Hearing Health Fall 2021
A Publication of Hearing Health Foundation
The Hearing & Overall Health Issue Caring for your hearing is a vital part of physical and mental health
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www.CapTel.com 1-800-233-9130 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 on to the CapTel user for using the service. CapTel captioning service is intended exclusively for individuals with hearing loss. CapTel® is a registered trademark of Ultratec, Inc. The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc. and any use of such marks by Ultratec, Inc. is under license. (v2.6 10-19)
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The mission of Hearing Health Foundation (HHF) is to prevent and cure hearing loss and tinnitus through groundbreaking research and to promote hearing health. HHF is the largest nonprofit funder of hearing and balance research in the U.S. and a leader in driving new innovations and treatments for people with hearing loss, tinnitus, and other hearing and balance conditions. As part of our outreach, we provide this quarterly magazine for free to our vibrant community of readers and supporters, as well as to the dedicated professionals who work with them. Please subscribe at hhf.org/subscribe and make a donation at hhf.org/donate.
Fall 2021: The Hearing & Overall Health Issue Untreated hearing loss is linked to a range of health issues, including heart and brain health. Let’s do more to protect our hearing.
Timothy Higdon President and CEO Hearing Health Foundation
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Hearing Health The Hearing & Overall Health Issue Fall 2021, Volume 37, Number 4
Publisher Timothy Higdon, President and CEO, HHF
Features
Editor Yishane
08 Managing Hearing Loss Hearing Loss Is a Practice, Not a Perfect. Shari Eberts 10 Hearing Health Of Sound Mind. Nina Kraus, Ph.D. 14 Managing Hearing Loss Q: What Is the Medically Necessary Part of Hearing Health That Is Rarely Provided? A: Auditory Rehabilitation. Nicole Laffan, Au.D., M.S., CCC-A/SLP 17 Hearing Health 9 Things to Know About Hearing Loss From Noise 18 Hearing Health Heart Health and Hearing Health Are Not Mutually Exclusive. Lauren McGrath 20 Living With Hearing Loss How I Cope When They See
That I (Sometimes) Can’t Hear. Heather Chambers
22 Living With Hearing Loss You Are Not Alone! Mary Horton 26 Technology Make Your Smartphone Even Smarter. Stephen O. Frazier 34 Research Meet the HRP Working Groups. Lisa Goodrich, Ph.D. 37 Research 2022 Emerging Research Grants Announced. Christopher Geissler, Ph.D. 38 Research Recent Research by Hearing Health Foundation Scientists, Explained. 46 Research Bench to Bedside: The Pipeline From Basic Research to Clinical Therapies and Treatments. Christopher Geissler, Ph.D.
Departments
Sponsored
06 HHF News 28 HHF 2021 Reader Survey 29 Meet the Donor Ariadne Aberin 32 Meet the Fundraiser Abe in California 50 Meet the Researcher James Dewey, Ph.D.
48 Advertisement Tech Solutions. 49 Marketplace 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 Shari Eberts in Great Sand Dunes National Park, Colorado. Visit hhf.org/subscribe to receive a FREE subscription to this magazine. 4
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Lee
Art Director Robin Senior Editor
Kidder
Amy Gross
Staff Writers Shari
Eberts, Kathi Mestayer
Advertising hello@glmcommunications. com, 212.929.1300 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 Jay R. Lucker, Ed.D., CCC-A/SLP, FAAA Joscelyn R.K. Martin, Au.D. Board of Directors
Chair: Col. John T. Dillard (U.S. Army, Ret.) Sophia Boccard Robert Boucai Judy R. Dubno, Ph.D. Ruth Anne Eatock, Ph.D. Jason Frank, J.D. Jay Grushkin, J.D. Roger M. Harris David S. Haynes, M.D. Elizabeth Keithley, Ph.D. Cary Kopczynski Anil K. Lalwani, M.D. Michael C. Nolan Paul E. Orlin Robert V. Shannon, Ph.D. Hearing Health Foundation 575 Eighth Avenue #1201, New York, NY 10018 Phone: 212.257.6140 TTY: 888.435.6104 Email: info@hhf.org Web: hhf.org Hearing Health Foundation is a tax-exempt, charitable organization and is eligible to receive tax-deductible contributions under the IRS Code 501(c)(3). Federal Tax ID: 13-1882107 Hearing Health magazine (ISSN 2691-9044, print; ISSN 2691-9052, online) is published four times annually by Hearing Health Foundation. Copyright 2021, Hearing Health Foundation. All rights reserved. Articles may not be reproduced without written permission from Hearing Health Foundation. USPS/Automatable Poly To learn more or to subscribe or unsubscribe, call 212.257.6140 (TTY: 888.435.6104) or email info@hhf.org.
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Download the Innocaption app today! www.innocaption.com support@ 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.
Erin Nolan, a Navy veteran, says her chronic tinnitus is especially upsetting when her young children are speaking to her but she can’t process what they’re saying because the tinnitus is drawing all her focus. “I worry they think that Mommy doesn’t care because she isn’t listening,” she says.
NEWS
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New HHF Videos Feature Powerful Interviews About Hearing Loss and Tinnitus Coinciding with October’s National Protect Your Hearing Month and as part of Hearing Health Foundation’s “Keep Listening” prevention campaign, HHF is rolling out a new video series that presents the stories of people from all walks of life and their challenges with noise-induced hearing loss (NIHL) and tinnitus. These include sometimes heartbreaking accounts by individuals whose lives have been upended by NIHL and tinnitus and regrets about how easily they could have protected their hearing—had they fully realized the risk to their ears. “Keep Listening” aims to kick off a major culture shift so that everyone will protect their hearing in the same way we all now routinely protect our skin from harmful rays and our lungs from cigarette smoke. The stories underscore the message that we can all avoid hearing loss from noise—and the brain, heart, and mental problems that can come with it—through simple precautions like wearing earplugs in noisy places and turning down the volume on headphones. For those of us already coping with hearing loss or tinnitus, we also need to protect our hearing from further damage from noise. Jon Barton is a Marine infantry veteran who served tours in Iraq and Afghanistan. The pressure from a rocket propelled grenade aimed at a building where his team was bivouacked pierced his eardrum, and as a platoon
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commander he regularly rode in light armored vehicles that had very noisy turrets. Barton admits he did not realize that playing video games with the volume turned up on his headphones—one of the ways he and his buddies relax—is potentially worsening his hearing loss and tinnitus. A fellow veteran, Erin Nolan, describes how her chronic tinnitus diverts her focus from her young children, which she fears her children may interpret as inattention. Daniel Rivera, a structural engineer, describes his emotional turmoil caused by debilitating tinnitus, which developed after attending an all-day concert where he stood close to the speakers. Rivera says he now sees that his hearing may have already been impaired because he listened to music on headphones, loudly, in grad school to tune out ambient noises when studying. This may have primed his ears to be further damaged at the concert. The video series was shot in Los Angeles in late August by the multimedia production company PICROW, which produced the Emmy award–winning TV series “The Marvelous Mrs. Maisel,” “Modern Love,” “Transparent,” and “Goliath.” Director Peter Lang has helmed many film and video projects including health content for USAA, MassMutual, Thomson Reuters, and RWJBarnabas Health. The video series will be released over the course of October at hhf.org/keeplistening.
Spring 2019
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The Managing Hearing Loss Issue
SHARE STORIES AND SOLUTIONS
Facing daily challenges with grit, and grace
The Older Adults & Veterans Issue Coping with hearing conditions due to age or service
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Hearing Health Foundation’s Hearing Health magazine is the ultimate consumer resource on hearing loss, tinnitus, and other hearing and balance conditions. Our FREE, award-winning quarterly highlights inspiring first-person stories and real-world solutions based on the latest research and technology. Hearing Health magazine provides opportunities to meaningfully connect with others in the hearing loss community.
The Workplace Issue Hearing and balance conditions provide inspiration and create awareness on the job
The Noise-Induced Hearing Loss Issue Scientists research hearing conditions caused by loud sounds
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Hearing Loss Is a Practice, Not a Perfect By Shari Eberts
I am almost as passionate about yoga as I am about hearing loss advocacy. I try to practice yoga every day but during COVID-19 when I could not visit the yoga studio, conditions were not ideal. I created a dedicated space for my yoga practice at home, but it is also the walkway out to the backyard. When temperatures dropped I brought in space heaters to simulate the warm temperatures of my studio, but they can only do so much. “It’s a practice, not a perfect,” my yoga teacher reminds us as we struggle with the frustrations of taking class from home. “Optimize the conditions and do the best you can in the moment. Then try again tomorrow.” Good advice for practicing yoga, and also for living with hearing loss. Wouldn’t it be nice to approach each listening challenge with this same attitude— open-minded, without expectations, but all the while actively working to optimize the circumstances to help you hear your best? This outlook can be the difference between anger or determination, isolation or engagement, and frustration or peace in living with hearing loss, tinnitus, or both. It is not an easy task. These thoughts may go through our minds each time we hit a challenging listening situation. “My hearing will never be perfect.” “Hearing aids help, but they don’t work like glasses, restoring hearing back to ‘normal.’” 8
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managing hearing loss Opposite page: Shari Eberts (shown at left with her family) practices yoga in the Grand Canyon.
“It’s hard to hear people speak when there is background noise.” “Why can’t people use communication best practices like getting my attention before speaking to me?” “How will I ever hear anyone when they’re wearing a mask?” It is easy to get discouraged and want to give up, but we cannot. Communication is too important to our physical and mental health; it’s what keeps us connected to others and to the world. If we can change our focus to one of action—optimizing the situation—rather than lamenting poor listening conditions, we are more likely to achieve our real objective: effective and enjoyable communication. A can-do attitude is important, but so is expertise—and to build this takes effort. Years ago when my son was in preschool, his teacher used to say, “Practice builds confidence.” She was talking about rehearsing for the class recital at the end of the year, but it is true for any difficult task. “Don’t you mean practice makes perfect?” I asked when my son repeated the phrase to me. “No, confidence,” he said. Wise words and an important life lesson. By changing the goal from how well the kids performed to how they felt while doing it, my son’s teacher encouraged the children to focus on behaviors that lead to success. Kudos to this teacher for inspiring her students to embrace rehearsal time. Practicing built both confidence and expertise so the children could perform at an optimal level without fear of failure. Perfection was never even a consideration. These same philosophies can be applied to living with hearing loss. It will always be challenging picking up a prescription at the pharmacy when people are wearing face masks. We know it will be hard to follow a Zoom meeting without captions or, as socializing slowly returns, to go out to a loud restaurant or party. But when we focus on actions to improve the situation and practice the skills we need to do this, we will feel more confident in the moment and execute the workarounds more effectively. For example, at the pharmacy, you can use a speech-to-text-app to provide captioning support for what you hear from behind the masks. Practice with a family member at home first so you will be more adept in the moment. Same goes for the Zoom meetings or any other listening challenge. Plan your action strategy, practice it at home, and begin to execute with more confidence and ease in the moment. And don’t forget to say namaste.
Share your story: Tell us your communication strategies at editor@hhf.org.
Support our research: hhf.org/donate.
Shari Eberts serves on the Board of Trustees of the Hearing Loss Association of America and is a past chair of HHF’s Board of Directors. This originally appeared on her blog, livingwithhearingloss.com. a publication of hearing health foundation
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Loud sounds can cause hearing loss and affect your overall health, but quieter but constant sounds may also keep our brains in a constant state of alarm. By Nina Kraus, Ph.D.
