That is my advice to my patients. If you suffer from hearing loss, your auditory cortex, where speech understanding occurs, needs more stimulation than before. Reading through TV subtitles makes your eyes tired and takes the benefit of stimulating your auditory cortex away. That's why you should switch off TV subtitles now. Continue reading this article to learn more about how you can exercise your brain by improving speech understanding when watching TV.
"Yes", is the answer I receive from the majority of my patients when I ask them "Do you use TV subtitles?"
If you are completely deaf the closed captioning and TV subtitles are the only way for you to understand and follow the program. But what if your hearing loss is only mild to moderate, or it is moderate to severe?
It appears to me that a lot of people start using subtitles on TV programs as soon as they start having problems with understanding the dialogue on TV. That is fully understandable. Most of the TV programs or programs on other networks such as Netflix, Apple TV and Disney Channel have a lot of sound effects that can make it difficult for most people with hearing loss to understand and follow the dialogue of the movie.
I fully understand why you have to use TV subtitles. But I need you to understand what is happening in your brain when reading through the subtitles of a movie instead of hearing the conversation.
We do not hear with our ears, we hear with our brain
Let's take a look at our auditory pathway (see Figure 1). Our ears are transducers to convert the sound that arrives in our ear canal to electrical signals and send them to our brain for processing. Understanding of the speech happens in part of our brain called the auditory cortex.
As you can see, we hear with our ears, but we understand the sound and the speech by our brain. That's why reading through the TV subtitles is counterproductive to stimulate your auditory cortex.
Figure 1 - Auditory pathway
How can I decelerate memory loss?
To decelerate the ageing process of our brain we need to exercise it. Analytical thinking, solving puzzles, researching, playing an instrument, learning a new language and other activities stimulating different brain parts are highly recommended. When you are talking to a friend, or listening to a dialogue on a TV program your brain is accessing different libraries of your knowledge and memories. In a conversation, you force yourself to analyse and process to be able to come up with an answer. That's why a daily conversation on different topics is even better than following a dialogue on a TV program.
Does using TV subtitles accelerate memory loss?
There is no evidence-based research on the impact of using TV subtitles on memory loss however, TV subtitles don't allow your auditory cortex to be fully engaged in the process of hearing and understanding the speech, hence it is counterproductive in exercising your auditory cortex.
I use hearing aids but still struggle to understand speech on TV programs, what else can I do?
Based on recent research by Resound, TV streamers could improve speech understanding of the hearing aid wearers (see the research paper here).
They did the exercise in different noisy environments including vacuuming noise, cooking and kitchen noise, people babbling noise in the background and kids playing noise. In all conditions, the use of a TV streaming to hear the soundtrack in your ears through hearing aids had a major positive impact on the speech understanding of the wearer of hearing aids.
The research showed that using a TV streamer can improve your speech understanding by 30%. If that helps you to switch off the TV subtitle then this is a win as you can manage to stimulate (say exercise it) your auditory cortex while watching your favourite TV program.
Chart 1 - Comparison of speech understanding of a TV soundtrack, TV soundbar versus TV streamer
Chart 2 - Mean speech recognition test improved by 30% when users use TV streaming devices versus TV soundbar
Where can I find a TV Streaming device for my hearing aid?
Here are the TV streaming devices for your hearing aid:
How do I know if my hearing aids can connect to a TV streamer?
All of the hearing aids with Bluetooth can connect to a TV Streamer. Some hearing aids which are not Bluetooth enabled can be connected to a TV streamer through an intermediary device if they are Telecoil enabled. Some examples below:
Please contact us if you have a non-wireless hearing aid and wondering how to connect it to a TV streamer.
When I hear TV through my hearing aids can everyone else hear the TV soundtrack?
Yes, you will receive the TV soundtrack straight through your hearing aids, and at the same time, everyone else enjoys the TV as before. You will also be able to adjust the percentage of the volume you hear through your hearing aids and directly from the TV (received by your hearing aids microphone.
I have a TV streamer, how can I connect it to my TV and my hearing aids?
You need to connect your TV streamer with the wires provided in the package to your TV. Also, you need to pair your hearing aids with the TV streamer. Here are the links to the how-to videos that can help you connect your hearing aids to a TV streamer and also con
I have two TV sets at home, can I use two TV streamers for my hearing aids?
Yes, most of the premium hearing aids can connect to several (usually up to 7 or 8) TV Streamers. Obviously not at the same time. When you pair your hearing aids to several TV Streamers you might need to choose which TV streamers you wish to stream from through your hearing aid app.
