Smashing Success: HLAA Convention 2011

This past Thursday afternoon to Sunday morning the annual Hearing Loss Association of America Convention was at the Hyatt Regency in the Crystal City section of Arlington, just outside of DC… And it was a smashing success, with over 1200 people preregistered, and hundreds more walk-up for free Expo Hall passes and on-site registration, making it the largest HLAA Convention in history.

All of the HLAA workshop classes provide ASHA & AAA CEU’s; and the two I attended on Saturday were chock full of information needed by hearing healthcare providers of all stripes:

Hearing Aid Compatibility in the 21st Century was led by Senior Group Manager for Accessibility Tony Jasionowski of Panasonic and Senior Engineer Al Baum from Uniden. Al, who is active both in IEEE¹ and TIA², spared no engineering detail explaining TIA-1083 — Telephone Terminal Equipment Handset Magnetic Measurement Procedures and Performance Requirements. Yes, it’s a mouthful; but for us Engineers (and for hearing aid dispensers & audiologists) it’s a G-dsend, as it lays out on which two orthogonal axes as well as the magnetic field strength scalar quantities new phones must supply to hearing aid telecoils.

What makes TIA-1083 so nice is that it addressed the problem we Hearing Aid dispensers & users had with 1A2 POTS compatibility with  the vertical T-coils found in BTE instruments, as well as the vertical T-coils glued to the faceplate of ITE’s by some manufacturers. As someone who has worked in the trenches as a retail hearing aid dispenser, nothing was more frustrating than taking the calls from irate patients (legitimately) complaining that they couldn’t hear on the phone, especially with BTE’s. HLAA’s Lise Hamlin & others cooperated with TIA to make this specification work… And it’s a signature achievement for all parties involved.

Tinnitus: Current Neuroscience Research and Theories was conducted by Amber Leaver PhD, who is a post-doctoral research fellow at Georgetown; and she taught us a lot, treating us as she would a class of grad students, and not dumbing it down. The only downside is that neither of the two recent treatments — Neuromonics or Widex Zen.

Our friend Bonnie O’Leary at Northern Virginia Resource Center (NVRC) took copious notes and emailed her Seminar report to Members; however, since the link has not yet been posted to their HLAA Convention Reports page, I am pasting Mrs O’Learys’ report below:

NVRC News – June 22, 2011

Tinnitus:  Current Neuroscience Research and Theories

By: Bonnie O’Leary, 6/22/11

If you struggle with tinnitus, you are not alone.  There are over 46 million people in this country who have some form of this often debilitating condition.  This tinnitus workshop was presented by Amber M. Leaver, PhD, who got involved with tinnitus research at Georgetown University’s [sic] Medical Center two years ago.  I thank her for providing notes from her power point to assist us in our report.

Dr. Leaver began the workshop with some background on tinnitus.  It is a common hearing disorder in which a person hears a “phantom sensation” of sounds in the ear – buzzing or ringing are the most common – even though no external sound is present.  Tinnitus can come and go, it can bother us
for long periods of time, or it can be present constantly.  Groups at high risk for developing tinnitus include those who are exposed to loud noise: construction workers, musicians, and military personnel.  More military veterans receive  compensation for tinnitus and hearing loss than for any other medical issue.

Tinnitus can be associated with difficulty sleeping and fatigue, stress, anxiety, depression, and other factors.

Causes of tinnitus

The exact cause of tinnitus is unknown, but there are triggers to watch out for.  The  most common is exposure to loud noise and resulting hearing loss.  Head or neck injury, temporomandibular joint/jaw dysfunction (TMJ), and certain drugs are other triggers.  However, not everyone with hearing loss or head injury develops chronic tinnitus, and this is a phenomenon that neuroscience research is attempting to understand.  To understand tinnitus, we need to understand how the brains of people with tinnitus are different from those without tinnitus.

Neuroscience research

How does tinnitus affect the brain?  Currently, research identifies changes in two parts of tinnitus patients’ brains: the auditory system and the limbic system.

The auditory system begins in the ear, where sound is converted to neural impulses which travel to the auditory sensory processing center, or the auditory cortex.  People with tinnitus have hyper-responsiveness to sound in their auditory cortex, especially sounds like their tinnitus sensation.  In all people, the auditory cortex contains tissue that’s organized by what pitch it responds to best, like a keyboard on the brain. This is called tonotopy.

