Best and Worst Private Hearing Aid Retailers 2018 by Which?

Independents Win Again, Scrivens Found Lacking, Hidden Pushes Too Hard & Cheap May Not be Value For Money.

Which? has undertaken another series of surveys about hearing aids and their providers. In this the second article covering their findings, I want to speak about their Best Hearing Aid Providers 2018 article. Which? surveyed thousands of hearing aid users about their experiences asking questions that covered places that offer the best hearing tests and product choice, to those that deliver the best value for money. I will let you in on a secret, Independents won out, but you can see which other hearing aid providers scored best in the table below.

Linx Resound Quattro rechargeable hearing aids

Why does it matter where you buy hearing aids from?

A hearing aid is a major investment, not just in monetary terms. That investment of time and money should result in a better life for you. It’s important that you choose a trusted, knowledgeable retailer to ensure you increase your chances of getting the best hearing aid for you. While Which? Feel that all hearing aids are pretty much the same, I wouldn’t ascribe to that view. That is probably an argument for another day. Having said that, I do agree with them when they say, “It’s the professional fit and service given by the provider that matters more”.

Hearing aids don’t just work, or at least not all of the time. It can take time to fit and adjust a hearing aid correctly so that it’s working to maximise your hearing. You need the support and aftercare of a decent professional to get the best out of your hearing aids. If you don’t get it, the hearing aids will often end up in a drawer forever. Most hearing aid users reported in the survey that they wear their aid/s every day (69%), with 13% wearing them three to six times a week. Interestingly enough, Which? Reported that the hearing aids providers were rated quite differently on the hearing aids themselves. Scrivens customers rated the store poor for the range of hearing aids offered, its appearance, comfort and suitability of the hearing aids for the individual. Elsewhere, Boots and Amplifon customers rated them good or excellent on all of these measures.

Best hearing aid providers

The survey results show that local independent hearing aid providers are rated most highly by customers. They reached an overall customer score of 87%. At the other end of the table was Scrivens, with 62%. Which? Reported that Independents excelled in pricing transparency and value for money. The survey respondents also gave independents the highest ratings in the categories covering professional and knowledgeable staff and the way they deal with questions and concerns.

Out of the national high street brands, Boots Hearing Care came top with an overall customer score of 79%. It received three-star or higher ratings for each of the 21 aspects of service that Which? quizzed its customers about. Boots got full five-star ratings for the quality of its hearing testing, follow-up care, privacy and clarity. Interestingly Scrivens fell down on its product offering – including a poor rating for the comfort of its hearing aids and how well they suit the individual.

Pressure sales

Interestingly, nearly a quarter (23%) of private hearing aid customers felt under some pressure to buy, and just over one in five (21%) felt that they were under pressure to select a more expensive option from a range of suggested products. This varied considerably between providers, with the biggest difference between Hidden Hearing and local independents.

How did hearing aid retailers differ?

It’s fascinating when you dig a little deeper into the survey, one thing that was interesting was that what you pay for hearing aids isn’t necessarily rated the same as value for money or transparency of price. For instance, Specsavers was rated good for price and price transparency but it was only rated average for value for money. So the survey seems to suggest that they are cheap and transparent but don’t deliver value for money no matter what they charge.

That’s a really interesting concept and I wish I could have delved deeper to identify why. I mean is it the service and aftercare, is it the efficacy of the aids? Why is cheap, not good value for money, did they feel that they would have to spend again to get better? I wish that Which? had asked questions about loyalty to the brands. If they did, they didn’t discuss them.

Customers rated independent hearing aid retailers excellent for transparency of price, and good on overall price and value. Hidden Hearing got spanked in those categories, customers rated the brand poor for price and value for money. It was rated average for price transparency, which is lower than the other brands rated (Hidden is the only high street brand that doesn’t put its hearing aid prices online).

Hearing aids cost?

According to the survey respondents, the average amount spent on a pair of hearing aids, was £2,475. The lowest average price paid by Which? members for a pair of hearing aids was with Scrivens at £1,583, but Scrivens also got the lowest customer satisfaction score, with 62%. Which seems to prove the old adage when you buy cheap, you pay dearly.

The highest average price paid for a pair of hearing aids with local independents was £3,217.74. Average prices paid at other chains for a pair of hearing aids were £2,657 at Amplifon. £2,882 at Hidden Hearing. £3,646 at Boots. and £1,767 at Specsavers.

In finishing, independent hearing aid providers are again rated top as providers. Other key lessons are that when it comes to hearing aid success and satisfaction, you get what you pay for and surprisingly, independents appear to be a little cheaper than Boots.

Which? Survey, NHS vs Private High Street Hearing Aid Retailers

Satisfaction With High Street Retailers High, But NHS Not Far Behind

Which surveyed hearing aid users in April 2018 to compare satisfaction rates of people provided services by the NHS and by private High Street retailers such as Boots, Specsavers, Hidden Hearing and Amplifon. The results were interesting, to say the least, and overall; private retailers pipped the NHS generally. The only area that was dramatically different was in the hearing aid questions. People were overall much happier with private hearing aids. The survey raises questions about what consumers are looking for as well, let’s take a look.

The Survey

Which? surveyed members who have recently got a hearing aid via the NHS or bought hearing aids from a private provider. They asked questions that covered the entire process and asked them to rate their experience. The results reveal that overall satisfaction with hearing aid providers is high among UK consumers, whether they use the NHS or go private. Of 3,183 Which? members surveyed, the total average satisfaction score was 84%.

Which? reported that there was not a significant difference in overall satisfaction between those paying privately (88%) compared with those who got their hearing aids from the NHS (84% ) and those for whom the NHS paid to go privately through the Any Qualified Provider scheme (75% satisfaction score). But I think that is a pretty strong spread and statistically significant. For me, it appears that the NHS and Private providers are similar while the AQP scheme lags significantly behind. As I said, the most significant differences in answers were all to do with the hearing aids provided as you can see below

NHS hearing aids vs privately bought hearing aids
NHS	Private sector
Waiting times	78%	95%
Cleanliness of hearing test facilities	96%	98%
Comfort of hearing test facilities	86%	90%
Level of privacy	96%	98%
Professionalism and knowledge of staff	93%	95%
Dealing with questions or concerns	91%	95%
Clarity of written and verbal information provided	89%	93%
Thoroughness of examination/ testing	94%	96%
overall customer service	92%	95%
Range of hearing aids offered	23%	84%
Appearance of the hearing aids	72%	95%
Comfort of the hearing aids	75%	92%
Extent to which the hearing aid/s suited you	74%	91%
Replacing lost or damaged aids	88%	90%
Dealing with repairs	87%	92%
Ease of booking follow-up appointments	78%	95%
Continuity of care (e.g. seeing the same audiologist)	48%	88%
Follow-up serv1ce	74%	92%
Overall price	N/A	72%
Value for money	N/A	75%

The Hearing Aid Questions

Hearing aids provided was really where the difference between NHS and private showed up. While I wasn’t surprised by the difference in satisfaction in either the answers to the range or appearance questions, I was surprised by the answers to the answers to the comfort and extent of suitability responses. I expected them to be pretty level. Some of that could be explained by the fact that NHS users weren’t satisfied with what was offered, therefore their feelings about comfort and suitability were swayed.

