Aural Diversity Network

We are delighted to announce that this month, the AHRC (Arts & Humanities Research Council) funded the Aural Diversity Network which will run for two years from July 2021, and the first network event will be led by the Hearing Aids for Music team at the University of Leeds in September 2021.

Background

Everybody hears differently! But our world is built on an assumption that everybody has the ears of a healthy 18-year old (BSISO226:2003; Sterne 2012). In fact, our hearing changes all the time. We experience varying amounts of hearing loss as we age (presbyacusis). Millions of people suffer from a range of more severe hearing losses related to conditions, disorders, traumas and shocks. And differences in hearing need not necessarily mean loss. Increased sound sensitivity (hyperacusis), aversion to sounds (misophonia), and tinnitus are experienced by many. Even having a cold can affect the way we listen.

The Aural Diversity network seeks to address this complex picture by researching differences in hearing and listening. It is not restricted solely to disability or deafness. Its objectives are to:

  • complement existing theoretical and practice-based research by exploring aural diversity;
  • review, critique and develop interdisciplinary methodologies for investigating aural diversity;
  • refine and develop thinking about enhanced access to the arts and humanities;
  • improve hearing care through increased understanding of hearing and listening types;
  • communicate findings to academic and non-academic communities;
  • build critical mass of expertise which is visible internationally and develop impetus for integration of aural diversity issues.

The initial network comprises the following groups:

  • core academic partners at the Universities of Leicester, Salford, Nottingham, Leeds, Goldsmiths, and Queen Mary University of London, with expertise in music, sound studies, acoustics, psychology, hearing sciences and audio technology
  • a wider network comprising a large number of academics and practitioners, artists and therapists, scientists and specialists, from many different centres, universities and organsiations across the UK and abroad;
  • several organisations, including: the British Tinnitus AssociationRNIDGNResound; the Noise Abatement SocietySound and Music; the Museum of Portable Sound; various Patient & Public Involvement groups; and many more.
  • The Attenborough Arts Centre, which has a tradition in accessibility is named as a Project Partner.

Workshops

The network will stage five workshops:

  • Workshop 1 (Leeds, Sep 2021): hearing care and technologies. How the use of hearing technologies may affect music and everyday auditory experiences.
  • Workshop 2 (Nottingham, Jan 2022): scientific and clinical aspects. How an arts and humanities approach might complement, challenge, and enhance scientific investigation.
  • Workshop 3 (Salford, May 2022): acoustics of listening differently. How acoustic design of the built and digital environments can be improved.
  • Workshop 4 (London, Sep 2022): aural diversity in the soundscape. Includes a concert featuring new works by aurally diverse artists for an aurally diverse audience.
  • Workshop 5 (Leicester, Jan 2023): music and performance. Use of new technologies in composition and performance.

The network builds on the Aural Diversity project led by Principal Investigator Andrew Hugill. It will benefit musicians and sonic artists by increasing understanding of hearing difference, leading to new audiences for accessible performance events. It will change compositional practice for a music that adapts to listeners’ needs. It will contribute to the study of hearing in literature, film etc. It will impact Soundscape Studies by challenging the widespread acceptance that current standardisations for perception of sound environments equates to standardisation of the ‘average’ listener. It will influence Equality, Diversity and Inclusion. It will help shape policy by improving the sound environment. It will benefit patient groups by understanding the experiences of people with auditory dysfunctions. It will inform healthcare practitioners to improve audiology and hearing devices.

The general public will be invited to attend workshops and included via the mailing list. If you would like to be added to the mailing list, please use the following contact form and leave your name and email address. Feedback to previous conferences showed the value of allowing the public to steer the research. Participants stressed the importance of “a variety of voices and experiences, from academic to everyday life”. The network will maintain a website and social media, and publish peer-reviewed articles

We will post more information about the first network event, including a call for papers, in due course.

 

Music listening and hearing aids: perspectives from audiologists and their patients

We are delighted to announce that we have just published results of the first two Hearing Aids for Music project studies in the International Journal of Audiology. The article is open access so you can read and download freely from anywhere in the world!

Article link: here

The first study explored hearing aid users’ experiences of music listening using a short survey distributed in clinic waiting rooms. The survey asked patients whether they had experienced any problems with music listening, whether they felt this affected their quality of life, whether they had discussed music with their audiologist and if so, whether this had improved their experience of music.

The second study explored audiologists’ perspectives on listening to music with hearing aids using an online survey. The survey asked audiologists to reflect on their training and background, their experiences of discussing music listening issues, their experiences of optimising hearing aids for music listening, and their perceived confidence in their ability to do so.

Results showed that around two-thirds of hearing aid users experience some issue with music listening, and commonly reported problems included pitch perception difficulties, listening in live contexts, distortion, and difficulties hearing lyrics in songs. Some hearing aid users reported that they had stopped participating in musical activities, whether listening or performing, as a result of difficulties experienced. Relatively few hearing aid users had discussed music listening in clinic, and for those who had, they reported that their audiologist was very helpful in trying to arrive at solutions, but that there was mixed results in terms of improvements in music listening experiences.