My Italian home base, Trieste, is near the Dolomite mountains. I have hiked there all my life. One recent spring, after a long ascent, my cousin Lucio and I sat at the top of the world, looking at the peaks and valleys around us and listening. I lay back in the grass. After about 10 minutes of just being, I said something to Lucio. When I broke the silence, the loudness of my voice was jarring. The lack of noise called for a recalibration of listening. The “sound mind”—sound, and what our brains do with it—accomplishes the herculean task of turning air movement into sensation, sound into meaning, on a routine basis. But what about the sounds that serve as obstacles to our extracting meaning from intended sounds? One of the impediments that gets in the way of our well-tuned auditory system—and it is a big one— is noise. I’m talking about noise in its usual sense of unwanted sound outside the head. But we also experience 10
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noise inside the head—the conditions that impede the sound mind from efficiently doing its job. What, if anything, can we do to combat it? We need to be less cavalier about the day-to-day commotion that surrounds us in our raucous world. These noises do not meet or exceed the generally accepted threshold of “unsafe.” They are not novel and alerting; rather, they are ongoing and have generally consistent acoustic properties over time, and hence, they do not convey much information. These are the sorts of sounds most would consider “background noise.” For this reason, we tend to ignore them. We tune them out. But are we really tuning them out, or are we simply living our lives in a constant state of alarm? We have all experienced not noticing a sound until it goes away. Often it is an air conditioner or an idling truck. The air conditioner cycles off or the ignition is cut, and
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We have all experienced not noticing a sound until it goes away. Often it is an air conditioner or an idling truck. The air conditioner cycles off or the ignition is cut, and suddenly we “hear” the silence. And we sigh in relief. We momentarily revel in the peace until it starts up again or is replaced by the next aural annoyance. If our ears are not being damaged and we can mostly tune it out, should these noises concern us? Science tells us we should indeed notice it and be concerned for the sake of our brains. suddenly we “hear” the silence. And we sigh in relief. We momentarily revel in the peace until it starts up again or is replaced by the next aural annoyance. If our ears are not being damaged and we can mostly tune it out, should these noises concern us? Science tells us we should indeed notice it and be concerned for the sake of our brains. Difficulty understanding speech in noise after exposure to moderate levels of noise can emerge in people with typical hearing thresholds. Moreover, a noisy environment has many underrecognized negative impacts that have little to do with hearing per se. Chronic noise exposure—for example, such as might be experienced by individuals who live near an airport— can lead to an overall decrease in perceived quality of life, increased stress levels along with an increase in the stress hormone cortisol, problems with memory and learning, difficulty performing challenging tasks, and even stiffening of blood vessels and other cardiovascular diseases. According to the World Health Organization noise exposure and its secondary outcomes such as hypertension and reduced cognitive performance are estimated to account for an astounding number of years lost due to ill health, disability, or early death. Noise disturbs learning and concentration. Students attending public schools in New York City had markedly different reading outcomes depending on whether their classroom was on the side of the school that fronted a busy elevated train track or on the other side of the school, which was shielded from the train noise. Students on the noisy side lagged three to eleven months behind their
peers in reading. In the wake of these findings, the New York Transit Authority installed rubber padding on the railroad tracks near the school and the Board of Education installed noise-abatement material in the noisiest classrooms, together reducing noise levels by about 6–8 decibels (dB). The reading-level difference soon vanished. The effect of noise is not limited to auditory or language tasks like reading. In one experiment, subjects were asked to track a visual target, a moving ball, on a computer screen with a mouse. Meanwhile, other balls were simultaneously roving around on the screen. Participants who had experienced long-term noise exposure as part of their occupation had a more difficult time with the task, especially when the task itself was accompanied by random noises; they were slower and unable to keep as close to the target ball. In “Why We Sleep,” UC Berkeley sleep scientist Matthew Walker calls the lack of proper sleep “the greatest public health challenge we face in the 21st century.” Sleep is becoming more recognized as crucial for our health, as it affects our cardiovascular system, our immune system, and our ability to think. Noise is one of the biggest culprits keeping us from a good night’s rest. Noise—even at fairly low sound levels— has a harmful impact on quantity and quality of sleep. Noise keeps us awake longer and awakens us earlier. While sleeping, noise in the environment affects the quality of sleep, prompting body movements, awakenings, and increased heart rate. Traffic noise can shorten periods of REM (dream) and slow-wave (deep) sleep, and diminish a publication of hearing health foundation
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Noise is one of the biggest culprits keeping us from a good night’s rest. Noise—even at fairly low sound levels—has a harmful impact on quantity and quality of sleep. Noise keeps us awake longer and awakens us earlier. While sleeping, noise in the environment affects the quality of sleep, prompting body movements, awakenings, and increased heart rate. Traffic noise can shorten periods of REM (dream) and slowwave (deep) sleep, and diminish one’s perception of the restfulness of a night’s sleep. one’s perception of the restfulness of a night’s sleep. In our waking lives, the insult of “safe” noise to the sound mind can be especially pernicious for children. Children are masters of language learning. Parents are gobsmacked at the short amount of time that elapses between observing their child say their first word to their speaking in full sentences. Sound to meaning connections are formed with great rapidity. Children cannot help learning the languages they are exposed to—even more than one. But what if the sounds children are exposed to at this critical age are meaningless? This question is difficult to address in humans because it is impossible to control noise levels adequately in a real-world setting. However, we can answer questions like this in animal experiments. By controlling the duration, intensity, and quality of sound exposure, it is possible to get a direct look at how the electrical signals—the currency of the nervous system—in the brain are affected. Just what happens to our sound minds when we are exposed to “safe” noise? And are these effects transient or permanent? Typically, by adulthood, the auditory cortex of a rodent is organized tonotopically. (Tonotopy—think tonal topography—is the tendency for structures in the auditory pathway to be arranged topographically by preferred frequency.) However, early in life, lowand high-pitch sounds have not yet settled into their cortical homes. Developing rodents were raised in an environment with continuous 70 dB noise. (For reference, the National Institute for Occupational Safety and Health’s occupational noise limit guidelines do not even go that low; 70 dB is considered a “safe” level of noise.) By the time the rodents reached maturity, their auditory cortices were still undifferentiated in terms of tonotopy; the low- to highpitch gradient had not formed. 12
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This raises concerns for human babies who spend time in an environment we might consider noisy but not “damagingly” noisy, like a neonatal intensive care unit (NICU). What might happen to a premature baby’s auditory cortical organization as she listens to the beeps and clatters of medical monitoring systems, ventilators, and pagers rather than typical intrauterine sounds like rhythmic heartbeats, digestive noises, and the filtered voice of her mother that she would still be enjoying if born full term? Preterm infants can have a host of developmental challenges, including language and cognition, that may be exacerbated by this early noise exposure. Scientists have introduced measures to mitigate the noisy NICU atmosphere. In one study, the sounds of the mother’s heartbeat and voice were piped into the incubator. Babies with exposure to these “good” sounds along with the bad had a more fully developed auditory cortex than the infants who heard only the bad sounds. Live music performed in the NICU also stabilized babies’ heartbeats, reduced stress, and fostered sleep. Cortical map disorganization need not be permanent. In rodents whose tonotopic maps were disorganized by noise, once the noise was removed, the tonotopic organization of the cortex resumed afresh. Similarly, after noise damage, cortical map disorganization can be minimized by exposure to an enriched auditory environment— reminiscent of the positive effect of enriched sounds for babies in the NICU. The sound mind is constantly reinventing itself.
Changing Attitudes
I have been to concerts where the musician boasts, “We’re going to play so loud we’ll make your ears bleed,”
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Cortical map disorganization need not be permanent. In rodents whose tonotopic maps were disorganized by noise, once the noise was removed, the tonotopic organization of the cortex resumed afresh. Similarly, after noise damage, cortical map disorganization can be minimized by exposure to an enriched auditory environment—reminiscent of the positive effect of enriched sounds for babies in the NICU. The sound mind is constantly reinventing itself.
and the audience responds, “Yeah!” There is a toughness that goes along with listening to loud sounds that can be destructive. This tough attitude is not unlike how we used to think about athletics—getting back in the game immediately after getting hit in the head. “Shake it off!” Consider seat belts and airbags in a car, or safety protection in sports. As recently as the 1970s, only a smattering of professional hockey players wore helmets, and major league baseball players would shed theirs as soon as they reached base. Today, a helmetless hockey player seems inconceivable. Baseball players wear their helmets while on the base paths and varieties with extended jaw guards have become the norm. We now appreciate the importance of protecting ourselves against concussions. Today, even most macho halfwits wear seatbelts, and more attention is being paid to safety in sports even to the extent that, for better or worse, contact sports are on the wane. It is my hope that we stop being so cavalier about noise in the same way. Attitude changes are in the air. People like Gordon Hempton in Los Angeles, with his Quiet Parks International initiative, are working to preserve silent spaces. People everywhere noticed and appreciated the reduced sound levels during the coronavirus shutdown. When noisy life resumed in Paris, noise complaints increased, especially about noisy motorbikes. Police antinoise brigades stepped up their patrols and street corner noise sensors were installed to issue automatic fines to motorbikes exceeding permitted noise levels. Our sound minds affect the choices we make in our sonic world. The less we appreciate silence and the more our brains become accustomed to noise, the noisier the world will get. A vicious cycle. Sound is an invisible ally and enemy of brain health.
Our engagement with sound leaves a fundamental imprint on who we are. The sounds of our lives shape our brains, for better and for worse. And our sound minds, in turn, impact our sonic world, again for better and for worse. Will we be expert listeners or poor listeners? As a consequence of what we value in sound, how will we build the sonic world we live in? A holistic understanding of the biological consequences of our lives in sound positions us to make better choices for ourselves, for our children, and for society.
This is excerpted from “Of Sound Mind: How Our Brain Constructs a Meaningful Sonic World,” by Nina Kraus, Ph.D. Reprinted with permission from The MIT Press. Copyright September 2021. A neuroscientist who has done groundbreaking research on sound and hearing for more than 30 years, Kraus is the Hugh Knowles Professor of Neurobiology, Communication Sciences, and Otolaryngology at Northwestern University in Illinois.
Share your story: Tell us how you’re protecting your hearing at editor@hhf.org.
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Q: What Is the Medically Necessary Part of Hearing Health That Is Rarely Provided?
A: Auditory
Rehabilitation By Nicole Laffan, Au.D., M.S., CCC-A/SLP
Believe it or not, I tell my patients who have been diagnosed with hearing loss that spending thousands of dollars on amplification is not enough. Hearing technology (e.g., hearing aids, middle ear implants, cochlear implants) may fix the measurement of hearing loss on paper, but it does not fix your ability to successfully communicate. Auditory (aural) rehabilitation, paired with properly fit amplification, does. Auditory rehabilitation is a medically necessary part of hearing health. Unfortunately, most patients do not receive it. Auditory rehab is therapeutic training that focuses on eliminating or minimizing communication difficulties by teaching the listener vital skills to communicate. We are communicative beings. Without communication we lose the connection with our world, our family, our friends, and our work. Communication gives us a purpose. Auditory rehab is the missing piece for improving the ability to communicate, with or without amplification. Successful communication can be compared to playing a game of catch. In a communication exchange there is a sender of the message (the speaker) and a receiver of the message (the listener). In a game of catch, there is a thrower and a catcher. Both the thrower and the catcher are required to work together to make the game thrive. If the thrower tosses the ball without gaining the catcher’s attention, making sure the catcher is ready, or throwing it within the adequate distance, then the ball will not be caught. Likewise, if the speaker fails to gain the listener’s attention, does not wait until the listener is ready (for example, until they’ve turned the television down), or is not within an 14
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managing hearing loss
Successful communication can be compared to playing a game of catch. In a communication exchange there is a sender of the message (the speaker) and a receiver of the message (the listener). In a game of catch, there is a thrower and a catcher. Both the thrower and the catcher are required to work together to make the game thrive. If the thrower tosses the ball without gaining the catcher’s attention, making sure the catcher is ready, or throwing it within the adequate distance, then the ball will not be caught.
adequate distance, such as facing each other in the same room, then the message will not be caught and the ball— the message—will be dropped. Although auditory rehab is developed to coach the individual with hearing loss, it also guides their loved ones as well. Often the burden is placed on the listener to catch every message, even the ones that were shared as the speaker turned away from the listener, spoken as they were doing the dishes with the water running and the silverware clanking, or shouted from another floor of the house, etc. When the speaker learns simple tips and has opportunities to practice them and problem solve common issues, then positive communication changes blossom. For the listener, auditory rehab focuses on improving their ability to use lipreading/speechreading skills, anticipatory strategies, environmental modifications, techniques to advocate for themselves, and repair strategies for when communication breakdowns occur. The listener is encouraged to work like a detective, analyzing the message from multiple modes: hearing, vision, cognition, and experience. This encourages the listener to play an active role in receiving the message. If they rely solely on the auditory message, without using other cues, then they are choosing to be a passive player waiting for the broken message and hoping they catch it correctly. I use the term “broken message” because many listeners have poor discrimination abilities. This means that even when the auditory signal is loud enough, the speech signal is still distorted. With auditory rehabilitation, the listener learns not to rely only on the auditory message. Instead,
the listener is taught to pull all the puzzle pieces together to solve the mystery message. This involves pairing what they heard, with the visual information they received from speechreading, with the knowledge they have regarding the topic and the speaker, and with their life experiences to guess what vocabulary words may be used in the context of the communication exchange. Learning these skills allows the patient to feel empowered to take control of communicative interactions and to repair breakdowns. People with hearing loss who feel empowered are more apt to participate in life. This is because those who avoid social exchanges due to their untreated hearing loss are more likely to experience depression, anxiety, and dementia. As an audiologist and a speech language pathologist who has been practicing for over 20 years, I always encourage patients to participate in auditory rehabilitation. It is an essential part of treating hearing loss but is rarely offered. With support from Northeastern University, I developed a free-of-charge auditory rehabilitation program. Sessions are offered virtually or in-person at the Northeastern University Speech, Language, and Hearing Center in Boston. Individuals with hearing loss and their loved ones are welcome to join the sessions to start learning techniques to take control of their communication challenges and start participating in life. So if auditory rehab is the missing link of hearing health that allows the amplification user to fully benefit from their amplification technology, why is it hardly ever a publication of hearing health foundation
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10 Tips for Effective Communication “How to Talk to People With Hearing Loss” is the book I recommend most to patients with hearing loss and their family members. It is a practical, cohesive guide full of valuable tips. The authors impressively share information about hearing loss in an uncomplicated manner. Not only does it share empowering strategies for the listener, but it also enhances their communication partners’ understanding of the challenges the listener faces and the simple adjustments the speaker can implement to make the communication exchange successful. I reference it weekly, especially the chapter “10 Tips for Effective Communication,” when I host complimentary auditory rehab training sessions as part of the Better Listening Program at Northeastern University in Boston. I encourage patients to use all methods such as auditory, visual, knowledge about the topic and speaker, and context clues to put the puzzle together and form the most educated guess regarding what might have been said. The book illustrates this idea and teaches how to navigate the most common challenges associated with hearing loss.
