The Stakeholders Forum held in Buffalo in 2000 addressed some issues faced by hard of hearing individuals. Who these individuals are, current devices used by them and the pros and cons of the current devices are all discussed in this article. Requirements for new products addressing unmet needs of hard of hearing individuals are established and a day-by-day breakdown of the forum, complete with concluding comments, is given as well.
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Who are "hard-of-hearing" people?
A snapshot of the current
Besides shrinking in size, the sophistication of the electronics has advanced in an attempt to boost the ability of the aids to process the sound and adapt it to the individual's particular deficiencies. Some digital devices contain mini-computers, which can be programmed via remote control units to automatically adjust amplification volume for changing conditions. As the devices have diminished in their dimensions, their price tags have ballooned, and tend to range from $850 to over $2,500.
problem with hearing aids
Assistive Listening Equipment
Without getting into detailed discussions or critical comparisons, these are currently the three most popular modalities for assistive listening:
Problems with ALSs/ALDs
Just as with hearing aids, a better technology can supplant the status quo, (e.g., the once-viable AM Broadcast ALDs are no longer found in communications equipment catalogs in the US) – but who will discover and develop the good ideas?
Getting things moving...
Our response: a meeting of minds
The Forum's specific purpose was to identify and validate unmet consumer needs, business opportunities, and specifications for technology solutions that would meet these needs. The anticipated ultimate outcome for this project is the introduction of innovative products and technologies that will have a significant, positive impact on persons with hearing disabilities.
Dr. Stephen M. Bauer of the University at Buffalo, the organizer of the Stakeholder Forum and co-Director of the T2RERC, succinctly described the paradigm behind the Forum and its subsequent activities. "The technology transfer process permits us to leverage investments which have already been made in the nation's science and technical base. As it will permit us to target specific technologies which require substantial improvement, we expect the Stakeholder Forum to generate opportunities for applying breakthrough technologies to the Hearing Assistance Industry."
Laying the groundwork
An industry profile was created for the hearing aid and assistive listening system industry and markets. "White papers" were written for each of the above technology areas, drawing upon information derived from interviews, panels, the industry profile and other sources. Provided to all participants prior to the Forum, these white papers summarized customer needs, the business opportunities to be realized, and the state-of-the-practice for each technology area.
This preparation won praise from Forum attendee Russ Thoma, a representative of Etymotic Research of Elk Grove Village, Illinois, a developer of circuitry and components used in hearing aids. "The preliminary information that was gathered prior to coming to this (Forum) with some of the general backgrounds of what we wanted to cover was a starting point. And then by bringing the mix of people, the consumers, the manufacturers, the different related industries together, sorting and sifting the mix, I think it was done quite appropriately."
The guest list garners kudos
The importance of involving a number of end-users of the equipment was described by David Baquis, Director of the National Center on Assistive Technology of the grass-roots advocacy group Self-Help for Hard-of-Hearing People (SHHH). "It's very important that consumers had representation here, today, because there (are) things that professionals, both in the fields of hearing/healthcare, as well as the electronics field, the pro audio industry, don't fully understand unless they hear the consumer perspective, and specifically the perspective of hard-of-hearing people. We can talk about some of our preferences and some of our problems, things that you wouldn't know unless you had direct practice in using devices … unless you've actually experienced certain frequency losses, first-hand."
Dr. Charles Laszlo, PhD, a researcher at the University of British Columbia's Institute for Hearing Accessibility Research, in Richmond, BC and Chair of the student-run business, Assistive Listening Device Systems, Inc. was enthusiastic about the effort to achieve diversity. "It is of great interest to me to see the different viewpoints that emerge; there are manufacturers, researchers, consumers all together, talking about the same topic. And there are always some interesting aspects that emerge that we didn't think about. And so, to one it's a marvelous way of sharing my experiences and expertise and, at the same time, receiving the various viewpoints of people, all of the different stakeholders. In many ways, this is the purpose of this getting together, and I think it's very well served."
Earmold section facilitator Brian Kon, who is President of AZtech, a T2RERC member agency, shared the feeling. "It's a unique chance for equipment consumers, researchers, third-party reimbursement agencies, and company representatives who rarely meet face-to-face to understand the implications of these developments to each others' interests."
Buckling down to business:
After the first set of concurrent discussions, Jeanne Stiernberg, a business development consultant to manufacturers of professional audio equipment, from Sherman Oaks, California, expressed the enthusiasm many felt for the Forum. "I think that it's extremely well organized, well run, and very focused as far as what each group's mission is. And I think because of that and because of the diversity of the people participating in the group, there's going to be a lot of interesting outcomes to this. I'm curious to know if … in the overall process, the Stakeholders meeting step is to confirm or add to some assumptions that already exist. And I'm betting that there's going to be some new assumptions to validate here."
Another inflamed with Forum Fever was Richard Carmen of Sedona, Arizona, who is a clinical audiologist and Editor of the popular collection A Consumer Handbook on Hearing Loss and Hearing Aids: A Bridge to Healing. "This is a great mix and blend of professionals and consumers… My particular group, I thought, went very well. It was enlightening to hear some of the complaints of the consumers, as well as some of the idealistic solutions that we might be able to approach as professionals and scientists and researchers…
"My report of evaluation and assessment of the program yet was excellent. It's gone very well. If the technology can be transferred to manufacturers and get into production, some of these ideas are very useful, definitely. To sum my experiences up here so far, I think this is a clearly unique program, an opportunity for all involved. I think it is a very worthwhile project."