To help improve music listening experiences, audiologists reported using a range of strategies, the most commonly cited being removing adaptive functionality (e.g. feedback cancellation, noise reduction), alterations to compression, changes to gain, and taking individual musical needs (e.g. contexts, instruments) into account, though it was not possible from the study design to tell whether these were having a beneficial effect. Most audiologists were not trained in fitting hearing aids for music, though around a third had received some training, mostly at a conference or continuing professional development event. Those with some training were more likely to report confidence in providing advice, confidence in programming hearing aids for music, and programming hearing aids for music for a greater number of patients.

Music listening plays a key role in people’s health and wellbeing as they go about their everyday lives, and that includes people with different levels of deafness. We argue in our paper that empirical research into audiologists’ fitting strategies, and their relationship to beneficial outcomes for hearing aid users, is needed in order to develop evidence-based, validated guidelines to support audiologists’ training.

Drs. Alinka Greasley, Harriet Crook, Robert Fulford

You can contact us on: musicandhearingaids@leeds.ac.uk

 

 

 

My experience of music and deafness (Hilary Rae)

Photo: Hilary Rae walking the new Forth Bridge in 2017

MY EXPERIENCE OF MUSIC AND DEAFNESS

“When I was at school, I was in the junior and senior choirs and played the violin in the orchestra. After I left, I continued to play in an amateur orchestra, and sang in various choirs.  I also taught myself the guitar, and played in the church music group.

“When I retired in 1997, I was beginning to lose my hearing. I could not hear my colleagues speaking to me across the office.  It got progressively worse and I will never forget the night I went with friends to a performance of Handel’s Messiah armed with a score.  To my dismay, I found I could not follow it!  I was shocked!

“In 1998 I got one NHS analogue hearing aid for my right ear.  In 2001 I went to a private audiologist.  She said I had bilateral high frequency sensorineural hearing loss, greater in my left ear than the right.  She gave me two digital aids, which were a big improvement.

“I soon found I could not tune my instruments, and sadly I gave them away. It is interesting that I lost the hearing in my left ear altogether by 2016.  I read in Bella Bathurst’s book Sound, that this is quite common for violinists.

“It got to the point where music just sounded like one long chord, and soloists sang on one note all the time! For a short time I could hear Yo Yo Ma’s solo Cello Suites, but soon even that became distorted, so I parted with most of my CDs.

“In 2016 after 22 years of struggling with increasingly powerful hearing aids, I asked to be referred for a cochlear implant. At my first visit to the only hospital in Scotland where they do the operation, they confirmed that I had no hearing in my left ear, and very little in my right.  I was upset that they would only operate on my right ear, which meant sacrificing all the hearing I had left.  I reluctantly returned for a second visit.  I was accepted, and in October 2017 I had an implant.  I could make out speech immediately when I was switched on after four scary weeks of silence!  I was part of the hearing world again! I scored 82% in the listening tests without background noise, and the next time I got 94%!  When background noise was introduced, however, I only got 49%.   Sadly, there is little improvement with music.

“If I hear something well known like Crimond at a funeral, I think I can hear it and sing quietly.  Most of the time I just mouth the words, and new songs leave me completely lost.  I can enjoy listening to a Church of Scotland service live on my computer on a Sunday morning, or later on YouTube.  Using headphones, I find I can pitch well known hymns and sing them out loud to my heart’s content!

“I had a visit from an organist friend, and tried singing him an octave. He said I ended up a few semitones too high!  With another friend I asked if I could sing a hymn he had just played to see if I was singing in tune.  He said no, but encouraged me to sing a few more verses, and after four, he said I was almost there.  That gave me hope!

“I had a couple more glimmers of hope in December. I had an e-Advent Calendar on my computer.  On one snowy page, I heard the dance of The Sugar Plum Fairy!  I was excited.  I asked a friend to check it for me, and I was right!  It was being played on a celeste.  Another page showed a carol singer at a cottage door, and a girl started singing O come all ye faithful.  However, when the rest of the singers and instrumentalists joined in, I lost it.

“I have a CD ROM from the USA which has a whole section on music. I can only make out the drums and the xylophone on the instruments section, and with a selection of well-known songs and nursery rhymes, I can make some out from the rhythm!  I will keep practising!  I try listening to the car radio, watching the News without the subtitles, and singing very quietly if I think I recognise something.

“I enjoy walking up the road for my paper, and I can hear the birds twittering, but they all sound pretty much the same except the magpies. I can also hear the church clock chime the hour, and it does sound like a bell.

“I do discover new sounds occasionally, and hope for a little more improvement. I heard some of the recent thunder!  They say one reaches the optimum level of hearing after two years, so I still have a few months to go.  When I go away, I make sure people are aware that I wouldn’t hear a smoke alarm during the night, but I have NO regrets about having the operation.”

Hilary Rae

Edinburgh

12.9.2019

Hilary’s story resonates with many we have heard during the Hearing Aids for Music project. Hearing loss can be especially challenging for those who have been immersed in musical activities their whole lives, but persevering with different solutions and engaging in listening practice can be hugely rewarding and lead to improved experiences.

If you would like to contact Hilary about her experiences, then she is happy to hear from you (hmrae@btinternet.com).

