Hearing Health Fall 2022

Hearing Health

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FEDERAL

The mission of Hearing Health Foundation is to prevent, research, and cure hearing loss and tinnitus through groundbreaking research and to promote hearing health. As the largest nonprofit funder of hearing and balance research in the U.S., we are a leader in driving innovation and treatments for people with hearing loss, tinnitus, and related conditions.

Since one pillar of our mission is prevention, we are excited about our Keep Listening campaign that is working to create a major culture shift in how we think about hearing and overall well-being. We want everyone, no matter their age, to be aware of the dangers of too much noise, especially the cumulative effect, in the same way we are aware of the damage from excess sun and cigarette smoke. Extra volume can come from our favorite music or other leisure activities, but we can enjoy them responsibly by being mindful of exposure, using hearing protection, and resting our ears. Please see the many stories in this issue from music lovers who are taking their hearing health seriously.

This issue’s theme is the Arts and Music and their power to change people’s hearts and minds. This is a cornerstone for how we are sharing Keep Listening’s message of prevention. The arts are also integral to our researchers and greater community at large. No matter what form creativity takes—whether in the research lab, concert hall, or family kitchen—it inspires and enriches our daily lives. Please enjoy this magazine, and thank you for your support.

Timothy Higdon President & CEO Hearing Health Foundation

Hearing Health

The Arts & Music Issue

Fall 2022, Volume 38, Number 4

Features

08 Art Code Art. Kenneth Vaden, Ph.D.

Roundup Creative Genius.

Music Unplugged. Robert Small

Music A Life, Loud. Jonathan Kane

20 Hearing Health To Create a Culture Shift Around Healthy Hearing, Start Young. Rohima Badri, Ph.D.

22 Music Harmonically Distorted Power. Lyle Preslar

24 Research Why I Appreciate My #StartWithERG. Viji Easwar, Ph.D.

26 Living With Hearing Loss Hear Me Out. Amy Linden

Departments

06 In Memoriam Neil Segil, Ph.D.

Meet the Researcher Robert Raphael, Ph.D.

28 Books Hearing So Strangely. Kathi Mestayer

30 Fashion Let’s Bring Bling to Hearing. Pat Dobbs

31 Fashion See Me Hear. Charlotta Norgaard

32 Managing Hearing Loss Bluetooth Assistive Listening Gets Closer Stephen O. Frazier

34 Research 2023 Hearing Restoration Project Funding Awards Announced.

35 Research Meet the 2023 Grantees

36 Research Recent Research by Hearing Health Foundation Scientists, Explained.

Sponsored

Advertisement Tech Solutions. 45 Marketplace

Publisher Timothy Higdon, President & CEO, HHF

Editor Yishane Lee

Art Director Robin Kidder

Senior Editor Amy Gross

Staff Writers Pat Dobbs, Shari Eberts, Stephen O. Frazier, Kathi Mestayer

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Editorial Committee

Judy R. Dubno, Ph.D. Christopher Geissler, Ph.D. Lisa Goodrich, Ph.D.

Anil K. Lalwani, M.D. Rebecca M. Lewis, Au.D., Ph.D., CCC-A Joscelyn R.K. Martin, Au.D.

Board of Directors

Chair: Elizabeth Keithley, Ph.D. Sophia Boccard Robert Boucai

Judy R. Dubno, Ph.D. Jason Frank, J.D. Jay Grushkin, J.D. Roger M. Harris Cary Kopczynski Sharon Kujawa, Ph.D.

Anil K. Lalwani, M.D. Michael C. Nolan Paul E. Orlin

Robert V. Shannon, Ph.D. Nancy Young, M.D.

Hearing Health Foundation PO Box 1397, New York, NY 10018

Phone: 212 257.6140 TTY: 888.435.6104

Email: info@hhf.org Web: hhf.org

Hearing Health Foundation (HHF) and Hearing Health magazine do not endorse any product or service shown as paid advertisements. While HHF makes every effort to publish accurate information, it is not responsible for the accuracy of information therein. See hhf.org/ad-policy.

Cover A 2015 Emerging Research Grants scientist generously funded by Royal Arch Research Assistance, Kenneth Vaden, Ph.D., is shown with his generative artwork “Places of Conflict” in his home studio. Photo by Sam Wolfe.

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Hearing Health magazine (ISSN 2691-9044, print; ISSN 2691-9052, online) is published four times annually by Hearing Health Foundation. Copyright 2022, Hearing Health Foundation. All rights reserved. Articles may not be reproduced without written permission from Hearing Health Foundation. USPS/Automatable Poly

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Who We Are

InnoCaption is owned and led by two Co-CEOs whose partnership and collaboration led to the launch of the first mobile-focused real-time call captioning service. We are a passionate, purpose-driven team on a mission to provide an empowering accessibility solution for the deaf and hard of hearing community.

The InnoCaption Difference

Our mission and mindset make our service unique. We focus solely on smartphone technology while our industry mainly offers landline phone solutions. We utilize live stenographers (CART) to provide faster and more accurate captioning despite the higher cost it entails. We are the only captioned phone service provider to offer users the choice between automated speech recognition technology or live assisted captioning on every call. All because we care about our users and put their needs first.

(Ringing) (Connected) Family Hearing Services, how can we help you today? You’d like to schedule an appointment with your audiologist? Sure, we can help you with that! What is your name? Thank you, Dr. Olsen can see you this Thursday at 9am. Does that work for you?

Okay, great, we will see you on Thursday then! Please don’t forget to bring your ID with you and fill out the patient questionnaire online before arriving. We look forward to seeing you. Have a great day!

Hearing Healthcare Professionals

Download our app and register for a demo account if you would like to test our service before recommending it to patients. If you have any questions regarding our service or require assistance, please contact us at healthcare@innocaption.com.

Disclaimer: InnoCaption is ONLY available in the United States. FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON. IP captioned telephone service may use a live operator. The operator generates captions of what the other party to the call says. These captions are then sent to your phone. There is a cost for each minute of captions generated, paid from a federally administered fund. No cost is passed along to the InnoCaption User for using the service.

*911 Calling Advisory: Calling 911 from a landline remains the most reliable method of reaching emergency response personnel.

Joe Duarte

Co-CEO and daily user of InnoCaption

"When I first discovered the InnoCaption app, I was blown away by its potential to completely change my life and the lives of many other deaf and hard of hearing individuals."

D r O l s en

We take comfort in the influence Neil continues to exert on the field thanks to his generosity as a mentor and colleague.

Hearing Health Foundation Mourns the Passing of Neil Segil, Ph.D.

Neil Segil, Ph.D., died peacefully in his sleep in July at his home in California after battling pancreatic cancer. He spent the last few months of his life at home with his family, according to fellow Hearing Restoration Project (HRP) consortium member Andy Groves, Ph.D., “reading, talking science, listening to music, watching old movies, and chatting with friends by Zoom and email,” including many consortium colleagues.

Neil was a professor at the Keck School of Medicine of the University of Southern California (USC), in the department of stem cell biology and regenerative medicine, the USC Tina and Rick Caruso Department of Otolaryngology–Head and Neck Surgery, and USC’s Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research.

Neil was also a founding member of the HRP. He chaired the Cross-Species Epigenetics working group, which is characterizing the molecular blocks to hair cell regeneration by comparing gene expression and epigenetics across species. He was also an active member of the Reprogramming and Gene Delivery working group that is piloting ways to induce hair cells by reprogramming supporting cells, both by assessing the effects of a

candidate transcription factor cocktail and by optimizing methods of delivery.

Neil’s contributions to science, the HRP, and many colleagues’ careers were invaluable. HRP scientific director Lisa Goodrich, Ph.D., describes the terrible loss. “Neil has been a leader in our field for many years, not only because of the beautiful work he carried out but also because of his generosity to others,” she says.

“I have benefited tremendously from Neil’s wisdom and advice over the years, especially since joining the HRP,” Goodrich adds. “He was always quick to answer my questions, share protocols, and jump on for a lastminute Zoom call to talk about his science and the vexing challenges we are all trying to solve as a consortium. Every interaction I had with Neil was both illuminating and rewarding—he was a genuine, warm, and kind friend. I will miss him very much.”

Many of Neil’s colleagues continue to reflect on his ability to prompt new ways of thinking about their research, pushing them to chart fresh directions and pitching in himself to help. HRP member Jennifer Stone, Ph.D., fondly recalls Neil’s scientific collegiality.

“Neil was a warm-hearted, generous, and honest

person,” Stone says. “He challenged my ideas in a thoughtful way, teaching me to consider alternative perspectives. He collaborated with me to tackle questions that I could not have addressed on my own. Neil always pushed me to look more deeply, to think about a better way to tackle a problem, and to relish the process of discovery. I cherished the time I spent with him, and I am thankful for what he taught me.”

Neil has had a profound impact on many researchers over several decades of a scientific career. Groves takes comfort in the influence Neil continues to exert on the field thanks to his generosity as a mentor and colleague.

“Neil and I collaborated for over 20 years and published 16 papers together,” Groves says. “He was one of the most widely read and gifted scientists I have ever known, a selfless and inspiring mentor, and a wonderful colleague to everyone who worked with him. I am heartbroken that I have lost my longest collaborator and my best friend, but his memory will live on in his science, and in the scientists he trained and helped throughout his career.”

“Neil had a huge impact on our field,” Stone agrees. “His work helped to frame many of the questions that we who study hair cell development and regeneration are asking today. Neil helped to forge new areas of study and to generate new scientific approaches, and he trained many bright people to carry this work forward and to generate stable and fulfilling careers for themselves. The world is fortunate that Neil decided to devote his work to hearing and balance research.”

A story on the USC Keck School of Medicine website highlights the USC Mentoring Award Neil received “for fostering an engaging, supportive, and inclusive academic environment.” The Segil Lab, which investigates sensory regeneration and inner ear biology, has trained many undergraduate and postgraduate students and postdoctoral researchers. Lab members have gone on to contribute to academic research, clinical medicine, and industry.

Former lab member, colleague, and new member of the HRP Litao Tao, Ph.D., says, “Neil always encourages his students and postdocs to try new ideas. If you have a new idea, no matter how baseless it is, you can always talk to him. He will think through it with you, talk about it, and say what the pitfalls and the outcomes might be. And the way he manages the lab, he likes people to be more selfmotivated and doesn’t push people for results. So that’s probably the reason why everyone in the Segil Lab is nice, because they don’t feel pressure from him, so they relax and enjoy the research.”

Timothy Higdon, HHF’s president and CEO, says, “We send all of those touched by Neil, both his family at home and his family in the lab, our deepest condolences. The HRP would not be where it is now without his significant insights into the processes driving embryonic development of the inner ear. We here at HHF—all of our researchers, scientific advisers, the board, staff, and volunteers—will miss him immeasurably.”

Support our research: hhf.org/donate.

Neil’s contributions to science, Hearing Health Foundation’s Hearing Restoration Project, and the careers of many colleagues and teammates were invaluable. His colleagues remain grateful for his ability to prompt new ways of thinking about their research, pushing them to chart fresh directions and pitching in himself to help. Neil challenged ideas in a thoughtful way. He was a genuine, warm, and kind friend whom we will miss very much.

For Kenneth Vaden, Ph.D., the generative art process begins with nearly empty code and a blank image output file. The image changes over many iterations of writing code, executing, and viewing the results. Shown on the opposite page is his artwork “Daisy Chain.”

Code Art

Research experiences with code, combined with art experience, led me to discover generative art. By Kenneth Vaden, Ph.D.

While art and science may seem like vastly different pursuits, good science and good art both require many of the same elements. These include creativity, discipline, patience, mentorship, and following your curiosity. My art practice adapts many of the computational skills that I learned for research, to craft algorithms that create a unique type of artwork.

My research experience involved the development of fluent code writing, over many years of data analyses and plotting results for publications. Mentors like Dr. Forrest Young, Dr. Sliman Bensmaia, and Dr. Stephen Wilson shared their calm, inquisitive, and methodical mindsets during code trouble-shooting sessions with me, which reshaped my frustration while fixing stubbornly broken algorithms. Their influences helped me see the fun and art in coding.

My postdoctoral research phase saw a transition to code-writing as a creative medium, when I started to write completely new algorithms almost as quickly as I could think of new statistical analyses or simulation models. While new hypotheses would often fail the test, my enthusiasm was fueled by composing new ideas and seeing the machines come to life.

These skills and the scientific opportunities that provided them to me were only possible because others helped me to figure out coding, so I have always appreciated the importance of teaching. I’ve advised many students that no matter what direction they choose to take, programming skills will open more doors than they could ever imagine.

Science

My scientific research is focused on age-related changes in brain function and peripheral changes in hearing that affect listening difficulties. I have characterized an adaptive control system in the frontal cortex, which is theorized to adjust behaviors and optimize performance for challenging tasks that include speech recognition in noise.

