 Hearing Review

Kuratko author boxBy Charles Kuratko, MS, Donna Rivers Grant, AuD, and Lisa Klop, AuD

Over the past 20 years, a significant amount of funding and resources have gone into identifying children with hearing loss as soon after birth as possible. Today it is estimated that over 92% of all newborns in the United States are screened for hearing loss at birth.1 Follow-up is then coordinated with local early intervention programs to be sure effective amplification and education begin as soon as possible.

Within the context of very young children, there is no shortage of information on causes of hearing loss, choices in education, speech and language development, the fitting of hearing instruments, and cochlear implants. It is clear this focus on pediatric hearing loss has been far-reaching with very positive implications.

However, when you begin researching hearing loss and hearing instrument choices among older children—“tweens” and teens—it rapidly becomes more difficult to obtain well-researched data. There seems to be very little information, other than anecdotal, on the likes and dislikes of the more than 120,000 wearers between the ages of 11 and 20.

Defining Today’s Teens

When beginning the design process for hearing devices for children and teenagers, it becomes apparent that some basic questions need to be answered:

1) What are the common listening situations in which teens wear their instruments?

2) Who decides what hearing instruments a child or teen is fitted with?

3) Do the instruments need to be “different” in any way for these active kids and teens than those fitted to adults?

To quote Bill Gates, “You’ve got to start with the customer experience and work back toward the technology.”

One approach is to review market research. Because this age group spends over $200 billion annually, many industries have taken an in-depth look at who they are and what they are buying. According to a 2012 poll2:

  • There are 25.6 million teens in the United States and they spend $208 billion a year;
  • Girls say the following is a source they use when finding the latest trends:
  • Friends/peers: 81%
  • Ads: 68%
  • Company websites: 44%
  • Parents: 25%
KuratkoFig1

Figure 1. Number of girls (n=1,051) and boys (n=1,081) who participate in organized and team sports. Source: Women’s Sports Foundation.2

According to a 2008 report titled Go Out and Play: Participation in Team or Organized Sports3 conducted by the Women’s Sports Foundation, 69% of girls and 75% of boys participate in organized and team sports (Figure 1). Other popular activities include hanging out with friends, going to the movies, and staying up late.

This age group is very fashion conscious, spending more than half of their disposable income on clothing, followed closely by music and electronic gadgets. They want to be identified with their peers and not perceived as different.

While each teen makes buying decisions based on their individual lifestyle, trends emerge quickly. Interestingly, a recent article reported teens expressed durability is more important than affordability, and they desire brands with reputations for quality.4

So how does this relate to older children and adolescents who require amplification? The purchasing habits of teens with hearing loss are no different than teens with normal hearing. When the time comes for teens to choose new hearing instruments, these and other factors shape the decision. Three groups of people have primary influence: the wearer, the hearing care professional, and the parents.

After reviewing the goals of these three stakeholders, four primary expectations can be identified:

1) Style/size;

2) Technology;

3) Connectivity; and

4) Robustness/durability.

The hearing instrument that satisfies these expectations and supports the lifestyle and audiologic needs of active kids and teens will become their product of choice.

1) Style and Size Considerations

Teens are more self-conscious and harder to please concerning how their hearing instruments “look” than people over the age of 60. To quote one 15-year-old, “Seeing a teenager who wears hearing instruments is like seeing a senior citizen with braces.”

Another teen, Arielle Schacter, shares the following:

I faced the bathroom mirror, trying to recreate a look that I had seen online…I tugged my hair, trying to decide what to do with it. Up or down? Hearing aids visible or invisible?

I couldn’t decide. I didn’t want to be the girl with noticeable hearing aids, but I wanted to look just like Kristen Stewart. Frustrated, I begged the looking glass to help me, “Mirror, Mirror on the Wall, should I let my long hair fall [and hide my hearing aids]?”5

Arielle is one of thousands of teenagers who reach for their hearing instruments and wonder, “How will I look today?” DeConde-Johnson6 points out hearing care professionals must recognize teens have a strong desire to fit in. They do not want to be known for their hearing loss or hearing instruments.