If you would like to share your own experiences of listening to and/or performing music, whether you are a hearing aid wearer or cochlear implant recipient, please do get in touch: musicandhearingaids@leeds.ac.uk

Musicians’ Hearing and Hearing Protection

Findings of the Help Musicians UK Musicians’ Hearing survey published in Psychology of Music journal

In 2014, Help Musicians UK (HMUK) conducted a national survey as part of their Health and Well-being Strategy which explored factors affecting musicians’ health and well-being, obtaining data from 552 musicians. Results highlighted a variety of issues including anti-social working hours, work instability, illness and physical problems, and mental health issues. However, an unanticipated finding was that 47% of the sample reported experiencing hearing problems (HMUK, 2014).

In response, HMUK devised a new survey to explore professional musicians’ hearing and use of hearing protection in more detail. The study was led by Nigel Hamilton and Maddy Pickard, with help from a steering committee which included professional musicians, an audiologist, a music psychologist, and representatives from Musicians’ Union and the British Tinnitus Association. Nigel and Maddy were then joined by Alinka Greasley and Robert Fulford, based at the University of Leeds, to analyse and write-up the findings which have now been published in the journal Psychology of Music.

Abstract

Musicians’ hearing has received increased attention due to the rising prevalence of hearing loss among general and musical populations. This paper reports results of a national survey exploring professional musicians’ awareness of, and perceptions surrounding, their hearing health, and associated help-seeking behaviour including attitudes towards hearing protection.

693 professional musicians took part, the majority being orchestral or instrumental musicians. 40% of the sample had experienced hearing loss or other hearing issues and many attributed hearing problems to their musical careers. 50% of the musicians were worried about noise at work however less than a third had taken a hearing test. Reasons for having a test included subsidised tests and experiencing symptoms of hearing loss or tinnitus, whilst reasons for not having a test included a lack of awareness about options.

Data revealed an on-going tension between a concern to protect hearing and the perceived negative outcomes of wearing protection on musical performance, and highlighted the need for more in-depth research into the experiences of musicians in high-risk instrumental groups (e.g. amplified/band musicians, brass, percussion). Providing advice to musicians about the risks of Noise-induced Hearing Loss (NIHL) prior to experiencing symptoms of hearing loss or tinnitus will support improved protection behaviour.

Contact us!

If you would like a copy of the article, do get in touch on musicandhearingaids@leeds.ac.uk

Hearing Futures II

Hearing Futures II – 16th October 2018 – Victoria & Albert Museum, London.

Drawing on the 3D Tune-In (http://3d-tune-in.eu/) and Hearing Aids for Music (http://musicandhearingaids.org/) projects, with partner organisation Reactify (http://reactifymusic.com/), the event will focus on the future of hearing devices for music listening.

More information can be found at the following link

https://www.vam.ac.uk/event/BleyEalE/hearing-futures-ii

This event will host a series of demonstrations and presentations focusing on the experience of music with hearing impairment and the future of hearing devices for music listening in terms of technology and practice. You will be able to try out applications such as Musiclarity (www.musiclarity.com) and the 3D Tune-In Toolkit (https://github.com/3DTune-In/3dti_AudioToolkit), interact with the V&A display Tonotopia: Listening Through Cochlear Implants (https://www.vam.ac.uk/event/y62mrN72/tonotopia-co-designing-sound-for-cochlear-users), and talk with developers, academics and industry professionals.

There will be demonstrations in the Sackler Centre Reception from 1 to 5:30pm, and the entrance is free (no registration needed)

There will also be a series of presentations and discussions between 2 and 4pm; entrance will be free, but you will need to register your attendance at the following page:

https://www.vam.ac.uk/event/oj3pepzJ/hearing-futures-ii-panel

If you have any questions about the event, please contact: musicandhearingaids@leeds.ac.uk

 

How does music sound to me?

The Sound of Music

How Does Music Sound To Me?

Ben Bennetts

Background

I have listened to and enjoyed music all my life.  The interest was sparked by the early rock and roll greats of the late ‘50s, early ‘60s.  Performers such as Buddy Holly, Gene Vincent, Elvis Presley (his early music), the Everly Brothers, Bill Haley, Fats Domino and so on got me started.   I was then introduced to classical music at my boarding school in the late ‘50s when I joined an after-class music appreciation society.  From these two vantage points, rock and roll and classical music, I expanded my musical interests and as I travelled around the world during my professional years, I collected all sorts of music.  I estimate that I have around 1,400 CDs in my collection; half classical, the rest a mix of jazz, world, ambient, percussion, trance, hip-hop, popular and other forms of progressive and modern music.

And then tragedy struck.  As I entered my sixtieth decade, my hearing started to go down.  I accepted it as a sign of advancing years and started wearing BTE aids.  They helped, but to my great disappointment, I discovered I could no longer enjoy music, with or without the aids.  All music, live or recorded, became distorted.  I could no longer whistle a simple tune, such as Happy Birthday.  I could no longer enjoy any of my CDs.  I began investigating the cause.  I had an MRI scan.  Maybe something was wrong inside my head—dead frequency zones in the cochlea, a damaged auditory nerve, a brain tumour?  Nothing serious was revealed.  As part of my investigation, I read about research going on at Cambridge University, contacted the group, and ultimately made three visits.  Here’s what happened.