I have performed neuroimaging studies that suggest a role for adaptive control during word recognition, gap detection, and memory encoding in noise and how these may change across the lifespan. As a recipient of an Emerging Research Grant in 2015, I performed neuroimaging studies that linked

Part of sharing my artwork online is writing plain-language recipes that allow nontechnical audiences to better appreciate the artwork and give fellow nerds a chance to replicate or create variations on interesting algorithms. In this way my teaching has extended to other audiences.

Additional examples of Vaden’s generative art are “Momentary” (top), “What Dreams May Come,” and (opposite) “Black Path.”

this activity to changes in how much information will be collected during speech recognition in multitalker babble (e.g., cafeteria noise) by middle-aged and older adults.

A few years ago, I was writing a tricky algorithm in the R Statistics Language to plot white matter pathways in the brain from an MRI diffusion imaging dataset collected at my institution, the Medical University of South Carolina.

First, I plotted lines as a flat representation of the three-dimensional coordinates for pathways. Coloring the lines and adding a dark line underneath each (like a shadow) allowed the flowing white matter bundles to be visually individuated, and their mass trajectory could now be appreciated.

Next, all of the pathways were broken up into segments and plotted based on depth, which created strong interposition cues. When the tracts were plotted this way, the beauty of these brain structures was striking—and I realized the creative possibilities of precision plots. Soon afterward, I began to experiment with similar techniques at home (with random numbers rather than data) to draw noisy 3D structures. I slowly reinvented code art, completely unaware that there was a fresh art movement called generative art.

Art

Generative art is defined by the use of an autonomous system that can produce imagery with minimal intervention by the artist, after writing the algorithm. The dual challenge of composing generative art algorithms is to produce beautiful output while ensuring that there is sufficient variation to make all of the output interesting.

Traditionally, generative artists curate and select the best images created by their algorithms. Long-form generative art is an even more arduous test—running a system without any curation, with sufficient quality and variability to produce hundreds or thousands of unique outputs for collectors. I have developed three long-form algorithms and released one publicly so far.

With modern computing and the arrival of cryptocurrencies, generative art has gained interest, although this art tradition goes back to the earliest computers with pioneers such as Lillian Schwartz, Herbert Franke, and Manfred Mohr. During the pandemic, I was fortunate to meet (that is, chat online) with many of the most prominent artists in the current generation by sharing my artwork on social media—including Aaron Penne, Jens Clarholm, Itzel Yard, Jeff Ipps, Andrew Strauss, Piter Pasma, Tyler Hobbs, and many others.

This international artist community became an essential resource to deal with positive and negative issues related to social media, and when collectors of nonfungible tokens (NFTs) turned intense attention to generative art in the summer of 2021. Briefly, NFTs are digital artworks that can be collected online through verifiable cryptocurrency transactions, also online.

My generative art process begins with nearly empty code and a blank image output file. The image slowly evolves over many iterations of writing code, executing, and viewing the results. I like to share the output online to see what people respond to, which can be surprising because of the nature of subjectivity in art.

Art was important to so many people during the pandemic; it helped to deal with the constant dread that pervaded everything and took away so much from everyone. Code art was something that I could work on, over sleepless nights, and share without leaving the house.

Part of sharing my artwork online is writing plain-language recipes that allow nontechnical audiences to better appreciate the artwork and give fellow nerds a chance to replicate or create variations on interesting algorithms. In this way my teaching has extended to other communities.

With advice from my wife, Haley Doty Vaden, an expert in fine arts and museum studies, I started creating fine art prints for collectors. The algorithms I compose can produce high-resolution images for prints or NFTs, which was supported by collectors who taught me how to “mint” my artwork, create digital collections online, and even release a long-form artwork titled “WORLDS.”

Life

Art was important to so many people during the pandemic; it helped to deal with the constant dread that pervaded everything and took away so much from everyone. Code art was something that I could work on, over sleepless nights, and share without leaving the house.

Through generative art, I found new friends among artists, collectors, and galleries. I’ve had fascinating conversations online with artists and collectors and look forward to more with many of these new friends.

In the spring of 2022, I traveled from Charleston to Los Angeles, and it was amazing to meet many of my online art friends for the first time. I was also fortunate to work with individuals at Art Blocks, whose philanthropy inspired me to donate proceeds from NFT drops to local and national nonprofit organizations. Cryptocurrency can make a positive change in the world, even though the system is new and volatile.

Since my Emerging Research Grant project completed, I have continued to develop novel techniques to study how brain systems enhance speech recognition in noise. I

have also written new manuscripts, submitted new grant applications, and mentored new students. Like my artwork, each new study provides an iteration that can lead to a better understanding of how the brain supports speech recognition in noise, and how older age and hearing affect those functions. My long-term research goal is to characterize brain systems to enhance communication and guide rehabilitation strategies for a range of patient populations.

As a middle-aged person, with a few more gray hairs from parenthood during the pandemic, I better appreciate that life does not slow down with increasing age. Passions and interests bloom like a garden full of growing plants. Cognition does not slow as much as it is overrun by the vines, leaves, and flowers of every kind bursting into thought.

Some corner of my mind is always occupied with thoughts of my parents, my kids Sabine and Remy, or myriad news stories and scientific reports. Endless possibility is what science, art, and life mean for me.

A 2015 Emerging Research Grants scientist generously funded by Royal Arch Research Assistance, Kenneth Vaden, Ph.D., is a research assistant professor in the department of otolaryngology–head and neck surgery at the Medical University of South Carolina (MUSC). His art has been selected for the permanent art collection at MUSC, the juried annual art publication MUSC Humanitas, and the Piccolo Spoleto Annual Juried Art Exhibition. For more, see vadenart.com.

Support our research: hhf.org/donate.

Two recent acrylic paintings by Jennifer Stone, Ph.D.

Creative Genius

Scientific breakthroughs require creative thinking, and art is often an expression of thought. It’s no wonder that many of our researchers are also artists, and that creating art provides a way for them to think in a different way.

Here is what our scientists have to say about the arts, music—and cooking! They are putting the A into STEAM (science, technology, engineering, art, and medicine).

Jennifer Stone, Ph.D.

In my life, art and science are intertwined and sometimes inseparable. I have loved to draw since I was a child, and I am learning to paint as an adult. Visual images have always had profound effects on me, conveying information about the world, raising curiosity, and evoking emotion. Our research focuses on anatomical analyses of the inner ear and the brain, so the ability to carefully observe and to detect differences in structure is key to our work. Scientists must convey information to colleagues and to the public using digital schematics and photographs. I am fortunate to work in a profession that allows me to enjoy both science and art almost every day!

Jennifer Stone, Ph.D., a member of HHF’s Hearing Restoration Project, is a research professor in the University of Washington’s department of otolaryngology–head and neck surgery, where she is also the director of research. She is a 1995, 1996, and 2000 Emerging Research Grants scientist.

The A in STEAM

Read more about how our grantees enjoy the arts as much as they love science.

Noah R. Druckenbrod, Ph.D., 2015

You may have heard of “Ancient Aliens” on the History Channel.

About three years ago, as a favor to one of the producers I’d met, I appeared on a couple of episodes. It was a fun experience—but I was sure to make no scientifically dubious statements, unlike some of their other so-called experts.

Druckenbrod’s grant was generously funded by The Barbara Epstein Foundation.

Richard A. Felix II, Ph.D., 2016

I am a karaoke enthusiast. I usually try to perform new songs onstage, but I often cannot resist Celine Dion.

Felix’s grant was generously funded by Royal Arch Research Assistance.

Elizabeth McCullagh, Ph.D., 2016

My husband (a chemistry professor) and I love to brew hoppy beers and make our own goat, cheddar, and other cheeses.

McCullagh’s grant was generously funded by Royal Arch Research Assistance.

Ngoc-Nhi Luu, M.D., Dr. Med., 2017

I cook to unwind. Everything related to preparing meals is relaxing to me: food shopping, researching international ingredients, composing creative meals from limited seasonal offerings, and finally making even picky eaters happy. Strolling through supermarkets was always the first thing I did after exams in medical school.

Luu’s grant was generously funded by The Estate of Howard Schum.

Timothy Balmer, Ph.D., 2017 and 2022

I repair and modify mechanical watch movements, focusing on those worn by U.S. service members, including a Rolex that kept time on the wrist of a close friend during the Korean War, and an Elgin worn by a pilot in World War II.

Balmer’s 2017 grant was generously funded by the Les Paul Foundation.

Inyong Choi, Ph.D., 2017

When I was a doctoral student, I was a huge fan of “An Introduction to the Psychology of Hearing,” a textbook by Cambridge professor Brian C.J. Moore, Ph.D. I attended his visiting lecture when I was conducting research at Boston University and I even brought his book with me to get autographed. After his talk, I was unable to reach him through the crowd and instead went out to dinner with a friend. Shortly after our meal started, incredibly, he came into the same restaurant and agreed to autograph my book!

Three years later, I crossed paths with Moore again and asked if I could translate his book into Korean. He agreed, and it took me the next two years to finish and publish the translation. This work enabled me to deeply understand the fundamentals of hearing science more than ever before.

Choi’s grant was generously funded by Royal Arch Research Assistance.

Senthilvelan Manohar, Ph.D., 2017

My interest in biochemistry came from my mother’s cooking, in a small village in India. She used a lot of spices in her food preparation, and as a child I always wondered how each spice influenced my taste and perception in general. I asked my

mom all about the spices and why she chose to add them to our food. My curiosity for small molecules affecting perception has not faded since. Manohar’s grant was generously funded by Hyperacusis Research.

Christina Reuterskiöld, Ph.D., 2017

A novel I wrote is almost finished so I don’t want to say more just yet. We will see if someone wants to publish it—if not, it will be a story for my family! I like to cook and I am an amazing baker. I make better Swedish cinnamon buns than anyone else, if I may say so myself.

Reuterskiöld’s grant was generously funded by Royal Arch Research Assistance.

Sandeep Sheth, Ph.D., 2017

One of my goals in life is to learn to play at least one musical instrument, so I am learning to play the guitar. Most of the people I know would be surprised to know that I was an average student in school but did very well in sports and cultural activities like singing and dancing. I have several medals to show for it.

David Ehrlich, Ph.D., 2018

My younger brother Max and I collaborated to design a board game. Players make up definitions for acronyms to impress their friends and family. Perhaps some inspiration came from the many acronyms used in research.

David Jung, M.D., Ph.D., 2018

I played violin for many years through college and grew up with classical music. In my spare time I enjoy attending concerts, including the Boston Symphony Orchestra. The arts scene here in Boston spoils us, with the BSO one of its crown jewels.

Tenzin Ngodup, Ph.D., 2018

I am the first scientist in the family—perhaps one of the first Tibetan neuroscientists in the exiled Tibetan community! I am working on a cookbook about traditional Tibetan dishes, a cuisine that reflects the lifestyle of Tibetans living at more than 10,000 feet above sea level. For instance, rice is a rare commodity so a dish like dre-si (sweet rice) is served mainly during special occasions like the Tibetan New Year.

Ngodup’s grant was generously funded by the Les Paul Foundation.

Khaleel Razak, Ph.D., 2018

I enjoy taking photos. Thinking about their composition makes me stop and look at a subject from multiple perspectives—I find that it’s not unlike examining research data.

Razak’s grant was generously funded by Royal Arch Research Assistance.

Soumen Roy, Ph.D., 2018

I love to cook. During school vacations, I volunteered at nonprofit kitchens where we sometimes cooked for 50,000 people. More recently I cooked more than 10 different, intricate courses for 100 people. Cooking gives me endless energy! It is also relaxing and therapeutic, and helps tune my planning skills and creativity, which I truly believe helps my research.

A. Catalina Vélez-Ortega, Ph.D., 2018

I take dance lessons and participate in flash mobs and other dance performances. But I used to be extremely shy. As a child I simply could not look anyone in the eye when talking to them. I was also terrified of being onstage. It was only after college that I decided to finally correct the problem. Interestingly, taking sign language lessons was

Bryan K. Ward, M.D.

I first got interested in art in middle school. My grandmother was a painter and encouraged me to draw and paint. I took art throughout high school, even taking AP Art and building a portfolio. It was a great way to relax, and I enjoyed learning that emotion could be expressed almost as a filter when you create a representation of something. I fell in love with watercolor; I found it relaxing and I could do it anywhere. I find that sometimes the same images are repeated in the medical literature, and sometimes they aren’t anatomically correct, or don’t emphasize the anatomy best for a particular article. So I started trying to create my own images to make different points. Currently, about half of my papers or book chapters have some artwork. During COVID, I did a few other random pieces while stuck at home. I actually just sent these to a family friend who was interested, so I have some compilations. Doing the art is fun for me! I really never thought the art would get anyone’s attention so that’s been fun, too.