Up to 84% of private customers rated the range of aids as above average in the private sector, compared with just 23% of NHS patients. While customers can access the same hearing aid brands on the NHS as they can by buying privately (not the latest models). The NHS does not offer a choice of different models. Interestingly enough, where people could name the brand of hearing aids that the NHA had provided, they didn’t really differ between the NHS or private. The bulk of the aids were Phonak, Oticon or Signia.

Having said all of that, the satisfaction rates that were achieved by private retailers also have a story to tell. For instance, why was the range of hearing aids provided only met with an 84% satisfaction rate? That surprised me considering that many of the high streets would offer a full range of models from many of the leading hearing aid brands. What more where the consumers looking for? I would dearly love to know the answer to that question.

Hearing Aids 2018, A Changing World

What are the best hearing aids innovations in 2018?

Remember that time that you bounced up and down because you were so excited about a hearing aid feature? Or is that just me? Anyway, in the hearing aid world, we are used to hearing about the next game-changing technology, the latest innovation, the new best hearing aid ever! Sometimes, we get a little jaded with the claims, perhaps a little cynical. Then something comes along and it bowls us over. Something that we immediately know will change hearing aids forever, or for at least the next five years or so. 2018 will be a year of different technologies, features and hearing aids which I believe will change things for a few years to come. Let’s take a look at the innovations in 2018 that will make a difference.

The Biggest Hearing Aid Innovations

I think the biggest hearing aid innovations for 2018 will be the following:

Own Voice Processing by Signia
Telecare by Signia and Resound
Sensors in hearing aids by Starkey
Rechargeable hearing aids which were led by Phonak
Wider or deeper connectivity whereby Signia has shown the possibilities
Biometric Calibration, a Phonak system
Made For Any Phone again another Phonak system
Cloud-based machine learning from Widex

OVP, Own Voice Processing

Signia made a huge deal of their new feature OVP or Own Voice Processing at the launch of their new Nx range of hearing aids. The feature is used to process the hearing aid user’s own voice differently from everything else. In fact, they have dedicated a completely separate computer processor on the platform to facilitate that. They said at the launch that the strategy will increase the acceptance of a user’s own voice dramatically.

I agree wholeheartedly with that statement, the OVP feature is truly amazing. My experience with it has been nothing but jaw-dropping, and I don’t say that very often. In the article Signia Pure 312 7 Nx Hearing Aids, Here is What You Need to Know, I talked in more depth about the own voice processing feature and why it might be of interest to you. The pertinent statement here though is:

When I was fitted with the Nx I was fitted with closed domes, I thought this isn’t going to work as I heard my voice explode in my head. Then, we went through the own voice training protocol (count from twenty-one until it is happy it knows your voice). The feature was turned on, and no more occlusion, just like that. I was a bit speechless (that doesn’t happen very often). By no more occlusion I mean no more auditory occlusion, I wasn’t caused any difficulty by my own voice.

What Difference Will This Make?

For new users of hearing aids the sound quality of their own voice can be off-putting, but it is usually something that they get used to. However, with this new .feature they won’t have to, in essence, problems with their own voice will be eliminated. This will mean that hearing aid users who traditionally would have to be fitted with open domes, can now be fitted with closed domes without causing auditory occlusion.

Closed Fittings are a Hearing Aid Manufacturer’s Dream

A closed fitting is, in fact, a hearing aid brand’s dream, it means that the full features and strategies they have designed can come into full effect to process the sound for a user. I mean they spend a huge amount of treasure and man-hours designing fantastic features to process sound. Then, we hobble them to a certain extent by using open fit tips which allow natural unprocessed sound in. Closing the ear canal will mean the end of that, with this new technology, for the first time, we will be able to close the canal in many Patients.

No matter what, I think OVP is going to change everything moving forward. I would expect to see this concept adopted across all of the hearing aid brands over the next few years.

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Real-Time Telecare

Signia was the first hearing aid brand to offer Telecare, but, it was a limited fine-tuning option. Resound quickly followed with the launch of the LiNX 3D and their Remote Assist which had far more functionality and delivered the ability to the professional to make complete changes to the settings of the hearing aids and to send those changes to the devices via an app.

Signia though quickly expanded their fine-tuning option and added video calling to the system. Which gave the user the ability to directly contact their professional through secure video calling. In Signia’s latest update, they have enabled full live remote tuning with video support which is a pretty huge breakthrough. Phonak have of course upped the game again with the introduction of their new Marvel hearing aids. The remote care system that has been introduced by Phonak is a really strong affair with video calling and full fine tuning.

What Difference Will This Make?

Simply put, it changes everything about how the professional and the user interact. It has the possibility to change the business model of provision of hearing aids forever. It gives complete freedom to hearing aid users to decide how they want to be looked after. It also offers professionals an opportunity to change how they work and what they offer.

The new service means that you can set-up a video call with your hearing professional and explain the issue you are having in the situation you are having it in. While you are connected, your hearing professional can tweak your hearing aid’s settings live and you can quickly assess if they are better.

It is early days for Telecare and some hearing healthcare professionals are a little non-plussed about it. Many within the profession are still trying to get their heads around it and how they will use the service. However, I expect it to slowly come to the wider attention of users and I believe that they will demand it. I think that no matter what, real-time telecare is going to change everything. Starkey has just announced that they are introducing telecare to their hearing aids and I believe that every hearing aid brand will do so over the next five years.