When we lose our hearing, these “brain keyboards” are missing “keys” corresponding to the hearing loss, and they also have extra “keys” corresponding to pitches close to their hearing loss.  In tinnitus sufferers, these extra keys often match the tinnitus sensation, and it is thought that the imbalances in hyperactivity and tonotopy produce the tinnitus sensation.  What is unclear is whether these changes are due to hearing damage or to tinnitus itself, making it hard to prove that changes to the auditory system alone cause tinnitus.

The limbic system is considered the emotional part of the brain, but it has also shown to be involved in deciding the value of our thoughts and behaviors.  The limbic system seems to be different in people with tinnitus due to a section of the brain being structured differently than in people without tinnitus.

Similar differences in this part of the brain are found in people with depression and chronic pain.  Dr. Leaver and her colleagues propose that this part of the limbic system works like a noise-cancellation system. When this system doesn’t work well, people are not able to suppress unimportant thoughts and perceptions – including phantom perceptions like tinnitus.

The impact of research on the development of treatments for tinnitus

As many of us know, there is currently no cure for tinnitus, and there is no treatment that works for everyone.  It will be crucial to identify the brain basis of tinnitus to develop effective treatments.  If the brain basis is mostly auditory, then treatments should target the auditory system.  If, on the other hand, the brain basis is limbic, then treatments will have to target the limbic system.

To learn more, Dr. Leaver directed us to the website for the American Tinnitus Association.

 

However, the highlight for me was meeting Miss Katie-louise Bailey, who came all the way from Derby, England for an action-packed week here in America with her friend Anna Herriman. For those who don’t (yet) know her, Katie-louise is a star soccer player who played for the England Deaf Ladies football team in international tournaments as well as University of Derby; and she is also one of UK’s top 250cc motocross racers, riding  for the Kawasaki factory team. Besides being a well-known athlete who just happens to be hearing impaired, she is also quite a role model for deaf & HOH young adults in the Derby & Nottingham region, across England, and around the globe, with her leading by example… And I’m proud to call her my friend.

Given the size of the crowd, all went surprisingly well, with the only real glitch Sunday at the Awards Breakfast when the adjacent session of the (Wired To Fail) Loop Conference bled into the banquet room, raining on Joe Gordons’ parade as he received a Lifetime Advocacy Achievement Award for his captioning advocacy. Other than that hiccup (which was Ampetronics’ fault), Convention Director Nancy Macklin indeed did a very good job with the largest HLAA convention in history.

Footnotes:

1: IEEE = Institute of Electrical & Electronics Engineers, of which yours truly is also a Member.

2: TIA = Telecommunications Industry Association

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About the author

Dan Schwartz

Electrical Engineer, via Georgia Tech

6 Comments

  1. Marcus
    June 26, 2011 at 5:19 am

    Interesting paragraph on the neuroscience, good read!


  2. hearing test
    July 11, 2011 at 3:49 am

    I like the helpful information you provide in your articles. I will bookmark your blog and check again here regularly. I am quite sure I will learn plenty of new stuff right here! Best of luck for the next! Thanks for sharing…….


  3. audiologist
    July 15, 2011 at 5:48 am

    Thanks for the introduction! I am always reading your blog and only today I have spotted the post with introduction! The current reporting requirements, which TIA argued could be streamlined, have proven effective in responding to consumer input. The FCC should not dictate technical standards for handset manufacturers. To do so would jeopardize industry innovation in improving such features as volume control, display screens and backlights. I am one hundred percent sure that Jodi is cool as other members are. Good luck in your future work. Thanks for sharing with us.


    • Dan Schwartz
      July 15, 2011 at 1:20 pm

      Greetings from the other side of the world!