A 2020 ERG scientist, Bryan Ward, M.D., is an associate professor of otolaryngology–head and neck surgery at Johns Hopkins University School of Medicine.

Opposite: Bryan K. Ward, M.D., drew this illustration to accompany a paper in Frontiers in Neurology. For more of his artwork, see hhf.org/bryan-k-ward.

Below: Gail Seigel, Ph.D. (far right), rehearses with the Clarinet Collection, one of two music groups she plays with.

Gail M. Seigel, Ph.D.

I find there are a lot of links between science and music. Many of the skills that I’ve learned as a musician translate to my career in science. In music, as in science, there is a preciseness and an orderliness in following the tempo, playing the right notes at the right time, and practicing techniques for the best results. There is an element of creativity in both science and music that allows us to express ourselves as individuals. People who play music together bond with one another just as scientists working together on a project orchestrate their efforts. So, I would say that music and science have been intertwined throughout my life in a synergistic way to the benefit of both. I can’t imagine one without the other.

A 2019 ERG scientist, Gail M. Seigel, Ph.D., is a research professor in the Center for Hearing and Deafness at the University at Buffalo, the State University of New York, where she runs the Ocular and Auditory Neuroscience Lab.

very helpful. Sign language forced me to stare at people to be able to communicate. It was terrifying at first, but it started to feel very natural after just a few months.

Vélez-Ortega’s grant was generously funded by Cochlear Americas.

Philippe Vincent, Ph.D., 2018

I enjoy making scale models. I can spend all day assembling and painting the different parts. Patience in both electrophysiology and making models is paramount. I recently completed the Air France Airbus A380 (scale 1:125). Given its size (roughly two feet long and wide), assembling and painting were pretty challenging.

Pierre Apostolides, Ph.D., 2019

When I was younger my hobby was tinkering with audio recording equipment, analog synthesizers, etc. This has come in quite handy for my current work because a lot of our auditory experiments require significant background knowledge of acoustics and signal processing.

Ross Williamson, Ph.D., 2020

I’ve always been obsessed with music. I grew up listening to the likes of Led Zeppelin and Pink Floyd, which naturally progressed into learning to play electric guitar. Trying to understand how guitar effects pedals worked led to a love of the mathematics behind signal processing.

Support our research: hhf.org/donate.

Unplugged

The surprising roots of a cultural phenomenon. By Robert Small, as told to Hearing Health Foundation

When I got out of college in the 1970s I started working backstage in off-Broadway theater. They’re up front and tell you there’s no money but that you can put it on your resume, which is a good thing at the start of your career. I was young enough then to fall for that line.

Still, I needed money. The music business had not yet really evolved into having an industry with the need for lighting and sets—that stuff didn’t exist. In the 1970s this began to change, and people setting up concerts would go to the theater to find crew who knew how to use lights and electrical to help produce concerts. I was driving a taxi and getting paid anywhere from $20 to $25 a day, and roadies for musicians were paid $75 a day—so I said, sign me up! And I became a roadie.

In the early ’80s heavy metal was just everywhere. It was the beginning of theatrical touring concerts, and I was able to carve out a niche in this new industry for staging shows and then touring with the shows.

I remember one metal show in Hollywood, Florida, in a giant gym, or maybe it was an airplane hangar. The headliners were Mötley Crüe, and I was doing a video for the opening act. The sound system was pretty substantial. I was wearing a headset to talk to the cameraman—a double earmuff headset with a mic. I was able to hear and speak to the director of photography but it was very, very distorted because of the high volume.

Below: Robert Small with Shirley Manson of Garbage, for his recent biopic about singer Lesley Gore.

Right: Small with Elton John for a VH1 promotional shoot in the 1980s.

I couldn’t really escape the loudness with the work I was doing. We were usually right next to the amplifiers, really close. If you were running a lightboard you knew you’d be next to a sound stack of Marshalls, and that’s where you’d work for the whole show. Then your head would ring and you didn’t know what kind of damage you were doing, long term, so you just didn’t pay attention to it.

Since I was onstage where it was especially loud, what I would do is hold the hips of the cinematographer and lead him to where I wanted to shoot. We were so focused on getting the shots in the midst of the loud music that it just seemed normal to have to communicate this way.

But afterward my head rang for a long time. And while I know that’s not the only loud event I experienced like this, that’s the main one I remember really affecting my hearing.

Nowadays when you go backstage at a concert, there are tables with piles of earplugs. It’s a no joke thing at this point. But back in the day, if somebody had earplugs or somebody would give you plugs, it just wasn’t something you used.

I couldn’t really escape the loudness with the work I was doing. We were usually right next to the amplifiers, really close. If you were running a lightboard you knew you’d be next to a sound stack of Marshalls, and that’s where you’d work for the whole show. Then your head would ring and you didn’t know what kind of damage you were doing, long term, so you just didn’t pay attention to it.

And I paid the price for that. I use a hearing aid now, which I am thrilled to have. It changed my outlook when I realized what I was missing.

Metal to MTV

Eventually I ended up doing work for MTV, Nickelodeon, and Comedy Central. I knew how to do things because of my theater background and how to make everything onstage look good. Then I started working on music

videos, also a new media type back then, first as an art director and then as a director.

The seed for “MTV Unplugged” really came from being on the road with musicians touring. When we had downtime we’d socialize with the band, hanging out with them in their hotel rooms and they’d eventually take out their guitars, or we’d be on the bus and it’d be the same thing with them strumming their guitars. This is how they made music. It’s how they created it and wrote songs, adding in other instruments and production later.

All artists understand acoustic music; they’re comfortable with it because it’s organic to them as artists and songwriters. With “MTV Unplugged,” this is what we tapped into, giving the artists the opportunity to show that side of how they create and perform.

People thought it would just be folk music. They didn’t get the concept that it was still rock music, just played acoustically. But bands got it, and it was maybe when Don Henley came on that we really started to get attention. And then Eric Clapton—the show attracted the interest of that level of artist, which was amazing.

Filming acoustic concerts also had the added attraction for me of not doing additional damage to my hearing. I needed to get away from really loud shows, and that pushed me toward finding something we could do around performances that could still resonate, just not literally.

Acoustic performances help create a greater intimacy and a deeper connection with the music, in my opinion. It’s not the same as Auto-Tune and other technology-related

The seed for “MTV Unplugged” really came from being on the road with musicians touring. When we had downtime we’d socialize with the band, hanging out with them in their hotel rooms and they’d eventually take out their guitars, or we’d be on the bus and it’d be the same thing with them strumming their guitars. This is how they made music. It’s how they created it and wrote songs, adding in other instruments and production later.

production you get these days.

When someone talks into a microphone and plays a guitar and then stops and says, let me start again, and you see them doing that, it just shows you another side of the artist beyond the big concert productions.

Inspired by the Theater

Because MTV was cool then, anything on MTV was automatically cool. But actually our pilot was done in front of a VH1 set because we didn’t have money for a studio. And because of this, we covered the set like you would a theater stage in rental drapes—and this went on to become a very signature look for musicians and musicians performing—having drapes. Behind those drapes was a talk show set!

The other theatrical touch was doing the show “in the round.” There weren’t many ways on TV you could show a 360-degree view around the artist. We needed to film in the round because we had all the cameras and sound crew and technology to fit, and that took up space where an audience might be.

So we decided to have the audience sit wherever we could fit them. Then TV viewers could look at the television screen and see the artist—and then also see the faces of the people behind or beside the artist who were also listening to the artist, including the crew, electrical wires. It’s like a behind-the-scenes look. It feels exclusive and intimate. Nowadays people get this approach, but in 1989 it was really unusual.

It all came back to those first days working offBroadway for no money and leading all the way to what

became a cultural phenomenon. Looking back, I see how some of the limitations we faced—only having a basic set, lots of equipment, and for me needing a quieter performance space—became hallmarks and the legacy of “MTV Unplugged.” I’m really proud of the work we did, and if acoustic performances saved someone’s hearing even a little, all the better.

Robert Small is a producer and director. He is the director of the New Media Lab at City University of New York’s Macaulay Honors College. With Jim Burns he was the co-creator of “MTV Unplugged” which earned numerous Emmy Awards. Many individual artists’ recorded sessions have gone platinum and earned Grammy Awards, including Eric Clapton’s 1992 “Unplugged” album that is the best-selling live album of all time. He also directed “I Ain’t Scared of You: A Tribute to Bernie Mac.” Most recently Small directed a biopic about 1960s-’70s singer-songwriter-activist Lesley Gore, titled “You Don’t Own Me” and featuring interviews with Quincy Jones, Shirley Manson, and others, with Melissa Etheridge reading from Gore’s diaries.

Share your story: Tell us your hearing loss journey at editor@hhf.org.

Support our research: hhf.org/donate.

A Life, Loud

A drummer since childhood is thankful for hearing aids. By Jonathan Kane

I was born to wear hearing aids. Not as a result of genetics, but rather through passion and career choices. I’m a musician, and I’ve played a lot of very, very loud music.

Although I also play guitar and bass, my principal instrument is drums, and I hit them hard. Always have and always will. The drums alone are enough to wreak havoc on one’s hearing, let alone if one is a hard hitter. You spend 50 years with a snare drum cracking between your legs, and crash cymbals mere inches from your head and we’ll see how often you say “what?” in a conversation!

My first professional bands played Chicago-style blues and yes, we cranked the volume. But later in my career I took the volume to the next level. I’ve toured the world and recorded with minimalist icon Rhys Chatham’s orchestra of 100 (yes, that’s one hundred) electric guitars.

As loud as that sounds, it’s actually not as loud as Rhys’s music for six guitars, massive volume and open tunings being central to the creation of the magical, swirling harmonics and overtones that Rhys’s compositions generate. Later I formed my own multi-guitar band, Jonathan Kane’s February, wedding Rhys’s overtone theory to my love of blues.

I also founded the industrial post-punk band Swans in 1981. Swans is on the books as one of the loudest bands ever. Mojo Magazine placed Swans as the 4th loudest band of all time in their December 2000 article “The Grateful Deaf,” claiming that we were louder than The Who, MC5, and other titans of tsunamic sound.

Then there were power tools, motorcycles, headphones,

and the NYC subway to add to my aural distress. I never wore any earplugs until 1991, when a monitor went bananas in my ear at a gig in Sicily, leaving me with a lifelong case of tinnitus.

About 10 years ago, my late wife Holly Anderson started bugging me to get hearing aids. Holly had grown weary of my constantly asking what, excuse me, and could you say that again? I was resistant but finally this year I caved. I think it was turning 65 and getting a coupon in the mail for a huge discount on the devices! I hated them at first. Really. But over the course of a few months I got used to them and now I am a convert.

My advice to anyone struggling with hearing for whatever reason is: Protect your ears from excessive volume with plugs when exposed, and if the damage is already done, don’t be ashamed, get hearing aids. They are very discreet nowadays (a plus for vain people like myself).

It’s wonderful to not struggle anymore to follow a conversation, and even to hear more birdsong, the beeps of a car, you know, the sounds of life. Oh and by the way, I still play loud music (with earplugs)!

Jonathan Kane is a musician, composer, and photographer, and he manages the archives and estate of his father Art Kane, the legendary photographer.

From left: Twelve-year-old Jonathan Kane, photographed by his father Art Kane.

Kane performing at Museum of Modern Art PS1 in Long Island City, New York.

Kane at the drums with Rhys Chatham’s 100 Guitars.

To Create a CULTURE SHIFT Around Healthy Hearing, Start Young

And other key strategies to encourage safe listening habits, for life. By Rohima Badri, Ph.D.

As the younger population is exposed to ever more noise, such as through the use of personal listening devices, the risk of hearing damage from loud sounds is growing. So it is critical to not only raise awareness of noise-induced hearing loss and tinnitus but also effect positive changes in listening habits, such as limiting noise exposure and using hearing protection.

But simply educating and raising awareness about NIHL does not guarantee a positive shift toward safe hearing habits among tweens and teens. I believe that to reform and sustain healthy hearing practices in youth, we need to better understand their attitudes, beliefs, and behaviors toward loud noise and the use of hearing protection such as earplugs.

According to Belgian research in Noise & Health in 2015, young adults with more problematic attitudes and beliefs about loud noise and wearing hearing protection had significantly worse hearing (as measured by pure tone audiometry and otoacoustic emissions) than those with neutral or negative attitudes about loud noise.

This is an opportunity for change. Finding answers to fundamental questions—such as why does this age group enjoy loud sounds, what impact does hearing damage have on this age group, and what will truly motivate them to use hearing protection devices?—will help us develop effective and sustainable hearing conservation programs.

Based on research into the factors that influence youth hearing practices, here are three approaches.

