Hearing loss can be mild, moderate, severe, or profound. In most cases, hearing can be improved with hearing aids, and this is one of the main needs of people with hearing loss. Hearing aids are devices specially designed to help people with hearing loss hear and communicate effectively. In recent years, more and more people are turning to alternatives to hearing aids. One of them is the personal sound amplification product, or PSAP. In this article, we will examine hearing aids and PSAPs in turn; we will then explain the differences between them and which one is suitable for people with hearing loss.
Hearing Aids
Hearing aids are digital devices designed to improve the hearing of people with hearing loss by amplifying sounds or making them audible. They have been around since the 17th century. The ear trumpet is one of the earliest forms of hearing aid: it was designed to capture sound energy and channel it directly into the ear canal. Today, however, hearing aids are computerized electroacoustic devices that make environmental sounds audible according to audiological and cognitive rules. Modern hearing aids are configured and customized according to the degree of hearing loss, lifestyle, and physical characteristics of the wearer. The device must also go through a step called fitting: this involves programming it from the most recent audiogram, frequency by frequency. The effectiveness of a hearing aid depends on the quality of this fitting. Hearing aids use sophisticated digital signal processing to improve speech intelligibility. This processing includes frequency lowering, feedback management, noise reduction, and wide dynamic range compression with directionality. Hearing aids are classified as medical devices and, in countries like the United States, they are regulated by the FDA. Before a hearing aid model is made available to the public, it undergoes extensive testing to ensure proper use. The advantage of hearing aids is that there is one for every degree of hearing loss. The market offers many types of models. This classification is made according to the location or positioning of the device in the ear. The size of each type varies, due to the demand for devices that are as invisible as possible. The downside is that the smaller a hearing aid is, the less effective it is. Here are the main types of hearing aid models.
1. Behind-the-Ear (BTE)
These hearing aids are custom-molded to fit perfectly over the top of the ear and rest behind it. This positioning does not make them less effective, as they have specially designed tubes with directional microphones, through which sound is directed into the ear canal. BTEs are the largest hearing aids. Some new miniature models are barely visible, but they are not yet widespread. BTEs are suitable for all ages and all degrees of hearing loss. The directional microphones they are equipped with give them superior sound amplification to other types of devices. However, they pick up more wind noise than other models.
2. In-the-Ear (ITE)
ITE hearing aids have two directional microphones and are suitable for people with mild to severe hearing loss, especially those with limited dexterity. ITEs are custom-made in two versions. The first fills most of the concha area of the outer ear, while the second only occupies the lower part. Even though ITEs are less bulky than BTEs, they retain some functions, such as volume control, which are absent from smaller models. They are also easier to handle, and their larger batteries offer longer battery life. ITEs are exposed to the risk of earwax obstruction: due to their position in the outer ear, earwax in the ear can enter the device and block the speaker.
3. In-the-Canal (ITC)
In-the-canal hearing aids are designed to fit partly in the ear canal. They are smaller and less visible in the ear than larger models. They are suitable for adults with mild to moderate hearing loss. As with ITEs, the speaker of these devices can easily be obstructed by earwax.
4. Receiver-in-Canal (RIC)
This type of hearing aid is also called Receiver-in-the-Ear (RITE). Like the BTE, it places a speaker, or receiver, in the ear canal. But instead of a tube, a very thin wire connects the casing behind the ear to the speaker located in the ear canal. This model is less visible at the part behind the ear; it also has directional microphones and can be adjusted manually. However, the part of the device in the ear canal is exposed to obstruction by earwax.
5. Completely-in-Canal (CIC)
As its name suggests, this hearing aid is designed to fit entirely inside the ear canal. It is suitable for people with mild to moderate hearing loss. It is the smallest and most discreet type of hearing aid. Due to its small size, it picks up less wind noise. It is difficult to manipulate and its very small batteries have a short battery life. It also does not have additional functions such as directional microphones or volume control. The speaker of this type of device can easily be obstructed by earwax due to its position in the ear canal.
