Hearing Loss Magazine January/February 2013 - 19

PSAPs are not medical “devices” but rather “electronic products.” As such, they are marketed, packaged, labeled, sold, and most importantly, regulated differently than hearing aids and other medical devices.
of the mid and high-range (meaning price) PSAPs available at that time did a pretty fair job of providing audibility for speech. Specifically, they made conversational speech as loud as the “fitting formulas” used by audiologists said it should be to allow a person with mild-to-moderate hearing loss to both hear and understand under certain conditions. These same studies also found that the lower end PSAPs fell short of that goal and often overamplified low pitch sounds, effectively drowning out critical speech sounds which tend to be higher in pitch and softer in volume. While it certainly is possible for a hearing aid fitted by a licensed hearing care professional to miss the mark, the software and best practices used to fit and program hearing aids make this much less likely. (For more detail on these practices, see my article in the January/February 2012 issue of Hearing Loss Magazine).

one that further separates PSAPs from hearing aids. PSAPs have no standard against which their performance is measured or reported. In contrast, all hearing aids sold in the United States must report several key data as measured against the American National Standards Institute (ANSI) S3.22 “Specification of Hearing Aid Characteristics.” This ANSI data is included in the packaging sent to hearing care professionals and allows them to select hearing aids that will, in fact, “compensate for impaired hearing.” Equally as important, the ANSI standard allows the hearing care professional to verify the performance of the hearing aids.

…studies also found that the lower end PSAPs fell short of that goal and often overamplified low pitch sounds, effectively drowning out critical speech sounds which tend to be higher in pitch and softer in volume.
have position statements encouraging people with hearing loss to seek the services of their members rather than purchasing PSAPs on their own. All that professional opinion is great, but how does that square with what people actually do when it comes to PSAPs?

…Dr. Ross cited two studies that found that at least some of the mid and highrange (meaning price) PSAPs available at that time [2009] did a pretty fair job of providing audibility for speech.
Hardware aside, electing to treat one’s own hearing loss with PSAPs removes the hearing care professional from the picture entirely. Regardless of one’s personal opinions or experiences with hearing care professionals, the fact that a third party is using calibrated equipment and procedures to evaluate hearing is preferable to the shooting in the dark method inherent in buying a sealed product online or hanging on an end cap at the local big box drug store. More importantly, working with a licensed hearing care professional offers the consumer the protection of their state’s professional licensure board. These entities ensure that those dispensing hearing aids meet minimum educational and technical requirements, are at least aware of HIPAA and other health regulations, and in nearly all states, participate in ongoing continuing education. It is no surprise that all of the major professional associations related to hearing loss and hearing aid distribution

Missing Features and Standards An important issue raised by Dr. Ross is that while some of these PSAPs can make speech louder, they nearly all at that time lacked the features common in most hearing aids that really make them useful in settings other than a really quiet room with a low ceiling, carpet, drapes and all conversational partners within four feet. Key among these “missing features” are directional microphones, feedback management and of course, a telecoil. At least one current PSAP now offers directional microphones, and depending on how one defines it, another offers a telecoil. I am being intentionally vague with brand names for a very good reason, and

Crunching the Numbers Whenever I want to know about trends in the use or non-use of hearing help, I turn to Sergei Kochkin, Ph.D. Dr. Kochkin’s MarkeTrak survey has informed the hearing aid and hearing care industry for 25 years. Performed every three to four years, MarkeTrak surveys 80,000 households which in 2008 resulted in 3,700 detailed followup surveys of people with self-identified hearing loss. While MarkeTrak looks at a wide spectrum of hearing loss and hearing aid data, we’ll focus on the PSAP section of MarkeTrak VIII. Readers interested in the full MarkeTrak series can find all the data and summary articles at www.betterhearing.org. In analyzing the PSAP data in 2009, Dr. Kochkin found the following:
• Approximately 1.5 million people with hearing loss use either directmail or PSAPs to compensate for their hearing loss; • Users of these devices, on average, have incomes $10,000 less than those of custom hearing aid users; • Despite the warning from the FDA that PSAPs should be used only when hearing loss is ruled out, it is apparent that approximately three out of four PSAP or direct-mail hearing aid users have hearing loss continued on page 20
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Hearing Loss Magazine January/February 2013

Table of Contents for the Digital Edition of Hearing Loss Magazine January/February 2013