it/its--i post photos sometimes--[Profile Picture ID: A photo of a cat facing the camera with one paw raised so it almost looks like she's taking a selfie./End ID]
I've seen lots of depictions of hearing aids and cochlear implants in writing and art, and very few of them actually match what that character would likely actually use. An especially common mistake is drawing hearing aids like they are wireless headphones, which is not how the vast majority of hearing aids look.
Here's a guide on hearing device types, uses, and how to better decide which one your character would have!
(Reminder that this is not medical advice, or perfectly tailored to every single situation. I am not an audiologist, just a Deaf person on tumblr.)
Hearing Aids:
[Plain Text: Hearing Aids]
There are many different types of hearing aids. Which type someone uses will depend on their hearing curve, the features they want, and the type of hearing loss.
1. Receiver in Canal.
Receiver in Canal (RIC) hearing aids are the newest type, and currently the most commonly prescribed. They have a small behind-the-ear component with directional microphones and processors, and are connected by a thin clear wire to an in-ear speaker, which is covered by a piece called the dome.
RIC are most commonly prescribed for: mild to moderate hearing loss (although they can be useful for some people with severe hearing loss), high-frequency hearing loss, noise-induced hearing loss, tinnitus, and auditory processing disorder. RIC are also available over the counter.
Benefits: small and discrete, fairly powerful, best integrated noise filtering systems, highest mapping customizability.
Drawbacks: sizing is not infinitely customizable, not good for more severe deafness, usually don't come in fun colors, difficult to use with low dexterity.
There are several different dome types, as I mentioned. Domes are soft silicone or plastic pieces fitted in diameter to the ear canal, but come in a few different shapes depending on the type of hearing loss. I'll talk about the most common ones, but there are a few other rarer custom types.
Open/Vented domes have slits cut in the silicone. They are the weakest at keeping sound trapped, but have the lowest occlusion effect (hearing your own voice loudly). They are good for mild to moderate hearing loss, but they can cause a lot of feedback, especially at higher frequencies, so they're most useful for high-frequency hearing losses. The amount of vents in the dome can be adjusted to reduce leakage.
Closed domes do not have slits or have very few slits. They keep more sound trapped, but have higher occlusion. They are good for moderate broad-spectrum and low-frequency hearing loss, since they allow less high-frequency noise to escape.
Power domes have no slits and often have multiple layers for maximum amplification. They have the highest occlusion effect, although people using power domes typically have hearing loss in the range of 60-80 dB, so occlusion is often necessary to hear one's own voice. Power domes can make the ear pressure feel unbalanced since there are no vents.
2. In the Ear / Completely in Canal.
In the Ear (ITE) and Completely in Canal (CIC) hearing aids are a less popular, but available, type. They feature a solid combined processor and speaker that sits in the ear canal. There is usually a small wire or clear plastic loop that fits along the curve of the outer ear both to keep it in place and to pull it out.
ITE/CIC are most commonly prescribed for: mild-moderate hearing loss when RIC is not preferred or available.
Benefits: no behind the ear component can be more comfortable, microphones in the ear have highest directionality, subtle.
Drawbacks: fewer features available, higher occlusion effect, can fall out more easily.
(There are some ITEs that have a behind-the-ear component for volume/power control and structural support, but the processor, microphones, and speakers are all in the canal piece.)
3. Behind the Ear.
Behind the Ear (BTE) are the most powerful type of hearing aid. The microphones, speaker, and processor are all present in the behind-ear component, which is larger than other types of hearing aids. This component is connected by a replaceable plastic tube to a mold, which is custom-fit to the user's ear and allows for maximum sound retention/amplification. Like domes, there are several types of molds.
BTE are most commonly prescribed for: severe to profound hearing loss, moderate or higher low-frequency hearing loss, children.
Benefits: sizing is fully customized, easy to use with lower dexterity, good for athletics (less likely to fall out), highest aesthetic customization, most powerful amplification.
Drawbacks: larger size, high occlusion, higher risk of ear infections, molds must be replaced as ear shape changes, tubes must be replaced regularly.
There are lots of different mold types. An ear mold is custom fit by creating a cast of the user's canal and ear shell. More or less of the "shell" of the ear can be covered by the mold. All molds have a vent hole to allow moisture to escape, but some molds have more holes cut into them to allow airflow or reduce occlusion. Some molds are hollow, while others are solid. (Molds can also come in lots of fun colors, including marbled or glittery, although insurance won't always cover these.)
