HEARING AIDS GO HIGH TECH.

Byline: Jillian O'Connor Staff Writer

Forget the hearing aids of the past - those clunky devices that amplified every little sound and made it all but impossible to hear a conversation in a crowded restaurant.

Today's models are smaller, sleeker and with vastly improved sound, thanks to digital technology that allows wearers to discriminate differences in noise level.

They're ``basically little computers,'' says audiologist Jeff Grama, the owner of Hearing Aid Services of Hollywood. Digital models often run multiple programs simultaneously to deal with various sound environments, such as crowded restaurants or stores, using spectral analysis to determine appropriate settings.

The switch to digital also has resulted in some tiny in-the-canal models attractive to many, especially those who don't want the device to be noticed by others.

But the small size comes at a price, with typical digital models running from about $2,500 to $3,500 per ear, and roughly 80 percent of users requiring a hearing aid on each side. However, conventional hearing-aid models can be procured for as little as $600 to $700 each.

Despite advances in hearing-aid technology, the devices are used by only a quarter of the 28 million Americans believed to suffer from hearing loss. And after age 65, as many as 1 in 4 people may need to use a hearing instrument. But many senior citizens, unaware of the new technology and wary of negative stereotypes, refuse to wear them.

In the past, hearing aids were troublesome in certain situations. When a wearer received a hug, for instance, the devices would often beep loudly. With new, intelligent digital technology, that problem has been thwarted and the startling beeping is down to a minimum.

``Now the longest you would ever hear anything would be maybe a tenth of a second, which most people wouldn't even recognize as being a sound,'' said Grama.

An added benefit is the increased subtlety of sound and clarity the new technology provides, according to David Fabry, vice president of education and public relations at the hearing-aid company Phonak and the former president of the American Academy of Audiology. Soft sounds are soft, and louder sounds do not become uncomfortably loud.

``Many hearing aids in the past have not really achieved that,'' said Fabry, who noted that the older models merely amplified sound. ``And through the use of digital, and a number of the signal-processing features that come along with that, we're providing a person with hearing loss the same capability, to offer dynamics of sounds that someone with normal hearing would (perceive).''

Phil Kaplan, 61, was born hard of hearing and has been using hearing aids for nearly 50 years, starting with the large behind-the-ear model that was commonplace at the time.

``It mainly was an amplification tool,'' said Kaplan, who is the president of the San Fernando Valley chapter of Self Help for Hard of Hearing People, or SHHH. ``All it did was increase sound. It didn't do much qualitatively. And it didn't have a lot of flexibility.''

But today, Kaplan owns a behind-the-ear digital model, one that he points out is precisely matched to an individual patient's needs. ``Fifty years ago, you could not do that,'' he said. ``All you could do was crank up the volume.''

He finds the newer hearing aids help him hear conversations even in loud restaurants and crowded stores, whereas before the devices just made everything louder.

But since it's always mechanically reproduced sound, Kaplan said, it can be ``tinny'' since hearing-aid technology still has ``even bigger strides'' to make.

One concern audiologists said they hear again and again from patients is a fear of being negatively judged for wearing a hearing aid - especially being thought of as old.

``Many people associate hearing loss with getting older, and many people don't want to,'' said Fabry. ``As we have baby boomers who are living longer and working longer, the idea of wearing a hearing aid might be seen by some as a sign of weakness - in some way, you're not going to be able to do your job as well as that young Gen-Xer who wants your job.''

As former Valley SHHH president Beverley Gaines, 76, of Van Nuys was quick to point out, hearing-aid wearers win in the trade-off: ``My philosophy is, I don't care who knows I'm wearing a hearing aid - as long as I can hear.''

In addition to wearing a hearing aid, Gaines helped start a lip-reading class in the Valley. ``I'll tell you this: It's not easy to learn to lip read because everybody in California is from a different state,'' she said with a laugh, underscoring the need for a little machine assistance.