Here are the tips:
1. Get my attention before you start speaking to me. 2. Speak slowly and clearly. A moderate pace works best. 3. Look at me, take your hands away from your mouth, and don’t exaggerate your pronunciation. 4. Don’t raise your voice too loud; moderately loud is best. 5. If you are going to change the topic, tell me. 6. If I do not hear you the first time, repeat with different words. Don’t say the same word I did not hear over and over again. 7. Try to limit or avoid background noise. I do not hear well in noisy environments. 8. Talk to me on the side of my better ear. 9. Gestures help me, but don’t be too extreme. 10. Hearing under adverse conditions can be exhausting. Sometimes, I need a break. The book adds essential context to these tips, so they can be applied with full effect. —N.L.
Learning these skills allows the patient to feel empowered to take control of communicative interactions and to repair breakdowns. People with hearing loss who feel empowered are more apt to participate in life. This is because those who avoid social exchanges due to their untreated hearing loss are more likely to experience depression, anxiety, and dementia. provided? The answer is simple: Insurance companies do not cover it, so audiologists do not provide it. Some insurance companies reimburse speech language pathologists for providing auditory rehab, but the patient frequently isn’t told about the benefits or cannot find a speech language pathologist who provides it. This needs to change!
Nicole Laffan, Au.D., M.S., CCC-A/SLP, is an assistant clinical professor in communication sciences and disorders at Boston’s Northeastern University; a practicing audiologist and speech language pathologist at Northeastern’s Speech, Language, and Hearing Center; and the chair of the Massachusetts Board of Registration of Speech Language Pathology and Audiology. An excerpt from “How to Talk to People With Hearing Loss” by Mary Florentine, Ph.D., Julia B. Florentine, and Michael J. Epstein, Ph.D., appeared in the Summer 2019 issue of Hearing Health magazine. For more, see glistentraining.co.uk/book.
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hearing health
9 Things to Know
About Hearing Loss From Noise It’s completely preventable with a few simple precautions.
1. Noise-induced hearing loss (NIHL) is a growing public 6. Damage to hearing is cumulative, says the NIDCD. health threat that most people don’t know about. A study in the journal Pediatrics cited by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) says 1 of every 5 U.S. teens, ages 12–19, has features of their hearing tests suggestive of NIHL in one or both ears.
2. The WHO terms this an impending global health
crisis, with 1.1 billion young people at risk from damaging sound, largely from personal audio systems turned up too loud.
3. You can protect yourself from hearing loss by taking
steps. Turn down the volume on personal listening devices to 50 percent of the maximum volume. Rest your ears by taking a listening break from loud music every hour. Get into the habit of always carrying earplugs and using them in noisy places such as sports stadiums or around lawn equipment.
4. Untreated hearing loss has serious health
consequences: It can harm the heart and brain, lead to mental health problems like depression, cause sleeping problems, and even lead to cognitive drain and dementia. Hearing loss that is not addressed can affect school and job performance and income.
5. Hearing loss can result from a one-time exposure to
loud sound—up close at a concert, or from loud noise over prolonged periods. Be aware of the noise level around you and protect yourself by using earplugs or moving away from the noise, urges the National Institute on Deafness and Other Communication Disorders (NIDCD).
The louder the noise and the longer the exposure, the greater the risk of permanent damage. If you have a hearing loss already, it’s even more important to protect your hearing from further damage.
7. Over-the-ear or noise-canceling headphones that
block out the sound around you are a better choice than in-ear earphones or earbuds. Without needing to complete with outside noise, you’re less likely to turn up the volume to unsafe levels—just make sure you remain aware of your surroundings.
8. The CDC considers sound at 70 decibels and below
to be safe. Some headphones top out at 100 decibels or more, which can permanently damage hearing in minutes. People are routinely exposed to loud sounds—in restaurants and bars, on subway platforms, at the gym, even while using a coffee grinder.
9. Hearing loss is usually subtle, occurring gradually,
and many people may not be aware they are affected. Often those close to us spot the problem first, so it’s a good idea to check your hearing from time to time. Online hearing tests (such as the WHO’s hearWHO app) are quick, easy, and can alert you to a potential issue that you should raise during an appointment with a hearing health professional.
For more, see hhf.org/keeplistening. For references, see hhf.org/fall2021-references.
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Like most gym classrooms, this group exercise room is all hard surfaces, making loud volumes feel even louder. But research has shown that higher volumes in fitness classes do not actually make people work out harder.
Heart Health and Hearing Health Are Not Mutually Exclusive By Lauren McGrath
“In my six years as a physical fitness instructor, I’ve never heard anyone complain about this.” That’s how the instructor replied after I reiterated my request to both lower the volume of the music in our group exercise classes and to use a microphone for his speech. These measures, I felt, would make classes both safer and more accessible. This instructor’s Sunday evening, one-hour core and lower body workout had just concluded, and the decibel meter on my iPhone—that I kept hidden stealthily in my tote bag—reported a maximum of 106 decibels (dB) and an average of 78 dB. I estimated that this average was at least 10 dB lower than the previous week’s class, and was pleased, but I still believed a conversation was warranted. A level of 106 dB is enough to cause permanent hearing damage in minutes. With this information, I approached the instructor directly about some of the noiserelated concerns I’d developed during my first few months as a member of my gym, which I’d recently shared with the gym’s owner by email. I had written to the owner the week prior, just after attending the same class. Though I didn’t take any decibel measurements that time, I would not be surprised if my ears were exposed to an average of 90 dB for 60 minutes. During my private cooldown stretch, I actually felt pain in my ears. Not ringing, but noticeable pain. After more than four years working for Hearing Health Foundation (HHF), equipped with plenty of knowledge about hearing health and hearing loss, I wasn’t surprised in the slightest by this outcome. I hadn’t been wearing hearing protection—I didn’t anticipate my need to!
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hearing health
Besides yoga, which is generally peaceful and quiet, this was one of my first group exercise classes following my COVID-19 vaccination. The sound was shockingly loud, probably on par with being near the stage during a rock concert. The group fitness room is a box-shaped, windowless room with hardwood floors, high ceilings, and metal paneling: an acoustic setup ideal for assaulting the ears. In my email, I let the gym owner know the volume in the class was painfully loud. I recommended two things: that the instructor (and all instructors) lower the volume, and that microphones be made available so that patrons who wish to wear earplugs— or who have hearing loss, or who have auditory processing difficulties—can more easily hear the cues in class. I alluded to recent research from Hearing Restoration Project member Ronna Hertzano, M.D., Ph.D., and colleagues at University of Maryland School of Medicine, that found higher volumes in group fitness classes do not actually make people work out harder. I warned that noise-induced hearing loss is permanent, and that group fitness settings are just one of the many ways in which we can hurt our ears for life. All I got in return from the gym owner was a promise that he’d look into a microphone. My other comments about science and hearing loss went ignored. I left feeling mostly discouraged, as if my plea to be able to protect my hearing health while participating in cardiovascular exercise was somehow crazy. The silence from the owner is what prompted me to speak directly to the instructor. He told me he’d received word from the owner about my emails and, quite frankly, that he had never heard of anyone requesting something of the sort. Flustered, I mentioned the Hertzano study. “I’ve never seen any of that type of research in my class,” he retorted. I frowned. “This is how people lose their hearing,” I said. I knew I wasn’t going to convince the instructor to change his mind during that brief encounter, and I doubt I’ll be able to in the future unless other students—other paying customers—express the same concern. It’s going to take a major culture shift through programs like HHF’s “Keep Listening” campaign to clearly illustrate to the public the dangers of noise-induced hearing loss—and to underscore how taking care of your hearing health is part of taking care of your overall health—and not contradictory. In the meantime, I’ll be wearing earplugs in loud group fitness classes to protect my hearing.
Lauren McGrath is HHF’s former marketing and communications director. For more, see hhf.org/blogs/research-callsattention-to-dangerous-noise-levels-in-gym and hhf.org/keeplistening.
Besides yoga, which is generally peaceful and quiet, this was one of my first group exercise classes following my COVID-19 vaccination. The sound was shockingly loud, probably on par with being near the stage during a rock concert. The group fitness room is a box-shaped, windowless room with hardwood floors, high ceilings, and metal paneling: an acoustic setup ideal for assaulting the ears.
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living with hearing loss
How I Cope When They Can’t See That I (Sometimes) Can’t Hear By Heather Chambers
Recently my family and I flew into Miami International Airport on the way home from vacation. What should have been a short layover turned into a six hour ordeal while a violent storm played havoc with airport operations. Active thunder and lightning directly over the runway meant planes, bags, and passengers could not move. People were stuck in the baggage reclaim hall, bags were stuck on the planes, and all we could do was wait for the weather to pass. I already find airports overwhelming and uncomfortable. The vast echoey spaces, rumbling machinery, and masses of people make it hard for me to pick out the sounds I need to hear. I have an auditory processing issue that has never been properly diagnosed. I know I can hear everything in isolation, but add interference and I can’t distinguish or focus on distinct sounds. It’s like my noise-canceling feature is broken. I have, of course, considered seeking further testing to nail down the exact nature of the issue, but it’s an expensive and time-consuming process so I’ve just tried to cope with it the best I can. Auditory processing disorders (APD, also known as central auditory processing disorders, CAPD) are hard to explain as there’s no singular definition. Sufferers experience APD in different ways. It’s not nearly as straightforward as being partially deaf or just missing a few words, and it gets worse or better depending on the environment. My hearing is technically perfect, but when you perceive all sounds at the same volume it’s hard to 20
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actively listen to what I need to actually hear. An equation of acoustics, noise levels, and proximity determines whether I’ll struggle on a given day or not. It’s like being hard of hearing, but not in all situations. Loud and busy places become incredibly triggering. First comes anxiety (when you can’t hear, you don’t know what you missed), swiftly followed by irritation and anger. It’s frustrating to be unable to do something others don’t need to think twice about. I don’t even consider it a disability as most of the time I can hear just fine—except when I can’t! I don’t normally talk about it and there’s no special needs lanyard or visible hearing aid as a clue, so no one knows there’s an issue until I raise a flag about it. And even that can be a tricky conversation. Trying to explain APD to a stranger is a challenge! Even friends and family members can be perplexed. I’ve dealt with rude questions such as “is that really a thing?” and minimizing and denial—“we all get that sometimes” and “that’s just you not paying attention”—none of which are helpful or provide a solution. My current coping strategy is to keep it vague, and make sure I identify the problem as mine. That day in Miami, I approached a staff member with a question. He was moving Tensabarrier stanchions around as I spoke. He started his response, looked away from me and, turning back around, scraped a metal post on the floor. I caught none of his answer. This happens a lot, and I’ve formulated the exact thing
living with hearing loss
A delayed flight, such as the one that affected the Chambers family (foreground), may lead to many announcements over the public address system that can be difficult for those with hearing challenges to fully understand.
to say through years of trial and error. The formula goes like this: Identify myself as the one with the problem + allude to deafness + specify what I need. So, in this case I said, “I have a hearing problem. I couldn’t catch what you said. Please can you look this way and repeat that?” It’s amazing how this combination inspires an appropriate and thoughtful response. I almost always find people are pleased to accommodate the differently abled, once you’ve given them the information they need.
photo credit (headshot): melissa hay
My hearing is technically perfect, but when you perceive all sounds at the same volume it’s hard to actively listen to what I need to actually hear. An equation of acoustics, noise levels, and proximity determines whether I’ll struggle on a given day or not. That said, the formula must be applied exactly. I’ve gotten the order wrong before and it comes off rude. Ironically, winding people up like that causes them to shout and then I hear them loud and clear! The magic formula deals with the people side of things, but in a busy environment, especially one you can’t escape, that’s only half of it. Background noise that others intuitively cut out becomes an irritation that you just can’t shake—a murmuring roar that won’t quit for hours on end. To cope, I always carry either headphones or my ultimate travel companion, a tiny headphone jack to iPhone adapter, but even standard Apple earbuds will do. Then I can play Spotify or an audio book. As my incredibly basic hearing favors the loudest and the closest sounds,
any of these are effective at providing something close to focus on. The best option is noise-canceling headphones, which I use with my phone in the terminal (and an adapter) and for watching movies inflight. They add the function I lack, plus the added bonus of making it obvious that you can’t hear what anyone is saying. A win-win! Of course these strategies don’t actually help when you absolutely have to hear the announcements. When I travel alone, I am always concerned that I’ll miss a gate change or other instruction that’s only been delivered aurally. With all the screens, apps, and visual information available in an airport, I find it bizarre that there is still so much reliance on public address systems and verbal updates delivered by staff at the gate, especially when dealing with the unexpected. I suppose that when scrambling to get information out to hundreds of grumpy passengers about a delay, the corporate disability inclusion guidelines fall by the wayside in favor of what’s quickest. These days, the technology is there to ensure everyone gets the message, such as asking people to opt in to text messages when they purchase the ticket. With this in mind, I’ll be writing to American Airlines and the airport to remind them that it’s incredibly ableist to rely on one single method of communication, even during chaotic and rapidly changing situations. It’s about time they did.