1. Target and tweak group behaviors and social norms, in addition to focusing on changing individual behaviors.

We (and especially young people) are drawn to loud activities because they are known to enhance

entertainment, mood, and socialization, among other things. The guidance on how to behave toward noise and hearing protection is shaped not only by individual attitudes and preferences but also by peer group/youth culture norms, New Zealand researchers reported in the journal Seminars in Hearing in 2017.

According to another 2015 Noise & Health study, students in North Carolina typically viewed loud noise exposure from non-leisure activities such as lawn mowing as unwanted and unacceptable, and used hearing protection without hesitation. But they saw loud noise exposure from leisure activities such as rock concerts and sporting events as acceptable and even desirable, and using hearing protection in these situations was awkward.

This social acceptance and expectation of loud music as a part of youth culture is one of the most significant barriers to achieving healthy and safe hearing practices among the younger population.

We must address larger social influences in addition to continuing to work on changing individual behavior. Some strategies are:

>> Educate and appeal to “arbiters of loud noise culture,” such as the staff and managers of traditionally loud establishments—such as nightclubs, concerts, sports arenas, even venues that host weddings and other celebrations—about safer hearing practices, advises the Seminars in Hearing report. This may require repeated messaging about how hearing loss is permanent and, left untreated, is tied to worse overall health outcomes.

>> Employ influential and well-known individuals who appeal to a younger audience, such as musicians, athletes, and social media influencers, to promote safe hearing practices and counteract the normalization of loud noise in youth culture.

>> Involve student groups as a team in promoting and

educating their peers about the dangers of loud noise and how to prevent them. For example, start a club, put on a play, use social media, and in general have open discussions about existing knowledge, attitudes, and experiences toward loud noise.

2. Raise awareness of noise-induced tinnitus in addition to hearing loss as an early indicator/warning sign of NIHL.

According to a survey of nearly 4,000 Belgian high school students published in PLOS ONE in 2013, three-quarters reported noise-induced tinnitus as an immediate result of loud noise exposure. The presence of phantom sounds after loud noise exposure, even in the absence of hearing loss, is linked to early hearing damage.

Interestingly, research shows that immediate, selfexperienced symptoms such as tinnitus and sound sensitivity often lead young people to change their attitudes and behavior toward healthy hearing practices rather than hearing loss, as shown in an International Journal of Audiology study surveying U.S. college students back in 2009 and 2013 Swedish research in Noise & Health.

Young people who experienced symptoms such as tinnitus were not only more likely to have a negative attitude toward loud noise exposure but also more likely to use hearing protection devices than those who had no symptoms, according to the Belgium paper.

Noise-induced tinnitus is highly prevalent among young people, and being aware of these symptoms is likely to improve their attitude and behavior regarding healthy hearing practices. We can place a strong emphasis on educating and raising awareness of noise-induced tinnitus and other self-experienced, noise-related auditory symptoms such as muffled hearing following a loud concert.

Noise-induced tinnitus, no matter how transient or temporary, often indicates an early stage of hearing damage and serves as a warning. Hearing Health Foundation’s Keep Listening campaign has posed the question on social media: “Walking out of a concert with your ears ringing is normal, right? But walking out of something with your vision blurry would be scary, right?”

3. Engage with younger age groups such as elementary and middle school students.

As children are increasingly becoming exposed to loud sounds at younger ages, the importance of providing

appropriate education and tools during their formative years cannot be overstated.

It’s even more critical when it comes to instilling safe and healthy hearing practices because we not only adapt and become conditioned to enjoying loud sounds over time, but we also conform to the culture of loud noise as a form of entertainment, according to the Seminars in Hearing report.

Younger children were found to be more receptive to interventions aimed at improving hearing protection behaviors in noisy environments than older children, and the effects of such interventions lasted longer in the former group, as reported in the American Journal of Audiology.

Because younger age groups are less likely to be deeply conditioned or acculturated and are more open to new ideas, raising awareness of the dangers of loud noise exposure among young children can prevent noiseinduced hearing damage in the future. Young people’s attitudes toward recycling, for example, have been shaped by early exposure to prosocial messaging.

We can encourage and motivate the younger generation about the importance of safe hearing practices by recruiting older peers to deliver the message of healthy hearing, and, with educators, devising classroom lessons that illustrate the importance of healthy hearing.

If we were able to convince young people about the dangers of cigarette smoking and excess sun exposure, I am hopeful that we can also create a culture shift around hearing and hearing protection.

Rohima Badri, Ph.D., lives in New Jersey. She is a hearing healthcare adviser for HHF’s Keep Listening prevention campaign. For more, see hhf.org/keeplistening. For references, see hhf.org/fall2022-references.

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Harmonically Distorted POWER

Minor Threat was a trailblazing hardcore punk band in the ’80s, when earplugs were an afterthought. By Lyle Preslar

I played guitar onstage steadily for the better part of 10 years, and every hour I was allowed to spend in front of a crowd was the product of 10 times as much time rehearsing.

And like my guitar heroes, I wanted, I craved, I needed to play through the legendary Marshall amplifier stack: 100 (sometimes for me, 200) watts of harmonically distorted power blasting through eight speakers in two cabinets (four speakers in each) stacked six feet high!

Being right-handed, I liked playing “stage right” so that I only had to glance up from the fretboard to see my band mates across the stage—and direct them. It was heaven: The amp stack was behind me roaring into my left ear, and the drums were just next to me, each cymbal crash trying to blow that ear off.

My head rang. A lot. There were far too many tiny practice rooms and shows in clubs that had all the acoustic refinements of metal boxes ventilated by jet engines. If you were a fortunate musician, your rooms got bigger and your stage monitors got better, and you might be able to bring your volume down somewhat. Still…

My awareness of the sonic dangers I faced increased, a little. I read that the great Roger Miller of the band Mission of Burma was forced to quit playing because of a hearing condition I couldn’t properly pronounce (and couldn’t

for years): tinnitus. I got a bit scared. At shows, I started wearing earplugs during support act sets and in some rehearsals. I bought the state-of-the-art ones of the time.

I used the term “ear fatigue”—by the way, a concept soundmen use as a justification to pump up the volume for the headlining act. But while performing, the plugs just didn’t work: With the top end cut, I found it impossible to tune or even hear that I was out of tune. And I still stayed in those tiny rooms for hours, blasting away at my songs and our brains, still largely ignorant of exactly what I was doing to myself and everyone else. Let it rock.

The noise went on, and it was sweet, but every night’s sonic drunk became the next day’s mild hangover, though manageable and smoothed out by late afternoon and ready for that night’s party. Let it roll.

I like to tell the story that Dave Grohl—no stranger to volume—pushed my brain’s audio system over a sonic cliff one evening during a Foo Fighters arena show. But while this tale might have some satisfying punk rock irony to it, it’s certainly untrue. My damage was years in the making.

People ask me how my tinnitus (now pronounceable!) developed, when it first happened, what it sounds like, when it got worse. I have no good answers besides the obvious ones. I can say it “crept” up on me; I don’t recall

Lyle Preslar played guitar for the D.C.-area hardcore punk band Minor Threat.

My head rang. A lot. There were far too many tiny practice rooms and shows in clubs that had all the acoustic refinements of metal boxes ventilated by jet engines. If you were a fortunate musician, your rooms got bigger and your stage monitors got better, and you might be able to bring your volume down somewhat.

any early milestones. But my day-to-day problem became impossible for me to deny several years ago when a filmmaker friend asked me to record sound for him on a low-budget production.

He shot a scene, and I took him aside: “I think there’s some hiss in the left channel,” I told him. Knowing he was on a shoestring budget, working with amateur actors, I wanted to make sure each take was captured properly.

He took the headphones and listened to the playback. He heard nothing but clear sound. A few takes later I repeated my concerns. Again, when he listened, there was nothing. He’s a charitable guy, but he must have thought I was crazy. In any event, goodbye to any possible sound engineer career: That left channel is the one in my brain.

I had my hearing checked around three years ago and, considering my age and history, I was told it was remarkably good. When I mentioned the everyday hiss in my left ear the audiologist shrugged ever so slightly: I took it as a sort of involuntary “and, so?”—a casual acknowledgement of a sad but unremarkable fact.

My condition has its own various performance highlight moments: It’s louder, or shriller, or hissier, or even tantalizingly gone for a bit. Sadly, it’s mostly just there. Best I can do is have noise around to take my mind off it. Noise to quell the noise. There’s never an enjoy-thesilence moment.

While there seem to be positive treatment developments, tinnitus is likely not curable in my lifetime. I try to control the extent of the damage. If you see me at a show, I’m probably one of the few wearing earplugs. I’ve replaced those 1980s earplugs with newer models. Turns out my old ones were really big with gun enthusiasts. That figures.

I’ve watched my teenage daughter and her friends spend virtually every waking hour with earbuds in: on the street, at lunch, in the car, while supposedly having a “conversation.” I warn her, and occasionally have managed, to get her to turn down. I’m worried about her in the way that all who “know” should be worried.

Maybe I’ll just start hiding the buds. She apparently doesn’t know what speakers are!

Guitarist and songwriter for ’80s hardcore punk band Minor Threat, Lyle Preslar also played in the bands The Meatmen and Samhain. After retiring from performing, he ran Caroline Records, working with Ben Folds, Smashing Pumpkins, Hole, Chemical Brothers, and The Misfits. Later he was a marketing executive at Electra and Sire Records. He now practices entertainment law in New York City and plays guitar (quietly) in his basement.

Share your story: Tell us your tinnitus journey at editor@hhf.org.

Support our research: hhf.org/donate.

Why I Appreciate My #StartWithERG

By Viji Easwar, Ph.D.

I decided to enter the field of scientific research after my work as a pediatric audiologist at the Royal Hospital for Children in Glasgow, Scotland. I saw babies, toddlers, and children with hearing loss, with and without hearing aids, as part of my caseload.

Many of them were doing well, but many did not like how their hearing aids sounded and felt they were not doing any better with hearing aids than without. It was especially bothersome among kids with steeply sloping losses on their audiograms—mild hearing losses and unilateral (in one ear) hearing losses—and not surprisingly, they were inconsistent device users. Some of them even returned their hearing aids and came for annual appointments only to have their hearing monitored.

Parents of young babies fit with hearing aids often asked how we would know whether hearing aids were of benefit as many of them were striving to achieve consistent hearing aid retention and use. Hearing aid fitting in children with additional developmental disabilities was even more challenging. If the hearing assessment was completed using auditory brainstem responses and hearing aid fittings were based on those results, it was still difficult to measure how well those children heard with hearing aids.

Given all these experiences, I wanted to do some research into how measures based on the EEG (electroencephalogram), or a recording of brain activity, could be used to assess hearing aid benefit. I also became interested in knowing if EEG-based measures could tell us something about why some children performed better than others, or if they could predict performance with intervention.

I was always interested in using EEG to infer one or more aspects of hearing since my undergraduate days. But it was my clinical experience in Glasgow that helped shape my research interests in using EEG to measure hearing abilities in children who did and did not use hearing aids.

Personal Connection

My grandfather developed hearing loss due to aging. It was gradual so it is difficult to say when he developed it precisely. I recall completing his hearing test when I finished my undergrad degree in audiology. Since hearing loss is expected as we get older, I don’t think he was too surprised or upset when it was first confirmed. Also, by the time he had a hearing test, he had already experienced poor hearing in most everyday situations. He had to turn up the TV volume and my grandmother would have to face him to have a conversation with him.

To me, it seemed like he accepted it as a part of aging. If he didn’t hear something, he didn’t care so much because he just felt it was a part of growing old and being retired. He said his grandchildren and great-grandchildren were loud enough for him to hear them, and he would joke that not being able to hear was an excuse to not be bothered by petty matters.

But when all our family members met, he would often get a bit upset that he couldn’t hear the jokes and would ask for them to be repeated. He wore hearing aids, made by two different manufacturers, in both ears. Despite not being able to hear well, especially in groups and over the phone, he wore them all day, every day—I think partly to please others, so they wouldn’t complain about him not wearing them.

Looking Forward

Hearing loss is commonly referred to as an invisible disability as it is unlike any physical disability. My hope is that, with new technology and improved hearing care services, children with hearing loss will develop like their typical hearing peers and be able to participate and enjoy

interacting with others seamlessly. I hope for the day when the invisibility of hearing loss does not matter! Or when hearing loss truly becomes invisible.

The Emerging Research Grant from HHF was my first independent grant to investigate using EEG to measure hearing aid benefit in children. While the study uses methods that were developed during my Ph.D. at Western University in Canada, at that time the method was only evaluated in adults with hearing loss.

The use of EEG for measuring hearing aid benefit is intended for babies who are too young to participate in clinical hearing/listening tests, and for older children who may have additional disabilities and are hence unable to participate in clinical hearing tests. With my recent move to Australia’s National Acoustic Laboratories—an entity that already has a significant track record of using innovative approaches like EEG to measure hearing aid benefit in infants—I am excited to continue the work of this initial project to pave the way to future evaluation in infants using our novel approach.