The Experiment

In 2012, I visited a PhD student, Marina Salorio-Corbetto, in the Auditory Perception Group in the Department of Experimental Psychology at Cambridge University.  At the lab, I was introduced to Professor Brian Moore.  Brian is the leader of the Auditory Perception Group and during our brief discussion he asked me to describe how music sounds to me—”What do you hear?” he asked.  This was a tough question and my reply at the time was flippant—”A cacophony”—and devoid of any meaningful content.   Subsequently, I pondered on how to answer this question more accurately and on my return, I conducted an experiment.  I selected around twenty of my CDs and played samples from them on my Bose Lifestyle 20 music system.  I kept my hearing aids in place (Phonak Nathos MW behind-the-ear aids) rather than listen to the music either with my hearing aids removed (I would not be able to hear much unless the volume was at full blast), or through headphones (which would again mean removing my hearing aids).  Here’s a summary of the results.

Results: Classical

I tried old favourites such as a couple of Beethoven Symphonies: the 5th (the Allegro, first movement) and 9th (the PrestoOde to Joy’, last movement).   I followed this with lighter music—Vivaldi’s mandolin concertos, classical guitar music composed by Fernado Sor and Robert de Visée, Telemann’s trumpet concertos, Dvořák’s From the New World, some Spanish Renaissance music (lute, vihuelas, guitar and female voice), and something more savage: Stravinsky’s Rite of Spring, an all-time favourite of mine.  In all cases, I would not have recognised the music in a ‘blind’ hearing.  I tried hard to recreate the music in my head from memory but it was extremely difficult to match memory with what was being received and processed by whatever part of the brain does this.  Notes did not go up and down as they should and in many cases the base lines dominated anything that was happening at higher frequencies.  Then I turned to other styles of music.

Results: Non-Classical

Drums and drum music have long been a passion of mine and I dredged up several CDs containing predominantly drum music, starting with a Dutch percussion group called Slagerij van Kampen performing on an album called Tan.  Here, I had more success.  I could make out the beat and also the transition and juxtapositioning of the drums.

Moving on from this, I tried other drum music—a Japanese group called Ondekoza, a Mission into Drums, a compilation of different trance-ambient artists who focus their music around a repetitive drum beat, an early 1986 electronic style recording called Transfer Station Blue by Michael Shrieve who used an electronic drum to create a sharp rhythmic beat, rich in pulse-punctuated full-frontal higher frequencies.

From here I moved on to more lush electronic music—albums such as Suave by B-Tribe (flamenco music mixed with trip-hop and ambient), Suzuki by Tosca (Dorfmeister and Huber, two early exponents of what we nowadays call ambient music); Big Calm by Morcheeba;  Moodfood by Moodswings (featuring the pure voice of Chrissie Hynde),  Sanchez and Mouquet’s Deep Forest,  Gevecht met de Engle (Battle with the Angel) by another Dutch group, Flairck, and, finally, one of my jazz CDs, an album called Blue Camel by the Lebanese oud  player Rabih Abou-Khalil.

All were lost on me.  Even with my musical memory, I could no longer appreciate the music.

Conclusion

I tried to be objective in my answer to the question, “What do you hear?”  By its very nature, the answer is difficult to express in unambiguous objective scientific terms.  We hear what we hear and if it’s pleasurable, fine.  If it’s not pleasurable, also fine.  We just don’t like it.  But, if it’s not pleasurable, whereas once it was, not fine.   I would like to know why listening to music is no longer pleasurable and why I can no longer recall complex tunes in my head.  Even if I can’t fix the problem, it would be good to know its root cause.

Marina, the PhD student working in Professor Brian Moore’s department, did send me a summary of her findings.  Basically, she said that my hearing loss had affected my ability to use temporal fine structure information which, in turn could affect pitch perception in both speech and music.  She also suggested that my hearing loss has modified my frequency selectivity and that my auditory filters were wider than normal.  Apparently, both deficits are common when you have a cochlear hearing loss but, contrary to my own thoughts, she could not find any dead regions in my cochleas.

So there you have it.  I am still working at understanding the physiological behaviour that underpins temporal fine structure and auditory filters but this is taking me deep into the realms of how the ear works and how aural data is processed by the brain and, quite frankly, is currently beyond me.  I accept that my ability to hear and enjoy music correctly will never return; there is no cure for what ails me, more’s the pity.

Footnote

In my initial answer to Brian Moore, I also said that music, to me, these days sounds just as if it had been played by the defunct Portsmouth Sinfonia.   This orchestra, founded in 1970, was comprised of people who were either non-musicians or, if they were musicians, were asked to play an instrument with which they were unfamiliar.  They were also asked to do the best they could rather than deliberately play out of tune.   Their first recording became a surprise hit and they continued playing until they disbanded in 1979.   You can sample the sound of this orchestra on YouTube.   Enter ‘Portsmouth Sinfonia’ into Google and see where it takes you.