Originally from the U.K., Heather Chambers lives with her family in Texas.
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hearing health foundati o n
You Are Not Alone! Always remember that, as you go through the difficulties of being hearing impaired, every person with a hearing loss has different hearing situations to deal with, yet they are similar to other people’s hearing impairments. We are in this together! By Mary Horton Do you think that you are too young to have hearing problems? Don’t believe it! I was just 50 years old when I began wearing hearing aids… and my hearing problems began long before that. Looking back, I accept that I was the cause of a lot of my hearing problems. When I was a teenager, I assisted writing a column for the local newspaper, aimed at drawing young readers to the newspaper. As one of the perks of the job, I interviewed many of the up and coming rock stars of the late 1960s and was given front row seats at their performances, usually right in front of the speakers. What teen would have passed up that opportunity? Between that, and choosing to turn my car radio and my transistor radio up in volume, I was damaging my ears already. If anybody would have told me that back in the
1960s, I would have shaken my head and rolled my eyes… as my kids and grandkids do now (but they do it a little more hesitantly, knowing my hearing problems). Let’s go back about 20 years from today. I was in denial. People weren’t talking loudly enough. I wasn’t paying enough attention. I hadn’t cleaned my ears in a while. I was tired. Anything to explain why I wasn’t hearing conversations. When I finally went to an otolaryngologist (an ear, nose, and throat specialist, or ENT), I was told that I did have moderate hearing loss in one of my ears, and not as much loss in the other one. It was recommended that I get hearing aids. Wait a minute! I wasn’t even 50 years old! Hearing aids were for old people—not me! So, I went further into denial, continually making excuses to family and friends, at work, and at all kinds of extracurricular activities for why I wasn’t hearing properly. Then, when I eventually decided that I couldn’t constantly make excuses for my hearing loss, my vanity entered in. I have worn my hair short the majority of my life. It was important to me, at my young age, that nobody knew I was wearing hearing aids. So, I delayed about
When I was a teenager, I assisted writing a column for the local newspaper, aimed at drawing young readers to the newspaper. As one of the perks of the job, I interviewed many of the up and coming rock stars of the late 1960s and was given front row seats at their performances, usually right in front of the speakers. What teen would have passed up that opportunity? 22
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living with hearing loss
As a hearing aid specialist once told me, having hearing aids is like having a satellite dish. The satellite dish has to rotate until it hones in on the signal. The same is true for hearing aids. Often, the first few words of any conversation are lost while the hearing impaired person is trying to locate the person who is talking, and hone in on their words. Do you have any idea how many conversations begin with the central theme of the conversation in the first few words? Without those words, the person with a hearing loss is totally lost in the remainder of the conversation. another year, while my hair grew about shoulder length, in order to cover up my ears—and my future hearing aids.
Accepting Hearing Aids
I received my first set of (analog) hearing aids when I was 50 years old. They provided a vast improvement in my hearing, but they weren’t perfect. They were adjusted, and readjusted, and readjusted again, to give me optimal hearing power. My otolaryngologist advised me that my hearing would never return to what it was when I was younger. I guess I thought that hearing aids would be the answer to all my hearing problems. How naive! Every few years, as the technology improved and my hearing continued to deteriorate, I purchased new “state of the art” hearing aids, now all digital. Each set was better than the ones they were replacing, but in a matter of a few years, they also needed to be replaced and updated. I am now on my sixth set of hearing aids in 19 years. What’s more, if there is any coverage for the cost of hearing aids, it is extremely minimal. I have received just $100 in insurance reimbursement in 19 years, and I have “excellent” insurance! The rest is out of your pocket. My most recent set cost almost $7,000. How many people can afford to spend that kind of money? So many people who are hearing impaired have no hearing devices at all, which often leads them to a different kind of life. The downsides can be overwhelming. Many family members and friends do not truly realize, even though you tell them—repeatedly—that you really do want to hear them, and their conversations. They don’t realize that it is often difficult to block out outside noise, such as radios, elevator music, traffic, other people’s conversations, etc., so that you can zero in on what they are saying. As a hearing aid specialist once told me, having hearing aids is like having a satellite dish. The satellite dish has to
rotate until it hones in on the signal. The same is true for hearing aids. Often, the first few words of any conversation are lost while the hearing impaired person is trying to locate the person who is talking, and hone in on their words. Do you have any idea how many conversations begin with the central theme of the conversation in the first few words? Without those words, the person with a hearing loss is totally lost in the remainder of the conversation. Along the same lines, many people speak too fast. I often tell people that I can’t hear as fast as they speak, and ask them to slow down. The society we live in today encourages speed in everything, and speech is no exception. Again, a lot of conversation is lost (and not just to people with hearing loss) because people speak too fast.
It’s Not the Volume
For many people with hearing loss, volume is not the general problem. Volume can be adjusted most of the time. Honing in on the sound source, speed, and also clarity are the biggest problems. Clarity, especially in the South, where I live, is essentially nonexistent. People do not speak complete sentences. People slur words together, which may appear lazy but they are actually just speaking as most Southerners do. Distinctly speaking each word separately from the word before and after is very helpful for all listeners. Picture this: You are at a restaurant with a small group of maybe six or eight people. There are other people in the restaurant, carrying on their own conversations. There is background music playing, sometimes softly, but usually these days loudly. You, the person with a hearing loss, are trying to block out those other conversations, and noise, while attempting to hone in on the various conversations taking place at your own table. a publication of hearing health foundation
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living with hearing loss
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Often, when a person is talking to me, and I can hear very little of the conversation, I will smile and nod, as though I understand it all. This is totally wrong, and I am guilty of it, even knowing this. The person could be telling me something that is extremely sad… not to be smiled at! Additionally, I am indicating that I understand what they are saying, which could be critical instructions like agreeing to pick up their child from school that very afternoon. It is wrong to indicate you fully understand something when you do not—but you pretend because you don’t want to feel isolated. Your satellite dish is whirring so fast, trying to stay with each conversation, unsuccessfully, that you finally just shut down. You are no longer part of the conversations, because you have lost the focus. You are exhausted trying to hear. You are alone in a group of friends or family. You feel isolated, while surrounded by others. You decide not to go to group meals, or group activities, or family functions. You feel that there is no reason for you to even be there. Another example: You, a person with a hearing loss, are trying to understand instructions from a salesperson, mechanic, repair person, installer, attorney, physician, [fill in the blank]. You have already told them you are hearing impaired, and for them to please speak slowly and clearly, because you want to understand their instructions, comments, information, etc. Rarely do these adjustments persist for more than a few words or sentences. And if there is someone with you, even if that person will not be dealing with the issue being discussed, the instructions or information will be directed to that person, totally leaving you out. I want to say, “I AM THE CUSTOMER! PLEASE SPEAK TO ME!” Instead I leave, often just choosing to do without the product or service. Often, when a person is talking to me, and I can hear very little of the conversation, I will smile and nod my head, as though I understand the conversation. This is totally wrong, and I am guilty of it, even knowing this. The person could be telling me something that is extremely sad… not to be smiled at. Additionally, I am indicating that I understand what they are saying, which could be some very critical instructions, like agreeing to pick up their child from school that afternoon! It is wrong to indicate that you understand something when you do not! But—you don’t want to be “isolated.” So you pretend.
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Next up: COVID-19! The impossible year (and beyond) for those with hearing loss! Not only do masks muffle voices, but they prevent seeing lips and any attempt to read them. You can see no expression, except eyes, assuming that social distancing allows you to be close enough to see eye expression. You experience even more intense isolation than even before the pandemic.
Other Challenges
What I wish typical hearing people understood are the daily challenges. First: telephone calls! Again, often the first few words of any phone conversation are lost while the person with a hearing loss tries to hone in on the person on the other end of the line without the advantage of seeing their expression or their lips. One of the many blessings of the technological age is emailing and texting! Hurrah! Nearly all of my family and close friends know that this is the way that I communicate. I know captioned calls can also be helpful. Group conferences/meetings! When there is a central speaker, hearing aids are generally very good, after the first two or three words. If a person with a hearing loss is in attendance, they should already be aware of the topic, so hopefully the first few words missed would relate strictly to laying out the purpose of the meeting, which would include the topic. If, however, there is any open discussion from the audience/participants, that is a completely different matter. A person with a hearing loss can pretty much forget hearing any of that. Occasionally, the speaker will repeat questions that participants ask, before giving the response, which is wonderful. In my experience, though, this rarely happens. You have to keep asking for it.
living with hearing loss
It is not easy to find volunteer positions when you are severely hearing impaired, but they are out there. And doing something like this restored my self-esteem.
Wanting to Give Back
Another issue: Many people like to give back by volunteering. As younger people are generally busy with jobs, families, and activities associated with them, the majority of volunteering—at hospitals, libraries, food banks, local charities—falls upon older, often retired, people… those who are more likely to have difficulty hearing. The inability to correctly hear someone’s question or instruction could be embarrassing at best or damaging at worst: » A person comes to church, wanting guidance and prayer for a personal situation. And instead you hear they need to know where the bathroom is. » A person has just lost a loved one, and wants prayer and solace. And instead, you smile and say something like “that’s nice.” » A person comes to a hospital, looking for the room number of their loved one. You hear the wrong name, giving incorrect, and sometimes very embarrassing, information. » A person is “shopping” at a food bank and tells you they have a specific food allergy. You misunderstand them, giving them food that could cause serious problems. You get the picture. It would be so easy to go into your home, close and lock the door, and shut yourself in, and everyone else out. It is so important to not isolate yourself. It is so important to feel like you are still a valued and necessary person, an asset to others. This, however, is often quite a struggle. I looked for a place where I could volunteer, even with my hearing loss, and was fortunate to find the perfect position for me. There is a local organization that serves clients with educational training and counseling, as well as clothing and supplies, most of which are donated. The
clients are trained and counseled by other volunteers. I sort through and organize all the clothing and supplies, and restock items as necessary. My hearing loss does not affect these tasks, nor does it hamper the caring and helpful function of the organization itself. It is not easy to find volunteer positions when you are severely hearing impaired, but they are out there. And doing something like this restored my self-esteem. Another idea, particularly if you are homebound or quarantined: Don’t we all enjoy getting a handwritten note in the mail? It is almost a lost art. I try to write and send handwritten notes to people, and particularly during the pandemic, I wrote and thanked people who went above and beyond to make the best of very difficult circumstances, including hospital staff, nursing/assisted living staff, restaurant owners, etc. Everybody likes to have a pat on the back. I often think about Helen Keller, deaf as well as blind, and who was truly an amazing woman. When asked whether she considered vision or hearing more important, she replied: “The problems of deafness are deeper and more complex, if not more important, than those of blindness. Deafness is a much worse misfortune.… Blindness cuts us off from things, but deafness cuts us off from people.” How true.
Mary Horton lives in Alabama.
