Personal sound amplification products: For some, an affordable alternative to hearing aids

Growing up I had to wear glasses. Back then it was considered socially unacceptable, but necessary to be able to see. Sixty years later, everyone wears glasses and they are a fashion statement. Now as an aging adult, I need to wear hearing aids. This was and still is in many age groups considered socially unacceptable — a sign of being old and maybe a little senile. But it appears that hearing aids are in the process of a similar transformation. A pared down, more affordable category of products — personal sound amplification products (PSAPs) — may lead to greater use of hearing enhancers at a younger age.

Hearing aids: Enhanced hearing, at a price

One of the major complaints about hearing aids is that they are expensive; they can run from $1,000 to $6,000 apiece. Their average lifespan is about five years, making this a recurring expense. Not everyone can afford or wishes to spend that amount to improve their hearing, especially if their hearing loss is mild and they can get by without aids.

There is a large segment of the population that has such a mild hearing loss. They struggle in certain situations, such as when there is a lot of background noise — in noisy restaurants, large crowds, and large rooms. They do fine in quiet situations with small groups or one-on-one conversation. They could benefit from "readers" for the ears — inexpensive help that they can use occasionally, or even continuously, for a little boost.

Until recently, the laws have been a barrier for development of such help. Hearing aids have been defined by law and regulated. High certification costs have served as a barrier to market entry. Hearing aid prices have not come down much over the years, though the quality of the aids and the sophistication of the instruments have improved as fast as any electronic device available. What you get now for the same price you would have paid 10 years ago is a far superior device. What's more, the cost to dispense, service, and maintain the devices has increased with the cost of living. All of this has led to a gap between the demand for and supply of inexpensive hearing aids.

PSAPs: A more affordable option

Along come PSAPs, which have the potential to fill a large gap in the existing hearing aid product offerings. They provide a lesser certified, less feature-filled, but lower-cost entry for hearing loss sufferers. PSAPs cannot be called or marketed as "hearing aids," as they do not meet the definition and rigorous manufacturing and safety standards of hearing aids.

PSAPs range from simple volume amplification devices to more sophisticated devices that can do many of the simpler tasks that hearing aids can perform. They are self-fitting and can be self-programmed using a smartphone or computer app. They are sold over the counter, and thus eliminate the expense of fitting. They are not as electronically sophisticated as hearing aids, and so can be sold cheaper. Lowering the cost of entry will allow most people to enjoy better hearing at a younger age.

PSAPs are not a replacement for hearing aids. They cannot replace the sophistication of hearing aids, or the skill in fitting them that audiologists bring to the job. They are devices that can fill the need for those with mild hearing loss, who just need a little more volume in certain situations. The good ones — the ones you should try — will be marketed as hearing aids in the near future.

Getting started with your PSAP

Suppose you want to try a PSAP. How do you know you are getting what you are being told you are getting? How do you know that what these products advertise is actually what they deliver? How do you know that they are safe? The FDA has stepped in to regulate this new market. Legislation was passed in 2017 and goes into effect in 2020 to allow for marketing of these low-end hearing aids to be advertised as such, if they meet certain (still-to-be finalized) criteria on performance and safety. Many of the devices are on the market today without any such oversight. That will change in 2020 to allow those devices that meet the established criteria to be marketed as hearing aids and not PSAPs.

Many of the new devices require some sophistication in setup and maintenance. You become the dispenser, fitter, and maintainer of the devices. You provide yourself with the services that an audiologist provides for hearing aids. YouTube videos and online support can resolve most if not all issues that may come up. Mandated trial periods can allow for return of goods when the issues cannot be resolved.

Better hearing, younger

In countries where hearing aids are free, more than half of the people who could use hearing aids do not use them. Money is clearly not the only issue preventing hearing aid use. Starting people earlier in the process and giving them control over the use of such devices can only encourage a greater long-term acceptance and usage of hearing aids as we age. Having more people use the devices eliminates the social stigma that has surrounded hearing aids.

I am hopeful that PSAPs are the intermediate steps that will lead to greater hearing aid use for the majority of us who should be using hearing aids, but do not.