While hearing aid technology has improved considerably over the last two decades, leading to an increased user satisfaction rate (Picou, 2020), one factor remains constant in the fitting process: each hearing aid user is unique. There are some systematic requirements shared across all hearing aid users, such as better speech intelligibility, but there are also some specific situations where the audiologist must pay attention to individual needs; one of them is listening to or playing music. Enjoying these activities, which have a positive impact on health and well-being, relies heavily on the individual’s hearing and the hearing aid fitting.
Different approaches for listening to or playing music
Our first approach is usually to propose a Live Music listening program which offers some specific solutions for listening to music. However, listening to music is not equal to playing a musical instrument. If the sound from my Hi-Fi system is too soft, then I just have to turn up the volume until I am satisfied. If I play in an orchestra or in a band, it is not possible to ask the other musicians to play louder or softer just for me. Active musicians using hearing aids therefore need specific attention during the fitting process. The perceived sound quality provided by their hearing aids is essential as it helps them to control the way they perform. They also have higher expectations about the auditory feedback influenced by the hearing aids, as they already have a clear idea about how music should sound (Vaisberg et al., 2019). These expectations are much lower when you listen in a more passive way to music.
Variety of music and musicians
Fitting musicians
The challenge for the audiologist is to understand what music means for each musician. There is a wide range of variables such as the instrument type, group size / orchestra, room acoustics and musical style. This variety directly impacts the acoustical properties of music such as the dynamic range, the long-term average spectrum, or the crest factor (Kirchberger & Russo, 2016). It is therefore not possible to have a generic solution for all musicians.
One way to optimize the hearing aid fitting with musicians is to let them play their instrument during the fitting session. Live adjustments and direct feedback from the musicians allow the audiologist to fully use the technological potential of the hearing aids until they hear their instrument as they want to hear it. While this approach is appealing and should lead to higher satisfaction in a clinical setting, it is not possible to generalize a priori these findings to other listening situations with music, such as when they practice, rehearse, or perform in different musical setups. This was the motivation behind our clinical study.
Clinical study design
Our clinical study evaluated a fitting protocol designed to improve the perception of music for active musicians in a lab environment and during a field test. We recruited 20 hearing-impaired musicians for this study and invited them to our clinic to apply the optimization protocol with their instrument and to make different measurements. Participants had to be regularly playing in different environments such as an orchestra, chamber music group, or band so that it was possible to evaluate different listening programs in a wide range of listening situations.
Study results
Our results indicate that the optimized music listening program was significantly preferred over the standard Live Music program when the subjects were playing music. This finding confirms the potential for fine tuning and personalization of hearing aids especially for musicians. Beyond my own professional interest in this clinical research project, it was personally very satisfying collecting the feedback from the test subjects.
Their testimonials highlight the importance of good hearing when playing music with many positive outcomes: better technical control during the performance, more enjoyment of all the details in the music when they play or when they listen to the other band members, and more confidence when playing with other musicians to adjust the loudness of their instrument. In the end, it contributes to a better quality of life when they can continue to play and enjoy interactions with other musicians.
This project also stresses the role of the audiologist in the fitting process for musicians. I do not believe that an “off-the-shelf” solution, like our Live Music program, is enough. It is a good starting point, as it provides the best technology for music. But the fine tuning with an active participation of the musician is the key. It also requires that the audiologist speaks a common language with the musician to have a common understanding of the problem and the solution.
You can find all the details about the protocol and the results in our White Paper. I would also recommend to visit the web site “Hearing Aids for Music” that provides a lot of information about this topic.
REFERENCES
Kirchberger, M., & Russo, F. A. (2016). Dynamic Range Across Music Genres and the Perception of Dynamic Compression in Hearing-Impaired Listeners. Trends in Hearing, 20, 233121651663054. https://doi.org/10.1177/2331216516630549
Vaisberg, J. M., Martindale, A. T., Folkeard, P., & Benedict, C. (2019). A Qualitative Study of the Effects of Hearing Loss and Hearing Aid Use on Music Perception in Performing Musicians. Journal of the American Academy of Audiology30(10), 856–870. https://doi.org/10.3766/jaaa.17019
Vaisberg, J. M., Martindale, A. T., Folkeard, P., & Benedict, C. (2019). A Qualitative Study of the Effects of Hearing Loss and Hearing Aid Use on Music Perception in Performing Musicians. Journal of the American Academy of Audiology30(10), 856–870. https://doi.org/10.3766/jaaa.17019