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technology
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Make Your Smartphone Even Smarter
If you’re of a certain age, hearing the words “get smart” will make you smile. If you are any age and have both a hearing loss and a smartphone, “get smart” is how to educate you and your phone. Smartphones have allowed us a degree of freedom and communication access undreamed of in the not too distant past. Caveat: While I have tried out most of these apps, I have also relied on developer descriptions and reviewer feedback that I researched online. Also, not all apps are available for both iOS and Android (which is the operating system I use on my phone), and while many are free or low cost, both are ever changing, as is the technology itself. Look for these apps by name online for the latest. SPEECH TO TEXT Google’s Live Transcribe is just one of many apps that transcribes spoken audio into text on your smartphone. This app goes one step further and also reports many of the background sounds you hear and how loud they are in relation to the speech it is transcribing. It supports 80 languages and will save a transcript of the conversation for up to three days. Use it with your favorite TV show and you’ll see it’s much faster and more accurate than the captions the show provides. Other options are Speechy 26
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By Stephen O. Frazier
that converts speech to text and also translates that text into a different language, and Otter.ai that can be used with Zoom to transcribe meetings—or any event where there are multiple speakers, such as the dinner table. For voicemail to text, the Rev voice recorder transcribes your voicemails so you can save and read them and organize the recordings (unlike the voicemail transcript that Apple smartphones already offer). YouMail is actually best known as a popular option for blocking robocalls but it also offers a voicemail to text feature that is cloud-based, so you can see your voicemail messages on any device. PERSONAL SOUND AMPLIFICATION DEVICE Keep a neckloop or earbuds handy and you can turn your smartphone into a “pocket talker” to amplify sounds you want to hear with EarMachine, which, in addition to volume control, has a fine-tuning feature that lets the user control which frequencies get boosted, a little or a lot. Similarly, ExSilent has individual controls for each ear for both volume and tone. Many volume boosters exist, including Max Volume Booster and Sound Amplifier—just be careful about overdoing it and damaging your hearing!
technology
SOUND LEVEL METER The general rule of thumb is, if you need to shout at your friend an arm’s length away to be heard, it’s too loud. These apps let you measure decibel levels using a variety of sound level meters. The National Institute for Occupational Safety and Health collaborated with EA LAB to create the NIOSH Sound Level Meter for use at worksites as well as during leisure time. SoundPrint functions as a sound level meter but then allows you to share the venue’s decibel measurement in order to crowdsource a Quiet List, identifying restaurants and bars in major U.S. cities that are less noisy. You can also distinguish between indoor and outdoor dining when sending in a measurement.
image credits (from above left): live transcribe, earmachine, soundprint, tunity
SAFETY ALERTS If you’ve ever missed a smoke alarm going off in another room, check out Sound Alert. This device can alert you via notifications, vibrations, and flashing lights on your smartphone or tablet when any pre-programmed sound goes off in the house such as a smoke alarm, doorbell, phone ring, or microwave ding. My SoS Family connects to a “first responder” family and friends list that keeps them informed in an emergency. Contacts are alerted instantly via the app, not your phone (faster and it frees your phone). It calls and texts your emergency contacts, even if they do not have the app, and the number of contacts is unlimited. The alerts designate your location using Apple’s Find My Device feature. HEARING TEST The Mimi Hearing Test, a medical product from the European Union, serves as a preliminary online hearing test only—you’d have to follow up with a professional after this initial screening. Using a six-minute hearing assessment, the results indicate each ear’s hearing capacity and show how the user’s hearing ability compares to others in their age group. BACKGROUND NOISE ERASER Using earbuds or a neckloop and the telecoil (T-coil) setting on hearing aids, Chatable can erase most of the background sound in an environment by using a new approach to the problem. Chatable identifies the voice of the person speaking and, using what’s called end-to-end neural speech synthesis, creates a new audio signal that sounds almost identical to the original and removes (rather than filters) the background sounds. STREAMING AUDIO Here’s another free app that may interest the hearing as well as the hard of hearing. Streaming audio via WiFi is the
latest entrant in the battle for assistive listening systems in public places. The catch with it is that each place may require a different app on your smartphone. MYE Fitness Entertainment is integrated into leading health club mobile apps including Gold’s Gym, Planet Fitness, 24 Hour Fitness, and many more. It may also be the app used in sports bars to hear the TV. To hear the streamed audio, you can use Bluetooth connected to your hearing aids, or the hearing aid T-coils and a neckloop. Tunity allows users to hear live audio from muted televisions. Through patented deep learning and computer vision technology, Tunity identifies a live video stream and its exact timing, syncing the audio with the user’s mobile device. It is used by people at bars, restaurants, gyms, waiting rooms, airports, and even at home. You can hear with your smartphone connected to hearing aids or earbuds that support Bluetooth, or the ever faithful T-coil/neckloop combo. Just point your smartphone’s camera at the TV screen and snap a picture. Without giving any additional clues like a time zone, channel, program title, or anything other than that photo, Tunity will search for your show and when found it will stream the audio to your hearing aids. I thought to myself there’d be no way it would work but amazingly, it mostly did—after a few tries and misses, and sometimes the app believing a show was still on when it had ended. You can sync the sound to be better in time with the person speaking. I’m now a believer! With so many of these apps installed, my smartphone is smarter than ever, maybe even genius level.
Trained by the Hearing Loss Association of America as a hearing loss support specialist, 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. For more, see sofnabq.com and loopnm.com.
Share your story: Tell us your favorite apps for managing hearing loss at editor@hhf.org.
Support our research: hhf.org/donate.
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Hearing Health Foundation 2021 Reader Survey Hearing Health Foundation would like to hear from our community to better serve your needs. Please fill out this survey (also accessible at hhf.org/survey) and mail it back using the envelope. Thank you for taking the time. What is your level of hearing loss? Mild Moderate Moderately severe Severe Profound I don’t know I don’t have a hearing loss
2. If applicable and known, please indicate the cause of your hearing loss. Check all that apply. Age-related hearing loss Noise-induced hearing loss Genetic or hereditary factors (e.g., Connexin 26, Usher syndrome) Medication Otosclerosis Head trauma or tumor (e.g., acoustic neuroma) Viral or bacterial infections (e.g., ear infections) I don’t know Other: _________________ 3. Do you use hearing assistive technology (e.g., an FM system, hearing loop, PockeTalker, captioned telephone)? Yes No 4. Do you wear hearing aids? Yes No 28
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5. Do you plan to purchase new hearing aids? In the next 3 months In the next 6 months In the next year I don’t plan on purchasing new hearing aids 6. What is your primary source for information about hearing aids? Hearing healthcare professional Hearing Health magazine Online research Other: _________________ 7. Do you wear a cochlear or another type of ear implant? Yes No 8. Where do you read Hearing Health magazine? Print Online Both 9. How did you hear about the magazine? Check all that apply. I subscribe Doctor’s office Family member Friend Social media Other: _________________
10. Please indicate your age. Under 18 years old 18 to 34 35 to 54 55 to 74 75 or older 11. What is your employment status? Employed or homemaker Out of work or looking for work Student Unable to work Retired 12. What is your pretax household income? Under $25,000 $25,000 to $49,999 $50,000 to $99,999 $100,000 to $149,999 $150,000 or more Prefer not to answer 13. Are you a veteran or active military service member? Yes No We’d also like to hear responses from your family and friends. The survey can be completed online at hhf.org/ survey. If you have any questions, please contact us at 212.257.6140 or info@hhf.org.
complete the survey online at hhf.org/survey
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meet the donor
Why I Want to #KeepListening By Ariadne Aberin
I recently donated to Hearing Health Foundation (HHF) for the first time. When I came across your organization, I knew I wanted to support it. I’m a musician, and I’m really passionate about research efforts on hearing restoration. I feel like we live in a really noise-polluted world, and as musicians we’re kind of taught that louder is better/more passionate/more fun—which is absolutely not always the case. We do our best to take care of our hearing, but there are also many factors outside of our control. I’m personally very interested in the science that HHF funds, and honestly having a better idea of what research is being done goes a long way in giving me comfort that I may be able to enjoy music in old age.
Musician Ariadne Aberin believes in funding hearing research and using hearing protection.
What Music Means to Me
Music has always been a big part of my life. My family is very musical; we love to sing and play instruments, and it’s one of the ways we spend quality time together. I started out playing the piano and listening to my mom’s old Celine Dion records, and as I got older and developed my own musical tastes (ranging from ’90s boy bands and Britney Spears, to Avril and Alanis, to Taylor Swift and Sara Bareilles, to Lin-Manuel Miranda… the list goes on), I started writing music that really captured what I was feeling. I’ve always loved books and stories and writing, and songwriting just felt like such a natural way I could express myself using the two art forms I loved. I currently write and record music that’s kind of a chill, pop vibe. And I love writing about things that are really personal to me but also I think are universally relatable—things like feeling euphoric when you meet someone, or lessons learned and realizations from past mistakes, or mental health. I also write music with other artists that they then record or that we record together. It’s been so fun getting to continue developing my skills as a musician and songwriter, and just getting to meet other songwriters and musicians who are on their own journeys. For me, the most important part of music is the journey. The real fun is in those little a publication of hearing health foundation
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meet the donor
hearing health foundation
I love that HHF advocates for normalizing things like wearing earplugs to loud events, concerts, and movie theaters. I’d love to see these venues offer hearing protection for their patrons, or even start using safer volumes during their events. The work that HHF is doing makes me hopeful that hearing health will be something more venues and businesses keep in mind, and something that more research is devoted to. everyday habits—practicing your instrument each day, writing a little bit each day, listening and discovering new artists. The more you focus on the journey and your own personal growth, it’s even more rewarding when you look back and see how far you’ve actually come. And as musicians, music is first and foremost a therapy of sorts. It’s the way we process and express our feelings; it’s where we feel most at home. And so the best part of being a musician is just getting to do it!
Hopeful About Hearing Health
I first came across Hearing Health Foundation because I had been looking into research done on hearing health, and ways that hearing health awareness is spread. The older I get, the more I realize we really don’t talk about hearing health enough, and the solutions that are currently out there aren’t always enough. I was really excited to come across HHF because of the amazing work they do, both on the research side and on the awareness side. I appreciate that HHF advocates for taking simple precautions like wearing earplugs to loud events, concerts, and movie theaters. I’d love to see these venues offer hearing protection for their patrons, or even start using safer volumes during their events. The work that HHF is doing makes me hopeful that hearing health will be something more venues and businesses keep in mind, and something that more research is devoted to. And as a musician, I certainly hope that we normalize hearing health within our community as well. Earplugs should be a staple in every musician’s arsenal, and there are plenty of apps available that measure the decibel levels in your environment—you can use these to ensure that when you’re playing, you don’t exceed safe sound levels. You can still get really into the music when playing it at levels that don’t damage your ears. Playing louder does not always mean passionate or better. It’s important we redefine what it means to play with passion and emotion, and that playing with passion and emotion can still be done at safe sound levels. Practice performing with ear protection, get accustomed to the sound of your voice with musicians earplugs in. Wearing earplugs protects your voice, too! You tend to hear your voice louder with earplugs in—so you’re more likely to sing with a lot less effort.
Earplugs, Please
I love HHF’s “Keep Listening” campaign that just launched. It’s very accessible for young people, especially because the adjustments are so simple—foam earplugs and turning down the volume definitely go a long way in preserving your hearing health, and they’re such easy, inexpensive things to do. One thing I wish I knew earlier was how to properly insert earplugs as well as other 30
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meet the donor
Aberin found HHF after researching how to spread hearing health awareness.
options for ear protection if standard foam earplugs are uncomfortable. A lot of folks with smaller ear canals tend to have trouble finding options for ear protection that feel comfortable and stay in place. Whenever I wear earplugs, they tend to stick out from my ear even though they’ve gone in as deep as they can—and since they stick out a bit, I have to keep adjusting them so they stay in place and can keep doing their job of protecting my ears. Being made aware of the different options for ear protection, as well as the proper fit for ear protection, would be really helpful for us small-eared folks! Young people can also be hesitant to seek help for hearing loss because of the stigma associated with it, so I really appreciate the work HHF is doing to dispel the stigma. Especially for musicians, a big fear with hearing aids is that they won’t sound the same as natural hearing, and if you’re a singer, you would need to almost retrain your brain to recognize your voice in a different way, since you’d hear your voice differently through a hearing aid. There’s so much more we could be doing to protect our hearing, and we often don’t realize how much we’re surrounded by loud sounds even in everyday life. So I’m really happy to support HHF, their campaigns, and their research. Hearing keeps us all connected, and it allows us to do what we love. It is worth protecting.
Share your story: Tell us how you protect your hearing at editor@hhf.org.
Support our research: hhf.org/donate.