A 2019 Emerging Research Grants scientist funded by the Children’s Hearing Institute, Viji Easwar, Ph.D., recently relocated to Australia to become the lead researcher of the pediatric hearing research program at the National Acoustic Laboratories in Sydney.

Support our research: hhf.org/donate.

Parents of young babies fit with hearing aids often asked how we would know whether hearing aids were of benefit as many of them were striving to achieve consistent hearing aid retention and use. Hearing aid fitting in children with additional developmental disabilities was even more challenging.

Hear Me Out

At first I didn’t pay much attention to the slight buzzing in my ears. Like pretty much everything else that seemed to be going awry with my health—needing glasses, aches, skin stuff—I attributed the ringing to the audacity of getting older. But I soon began to realize that the slight tinny sensations in both ears were maybe more than just some (almost) senior moments, so I decided to get my hearing checked, something I probably had not done since mandatory hearing exams in elementary school.

Along with the ringing I had the sense that I wasn’t hearing everything quite clearly; friends and my son noted that I kept the volume up on the TV and when I went to concerts I found that after a while my ears hurt, and sticking wadded up tissues didn’t do much other than make me look silly and cut out the dynamics.

In hindsight, that I would have tinnitus or even a hearing loss wasn’t that surprising. I’d spent the better part of my adult life listening to loud music, either via headphones or at clubs and concerts. Back in my 20s my gauge for a satisfying night out was if the bass levels were so intense that my stomach hurt, not the healthiest of benchmarks. I was someone who constantly cranked up the bass and felt that volume (not ear splitting but certainly loud) was the optimal way to enjoy music.

Add to the mix living in New York City, which is a whole other category of noisy. I never covered my ears to block out the screech of incoming trains, nor did the wail of fire engines bother me; I just took it all in and shrugged it off to city life. But, by my 40s all of that exposure was clearly taking a toll.

My first exam was about a dozen years ago at which I was informed that I had a minute issue with my left ear. I took it in stride and that diagnosis pretty much stayed

the same for 20 years, although I have found myself having to lean in when people are talking. I switched careers from music journalist to teacher, but often chalked up my struggle to make out what the kids were saying to their failure to speak up or enunciate.

TV also got more difficult to make out, although in my defense there’s definitely a trend toward actors talking under their breath. But, the tinnitus got worse, especially when I was alone and without ambient or distracting noise, such as during the early weeks of the lockdown. There were times when it was so quiet that all I could hear was the sound of my poor ears trying to work.

My sister began wearing hearing aids when she was 40 so I knew there was a chance that whatever was going

A solution for tinnitus leads this former music journalist to try out hearing aids. By Amy Linden

Back in my 20s my gauge for a satisfying night out was if the bass levels were so intense that my stomach hurt, not the healthiest of benchmarks. I was someone who constantly cranked up the bass and felt that volume (not ear splitting but certainly loud) was the optimal way to enjoy music.

Yet another reason I decided to do something constructive about my tinnitus and hearing problems stemmed from watching the film “Sound of Metal,” which tells the story of a drummer who goes deaf. It’s a pretty good film but the depiction of the lead character going—very quickly—from what appeared to be perfectly okay hearing to profound deafness freaked me out so badly I had to turn the TV off. That I also was watching a film about going deaf with the volume up was an irony I could have done without.

on might be congenital—except that my sister never fell asleep with her head in an amp or made sure her headphones had a turbo bass feature.

Finally, after a few hearing checks about five or so years apart, I decided to get fitted for hearing aids a few years ago in the hopes it would help the tinnitus; I no longer cared that much about the slight loss of hearing because I’d learned how to compensate.

Part of the reason it took so long to make the jump to hearing aids was financial but thankfully I qualified for free devices. The other reason was vanity; it was bad enough that I had to wear glasses—did I need to advertise yet another thing that signaled that I was getting old?

Yet another reason I decided to do something constructive about my tinnitus and hearing problems stemmed from watching the film “Sound of Metal,” which tells the story of a drummer who goes deaf. It’s a pretty good film but the depiction of the lead character going— very quickly—from what appeared to be perfectly okay hearing to profound deafness freaked me out so badly I had to turn the TV off. That I also was watching a film about going deaf with the volume up was an irony I could have done without.

I would like to say that I use my hearing aids (which are not as dorky as I feared they would be) and everything is okay. But the ear mold somewhat hurts my ear canal (I’m one of those people who can’t wear ear buds which might be a blessing in disguise), and when I have tried to use the hearing aids they don’t seem to work. But, inspired by sharing my story here, I made an appointment for a followup adjustment and eventually got to a place where my hearing aids are working as I want them to.

It’s a little scary to realize that this tinnitus will probably never go away. I’ve had medical issues in the past and most of them were resolved because I changed my habits or took

medication or simply grew out of the condition. But this nonstop tinny irritant shows no sign of leaving, and that’s a bit daunting. Will it get worse? I’ve gotten used to it, but then again you never really get used to it because it’s just not normal and it is distracting and at times depressing.

Meditation helps but then again it doesn’t—because as soon as I open my eyes I’m right back in my thoughts and the ringing picks up. Thankfully the tinnitus has never prevented me from sleeping, but it’s like having this annoying friend who won’t leave, and knowing that there’s pretty much nothing I can do about it often makes me depressed.

Should I have known better than to not expose myself to loud music? Yeah, sure, but it wasn’t on my mind that anything would happen. But it has, and the tinnitus is just a part of my life that I can either obsess over—or try my best to treat and live with. I’m opting for the latter.

Amy Linden is a veteran music critic and journalist whose work has appeared in numerous outlets including The New York Times, The Source, Vibe, XXL, Spin, People, and the anthologies “Rock She Wrote” and “Trouble Girls: Rolling Stone’s Book of Women in Rock.” She cohosts the podcast “ImmaLetYouFinish” and serves on the Rock and Roll Hall of Fame Nominating Committee.

Share your story: Tell us your hearing loss journey at editor@hhf.org.

Support our research: hhf.org/donate.

Hearing S o S t r a n g e l y

Why the book “Musical Illusions and Phantom Words” is so thought provoking, especially if you have a hearing loss. By Kathi Mestayer

At first glance, this book’s title suggests a science fiction novel. Well, it is science, but not fiction. It’s about the amazing things our brains, and our auditory systems, do with sound.

I first heard the author, Diana Deutsch, Ph.D., on a Radiolab podcast about the slippery slope between words and music. Deutsch, a professor of psychology at the University of California, San Diego, and a fellow of the Acoustical Society of America, is interviewed during the podcast and presents her research in very clear and accessible language.

Intrigued, I bought her book. It is now packed with sticky notes and dog-eared pages, highlights of various colors, and notes in the margins. That’s how I treat my favorite books.

Hear for Yourself

Some of the coolest features of the book are the QR codes and website links that you can use to actually hear and experience the strange audio effects, with Deutsch’s narration. When I listened to the first one, Octave Illusion, I learned that my cell phone did not provide the stereo signal required. So I borrowed a pair of stereo headphones, plugged them into my laptop, and it was perfect!

Perfectly… wrong, which is exactly what Deutsch had prepared me for.

Here’s what happens in Octave Illusion: Identical high and low notes, an octave apart, are delivered to each ear but as opposites. The left ear hears high-low-high-low, the right ear low-high-low-high.

However, when you listen to them, you will hear only the high tones in one ear, and only the low tones in the other ear. Even switching the headphones between ears doesn’t change the effect. Hard to believe, right?

In fact, when Deutsch first experienced the Octave Illusion, she was in her office, using headphones. What she heard was not at all what she expected. She switched her headphones around to the opposite ears—but nothing changed. So she went looking for more data.

“The next thing that occurred to me was that something really peculiar had happened to my hearing,” she writes. “Somewhat alarmed, I grabbed a few people from the corridor to find out whether they, at least, heard the pattern as would have been expected. To my amazement (as well as my relief), most of them experienced the same illusion as I did, and none could guess what was really being played.”

To listen to the Octave Illusion, scan this QR code from page 25 of Deutch’s book. Listen with real stereo audio to hear this correctly.

The Octave Illusion really sparked Deutsch’s curiosity. She writes about possible explanations, touching on psychology, the grouping of similar (e.g., high vs. low) sounds to help locate their source, and other potential factors. There is still more to be discovered to completely understand and explain it, and it’s one of several opportunities for further research that Deutsch identifies.

The spoken phrase “sometimes behave so strangely,” as it appears to be sung.

Phantom Words

The Phantom Words sections of the book may be a bit less surprising to those of us with hearing loss. After all, we hear strange words all the time.

A few weeks ago, my clothes dryer started talking to me, again, this time saying, “I had to smash ’em, I had to smash ’em….” I sent a short recording of it to my sister, who also has a hearing loss, and she heard the same thing.

When I shared this point with Deutsch via email, she expressed an interest: “Now that you mention it, I’m guessing that people with hearing loss should hear a large number of phantom words. I’ll definitely look into this.”

The Phantom Words audio is amazing to listen to. It’s basically just a series of tones, some repeating, some not. Maybe it was partly my hearing loss, but my brain started making words out of those sounds almost immediately, like these:

To listen to the Phantom Words, scan this QR code from page 107 of Deutch’s book.

“sometimes behaves so strangely,” when heard repeatedly, turned into a tune.

She also discusses her finding that “absolute pitch” (also known as “perfect pitch”) is far more common among people whose first language is “tonal,” such as Mandarin, Cantonese, and Vietnamese.

Surprises Matter

Throughout the book, Deutsch focuses on things that are unexpected, counterintuitive, and puzzling. Here’s why:

“Illusions are often regarded as entertaining anomalies that shed little light on the normal process of perception. Yet I hope to convince you that the contrary is true. Just as the failure of a piece of equipment provides important clues to its successful operation, so perceptual anomalies— particularly illusions—provide us with important information about the system that generally enables us to perceive the world correctly.”

That’s one reason why Deutsch’s book, the recordings, and the Radiolab episode are so intriguing. She presents mysteries, explains parts of them, and then poses the next set of questions for investigation. It’s like seeing science from the inside out.

“...bonk-bonk-bonk, delta-delta-delta, wombat, wombat, cahoot, cahootka, ca ca ca hootka, elvis, elvis, no brain, no brain...”

Deutsch’s students heard a wild variety of words, some accented, depending on their native language. She writes in her book that one student insisted that a German word had been intentionally inserted into the recording, and refused to accept Deutsch’s insistence to the contrary.

Words and Music

Another fascinating topic Deutsch explores is how language and music overlap. After all, pitch, rhythm, emphasis, tone, and other qualities exist in both. In the Radiolab episode, Deutsch talks about how a simple sentence fragment, when repeated, can become musical. Her example is how a recording of her voice, saying

Staff writer Kathi Mestayer is on the board of the Greater Richmond, Virginia, chapter of the Hearing Loss Association of America, a member of the Acoustical Society of America’s Engagement Advisory Board, and a is a technical consultant for the Industry–Consumer Alliance for Accessible Technology (ICAAT). For references, see hhf.org/fall2022-references.

Share your story: Tell us your favorite musical illusions and phantom words at editor@hhf.org.

Support our research: hhf.org/donate.

A few weeks ago, my clothes dryer started talking to me, again, this time saying, “I had to smash ’em, I had to smash ’em….” I sent a short recording of it to my sister, who also has a hearing loss, and she heard the same thing.

Let’s Bring Bling to Hearing

Wouldn’t it be cool if manufacturers of hearing aids partnered with designers like Gucci and Prada to make beautiful hearing aids, much like designer eyeglass frames? By Pat Dobbs

Manufacturers these days advertise that their hearing aids are small and inconspicuous. Why small and inconspicuous? What’s wrong with people seeing our hearing aids or cochlear implants?

I hate to say it but I believe people with hearing loss have bought into the negative stereotypes of hearing loss like old, less intelligent, and out of it. So of course they want to hide their hearing aids. Who wants to be thought about with those negative descriptions? Hearing loss manufacturers are just delivering what people want.

But in our hearts, we know the stigma of hearing loss isn’t true. Sure, many of us are over age 60, but 60 percent of the 48 million Americans with hearing loss are still in the workforce, according to a 2010 MarkeTrak report. So, the majority of us are not “old.”

As for appearing out of it or not very intelligent—that’s also not true. We just missed what was said.

It’s not easy to let go of these negative stereotypes. I believed them for years. Rather than telling people I couldn’t hear them, I bluffed and pretended that I had. I also wore my hair so that my aids were covered.

I finally realized that my hearing loss is just that— hearing loss—and has nothing to do with my intelligence.

I now want people to notice my devices. That way, if I miss something, I can easily explain why and suggest how they can speak to me so I can understand them better.

Small and discreet should no longer be a selling point. All we should care about is that the aids help us hear better and that they are affordable. Then designers will recognize a potential market for partnering with manufacturers to make beautiful and exciting designs for our devices.

