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Young Peoples' Use of Wireless Technologies with Bone Conduction Hearing Implants



This study aims to explore and identify hearing and quality of life outcomes from teenagers with hearing impairment using wireless assistive technology with their bone conducting hearing implant.
Young Peoples’ Use of Wireless Technologies with
Bone Conduction Hearing Implants
Imran Mulla1, Zheng Yen Ng1, Di Harbor1and Sue Archbold1
1The Ear Foundation, Marjorie Sherman House, 83 Sherwin Road, Lenton, Nottingham, NG7 2FB
Wireless technologies can provide a much needed option for young people with hearing loss to access a wider range of listening environments and devices that many of
their hearing peers would have daily access to. The current study has highlighted when young people were provided with the correct support and advocacy on
incorporating wireless devices with their existing hearing technologies, this can help them to take ownership for their listening in everyday situations. It is important to
ensure young people are adequately informed of the device options available and are given enough information and support to maximise on these opportunities.
Bone conduction hearing implant/device (BCHI) technology has developed considerably and the latest models of BCHI include streamers to help improve signal to noise
ratios (SNR). In spite of the scientific evidence on the benefits of an improved SNR for teenagers (for example: Johnson, 2000; Brown et al., 2010), older children with
hearing loss have reported limited uptake of wireless microphone technologies (Ear Foundation, 2014). The current study therefore proposed to explore the views and
experiences of young people who own proprietary Oticon ConnectLine microphone/streaming devices that work with the Oticon Medical Ponto Plus. A mixed methods
multiple case study design was employed with three young people (aged P1= 18, P2= 16 & P3= 11) and their families. Quantitative findings (COSI, GHABP, FM Listening
Evaluation for Children) were significantly positive for all three young people. In depth qualitative analysis of data collected through initial interviews, daily diaries and final
interviews resulted in four main themes and 23 sub themes. Some of these sub themes are discussed below:
We would like to sincerely thank all who participated in
this research.
Main Themes
Sense of Self-Efficacy Acquiring Useful
Information Value of Significant
Other Attending Course Feedback
“I’ve relaxed a bit in
myself- cos I’ve always
been and always will be
the only person in my
family or my friends who’s
deaf, but I’m going to
make them more aware of
what I can and can’t do”
“I feel more positive. I feel
that I might have some
stuff to offer after being so
sick for a while and down
Interviewees commented
on how useful it was that
different speakers often
rephrased or repeated key
“A lot of things have
overlapped- which they
were bound to …but that’s
fine because if you don’t
hear everything the first
time round you get a
reminder the next time
round.” [P1]
All commented how
valuable the course had
been for their partner. The
hearing loss simulation
session was particularly
“It was SO GOOD the
hearing people as you
know had their mufflers on
and it was just amazing to
see the difference,
absolutely amazing!...
Within a few minutes their
body language, the way
The feedback from the group
was overwhelmingly positive
but some concerns was
expressed on lack of publicity
and marketing for the courses:
“I tell you what I’m hearing all
the time, and this isn’t a
criticism, if anything in a way
it’s kind of a compliment - you
give such good stuff and no
one knows about it! And I don’t
Practical Considerations
As with any technology practicalities of device use were observed and shared by
the young people. This included feedback on the device itself and also on the
practicalities associated with obtaining the technology and its use by others:
Main Themes
Start Up Delay Transmitter Battery Life Lack of Initial Support
(Try Before You Buy) Advice to Others
P2 Mum: the only
problem was if a Dr came
along when it was
switched off it did
sometimes take a little
time to pair up, and they
would say what they had
to say and then go. [P2]
didn't want to ask them to
wait until it paired, but
hopefully over time he
will as it is all still new to
P3 Teaching Assistant: I
put it on charge every
night before I go home
once we’ve finished. But
if [P3] does an after
school club I’m not here
when she’s finished… the
only thing I find is the
charging time doesn’t
seem to be long enough.
A better battery life would
be good because I think
by 3 o clock it’s getting to
that point where you’re
not getting as much.
P3 Mum: When I got
given the streamer I got
told about it and I got a
booklet, but the only
thing I could say is there
was nothing to say how
to go and get additional
devices. Now I do know
because they’ve got a big
booklet at Connevans…
but yes we could have
that, we could have this,
alright you have to go
and buy it, but there’s
nowhere to go and try it.