Sensors in Hearing Aids

In the article “Starkey Announces Hearing Aids of The Future at Starkey Expo” I spoke about the announcement of new hearing aids by Starkey. They announced that they would introduce hearing aids this year that would have onboard inertial sensors that would be used to track activity and detect falls. Not just that, they also said that when and if a fall occurs, the hearing aids would report it. At the time I made the comment, “About Damn Time!”

What Difference Will This Make?

Who knows? I am not trying to be funny, the changes in use case and functionality are endless. They are only limited by the imagination of the research and design guys. I wrote an article recently on Linkedin which was basically a daydream about the future of hearing aids. Introducing sensor sets to hearing aids is just the first step towards that dreamed future. Let’s take a look at it:

“A busy day ahead, hit the floor of the bedroom running as you do. Put my hearing aids on and IFTT told my coffee machine to wake up and turn on the radio.

Bob Gave Me My Day

I call him Bob, don’t know why, but hey, you got to call him something right? Bob, the virtual assistant in my hearing aids gave me a rundown of my day, first appointment inDublin 15 at 09:30. Meeting Tom and Stacey, current travel time 30 minutes. Plenty of time to become human.

Traffic Snarl

Sitting down to my coffee Bob tells me the M50 is a disaster, what’s new? I need to leave now to make the appointment and he has given me a new route. Not too familiar with the route but Bob gives me turn by turn guidance so I get there without a hitch.

Meeting Run Down

Bob gives me a quick rundown of the LinkedIn profiles of Tom and Stacey, telling me Stacey has just been promoted. The meeting goes well with Bob chirping in towards the end to tell me my blood sugar is a bit low. Well Bob, if you hadn’t interrupted breakfast it wouldn’t be.

With the meeting finished I ask Bob for the nearest cafe, he finds the best reviewed one nearby and gives me turn by turn guidance. He also informs me that an email has just come in and my next appointment is cancelled. He then tells me that swearing is impolite.

You Are Really Fat!

While walking from the car to the cafe he tells me I am a fat bloke who doesn’t get enough exercise. Sorry, I paraphrase, what he says is that I have just taken 1000 steps so far today and on current projections will miss my target. Same thing really.

He informs me that my resting pulse rate has increased over the last four weeks and my activity levels have fallen. So back to the gym for the fat lad. I ask Bob to call Richard on his mobile, hands-free calls directly from Bob are pretty sweet, I can’t remember the last time I used a phone for anything?

With the call over, I get Bob to read my emails to me and dictate responses. As usual, he edits out the curses, helping me hear, making my day easy and making me civilised! Wonders will never cease.

I tell Bob that I am going home and he uses IFTT to turn on the heating and start the coffee pot again. As I drive up to the driveway Bob turns on the front light so I can get my damn key in the door. Bob says he can open the door using the electronic catch release applet on IFTT but hey, I like keys!

As I enter I ask Bob to turn the kitchen TV on and start the oven. Dump my stuff in the hall grab some coffee and take a seat. Bob announces to me that he has grabbed the latest marketing podcast I listen to so I tell him to play it. Relaxing with coffee, a podcast and Bob, what more could a body ask for?”

Futuristic? Not Really

Sound futuristic? It actually isn’t, there are many virtual assistant services right now that will allow you to go through your day in this manner, of course, they aren’t centred in and controlled by a hearing aid, but that’s probably going to change. We are already seeing the integration of Alexa (Amazon assistant) into hearables. So what is to stop the hearing aid brands integrating them into their hearing aids?

If Starkey pulls off the integration of inertial sensors, expect other hearing aid brands to begin the integration of sensor sets into their devices. It is the future and I believe that the Starkey announcement is just the first of many.

Rechargeable Hearing Aids

Oh, rechargeable hearing aids are so last year, right? Well yes and no. The introduction of modern rechargeable hearing aids certainly occurred last year. However, we are seeing an expansion of Lithium-Ion rechargeable hearing aids this year. Starkey has just announced the introduction of a Lithium-Ion rechargeable hearing aid. I think that some of the other hearing aid brands will be looking at doing the same thing. I also think that many of the hearing aid brands will be looking at expanding their rechargeable hearing device types.

At present, most of the rechargeable hearing aids that are available are receiver in canal hearing aids. Three of the brands (Phonak, Unitron and Signia) have rechargeable behind the ear hearing aids but I expect many of the others to follow this year. I think that in the future more and more devices will become rechargeable.

What Difference Will This Make?

Rechargeable batteries offer the hearing aid manufacturers more and more power to run the features and strategies that they want to on their hearing aids. Power usage has always been a problem for hearing aid brands, many of the really fantastic features are power hungry. However, modern hearing aid batteries offer a huge reservoir of power.

It makes sense for the brands to push more of their devices onto this rich power source because it offers outstanding levels of power without causing the user any hassle.I think that the push towards rechargeable and the increasing advancement of rechargeable battery technology will allow hearing aid brands to do more and offer outstanding features that to now have been restricted because of battery drain.

Wider Connectivity Protocols

Nearly all of the hearing aid brands have now introduced Made For iPhone hearing aids. This feature was initially seen as a fad when it was first introduced, however, the market responded exceptionally well and it became obvious that every manufacturer would have to respond. While Made For iPhone, does not mean Made For Android, or at least not in the ability to stream music or phone calls, nearly all of the Made For iPhone hearing aids can exchange data with Android phones. It is this ability that has not been utilised fully yet and which I believe may change hearing aids forever.

As part of Signia’s introduction of their original Made For iPhone hearing aid, the Pure 13 BT, they introduced a deeper connection with the iPhone, not only could it stream audio but the hearing aid used information from the inertial sensors in the iPhone to change how it processed sound. This really was a brand new concept and I feel it is one of the most exciting things that has happened in the last few years.

What Difference Will This Make?

I believed that it was exciting, not because of what it does (which is kind of cool) but because of the possibilities that it conjured up. Signia had the foresight to construct a deeper integration with the smartphone, I believe that this concept can be expanded to really ensure that hearing aids use the full benefits of a connection to a smartphone. For instance, I think that in the future, hearing aid brands could offset some of the calculations and processing needed for really advanced hearing aid features to the smartphone, or even to the cloud through the smartphone.

While there are many things that need to happen for this to become a reality, we are already seeing the first steps. Wider connectivity is part of those first steps. I think that the features I have discussed here will play a bigger part in hearing aids for the next few years, I certainly think that these features will ensure a complete change in hearing devices and certainly signpost the future.

