A nanobiomaterials company based in Oklahoma, NanoBioMagnetics, Inc, has received a patent to implant nanoparticles in hard of hearing patients’ middle ears. These particles will help the ear to become more responsive to sound vibrations and should allow hearing aids to become smaller. NBMI’s technology may be the first to demonstrate nanochemical tissue movement. It detects sound waves, processes the signals and uses these signals to stimulate an electromagnetic coil, which then transmits a signal that causes the nanoparticles to vibrate. This amplifies the sound and should act much the same as a commercially available electromagnetic hearing aid. The 28 million Americans suffering from hearing loss will eventually benefit from more improved hearing aid devices

The co-inventor of the ‘Method and Apparatus for Improving Hearing’ patent, Charles Seeney, believes that, as “part of an emerging trend” these hearing devices will become smaller. The company started researching and developing this technology between 2002 and 2004 and NBMI plans to find commercial partners for the patent.

Mr Seeney, who is also the CEO and founder of NBMI, revealed that his company is working on a companion hearing aid technology, which is based on sending bioactive materials to the middle ear. Besides their focus on improving hearing, there are various other research projects underway at the M D Anderson Cancer Center in Houston. One of these projects tries to assess the tumor-specific delivery of cancer therapeutics.

The University of Oklahoma and the Massachusetts Eye and Ear Infirmary, an affiliate of Harvard Medical School, played a big role in the development of NBMI’s technology, which is viewed as Oklahoma’s first nanotechnology-based patent for a health-care application.

Reading the Signs – Is my Child Ready for Sign Language?

How early can I start signing with my child?

Why not start today? Sign ‘milk’ to your newborn when you’re about to nurse or offer a bottle. At bedtime, sign ‘sleep’. When you’re feeding the baby, take the little one’s hands to help them sign ‘more’ in-between spoonfuls. By doing this, you will get them used to signing and make it part of your daily routine. Before long, you will see that the repetitions and reinforcements occur naturally as your infant grows. Even better, it will help your infant to realise that crying might not be the best means of communication.

Should I teach my child who is already talking, SL?

There are many reasons why learning a second language should be encouraged, and learning SL is great for stimulating a child’s learning through different senses. Children who others see as ‘visual’, ‘spatial’ or ‘tactile learners’ can learn a lot from sign language. Some believe that learning a second language, including SL, can raise a child’s IQ. Hearing loss may be more common than you think; one in ten Americans suffer some degree of hearing disability. If you are familiar with some of the signs, you can give your child the confidence to interact with a deaf child. This would ensure that both children feel comfortable around each other.

I’m worried that learning SL will delay my child’s speech.

You share this concern with many other parents. They are worried that signing will either delay or stint a child’s speech. We are pretty confident that our experience has been the opposite. Your child’s communication needs should be met by learning SL, even if it is done before teaching the child speech. Sign language is as much a language as English or Spanish.

Should I become fluent in SL?

This is your decision. It will certainly be a great achievement if you become fluent in SL, but knowing the basics should suffice. Sign language, like any other second language, will require time, patience and plenty of practice. So surround yourself with others who are fluent.

Why can’t I just use made up signs?

You are taking time to teach and reinforce signs that have meaning to millions of SL users. Would it not make more sense, therefore, to involve your child in a language that has international recognition? Your child’s caregivers (who might include doctors, preschools, daycare centres, etc.) may prefer using SL and not a made up language consisting of different signs for each child in their care.

If a hearing child starts out as a ‘baby signer’, he or she can communicate with deaf children and adults. This child can also take advantage of other SL materials, which may include videos or SL playgroup. The foundation for the study of SL as a second language later in life exists and this may be made possible by using SL signs instead of made up signs.

A very valid point, brought up by some of our Deaf customers, is that made up signs may mean something completely different in SL, which could lead to potentially humorous and/or embarrassing situations.

My child is struggling with the SL signs. Is that ok?