I realize there are already various colors and designs available for hearing devices that are beautiful and fun. But I would love to be able to show off my Gucci hearing aids not only because they help me hear better but also because they’re so exquisite.

If you wore eyeglasses decades ago, you were made fun of and often called “four eyes.” My oldest sister wore glasses as a child, but there are no pictures of her wearing them. That’s because my mother was embarrassed and would remove them before photos. Now eyeglass frames (even with fake lenses) are fashionable.

It’s entirely possible for hearing aids and cochlear implants to become fashion statements. My implants

could display a pearl surrounded by dangling gems, maybe in place of earrings.

The most important point, however, is that we let go of the feeling of being somehow less because of our hearing loss. Our loss does not make us less. When we realize that, all good things will fall into place.

Pat Dobbs launched the Hearing Loss Association of America (HLAA) Morris County Chapter in New Jersey, serving as president. Now a Maine resident, she is the president of SayWhatClub, a global online hearing loss support group. For more, see Hearing Loss Evolution, at hearinglossevolution.com.

The U.K.’s Bijoux De Mimi has a hearing aid-friendly jewelry collection—as does the writer opposite.

Share your story: Have you dressed up your hearing devices? Tell us at editor@hhf.org.

photo credit (above left): david veit photography

Pat Dobbs suggests we show off our hearing devices, not hide them.

See Me Hear

When her daughter wanted to hide her hearing aids, she saw an opportunity to make them shine. By Charlotta Norgaard

In 2003, I was given the first of many diagnoses: systemic lupus erythematosus (lupus for short). This diagnosis would later be the reason why I had to wait many years to have a child.

Although hard for the doctors to believe, I became pregnant and in 2014 gave birth to a beautiful baby girl. The birth was highly problematic, with both of us clinging on to dear life.

Our baby would come into this world with what appeared to be permanent kidney, liver, and brain damage. But I told Lea (over and over again) to fight and show them that she was meant to live. I knew Lea could prove them all wrong.

Against all odds, Lea survived. But the medication that saved her life unfortunately caused bilateral hearing loss and she received hearing aids as an infant.

I had always insisted that Lea’s ears (aka her hearing aids) were amazing. I instilled in Lea that her magic ears were her best feature. Together we celebrated every single pair of earmolds and hearing aids by decorating them with colors, glitter, and stickers.

Until that wasn’t enough. As Lea grew older, she became acutely aware that she was different due to her hearing loss and became sad and didn’t want to wear them. I decided to create something that could let Lea celebrate her magic ears. Inspired by a favorite candy, I created gummy bear hearing aid earrings.

Their success was tremendous. The hospital, the hearing center, and all other parents were eager for this “ear bling” to make hearing loss fun for their little ones. So today I produce handmade hearing aid earrings that are fun, happy, and colorful—perfect for younger girls and teens. The earrings are made to fit on the hearing aid tube and not irritate the ear or the quality of hearing.

Now Lea is 8 years old and healthy. All her medical concerns have disappeared, and she is just like every other little girl out there changing her (hearing aid) earrings every day to fit her outfit and mood.

My husband and I have always been open to conversations about Lea’s hearing aids, to normalize hearing loss and treatment. I created the earrings precisely so others would notice the hearing aids and see how cool they are. The earrings reflect the wearer’s personality and bring out a smile, or even a jealous stare! Funnily enough,

everyone is so mesmerized by the cute earrings that they don’t see the hearing aids.

We cannot hide that we or our kids need assistance to hear. That is why I named the business See Me Hear, because I want you to notice the hearing aids and for kids to be okay with them—even proud.

Our kids’ hearing devices allow them to hear better. And that should be celebrated because that is truly magical.

Charlotta Norgaard lives with her family in Denmark. See Me Hear hearing aid accessories can be purchased in the U.S. with shipping from California at etsy.com/dk-en/shop/VikingWorld, and in Denmark at facebook.com/See-MeHear-101011982770927.

Support our research: hhf.org/donate.

She is just like every other little girl out there changing her (hearing aid) earrings every day to fit her outfit and mood.

Fun and colorful, the handmade earrings fit on the hearing aid tube.

Bluetooth Assistive Listening Gets Closer

Auracast could make connecting to an assistive listening system as simple as it is with a hearing loop. By Stephen O. Frazier

Ever since Bluetooth was first used with Starkey hearing aids in 2005, many users have had the mistaken impression that Bluetooth could be used as an assistive listening system. Though not possible previously, this is about to change.

The Bluetooth Special Interest Group (SIG), the standards organization for the technology, recently announced Auracast, formerly known as Bluetooth LE Audio Sharing, will allow multiple users to connect to a Bluetooth signal. With Auracast, the door will be open to many applications and make Bluetooth a competitor with FM, infrared, hearing loop, and Wi-Fi audio assistive listening systems.

Many people don’t realize that Bluetooth is a one-to-one technology that allows two devices to wirelessly exchange data. Created over 20 years ago, Bluetooth increased its speed and capability, but that increased its need for more power, draining hearing aid batteries linked by Bluetooth to another device such as a smartphone.

This issue was addressed in 2020 with a new Bluetooth LE (low energy) version that then led to Auracast. Derek Edwards, Au.D., an audiologist and audio engineer, says on his website that this technology is “broadcast audio,” noting, “You can broadcast one or more audio streams to an unlimited number of devices like headphones, earbuds, and hearing aids.”

In 2014 the European Hearing Instrument Manufacturers Association urged SIG to explore using Bluetooth for assistive listening systems able to connect wirelessly with hearing aids. Bluetooth has delivered.

On the Bluetooth blog late in 2021, Jeff Solum, a wireless system architect at Starkey Labs, was asked how soon Starkey will offer products that include multi-user assistive listening. He predicted hearing aids will be “hardware ready” by 2023. He then said, “I would estimate the breakout year for this technology will be 2024, when most

smartphone and computer platforms will have adopted the technology.” In a first step, some Starkey hearing aids using Bluetooth LE are already able to receive sound in digital form directly from the Amazon Fire TV Cube.

Nikolai Bisgaard, the vice president of external relations at hearing aid manufacturer GN ReSound, is not as optimistic. On the Better Hearing website run by Hearing Industries Association, he wrote in January 2022 that “hearing aids are medical devices and thus subject to rather strict regulatory requirements, so it will therefore take some time to get products out.”

Experts like Solum and Bisgaard have indicated that, as most of today’s hearing aids are already using Bluetooth LE technology for their programming, as it is implemented in new models wearers will be able to benefit from Auracast as well as the already available connectivity to phones, TVs, and other devices.

Bluetooth LE is available in Android 4.3 and later devices where it provides reduced power consumption compared with classic Bluetooth. On the Android Authority website, a June 2022 report states that a Bluetooth spokesperson told a few publications that consumer products with support will come as early as “toward the end of the year and the holiday season.”

Other tech firms are already on board. CEVA Inc., a licensor of wireless connectivity and smart sensing technologies, has announced that its latest IP family now supports Auracast. Wireless software licensor Packetcraft Inc. is providing commercial licensees with SIG-qualified LE Audio software supporting the Bluetooth LE Generic Audio Framework specifications that are an integral part of Auracast.

Auracast could make connecting to an assistive listening device as simple as it is with a hearing loop. Wearers of Bluetooth-capable hearing aids could connect with the touch of a button (or possibly even automatically

A low-energy version of Bluetooth, Auracast has the promise of delivering multi-user assistive listening.

once you enter a room with a Bluetooth assistive listening system). Those without hearing aids could connect with a pair of Bluetooth earbuds or use their Android or an older iPhone with plug-in, wired earbuds, and those with telecoilequipped hearing aids could connect using a neckloop.

With Auracast ready, the focus is on hardware such as transmitters. Predictable Designs, a firm that helps entrepreneurs, inventors, and small companies develop electronic hardware products, says it takes at least two years to develop, manufacture, and market an electronic hardware product.

Andrew Thomas, the market development director at loop maker Contacta, is aware of the challenges and cost of installing hearing loops. In the Bluetooth blog in October 2021 he says, “Bluetooth LE has the potential to be used as an ALS across a variety of public applications.” For Contacta, he adds, “There will be opportunities to develop new products as the technology develops, particularly outside of the ALS arena.”

Ampetronic, Contacta’s largest rival in the U.K., offers a different perspective. On their website is a 2020 post from German audio therapist Rosemarie Muth in which she says, “We all hope that one day there will be better and cheaper public hearing system technology that can replace induction. If this should be Bluetooth Low Energy Audio it will still take many years to get there and it will be much, much longer before induction can be replaced completely with a clear conscience.”

A concern to the legions of hearing loop advocates in the U.S. is the often asked question, “Will Bluetooth replace loops?” I contacted Williams AV in June 2022 to get their opinion and heard back from Tony Braun, the vice president of global marketing at Williams AV. “We continue to see the proliferation of hearing loop enabled venues in both domestic and international markets,” Braun says. “We at Williams AV are confident that hearing loop

technology will remain a preferred option by many venues for years to come.”

I also reached out to Contacta’s Andrew Thomas, who agrees: “Many industry experts have suggested that loops/T-coils will be around for at least 10 years.”

Where hearing loops are concerned, it’s conceivable that Auracast will initially be installed to supplement existing hearing loop installations and the two systems would be run in tandem for as long as another decade until the vast majority of telecoil-equipped hearing aids have been replaced.

In her Ampetronic post, Muth says, “Induction loops and Bluetooth Low Energy Audio (or other successor standards) could coexist, and maybe it will stay that way for a very, very long time.”

It’s not really known when Auracast assistive listening will be a reality—only that it’s getting closer.

Trained by the Hearing Loss Association of America as a hearing loss support specialist, staff writer and New Mexico resident Stephen O. Frazier has served HLAA and others at the local, state, and national levels as a volunteer in their efforts to improve communication access for people with hearing loss. Contact him at hlaanm@juno.com. For more, see sofnabq.com and loopnm.com. For references, see hhf.org/fall2022-references.

Share your story: Tell us what you use for assistive listening at editor@hhf.org.

Support our research: hhf.org/donate.

2023 Hearing Restoration Project Funding Awards Announced

The work of the Hearing Restoration Project (HRP) consortium continues in line with the working group model introduced last year. There is a strong consensus among members of the consortium and the Scientific Advisory Board that this model has further improved the team science, collaboration, and faster exchange of data that have been hallmarks of HRP since its founding.

These working groups are organized in line with the consortium’s three main goals.

The Cross-Species Epigenetics working group compares gene expression and epigenetics across species to identify and describe the molecular mechanisms that prevent hair cell regeneration.

The Integrative Analysis working group performs a meta-analysis of data collected from different species over the years and will curate the data available to access via the gEAR, the data sharing and data visualization tool developed with HRP funding. The third working group, Reprogramming and Gene Delivery, is charged with finding ways to stimulate hair cell regeneration by targeting supporting cells.

Each consortium member belongs to at least one working group, and a total of $1.6 million is being distributed to HRP members for the new project year (October 1, 2022, through September 30, 2023), representing a 33 percent increase on funding from last year.

Cross-Species Epigenetics Group

Tatjana Piotrowski, Ph.D. (chair), Stowers Institute for Medical Research

Alain Dabdoub, Ph.D., Sunnybrook Research Institute

Andy Groves, Ph.D., Baylor College of Medicine

Stefan Heller, Ph.D., Stanford University

Litao Tao, Ph.D., Creighton University

Segil Lab* (Andrew McMahon, Ph.D., and John Oghalai, M.D.), University of Southern California

Integrative Analysis Group

Seth Ament, Ph.D. (co-chair), University of Maryland

Ronna Hertzano, M.D., Ph.D. (co-chair), University of Maryland

Albert Edge, Ph.D., Mass Eye & Ear

Stefan Heller, Ph.D., Stanford University

David Raible, Ph.D., University of Washington

Jennifer Stone, Ph.D., University of Washington Mark Warchol, Ph.D., Washington University in St. Louis

Reprogramming and Gene Delivery Group

Andy Groves, Ph.D. (chair), Baylor College of Medicine

John Brigande, Ph.D., Oregon Health & Science University

Yehoash Raphael, Ph.D., University of Michigan

Segil Lab* (Andrew McMahon, Ph.D., and John Oghalai, M.D.), University of Southern California

*Neil Segil, Ph.D., passed away in July 2022. Please see page 6 for his remembrance.

For more information and updates, see hhf.org/hrp.

Meet the 2023 Grantees

With the new grant year starting each October, Hearing Health Foundation (HHF) is thrilled to announce the 15 researchers who earned funding through our Emerging Research Grants (ERG) program. These include first-year projects that are renewable for a second year, as well as second-year funding for researchers who demonstrated compelling progress. We are thankful to our scientific reviewers and Council of Scientific Trustees, who had the very difficult task of deciding whom to fund among an exceptional pool of new proposals and applicants.