If you do this, the renditions you will hear are extremely close to what I now hear when I play correctly-played classical and non-classical music.  But, there’s an interesting paradox here.  When I listen to the Portsmouth Sinfonia on YouTube, am I hearing what they actually played or am I hearing a distorted version of what they played?   A distorted version of music that is already distorted?   I will never know the answer to this question but I have to admit, I collapsed with laughter today when I listened to Also sprach Zarathustra, Richard Strauss’s stirring music used to herald the start of Stanley Kubrick’s movie 2001, A Space Odyssey.  The Portsmouth Sinfonia’s version of this piece of music encapsulates the meaning of what I meant when I described my listening experience to be a cacophony.

Note: this article is a summary of a much longer article with the same title that delves more into what I heard when I conducted my experiment.  You can download the full article here.

If you would like to contact Ben about his experiences, email ben@ben-bennetts.com

If you would like to share your own experiences of listening to music with a hearing loss, do get in touch with us on: musicandhearingaids@leeds.ac.uk

 

New Year Update

Dear all,

Happy New Year to you!

Here at HAFM HQ we’ve been busy reflecting on our conference, looking at some initial findings from the online survey, and drafting various documents, including a revision of our patient leaflet, and drafts of a practitioner leaflet, glossary of terms and stakeholder report.

Conference materials

All of the abstracts, many of the powerpoint slides and some of the videos from the conference can now be downloaded on our conference webpage. This includes the concert by the FORTE Ensemble.

We are interested to hear your reflections on the conference four months on, so if you have two minutes, please answer three short questions here.

 

Extension until August 2018

Numerous NHS Trusts across the country have expressed a desire to be involved in the HAFM research, and so we have secured an extension to the project (until the end of August) to be able to do this. We have just started working with 20 Trusts, including  Aintree, Airedale, Birmingham, Durham and Darlington, Harrogate, Kingston, Manchester, Sheffield, South Tees, Southend, Sunderland, Tameside and Glossop, and Western Sussex to name a few! We are adding further sites this week. This is very exciting for us because it ensures that we can survey hearing aid users from all over the UK.

Working with the first N=1,000

We are currently analysing the first 1,000 responses to the online survey, and results summaries will be available in due course. Thanks to all who have taken the time to participate in this survey – your time is greatly appreciated.

If you know others who would be willing to complete the survey, do send on the link: http://tinyurl.com/musicandhearingaidssurvey

Your thoughts!

If you have any other reflections, or you would like to write a blogpost for our website, please do get in touch with us on musicandhearingaids@leeds.ac.uk

Best wishes from

Alinka, Harriet and Amy

University of Leeds, 23.01.18

Hearing Aids in Brass Bands

In this blog post, Professor Pete Thomas describes how he and his wife use accessories alongside their hearing aids to help them enjoy playing in a brass band.

Despite being branded as tone deaf in schooldays, and suffering from moderate hearing loss too, seven years ago I started to play trombone. Now, aged 69, I play in a brass band. My wife, Carol, a lifelong musician who plays euphonium is afflicted with a severe hearing loss as well, a long term condition combined with severe tinnitus.

Playing music in a brass band presents a range of challenges for hearing aid users. Some opt in despair to abandon aids and make do with whatever residual hearing they have, or else to give up playing altogether. Sound levels may exceed 105dBA, although this can depend on seating position within the band, and most hearing aids do not work well in these conditions.

Pete Thomas Blogpost 2Players should be able to clearly hear neighbouring players, so as to be able to play in time and in tune with one another. They also need to hear other sections of the band to effect the overall tuning and timing of the music. As a trombone player, I need to be able to hear euphonium and baritone horns immediately in front, to perceive the higher pitched sounds of the cornets from the far side of the band, to be aware of the horns, all whilst not forgetting the basses (tubas) which are hard to ignore. And in rehearsal, it is important of course to hear the instructions from the conductor!

For me, playing without hearing aids is not a realistic option. With my high frequency loss, I am barely aware of the cornet sounds and much of the articulation is lost. The resultant dead and rather woolly musical environment, with no perception of commands from the conductor would preclude participation.

My aids were initially prescribed following diagnosis/treatment for benign positional vertigo; as a result the world became a more interesting place where many of the sounds diminished over the years were reinforced. Percussive sounds and cornet sounds became so much clearer and more vibrant.

However, with those first digital aids there was a major drawback. When the cornets played certain higher notes, this tended to excite feedback cancellation in the aids and it seemed as though some of the feature recognition aspects of those aids distorted the balance of the sound. Exploring this, I found that even on what was supposed to be the music setting, if I sat at home listening to my wife playing the piano, the ticking clock which is normally barely perceptible, would become a loud clacking, clearly audible above the piano. The squealing with the cornets was clearly a problem, especially as when it occurred it would take some considerable time for the aids to settle back to normal operation. I found the condition could be repeated in a quiet environment with a tone generator – a tone of approximately 2KHz from a loudspeaker would trigger it. I discussed the problem with audiologists who attempted changes of settings, changed ear moulds and generally puzzled over the problem, before concluding I was seeking the impossible.