A teen should feel comfortable with not only their choice in clothes but also their choice in amplification. Choices like traditional behind-the-ear (BTE), receiver-in-canal (RIC), and custom (including completely-in-canal or CIC) are now available in tiny, discreet forms that are still capable of offering an extensive variety of desirable features.

Traditional BTEs comprise 26% of the hearing instruments in the United States sold today. This style is traditionally fit on children as their first hearing instruments, shortly after their hearing loss is identified. BTEs come in a range of sizes, are usually larger than RICs, and may have different features such as locking battery doors, direct auditory input, and brighter color choices.

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Figure 2. Most hearing aids today offer discreet styles with desirable features.

RICs are the fastest growing choice for style of BTE instrument, and currently comprise over 50% of all hearing instruments sold. Their increase in popularity is primarily due to their small size paired with fashionable design, while providing desired power and ease of use (Figure 2).

The larger custom instruments fill the entire concha of the ear, and are referred to as in-the-ear (ITE). The smaller custom instruments fit deeper in the ear and are contained in the ear canal, referred to as CIC. Custom instruments are fitted to 26% of consumers purchasing hearing instruments, but until recently have been considered a solution primarily for adults. With today’s ear modeling devices and new advances in technology, it is now possible to fit custom products on teenagers when their ears reach an appropriate size.

2) Superior Technology and Sophisticated Features

Powers and Beilin7 discussed the motivating factors for professionals in choosing what products to fit in their practices: “[It is] to a large degree technology driven.” That is, the patients usually are searching for “the best” hearing instrument, which generally means the best technology available. This would include such features as feedback cancellation and noise reduction, the ability for the device to “learn” in different hearing situations, and directional speech enhancement.

Hearing instruments that include advanced features are more likely to be offered to patients, thus satisfying the hearing care professional as influencer in the buying decision process. Given the many challenging listening environments experienced by teens, this population needs these advanced features to the same degree as adults—or maybe more so.

There are many advanced features available, and these advanced digital algorithms can be found even in the small RIC products:

  • Extended bandwidth and frequency shaping to maximize audibility of important high frequency speech signals while improving speech quality.
  • Frequency compression technology provides audibility of the high frequency speech signals for the more severe hearing losses.
  • Effective digital noise reduction provides relaxed listening and reduces listening fatigue.
  • Optimized directionality improves the signal-to-noise ratio (SNR) for many listening conditions.
  • Fast feedback cancellation allows optimized gain for all listening situations.
  • Automatic situation detection in one program makes manual changes unnecessary; the hearing instrument automatically adjusts for each listening encounter.
  • Trainable to allow the teen to shape the response and adjust compression to their desired gain and output settings for all listening situations.

3) The Importance of Connectivity

We live in a world that is increasingly more in touch every hour of every day via cell phones, tablets, and computers. Every day you see teens and active kids scrolling through their smartphones, listening to their iPod®, gaming, or gathered around a computer screen. Therefore, offering a range of digital wireless solutions that help youngsters to stream content from all manner of devices—including today’s most popular apps—is mandatory.

Hearing clearly in a wide variety of listening environments is also vital. Options such as Bluetooth® enabled wireless devices and digital FM receivers and transmitters designed to enhance speech and filter out disturbing background noise before it reaches the hearing instruments are selling points for young consumers. These should provide improved clarity and speech intelligibility not only in the classroom but also on the soccer field, riding in the car, or enjoying lunch with friends.

For kids or teens with hearing loss, amplification alone may not be enough to hear teachers in a classroom where distance, reverberation, and background noise present challenges. The ability to connect with T-coils to DM microphone configurations and receivers in classrooms, auditoriums, and other learning environments can vastly improve their school experience and performance.

Rechargeability has become a standard in today’s electronics world. Cell phones, hand-held video games, MP3 players, and tablets are all rechargeable. Offering busy young wearers the option to skip the weekly battery changes (and the unexpected dead battery) in favor of simply placing hearing instruments in a charger at night and then putting them on the next morning completely charged and ready to go is a powerful selling point.

4) Robustness and Durability

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Figure 3. Percentage of times that hearing instrument wearers remove their hearing aids for specific activities.