6. Open Fit
An open-fit hearing aid resembles a BTE with a thin tube, or a RITE with an open dome. Low-frequency sounds can enter the ear naturally because the open fitting leaves the ear canal very clear. The hearing aid then amplifies high-frequency sounds. Since the dome is not custom-made, it is often difficult to fit and does not block the ear like other types of devices. However, this solution is suitable for people with mild to moderate high-frequency hearing loss.
Personal Sound Amplification Products (PSAPs)
PSAPs, also known as personal sound amplification devices, are portable electronic devices that amplify sounds for people who are deaf or have hearing loss. The FDA does not classify them as hearing aids because they do not meet the manufacturing and safety standards applicable to hearing aids. Despite the FDA's position, most people consider PSAPs to be an affordable alternative to hearing aids. Since they are not considered medical devices, PSAPs can be purchased over-the-counter or online for as little as fifty dollars. While PSAPs do not offer the functions or fitting required for people with hearing loss, the FDA believes they are good supplemental solutions for perceiving faint sounds during a lecture, presentation, or recreational activities such as hunting or birdwatching. Unlike hearing aids, they do not need to be fitted by an audiologist: PSAPs are self-adjustable and self-programmable using a smartphone or computer. PSAPs are not limited to volume amplification; some advanced models provide basic hearing aid functions. However, this does not mean that they can replace them. PSAPs simply meet the needs of people with mild hearing loss who want to amplify sound in certain situations. Using a PSAP instead of a hearing aid can, in the long term, do more harm than good to your hearing.
PSAPs vs. Hearing Aids
As we mentioned above, PSAPs and hearing aids are not the same thing and cannot replace each other. In this section, we review the differences between these two devices and tell you which one to choose.
Here are the differences between PSAPs and hearing aids.
1. Product Category
Hearing aids are classified by the FDA as medical devices and are adapted to compensate for hearing loss. They can only be obtained from hearing healthcare professionals. PSAPs, on the other hand, are just sound amplifiers, and the FDA only approves their use for people without hearing impairment. Unlike hearing aids, PSAPs can be purchased over-the-counter without a prescription. They can also be ordered online.
2. Price
Hearing aids are relatively expensive. The average price of a hearing aid is between $1,000 and $3,000. This high cost makes them inaccessible to the majority of people with hearing loss: only ten to twenty percent of them can afford a hearing aid. PSAPs are cheaper, even if they are not designed to help or improve the hearing of people with hearing loss. They are often considered a cheap alternative to hearing aids, especially for those who simply need to amplify sound. The average price of a PSAP is between $50 and $500.
3. Functions and Fitting
Hearing aids are specifically designed for people with various degrees of hearing loss and can only be fitted and programmed by an audiologist. Each hearing aid is adapted to the specific hearing needs of its user and custom-programmed by a professional. Hearing aids also have functions such as tinnitus management, audio streaming, or directional microphones. Unlike them, PSAPs are only offered with standard settings. PSAPs are unique devices meant to suit everyone; they cannot be custom-programmed.
PSAPs also do not have any additional functions: they consist of a microphone, an amplifier, and a receiver.
4. Amplification Mode
Hearing aids are designed to selectively amplify only useful sounds, while reducing background noise and feedback. This allows people with hearing loss to communicate effectively, especially in crowded places. PSAPs, on the other hand, amplify all sounds within a certain radius, including those that are not needed. Amplifying all surrounding sounds can damage your ears if the sound level exceeds the number of decibels your ears can withstand. PSAPs may amplify sounds very well, but that's where their role ends. They cannot improve hearing, although they can damage your ears. The fact that they cannot be custom-programmed makes them a very poor choice for anyone with hearing loss. Since no two hearing losses are alike, a one-size-fits-all device will not improve your hearing. In addition to not being medically recommended for hearing loss, PSAPs can also increase the risk of earwax blockage: their tips tend to push earwax deeper into the ear.
Conclusion
If you are considering purchasing a PSAP for the sole purpose of amplifying sounds, that's fine. However, if you have hearing loss, an over-the-counter or online device is not for you. You should consult a doctor. After a proper examination, the appropriate type of hearing aid will be prescribed for you. Have you ever used a hearing aid or a PSAP? Did it improve your hearing? Share your experience with us.