Fortunately I encountered a more determined audiologist who appreciated the objective feedback and wanted to be of help. She prescribed some alternative aids for evaluation and following some adjustments they have proved remarkably effective. Initially, things were very confusing, as each aid made my custom-made trombone sound rather different and unpleasant to my ears. Fortunately, this was a transient situation as my brain adapted to the different hearing aids and within a few days I could switch between aids without any unpleasant perception of the sound. The new aids, whilst providing the necessary high frequency compensation, appeared less intrusive, such that apart from the useful improvement in music and comprehension of speech, I could be unaware of using them. Most importantly they were far less susceptible to excitement from those higher pitched cornet sounds!

Initially the aids were sometimes apparently overloaded by the mellow tones of the euphonium, but presumably due to the adaptive capabilities of the aids, even this problem rapidly diminished. The aids are not perfect and I will sometimes query as to whether the conductor wants to play from rehearsal mark ‘M’ or ‘N’, and it can be frustrating to miss out on the punch line of jokes from around the band. This leads on to the consideration of Carol’s more challenging problems of playing the euphonium.

Carol has played church pipe organ and piano since childhood, but during the last three or four years she has succumbed to pressure to join the band, playing a euphonium. The expectation was that this would be easy for someone of her musical experience, but with brass band pitch being transposed from concert pitch such that notes written as C sound as B-flat, there were additional challenges for her hearing. The single line of euphonium music might have paled into insignificance compared to the complexities of the Bach and Buxtehude, with pedals and multiple manuals to cope with; however in the brass band there is someone else (the conductor) setting the tempo and all those other players to fit in with.

Carol uses two Phonak Nathos SP aids with features such as the frequency translation of higher pitched sounds, enabling her to comprehend some of those missing high frequency sounds. Early experience with these aids suggested that she had trouble precisely pitching and playing in tune and this was particularly evident if playing in a small ensemble. Fortunately, the enabling of a music program, disabling some features of the aids, made a dramatic difference and in the small ensemble she was able to play far more reliably in tune. However, in band a major problem unfolded whereby when playing her euphonium, especially when accompanied by a neighbouring euphonium, she could hear virtually nothing of the rest of the band. This problem intrigued me and I set about trying to find why the euphonium was so troublesome!

Pete Thomas Blogpost5All brass instruments have characteristic spectral properties, whereby the fundamental of a note with a particular set of overtones gives the instrument its sound. The different instruments differ in size (from the tiny soprano cornet to the large B-flat tuba) and in construction with the size and degree of taper in the bore. The trombone is a parallel bore instrument, and this reflects in the sound which is rich in overtones – the FFT analysis here shows peaks extending to the 15th or even 20th harmonic of the note being played. Curiously, the trombone can seemingly be very light on the fundamental of the note being played. In contrast, the euphonium with its taper bore is very strong in the fundamental, with the overtones rapidly dying away. The similarly pitched baritone horn with a less tapered bore has a spectrum more like that of the trombone.

It is therefore no surprise when my wife encountered the problem with the euphonium and the musical director of the band suggested trying the baritone horn for a while, that Carol found this a great benefit. This enabled her to play in the band and still hear much of the music from other sections of the band. However it did not help with hearing direction from the conductor.

We therefore looked into the potential use of a microphone and loop system. Whilst this could have worked within the band room, it was clearly not a practical solution for performance venues. It was around this time we discovered the Phonak Roger pen system. Initial enquiries with a supplier were far from optimistic of its utility, but discussion with CamTAD suggested it might be worth further exploration. With a musical director keen to cooperate, a microphone and receivers were sourced. With Carol’s severe high frequency hearing loss, the bandwidth limitations of the telecoil loop interface was not seen to be a problem compared to the convenience of implementation without assistance from the NHS audiologist. However with my helpful NHS audiologist happy to enable such things we got some Roger receivers for my aids in the hope they might be a benefit.

The Roger pen proved to be a major benefit for Carol. She was able to clearly hear instruction from the musical director (wearing the microphone) and as a bonus could hear more of the cornet section music, which often provided the lead in the music. Somewhat disappointingly, we found that although I could hear the conductor more clearly with the microphone, due to the bandwidth limitations of the Roger pen and my open ear moulds, I perceived the rather tinny overlay of music rather unhelpful even with the wireless receivers giving direct audio to my aids. However I have at times found the mixed mode of normal aids and the Roger input useful. The wider benefits of the Roger pen are obvious.

Recently with more experience, Carol has been returned to playing euphonium. We have to conclude that from our experience, hearing aids and appropriate accessories can be a real benefit and enable hearing impaired users to successfully participate within a brass band. The recent HAFM conference at Leeds inspires us for further work.

 

Upcoming Conference 2017

We’re excited to be organising our ‘Hearing Aids for Music’ conference which is taking place in Leeds this September.

The conference will allow hearing aid users, researchers, audiologists and manufacturers to get together and discuss current issues in listening to music with hearing aids.

There are four programmed strands of activity: conference presentations, an exhibition area, practical workshops, and an evening performance.

The conference presentations cover a range of topics and are presented in a variety of styles – study reports, applied research, practical work and personal experience from people based all over the globe.

