Conjuring Images of a Bionic Future

And the last one in the series, from NYTimes

Dick Loizeaux recently found himself meandering through a noisy New York nightclub. This was unusual; Mr. Loizeaux, a 65-year-old former pastor, began suffering hearing loss nearly a decade ago, and nightclubs are not really his scene. “They’re the absolute worst place to hear anybody talk,” he said.

But this time was different. Mr. Loizeaux had gone to the club to test out theGN ReSound Linx, one of two new models of advanced hearing aids that can be adjusted precisely through software built into Apple’s iPhone. When he entered the club, Mr. Loizeaux tapped on his phone to switch his hearing aids into “restaurant mode.” The setting amplified the sound coming from the hearing aids’ forward-facing microphones, reducing background noise. To play down the music, he turned down the hearing aids’ bass level and bumped up the treble. Then, as he began chatting with a person standing to his left, Mr. Loizeaux tapped his phone to favor the microphone in his left hearing aid, and to turn down the one in his right ear.


Dick Loizeaux, 65, who began suffering hearing loss nearly a decade ago, recently had a “comfortable conversation” in a noisy New York nightclub using the GN ReSound Linx hearing aid.CreditSally Ryan for The New York Times

The results were striking. “After a few adjustments, I was having a comfortable conversation in a nightclub,” Mr. Loizeaux told me during a recent phone interview — a phone call he would have had difficulty making with his older hearing aids. “My wife was standing next to me in the club and she was having trouble having the same conversation, and she has perfect hearing.”

It’s only a slight exaggeration to say that the latest crop of advanced hearing aids are better than the ears most of us were born with. The devices can stream phone calls and music directly to your ears from your phone. They can tailor their acoustic systems to your location; when the phone detects that you have entered your favorite sports bar, it adjusts the hearing aids to that environment.

The hearing aids even let you transform your phone into an extra set of ears. If you’re chatting with your co-worker across a long table, set the phone in front of her, and her words will stream directly to your ears.

When I recently tried out the Linx and the Halo, another set of iPhone-connected hearing aids made by the American hearing aid company Starkey, I was floored. Wearing these hearing aids was like giving my ears a software upgrade. For the first time, I had fine-grain control over my acoustic environment, the sort of bionic capability I never realized I had craved. I’m 35 and I have normal hearing. But if I could, I’d wear these hearing aids all the time.

IPhone-connected hearing aids are just the beginning. Today most people who wear hearing aids, eyeglasses, prosthetic limbs and other accessibility devices do so to correct a disability. But new hearing aids point to the bionic future of disability devices.

As they merge with software baked into our mobile computers, devices that were once used simply to fix whatever ailed us will begin to do much more. In time, accessibility devices may even let us surpass natural human abilities. One day all of us, not just those who need to correct some physical deficit, may pick up a bionic accessory or two.

“There is a way in which this technology will give people with hearing loss the ability to outperform their normal-hearing counterparts,” said Dave Fabry, Starkey’s vice president for audiology and professional relations.


CreditStuart Goldenberg

Imagine earpieces that let you tune in to a guy who is whispering across the room, or eyeglasses that allow you to scan the price of any item in a supermarket. Google and several international research teams have been working on smart contact lenses. In the beginning, these devices might monitor users’ health — for instance, they could keep an eye on a patient’s blood pressure or glucose levels — but more advanced models could display a digital overlay on your everyday life.

Or consider the future of prosthetic limbs, which are now benefiting from advances in robotics and mobile software. Advanced prosthetic devices can now be controlled through mobile apps. For instance, the i-Limb Ultra Revolution, made by Touch Bionics, allows people to select grip patterns and download new functions for their prosthetic hands using an iPhone. The longer you use it, the smarter your hand becomes.

Hearing aids are the natural place to begin our bionic quest. About 36 million American adults report some degree of hearing loss, according to theNational Institute on Deafness and Other Communication Disorders, but only about a fifth of the people who would benefit from a hearing aid use one.

That’s because hearing aids, as a bit of technology, have long seemed stuck in the past. “Most people picture large, clunky bananas that fit behind your ears and show everyone you’re getting old,” said Ken Smith, an audiologist in Castro Valley, Calif., who has fitted more than two dozen patients with the Linx.

Until recently, many hearing aids were also difficult to use. For lots of potential users, especially people with only mild or moderate hearing loss, they didn’t do enough to improve sound in noisy environments.

Talking on the phone with a hearing aid was especially problematic. While some hearing aids offered streaming capabilities to cellphones, they were all clunky. To connect to phones, they required an extra streaming “wand,” a battery pack and wireless transmitter that the user wore around his neck — a device that nobody looked good lugging around.