Some children may struggle with the signs, and adapt to whatever they are physically able to do. Eventually, when their motor skills have had more chance to develop, their signing should improve. Compare this so speech development, where ‘Da-da’ becomes ‘Daddy’ or ‘Dad’ over time.

How long will it take my child to learn SL?

This will depend on when you start signing with your child. Newborns may not be able to sign until they are 8 to 14-months-old. Should you start signing with your 2-year-old, you’ll notice the uptake is slow. The child may not respond immediately, and it may take a couple of months. Any physical, mental or developmental delays should be taken into consideration.

Why should my hearing child learn SL?

There are children who are not developmentally ready to speak until they are two years old. Signs are far easier to learn, especially for babies. There are studies that show children who are as young as 6-months-old understanding and communicating with limited signs.

Being unable to communicate may cause frustration and anger tantrums, so very small children benefit from SL as they can express themselves.

Would signing help with tantrums and ‘The Terrible Twos’?

Tantrums and ‘The Terrible Twos’ are about frustration and the inability to communicate. Children who can communicate show less frustration. Verbal skills take a backseat to motor skills in the early years, so signing can be a tremendous help.

Is it a good idea to teach my 6-year-old SL?

Children of all ages can learn to love SL. It proves to be a valuable tool at any age and your six-year-old will be quick to learn all the signs, perhaps even picking up additional signs that will impress deaf playmates. And older children love using SL as their own ‘secret language’.

Many hard of hearing people would prefer to go without normal hearing aids. These people may participate in swimming and fear the water will harm the device. Or there might be worries about the device’s ease of use while sleeping.

Otologics has developed a new kind of hearing aid that will overcome these problems. The device is implanted in the user’s middle ear and uses a microphone to pick up sound signals, which are then processed by electronics. From there, it is sent to a piston against the small bones in the middle ear, which then transmits the vibrations to the inner ear. The inner ear encodes these vibrations as nerve impulses and sends the information to the brain. This method works because it sends sound directly to the cochlea.

This means a chance at a normal life for hard of hearing people. “You can be exposed to environments in which hearing aids have difficulty operating properly”, says Otologics’ CEO José Bedoya.

The challenge in manufacturing a device to implant is to design one that works well under the skin. Mr Bedoya explained that human skin changes throughout the day due to hydration levels and other factors.

The device charges by putting the charger coil on the spot where the implant was made. The average charging time is about one hour each day and the wearer can carry on with normal activities while it charges. The battery lasts for at least five years, after which it needs replacing. The components are sealed together to protect against leaks, so everything except the piston would have to be replaced.

The hearing aid’s phase I clinical trial in 2007 implanted aids into twenty subjects’, who all had moderate to severe hearing loss. The subjects all had slightly worse hearing than with their old hearing aids for the duration of the study, but their satisfaction levels were up. Even though their word-recognition scores dropped by 20 per cent, they felt that the device improved their hearing by making it sound more natural.

There are experts who doubt whether Otologics’ implant is a big improvement. The cost may be prohibitively high. The cost is $19,000 in Europe for the implant alone, while it costs $6,000 for a high-end conventional aid. This implantation device is still in clinical trials in the United States. Another critic, Gerald Loeb, who is a professor of biomedical engineering at the University of Southern California, would prefer implanted hearing aids to outperform conventional ones. Only then, he reckons, would they be worth the extra cost and risk.

He asked an important question: “How big an issue is it to have a little appliance on your ear when the whole world is walking around with cell-phone headsets and iPod earpieces?”

Other experts see great progress being made in implantable microphone design. Joseph Roberson, who is an ear surgeon and the CEO of the California Ear Institute, says, “I listened to a good-fidelity musical signal received by an implantable microphone positioned under half an inch of raw steak.” The functional outcome of the Otologics device, he says, is “roughly equivalent to existing visible external technology.”

However, the phase I study revealed that the Otologics hearing aid technology “serves as a viable treatment alternative for moderate to severe sensorineural hearing loss.” Bedova’s company is addressing the problems found and is preparing for phase II trials. The second trial will test 90 subjects with a revised device.