Biometric Calibration

Phonak introduced a completely new concept along with their latest in the ear hearing aids, the Virto Belong range. They called the strategy “Biometric Calibration”, in essence, the system uses the shape of your ear and its anatomy to make the function of their hearing aids better. They say that they will identify over 1600 biometric data points in and on your ear, which they use to deliver unique calibration settings for each Virto B hearing aid. In this way, Virto B is able to more reliably sense where a sound is coming from, thereby giving you access to better hearing performance.

What Difference Will This Make?

Phonak are the first ever hearing aid manufacturer to carefully map the outer ear to take advantage of its natural abilities. The outer ear naturally heightens some sounds while also helping us to identify where sounds are coming from. They say that this new process will deliver a 2dB signal to noise ratio improvement. Basically means it will make the signal (what you want to listen to) 2dB higher than the noise. While that doesn’t sound like much, combined with all the other strategies that hearing aid brands use it will be a marked improvement.

I would expect many of the hearing aid brands to look at integrating this in their in the ear hearing aids. However, I think that the strategy might not stop there, the information that is used may actually help with better function with behind the ear hearing aids and receiver in canal hearing aid devices as well.

Made For Any Phone

Phonak have been tortured by their shareholders for many years about their lack of activity on the Made For iPhone front. In 2017, they introduced Made For Any Phone hearing aids, hearing devices that would connect to any mobile phone with Bluetooth. Phonak used a unique approach to connecting to the mobile phone. In essence, it used the connection protocol used for Bluetooth headsets. This allowed a user to answer their phone from their hearing aid and talk on the phone completely handsfree because the microphones on the aid were used to pick up their voice.

Phonak have further built on this protocol in 2018 with the launch of the new Marvel hearing aids. The devices now offer stereo streaming of phone calls and audio from any Bluetooth enabled phone. More than that, the devices can be used to stream audio from any modern Bluetooth enabled device including Macs, Windows computers and even TVs.

What Difference Will This Make

I think it points the way for other manufacturers to consider innovative ways to connect directly to other mobile phones. While the Phonak system is pretty good, it does have its disadvantages. For instance, it is power hungry, while initially, the use of the Bluetooth radio meant that there was no audio streaming between the hearing aids, Phonak have overcome that with the Marvel.

I think the introduction of this system by Phonak will make all of the hearing aid brands look again at how they can deliver direct connectivity to Android phones and beyond. That connectivity offers many opportunities, as I said earlier, wider connectivity offers huge opportunities for deeper integration.

Cloud-Based Machine Learning

On the 17th of April 2018, Widex announced the launch of a new hearing aid platform called the Evoke, in a first for the hearing industry the device will access cloud-based machine learning to continually improve the user experience. Access to the cloud will be facilitated through the connection to a Smartphone and a Widex app. The app will be used by the user to make the changes to their hearing aids that the system uses to learn. Those changes will be combined with changes from thousands of other hearing aid users in order that the system learns and delivers better outcomes.

What Difference Will This Make?

in essence, my vision of machine learning has been that the hearing aid user would move through their days using an app to change settings and customise them as they move through different sound situations. Each customisation would be stored in the cloud alongside thousands of other user’s customisations and preferences. Over a period of time, these data points would be used to push changes to the automatic features in the hearing aids and the user’s experience would become seamlessly better.

I think that this concept will prove to be a huge step forward for hearing aids and I firmly believe that every hearing aid brand will adopt it in some way.

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Phonak Marvel Hearing Aids Launched in The UK, Here is What We know

As we reported, Phonak is rolling out the new Audeo Marvel across the world. On Friday the 2nd of November the devices were launched in the UK, and we learnt a little more about the range and its availability. Phonak is only introducing two of the devices initially, and they are available for pre-order right now. Phonak UK expects to be delivering those orders from November the 22nd. Let’s talk about the Phonak Marvel.

New Programmes New AutoSense 3.0

The Marvel range will have two new programmes available to it, streamed speech and streamed music. Both of course designed to get the very best from the audio streaming capability that the devices have. AutoSense (which is the management system for the hearing aids) has been upgraded again with additional training. The deeper the training that these systems are given, the better the learning and the better they work in the real world. Phonak are quoting research about improved listening ability and reduced listening effort amongst other benefits.

The Audeo Marvel RT is a rechargeable RIC hearing aid which will have a telecoil. It can be used with several receiver variations meaning it can cover a lot of hearing losses. The device will connect directly to any Bluetooth enabled Mobile phone and will stream phone calls and audio in stereo. This device will not be available until late 2019.

Expected Price

From £695.00 to £2200.00 in the UK. From €1200.00 to €3000.00 in Ireland. From $1400.00 to $3200.00 in the USA.

New Charger Cases

Phonak has also released two new charger cases with the Marvel range and a power pack.

Phonak Mini Charger Case

The Phonak Mini Charger Case, with standard USB-C charging outlet, is a compact charger for two Audéo M-R or Audéo M-RT hearing aids.

Phonak Combi Charger Case

The Phonak Charger Case Combi is a charger, drying kit and protective hard case all in one. Additionally, it includes a cleaning tool in the robust and splash-proof housing.

Phonak Rechargeable Hearing Aid Power Pack

Phonak Power Pack

For charging rechargeable hearing aids on the go, the Phonak Power Pack can be easily attached to the bottom of the Phonak Charger Case Combi.

My Experiences With The LiNX Quattro, Damn Impressive Hearing Aids

Outstanding sound quality, jaw-dropping battery life

Steve has given his review of the Resouond LiNX Quattro already; now it is my turn. In fairness, there is very little I will say here to refute Steve and his assertion that these are fantastic hearing aids, but I have a little more to add and a little more technical insight to speak from. So here goes, what the fat lad thought of the new ReSound LiNX Quattro, pretty impressive, outstanding sound quality and jaw-dropping battery life from a rechargeable.

I Love Lithium-ion Rechargeable! Who Knew?

I have realised that I love rechargeable hearing aids, in fact, I should qualify that, I Love Quattro rechargeable hearing aids. As Steve has said, “Any product with a rechargeable battery is only useful if it lasts a decent amount of time between charges, annoys the hell out of me that I have to charge my phone twice a day.” ReSound say that you can you can use the Quattro for 30 hours on a single charge. They aren’t telling fibs, I managed to use my Quattros for two full days. In fairness, that was without streaming or even a connection to a phone and it was based on twelve hours of actual in my ear use per day. I mean that is jaw-dropping. So you will easily manage a full-on day of use on one charge.

