By Larry Medwetsky Mobile Device Apps for People with Hearing Loss Expanding the Horizons of Hearing Access Here are some amazing apps for people with hearing loss that are now available for download to smartphones, tablets, and the Apple Watch. In the July/August 2015 Hearing Loss Magazine, I wrote an article concerning hearing aid connectivity. This technological advance has allowed hearing aid users to connect their hearing aids directly by Bluetooth® or indirectly through an intermediary device to external sound sources like a cell phone or television. Connectivity can also allow hearing aid wearers to hear others across the room as if they were speaking right next to them. This is made possible through the use of the paired device as a remote microphone. In this article I will write about other significant advances for those who have a hearing loss; that is, the myriad of applications— “apps”—which have been developed for individuals with hearing loss for download to smartphones or tablets. It is estimated there are more than one billion users of tablets worldwide. By 2016 there will be more than two billion owners of smartphones. Much of the popularity of apps can be attributed to their lower cost than comparable commercial products. With a simple download of these apps, people with hearing loss have the ability to transform their smartphone or tablet for various hearing-related applications. Apps by Their Function In this article, I have categorized the types of apps available by their functional purpose. Refer to the end of this article for a list of apps in these categories as well as the cost for downloading them. You might also want to search these category keywords online to find more offerings. Please note that I have not purchased or tested most of the apps I will be discussing nor is my mention of any of these products meant to imply any form of endorsement. I have however, researched and compiled a list of apps and used their website descriptions. There 20 Hearing Loss Magazine Visit us at hearingloss.org and follow @HLAA on Twitter are some app categories where I will measurements depends upon the note caveats to their usage based on my calibration of the headphones knowledge and experience. before administration of the test and the amount of noise in the Mobile Device Apps Serving background environment. If not as a Hearing Screening Device addressed, the latter can often Hearing screenings typically use calibrat- result in raised hearing thresholds ed audiometers for the purpose of iden- when conducting a hearing tifying whether one has a hearing loss, screening. This might, in turn, and possibly the extent of a hearing loss lead to a false referral for a via air conduction pure tone threshold comprehensive hearing test. testing. Recently, software for conduct- ing hearing screenings/air conduction To determine the exact level of threshold testing has been available for the background noise requires a Sound download to smartphones or tablets. Level Meter (SLM) app that can ensure Two uses for this type of app include: for the output meets a target standard hearing professionals to conduct hearing within an acceptable level. In my review screenings in remote or low-income areas; of many of the hearing screening apps and, for consumers who suspect they currently available, most of these do not might have a hearing loss to conduct incorporate or suggest calibration, nor their own initial screening. do they discuss the type of headphone In Third World countries, this that should be used. Consequently, software is used as a mobile hearing if one does not address these issues, Example of a hearing screening app screening device to easily screen a lot one has to be cautious relative to the (uHear 2.0 hearing screening software of people who might not have access results obtained, as they might result from Unitron). Photo courtesy of Unitron. to hearing screening. Professor De in inaccurate findings. Wet Swanepoel from the University However, I did note some hear- Amplifier Apps of South Africa along with colleagues ing screening apps that do incorporate Recently, apps have become available from other countries have developed a calibration process as well as a to transform a mobile device into a hearScreenTM, a mobile hearing means of addressing any background personal sound amplifier. Amplifier screening app, to conduct hearing noise present. The hearScreenTM apps typically use the microphone of screenings in community-based pro- app by Swanepoel and colleagues is the mobile device to pick up sounds grams in South Africa. In conducting now commercially available to the and then apply processing to the these hearing screenings, headphones public, while an app developed by incoming signal so that the individual were calibrated (the software was pro- Na and colleagues also shows much can hear more clearly and easily. There grammed to ensure the desired output promise. Note that the hearScreenTM are a wide variety of amplifier apps; levels), and real-noise monitoring app must be purchased with the however, some of these only increase was done to ensure that background Sennheiser headphones for which it the overall volume, while others provide noise would not interfere with the has been designed. In addition to these similar volume-control options found reliability of the results obtained. In aforementioned apps, a number of within a basic hearing aid. The more their field studies, Dr. Swanepoel and hearing aid manufacturers, including comprehensive apps also include his colleagues found that they were able Starkey and Unitron, also offer down- options that can focus on sounds that to obtain results comparable to those loadable hearing screening apps though are far away or those that are close up, obtained in an audiologist’s office. from what I can tell they do not while some of the sites also claim their In a paper examining hearing incorporate any calibration process. apps can decrease background noise. health care apps for mobile devices, Na An alternative for individuals who I will first describe some of (2015) indicated a number of factors do not feel they have the technological the many apps that are available for that need to be considered when using know-how to run a mobile app, or are download, starting with the simpler mobile technology to conduct hearing not ready to schedule an appointment ones. I will then offer my opinion as screening/testing. These include: with an audiologist, is hearing screening well as discuss a number of caveats to • the frequency response of the offered in the community from service their general usage. headphones used can affect the organizations such as the Lions Club TV Louder is one of the simplest accuracy of the hearing screening. and Sertoma or various hearing health- amplification apps. All one has to do • the accuracy of app-based hearing related practices. continued on page 22 Like HearingLossAssociation on Facebook September/October 2015 21 Apps continued from page 21 iPhone. Directional microphones pick up sounds more easily from in front of is plug in the headphones and tap the listener than from other directions the program-on button. To adjust the making it easier to hear a speaker in volume to one’s comfortable listening the presence of background noise—as level, one adjusts the volume on the long as the speaker is located in front side of the mobile device. of the directional microphone). There HearYouNow consists of a are many directional microphones simple interface where the overall in the marketplace that can be used volume can be adjusted per ear; the in conjunction with a smartphone, user can also adjust the volume in three although obviously some are better separate frequency bands (low, medium and more expensive than others. and high frequency range) and there is In reviewing the various apps, a focus feature that allows you to hone it is clear that many of them can in on a conversation held close by or assist individuals with hearing loss. farther away from you. Candidates for such apps include BioAid has been designed to individuals: enhance sound clarity and regulate the loudness of ambient noise. According • who have a mild hearing loss for to the website, one does not need a whom hearing aids are not yet hearing test prior to using this app. Example of an amplifier app (HearYouNow appropriate or necessary because Instead, the user chooses between amplifier app from ExSilent). Photo they just need some additional different settings associated with six courtesy of ExSilent. amplification, basic audiogram shapes and the listener • for whom finances are a major chooses the one that sounds best. The Recently, a new app has come on concern or they are not ready to user also has control of the overall the market, whereby the manufacturer commit to the expense entailed sound level and can vary the level indicates that it is the world’s first USA by hearing aids, in which background sounds can be Food and Drug Administration (FDA) • who live in poor areas of the world, suppressed. registered medical standalone software • who might be sedentary, such as Hearing Aid Replay Lite’s main hearing aid. The Jacoti ListenApp individuals residing in a nursing features include: a volume control; a has been designed to assist individuals home who can’t get out to get their balance control to adjust left or right with mild-to-moderate hearing loss and hearing tested, or, ear volume; an equalizer to adjust is audiogram-based (i.e., the hearing • who simply are just not ready the degree of amplification across testing must be conducted by a hearing to try a hearing aid.