There are too many types of molds and considerations to really get into exact types here, but if you look up behind the ear hearing aids there are tons of references online. [One type of mold I've seen a lot in real life but that I can't find the name of online are sort of square-shaped solid (often colored) plastic with lots of holes in them. They remind me of a waffle.] In general, the more severe the hearing loss, the less "air space" there's going to be in the mold.
4. Bone Conduction.
Bone Conduction hearing aids (BCHA) are probably the closest-looking in real life to those headphone ones, although many of the over-the-counter devices calling themselves BCHAs that look like headphones are in fact just bone conduction headphones. Prescribed BCHAs are often two individual rectangular devices, attached via stickers or a headband. There are a few that go behind the ear, although no component of the aid is in the canal.
BCHAs are bone conduction rather than air conduction, which means they get the sound to the cochlea by vibrating the skull bones rather than sending sound through the middle ear. BCHAs are often temporary aids (see BAHA in the CI section of this post).
BCHA are most commonly prescribed for: severe conductive or mixed hearing loss, microtia/atresia, and young children.
Benefits: more powerful and safer long-term for conductive hearing loss, typically no in-ear or over-ear component.
Drawbacks: require an external component (stickers or headband) to stay attached.
5. Airpods / Actually just headphones
Did you know, Airpods were recently approved by the FDA as over-the-counter hearing devices? The noise filtering technology makes smart wireless headphones a possible alternative for mild hearing loss, auditory processing disorder, tinnitus, or anyone who can't get prescription hearing aids. These are not a long-term solution, nor are they used by audiologists, but for people who just need a bit of a boost, having their headphones in all the time might be their way of navigating the world.
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All hearing aid types have their benefits and drawbacks, and no aid will ever be perfect for someone. Even the best hearing aids available can't make someone become Hearing. Some people who are severely to profoundly deaf report hearing aids giving them around 60-80% of what a hearing person can hear, and this number improves with decreasing severity of hearing loss. Still, nearly all d/Deaf/hoh people struggle to some degree with auditory processing. They may use hearing aids to give them general awareness of background noise (eg fire alarms), or for a boost while lip-reading, even if they don't help in understanding noise more generally. Hearing aids can also die or malfunction, removing the benefits they provide.
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Cochlear Implants:
[Plain Text: Cochlear Implants]
Cochlear Implants, or CI, are surgically implanted devices that stimulate the cochlea.
More on CI in one second, because I promised a return to BAHAs, which are a type of surgically implanted hearing aids. They get to go in this section because they are implants.
BAHA stands for bone anchored hearing aid (as opposed to BCHA, which stands for bone conduction). BAHA are the long-term alternative to BCHAs. A titanium plate is anchored to the skull, and an external hearing aid component attaches to the plate and vibrates it.
BAHA are most commonly prescribed for: severe to profound conductive hearing loss, microtia/atresia. (One of the major use cases for BAHA is Treacher-Collins Syndrome, which often causes bilateral microtia. Since the hearing loss is purely conductive, and traditional hearing aids do not typically fit people with microtia even without atresia, BCHA/BAHA are the best aids.)
Back to CIs. Unlike BAHAs, cochlear implants are implanted into the cochlea to directly stimulate the auditory nerve. They bypass the outer, middle, and inner ear systems, so they are useful for any type of hearing loss.
In order to qualify for a CI, one needs profound hearing loss across all or most frequencies, and the presence of both the cochlea and the auditory nerve (CI won't work without those structures). Someone can qualify for a CI in one ear but not the other; even if someone is qualified to receive implants in both ears, they're expensive and the surgery has risks, so many bilaterally deaf people have only one implant.
In the United States, CIs are approved starting at 9 months old, but not any younger. (This is a problem for auditory development--although CI are often billed as a "cure" or "complete treatment" to deafness, the reality is that even bilateral CI users who received speech and auditory therapy from the moment their devices were programmed still lag behind hearing peers in auditory development, because they are deaf. But that's part of a larger conversation regarding deaf development and audism.)
