Written by Stephanie Anderson, Kaylyn Leonard, Jada Zevenbergen, & Ronald Romero
Musicians often rely on their hearing as the optimal way to tune instruments or understand music (Hearing Healthcare, 2021). This creates a challenge for hard of hearing individuals who want to listen to music, play music or have a desire to become musicians themselves. Individuals that are hard of hearing often turn towards hearing aids, allowing them to hear sounds in their environment. Hearing aids are a way to help someone amplify the sound surrounding them, allowing them to better navigate the world around them. Although hearing aids are a remarkable tool for those with hearing loss, they are not perfect. The primary purpose of hearing aids is to help people understand human speech. They are designed to amplify sounds within a certain frequency range that are typical for human speech (Ehrenfeld, 2021). Most often, this range is smaller than the range of frequency and volumes presented in music. For example, a piano has a range 40 percent larger in frequencies than a female voice (Ehrenfeld, 2021). This brings forth limitations for hearing aid users in regard to music. Hearing aid users will often miss important sounds, such as very quiet or extremely loud sounds, when listening to music due to the limitation of the narrow frequency range of hearing aids. Additionally, loud sounds will often be distorted by hearing aids when exceeding their maximum input level, or level of sounds they are designed to detect (“Hearing Aids and Music”, 2015). This creates an unpleasant experience for the hearing aid user, who hears a noisy and loud sound rather than a loud clear musical note. For hearing aid users who have a desire to become a musician this creates a difficulty.
Nonetheless, hearing aids have played a vital role in allowing hard of hearing individuals to create, listen, and understand music. There have been advancements from the standard hearing aid, creating advanced hearing aids that have a wider frequency range, better equipped for individuals with a musical inclination. Musicians that are hard of hearing require these advanced hearing aids, instead of basic or mid-range, because of the extra features that are included.
| Hearing Aid Features | Basic | Mid-Range | Advanced |
| Digital sound processing | Yes | Yes | Yes |
| Feedback cancellation | Yes | Yes | Yes |
| Up to 4 hearing programs | Yes | Yes | Yes |
| Adjustable speech recognition and speech enhancement | No | Yes | Yes |
| Directional hearing for ultimate clarity in conversations | No | Yes | Yes |
| Automatic 360 degree hearing for outstanding spatial orientation | No | No | Yes |
| Automatic adjustment to different hearing environments | No | No | Yes |
Feature comparison for different levels of hearing aids (Hear, 2020).
These advanced hearing aids incorporate multiple channels to process different sounds, such as speech and music, to provide an individual with better clarity (Hearing Healthcare, 2021). Prominently, hearing aid channels are used to process different frequencies, so having more channels allows them to cover a wider range of frequencies. This aspect of advanced hearing aids is beneficial for musicians because healthcare professionals can adjust the channels to best accommodate an individual’s needs (PHB, 2016). This is especially important for instrument players because hearing aids can be tweaked based on each instrument to produce the most natural sound for the musician. Advanced hearing aids can also be programmed with algorithms to sort through a variety of sounds in an environment and then modify the settings to best fit the environment (PHB, 2016). For musicians practicing in a rehearsal or performing live, advanced hearing aids would be able to suppress speech to allow for an increased input of noise (Widex, 2015). This allows a musician to hear their own instrument or others in an ensemble more clearly. However, hearing aids still continue to be primarily created for speech and this brings forth issues for musicians despite the advancements made in hearing aids.