The Charger Case

The case the rechargeable devices come in charges the hearing aids. It also contains three full on the go charges in its battery pack. You charge the case with a simple USB lead. I really liked the case, it is obvious that a bit of thought has gone into the design of it. It is pleasant to hold and satisfyingly robust, it is also small enough to slip in a coat pocket or bag. The LEDs on the case allow you an instant visual understanding of the charge state of the hearing aids and the charge state of the case itself. Like I said, well designed with some thought.

Like I said earlier, I love rechargeable, but I really didn’t know that until just recently. The ease of use and the complete lack of worry about batteries was a bit of a revelation. Before now, I would have considered rechargeable devices as really a device most suitable for people with eyesight or dexterity issues, the Quattro has changed my mind about that. And using the recharger is simple, you just drop them into the charging ports in the charger and away it goes. The green flashing lights let you know it is charging.

Bluetooth streaming for phone calls, music and TV

The Quattro is a direct streaming hearing aid, a so-called Made For iPhone device. Hopefully, very soon, a Made For Android device as well. So you can stream audio from your iPhone or iPad directly into your hearing aids. Resound have a lot of experience in the field by now. That experience aligned with their more powerful antenna really shows up. The Quattro delivers an outstandingly rich, full and warm sound experience that is perhaps the most stable I have ever tested so far.

During my testing, I had no dropout or refusal to recognise or pair episodes. That’s not to say Apple won’t push out an update and make a temporary mess of course, but right now, they seem to be as solid as a rock. There is no delay in streaming, when your phone rings, you hear the ring in your hearing aids. When you answer the call, you are straight into the call without stutter. When you finish the call, it simply reverts back to the streamed audio you were playing. Or the environmental programme you were in.

Environmental Awareness

Resound have ensured that the Quattro strikes a decent balance between streamed audio and environmental sounds. You can hear the streamed audio clearly but are still aware of what is going on in the environment. You can also adjust the balance within the app yourself.

GN ReSound Smart 3D App

The Smart 3D App works with the LiNX Quattro hearing aids, the App automatically recognises that you have Quattro hearing aid and gives you some new options. As Steve has previously said, the app is relatively intuitive and it also gives you plenty of customization options. The user experience is pretty good and the GN UI (User Interface) team really need to be applauded. They have delivered a whole shed load of power to users without befuddling them. That isn’t something that is easy to do, but the Smart 3D app does it well. The App options are clearly labelled and easy to press, I think that most users should be able to work their way around it quickly enough and the app offers a lot of benefits for users who will use it, as Steve says.

The ReSound Smart 3D App isn’t a novelty that the company thought would be a good selling point (“Hey, we’ve got an App, how cool is that?”), it’s a powerful tool that gives you fine-grained control over your hearing experience, allowing you to configure your own personal setup.

The basic stuff like programme changes and volume changes are all there, but the deeper sound customisation ability is fantastic. This is where modern thought in hearing aid development really shines, giving power to the people who want it over how they hear.

A comfortable and natural sound in everyday environments

I really liked the Resound LiNX 3Ds, I mean really liked them. When I first saw the details of the Quattro, I was a bit dismissive of it. Initially, I thought that GN had really packed a lot of headline features into a beefed up 3D. Let me explain what I mean, basically they had introduced a directionality strategy that was a headliner in the profession, combined it with wider frequency response and a higher upper sound limit, which was another headliner in the profession, combined all of that with Lithium-ion rechargeability, you know where I am going with this right? I thought they were offering something that just ticked the boxes. I was wrong, again (getting to be a habit lately, maybe my wife is right! hahaha).

The Quattro sound amazing, they offer a detailed awareness of your surroundings. Noise is no longer a wall, it is a detailed soundscape, more natural, the way it should be. Even in very noisy situations, the devices handle the noise versus speech equation exceptionally well. The clarity of speech is exceptional as is the clarity and fullness of both live and streamed music. Steve says that he has noticed voices and music both have more detail to them. Even with my moderate high-frequency hearing loss, I can understand what he means.

The introduction of the impact sound manager also makes a difference to sudden hard noises. I can hear the difference when a plate bangs or cutlery is rattled. Speech understanding is excellent, I found it pretty good with the 3D, but I always liked to use the app when I was in difficult noisier situations. With the Quattro, I don’t spend much time with the app, it just kind of works.

When in noisier situations you are able to hear who you are speaking to relatively well, the remarkable thing is that the typical wall of noise has been transformed to a multi-faceted soundscape, just as it should be. I can hear the conversations going on around me. Not nuanced enough to know what they are saying, but I shouldn’t be able to. But it isn’t just a background wall of noise or speech babble any longer.

The Sound of Music” (yes I went there)

The sound quality of Music is outstanding, both streamed and live. It is difficult for even a professional like me to discuss sound quality. Finding the right universal words is difficult. The Quattro hearing aids add to the experience that the 3D provided. The 3D offers real clarity and warmth, but the Quattro provides even more than that. I hate to echo Steve here, and it is a bit trite, but it really does provide more layers of sound. It really is about the awareness of subtle changes in music or tone, the Quattro really delivers the ability to be aware of them.

An excellent hearing aid

The Quattro really is a fantastic offering from Resound. As I said earlier, it does offer many of the headline features that people are excited about in the profession. However, ReSound haven’t just bolted on features to an existing aid for headline status. They have intelligently re-designed and engineered their device to offer market leading features in a very attractive package.

I really liked the Quattro, day to day sound was excellent and the streaming experience is amazing. Being able to throw it in the charger and forget about batteries is much more fun than I ever would have imagined and the carrying case is a fantastic innovation. All round, these devices are pretty damned good and I would really have no issue with recommending them to anyone.

Oticon Introduces Kaizn, A Personal Assistant For Hearing Aids

A Step Towards an Integrated Lifestyle

I think the picture is a bit dodgy, but how and ever, that’s marketing people for you! I for one am celebrating the introduction of Kaizn from Oticon. Not because of what it is. Although that is something of real power. But for what it portends. Great word portent, satisfyingly mysterious. Anyway, what I mean is that Kaizn is a step towards the day when your hearing aids are your personal assistant. Where your hearing aids facilitate and are deeply integrated into your life. That is something worth celebrating. Let’s talk about what Kaizn does and what I hope something like it will do in the future.

Imagine

The blurb goes “Imagine a hearing aid that gets to know you. Using data from other devices, your hearing aids can tell that you’ve entered a restaurant and adjust accordingly. By accessing collected data about your habits, they can even predict when you’ll enter this restaurant and adjust proactively.” and that is our introduction to a new concept in personalised hearing care.