It seems ‘alpha adopters’ may be the ones most suited to this type of device. Roberson thinks they “are motivated to keep their use of a hearing device a private matter, or those who are intolerant of standard hearing-aid technology.”

Thanks to their extremely small size, these aids are nearly invisible to most observers. Size matters, and in this case, it means that smallness is prized. Some may also refer to these devices as Open Ear Hearing Aids. This is a new technology, and is an improvement on BTE Hearing Aids. The shell that fits around the ear tends to be smaller and the whole aid is much lighter than the older aids.

There is much research being done to improve Open Fit Hearing Aids for people with severe hearing loss. At present, those with high frequency hearing loss and normal to low frequency hearing may get the most benefit out of these aids.

A symptom of high frequency hearing loss is being able to hear, but not understand, what is being said.

These aids are lightweight and many users forget they are wearing something after just a short while. Another big difference is that standard hearing aids have an ear mould; these do not, so the wearer’s ear canal is open.

Benefits

Besides not causing occlusion, which is really just a fancy term for blockage, Open Fit Hearing Aids may not be much more expensive than regular in-the-ear or behind-the-ear hearing aids. Some users may find the automatic controls to be an advantage and the fact that they are not custom made, could make them easier to fit. This also means that the fitting time is considerably shorter because the audiologist does not need to take impressions of your ears to create the moulds.

No longer will it feel as though you are talking with one finger stuck inside your ear. And that oh so familiar sensation of hearing your own voice echo while talking, will also be eliminated with an Open Fit aid.

How do these devices differ from what else is available?

Open Fit hearing aids have digital a feedback cancellation system that eliminates the horrible howling or squealing sound that so many wearers complain of.

They do not have visible controls and function automatically.

These hearing aids are also known as post-aural aids, and consist of two parts. A mould goes inside the ear and another small plastic unit fits behind the ear. A small piece of tube connects these two parts. Hearing aid technology has progressed beyond the very first models, but they are still only aids to complement a wearer’s hearing.

Most hearing aids are binaural, and are used in both ears. This is a good idea, as the level of hearing would become much bigger. A small percentage of hearing aids are monaural, which means it is meant for one ear only.

These pieces are comfortable and there are different models that would suit almost any degree of hearing loss. It is possible to have them custom made to precise dimensions, which will give maximum comfort. There may even be different colours to match the wearer’s hair and skin tone.

Besides this one key advantage, there are also some less obvious ones:

• All age groups can wear a BTE hearing aid.
• Hearing amplification is very good with a BTE hearing aid.
• The batteries are bigger and easier to handle.
• Hot earwax would not affect BTEs.
• Directional microphones come standard with most BTEs
• BTEs tend to be more reliable.

Behind the ear hearing instruments are also not perfect. Some users may receive a bad fitting, which could cause feedback. Ear moulds may need the occasional remake to preserve the acoustic seal. These instruments are also larger than other hearing aids. This does mean they are a bit more noticeable.

How does a BTE hearing aid work?

Most normal hearing aids consist of the following:

• A tiny microphone
• An amplifier
• A loudspeaker

Who should consider a BTE hearing aid?

People who are prone to getting ear infections, have had surgery, or who suffer from excessive earwax production may want to get BTE hearing aids.

Digital Signal Processing

BTE Digital hearing aids use digital technology to process sound signals. The processor, which is really a tiny computer, has scientific models for sound and hearing programmed into it. Digital hearing aids therefore have a wider range of possibilities compared to analogue hearing aids.

Digital Signal Processing relies on the microphone for the incoming analogue signal. The signal gets sent to an analogue-to-digital converter (ADC) and is converted into numerical values, which the digital signal processor can process.

When the digital signal processor finishes the task, a digital-to-analogue converter (DAC) converts these signals back into an analogue signal.

Hearing aids have come of age in this modern, technological world. Digital hearing aids are now the preferred style and analogue technology may soon be superfluous.