CIs have a small disc that magnetically attaches to the skull near the implant site. That disc transmits the sound through the bone, which is then transmitted to the auditory nerve. Usually, the disc is connected to a wire, which runs to a behind-the-ear processor piece. CIs have a couple different types, just like hearing aids. I'll run through them pretty quickly.
1. "Button" CI.
These are fairly new. They only have the magnetic disc; all the processors and microphones are inside it. They're less visible, but less powerful.
2. Behind the ear microphone.
The BTE component contains the microphones and processors. There is a hook to keep it in place on the ear, but no part of the CI goes into the ear canal. These have similar directional power to BTE hearing aids.
3. In-ear microphone.
The processors are on a behind-the-ear component, but they receive signal from a microphone positioned at the opening of the ear canal. These give the best directional sound filtering, since they receive the auditory input from the same place as a hearing person, often with the benefits of the shape of the outer ear.
4. Mixed type CI + hearing aid.
These are also very new! Previous CI techniques, and many surgeons today, destroy residual hearing, so when the CI processor is disconnected, the user receives no auditory input, even if they had some before getting a CI. However, some new techniques can preserve residual hearing, and the cochlear implant can be combined with a hearing aid. This device looks like a BTE hearing aid with either a mold or power dome, but also connected by a wire to the magnetic disc of a CI.
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What type of CI a person has depends on the technology when they were implanted, what sound quality they want, or what they can afford.
The sound from CIs don't match how hearing people hear things. CI have way fewer neural connections than the cochlea has. Bilateral CI is often more effective for oralism than unilateral, but even then, CIs do not replicate natural hearing.
A CI can be implanted at any age, although it's most "effective" in infancy or adults with new-onset hearing loss, rather than people who have grown up d/Deaf. Getting a CI in adulthood is a very personal choice and can have a lot of meaning for a Deaf person.
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Gene Therapy:
[Plain Text: Gene Therapy]
This post has gone on long enough, and this isn't a hearing assistive device, but it is something to consider in a sci-fi or post-modern setting, and something we (the Deaf community) have to deal with right now.
There are currently new therapies (around 3 years in trial) that target OTOF mutations that cause severe to profound congenital deafness. OTOF mutations cause the loss of a protein that turns cilia movement in the cochlea into neural signals. The gene therapy introduces the gene that codes for this protein into the inner ear.
A small study on around 20 children, teens, and young adults with profound hearing loss (>100 dB) saw hearing curves change to 56 dB +/- 30 dB. I couldn't get the raw data because I couldn't access the study, but that means the average participant is still moderately hard of hearing and still needs hearing aids and accommodations. Depending on the metrics for calculating that error, there was likely at least one participant who remained severely to profoundly deaf after the gene therapy, and no participants became medically hearing.
We still have no data on if this gene therapy lasts forever or what kind of side effects it has. It also only works for a specific class of OTOF mutations, which account for many cases of congenital genetic deafness, but not all. Every single study on the gene therapy is produced by one company. This technology has not yet been peer-reviewed or tested for long enough. Nevertheless, hearing people are treating this as a cure, that the Deaf community doesn't want.
If a deaf person wants access to a technology like this, that is again their choice. Forcing this onto infants and children without autonomy or the ability to make an informed decision is horrible. The push to "cure" deafness goes hand-in-hand with the destruction of Deaf culture. It is eugenics. If you're going to include gene therapy or some other magical "fix" to deafness in your story, think about that.
my project hail mary take is that even though stratt is the one to mention that grace doesn't have any close relationships, that actually tells us more about why grace refused to participate in the mission than it does why stratt chose to send him: grace wasn't her plan A or her plan B; he's just the best option she had left and i'm pretty sure she would have made the same choice if he was married and had 10 kids.
one of the only things we know about the other astronauts is that they did have close relationships— friends, children— and that they were willing volunteers, implicitly because of those relationships. obviously grace has people he cares about and people who care about him, but it's not until he has that kind of deep, tangible connection with rocky (as opposed to a general investment in the fate of humanity) that he's willing to make that type of sacrifice
"don't cry-" ah ah ah stop right there. no. you gotta stop doing that. it don't help. cry if you feel like it. take a break if you need to. take care of yourself.
In a place where children no longer know what safety feels like, a mother is trying to keep her children alive despite everything 💔
I don’t know how I am still holding on...
My name is Najah, and I am a mother of six children, including newborn twins 👶👶 who need urgent care every single moment.