FIRST YEAR Francisco BarrosBecker, Ph.D. University of Washington Project: Aminoglycoside compartmentalization and its role in hair cell death

George Burwood, Ph.D. Oregon Health & Science University Project: Apical cochlear mechanics after cochlear implantation

Carolyn McClaskey, Ph.D. Medical University of South Carolina Project: Age and hearingloss effects on subcortical envelope encoding Generously funded by Royal Arch Research Assistance

Sharlen Moore, Ph.D. Johns Hopkins University Project: Modulation of neuro-glial cortical networks during tinnitus Generously funded by the Les Paul Foundation

Melissa Polonenko, Ph.D. University of Minnesota–Twin Cities Project: Identifying hearing

loss through neural responses to engaging stories

Generously funded by Royal Arch Research Assistance

SECOND YEAR

Timothy Balmer, Ph.D. Arizona State University Project: The role of unipolar brush cells in vestibular circuit processing and in balance

James Dewey, Ph.D. University of Southern California Project: Filtering of otoacoustic emissions: a window onto cochlear frequency tuning

James Dias, Ph.D. Medical University of South Carolina Project: Neural determinants of age-related change in auditory-visual speech processing

Generously funded by the Meringoff Family Foundation

Our ERG program remains the preeminent seed funding opportunity for hearing and balance researchers, particularly in early stages of their careers. By earning this competitive grant, they are better poised to earn future major federal funding, thanks to the preliminary data, findings, and experience gained from their HHF grants.

We are deeply grateful for the continued dedication of our generous donors. The advances these scientists will make is only possible because of your support. Thank you and congratulations to the 2023 grantees:

Mishaela DiNino, Ph.D. University at Buffalo Project: Neural mechanisms of speech sound encoding in older adults

Generously funded by the Meringoff Family Foundation

Subong Kim, Ph.D. Montclair State University Project: Influence of individual pathophysiology and cognitive profiles on noise tolerance and noise reduction outcomes

Manoj Kumar, Ph.D. University of Pittsburgh Project: Signaling mechanisms of auditory cortex plasticity after noiseinduced hearing loss Generously funded by Royal Arch Research Assistance

Matthew Masapollo, Ph.D. University of Florida Project: Contributions of auditory and somatosensory feedback to speech motor control in congenitally deaf 9- to 10-year-olds and adults

Z. Ellen Peng, Ph.D. Boys Town National Research Hospital Project: Investigating cortical processing during comprehension of reverberant speech in adolescents and young adults with cochlear implants

Generously funded by Royal Arch Research Assistance

Megan Beers Wood, Ph.D. Johns Hopkins University School of Medicine Project: Type II auditory nerve fibers as instigators of the cochlear immune response after acoustic trauma Generously funded by Hyperacusis Research

Calvin Wu, Ph.D. University of Michigan Project: Development and transmission of the tinnitus neural code

Generously funded by the Les Paul Foundation

The next cycle for grant applications opens in mid-October. For more, see hhf.org/erg.

Recent Research by Hearing Health Foundation Scientists, Explained

Major Federal Funding to Continue Hidden Hearing Loss Research

A team of Mass Eye and Ear researchers in the Eaton-Peabody Laboratories has been awarded a five-year, $12.5 million P50 Clinical Research Center Grant from the National Institute on Deafness and Other Communicable Disorders (NIDCD) of the National Institute of Health (NIH) to continue their research on cochlear synaptopathy, or hidden hearing loss, a type of hearing damage first discovered at Mass Eye and Ear in 2009.

Funding from the grant extends support of four projects that aim to clarify the prevalence, nature, and functional consequences of hidden hearing loss in humans. The work promises to inform cellular-based diagnosis and development of future therapies. Each of the related projects is led by a separate principal investigator.

The collaborating Mass Eye and Ear principal investigators on the projects are Sharon Kujawa, Ph.D., the Sheldon and Dorothea Buckler Chair of Otolaryngology at Mass Eye and Ear and professor of otolaryngology–head and neck surgery at Harvard Medical School; Charles Liberman, Ph.D., professor of otolaryngology–head and neck surgery at Harvard Medical School; Stéphane Maison, Au.D., Ph.D., CCC-A, associate professor of otolaryngology–head and neck surgery at Harvard Medical School; and Daniel Polley, Ph.D., professor of otolaryngology–head and neck surgery at Harvard Medical School and interim director of the EatonPeabody Laboratories.

Kujawa is the program director overseeing the entirety of the grant. She is a member of Hearing Health Foundation’s Board of Directors and its Council of Scientific Trustees, which oversees HHF’s Emerging Research Grants program, from which Kujawa received a grant in 1999.

Under the initial NIH grant, the research team focused on detecting and characterizing hidden hearing loss in humans and animals with typical hearing thresholds. With the new grant, their focus will expand to detecting

this hearing damage in the presence of hearing loss as traditionally defined by a clinical audiogram, as well as to better understanding the consequences of this damage in hearing function.

“The discovery of hidden hearing loss has forever changed the way clinicians think about hearing loss, from its diagnosis to its treatment,” says Mark A. Varvares, M.D., FACS, the chief of the departments of otolaryngology–head and neck surgery at Mass Eye and Ear and Massachusetts General Hospital. “The continuation of this P50 grant is another example of our commitment to pioneering life-changing diagnostics and cures at Mass Eye and Ear.”

Hidden Hearing Loss

The audiogram has long been used by clinicians as the gold standard for hearing tests. The test reflects the health of sensory cells in the inner ear, called hair cells, which convert sound into electrical signals. While the health of these cells can determine a person’s hearing threshold, or how loud a sound needs to be in order for a person to hear it, the thresholds do not reveal how clearly sounds are heard. A healthy auditory nerve, able to faithfully transmit sound information to the brain, plays a crucial role.

In 2009, Kujawa and Liberman discovered that exposure to noise destroys the synapses connecting hair cells to the auditory nerve well before the noise-damaged hair cells, which meant hearing damage could exist before it was revealed by the audiogram.

“We used to think that if thresholds recovered to normal after exposure to noise, then there was no lasting ear damage, which we’ve come to find out isn’t the case,” Kujawa says. “Rather, it’s as if the loss was ‘hidden’ in the normal audiogram.”

This prompted the researchers to evaluate widespread neural degeneration in patients who had hearing difficulties, but also had typical audiogram measurements.

Under the NIH initial grant, the research team focused on detecting and characterizing hidden hearing loss in humans and animals with typical hearing thresholds. With the new grant, their focus will expand to detecting this hearing damage in the presence of hearing loss as traditionally defined by a clinical audiogram, as well as to better understanding the consequences of this damage in hearing function.

Building on Earlier Projects

Since Kujawa and Liberman’s 2009 discovery, investigators have made it a priority to understand what hidden hearing loss is, what causes it, and how to identify it. In 2017, the NIH awarded Kujawa, Liberman, Maison, and Polley a P50 grant to research this new type of hearing damage from multiple angles. Through four separate projects, including one studying donated human temporal bones, one focusing on animal models of human hearing loss, and two working with human subjects, the team of researchers has found widespread evidence of neural degeneration hidden behind typical audiogram measurements.

Their research also unveiled several new clues about this new type of hearing damage. Growing evidence has suggested that perceptual disorders, some as mild as difficulty hearing in a noisy environment, or as potentially debilitating as tinnitus and hyperacusis, could share a common tie to neural degeneration. Additionally, studies found that sound deprivation—not just aging, loud noises, or ototoxic drugs—can lead to neural degeneration.

According to Kujawa, evaluating human and animal subjects with overt hearing loss under the new P50 grant will bring investigators a step closer to devising sensitive diagnostic tools, thereby making it possible to apply future therapeutics to prevent, limit, or reverse cochlear neural degeneration.

“Right now, we have therapeutics on the horizon that have shown the potential to repair or reconnect these nerve fibers in the inner ear,” she says. “If we can improve our tests so they show us who has neural degeneration and who doesn’t, then we can test the efficacy of these therapeutics, which would be a big advance for hearing loss research and clinical treatment.” —Mass Eye and Ear

This is adapted from a press release by Mass Eye and Ear. Research reported above was supported by the National Institute on Deafness And Other Communication Disorders of the National Institutes of Health under Award Number P50DC015857. A 1999 Emerging Research Grants (ERG) scientist, Sharon Kujawa, Ph.D., is a member of HHF’s Board of Directors and Council of Scientific Trustees. She presented her research on hidden hearing loss for HHF’s Hearing Health Hour webinar, at hhf.org/webinar.

Support our research: hhf.org/donate.

How Pharmacists Can Help Bridge the Gap in Hearing Care for Seniors

One third of people between 65 and 74 years of age and one half of those 75 years of age and older have some degree of hearing loss, according to the National Institute on Deafness and Other Communication Disorders.

The number of people with hearing loss is expected to continue to rise because of the aging population of the United States.

The World Health Organization says hearing loss is associated with impaired cognition, communication, and balance, as well as an increased risk of dementia, falls, hospitalization, and early mortality. The risk of dementia is up to five times greater and the risk of falling up to three times greater in people with hearing loss left untreated.

To mitigate these risks, it is crucial for older people with hearing loss to be identified in order to treat their hearing. Historically, collaboration between otologists, audiologists, and pharmacists has been limited, but pharmacy graduate students and their advisers at the University of Maryland in Baltimore and College Park recognized that as frontline health care providers, pharmacists have the potential to expand knowledge and facilitate hearing care for patients.

After reviewing the literature on pharmacy, audiology, and their integration, their paper in The Senior Care Pharmacist in July 2022 aims to provide pharmacists with education on hearing loss that colleagues in audiology believe is most critical for pharmacists.

Access to Care

Hearing care is delivered through a clinic-based model by a hearing care professional such as an audiologist or otologist. This model limits access to care for individuals living in remote areas and often leaves the responsibility with the patient to prioritize and seek out their own hearing care. The need for a separate specialized office visit creates a barrier for patients with financial struggles.

Recent changes in legislation led to the approval of over-the-counter (OTC) hearing aids for patients with mild to moderate hearing loss. These hearing aids will be offered, like reading glasses, in pharmacies and other consumer shops. As a result, pharmacists may not only be the most accessible frontline providers, but also be best positioned to promote hearing health and provide on-site consultation.

Geographically, more than 90 percent of people in the United States live within 2 to 5 miles of a community pharmacy. In the United States, 66 percent of adults older than 65 years of age use at least five prescription medications; as a result, most older people interact with a pharmacist multiple times per year. In collaboration with audiologists and otologists, pharmacists can bridge the gap for patients in need of hearing assistance.

Hearing Screenings

According to the U.S. Census population prediction, by 2034 patients older than 65 years of age will outnumber children in the United States. As the population ages, increasing access to screening has never been more relevant. Early identification of hearing loss is key to effective management. Screening is recommended every 10 years for adults and every three years for adults 50 years of age or older and those with risk factors for hearing loss—but compliance with this practice is low.

In the community, pharmacists can informally screen patients for hearing loss, by identifying older patients who ask them to repeat statements or respond with short, noncommittal answers. A more formal screening is possible when the pharmacist is providing annual wellness visits or medication therapy management.

Enhanced Communication

Apart from screening, there are other ways senior care pharmacists can tailor their practices to better serve older patients with hearing loss. Studies have demonstrated inconsistent knowledge of common health issues among older patients with communication difficulties. Hearing loss can lower the quality of care delivered and lead to negative health outcomes.

Considering the prevalence of hearing loss, pharmacists should anticipate the need for auditory accommodation and have these services readily available to ensure effective communication. Auditory accommodations can include assistive listening devices, written information to supplement verbal communication, and ensuring that the environment is conducive to communication, such as through face-to-face communication in a quiet, well-lit area.

Geographically, more than 90 percent of people in the United States live within 2 to 5 miles of a community pharmacy. In the United States, 66 percent of adults older than 65 years of age use at least five prescription medications; as a result, most older people interact with a pharmacist multiple times per year. In collaboration with audiologists and otologists, pharmacists can bridge the gap for patients in need of hearing assistance.

Over-the-Counter Hearing Aids

The U.S. Food and Drug Administration (FDA) has recommended implementing a new device category for OTC wearable hearing devices for adults with no greater than moderate hearing loss. To date, the FDA approval process is not complete, so the following recommendations come from what the authors predict the technology of the approved OTC hearing aids will include.

It is estimated that 28.8 million adults in the United States could benefit from hearing aids, and less than 30 percent have ever used them. OTC devices are intended to address issues with the accessibility and affordability of amplification devices by reducing the regulatory burden of bringing hearing aids to the market.