There are many different types of hearing aids: the normal behind-the-ear type; the in-the-ear type; the in-the-canal type; a small box worn on the body and bone conduction hearing aids.

Behind the ear

The aid has a small plastic case that fits behind the ear, and a plastic tube connects it to the ear mould inside the ear.

Open ear fitting is a newer, slightly more hidden than ear moulds, version of BTE aids. These aids would only be suited to people with mild hearing loss.

In-the-ear and in-the-canal hearing aids

This device’s working parts are in the ear mould, so it is small enough to fit into your ear. Some ITE aids are visible from the side, though other ITC aids are inconspicuous as they fit into the ear canal.

These aids might not be safe for people who have severe hearing loss, or who have very narrow ear canals.

Body-worn hearing aids

A small box clips to your clothes or onto your pocket. It contains the microphone and working parts and connects to an earphone that clips into your ear mould.

These aids are great for people who have sight problems or who find it difficult to use small switches or buttons.

Bone conduction hearing aids

Someone who struggles to wear a conventional hearing aid or someone with conductive hearing loss would benefit most from these types of aids. Conductive hearing loss is the condition where sound vibrations pass through the outer and middle parts of your ear with increasing difficulty.

Bone conduction hearing aids transmits sound vibrations through the skull, directly to your inner ear. Patients wear a headband that holds a small bone vibrator behind their ear.

A second type of hearing aid, called a bone anchored hearing aid (BAHA), requires an operation behind the patient’s ear to insert a fixture into the bone. This will remove the need for a headband.

CROS/BiCROS hearing aids

People with hearing in only one ear might prefer these aids. A CROS hearing aid picks up sound from the side with limited hearing and feeds it to the hearing ear. A BiCROS aid amplifies sound from both sides and feeds it into the ear that has some hearing.

What is the difference between digital and analogue hearing aids?

The difference lies inside the hearing aid. Miniature computer chips control, monitor and instruct digital hearing aids. These instructions or “programmes” give digital hearing aids their name – digital programmable or digital signal processing (DSP) aids.

These aids are connected to a computer that automatically adjusts the settings to the patient’s requirements. Each patient’s programme is stored, and this makes adjusting or reprogramming the aid a cinch.

Analogue hearing aids use microphones to pick up sound and convert it into small electrical signals. Depending on the sound’s pattern, the signal may vary slightly. The device amplifies these signals and sends them to the earphone.

The upper-scale hearing aids use automatic gain control that amplifies quiet sounds just enough until can be heard. The patient’s ears will not suffer from much noise, but an analogue hearing aid does not have the same type of settings to suit someone’s individual hearing loss.

How advanced are these devices?

These hearing aids are highly intuitive and can filter out unwanted noise, and prioritize the type of sounds the patient wants to hear. Artificial intelligence enhances speech in listening situations that may be difficult for hearing impaired people. It changes automatically to adapt to changing listening conditions, and ensures you will always hear voices clearly.

These devices use the same type of artificial intelligence as that of voice-activated phones and speech recognition software. These programs shift through the normal clutter to detect human voices, and filters out office clatter, traffic and other normal sounds.

Comfort and design

Hearing aids have become more comfortable to use than in the past. There are different volume levels and the aid can be programmed to suit a particular hearing need.

Some hearing aids have a certain form of loudness compression system, and this will work well if the person who fits it adjusts the settings carefully.

There’s also no reason why you should put up with an ugly hearing aid. A growing awareness of people’s needs have prompted companies to design hearing aids that any aesthete will be proud of. These new aids blend in behind the wearer’s ear, and even if it is visible, e.g., a bald man who wears a hearing aid, it could still be an attractive piece.

Bluetooth technology can also be used in these new devices. The wearer would be able to listen to music through a portable music player, or answer a mobile phone.

Small enough

Digital hearing aids have different sizes, and private dispensers may have the widest range. There are small models that may be attractive options, even though these aids are notoriously fiddly to use. They also break easier and may not be very co-operative when you want to use the loop system.