By Deborah Jeanne Sergeant
The Over the Counter Hearing Aid Act, signed by President Trump in 2017, has started the process toward hearing aids sold directly to consumers with self-identified mild to moderate hearing loss.
The Food and Drug Administration has until 2020 to finalize the rules on guidelines as to what qualifies as an over-the-counter (OTC) product.
Hearing amplification devices or systems, also called personal amplification sound products (PASPs), are considered the entry level devices by people like Michelle Gross, member of the Hearing Loss Association of America Rochester Chapter and a resident of Brighton.
Gross said the general public often mistakes PASPs for OTCs or even prescribed hearing aids.
“When they see an ad in the paper, they don’t realize what they’re looking at,” she said.
Although some ads for PASPs state “These are not hearing aids,” Gross said the wording might be more for reducing stigma instead of providing clarity. Some PASPs’ ads don’t mention “hearing aids” but stress the devices are for recreation, such as hunting, birding, or watching television.
While PASPS do amplify sound, “most don’t have some of the safety features to protect a person’s hearing, like sound limits,” Gross said. “Their frequencies aren’t adjusted to the person’s needs. They make things louder without any real control.”
Though they’re as cheap as $30 to $200, they may not help a person with hearing impairment better follow a conversation at a restaurant or understand their soft-spoken granddaughter.
Gross said that OTC hearing aids are “actual hearing aids with the features a hearing aid would have.”
Since there’s no audiologist or hearing aid dispenser involved, the cost is lower. But that also removes the benefits of the skill of these professionals.
Carolynne M. Pouliot, doctor of audiology with Hearing Aid Works Audiology, PLLC in Rochester, doesn’t view the emergence of OTCs as an entirely negative trend.
“It will introduce people with mild hearing loss into the world of what hearing aids could do to help them and transition into care from an audiologist,” Pouliot said.
She said that OTCs don’t have built-in compression. Hearing aids work pitch by pitch and compress loud sounds so the user doesn’t experience further hearing loss, traits an OTC doesn’t have.
“It’s not going to be finely tuned and adjusted like from a digital prescription hearing aid,” Pouliot said. “They won’t address hearing loss issues without creating a whole bunch of feedback.”
While OTCs might provide a steppingstone for some people with mild to moderate loss, which is the recommendation for these devices, Pouliot fears that some with more profound hearing loss may think that since an OTC device doesn’t help them, there’s no use in trying a prescribed hearing aid.
Seeing an audiologist can also help a person discover what’s causing the problem, which may be as simple and remediable as built up wax, fluid behind the eardrum or other problem that’s hampering their hearing.
“We might recommend an OTC for financial reasons after they have an evaluation to make sure nothing else is wrong,” Pouliot said. “There are a lot of health issues that can go with hearing issues. An OTC won’t help people with that.”
Going the OTC route also doesn’t provide device maintenance, repair, cleaning and adjustments.
Buying a hearing aid is unlike picking up a pair of “cheater” reading glasses from the drugstore, where it’s easy to sense if the lenses compensate for poor near vision. Hearing and visions work much differently.
“I’m very nearsighted, but my retina works fine,” said Ron D’Angelo, doctor of audiology at Clear Choice Hearing and Balance in Greece and Brighton. “It’s the focusing mechanism that doesn’t work. For hearing loss, it’s the inner ear, like the retina, is damaged. That’s why you can’t have a one-sized-fits-all approach because it varies with patients.”
The preset aspects of OTCs may or may not help. Also, the fit of the device may not work for the person buying it, since it must physically fit the ear.
Many think of hearing loss as a quality of life issue, but it also bears medical effects. D’Angelo said that hearing loss can affect balance and has been associated with greater incidences of dementia.
“Auditory depravation is a real thing,” he said.
Naturally, the high-end hearing aids can cost thousands of dollars; however, “there’s quite a range for what a custom fit hearing aid can cost,” D’Angelo said. “There might be financing available or payment plan that is approachable by the patient. If something doesn’t work, it’s not worth anything. If it does, it’s worth every penny.”