      Actually, although almost all of the TIA member companies are really on the ball for hearing aid compatibility, we still need FCC regulations dictating technical standards because of Apple: They are the most deaf-UNfriendly corporation in America — I have a whole litany of complaints; but that is the subject for a separate Hearing Blog article. But, for just one relevant example, Apple received a record fine from the FCC over their iPhone shenanigans. From Patently Apple:

      Apple Gets knuckles Rapped with FCC Fine

      On December 2, 2009, a Notice of Apparent Liability for Forfeiture was made public against Apple Inc. by Kathryn S. Berthot, Chief Spectrum Enforcement Division of the FCC under file number EB-09-SE-152. According to the FCC document “Section 20.19(i)(1) of the Rules requires handset manufacturers to file hearing aid compatibility status reports under revised rules initially on January 15, 2009 (covering the six month period ending December 31, 2008) and then annually beginning July 15, 2009. Apple did not file the report covering the six month period ending December 31, 2008 until June 3, 2009, nearly 5 months after the January 15, 2009 due date. Accordingly, we find that Apple failed to timely file the hearing aid compatibility status report in apparent willful violation of the requirements set forth in Section 20.19(i)(1) of the Rules.” Additionally, the FCC documents state that “We conclude under this standard that Apple is apparently liable for forfeiture for its failure to timely file the required hearing aid compatibility status report in apparent willful violation of the requirements set forth in Section 20.19(i)(1) of the Rules.” The FCC, however, did find “that downward adjustment to the $6,000 base forfeiture amount to $5,000 is warranted based on Apple’s demonstrated good faith effort.” A major portion of the FCC document is enclosed in this report for verification purposes.

      Introduction

      In this Notice of Apparent Liability for Forfeiture (“NAL”), we find that Apple, Inc. (“Apple”) apparently willfully violated the wireless handset hearing aid compatibility status report filing requirements set forth in Section 20.19(i)(1) of the Commission’s Rules (“Rules”). For this apparent violation, we propose a forfeiture in the amount of five thousand dollars ($5,000).

      Background

      In the 2003 Hearing Aid Compatibility Order, the Commission adopted several measures to enhance the ability of individuals with hearing disabilities to access digital wireless telecommunications. The Commission established technical standards that digital wireless handsets must meet to be considered compatible with hearing aids operating in acoustic coupling and inductive coupling (telecoil) modes.

      The Commission further established, for each standard, deadlines by which manufacturers and service providers were required to offer specified numbers or percentages of digital wireless handsets per air- interface that are compliant with the relevant standard if they did not come under the de minimis exception. In February 2008, as part of a comprehensive reconsideration of the effectiveness of the hearing aid compatibility rules, the Commission released an order that, among other things, adopted new compatible handset deployment benchmarks beginning in 2008.

      3. In order to monitor the availability of these handsets, the Commission initially required manufacturers and digital wireless service providers to report every six months on efforts toward compliance with the hearing aid compatibility requirements for the first three years of implementation (May 17, 2004, November 17, 2004, May 17, 2005, November 17, 2005, May 17, 2006 and November 17, 2006), and then annually thereafter through the fifth year of implementation (November 19, 2007 and November 17, 2008). In its 2008 Hearing Aid Compatibility First Report and Order, the Commission extended these reporting requirements with certain modifications on an open ended basis, beginning January 15, 2009. The Commission also made clear that these reporting requirements apply to carriers that fit within the de minimus exception.

      4. Apple failed to timely file the required report for the period July 1, 2008 through December 31, 2008, filing it on June 3, 2009, nearly five months after the deadline of January 15, 2009. Apple timely filed the required report for the period January 1, 2009 through June 30, 2009 on July 15, 2009. On September 16, 2009, the Wireless Telecommunications Bureau (“WTB”) referred Apple’s apparent violation of the hearing aid compatibility reporting requirements to the Enforcement Bureau for action.


  4. Peter Phua
    August 7, 2013 at 3:06 pm

    Hi there!

    I’ve been reading your blog, and am really impressed by the in depth technical explanations of some of the more advanced topics within the field of hearing related health and audiology.

    I’m wondering if you might be interested in a guest post about Notched Sound Therapy, a new treatment for tinnitus being independently pursued by multiple groups of European researchers (http://www.audionotch.com/faq#science).

    Like Neuromonics, I work for a tinnitus treatment service, however unlike Neuromonics, we’re available to patients at a fraction of the cost, and are therefore more accessible.

    Cheers,
    Peter Phua
    MD, McMaster University


    • Dan Schwartz
      August 8, 2013 at 3:16 pm

      Peter, we are familiar with Audio Notch: We would welcome a guest article on it!


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