Oticon says that Kaizn is an AI-powered tool that learns to automate hearing aids settings based on wearer’s preferences and behaviour. Still mystified? Kaizn is an app that lives on your Smartphone. It connects to your Opn hearing aids and it uses a combination of real-time local data, aggregated ‘big’ data and artificial intelligence to deliver the best sound experience.

Basically and in non-tech babble, the app collects and analyses data about your hearing aid use and the different listening environments you find yourself in to learn your behaviour and hearing preferences. It will then provide real-time hearing aid recommendations and adjustments. It communicates with you through notifications at key moments to learn what you want to gain from different sound environments. Oticon gave a prime example of how Kaizn may work:

Kaizn™ will recognize when a hearing aid wearer enters a noisy environment, like a loud restaurant, and will contact the wearer, via a push notification, to ask whether they need “focus” or “comfort” in the scenario. Kaizn™ will then adjust the user’s hearing aid settings to reflect that preference. Over time, Kaizn™ can automate adaptive changes based on the user’s feedback/validation and adjust the user’s Opn hearing aid settings automatically when they enter similar noise environments.

Making Your Experience More Personalised

The system will make your experience better over time, it will personalise your experience to you and your preferences, more than that, Like the system from Widex, it will make all Oticon hearing aids moving forward better at what they. As I said, that is something to be celebrated. But I want MORE!!!!!!! hahahahahah, like a power-drunk six-year-old, I would like some more, please.

A True Personal Assistant

I really like this, again, not just because of what it is, but also because of the deeper thought it shows. I think that hearing aids are on their way to deeper integration, I mean why can’t hearing aids tell you what your schedule for the day is and what the weather is like every morning?

Why can’t the use geo-location data from your phone to give you information about where you are when travelling? Tell you more about the places you visit, give you the reviews of the restaurant that you are standing outside? All of this could be done, I mean it would take some deep thinking, some development time and a committed team, but the ability to do it is there.

It is a case of tying some existing Smartphone functionalities and apps together and delivering their data through audio. Okay, that’s a simplistic version, but I think the day is coming, and I celebrate that even more.

New Invisible Hearing Aids From Bernafon Suitable For More People

I attended the UK launch of the new custom hearing aids from Bernafon a while ago and learnt the outline of what would be on offer. At EUHA recently I stopped by the Bernafon stand to learn a little more about the new invisible hearing aid and to get a rundown of their early experiences with it. I was talking to some of the guys from the International department and they were telling me about some early testing they had undertaken that was focused on the suitability of the devices. Historically, IIC (Invisible In Canal) hearing aids have not been physically suitable for many people mainly because of the size and shape of their ear canals. Bernafon believes that their new device will fit close to 80% of ears. Let’s talk about what they have found so far.

Suitable For More Than Ever

The guys told me that they had a run an early trial to get a clear idea of what effect the new smaller size would have on the suitability for fit. So they had some of their customers send them early orders so they could run them through. They were surprised to find out that they could fit all of them with the new IIC, they were really not expecting that. While they can’t be sure from such a small test case, it does bode well for the suitability of the hearing aids for more people than ever.

Who is The IIC Suitable For

First, let’s talk about the technical suitability for hearing loss types. The new invisible hearing aids will fit hearing losses from mild all the way through to severe to profound.

Although, that does depend on the size of the speaker they can fit into the hearing aid. So technically, they can fit a whole lot of hearing losses. I spoke to the lads about more typical high-frequency hearing losses. Quite often when someone has a high-frequency hearing loss, they have really good low-frequency hearing. With that type of hearing loss, we have to be careful about closing off the ear canal because people suffer from occlusion problems (the feeling of their ears being stuffed up).

The lads from Bernafon say that there are two possible ways that the new invisible hearing aids can deal with this. Because of the smaller size of components, there is a good chance that the device can be inserted deep into the bony portion of the ear canal. This has been the traditional way to beat occlusion but it has been hard to actually deliver. The new sizing of the IIC should allow this to happen now for more people than ever.

The second way to deal with occlusion is through venting of a hearing aid, in essence putting a hole through it, the larger the better. Again, the new size of the components ensures that there is more space to put a larger vent and they have a fascinating new vent system that we will talk about here later which again means that they should be suitable for this type of loss.

In essence, it all means that the new Bernafon invisible hearing aid should be suitable for a great many people. The best part, they are now available to order in the UK and across the world.

The Gold Standard in Hearing Aid Fittings

Live Speech Mapping and Real Ear Measurements, Why You Need Them During Your Hearing Aid Journey

In a conversation with Steve recently it became obvious that we hadn’t taken a real stand on a subject that is important to us. Looking back at it, I don’t really know why we haven’t done it before now. The subject is probe tube measurements of hearing aids. They are more commonly called Real Ear Measurements (REMs) and Live Speech Mapping. They are elements of hearing aid verification and validation. They are the best practice, gold standard in hearing aid fitting. They are a proven strategy for increasing satisfaction with hearing aids and have been for many years. In fact, as a consumer advice site, advising you of what they are, what benefit you will derive from them and why you should demand them is really our job. Well, we may have failed you up to now, but we are fixing it today. Let’s talk about what they are, how they are done and why you aren’t getting the best service if a hearing care professional doesn’t carry them out for you.

Probe tube or real ear measurement set-up

In the image above, much thanks to Auditdata (a manufacturer of real-ear measurement equipment and audiometers) for the use of it, you can see a lady sitting with a Probe Tube measurement system on her ears. You can just make out the white tube inserted into her ear canal which is used to measure the sound close to the eardrum. Before I go into how let’s talk about why.

What do REMs and Live Speech Mapping Offer?

They are forms of verification of a prescriptive target and validation of a prescriptive target. Let me explain the difference. Real Ear Measurements are designed to verify that the hearing aids in your ears are actually hitting the targets prescribed by the fitting prescriptions Nal and DSL. Those fitting prescriptions have been with us for many years and in the clinical world, they are accepted as the very best fitting prescriptions.

However, not everyone agrees that in the modern world of hearing aids, that Nal or DSL is still the best way forward. Some people, like me, think that hearing aid manufacturers often use their own fitting prescriptions because they know their hearing aids best. With that in mind, we need a test to see if those non-standard (as such) prescriptions deliver the speech signal needed to help people.