In 2012, Apple announced the Made for iPhone Hearing Aid program, which would let the company’s mobile operating system connect directly to hearing aids using a low-power version of Bluetooth wireless technology. Representatives of both Starkey and GN ReSound say they saw the iPhone as a way to correct many of the tech problems that had hampered hearing aids. The phone could act as a remote control, a brain and an auxiliary microphone for hearing aids, and it would finally let people make phone calls and listen to music without carrying a wireless dongle.


GN ReSound’s Linx is one of two new models of advanced hearing aids that can be adjusted precisely through software built into Apple’s iPhone.

But more than that, the companies say, the iPhone could do something potentially revolutionary for hearing aids. “A lot of the people who could benefit from wearing a hearing aid now don’t have any excuse — they can’t say it’s too clunky or not cool,” said Morten Hansen, GN ReSound’s vice president for partnerships and connectivity.

Dr. Fabry, of Starkey, was blunter: “We thought we could make hearing aids cool.”

Aesthetically, both companies seemed to have pulled off something close. The GN ReSound and Starkey hearing aids are fantastically tiny and attractive; each is just a fraction of the size of a conventional Bluetooth headset, and when they’re set behind your ears, they’re virtually invisible. They are also quite comfortable. A few minutes after fitting each model into my ears, I had forgotten they were there.

On the other hand, neither is cheap. Starkey’s Halo starts around $2,000 a hearing aid, while GN ReSound’s Linx begins at more than $3,000 each. Few health insurance plans cover the cost of hearing aids; Medicare does not.

Some people who have used them, though, said the new hearing aids were well worth the price. “I fell in love with them in the first 30 seconds,” said Todd Chamberlain, who recently began using a pair of Halos.

Mr. Chamberlain, who is 39 and works as an industrial safety officer in Ephrata, Wash., has worn hearing aids since he was 3 years old.

“I’m surprised they haven’t done this earlier — putting it all in an app, that seems so obvious these days,” he said.

Soon, we might be saying the same about all of our senses.

Better Hearing Through Bluetooth

Larry Faust, 61, uses a Bluetooth-based personalized sound amplification device.

Stuart Isett for The New York TimesLarry Faust, 61, uses a Bluetooth-based personalized sound amplification device.

These are interesting, from the NYTimes

Like many men of his generation, Larry Faust, 61, of Seattle, went to a lot of rock concerts in his youth. And like many men of his generation, his hearing isn’t what it used to be.

“My wife has been bugging me for several years to do something about my hearing,” said Mr. Faust. “I spent part of the summer of 1969 at Woodstock. So that probably didn’t help.”

Instead of going the traditional route — buying hearing aids through an audiologist or licensed hearing aid dispenser — Mr. Faust purchased a device that is classified as a personal sound amplifier product, or P.S.A.P., which is designed to amplify sounds in a recreational environment.

Unlike hearing aids, P.S.A.P.’s are exempt from Food and Drug Administration oversight and can be sold as electronic devices directly to consumers, with no need to see a physician before buying one. They come with a range of features and vary widely in price.

And while some hearing professionals have long cautioned against the devices, citing their unreliability and poor quality, many also say that a new generation of P.S.A.P.s that utilize the latest wireless technology are offering promising alternatives for some people with hearing loss.

The device Mr. Faust bought, the CS10 from a Chicago-based company called Sound World Solutions, cost $299.99, thousands of dollars cheaper than most digital hearing aids. While it has many of the same features that high-end hearing aids have, including 16 channels to process sound, directional microphones, feedback insulation and noise reduction, it has one capability that hearing aids and other devices on the market currently don’t have. It comes with software that enables consumers to program it themselves, a feature made possible in part by the adoption of the widely available Bluetooth wireless technology, rather than the proprietary platforms used by most wireless hearing aids.

Rather than having to visit an audiologist to program the device, something that hearing aid users must do, CS10 customers can program it themselves by downloading the app to an Android phone or a computer (an iPhone version is under development). After opening the software, users respond to a series of beeps and tones of varying volumes by clicking a button to indicate whether they have heard the sound. This self-programming feature may make the CS10 especially useful for consumers in developing countries, where Sound World intends to distribute them, and where there is no formal distributional model for hearing aids and “no audiologists,” said Stavros Basseas, the company’s co-founder.

There are limitations to who can benefit. “A personal sound amplifier is really designed for patients who have normal or near normal hearing. It’s not really designed as a hearing device to address significant sensorineural hearing loss,” said Bettie Borton, the president of the American Academy of Audiology. It is also important that those with hearing loss be screened for potentially serious medical problems that may be causing the problem.

