Chapter 1 24 connecting the hearing aid to a mobile phone. Maidment et al. (2018) conducted a systematic review and meta-analysis on the efficacy of additional listening devices. Their evidence suggests that the outcome of speech perception tests in noise improve when alternative devices are used compared to using only hearing aids or no other technical devices. However, there was no robust evidence that self-reported outcome measures also improve, including listening effort and quality of life. Hearing protectors Hearing protectors can be used to attenuate loud sounds. A first distinction can be made between ear muffs and earplugs. Ear muffs are rigid cups that completely cover the external ears (Rice & Coles, 1966). They are held in place by an adjustable headband or can be mounted in a helmet. Earplugs are often made of rubber or plastic and are designed to insert into the ear canal. Earplugs can be either disposable, generic (pre-molded), or custom-molded. A second distinction can be made between hearing protectors that provide passive versus active protection. Most hearing protectors provide passive protection. In this type of protectors, the attenuation is provided independently from the level of the sound. Passive hearing protectors have no electrical or digital components in them. Contrarily, in active hearing protectors, the attenuation depends on the level of the sound. Active hearing protectors have mechanical, electrical, or digital components in them. Some active hearing protectors can also provide extra noise reduction by offering a soft sound that is exactly the opposite of the sound wave of the noise. Lastly, some active hearing protectors can be used to communicate with – for example the office headset – or to play music. Hearing protectors attenuate sounds on average with 20 dBA (Brennan-Jones et al., 2020), but have the disadvantage of being uncomfortable to wear, especially when they are worn for a long duration. Another disadvantage of hearing protectors for individuals with hearing loss is that they may even further complicate the performance of auditory tasks (Morata et al., 2005; Smalt et al., 2020). Additional rehabilitation strategies Since technical interventions cannot fully compensate for all consequences of hearing loss, there is often a need for additional rehabilitation strategies (Cox, 2005).
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