Distinguishing speech from background noise has been getting better, despite the fact that hearing aids generally amplify all incoming audio. As they aren’t wired to the brain, and everyday listening environments vary so widely, it has been challenging for them to separate the intelligibility of different sounds.

In some ways, modern hearing aids are simply becoming one more element in a selection of devices that anyone can use, says Marshall Chasin, doctor of audiology and editor-in-chief at The Canadian Audiologist.

“This is related to better directional microphones that communicate between the two hearing aids that a person is wearing, as well as better hearing aid ‘algorithms’ that can focus more on what a person wants to hear,” says Chasin. “One new technology is the 24-bit platform, which means that modern hearing aids are able to amplify the full range of sounds of speech and also of music, with minimal distortion.”

“For some hearing aids, the smartphone can even serve as a remote microphone for the hearing aid — point the phone at a person sitting across a table and its microphone will pick up the speech and stream it directly to the hearing aids.”

Bluetooth wireless can also be helpful in that regard, he adds. By using a higher 2.4GHz frequency, the antenna inside can be smaller, enabling even the smallest completely in the canal (CIC) models to work with a remote control. Eventually, hearing aids will be able to receive a Bluetooth signal directly from a TV or radio without the need for any intermediate boxes or control systems to facilitate, he says.

Finding the right fit

CICs have been on the market since the late 1980s, and are aesthetically appealing because they are more discreet in fitting in the ear canal, shortening the distance in which sound travels to a person’s ear. However, Chasin warns against assuming that they are better than larger behind-the-ear (BTE) models.

“There are limitations with the very small type and these include a more limited battery life, a limited ability to take advantage of newer technologies such as wireless Bluetooth, and a limited amount of amplification, so this small type of hearing aid may not be suitable for those with very significant hearing loss,” he says.

There are now several different styles of hearing aids, says Grace Shyng, head of audiology at the Western Institute for the Deaf and Hard of Hearing (WIDHH).

Aside from the common BTE and CIC models, there are in-the-ear (ITE) and tiny invisible in-the-canal (IIC) hearing aids, plus a smaller version of the BTE called the receiver-in-the-canal (RIC). The latter one is very similar to its larger predecessors, yet the piece above the ear is markedly smaller with only a thin wire running from the device to the part going in the ear.    

“In the past, smaller aids could only be fit to very mild losses,” says Shyng. “With advances in hearing aid design, computer chip technology and feedback control, higher degrees of hearing loss can be fit with one of the smaller hearing aids. Newer aids also offer improved battery life, so that hearing aid users wearing smaller aids do not have to change their batteries as frequently as before.”

Partnering with other devices

Smartphones are also playing a significant role, offering the ability to pair with an aid via Bluetooth. Users now can have a hands-free conversation on the phone, as well as using specific Apple iPhone and Android apps to adjust volume and serve as a remote control.

“For some hearing aids, the smartphone can even serve as a remote microphone for the hearing aid — point the phone at a person sitting across a table and its microphone will pick up the speech and stream it directly to the hearing aids,” she says.