Still, despite these concerns, the CS10, which looks and behaves like a cross between a Bluetooth headset and a hearing aid, may be a road map for hearing aids in the near future. Most hearing aids with wireless capabilities currently use either a proprietary wireless platform or Bluetooth’s “Classic” technology, an older, more power-hungry version of Bluetooth, and require an intermediary remote-control-like device or a body-worn device to connect the hearing aid to cellphones, televisions or Bluetooth-capable speakers. In addition to being inconvenient, these external devices are also costly, ranging from $150 to $500. In contrast, the CS10 requires only one external rechargeable battery that fits behind the ear like a traditional hearing aid. The concept is catching on: Dr. Rodney Perkins, an otologist who founded the California Ear Institute at Stanford University, plans to release a similar device next year, dubbed Soundhawk.

Ms. Borton said many patients hesitated to buy wireless hearing aids with intermediary devices. “Several of them told me, ‘I’m going to wait and when you have a product where I don’t have to wear the streaming device, then I’ll be back.’”

Not surprisingly, hearing aid companies are investigating more efficient, less power-hungry forms of Bluetooth technology such as Bluetooth Smart — currently used by gadgets like Fitbit and Nike Fuelband — that would enable their products to skip the intermediary device. Suke Jawanda, chief marketing officer of the Bluetooth Special Interest Group, said that several major hearing aid companies have become members in the last year.

One of the roadblocks to developing hearing instruments that connect seamlessly with all mobile devices has been the lack of a standard protocol for wireless connection. “It is important that we can serve all smartphones, and not only a small subset,” said Stefan Launer, vice president of science and technology at Phonak, a major hearing aid manufacturer. “In order to achieve that, a standard has to be defined and implemented by everyone involved. When this will be the case is hard to predict.”

The technology may bring new functionality to the next generation of hearing aids. As with the CS10, Bluetooth-enabled hearing aids could theoretically route Skype computer calls directly to the aid, and users could link directly to their Bluetooth-enabled smart TVs or digital stereos, listening at the volume of their choice, without drowning out their non-hearing-impaired neighbors.

Manufacturers of hearing devices are making progress. Recently GN ReSound revealed its “Made for iPhone” hearing aid, theReSound LiNX, at the Consumer Electronics Show in Las Vegas; it uses proprietary wireless 2.4 GHz technology and Bluetooth Smart and is expected to be released worldwide in the first quarter of 2014. And rather than a body-worn device, the iPhone itself will serve as the remote, enabling the user to switch between already-programmed “environments” (such as hearing in a restaurant, for instance, or listening to music). With the iPhone’s latest operating system, iOS7, users with two Made for iPhone hearing aids can listen to music on their iPhone in stereo via the Airplay feature or follow turn-by-turn directions in their car. Though the company didn’t announce a price, ReSound’s president, Kim Herman, said that the LiNX will be sold at “a premium” to another ReSound product, the Verso, which starts at $2,900 and sells for as high as $3,500.

And in September, Advanced Bionics, a sibling company of Phonak, released a new sound processor, dubbed the Naida, that allows cochlear implants to connect with devices using Bluetooth technology.

An online hearing retailer, Embrace Hearing, is currently developing a device that would “jailbreak” existing hearing aids that come with Bluetooth Classic technology, said the company’s co-founder, Ross Porter. The device and accompanying app would allow users to adjust program settings on their hearing aids themselves.

There is ongoing debate about whether user-programmable hearing needs will one day replace the need for costly visits to an audiologist. Mr. Porter thought that major hearing aid manufacturers “want to give a little bit more flexibility to the user, but not replace audiologists.”

But Ms. Borton said that even if users could adjust the settings themselves, it wouldn’t be a replacement for a professional custom fit. “A successful hearing aid fitting is not solely putting the device on the patient and patting them on the back and sending them out the door,” she said. “High quality hearing aid fittings by audiologists involve verifications by various electronic measures and validation.”

Perhaps a larger obstacle to the wholehearted adoption of Bluetooth technology in hearing aids, though, is the patients themselves: the average age of a hearing aid user is 71.

“I would say probably 80 percent of my caseload, even if they had Bluetooth programming technology available to them, are not, perhaps because of their age demographic, capable of embracing that kind of technology easily. They don’t own computers, they are not online,” said Ms. Borton.

As an IT networking consultant who is comfortable working with new technology, Mr. Faust is an exception to that rule. He is happy to use the CS10 to make calls and looks forward to the next iteration of the device, when the device is able to stream music directly from his phone. But for now, Mr. Faust likes being able to program the CS10 himself. “I can really turn it up and I can hear things that other people can’t hear,” he said. “With the adjustability this easy — it’s almost like ‘more than’ a hearing aid.”