P1: It has had a great
impact, it’s made everything
so much easier. It’s
improved my ability to just
listen to people, just hear
people, so much more ease
to it. I don’t have to focus on
anything I can just let it flow
in, it’s had a great impact…
Don’t rush it, always read the
manual, make sure you
understand fully how
everything works and then
what you can do with it is
limitless. Read the manual!
The benefits of incorporating wireless technologies into their everyday routines did
not only lead to improved listening but as a result the young people and their
families noted an improved sense of well being, for example:
Improved Listening
The young people and their families all described the improved listening
opportunities the transmitter microphone provided with three sub themes
Engagement with Technologies
Connectivity with a wide range of everyday wireless devices was apprecaited by all
the young people and this was something they were able to take control of. This
main theme had three sub themes:
Main Themes
Social-Family Listening Effort Improved Confidence Safety
P3 Mum: It must be
working better because
she wants to do more
after school activities.
Before she didn’t now
she wants to.
P3Mum: She said in the
car it was better was nice
to have a talk I'm no
longer on my own now.
She said felt sometimes
that she felt left out …
P1 Mum: because you’ve
asked him how its affected
him, well that benefits us
as well, and it definitely
has, he seems much more
connected, he’s less
isolated, spends less time
on his own just kind of
switching off which is what
he used to do... it was such
an effort to listen, such an
effort to do all the listening
and to concentrate all day
that when he came home
he just switched off.
P2 Mum: He used to give
(mic) to the different Drs
and nurses to use when
talking… (although one
seemed to think that she
now needed to talk very
loudly because she was
wearing it!)… he could
hear quite clearly what
they were saying so he
could answer the
questions… because now
he’s 16 he had to answer
them himself
P3 Mum: Went on the
bike today was more fun as
she was able move away with
confidence…I was able to tell
her watch out for things
without shouting she said my
voice was clearer as her
helmet (without mic) took my
voice away .I tried without but
we stopped and started as she
needed to see my face… you
have to stop, look at each
other sort of thing… now I can
ride along and have a chat
with her.
Main Themes
Comprehension Access to Speech Control of Own Listening
P2 Mum: This has had good and
bad points for me: first the good.
during hospital visits we could have
more private conversations as I am
not having to speak loudly for him to
hear, the bad point is he turns me
off when not interested (P2)
P3 Teaching Assistant: I can tell
she is getting the words because
before when we were doing
spelling and they weren’t even
anything like I’d said and I’d re-
say it, she’d still say what she
wrote down, so I thought is it the
way I’m saying it, is it the way its
coming through. But she has
changed. And its little things,
they’re little should I say they’re
going gradually, daily, the
smallest things but big in the
whole of what she’s doing or what
she’s achieving… Her spellings
are coming on, even.
P1: I work in the workshop on
Mondays and it’s for about a six hour
stretch, it’s a lot easier to listen when
I’m on mic. And I can just cut the rest
out… Because quite often there’s
extra people in the workshop working
machines. So with that in the
background I can listen to him (tutor)
so I turn on the mic and turn off the
(hearing aid) microphones, all you
have to do is hold down one of those
two top side buttons and it eventually
cuts them out. And you do the same
to turn them back on again…
Main Themes
Improved Connectivity Advantage over Hearing Peers Control of Multiple Devices
P1: When online with my friend... I
can also put this into just basic
Bluetooth mode and connect it to
the PS3 so it can function as a
Bluetooth headset… The big fancy
headsets won’t work because my
hearing is basically back there
(pointing to mastoid) so… all I
have to do is wear this round my
neck, whereas they have to have
dirty great headphones on their
ears… It’s a great help
P1: It’s much better, it’s so much
easier. As I say with the
messages she (Cortana,
Windows Phone voice activation
interface) can read them out to
me through the streamer, so no
one else can hear her … I can
make it so that I don’t have to
touch my phone at all to do
anything when it comes to calls or
texts or anything, I can tell her
what to text as well.
P3 Mum: We have a Bluetooth radio in
the car and it's great it just talks to it
directly. She can hear it perfectly and
she's really pleased. She was able to
listen to music in the car then switch it
me when talking to me... she
understands better rather than having
to keep repeat or asking “what?”
(at home)… when the adverts were on
TV she’d switched it over to mic and
have a conversation and she was able
to do that which was good because
she was able to take control on her
... Participation in one's own health and hearing care, for example self-assessment and self-help, are important in improving outcomes (e.g. Laplante-Lévesque, 2010; Grenness et al. 2014); engaging young people in using their hearing technology improves not only control over their hearing, but also improves social/ family life and confidence (Mulla et al. 2015). ...
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