And Day Two followed…
Robert Bellinger, the Chair of the Inventions Evaluation Board at the Naval Undersea Warfare Center at Newport, Rhode Island seemed impressed with his fellow Forum attendees. "Generally speaking, I'd say that this is a very involved group… Everyone seems to be dedicated, and I'm delighted to be here, because I hadn't seen many groups with so much dedication in a long, long time."
Corporate representative Russ Thoma was upbeat as well. "…Sometimes you need to have the different organizations that are centered around the disability (listen to) the hard-of-hearing individuals' reminders, and I truly believe that this was a very positive conference for that. I haven't always been involved in a lot of the different discussions that go on, so it was a great opportunity to hear some of the new topics that were being talked about. And so it will be an opportunity for me to take it back and share it with our staff back at the office."
Wrapping it up with a bow
Dr. Charles Laszlo considered its consequences. "Most of the things that we have discussed are known, either explicitly or implicitly, but I think that the main purpose and the main value of this (event) will be that it was systematized to some extent to (clarify) what we seem to know in bits and pieces. And it helps a little bit to exchange ideas on things that concern people in different parts of this group. Our customers have a particular set of concerns and sometimes these are not fully understood by manufacturers. One of the issues that's definitely emerging in my mind is the need to ensure that consumers, hard-of-hearing people in particular, have full access to the benefits of this technology...
"We have exchanged ideas and there was some interesting information that I was not privy to, before. Now I have learned about something, and the very fact that we could talk about this in an open forum, and with the understanding and within the framework that was specified: that we look at the current technology. What are the impediments of improving it and which direction we may move? I think that this is a very important thing; something that we can take back with us and think about. I do believe that, apart from the fact that there will be an outcome of possibly a report, we all go back with some thoughts that we can discuss with others and perhaps something has been generated that wasn't there before. I think it's very positive."
An even more upbeat view was offered by the Forum's Co-host, Principle Investigator of the RERC on Hearing Enhancement, Dr. Matthew Bakke. "I was very pleased with the discussion. I thought there were a lot of great ideas that got thrown around, at least in our session. And the information has been carefully documented. It exists not only in a transcript of the meetings but also in highlighted notes about the major ideas that we wanted to preserve from the meetings. So, I think that, if the people in the Buffalo RERC are able to take these ideas and formulate them into very clear statements of need, I think the outcome could be terrific. I'd bet a lot of money that at least one very advanced technology is going to come forward that's going to help with some of these problems." The Forum exceeded all of his expectations, and "(he came in with) very high expectations."
David Baquis expressed those collateral benefits quite specifically, "It was very important for consumers to hear some of the terms defined and some of the products that are available on the market, so we can bring that (encouraging) knowledge and effective solutions back to our membership. And be able to respond in new and different ways to people who bring various frustrations to us. …It's really important for engineers who are trying to develop new technologies to understand some of the very basic frustrations, about how sound can spread to a wide area, in that, we can't pick it up in a very pointed way with a beam that might be as narrow as a flashlight. … On the other hand, it was pleasing to hear how far we've already come with technology and some of the more specific ways that we think we can tweak it for ourselves."
A ringing concurrence came from Russ Thoma in the manufacturer's corner. "(Taking part in the Forum) gives us a great reminder of what it's really like for the person. Most of the conversation, from a manufacturing viewpoint, has always been with the audiologist, the person who has to deal with the patient at the frontline … we try to get the aftermath or the feedback from the hearing professionals who are dealing with the end-users and try to solve their problems. .... I don't usually get an opportunity to deal with the end-user, the individual's problems. … The different frustrations of the people who have had all different levels of hearing impairment, from the mild to moderate loss, to the person who has had a cochlear implant, the person who has had to deal with different assistive listening devices, and all the problems that they've experienced."
Similarly, clinical audiologist Richard Carmen noted, "It gives me a broader perspective on the needs of the consumer. (While) my own patients may be reluctant to complain about a particular system, the consumers here want to complain; that's why they're here."
until the paperwork's
Brian Kon describes his organization's contribution to the event. "As a partner in these technology transfer stakeholder forums, AZtech brings experience in facilitating the process of identifying and clarifying the needs of the stakeholders, in order to draw out the innovations of the Federal Laboratories, …and other cutting-edge researchers. Our role in the Forum will be translating the needs of the stakeholders into technical problem statements for use in identifying the new technologies and design ideas, which can address those needs in a commercially viable product."
Personnel from the RERC on Hearing Enhancement and the T2RERC screen innovative proposals submitted by any responding technology developers. Commercialization packages are developed for promising proposals and offered to participating manufacturers for transfer or development (various mechanisms exist to achieve this transfer). Forum Proceedings summaries are written that incorporate all work up to and including the problem statements. White papers and Forum Proceedings can be reviewed or downloaded from the T2RERC or RERC on Hearing Enhancement Internet web sites. The T2RERC address is http://cosmos.ot. buffalo.edu/t2rerc.
Dr. Charles Laszlo seemed intrigued by the promise of the problem statements. "I think they will be very appropriate and they will be of interest to people outside our own group, here, because they are of the nature that go to the care of the problems. I'm actually looking forward to the reaction, and not just of our own group, but people who will see it on the website, and see whether they can come up with some thoughts or some contributions that we didn't think about. I think the process actually is quite fascinating."
From the perspective of the Rehabilitation Engineering Research Center on Technology Transfer (T2RERC) and its finding ways to use the Demand-Pull Technology Transfer Process to commercialize assistive devices that improve peoples lives, it's practically just the beginning. So keep listening!...
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