Water, dust, and shock impose challenges in the lives of wearers. These challenges are even more accentuated for active kids and teens, as they are always on the move. A 2012 survey of 500 hearing instrument wearers by Siemens Hearing Instruments revealed the need for a more robust hearing device to accommodate today’s active lifestyles (Figure 3). According to the study, wearers want to lead a more vibrant daily life, but feel bound by the shortcomings of today’s traditional hearing devices. First and foremost were situations in which the hearing instrument might get wet.

  • Nearly all respondents (96%) stated they remove their hearing instruments prior to bathing and (92%) prior to swimming.
  • Other activities that cause wearers to remove their hearing instruments include jogging and biking.
  • A third of respondents state that not wearing their hearing device on a day with adverse weather conditions directly affects their routine.

When asked about the consequences of removing their instruments for such activities, inconvenience and missing the benefit of hearing were among those reported. For example, wearers would miss the benefit of hearing instructions from a swim coach or a possibly a lifeguard at the beach.

Active kids and teens want to live on-the-go lifestyles without stopping to consider the potential adverse affects of rain, dust, and perspiration on their hearing instruments. Their parents support these activities but also want their hearing instrument investment to survive these conditions. Of course, hearing care professionals want to be able to offer instruments that stand up to everything kids put them through so that patients and parents remain satisfied customers. There is clearly demand for hearing devices that offer resistance to water, dirt, and shock, and manufacturers would be wise to develop more hearing instruments rated at IP67 or higher in order to satisfy all three stakeholders in the buying process.

Conclusion

Siemens’ goal was to build a line of hearing products that met the essential requirements of wearers and fitters of active kid and teen instruments. In doing so, we identified the following as the four most in-demand features: 1) Modern and convenient style and size; 2) Cutting-edge technology; 3) Wireless connectivity; and 4) Robustness and durability.

micon meets these goals by delivering the most advanced features available that ensure natural and comfortable sound quality and audibility in the most challenging environments, all while offering options for the instruments to adapt to different environments. These are all packaged in a wide variety of style options from slim-neck BTEs to discreet customs, including wireless CICs. Siemens has packaged these solutions, as well as various wireless accessories offering universal connectivity and rechargeability, into its Siemens Active Kids & Teens (AK&T) product portfolio.

Whether kids or teens are looking for hearing aids to keep up with their rough-and-tumble side, to keep them connected while being discreet, or to enable access to classroom information, the Siemens AK&T portfolio has a solution—all while not overlooking intuitive technology and value requirements of both parents and hearing care professionals.

References

1. Joint Committee on Infant Hearing. 2007. Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. Pediatrics, 120(4):898-921 (doi:10.1542/peds.2007-2333).

2. Statistic Brain. Teenage Consumer Spending Statistics. Sept 8, 2012. Available at: http://www.statisticbrain.com/teenage-consumer-spending-statistics

3. Womens Sports Foundation. Go Out and Play: Participation in Team or Organized Sports. Available at: http://www.womenssportsfoundation.org/home/research/articles-and-reports/mental-and-physical-health/go-out-and-play

4. Santana M. The entirely surprising thing teens demand from brands. Media Post Blogs, October 4, 2012. Available at: http://www.mediapost.com/publications/article/184248/the-entirely-surprising-thing-teens-demand-from-br.html

5. Schacter A. HHM: Mirror, Mirror on the Wall, Should I Let My Long Hair Fall? [bf4life-hearing Blog] October 11, 2011. Available at: http://bf4life-hearing.weebly.com/3/post/2011/10/hhm-mirror-mirror-on-the-wall-should-i-let-my-long-hair-fall.html

6. DeConde Johnson C. Teenagers, hearing loss, and hearing aids. Hear Jour. 2007;60(7):49. Available at: http://journals.lww.com/thehearingjournal/Fulltext/2007/07000/Teenagers,_hearing_loss,_and_hearing_aids.10.aspx

7. Powers T, Beilin J. True advances in hearing aid technology: What are they and where’s the proof? Hearing Review. 2013;20(1):32-39. Available at: http://www.hearingreview.com/2013/01/true-advances-in-hearing-aid-technology-what-are-they-and-where-s-the-proof-january-2013-hearing-review

Original citation for this article: Kuratko C, Rivers Grant D, Klop L. Creating the right hearing aids for active kids, including tweens and teens. Hearing Review. 2014;21(5):30-34.