A commanding presence behind hearing aids hasn't hurt, either, as Presidents Reagan and Clinton, who both used the devices in office, made the instruments more high-profile and more accepted, according to Grama.

``I guess we need more presidents who don't hear well,'' he said.

Karen Spayd, a California State University, Northridge, audiology lecturer and clinic supervisor, said that hearing loss is often gradual and can have a variety of causes - and it's not always apparent to a person that he or she has lost hearing until communication with family and friends suffers.

``We try to tell our patients that the hearing aid will provide better quality of life,'' said Spayd, noting that not hearing well can have ramifications beyond missing a few words.

``If you let the hearing loss go, the hearing loss is associated with not only communication breakdowns but depression, isolation and other factors.

``And all that can be avoided by just having a hearing aid.''

Unfortunately, the cost of a hearing aid is a major concern for many. Apart from some union plans, most insurance options do not cover the cost of hearing aids, much to the chagrin of hearing-aid users and audiologists.

But as audiologist Rose Bongiovanni, director of training and development at the hearing-aid company Widex, explained, digital devices, which typically last four to six years, can pay for themselves as audiologists can tweak the instruments to match a patient's changing hearing ability over time.

Even with the new advances, though, patients do not always heed their audiologist's recommendations to get help for their hearing in a timely fashion.

``Research has shown that from the time a hearing loss is diagnosed to the time a person does something about it, it is seven years,'' said Spayd. ``That's seven years of not having good quality of life.''

As Carol Fee, a senior citizen who uses a digital model, summed it up: ``If you want to communicate, get a hearing aid.''

Jillian O'Connor, [phone]

jillian.oconnor(at)dailynews.com

Useful links for hard of hearing

--www.hearingloss.org: National Web site for SHHH, Self Help for Hard of Hearing People, which distributes a magazine on hearing issues to members.

--www.shhhca.org: California State Association of SHHH. Provides link to more than 15 chapters in Southern California, including Van Nuys, Burbank and Encino.

--www.ddtp.org: Deaf and Disabled Telecommunications Program, mandated by state Legislature and run by the state Public Utilities Commission. Provides access to various telephone services for the hard of hearing and deaf, among others.

--www.leginfo.ca.gov: Links to California's SB 724, which would allow CSUN to grant a clinical doctorate of audiology, which will become the required degree for all American audiologists in the next few years. There is currently only one audiology doctorate program in the UC/Cal State system, and many fear that there will be a severe shortage of audiologists in California once the new standards are in place.

Signs of hearing loss

You should have your hearing checked by an audiologist if you experience any of the following problems:

-- Complaining that people are mumbling or speaking unclearly or too rapidly.

-- Having problems with understanding speech when there's background noise.

-- Experiencing problems hearing on the phone.

-- Asking people to repeat themselves often.

Hearing aid lexicon

In the ear (ITE): Rests in ear; may fill exterior.

In the canal (ITC): Rests in ear canal and extends into ear.

Behind the ear (BTE): Hooks onto top of ear and rests behind it.

Completely in the canal (CIC): Inserted in ear canal; nearly invisible.

Digital programmable: An individualized digital model that can run programs for different environments, such as in crowds or at home.

Wireless microphones: Often worn on neck or elsewhere away from hearing aid.

Directional microphones: Help to filter noise and offer ability to tell where sound is coming from better than traditional hearing aids. Usually offered in the larger models.

CAPTION(S):

3 photos, 3 boxes

Photo:

(1 -- cover -- color) HEARING AIDS

Smaller, sleeker and with better sound

(2) Digital technology has made hearing aids better equipped to filter unwanted noise. Experts hope the advances will help reduce the stigma many people associate with the devices.

Tina Burch/Staff Photographer

(3) Hearing aids come in a variety of styles, depending on an individual's lifestyle and listening needs. From left: (BTE) Behind the Ear; (ITE) In the Ear; (ITC) In the Canal; (CIC) Completely in the Canal.

Box:

(1) Useful links (see text)

(2) Signs of hearing loss (see text)

(3) Hearing aid lexicon (see text)