There is ample time for networking in the exhibition space too, with the chance to meet representatives from some of the major hearing aid manufacturers and smaller companies alike.

The workshops are a fantastic opportunity to engage with a number of themes:

• Clinicians discussing service provision, rehabilitation and learning methods.
• Researchers presenting work using new technologies to improve music listening.
• Hearing aid developers discussing the state of the art, and issues still to be surmounted.

Finally, we are privileged too to have the FORTE Ensemble, a group of professional musicians who are deaf, join us on the Thursday evening to perform in the Clothworkers’ Centenary Concert Hall.

Registration is open now and it’s not too late to sign up… Please join us if you’re interested!

Related pages

An organist’s perspective

In this blog post, Brian Henderson describes the trajectory of his hearing loss and how this has affected his experiences of playing the organ over time.

“I am a 70 year old church organist, now with moderate hearing loss in both ears.  I have played the organ from the age of 18.  Other relevant personal information includes a career of Physics teaching up to A level and a 10-year spell of helping a local organ builder after retiring from full time teaching.

“My first experience of hearing loss was sudden and traumatic.  I was making a mobile phone call in 2011 in a busy shopping street and put the phone firmly to my ear to hear it answered.  At that exact instant someone called me and the phone rang while against my ear.  My head seemed to explode.  Luckily I was with family members who helped me to a seat and half an hour later I felt able to move on, but with the realisation that hearing in my left ear was damaged.  A visit to my GP the next day brought the news that my hearing might or might not recover.  It didn’t.  Hospital ENT consultation and an MRI scan followed but produced no answers, and an NHS hearing aid was soon supplied.  The loss was worst from 1kHz upwards, so consonants were missing from speech and the organ upperwork (the higher pitched stops) lost from my left ear.  But I still had a good right ear and I thought life was still mostly fine in spite of the chance in a million that had deafened me.

“I used the aid for conversation, but I took it out for playing as it distorted the organ sounds badly.  I read that one of the consequences of sudden hearing loss could be hyperacusis, increased sensitivity to some sounds.  This explained why organ notes in the tenor octave were now sounding thick and unpleasant, with tenor A and B booming out from what had been a well-regulated quiet flute stop.  After a year or so I realised I was not hearing this.  This was my first taste of the ability of the brain to gradually improve an initially troubling situation but little did I know that I would come to rely on this property of the brain to help me a few years on down the line.

“In mid 2015 I became aware that my right ear was not hearing as well as before.  It showed up most on the organ where I could no longer hear the highest notes of a 2 foot stop (a stop which plays 2 octaves above piano pitch) and I realised that sounds around 6 kHz and above were gone.  There was also a strange blocked feeling in my right ear, with intermittent popping, and I was aware that this right deafness did not feel the same as the left deafness.  A GP investigation started, I tried a nasal spray and inhalation.  I used olive oil and later sodium bicarbonate solution but the blocked feeling persisted even though the ear drum was visible.  I had an audiogram and a right aid was supplied for what was then described as slight deafness.

“The GP investigation into the blocked feeling continued (now 6 months after it started) and in February 2016 microsuction was performed to remove the small amount of wax that was visible.  Initially all seemed well, but 3 hours later I realised my right hearing had gone the same way as my left.  Organ experimentation showed a fall off at 2KHz, not quite as bad as the left but bad enough to make the organ sound dreadful.  The hearing loss was described now as moderate in both ears and I found conversation difficult and TV listening often unintelligible.  My life seemed to collapse around me.  To lose the left hearing had been an accident, but the right deafness seemed the direct result of a GP procedure.  I felt bitter and defeated.  And my greatest relaxation and my defining role – as church organist – was lost.

“There were two separate but overlapping strands to my life with hearing loss.  One was searching for advice about hearing loss and music.  The other was an NHS investigation into my sudden right hearing loss.  This investigation took the form of two hospital ENT consultations, several audiograms and an MRI scan.  The noisy MRI machine accentuated the hyperacusis now present in the right ear but revealed no reasons for my problems.  The three audiograms were wildly inconsistent, one even showing normal hearing in the right ear, possibly because my tinnitus and hyperacusis were masking the true situation.  This was a time of fear and frustration until in May I was finally passed on to a wonderful senior audiologist who listened intently to my descriptions.  I could tell from the way she conducted my hearing test  (with quick repetitions and surprising frequency jumps) that she was using her considerable experience to “catch me out”.  I was delighted that she produced an audiogram that matched the view I had gleaned from listening note by note on the organ.  The aids were reprogrammed and at least speech in a quiet space became easily intelligible.  Furthermore the senior audiologist understood the importance of music in my life and ordered for me a pair of Phonak Nathos S+ MW aids which she said had better musical capabilities than the standard NHS aids.

“I felt I was making real progress now with audiology, but frustration soon set in with delay in the delivery of the aids, the substitution by management of a locum at one appointment resulting in a mis-setting of the aids, and repeated difficulties in ensuring that future appointments were made with the senior audiologist who had rescued me (and actually asked that all appointments be made with her).  There is a real personal difficulty here – does one complain and risk alienating the organisation that is trying to help?  In the end I have been quietly persistent and have eventually seen the person I need, but the missed opportunities and time lost have led to a roller coaster of hopes and disappointments lasting over 6 months.