Ariadne Aberin is a musician in Texas. Find her listed as Ariadne Mila on Spotify, Instagram @ariadne.mila, and Linktree. For more, see hhf.org/keeplistening. a publication of hearing health foundation
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It was at the end of 4th grade, the first day of summer, when I was in the pool and doing lots of somersaults in the water. When I got out, I had water in my left ear. I tried to shake it out, hopping on one foot and tilting it toward the ground, but my ear still felt clogged. This had happened before, so my mom and I didn’t think that much about it and figured it’d go away on its own. Two days later, after my ear still felt clogged and we were on a family vacation, my mom called our doctor’s office. They recommended an earwax kit to help unclog my ear. We tried it twice but it was still the same. Then we went in person to see the pediatrician, who diagnosed me with Eustachian tube dysfunction. The doctor said it’d take three to five months, all summer, for it to unclog. My mom says we kept going to the doctor, to two other pediatricians in the practice, who all said the same thing—just to wait. And then finally in September my mom wanted something to change. She says she realized I couldn’t hear out of my left ear because when we were at synagogue she spoke to me in my left ear, and I turned my head all the way around so I could hear out of my right ear instead. My sister had an ENT (ear, nose, and throat specialist) because she broke her nose that year. I went to her ENT, and he immediately sent us down the street to see an audiologist. That’s when we learned that I have a hearing loss in my left ear.
A Meaningful Mission We had to do lots of tests for a year to make sure there wasn’t some other medical issue, like a tumor. When I got an MRI I remember there were wildfires going on and it smelled like smoke in the room. I was missing so much school for these tests that I didn’t want to go anymore, so we scheduled the appointments for evenings. In addition to hearing tests every three months, I also had genetic testing but it didn’t reveal anything. I don’t really remember this but I was exhausted every night, too. I wasn’t sleeping well because of my ear. The doctor said my sleep was probably being affected from my brain having to work so hard to hear all the time. At night I just couldn’t quiet my brain down after all the effort of trying to hear, so I wasn’t falling asleep easily. It really worried my parents. Eventually my mom started preparing me for the 32
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photo credit: gina logan
By Abe, with input from his mom
meet the fundraiser
Shown with his family, Abe decided his bar mitzvah project would raise awareness of noiseinduced hearing loss while encouraging donations to Hearing Health Foundation.
idea of using something to help me hear. We were driving on the way to Hebrew school, and she said, “I think you’re going to need a hearing aid.” And I was like, straight up, no. I thought it’d be embarrassing, with people asking me, “What is that thing in your ear?” We went back to my sister’s ENT, who didn’t think I needed a hearing aid since I had one fully functioning ear. My mom got a second opinion at UCSF Benioff Children’s Hospital, and Dr. Chang there recommended I get a hearing aid for sure. My audiologist, Dr. Newman, gave me a tester, silver colored, to try out for a while at home and school. We also went to Stanford Children’s Health to get a third opinion, since the two doctors before had opposite opinions for treatment, and the third doctor said to definitely get a hearing aid. My parents and sister noticed I could hear better using the hearing aid tester at home, and that made me a little more comfortable about wearing it at school in 5th grade, which for us is the start of middle school. The first time I finally decided to wear the hearing aid full time, I’d just gotten a haircut, so two of my friends noticed. Eventually I did get a brown hearing aid to match my hair color. People sometimes ask what it is, and I just say it’s a hearing aid to help me hear. There are other little things I need to do, like making sure I sit up front in class so I can hear better, but I also don’t like assigned seats and like to move around. We learned that the only other student with a hearing loss in my school happened to be in the same class. Their family has been really helpful. Although I’ve definitely adapted to wearing the hearing aid, and can even keep it on for sports like baseball because it fits under my helmet, masks during the pandemic have been hard. With teachers and classmates all behind masks, I really had to ask other people to repeat themselves. I keep asking Dr. Newman, “Do you think you’ll ever be able to fix my ear?” She replies, “Probably. We’re working on it, and we really hope we can do it in your lifetime.” So while studying Hebrew to prepare for my bar mitzvah, and in the middle of the COVID-19 craziness, my mom found Hearing Health Foundation and its mission to prevent, research, and cure hearing loss. For my bar mitzvah project, I am doing a fundraiser for HHF. It makes total sense to support this mission that means so much to my family and me. And one silver lining, my grandfather finally got hearing aids, and my great-grandmother upgraded her 20-year-old hearing aids. We like to think it was because of my experience. We’re a hearing family!
Now in 7th grade, Abe turned 13 in September, and his bar mitzvah is in October. The family lives in California. Hearing Health Foundation sincerely thanks the family for their support.
Share your story: Tell us your hearing loss journey at editor@hhf.org.
Support our research: hhf.org/donate.
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research
Meet the HRP Working Groups Reorganizing its research into three groups further energizes the nimble, collaborative approach pioneered by the Hearing Restoration Project (HRP). By Lisa Goodrich, Ph.D. The Hearing Restoration Project consortium model has, since its start, centered on team science, collaboration, and the faster exchange of data. To further energize this approach and facilitate even closer interaction, including among HRP researchers’ postdoctoral researchers and other lab members, the HRP decided at its March 2021 annual meeting to reorganize its research into three working groups. These 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. Starting this year, funding is being distributed to members of each group, all of whom contributed to the submission of one joint proposal for each working group and all of whom will be contributing in specific ways to achieving their respective working group’s aims and milestones. The work previously organized in individual projects will continue, including the multiyear Seattle Plan projects readers are familiar with, but the working group model fosters the addition of even more timely and synergistic collaboration. Each consortium member belongs to at least one working group, and a total of $1.2 million is being distributed to HRP members for the new project year (October 1, 2021, through September 30, 2022).
Cross-Species Epigenetics This group will complete the collection of transcriptomic and epigenetic data from systems that regenerate (neonatal mouse, zebrafish, chick) and those that do not (mature mouse and human). In addition, they will begin to perform cross-species comparisons of the behavior of a shared set of hair cell loci across species, starting with fish and mouse and adding chick data. The group will also add data from humans using a pipeline that is now in place.
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Neil Segil, Ph.D. (chair), University of Southern California
Alain Dabdoub, Ph.D., Sunnybrook Research Institute
Stefan Heller, Ph.D., Stanford University
Tatjana Piotrowski, Ph.D., Stowers Institute for Medical Research
Andy Groves, Ph.D., Baylor College of Medicine
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Integrative Analysis This group will take the lead on data curation and analysis. The HRP is adding a dedicated full-time HRP analyst to work across groups to help collect and process data, thereby facilitating a long-planned cross-species analysis. The group will start by annotating hair cell types from all species so that anyone in the field can assess what kind of hair cell their regeneration approaches may produce, while also easing identification of common hair cell genes, which will help the Cross-Species Epigenetics group. Analysis of the hair cells produced in mouse organoids will be performed as an example and to lay the groundwork for using organoids to screen genes in the future.
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
David Raible, Ph.D., University of Washington
Jennifer Stone, Ph.D., University of Washington
Mark Warchol, Ph.D., Washington University in St. Louis
Andy Groves, Ph.D. (chair), Baylor College of Medicine
John Brigande, Ph.D., Oregon Health & Science University
Yehoash Raphael, Ph.D., University of Michigan
Stefan Heller, Ph.D., Stanford University
Reprogramming and Gene Delivery This group will take the lead on transitioning to Phase II, testing candidate genes. They will study the effects of current transcription factor reprogramming cocktails on supporting cell behavior, including the collection of additional transcriptomic and epigenetic data. They will additionally work toward developing new methods to deliver molecules and/or genes, including endogenous activation of reprogramming factors via CRISPR/Cas-9.
Neil Segil, Ph.D., University of Southern California
HRP scientific director Lisa Goodrich, Ph.D., is a professor of neurobiology at Harvard Medical School. For more, see hhf.org/hrp.
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Apply for an Emerging Research Grant Hearing Health Foundation’s Emerging Research Grants (ERG) program provides seed money to researchers with innovative approaches to hearing and balance science. Grantees advance knowledge in these and other under-researched areas: » » » » »
Hearing loss in children Auditory processing disorder Hyperacusis Tinnitus Ménière’s disease
» » »
Usher syndrome Reducing cancer drug ototoxicity Links between hearing loss and diabetes, heart disease, and kidney disease
The ERG program is a competitive funding opportunity that awards grants to only the most promising investigators. Awards are up to $50,000 per year for two years. Recipients are exceptionally well positioned to go on to win funding from the National Institutes of Health and other federal funders, leading to dramatic innovations in the hearing and balance fields. Since 2002 ERG alumni have been awarded an average $47 in federal grants for every dollar of their ERG grant. While early career researchers are especially encouraged to apply, ERG grants are open to both early career researchers and senior investigators. Applications for the next ERG grants period open October 18, 2021.
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2016 ERG researcher Elizabeth McCullagh, Ph.D., and colleague at the University of Colorado Denver (top); and a microscopic view of a mouse cochlea showing sensory hair cells in green.
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2022 Emerging Research Grants Announced By Christopher Geissler, Ph.D.
Hearing Health Foundation has reported since spring 2020 on the astounding resilience of HHF-funded scientists as they continued their work remotely and in hybrid setups. Just as they conducted scientific work during the past year and a half of lab closures and COVID-19 restrictions, so too were Emerging Research Grants applicants busy collecting preliminary data and drafting research proposals. We remain incredibly impressed by scientists’ and clinicians’ dedication to hearing and balance research even during trying circumstances. ERG applications increased in number again this year, and HHF’s scientific reviewers and Council of Scientific Trustees had the very difficult task of deciding whom to fund among an exceptional pool of proposals and applicants.
Congratulations to this year’s ERG recipients: FIR ST Y EAR Timothy Balmer, Ph.D. Arizona State University Project: The role of unipolar brush cells in vestibular circuit processing and in balance James Dias, Ph.D. Medical University of South Carolina Project: Neural determinants of agerelated change in auditory-visual speech processing Generously funded by the Meringoff Family Foundation Subong Kim, Ph.D. Purdue University Project: Influence of individual pathophysiology and cognitive profiles on noise tolerance and noise reduction outcomes
We are also deeply grateful for the continued dedication of our generous donors. Your support has ensured that we can fund the innovative research projects listed below. You will have noted that these projects form the “2022 ERG” cohort. Rest assured, HHF has neither skipped a year nor interrupted research funding. In 2020 HHF aligned its project years with its fiscal year (both now start October 1), and as of this year, HHF grant years will take the same year designator as the fiscal year. Additionally, ERG awards are now renewable for a second year. Two 2020 ERG grantees, listed below, will receive their second year of funding on October 1; the remaining five 2020 ERG grantees have requested an extension to complete their first year plans and will apply for their second year of funding in 2022.
Manoj Kumar, Ph.D. University of Pittsburgh Project: Signaling mechanisms of auditory cortex plasticity after noise-induced hearing loss Generously funded by the General Grand Chapter Royal Arch Masons International 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 Robert Raphael, Ph.D. Rice University Project: Understanding the biophysics and protein biomarkers of Ménière’s disease via optical coherence tomography imaging Megan 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 Ltd. S ECO N D Y EA R Pei-Ciao Tang, Ph.D. University of Miami Project: Elucidating the development of the otic lineage using stem cell–derived organoid systems Ross Williamson, Ph.D. University of Pittsburgh Project: Characterizing tinnitusinduced changes in auditory corticofugal networks
Christopher Geissler, Ph.D., is HHF’s director of program and research support. The Winter 2022 issue of Hearing Health, coming out in January, will have additional details about these projects. For more, see hhf.org/erg.
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Recent Research by Hearing Health Foundation Scientists, Explained The Latent Regenerative Potential of the Inner Ear
The organ of Corti, the hearing organ of the inner ear (cochlea), contains rows of sensory hearing cells (green) surrounded by supporting cells (blue).
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Scientists from the University of Southern California (USC) Stem Cell laboratory of Neil Segil, Ph.D., have identified a natural barrier to the regeneration of the inner ear’s sensory cells, which are lost in hearing and balance disorders. Overcoming this barrier may be a first step in returning inner ear cells to a newborn-like state that’s primed for regeneration, as described in a study published in Developmental Cell in July 2021. “Permanent hearing loss affects more than 60 percent of the population who reach retirement age,” says Segil, who is a professor in the department of stem cell biology and regenerative medicine, and the USC Tina and Rick Caruso Department of Otolaryngology–Head and Neck Surgery. “Our study suggests new gene engineering approaches that could be used to channel some of the same regenerative capability present in embryonic inner ear cells.” In the inner ear, the cochlea contains two major types of sensory cells: hair cells that have hairlike cellular projections that receive sound vibrations, and so-called supporting cells that play important structural and functional roles. When the delicate hair cells incur damage from loud noises, certain prescription drugs, or other harmful agents, the resulting hearing loss is permanent in older mammals. However, for the first few days of life, lab mice retain an ability for supporting cells to transform into hair cells through a process known as transdifferentiation, allowing recovery from hearing loss. By the age of 1 week, however, mice lose this regenerative capacity—which is also lost in humans, probably before birth.