Hearing aids are designed to limit and reduce background noise, to allow the individual to focus on speech sounds. Due to the limits placed on sound feedback and noise management systems, this may erroneously label some features of music as feedback or noise causing one to incorrectly hear echoes, whistles, or howls. One in three hearing aid users experience this feedback when listening to music (Fulford, 2020). A solution to this problem can be found through disabling the automatic functions designed for speech. The first step for audiologists is typically to disable speech in noise. The hearing aid user can decide to turn the speech setting on after performing or listening to music. Feedback cancellation is another plausible solution. Further, focusing on reducing or removing the feedback may help. This is supported by hearing aid users who have reported that music sounds better when the feedback system is turned off or minimized temporarily in the moment. Microphone directionality is another helpful solution as some hearing aid users prefer omnidirectional (sound being processed from multiple directions) when listening to music through hearing aids. When it comes to live music, a fixed microphone direction might be better (Greasley, 2020). This way the sound input is coming from one direction only, specifically the stage. Adjusting the Maximum Power Output (MPO) or the master sound may help increase the clarity of music by reducing feedback as well. Although some listeners prefer an increase of MPO while others prefer a decrease (Greasley, 2020). “An ‘at home’ solution is adding clear adhesive tape to the hearing aid. This can decrease distortion by decreasing the input dynamic range, lowering maximum intensity peaks of music by about 10 decibels” (Medicine UIowa, 2022). The tape essentially suppresses the powerful sound waves that come with high frequencies creating feedback in the hearing aids. All of these solutions will differ from person to person, as music is diverse and hearing loss and perception is unique.
67% of hearing aid users report having some difficulty listening to music, yet 58% of them report never discussing that in the clinic, making this a pressing issue for audiologists. Audiologists are healthcare professionals who manage hearing disorders; however, it has been found that only 50% of audiologists surveyed asked patients about listening in regards to music and 67% had never received music-specific training. “Audiologist training on music was significantly associated with confidence in providing advice, confidence in programming hearing aids for music, and programming hearing aids for music for a greater number of patients” (Greasley, 2020). This presents a further issue for hard of hearing individuals who have a desire to become a musician,as there are a limited number of audiologists trained to alter hearing aids for musicians specifically.
Individuals who have a desire to become a musician and are hard-of-hearing are presented with many challenges with the hearing aids available today. Hearing aids are designed to amplify sounds comparable with human speech, not music. Although hearing aid advancements have led to the creation of advanced hearing aids, better equipped for hard-of-hearing musicians, music is still often confused for feedback in hearing aids. There are plausible solutions to this through the alteration of settings in hearing aids through audiologists. However, the majority of audiologists lack music-specific-training making these solutions unknown to many musicians. There is a need for music-specific-training for audiologists to make these solutions more available to musicians who are hard-of-hearing. Further, there continues to be a need for new advancements in hearing aids that are focused on improving the hearing experience of musicians.
References
Ehrenfeld, T. (2021). Optimize your heating aids for music listening. Healthy Hearing. https://www.healthyhearing.com/report/53122-Hearing-aids-for-music
Greasley, A., Crook, H., & Fulford, F. (2020). Music listening and hearing aids: perspectives from audiologists and their patients. International Journal of Audiology, DOI: 10.1080/14992027.2020.1762126
Hearing Aids for Musicians. Hearing Healthcare. 16 Feb, 2021. https://hearinghealthcare.net/blog/hearing-aids-for-musicians
Hearing Aids and Music – A Tricky Combination. Widex. 8 Sept, 2015. https://www.widexpro.com/en-us/blog/global/hearing-aids-and-music/
Hearing Aid Prices. Hear. 2020. https://www.hear.com/ca/hearing-aids/prices/
Killion MC. What special hearing aid properties do performing musicians require? Hearing Review. 2009;16(2):20-31. Retrieved April 6, 2022 from https://hearingreview.com/practice-building/practice-management/what-special-hearing-aid-properties-do-performing-musicians-require
The Pros and Cons of Multiple Hearing Aid Channels. People Hearing Better. 29 Mar, 2016. http://phb.secondsensehearing.com/content/pros-and-cons-multiple-hearing-aid-channels
University of Iowa Healthcare (2022). Hearing Aid (HA) and Music: Limitations and Problem Solving Strategies: Information for Audiologists. University of Iowa Healthcare. https://medicine.uiowa.edu/iowaprotocols/music-and-hearing-loss/hearing-aid-ha-and-music/hearing-aid-ha-pages-audiologists/hearing-aid-ha-and