Hearing aids for music: exploring the music listening behaviour of people with hearing impairments

Today, people with mild, moderate, severe or even profound deafness are able to perceive music to some degree by using modern hearing aid (HA) technology. In this way, music can form a powerful personal, social and emotional aspect of their lives, enhancing physical and psychological well-being, just as it does for people with 'normal' hearing. Current research on music listening behaviour highlights the ways in which people use music to facilitate day-to-day activities (e.g. while doing housework, travelling or working), to manage mood and emotions (e.g. during exercise or when feeling particularly elated or depressed), and for therapeutic reasons (e.g. to manage pain or aid relaxation). This research, however, is usually carried out with 'normally' hearing adults and there is a lack of understanding about how mild, moderate, severe or profound deafness and the use of HAs affect music listening. There are currently over 10 million people with some level of deafness in the UK representing one in six of the population and this figure is set to rise dramatically to 14.5 million by 2031.

This three year project represents the first large-scale systematic investigation of how music listening experiences are affected by deafness and the use of HAs. This interdisciplinary research brings together academic researchers in fields of music psychology and audiology and is concerned with questions of auditory musical perception. By exploring the links between hearing impairments, HAs and music listening behaviours, this research seeks to improve the perception of music using HA technology. In-depth case studies exploring subjective experiences will set the context for a wider national survey of music listening among people with hearing impairments. Alongside this psychological research, audiometric data will be used to quantify levels of hearing impairment and amplification to provide a clear picture of musical auditory perception. A stakeholder report outlining the current and potential role of manufacturers, distributers, audiologists, and users with respect to the improved function of HAs for music listening, will be sent to all parties. It will outline fitting strategies of benefit to NHS and private sector clinics. It will also highlight priorities for research and development in new digital signal processing of benefit to manufacturers. The proposal includes resources for a bespoke website and discussion forum which will provide the general public with facts and figures, research findings, useful contacts, and a means to interact with the project and other HA users interested in music listening issues. The website and forum will be promoted though existing links with deafness organisations and through existing twitter feeds (@musicndeafness) and social media to maximise public engagement.

The research findings will directly benefit people with all levels of deafness and HA users, both in the UK and internationally through open access content on the website and forum, and via more traditional modes of dissemination including conferences. This growing population will benefit from knowledge exchange provided by psychological insights into aural musical rehabilitation. It will support audiologists in addressing music listening challenges presented by patients in their clinics in a field in which there exists no formal training. It will also provide an empirical basis for manufacturers of HAs to align their signal processing research and development activities with real-world problems and experiences of everyday music listening. Improved access to music using HAs will benefit people of all ages, facilitating music education for deaf children and young people, musical listening and performance in adulthood, and continued musical engagement into old age. This research has the potential to transform thousands of people's lives.

The research will benefit the following three groups: people who use HAs, audiology professionals who fit HAs and commercial stakeholders who manufacture HAs.

First, and primarily, the research will benefit HA users (approximately 1.4million people) by enabling them to improve their access to music and their enjoyment of music listening and performance. This research will provide HA users in the UK and internationally access to an online website and discussion forum and a printed leaflet containing facts and advice about getting the best from hearing aids and music, which will also be of benefit to providers of hearing aids and aural rehabilitation. The leaflet will be hosted online and sent to NHS audiology clinics and private HA fitters throughout the UK, highlighting key facts and promoting the project website. In these ways, the research will allow HA users to extend the use of their technology into music-listening situations and ensure that a music listening program is provided to maximise the users' potential to listen to music. For D/deaf children, this will provide opportunities for musical development, learning and performance that would not exist otherwise. For adults and those with age-related presbycusis, improvements to HA technology fitting will allow music listening for enjoyment, benefiting the health, wellbeing and quality of life of users across the human life-span.

Second, the research will benefit audiology professionals by providing evidence-based clinical recommendations and strategies to improve the fitting of HAs for music listening, increasing clinicians' level of confidence and expertise. Strategies will extend to social and behavioural changes the user can make to improve music perception in different listening and performance situations. As HAs are not currently optimally designed for music perception, and formal training in this area is not mandatory, there exist challenges and opportunities for audiology professionals to extend their skills. This will be enabled by academic dissemination via UK audiology societies, supported by the patient advice leaflet in addition to development of a web based learning module which can be accredited for CPD by the BAA. By providing empirical and objective strategies, the recommendations will increase clinicians' ability to discuss patients' music-listening experiences and extend their use of existing outcome measures from both audiology and music psychology allowing them to better address patients' needs. Practitioners will be invited to engage with discussions on the website and forum connecting their expertise with HA users throughout the UK, helping patients access nearby clinics and allowing fitters to expand their practice.

Third, the research will benefit the commercial HA manufacturing industry, estimated to be worth £350-£375 million in the UK, by providing empirical, academic research into the usage patterns, problems and preferences of their user market with respect to music listening, via large-scale survey research. Manufacturers' in-house research and development (R&D) activity over recent decades has yielded significant advancements in digital signal processing solutions for speech perception using HAs, with music-listening solutions being a lower commercial priority. This research will provide an agenda for future R&D activity for HA manufacturers with respect to problems that need to be targeted by signal processing solutions for music listening, and enable manufacturers to focus their activity on confirmed trends. Manufacturers will also benefit from learning more about the issues faced by audiology professionals regarding fitting for music listening. The stakeholder report will be sent to all UK HA manufacturers directly and via the British Hearing Aid Manufacturers Association (BHAMA). Representatives of HA manufacturers will also be invited to contribute articles and discussion on the project website and forum.