My husband and I both use hearing aids, can we both stream through a single TV Streamer?
Yes, most TV Streamers can pair to 8 pairs of hearing aids and stream to all of them at the same time. Please consult with your audiologist or refer to the brochure of the TV Streamer for more details
Will I be able to switch on and off the streaming to my hearing aids through a TV Streamer?
Yes, while watching a TV program you can switch the TV streaming soundtrack on and off through your hearing aids app. This can also be done through the buttons on your hearing aids if your audiologist has set them for you.
How can I make my next hearing aid future-proof in terms of connectivity with a TV streamer?
Hearing aids are advancing fast in different technological aspects including connectivity. If you are in the market to purchase a new pair of hearing aids my advice is to make sure they are ready for the next generation of connectivity, LE Audio Bluetooth and Auracast (see Chart 3):
LE Audio Bluetooth - LE Audio Bluetooth is the next generation low energy Bluetooth protocol that is being enrolled on hearing aids, headphones and other listening devices. Devices and hearing aids equipped with LE Audio Bluetooth provide a higher quality sound to the wearer and the protocol uses less energy from your hearing aids, which means a longer run time, especially for rechargeable hearing aids.
Auracast - Auracast is a one-to-all broadcasting protocol that is being rolled out to hearing aids and other listening devices such as headphones and earbuds. The hearing aid equipped with Auracast allows you to receive the soundtrack in concerns, theatres, public places, pubs, showrooms and so on. It is the next level of telecoil for future hearing aids.
Chart 3 - Hearing aids wireless communication
Why should I make sure that my TV Streamer is LE Audio Bluetooth and Auracast?
If you are in the market to purchase a TV Streamer my advice is to look for one with LE Audio Bluetooth and Auracast, because:
Your hearing aids save battery life
Other people can watch the TV with you and receive the TV soundtrack in their LE Audio Bluetooth or Auracast compatible hearing aids or headphones
I use hearing aids but still struggle with speech understanding when with friends, what can I do?
This is a very common question and in my opinion, you need to explore a few areas.
Here are a few reasons why you may be struggling with speech understanding even with hearing aids:
Please make sure that your hearing test result is recent, i.e. not older than 12 months.
Make sure that your hearing aids are programmed for your very recent hearing test results.
Ask your audiologist to do Real Ear Measurement (REM) on your hearing aids.
Here are some additional advice that I offer to my patients:
Smart sitting arrangement - Make sure that you leave the noise behind! It means that if you sit to chat with a friend in a coffee shop or restaurant, take a position at the table that leaves the kitchen noise or street noise behind you. This way your ears, your hearing aids and your brain can do a better job for you to understand the speech better.
What else can I do to hear speech better?
Assistive listening device. You will be surprised by how much a remote microphone such as Phonak Roger On iN can help you understand speech better in a noisy environment. The hearing aid app in some of the models can also work as a remote microphone for you, but nothing can replace the super sensitive microphones on a remote microphone. Please check our hearing aid shop section, go to the model of your hearing aid and filter for accessories. All hearing aids have their special remote microphone.
Do you have a question about the connectivity of your hearing aids with your TV? Please leave your question at the bottom of this page.
References
Thorn, F., & Thorn, S. (1996). Television Captions for Hearing-Impaired People: A Study of Key Factors that Affect Reading Performance. Human Factors, 38(3), 452-463. https://doi.org/10.1518/001872096778702006
Griffiths, T.D., Lad, M., Kumar, S., Holmes, E., McMurray, B., Maguire, E.A., Billig, A.J. and Sedley, W., 2020. How can hearing loss cause dementia? Neuron, 108(3), pp.401-412.
Nadhimi, Y. and Llano, D.A., 2021. Does hearing loss lead to dementia? A review of the literature. Hearing research, 402, p.108038.
Park, S.Y., Kim, M.J., Sikandaner, H., Kim, D.K., Yeo, S.W. and Park, S.N., 2016. A causal relationship between hearing loss and cognitive impairment. Acta oto-laryngologica, 136(5), pp.480-483.
Shahidipour, Z., Geshani, A., Jafari, Z., Jalaie, S. and Khosravifard, E., 2013. Auditory memory deficit in elderly people with hearing loss. Iranian Journal of Otorhinolaryngology, 25(72), p.169.
Uchida, Y., Sugiura, S., Nishita, Y., Saji, N., Sone, M. and Ueda, H., 2019. Age-related hearing loss and cognitive decline—The potential mechanisms linking the two. Auris Nasus Larynx, 46(1), pp.1-9.
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