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photo credit: yassan abdolazimi/segil lab/usc stem cell
Based on these observations, postdoctoral scholar Litao Tao, Ph.D., graduate student Haoze (Vincent) Yu, and colleagues took a closer look at neonatal changes that cause supporting cells to lose their potential for transdifferentiation. In supporting cells, the hundreds of genes that instruct transdifferentiation into hair cells are normally turned off. To turn genes on and off, the body relies on activating and repressive molecules that “decorate” the proteins known as histones. In response to these decorations known as epigenetic modifications, the histone proteins wrap the DNA into each cell nucleus, controlling which genes are turned on by being loosely wrapped and accessible, and which are turned off by being tightly wrapped and inaccessible. In this way, epigenetic modifications regulate gene activity and control the emergent properties of the genome. In the supporting cells of the newborn mouse cochlea, the scientists found that hair cell genes were suppressed by both the lack of an activating molecule, H3K27ac, and the presence of the repressive molecule, H3K27me3. However, at the same time, in the newborn mouse supporting cells, the hair cell genes were kept “primed” to activate by the presence of yet a different histone decoration, H3K4me1. During transdifferentiation of a supporting cell to a hair cell, the presence of H3K4me1 is crucial to activate the correct genes for hair cell development. Unfortunately with age, the supporting cells of the cochlea gradually lost H3K4me1, causing them to exit the primed state. However, if the scientists added a drug to prevent the loss of H3K4me1, the supporting cells remained temporarily primed for transdifferentiation. Likewise, supporting cells from the vestibular system, which naturally maintained H3K4me1, were still primed for transdifferentiation into adulthood. “Our study raises the possibility of using therapeutic drugs, gene editing, or other strategies to make epigenetic modifications that tap into the latent regenerative capacity of inner ear cells as a way to restore hearing,” Segil says. “Similar epigenetic modifications may also prove useful in other non-regenerating tissues, such as the retina, kidney, lung, and heart.” Along with Segil’s USC Stem Cell Lab, coauthors include Andy Groves, Ph.D., of Baylor College of Medicine and a fellow member of the Hearing Restoration Project at Hearing Health Foundation. —USC
A Common Ancestor for Cells Involved in Hearing and Touch The sensory cells in the inner ear and the touch receptors in the skin actually have a lot in common, according to a new study from the USC Stem Cell laboratory of Neil Segil, Ph.D., published in the Proceedings of the National Academy of the Sciences on July 20, 2021. “There are striking similarities in the development of two types of specialized sensory cells: the so-called hair cells that receive sound vibrations in the inner ear, and the Merkel cells that sense light touch at the surface of the skin,” says Segil, who is a professor in the department of stem cell biology and regenerative medicine and in the USC Tina and Rick Caruso Department of Otolaryngology–Head and Neck Surgery. “Ultimately, these developmental similarities are a legacy of shared evolutionary history,” he says. “This demonstrates how the story of evolutionary developmental biology,
Support our research: hhf.org/donate.
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Inner ear sensory cells (left) and skin sensory cells from a 1-day-old mouse.
or ‘evo devo,’ also extends to what we call the ‘epigenetic level’—or how genes are regulated.” In the study, doctoral student Haoze (Vincent) Yu, postdoctoral scholar Litao Tao, Ph.D., and colleagues identified a shared mechanism involved in gene regulation, or epigenetics, that enables stem cells and progenitor cells to differentiate into more specialized hair cells and Merkel cells. In order to begin the process of differentiation, the right parts of a stem cell’s DNA need to be taken out of storage. Each human cell can store around six feet of DNA in its nucleus, because this DNA is wound around tiny “spools” made up of proteins called histones. These spools of DNA and histone protein are further packed together to form what are known are nucleosomes, which are stacked to create chromatin, the material that makes up the chromosomes. When DNA is wound tightly into this storage configuration, the chromatin is closed and inaccessible to the protein ATOH1. This protein is a “master regulator” that can activate a network of differentiation genes in the DNA within the chromatin—but not without first gaining access. To this end, ATOH1 stimulates the production of a second protein known as POU4F3, an aptly named “pioneer factor” with the ability to venture into new frontiers by binding to closed and inaccessible chromatin. After POU4F3 blazes a trail by binding to the closed chromatin, ATOH1 is able to move forward with engaging and activating the network of genes that drives differentiation into hair cells and Merkel cells. 40
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Strikingly, there is significant overlap in the specific regions of chromatin that POU4F3 makes accessible to ATOH1 in hair cells and Merkel cells. “It’s remarkable that these two cell types, which are both involved in sensing mechanical stimuli but derive from distinct parts of the embryo, both rely on the same ATOH1/POU4F3 mechanism in order to differentiate,” Segil says. “Our study suggests that this mechanism is extremely ancient, and emerged before hair cells and Merkel cells diverged from a common evolutionary ancestor—an ‘ur-mechanoreceptor’ cell type.” —USC
These are adapted from USC press releases, at segillab.usc.edu. Hearing Restoration Project (HRP) member Neil Segil, Ph.D., is a professor in the University of Southern California’s department of stem cell biology and regenerative medicine and the USC Tina and Rick Caruso Department of Otolaryngology–Head and Neck Surgery. A coauthor on the Developmental Cell paper, fellow HRP member Andy Groves, Ph.D., is a professor and the Vivian L. Smith Endowed Chair in Neuroscience at Baylor College of Medicine in Texas. Additional coauthor Zlatka Stojanova, Ph.D., in the Segil Lab at USC, is a 2011–2012 Emerging Research Grants recipient.
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Specific Group of Cochlear Cells in Mice Demonstrate Regenerative Potential Cochlea
Hair
cells
GER
Supporting cells New hair cells New supporting cells
FACS
A surprising finding of this project was that a specific group of cells, called the greater epithelial ridge (GER), contained the majority of cells capable of growing into organoids. This ability can be interpreted as a form of regenerative potential because the GER cells can multiply and generate new sensory hair cells. (FACS is a cell sorting technology.)
photo credit: vincent yu/segil lab/usc stem cell
Organoid
Permanent hearing loss is often the result of loss of mechanosensitive sensory hair cells inside the cochlea. Hair cells are susceptible to noise damage, infection, ototoxic agents, and the effects of aging. Although cochlear hair cell regeneration does not occur in adult mammals, including humans, studies have shown that, in the neonatal mouse, nonsensory cochlear cells have a limited and transient ability to generate new hair cells. For example, isolated cochlear cells of newborn mice can grow into spherical balls of cells, so-called organoids. These organoids grow and can become differentiated cells that resemble young hair cells and their surrounding supporting cells. Our team used specific cell culture conditions for the efficient generation of inner ear organoids. We then used a cell sorting technology called FACS to purify the different cochlear cell subtypes, and then compared the individual organoid-formation capacity of each cell group. A surprising finding of this project was that a specific group of cells, called the greater epithelial ridge (GER), contained the majority of cells capable of growing into organoids. This ability can be interpreted as a form of regenerative potential because the GER cells can multiply and generate new sensory hair cells. GER cells occur only in the cochlea of newborn mice, and they are no longer present in adult mice. Our findings provide methods to purify these cells, inspiring future studies to research why GER cells have regenerative capacity. The principal discovery was published in January 2021 in the journal Cell Reports. The methods for GER cell purification were published in STAR Protocols in September 2021. —Marie Kubota, Ph.D.
HRP member Stefan Heller, Ph.D., is a coauthor of the Cell Reports and STAR Protocols papers with Marie Kubota, Ph.D., a postdoctoral researcher in his lab at Stanford University.
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research
Major Funding for the gEAR The gEAR (gene Expression Analysis Resource), a data sharing and data visualization tool developed and maintained by HRP member Ronna Hertzano, M.D., Ph.D., and team, recently received major R01 funding from the National Institute on Deafness and Other Communication Disorders (NIDCD). Begun in 2016 and expanded since with majority funding from Hearing Health Foundation, the gEAR is a model example of the way seed funding from HHF—via the HRP, in this case—is meant to move ideas from concept, to robust contribution, to auditory research. Now that the gEAR is a vital tool for ear researchers across the world and the primary means for data sharing in the field, the NIDCD will provide substantial funding to further refine this tool and expand its capabilities in service to the entire research community. HHF is incredibly proud of Hertzano’s team and gratified that our willingness to take a risk back in 2016 has led to greater scientific understanding for the gEAR team and researchers everywhere. And we are grateful to our donors for continuing to express confidence in HHF’s ability to direct funding to innovative concepts that would encounter difficulties securing funds elsewhere.
High-Tech Portal Speeds Innovations Toward Reversing Hearing Loss Free online tool helps researchers easily utilize complex data from sophisticated genetic studies Researchers at the University of Maryland School of Medicine (UMSOM) launched a new online tool that could more quickly advance medical discoveries to reverse progressive hearing loss. The tool enables easy access to genetic and other molecular data from hundreds of technical research studies involving hearing function and the ear. The research portal called gene Expression Analysis Resource (gEAR) was unveiled in a study in Nature Methods in August 2021. It is operated by a group of physician-scientists at the UMSOM Institute for Genome Sciences (IGS) in collaboration with their colleagues at other institutions. The portal allows researchers to rapidly access data and provides easily interpreted visualizations of datasets. Scientists can also input their own data and compare it to other datasets to help determine the significance of their new findings. “It saves scientists a huge amount of time,” says study 42
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corresponding author Ronna Hertzano, M.D., Ph.D., an associate professor of otorhinolaryngology–head & neck surgery at UMSOM and founder of the gEAR. “Instead of relying only on identifying mutations in genes for hearing loss, researchers can easily identify which cells express any gene in the ear, and how this expression changes, for example, as a result of noise exposure or in processes of regeneration in other species.” Hertzano and team recently added data from the National Institutes of Health’s BRAIN (Brain Research Through Advancing Innovative Neurotechnologies) Initiative to a specialized domain of the gEAR portal. This provides access to those performing neuroscience studies to better understand brain function and neurodegenerative diseases like Alzheimer’s. The portal is free and available to any researcher seeking access. Users of the portal can do a variety of applications depending on their needs. They can access the dataset
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Ronna Hertzano, M.D., Ph.D., has been introducing the gEAR as a research tool to fellow scientists for the past several years.
uploader and add their dataset into gEAR to view their data in a private setting. This enables them to see their findings in the context of other public data before posting their results online or submitting their paper for publication. Once a manuscript is published, a permalink can be included in the manuscript that links readers directly to a curated view of that dataset. “The gEAR portal currently includes over 800 datasets, which we carefully reviewed before inputting,” Hertzano says. “We have more than 1,200 registered users and over 80 citations in research studies. We are expecting a large increase now that our methods paper is published.” Hertzano and colleagues did a soft launch of the portal a few years earlier and publicized its existence via discussions with colleagues and user workshops at scientific meetings. The Hearing Restoration Project (HRP), a research consortium funded by Hearing Health Foundation, provided initial support of the gEAR in an effort to better understand the mystery of hair cell regeneration—why sensory hair cells in the inner ear regenerate in certain species but not in mammals, including humans. Mammalian hair cells do not naturally regenerate when they die or are damaged due to excess noise or exposure to certain medications like chemotherapy drugs, leading to permanent hearing loss. The consortium uses genomic analyses to compare molecular processes in species that do and do not regenerate hair cells. “The gEAR team closely interacts with the [HRP] consortium researchers who also serve as our focus group, providing priceless feedback and suggestions,” Hertzano says. Understanding how the expression of certain genes plays a role in hair cell regeneration—and how enzymes and other proteins mediate that process—could lead to new treatments to reverse hearing loss by triggering a regeneration of these cells. “By enabling rapid access to enormous datasets, the gEAR portal can serve as a valuable hub for community building around common research areas,” says Claire M. Fraser, Ph.D., the Dean’s Endowed Professor of medicine,
microbiology, and immunology, and the director of IGS. “Having access to data in large repositories is not enough. What’s essential is that the gEAR curates and organizes the data into an accessible format so it can be used to address important scientific questions.” Study lead author Joshua Orvis, a bioinformatics software engineer at IGS, and study coauthor Yang Song, Ph.D., a bioinformatics analyst at IGS, were instrumental in the development of the gEAR. Researchers from the University of Maryland, College Park, National Institute on Deafness and Other Communication Disorders, University of Iowa, Johns Hopkins University School of Medicine, and Bar-Ilan University in Israel also contributed to this study. “The gEAR portal is a beautiful example of the value of close collaboration of clinicians, biologists, and engineers to bridge the gap in technology and make the critically important ‘omic’ data generated across the world immediately accessible to biologists in a meaningful format,” says E. Albert Reece, M.D., Ph.D., the executive vice president for medical affairs at UM Baltimore, UMSOM Dean, and the John Z. and Akiko K. Bowers Distinguished Professor at UMSOM. The gEAR portal’s development has been funded by the National Institute on Deafness and Other Communication Disorders and the National Institute of Mental Health, both part of the National Institutes of Health, and Hearing Health Foundation through its Hearing Restoration Project. —Deborah Kotz
This is adapted from a UMSOM press release, at medschool.umaryland.edu/news. For more, see umgear.org. For references, see hhf.org/fall2021-references.