We can’t use REMs to verify because all REM protocols are designed just for Nal and DSL, however, we can validate it using live speech mapping to ensure that a controlled speech signal is amplified into the residual hearing envelope of a Patient. For me, and it is only a personal opinion, live speech mapping is the better option. That is mainly because I am not necessarily beholden to Nal or DSL.

Why are REMs and Live Speech Mapping Important?

These tests are important because they verify or validate that the hearing aid is actually providing the sound that you need to hear better. The settings take your hearing loss into account and provide the calculations for the amplification needed to deliver for you. Then when we run the tests they actually assess what is going on in your ear canal. There is no guessing, no trusting the hearing aids to just work, it is a clear assessment of whether they are delivering or not.

This allows us to make real-time changes to the hearing aid settings to ensure that they do deliver exactly what you need. More than that, all of the studies undertaken into the use of verification and validation within hearing aid fittings show that people get on better and are more satisfied with their hearing aids when it is done.

The Possible Pitfalls

Here is the thing though, when we use these tests we get the hearing aids to the optimal settings for your hearing loss. You actually might not like the sound, in fact, you might hate it and need it turned down. That’s okay, that’s fine, I will explain to you that you won’t get the best possible experience but we can help you work towards it during your rehabilitation. Just because you might not like the sound, doesn’t mean I shouldn’t do it, and anyone who uses that excuse is talking rubbish. Utter and contemptuous rubbish.

How is it Done?

Both test procedures are done in a similar way, we use a probe tube system, most are exactly like the one in the picture above. There is a probe for each ear. First, we calibrate the probe tubes by holding them in front of a speaker which plays the calibration tones. This doesn’t have to be done every time, just after the probe tubes have been changed. Normally, we would only use the probe tubes for one person, then throw them away.

After the calibration, we would hang the system from your ears and place the probe tubes in your ear canals. We are trying to get them within 5mm of your eardrum. To do so, we would normally check the positioning visually. Once that is done, we play different test signals through the speaker to assess what is happening. This can be done with no hearing aids in, with the hearing aids in and turned off and finally with the hearing aids in and turned on.

The results are shown on our computer visibly and we can see clearly where the amplification is missing the targets if that is the case. Sometimes, the amplification might not be enough, sometimes and in certain ears, we see that there may be too much amplification at one or more points. You know what, sometimes it is bang on target. In fact, more often than not in the last few years, it is more or less bang on target.

Here’s the thing though, we don’t and can’t know that for sure. So the fact that many modern hearing aids perform in the ear as they should. Is not an excuse not to undertake the test. Again, anyone who says it is is speaking utter rubbish. I have heard many excuses for not performing probe tube measurements on hearing aid users. They are generally all utter and contemptuous rubbish. Dr Cliff Olson AuD has a couple of great videos on the subject on Youtube. In one, he identifies and refutes each excuse. Let’s take a look at those excuses and his answers:

Bad Excuse #1. New hearing aids are so advanced that they can self-calibrate to your hearing loss. If you truly believe that a hearing aid self-calibration could perfectly fit your hearing loss, then why would you need a hearing care provider at all? The truth is, even hearing aid manufacturers themselves advise providers to perform Real Ear Measurement. They request this because they know more hearing aids are returned for refunds when these measurements are not performed.
Bad Excuse #2. Real Ear Measurement is only for complex cases of hearing loss. Yes, some hearing losses are more complex than others. However, all hearing losses have a prescription that must be met. Does a surgeon only wash his/her hands before “complex” surgeries? No, they wash their hands for all surgeries because best practices indicate that they should. Complex or not, the only way to ensure that your hearing loss prescription is being met is to perform Real Ear Measurement.
Bad Excuse #3. Real Ear Measurement can’t be used in cases of Single Sided Deafness (SSD). When you have SSD, some of your treatment options included CROS and BiCROS. This is when sound is taken from your deaf side and sent to your better hearing ear. This helps to overcome headshadow effects. It is comical to think that you wouldn’t need to verify if the headshadow effect has been compensated for and if a prescription for hearing loss in the better ear has been met.
Bad Excuse #4. Real Ear Measurements don’t provide any additional benefit over not using them. Yes, in some cases default programming of hearing aids will provide some hearing benefit. However, research study after research study indicate that performing Real Ear Measurement provides consistently better outcomes than not performing them. In a study be Levitt and Flexor (2012), the performance of seven hearing aids were compared with using REMs and without using REMs in a background noise. In every device, the performance in background noise was better when Real Ear Measurement was used. Even the Old Analog hearing aid programmed using REMs outperformed all of the Premium Digital hearing aids that did not have these measurements performed on them.
Bad excuse #5. Real Ear Measurements are not repeatable. This is probably the worst excuse of them all. The claim is that from measurement to measurement, you will get different results. However, any Real Ear equipment that has been properly calibrated is designed to function within a specific +/- range of repeatability. They even have reference microphones to ensure that the sound coming out of the loudspeaker is at the correct level throughout the measurement. Just to be clear, there is no test in the history of the world that doesn’t have at least some variability. The question is, does it fall within the pre-determined realm of acceptability? With Real Ear Measurement, the answer is YES!

DR Cliff Olson AuD: 5 WORST Excuses to NOT use Real Ear Measurement

When Should it be Done?

The answer to that is when you are to full prescriptive level, that could be at the first fitting or it may be later, let me explain. If you are new to hearing aids, most professionals will not fit you to your prescription level at the beginning. You simply wouldn’t be able for it. You would find it uncomfortable and loud. To manage that, we tend to fit you to a reduced level and over a varying (varying because it depends on the Patient) amount of time we would move you to the prescriptive level.

It is then that the process should happen because it is then that we have reached the best possible amplification for your hearing loss. Therefore, that is the time to test the outputs in the ear. If you are an existing user of hearing aids buying a new set of hearing aids, well then we might fit you to prescription immediately. If so, well then the process should be done at the fitting.

The Best Possible Outcome

If I am committed to delivering the very best possible outcomes for my customers, I need to undertake some sort of probe tube measurement be it REMs or Live Speech Mapping. It is only then that I can be confident that I am delivering what is needed to deliver the parameters for the best possible outcome. Having said that, in some cases, even after delivering those parameters there can still be problems.

