The Assistive-Tech Future Is Hear Five experts in hearing-assistive technology predict where innovation is headed—and it seems much of it revolves around the device in your pocket. Features
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Features  |   February 01, 2017
The Assistive-Tech Future Is Hear
Author Notes
  • Haley Blum is a writer/editor for The ASHA Leader. hblum@asha.org
    Haley Blum is a writer/editor for The ASHA Leader. hblum@asha.org×
Article Information
Hearing & Speech Perception / Hearing Disorders / Hearing Aids, Cochlear Implants & Assistive Technology / Telepractice & Computer-Based Approaches / Features
Features   |   February 01, 2017
The Assistive-Tech Future Is Hear
The ASHA Leader, February 2017, Vol. 22, 52-59. doi:10.1044/leader.FTR2.22022017.52
The ASHA Leader, February 2017, Vol. 22, 52-59. doi:10.1044/leader.FTR2.22022017.52
Hearing-assistive technology is getting a makeover.
As stakeholders look to the future, developers and product manufacturers have already been busy over the past few years creating technology that more seamlessly taps into mainstream, universal devices to help people who are deaf or hard of hearing. Apps can now transform smartphones and tablets into hearing-assistive devices, and Bluetooth connectivity in hearing aids often takes the middleman (devices like TV listeners and induction loops) out of connecting directly to audio sources.
But that doesn’t mean the ongoing transition lacks growing pains. Financial barriers, not-quite-there technology and the continued practicality of dedicated-use devices mean innovation in some areas could still be far off (and perhaps unnecessary).
Of course audiologists can’t be completely sure of what the future holds, but staying current on the latest developments in hearing-assistive technology (HAT) can translate to better patient care.
We spoke with five HAT experts representing different corners of the industry—including academia, manufacturing, consumers and advocacy—about the current state of HAT and its future.
The Powerful Processor in Our Pockets
Abram Bailey, audiologist and CEO of HearingTracker.com
On the power of smartphones in HAT:
We have this tremendous computer in our pockets that, hands down, beats the processing power in a hearing aid—and battery consumption isn’t such an issue, either. Challenges with hearing in background noise can be partially accounted for by the computer-processing limitations of hearing aids and limitations on power consumption, where more power is needed to support intensive processing.
With increasingly sophisticated smartphones—they’re just going to keep advancing and getting better and faster—you could potentially get to a point where you could clean up the sound nicely and make speech easier for people with hearing loss to understand.

“We have this tremendous computer in our pockets that, hands down, beats the processing power in a hearing aid.”

On the challenges of wireless smartphone solutions:
There are some issues with latency, and that’s why you really can’t use these smartphone amplifier apps with wireless headphones. The problem is, by the time the sound gets picked up by the microphone in your wireless earphones, sent to the phone, processed and sent back to the wireless earphones, you get a delay—the speaker’s lips aren’t syncing with the sound of the words they’re saying.
Right now, if you’re using a smartphone app, you hold the phone out so the microphone on the phone can pick up the sound, which is amplified and sent through earphones with limited delay, but there are some problems: Holding your phone out and wearing earphones everywhere you go is not a flexible solution, and it really can’t compare with the convenience and discretion of hearing aids. We have amazing potential to use smartphones to do a better job processing speech in noise than hearing aids, but until we’ve solved the wireless latency issue, hearing aids are still the best overall solution.
On how audiologists can stay up-to-date with developments in assistive technology:
Our time can be strained, especially if you’re running an independent practice and trying to juggle a business. But you can try to stay abreast of these new technologies—read articles from time to time, flip through journals, look at the Apple and Google app stores to see what’s there, sign up for newsletters for some of the companies that sell assistive-listening devices, follow the news sources that cover our industry.
On rethinking the standard business model to align with needs of the modern patient:
A lot of the time, audiologists’ service structure isn’t geared toward breaking out of the mold of the hearing test and the hearing-aid fitting. It’s bundled right now. [Once you rework your business model and pricing structure], create a strategy or process for when a patient says they’re interested in buying an assistive listening device, or they’re interested in getting some counseling on an app, or they want someone to set up and confirm that an app is working for them—that they’re using some device the best way possible. Counseling, instruction or additional testing could be provided around these apps.
Toward the Helpful House
Wade Wingler, vice president of technology and information services at Easterseals Crossroads in Indiana; host of the “Assistive Technology Radio” podcast
On assistive technology meeting the mainstream:
I’m seeing overall integration with mainstream telephony and other types of technology—like smartphones and the way they’re now being built with Bluetooth integration for hearing aids. I’m seeing more accessibility for hearing built into mainstream products. A recent example is Nest Cams, the monitoring cameras that can be set up to watch your front porch or other parts of your house—they can also be triggered by sounds. So if there’s a sound in a certain area of your house, you get an email or other notification.
And these aren’t assistive-technology products anymore—they’re mainstream products that have a lot of this universal design and compatibility built in. We’re seeing a lot in home automation—things like Amazon Echo and Echo Dot, where you can speak commands and have, for example, lights turn on and off. It’s all mainstream stuff that you can buy at Best Buy and home-improvement stores. It’s funny—we have the most developed assistive-technology lab in Indiana, but it’s less and less specialty stuff and more and more things that we’re buying at Lowe’s and Best Buy.

“We have the most developed assistive-technology lab in Indiana, but it’s less and less specialty stuff and more and more things that we’re buying at Lowe’s and Best Buy.”