“On the musical side things have at least been more under my control.  When the right hearing loss occurred the unpleasant sound of the organ made it impossible to continue playing for services.  With hearing aids (even the later Phonak pair described above) the distortion was more than I could bear, and I tried playing with no aids.  Quiet music on 8’ flutes1  was similar to what I remembered.  Louder music on 8’ and 4’ diapasons2  sounded thick and muddy, and adding further upperwork (2’stops and mixtures) was simply frustrating because there was no change.  All the majesty of the brighter sounds was lost, but I persisted in playing to myself frequently and for short times using only the quiet foundation stops.  Over a period of time my musical memory and the adaptability of the brain enabled me to hear (or imagine) brighter sounds as the higher pitched stops were added.  Separately these stops were almost inaudible, and different notes had no discernible pitch difference.  But in the chorus there was an unmistakable element of brightness that enabled me to get some enjoyment from my playing and even contemplate returning to service playing a month or so after the sudden loss.  At this time I was still taking my aids out as I approached the organ, so my initial service playing showed up the inevitable problem – I did not know what was going on in the service.  I sometimes only knew when to play a hymn after a gesture from my wife in the front row of the congregation!

“This situation could not continue.  I persisted without aids but with the help of a small loudspeaker placed as close to my ear as possible.  It was driven from the church microphone system using its own amplifier with bass turned down and treble up to max.  In this way I played for some services although most were covered by pianists in the church doing a good job on the organ in spite of their initial fears.

“As time went on I got more used to the various programmes in the aids, and began to play to myself with aids in, music programme selected, volume set almost to lowest.  The distortions were many and varied.  All sounds above 500 Hz had a strange edge to them.  Soft flutes (with an almost pure sine waveform) had a curious repetitive hiccup caused I believe by the digital signal processing.  Rapid passages of music did not sound too bad, as individual notes did not last long enough for the distortion to offend, but slow sustained notes were horrid.  It was almost impossible to balance a solo stop with a suitable accompaniment on a different manual.  For instance an oboe stop did not sound as it used to because so much of its energy is in the upper harmonics.  The accompanying flute stop will have much of its energy within the fundamental, and the differing amplification of high and low frequencies, intended to correct my hearing, is not done precisely enough to judge the balance between a distorted oboe and a distorted flute.  Much of my playing is done by remembering combinations that used to work, but when I try a new piece (or harder still a different organ) it is almost impossible to judge whether I am producing reasonable sounds.

“There are some other aspects that make practising harder work than before.  Hyperacusis presents itself in odd and initially unsettling ways.  Treble F on a stopped flute is hugely louder than its neighbouring notes.  It actually shouts out and unbalances any chord containing it.  The same note played on a stop with a differing harmonic make up, such as a diapason rank, or an open flute, fits perfectly with its neighbouring notes.  Pitch discrimination has suffered.  Any given note sounds slightly sharper in one ear than in the other!  Chords which contain close harmonies can now set up a beating effect, presumably because of this discrepancy.  So all practice is now punctuated by repeated checks of strange out of tune sounds.  They are often caused by wrong notes, but they are equally often caused by my wrong ears.  In some cases repeated playing of a nasty sounding chord has taught my brain to accept it, and I can even return to a piece several weeks later and find that the chord I battled with and beat into submission has stayed reasonable.

“I do not expect the lost hearing to magically return, but I do hope that somehow in the future I will find better settings for the existing aids, or perhaps better aids, that might help me hear more of the organ as it really sounds.  The present problems are still considerable.  So should I have given in and stopped playing?  My answer is an emphatic no.  I am back to playing for about 3 services a month. I have dispensed with my local treble enhanced loudspeaker.  I use my aids on the music setting and have found a volume setting which is reasonably appropriate for organ sounds and much of the spoken word, and clergy have helped by giving clear announcement of hymns.  I do get satisfaction from playing the right notes in the right order, even if the practice has taken longer and even though the sound of the instrument has lost a lot of beauty and majesty.  I can still get my excitement from a loud conclusion with several ranks of mixture and pedal reeds.  And above all I once again get a buzz from leading a congregation which sings with enthusiasm and sensitivity as I play.

“And of course there is more to musical life than playing the organ.  I enjoy singing (although sometimes with difficulty) in a community choir.  Pitching notes is far more uncertain than it used to be, and the trick of checking by putting a finger in an ear is not possible with a hearing aid in the way!   I nearly stopped attending concerts in Birmingham Symphony Hall after a couple of disappointments, but then experimented with different seating positions.  Concerts have once more become enjoyable provided I pay for the best seats in the house.  Now that I can see the full orchestra clearly I find that I can hear and recognise individual instruments much better; another example of the brain’s remarkable ability to adapt and improve distressing situations.”

  1. the organist’s term 8’ means organ pipes at piano pitch (ie middle C key plays a middle C sound)
  2. 4’ refers to pipes sounding one octave above piano pitch. Diapasons are the family of open metal pipes which give the basic organ tone, and they have more harmonic development than organ flutes.

 

Brian Henderson

Bromsgrove

March 2017