Hearing and hearing ability is unique. Sometimes people with treatable hearing losses have problems understanding speech in noise no matter what is done with their hearing aids. This is a function of an underlying problem in the hearing area of the brain and no matter how well the hearing aids are fitted, they may struggle to help. Here’s the thing though, we, and by that I mean the professional and you the user, will never know that is the case unless we have clear and irrefutable evidence that the hearing aid is performing at it’s best. Irrefutable evidence that it is doing exactly what it should in the ear canal of the user. The only way to gain that irrefutable evidence is through probe tube measurements.

I echo Cliff Olson when he says “I find it sad that some hearing care providers feel the need to fabricate excuses as to why they don’t feel the need to perform Real Ear Measurement.” We have known for years that all the studies support it as a best practice. In fact, Best Practice guidelines indicate that probe tube measurements are the Gold standard for hearing aid verification and validation.

Find A Provider Who Does

It is our best advice to you, knowing what we know, after studying the studies available, and indeed through my own experience fitting hearing aids, that you need probe tube measurements as part of your hearing aid journey. It is our best advice to you, to find a hearing care provider who does offer them when you are purchasing hearing aids. Ask any provider you deal with, do they offer probe tube measurements, if they say no, tell them you will go somewhere else.

In a later article, I want to cover the study evidence that is available in relation to this subject. Don’t worry, I won’t bore you with blah, but I will arm you with the relevant information. Below is the Youtube video from Dr Cliff Olson AuD on the worst excuses. He has done a couple of videos on Real Ear Measurements, simply search Youtube with the term real ear measurements to find them all.

FDA Gives Approval To Bose For Marketing of Self Fitting Hearing Aid

Today, the FDA announced the approval of the “Bose Hearing Aid”, a new self-fitting hearing aid. Bose has been granted an unprecedented position by the FDA, the FDA has given Bose permission to market their new Bose Hearing Aid as a self-fitting hearing aid. The regulations governing this type of device do not exist and right this minute the over the counter (OTC) hearing aid regulations have not yet been finalized. We spoke in 2016 about initial forays into the amplifier market by Bose in the article “BOSE HearPhones, Hearing Aids?” It appears that Bose has decided to enter the over the counter hearing aid market as soon as possible and the FDA appears to be facilitating them.

The FDA press release follows:

The U.S. Food and Drug Administration today allowed marketing of a new device, the Bose Hearing Aid, intended to amplify sounds for individuals 18 years or older with perceived mild to moderate hearing impairment (hearing loss). This is the first hearing aid authorized for marketing by the FDA that enables users to fit, program and control the hearing aid on their own, without assistance from a health care provider.
“Hearing loss is a significant public health issue, especially as individuals age,” said Malvina Eydelman, M.D., director of the Division of Ophthalmic, and Ear, Nose and Throat Devices at the FDA’s Center for Devices and Radiological Health. “Today’s marketing authorization provides certain patients with access to a new hearing aid that provides them with direct control over the fit and functionality of the device. The FDA is committed to ensuring that individuals with hearing loss have options for taking an active role in their health care.”
Approximately 37.5 million adults aged 18 and over report having some trouble hearing without a hearing aid, ranging from “a little trouble” to “deaf.” Hearing loss can be caused by aging, exposure to loud noises, certain medical conditions and other factors. Hearing loss may be permanent or temporary. Individuals with permanent hearing loss can use hearing aids to help them hear the speech and sounds around them better, enabling them to communicate more effectively with others.
The Bose Hearing Aid is a user-fitted wireless air conduction hearing aid. Air conduction hearing aids work by capturing sound vibrations through one or more microphones. The signal is processed, amplified, and played back through an earphone placed in the ear canal. Patients can adjust the hearing aid through a mobile application on their phone. This technology enables users to fit the hearing aid settings themselves, in real-time and in real-world environments without the assistance of a health care professional.
While users may fit, program and control the Bose Hearing Aid on their own, the device must comply with applicable federal and state laws regarding the sale of hearing aids, including state laws that might require hearing aids to be purchased from or dispensed by a licensed hearing aid dispenser. The FDA is in the process of drafting proposed regulations for a new category of over-the-counter hearing aids as required by the FDA Reauthorization Act of 2017.
In authorizing marketing of the Bose device, the FDA reviewed data from clinical studies of 125 patients, which demonstrated that outcomes with self-fitting of the Bose Hearing Aid are comparable on average to those with professional fitting of the same device with respect to the amount of amplification selected, speech in noise testing and overall benefit. In addition, when participants self-fit the Bose Hearing Aid, they generally preferred those hearing aid settings over the professionally-selected settings. The Bose Hearing Aid has been labeled to inform the consumer when to consult a hearing health care professional.
The Bose Hearing Aid was reviewed under the FDA’s De Novo premarket review pathway, a regulatory pathway for some low- to moderate-risk devices that are novel and for which there is no prior legally marketed device.
The FDA granted marketing authorization of the Bose Hearing Aid device to Bose Corporation.

In essence, this approval means that Bose can market these devices as hearing aids and they can be purchased in states that allow it. In states that regulate the supply of hearing aids through professionals, the devices will have to be purchased from a professional.

At the time of writing, there were no images or full outlines of what the new Bose hearing aids would be. It is hard to tell from the press release if the devices will be hearing aids as is commonly understood or headphones like their HearPhones devices. As more information becomes available, we will update the article. We have spoken before about our belief that self fitting hearing aids may well be the future of hearing aids in the article “Are Self Fitting Hearing Aids The Future?”.

First Ever Hearing Aid Know Podcast is Now Live

Well, don’t blame me, Steve made me do it, just be thankful it is audio and not video, I draw the line at a video. What am I talking about, our first ever podcast for Hearing Aid Know. The first of many, we plan to undertake regular podcasts to accompany our articles. It makes sense really for us, while we believe the articles are very important, to get all of the information across sometimes would take thirty feet of text. So we plan to drive the core information in the articles, and where it makes sense, deliver the wider picture in our podcast. The topic of our first podcast, is hearing loss.

Hearing loss is pretty much misunderstood by the general population, and I think the reason for that is our cultural understanding of hearing loss. Our cultural understanding of hearing loss is formed by what we see on TV or the theatre stage, or perhaps what we hear on the radio. Generally, we believe that hearing loss is all about volume, well, it isn’t. In general, hearing loss is actually about clarity.

Most run of the mill hearing losses begin in the high-frequency area, this area of hearing is responsible for our perception of consonants in speech. Without consonants, speech is basically mush. In the podcast, I explain it in a little deeper manner, and I also explain why you can hear some sounds really well.