We are living through extremely difficult days filled with fear, hunger, and the lack of basic necessities 🥺🍞
Sometimes my children go to sleep without enough food, and I stand helpless before their tears because I cannot provide milk, diapers, or medicine for them.
My newborn twins are still so fragile, and their tiny bodies need constant nutrition and care 🍼💔
But our situation has become far beyond my ability to handle, while my other children face hunger, cold, and fear every day.
For many days, we have not received any donations or help, and our situation keeps getting worse with every passing hour.
I try to stay strong for my children, but my heart breaks every night when I see them suffering and I have nothing to protect them with.
Every second now is precious ⏳
Every act of kindness could be the reason my children survive 🙏
I am not asking for the impossible — only for a chance for my children to live safely, stay together, and have hope for another tomorrow.
Please, from the bottom of my heart, do not ignore our suffering 💔
Any small donation could help me buy milk, diapers, food, and medicine for my children.
I am Najah, living with my twin children in a tent. As the tanks approached the area where we are staying, my fear was no longer for myself, but for my two little children who need safety more than anything else. All I hope for is that this danger passes peacefully and that I can protect them from being displaced once again.
Please donate $25, $50, $100, or any amount you can give 🤲
Every contribution, no matter how small, can make a real difference in my children’s lives.
And if you cannot donate, please share our story everywhere you can 📢
Your compassion may reach someone who can save my children before it is too late.
I beg you — stop here, donate, share, and choose kindness before this silence becomes another tragedy for my family.
Thank you to everyone who listened to our pain 🌸
Your kindness today could give my children another chance at life and safety.
Donation link
From the heart of Gaza, we reach out to you with deep pain and a plea for help… amelia romain needs your support for Help Wedad's family in
the aroace read of ryland grace is so personal and haunting. "you don't even have a dog." was it not enough to love the world for the sake of living in it. was it not enough to live for the thrill of discovery. was it not enough to smile at your students. was it not enough to be afraid.
we're moving to an internet where children would be banned from reaching out for help and friendship online but abusive parents can post their children's every second online to humiliate and expose them for money with no pushback
So Rocky has a bunch of permanent carvings along his carapace like family crest, rulers and protractors, marriage symbol, etc. I assume thats normal for Eridians, but the possibility that it's socially equivalent to getting full body tattoos for humans is funny. Imagine seeing this super inked out dude, but you look closer and its just a bunch of tattoos like.
"I LOVE MY HUSBAND," "FAMILY MAN," "ENGINEERING4LYFE."
i think we should be ridiculing them more for this. you don't get to try and go all "queer website" when your staff likes to go on nuking sprees targeting the trans fem users
i get why people don't believe in marriage as a social construct but legally it is the best and easiest way to say "this is who i trust to take care of me when i can't take care of myself" and i'm so glad gay people fought for that right bc when shit gets scary at least i know im in good hands
I swear I didn't want to write these words out of shame and embarrassment, but what happened to us in the Gaza Strip—the destruction, the genocide, the starvation of the people—is beyond imagination. My older brother, who was our provider, was killed by a treacherous bullet to the head. He was our only support, the one who provided us with food, and now we go to bed hungry, ravaged by the hunger that has consumed our bodies.
A few months later, my mother died from cancer that ravaged her body. We couldn't find her any treatment, medicine, food, or clean water until she passed away from the intense pain and hunger.
Now it's just me, my brother, and my father. We can't find the food and medicine I need because I suffer from chronic obstructive pulmonary disease (COPD), which causes me to have difficulty breathing and choke in the middle of the night. Please donate; we need $450 to buy the necessary medication. I don't want what happened to my mother to happen to me. Please donate. 😭😭💔
Vetted#475 pay pal
Help support Mohmd Hlywat by donating or sharing with your friends.
I'm experiencing severe shortness of breath right now, I can't breathe. Please help me get the medication. Please donate, donate! We still need $440. Donate, donate! 😭😭💔
Why are you letting us down? Are we just numbers in a death register? Every night is harder than the last. Please donate, we only need $435. Please don't let us down, donate! 😭😭💔
I just spoke to the doctor and he told me they gave me a 25% discount on the price of the medication. Please, I still need $309. Donate and help me, I don't want to die, please 🥺🥺💔
Please help us. My father was crying by my side, saying, "I don't want to lose you like I lost your mother." He kept crying. Please save my life, even with a small amount. We still need $294. Please donate. 💔💔😭
The shooting occurred Sunday afternoon outside a Walmart in Senatobia, according to the Mississippi Bureau of Investigation.
literally yesterday. all because someone called the police about DIAPERS being shoplifted.