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research
3D-Printed Tumor Guides Brain Surgery for Vestibular Schwannoma
A 3D-printed vestibular schwannoma with the facial nerve (cranial nerve VII, or CN VII) drawn on it in red.
A vestibular schwannoma, also known as an acoustic neuroma, is a benign tumor of the cochleovestibular nerve that connects the inner ear to the brainstem. Vestibular schwannomas may result in both hearing and balance symptoms. Surgery for vestibular schwannomas aims to remove the tumor and preserve function of surrounding cranial nerves, including the facial (cranial nerve VII) and cochlear nerves. In a study led by Lorenz Epprecht, M.D., and Daniel Lee, M.D., at Mass Eye and Ear, we sought a method to better predict the course of the facial nerve to help guide the surgery and reduce potential complications. More specifically, we used an imaging technology called diffusion tensor imaging (DTI), also known as diffusion MRI-based tractography, and 3D-printing techniques to generate 3D maps of the facial nerve. Our results, published in the journal Otology & Neurotology in June 2021, detail a new, 3D-printed, patient-specific tumor model for quantitatively assessing the accuracy of facial nerve tractography in vestibular schwannoma patients. We compared tractography with the intraoperative 3D course of the facial nerve. Surgeons were blinded to tractography and drew the intraoperative course of the facial nerve on a patient-specific, 3D-printed tumor model for detailed comparisons. 44
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In our cohort, the description of the cranial nerve VII course in relation to vestibular schwannomas was highly reproducible. In 94 percent of tumors with tractography (15 of 16), the intraoperative description of the facial nerve matched the tractography findings. There were limitations with this approach. The maximum distance between tractography and intraoperative course of the facial nerve was 3.7 mm ± 4.2 mm, which may be clinically significant. In summary, this study presents a novel approach to facial nerve tractography in patients with vestibular schwannoma. Further research is needed as quantitative measures suggest a clinically significant distance between tractography and the course of the facial nerve. —Elliott Kozin, M.D.
A 2018 Emerging Research Grants scientist generously funded by the General Grand Chapter Royal Arch Masons International, Elliott Kozin, M.D., is a physician and surgeon at Mass Eye and Ear and assistant professor of otolaryngology–head and neck surgery at Harvard Medical School, both in Boston.
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Autism-Related Language Difficulties Tied to Involuntary Attention Capture The top row shows the brain regions studied, while the bottom row depicts the differences between listeners with autism spectrum disorder (ASD) and those who are typically developing (TD) when presented with meaningful versus jabberwocky sentences.
Autism spectrum disorder (ASD) is associated with language impairments, yet the neural mechanisms underlying these deficits are poorly understood. Neuroimaging has shown that processing of socially relevant sounds, including speech and non-speech, is atypical in ASD. However, it has been unclear how the presence of lexical-semantic meaning (understanding vocabulary and context) affects speech processing in ASD. We recorded magnetoencephalography data from individuals with ASD and typically developing (TD) peers while they listened to meaningful auditory speech sentences and meaningless jabberwocky sentences. Our findings, published in the journal Progress in Neurobiology in August 2021, demonstrate that ASD individuals show significantly stronger cortical responses to meaningless compared with meaningful speech in the same canonical language regions where TD individuals exhibit stronger responses to meaningful speech. These differences emerge well past the stimulus onset, at around 800–1,000 milliseconds into the sentence. This divergence in responses as a function of the presence or lack of lexical-semantic information in speech is a striking difference between ASD and TD in the neural mechanisms underlying auditory speech processing. This suggests a receptive speech processing dysfunction in ASD, where unattended meaningless speech, filtered out in TD individuals, engages the language system through involuntary attention capture. The responses correlated with ASD symptom scores in several areas, including social-affective, attention-related, and sensory processing domains, demonstrating the relevance to the ASD phenotype. —Hari Bharadwaj, Ph.D.
A 2015 Emerging Research Grants scientist generously funded by the General Grand Chapter Royal Arch Masons International, Hari Bharadwaj, Ph.D., is an assistant professor at Purdue University with a joint appointment in the departments of speech, language, and hearing sciences, and biomedical engineering. For references, see hhf.org/fall2021-references.
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>>> Bench to Bedside: The Pipeline
From Basic Research to Clinical Therapies and Treatments Hearing Health Foundation’s goal, as ever, is to contribute to the progression from preliminary experiments through to firm, corroborated results—a process whose timescale is directly related to the availability of research funding—so that these findings can be applied clinically to help patients. By Christopher Geissler, Ph.D. Research that Hearing Health Foundation has funded over the past 60-plus years has had a profound impact on our clinical understanding of the auditory system and patient care. HHF’s dual funding structure—the broad-based Emerging Research Grants (ERG) program and the more focused, closed membership Hearing Restoration Project consortium—reflects the fact that improving clinical outcomes for people living with hearing loss and other auditory or vestibular conditions is multipronged. It involves advances in ultimately restoring hearing, but also in improving diagnoses, assistive devices, and therapeutic treatments on the way toward a biological cure for hearing loss. HHF funding was instrumental, for example, in restoring hearing function through cochlear implants, and our researchers continue to work on projects that further refine the design of CIs and other devices, including hearing aids. Our scientists’ research has improved diagnostics, which means earlier, better, and more targeted intervention to enhance the lives of people living with hearing loss and other disorders.
We recently featured a webinar presentation by Richard Tyler, Ph.D., a 2012 ERG grantee, one of the leading global experts in tinnitus, whose work has been instrumental in raising the research profile of tinnitus and learning how to better understand patients’ experience of the disorder, which remains subjective and difficult to evaluate. Better diagnosis and understanding of the severity and type of tinnitus is key for clinicians working with tinnitus patients to find relief. HHF research has also resulted in advances in auditory training and the development of new technology to improve therapeutic results, such as the app-based training discussed in another webinar by 1987–1989 ERG grantee Nancy Tye-Murray, Ph.D. Tye-Murray’s work, which began with her ERG funding, has helped countless people with hearing loss—including “hidden hearing loss,” a newly defined type that is difficult to assess—to more effectively work with the hearing they do have, with or without assistive devices. This translates to better interactions with healthcare providers, social connections and engagement with friends and family, and mental health overall.
HHF funding was instrumental in restoring hearing function through cochlear implants, and our researchers continue to work on projects that further refine the design of CIs and other devices, including hearing aids. Our scientists’ research has improved diagnostics, which means earlier, better, and more targeted intervention to enhance the lives of people living with hearing loss and other disorders. 46
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Our researchers, some funded through the Emerging Research Grants program but especially those in the Hearing Restoration Project consortium, have made huge strides in understanding the mechanisms that allow some species to regenerate inner ear hair cells and restore their hearing.
These are just some examples of the ways in which HHF-funded research is improving the lives of individuals with hearing loss and tinnitus. Our researchers, some funded through the ERG program but especially those in the Hearing Restoration Project consortium, have made huge strides in understanding the mechanisms that allow some species to regenerate inner ear hair cells and restore their hearing. Thus far, no one has found a mechanism to regrow these hair cells in human beings to restore hearing. This remains the goal, but given the complexity of the biophysical and genetic makeup of the inner ear, will take time. Hearing Restoration Project (HRP) scientific director Lisa Goodrich, Ph.D., and HRP consortium member Ronna Hertzano, M.D., Ph.D., who is also a 2009-2010 ERG recipient, recently spoke about the HRP’s current work, including a detailed discussion of the biology of inner ear hair cell regeneration. They reviewed the direction of future hair cell regeneration research and presented the gEAR (gene Expression Analysis Resource) portal, an important data visualization tool funded by HHF. The portal is also being used beyond the auditory field and recently received additional significant National Institutes of Health funding, both testaments to the gEAR’s scientific value. The pipeline from preliminary experiments to published results, subsequent experiments by other scientists in order to confirm findings, and then, finally, to clinical application in the form of treatments, devices, and drugs requires time and funding. This is true of all fields of medical research. HHF is the largest private, nonprofit funder of hearing and balance research in the United States. It will disburse $1.65 million in research funding this fiscal year 2022. The National Institute on Deafness and Other Communication Disorders (part of the National Institutes of Health) is the primary funder for hearing research worldwide. In 2020, its research budget was
$490 million. These funds cover all areas of research related to hearing loss, other otological disorders, and vestibular disorders. The world recently experienced the way concerted effort and significant funding can accelerate research outcomes in the development of the COVID-19 vaccine. Globally, governments and nonprofit funders contributed over $10 billion to this research on a single question. We have seen that incredible levels of funding toward a single goal can significantly shorten the timeline from the bench to bedside, and many of us are rightfully amazed at what researchers in that field have accomplished. It also serves as a reminder of just what it takes to move the needle on one single medical problem. HHF remains committed to funding a broad spectrum of innovative research that will provide significant improvement to the lives of people living with hearing loss, both in the short and the longer term.
Christopher Geissler, Ph.D., is HHF’s director of program and research support. HHF regularly reports on HHF-funded researchers’ investigations via our quarterly print magazine, also available digitally, and our monthly emailed newsletter. Subscribe at hhf.org/subscribe. For more on HHF’s webinars, please see hhf.org/webinar.
Share your story: Tell us what research means to you at editor@hhf.org.
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meet the researcher
hearing health foundation
Meet the Researcher
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.
James Dewey, Ph.D.
University of Southern California
Dewey received his doctorate in communication sciences and disorders from Northwestern University in Illinois. He has since been a postdoctoral research associate, first in the otolaryngology–head & neck surgery department at Stanford University, California, and now at the University of Southern California. Dewey is a 2020 Emerging Research Grants recipient. i have long been interested in how the ear emits sounds and what these sounds tell us about the inner workings of the cochlea. I first studied these sounds, termed otoacoustic emissions (OAEs), in human ears during my doctoral work, when it became clear that there are many fascinating, unexplained patterns in the measurements. I’ve since learned how to measure vibrations of the structures within the cochlea in animal models, and now I am finally in a position to trace (in mice) the path of OAEs from where they are generated in the cochlea out to the ear canal. both my mother and brother are scientists and professors but I was initially more interested in the arts. In the end, being a scientist is somewhat like being an artist. There is a lot of uncertainty, creativity, and decisionmaking involved; you have to convince others to fund your work; and your output is routinely criticized and refined. I aim to share research results in an aesthetically pleasing, easy-to-understand way. i have a mild high-frequency hearing loss, likely from listening to loud live music with little or no hearing protection. I changed my ways after starting a clinical doctorate program in audiology, where I was able to both routinely test my hearing and learn about the permanent physiological impacts from noise exposure. camping in the deserts of Southern California plays a role in helping to clarify my science. While the desert may seem empty, there is an amazing level of detail and diversity in each micro-environment, and there are always 50
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unexpected turns in weather or encounters with wildlife. Afterward I find it easier to make progress in connecting scientific ideas, writing, and planning the next experiments. i often record interesting acoustic events I encounter when I travel or even just during my daily routine, such as running down a sand dune or a blizzard outside my window. I enjoy going back to these recordings, some dating back two decades now, much like looking at old photo albums. i hope to continue unraveling the mystery of how the cochlea works. As we learn more about what noninvasive, objective measurements can tell us about cochlear physiology in animal models, the hope is to ultimately translate these findings into ways to better detect, characterize, and prevent hearing loss in humans.
James Dewey, Ph.D., is funded by donors to Hearing Health Foundation who designated their gifts for the most promising research. HHF thanks our community for supporting projects that address 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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6 Ways to Make an Impact Today and Tomorrow You can make a meaningful difference in hearing loss research. Whichever method below you choose, every gift to Hearing Health Foundation (HHF) counts.
The De Francescos named HHF in their estate plans.
Check or credit card gifts online or by mail are easy and immediate. For more of an impact, schedule a monthly gift that helps sustain research without interruption.
If you are in possession of life insurance policies that you no longer need, you can designate HHF as the beneficiary.
Donating appreciated stock can reduce your tax bill. You receive a charitable tax deduction for the full value of the stock, and avoid paying taxes on the stock as it appreciates.
IRA distributions that begin when you turn 70 1/2 can be taxed as income, but if you choose to donate them to HHF, you avoid the penalty.
A charitable bequest in your will can be a more substantial gift if you are unable to donate today. If you do not have a will, create one for free at freewill.com/hhf.
Retirement plan benefits left to heirs are more highly taxed than other assets. Make a meaningful gift to HHF instead, leaving lower-taxed assets to loved ones.
This publication is distributed for free through the generous support of our community. To learn more, visit hhf.org/how-to-help, email plannedgiving@hhf.org, or call 212.257.6140.