With OTC devices available for sale in community pharmacies, pharmacists have the potential to provide vital education and counseling to older patients seeking hearing health care, helping to determine if they are a suitable candidate for an OTC hearing aid or if they should be referred to an audiologist or an otologist. Signs a patient may be a good OTC candidate

» Hearing loss falls within the mild to moderate range

» Patient has accurate and consistent perception of his or her hearing ability

Signs a patient may not be a good OTC candidate (prompting a referral)

» Signs of cognitive impairment

» Inappropriate expectations about hearing aid benefit

» Poor dexterity

Pharmacists should be aware of criteria for immediate medical referral which include dizziness, sudden hearing loss, pain or discomfort, discharge, or excessive earwax. Consulting with a medical professional can rule out an infectious disease or other trauma, or the ability to medically treat (e.g., steroid administration for sudden hearing loss).

Senior care pharmacists are well positioned to help but must be aware of the prevalence of hearing loss in their communities and be actively engaged in screening and person-centered interventions. Collaboration with audiologists and otologists will allow for referrals to be made by pharmacists when an older patient’s hearing loss needs further care.

When OTC hearing aids are made available, pharmacists will need to be able to make recommendations regarding hearing aids but also identify patients who require referral or are otherwise not good candidates for an OTC device. By working with audiologists and otologists, pharmacists have the potential to help mitigate the widespread problem of untreated hearing loss by helping older patients overcome the barriers of access and affordability in hearing healthcare.

—Ronna Hertzano, M.D., Ph.D

This is adapted from the paper “Senior Care Pharmacists, Audiologists, and Otologists: Improving Hearing Health for Older Patients Through Interprofessional Collaboration” in The Senior Care Pharmacist, July 2022. The paper’s coauthor Ronna Hertzano, M.D., Ph.D., is a 2009–2010 ERG scientist and a member of HHF’s Hearing Restoration Project and Council of Scientific Trustees. She is a professor in the department of otorhinolaryngology–head and neck surgery at the University of Maryland School of Medicine.

Support our research: hhf.org/donate.

In this graph modified from Karawani et al., in Frontiers in Aging Neuroscience, 2022, the average changes in cortical response amplitudes to a speech syllable in 17 new hearing aid users are displayed for six sessions. A significant increase in N1 amplitude was noted in session 2 (two weeks after hearing aid fitting) but the increase in P2 amplitude did not consistently occur until session 4 (12 weeks after hearing aid fitting).

Hearing Aid Use Improves Brain Processing Over Time

New hearing aid users often report significant improvements in quality of life as they connect once again to the hearing world around them. Yet, first-time hearing aid users may find that newly amplified sounds are overwhelming.

The onset of hearing loss usually occurs slowly, and individuals may wait seven or more years before deciding to pursue treatment for hearing loss. During this time, the brain adjusts to the lack of sound input by increasing the firing rate of auditory neurons, making them more excitable. This increased excitability can make newly amplified sounds seem uncomfortably loud.

Fortunately, the brain can readjust to an increase in auditory input through the use of hearing aids. This adjustment period takes time, however, and knowledge of the time course of neural adaptation may be useful when counseling patients fit with hearing aids for the first time.

In 2014, my colleagues at the University of Maryland and I were awarded an Emerging Research Grant to evaluate neural plasticity associated with hearing aid use. We recruited listeners with mild-to-moderate sensorineural hearing loss who had never worn hearing aids and randomly assigned them to two groups.

The first group of 17 individuals was fit with hearing aids and wore them for at least eight hours a day for six months. The second group of 14 individuals was fit and tested with hearing aids but did not wear them during the six-month period. Both groups were tested with a battery of behavioral, electrophysiological, and cognitive tests.

Our initial studies demonstrated plasticity in the hearing aid use group through improved brain processing, speech-in-noise performance, and working memory scores (Neuropsychologia, 2018; Clinical Neurophysiology, 2018). These changes were not observed in the no hearing aid use group.

Our group recently published a follow-up study in Frontiers in Aging Neuroscience in May 2022 that determined the time course of changes in brain processing over the course of six months. We measured cortical speech processing while wearing hearing aids at six time points: initial fitting, two weeks, six weeks, 12 weeks, 18 weeks, and six months post-hearing aid fitting.

We found that early stages of brain processing changed rapidly. Peak N1 of the cortical response signals the brain’s orientation to an auditory stimulus.

The amplitude of N1 increased after just two weeks. Later stages of brain processing required more time to observe a consistent change. Peak P2 of the cortical response signals the brain’s early identification of an auditory stimulus. For example, if one hears the sound of a toilet flushing, the brain forms an auditory image of a toilet at an unconscious level. Increases in P2 amplitude were observed after six weeks of hearing aid use. Figure 1 displays changes in these amplitudes over the course of six sessions.

So, what does this mean for the new hearing aid user? The brain adjusts quickly to amplified sound—that’s a good thing. But the brain’s ability to fully interpret amplified signals in a meaningful way requires a longer period of time. The typical hearing aid trial period is 30 days, so the hearing aid user may not be experiencing the full benefits of amplification at the end of that period.

Audiologists may wish to use this information to counsel the patient that hearing through amplification should continue to improve, especially with respect to clarity. Our paper also found that electrophysiology testing on the first day of hearing aid fitting predicted later improvements. Perhaps in the future we will see an increase in the use of electrophysiology to manage hearing loss and to counsel patients regarding appropriate expectations. —Samira Anderson, Au.D., Ph.D.

A 2014 ERG scientist generously funded by Royal Arch Research Assistance, Samira Anderson, Au.D., Ph.D., is an associate professor and the director of graduate studies in the department of hearing and speech sciences at the University of Maryland.

Support our research: hhf.org/donate.

Fortunately, the brain can readjust to an increase in auditory input through the use of hearing aids. This adjustment period takes time, however, and knowledge of the time course of neural adaptation may be useful when counseling patients fit with hearing aids for the first time.

As shown in this University of Florida image by Hillary Carter and Shena Hays, by combining electromagnetic articulography and electroglottography, researchers can simultaneously record lip, tongue, jaw, and glottal motion during speech production without electromagnetic interference.

Improving How to Assess Speech Production

When we talk, we have the impression that we don’t have to do much. We have an idea, our mouth starts to move, and the sound comes out, and we don’t have a sense of the steps involved in the process. Yet anyone who has ever attempted to produce speech in a foreign language can readily attest that the ability to produce the sound sequences in a fluent, natural, and coordinated way is a far from trivial skill. Moreover, the challenges encountered in learning to speak by individuals born with profound sensorineural hearing loss also hint at the complexity involved.

During typical conversational interactions, humans use over 100 different muscles in the vocal tract to produce up to 6 to 9 syllables per second, which is one of the fastest types of motor behavior. More complicated still, the various articulators of the vocal tract—the lips, tongue, jaw, and glottis—do not move in an isolated, independent manner. Rather, their movement patterns are lawfully orchestrated with one another in space and time. Unfortunately, though, no single instrument is capable of concurrently measuring the complex motion patterns of all the articulators involved in speech production.

Recently, my team and I demonstrated that two different instruments with complementary strengths—electromagnetic articulography (EMA) and electroglottography (EGG)—can be combined to concurrently measure laryngeal and supralaryngeal speech movements. EMA uses diffuse magnetic fields to track the positions of sensors fixated on the lips, tongue, and jaw during speaking, and EGG measures electrical impedance across the larnyx during the production of voice.

We plan to use these instruments to better characterize how congenitally deaf talkers who received cochlear implants (CIs) and their typical-hearing peers control and coordinate laryngeal and supralaryngeal movements. As published in JASA (Journal of the Acoustical Society of America) Express Letters in September 2022, this approach is novel because most clinical interventions for children with CIs focus on listening to speech. In our well-intentioned efforts to promote listening experiences we may be overlooking the importance of practice in producing speech.

During typical conversational interactions, humans use over 100 different muscles in the vocal tract to produce up to 6 to 9 syllables per second, which is one of the fastest types of motor behavior. More complicated still, the various articulators of the vocal tract—the lips, tongue, jaw, and glottis—do not move in an isolated, independent manner. Rather, their movement patterns are lawfully orchestrated with one another in space and time.

We hypothesize that providing CI wearers with orofacial somatosensory inputs associated with speech production may “prime” motor and sensory brain areas involved in the sensorimotor control of speech, thereby facilitating perception of the degraded acoustic signal experienced through their processors.

—Matthew Masapollo, Ph.D.

A 2022–2023 ERG scientist, Matthew Masapollo, Ph.D., is an assistant professor in the department of speech, language, and hearing sciences, and the director of the University of Florida Speech Communication Lab.

For references, see hhf.org/fall2022-references.

YOU CAN MAKE A DIFFERENCE NOW

announcing a planned giving matching challenge

Planned giving, also called estate or legacy giving, means a gift that your favorite charity receives upon your passing. It is a gift for the future.

A generous, anonymous donor has launched a challenge that will match your planned gift now. This enables Hearing Health Foundation to continue funding the life-changing science that benefits the millions of people who live with hearing and balance challenges.

Your planned gift will be matched when you make a bequest to HHF or name us as a partial beneficiary of a retirement fund or life insurance policy.

Here’s how the matching challenge works:

» For any planned gift of up to $10,000, HHF receives a match of $1,000.

» For any planned gift of $10,000 or more, HHF receives a match of $10,000.

» For larger planned gifts, HHF receives a match of $100,000.

Ann Pruitt has named HHF in her estate plans. Don’t have a will? Create one for free with our partner FreeWill at freewill.com/hhf.

Please email Harriet Hessam at hhessam@hhf.org to let us know about your planned gift or for more information.

You can make a difference NOW as well as in the FUTURE .

Please scan this QR code to learn more about Hearing Health Foundation’s extraordinary planned giving matching challenge.

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Hearing Health Foundation’s Hearing Restoration Project is the first international research consortium investigating how to regenerate inner ear sensory hair cells in humans to eventually restore hearing. hhf.org/hrp

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Hearing damage from too much noise is entirely preventable. Our hearing is too important to everyday life—and our overall health—to take for granted. Let’s all take care of our hearing, forever. hhf.org/keeplistening

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Hearing Health Foundation’s Emerging Research Grants (ERG) fund innovative approaches toward understanding, preventing, and treating hearing and balance conditions. hhf.org/erg

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Meet the Researcher

Robert Raphael, Ph.D. Rice University

Emerging Research Grants (ERG)

As one of the leading funding sources available for innovative research, HHF’s ERG program is critical. Without our support, scientists would not have the needed resources for cutting-edge approaches toward understanding, preventing, and treating hearing and balance disorders.

Raphael received his doctorate in biophysics from the University of Rochester. He did postdoctoral training in the department of biomedical engineering and the Center for Hearing and Balance at Johns Hopkins University. He is an associate professor in the department of bioengineering at Rice University where he directs the Membrane and Auditory Bioengineering Laboratory. Raphael is a 2022 Emerging Research Grants recipient.

i was trained in biophysics and hearing science. I was surprised at how little was known about the vestibular system and how small the field was. Several ENTs I talked to expressed how frustrated they were with being able to help Ménière’s disease patients. Many researchers have been using optical coherence tomography (OCT) to study the cochlea, but not the vestibular system. We had previously developed computational models of ion transport by vestibular dark cells and I realized we could expand these models and complement them with experiments. A colleague had developed a new technology for enhancing OCT contrast using gas vesicles, which are protein nanostructures. So we are using OCT, which is capable of imaging through bone, to observe changes in the fluid compartments in the inner ear.

my mother is a scientist and really encouraged all of us six kids to study science. She still reminds me that she knows more about biochemistry than I do. Looking back, I was very idealistic in college—a dual major in physics and philosophy. I wanted to understand how the universe worked and do research on Grand Unified Theory. Now I will settle for a Grand Unified Theory of how the inner ear works.

we have a genetic form of dominant progressive hearing loss in our family and I lost my hearing gradually throughout my life. I needed my first set of hearing aids

at the end of high school and received a cochlear implant in 2012. In retrospect, I waited too long to get the cochlear implant. I’m the oldest and four of my siblings now have cochlear implants too.

i often think about science when cycling long distance. Einstein has a quote, “Life is like riding a bicycle. To keep your balance you must keep moving.” I also like listening to music, and take advantage of Rice’s many free music recitals and concerts. Unfortunately people with hearing loss and cochlear implants can lose music appreciation. I actually have a side-grant with a music professor to work on improving music processing for cochlear implant users.

there are so many fascinating unanswered questions in hearing and balance science. I’ve always believed we need to better understand how things work at a fundamental level, and with the emergence of new technologies there are more opportunities to help people like myself who suffer from auditory and vestibular disorders.

Robert Raphael, Ph.D., is funded by donors to Hearing Health Foundation who designated their gifts for the most promising research. HHF sincerely thanks our community for supporting the full range of hearing and balance science.

We need your help funding the exciting work of hearing and balance scientists. Please consider donating today to Hearing Health Foundation to support groundbreaking research. Visit hhf.org/how-to-help.

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