Black children deserve to live and be safe around ALL people, around the world but something so simple is routinely denied to us on the daily by people more concerned with making sure their group doesn’t become the next underclass in which the entire modern world operates on its dehumanization.
im so sorry to this baby, their family, and every Black family dealing with the horrors of antiblackness, having our freedom or lives stolen from us every day.
meanwhile, LAPD shot and killed a Black woman’s dog after being called by her neighbor for being “too loud” during the Knick’s game, one of the biggest basketball event in years.
i seen more comments by nonblack ppl showing sympathy for the dog than the Black woman in the video literally hugging her beloved pet’s dead body in tears while a mob of LAPD officers stand around and watch her dispassionately.
Hey everyone. There's a new youtube feature that rolled out just yesterday that's raising some privacy concerns.
People in the U.S., U.K., Brazil, and Singapore can now share videos and chat with friends directly within the YouTube app. The update bring
This post talks about a new DM feature in youtube. What it fails to mention is that as part of this new feature is that when you send someone a link to a video, and they open it in the youtube app, they will see who sent them the link. Specifically, your channel name.
If your google account name is your real name, so is your channel name by default.
This means the new default behavior is that everyone you send a youtube link to will see your full name if they open it in the mobile app.
To turn this off:
Go to your youtube app settings
Go to Privacy
Turn off "Channel visibility for shared links"
Trimming the source id (the stuff after the '?' in links) will also prevent this from happening.
I think if you want to understand bigotry against aromantics, I have a good case study. Let me talk a little about my dad's family.
My dad has 4 half siblings and two step siblings. They're all a decent bit younger than him. When I was a teenager, we went to a family reunion, and I realized something—my dad did not respect his siblings. He looked down on all of them. He saw them as fuck-ups and overgrown children. My dad had the American dream: well paying management job, suburban house, wife, and three kids. My aunt and uncles did not. Excluding my aunt, none of them were married or in serious relationships. They hadn't really settled into long term careers. Several of them were working the kind of jobs that get called "Unskilled labor." So he looked down on them because the youngest one was in his thirties (and several were much older), and yet none of them had "settled down" into what he saw as lifelong, permanent careers and relationships and lives. He was polite to their faces, sure, but I heard how he talked about them behind their backs, to my mother.
And then a few years ago, we visited his brothers again for Thanksgiving. And I realized something again--he respected them now. He saw them as equals. Why? Well. All of a sudden, every single one of them had serious, committed romantic partners. They didn't even need to still be with those partners—one of my uncle's fiance passed away from cancer before they could marry—just having had one showed that they matured into a real adult participating in society. In fact, at one point, my aunt was telling my mom about how one of my uncles was no longer living in an apartment she owned, but instead, after having a steady girlfriend for about a year, he moved in with her. And my mom literally said to my aunt, "wow. Look at that. He finally grew up."
One of the lines that frequently gets repeated about anti-aspec sentiment is "why would anyone hate asexuals/aromantics/etc? They aren't even doing anything." And that's exactly it. In the eyes of amatonormative culture, we aren't doing anything. Adults are supposed to do things. That's how you become a member of society.
I know that my father will never see me as a successful adult. He will never approve of my life. And I think most people would assume that that's because I'm trans. And don't get me wrong, he sure as shit doesn't like or respect that, but I do think if given enough time, he would get used to it. He would eventually realize that it isn't going away. And if I settled down with a spouse and a respectful job and a few kids, he could see me as a successful adult that he could be proud of anyway. But of course, that's not going to happen. Because I'm aromantic. So I'm never going to do that one thing that signifies that his job is complete, and I'm officially a full-fledged adult. I will perpetually be that fuck-up kid who won't settle down. In my personal case, that's okay. My dad is a conservative piece of shit, and if he doesn't approve of you, that just means you're doing something right. But on a societal level? This kind of attitude is a massive problem. Aromantics deserve to be treated like adults, and to feel like the accomplished adults that they are. We should feel like we belong in society.