On the movement toward universal, mainstream design:
It all goes back to the concept of universal design; making something work well for everybody. Electronics stores are full of Bluetooth speakers, and we’re seeing more consumer products with better sound, which means more options for amplification. It’s super easy to buy things that are designed to make it easier to have music at your party or to listen to a YouTube video, a podcast or a book on tape. Even products from Bose and Beats, the big names for audio accessories these days, are helpful for folks who struggle with hearing.
On the realities of what smartphones can and can’t do for HAT:
We saw this in the ’80s and the ’90s with the personal computer—it became the magic platform for everything, and everyone was building software for Windows or Macs. But we still didn’t see things like cash registers disappear. We still see all kinds of special hardware that wasn’t quite right for the computer, and it’s the same for smartphones.
It’s an amazing platform—the iPhone, the iPad and related technologies are the most important thing to happen to assistive technology, and maybe even in the world of technology, in my lifetime. But there are things that it can’t do. You can’t make your iPhone spit out Braille, so you still need a dedicated hardware device for that. The trend that I do see is that smartphones and tablet platforms keep getting better. Anywhere there is a gap in the market where specialty products exist, that kind of functionality will be added on to smartphones and tablets.
Still a Place for Dedicated Devices
Larry Medwetsky, associate professor and chair of the Department of Hearing, Speech and Language Sciences at Gallaudet University
On dedicated hearing-assistive devices and universal devices:
Right now, we’re in this transitional phase. I do believe for a certain period of time there will be a certain domain of assistive technology that will still require dedicated devices—a lot in the alerting area. For example, an alarm clock. If you’re normal hearing, your smartphone can serve as an alarm clock. I don’t know if we’ll get to the point where people who are deaf or hard of hearing could use a smartphone—and tuck it under their pillow and it would vibrate strongly enough to wake them that way.
In the absence of that, you’re going to have smoke detectors and alarm clocks or other types of dedicated alerting devices. And I do see in an area such as TV, you still have the need for captioning, but if you want to be able to hear the TV instead of using TV listeners, you can put a Bluetooth transmitter or some other kind of transmitter on the TV, and then pair that with either a streamer or to your hearing aid directly. That kind of area is where it’s going to ultimately transition to wireless connectivity, such as pairing the TV to a smartphone and, in turn, the individual perhaps wears Bluetooth-capable earphones, thus, not being tethered to the phone itself.
On the future of hearing-assistive devices:
I have a vibro-tactile mode on my phone, but often it’s not strong enough to alert me. I really do see that for a while, there will be still dedicated HAT needs out there. But I do think more and more it will all be contained [within your smartphone or other multi-use devices]—and the future will be either in wireless technology or wireless technology combined with downloaded apps that will be able to address many individuals’ needs.
Tech Is Great; Good Communication Is Better
Rachel Kolb, Rhodes scholar and doctoral student at Emory University, focusing on American literature, disability studies and bioethics. (She is deaf and uses hearing-assistive devices.)
On her everyday use of assistive technologies:
I primarily use email and text message to get in touch with other people about everyday matters. Other non-sound-amplification technologies are present in my life, though: I use a vibrating alarm clock to get up in the morning, and also have a strobe light installed in my apartment for the fire alarm. I use Skype and FaceTime quite a lot in connecting with friends, family members and colleagues from a distance. I have also tried some voice recognition/transcription apps in various situations with hearing people, but tend to try to make direct in-person communication work in other ways whenever possible.
On what kind of technology and products she’d like to see in the future:
I’d love to see more hearing-assistive devices that generate accurate live captioning through voice recognition, in a range of situations. Beyond captioning, I’d also like to see more options for transmitting sound clearly into listening devices, beyond hearing loop technology, which I tend to dislike because I’ve encountered connection problems and also issues with the electromagnetic hum in the background.
There have been some mobile microphone transmitters developed for this in recent years, which I admittedly have yet to try in most mainstream situations, mainly due to the expense of these devices and also the tediousness of carrying around a microphone with me everywhere (and figuring out how to ask hearing people to speak into it, pass it around, use it properly in a range of situations, etc.). Smartphones could be one potential transmitting solution for this.
On keeping the bigger picture in mind:
I don’t always think technology is a substitute for good communication practices and communication awareness (and also the broader culture change that goes along with those things), but it certainly is wonderful and can help.
Embracing Apps and Accessories
Michele Ahlman, president and owner of ClearSounds Communications, telecommunication products manufacturer
On embracing the smartphone as the future of alerting devices:
The deaf population isn’t required to invest significantly in anything super special anymore for alerting devices, as many have tapped into the power of the smartphone. The universal design component has removed a sizable chunk of the specialized market of products—they’re not necessary. All cellphones vibrate—there’s nothing new there. There’s no need for some extra expense. As a consumer, do I want to spend another $39 on something I could probably get my phone to do anyway? There has to be a real value in it. Enabling people to leverage the power of their smart device—that’s really where the growth is.

“Smartphones are continuing to tap into that strength with things that personalize the device to my needs. That’s where there’s going to be growth: accessories and apps.”

On smartphone manufacturers entering the hearing industry:
What’s exciting and new is how we’re leveraging the rapid development of technology and applying it universally to all kinds of different marketplaces. I think what’s going to be really interesting is how things develop as the cellphone manufacturers really own the power—our cellphones are massively powerful computers that we walk around with. Smartphones are continuing to tap into that strength with things that personalize the device to my needs. That’s where there’s going to be growth: accessories and apps. When Apple enters—and they will enter—this space, what’s going to happen? That’s what I think is going to be interesting.
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February 2017
Volume 22, Issue 2