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Don't settle for a PSAP when you need a hearing aid

With nearly 20 percent of Americans suffering from hearing loss (according to a 2011 study conducted by The Johns Hopkins Center on Aging & Health) it’s no surprise that many people with hearing impairment have started searching for hearing loss solutions online, where they can find information about hearing loss, hearing aids and other sound amplification options.

These days, more and more consumers have been tempted to purchase less expensive over-the-counter devices, called personal sound amplification products (PSAPs), rather than see a hearing care professional for hearing aids. Although hearing aids are custom-fitted devices that provide the best solution for most individuals with hearing loss, they carry the stigma of "making you look old" and having a price tag that's "too expensive". It also takes time to get hearing aids fit appropriately by a hearing care professional, including follow-up visits for adjustments and maintenance as time goes by.

In this busy world, consumers are looking for a much quicker, more cost-effective solution. But is a PSAP actually more cost-effective? And is your hearing ability really the place to cut corners?

What is a PSAP?

PSAPs are best for bird watching

A personal sound amplification product, or PSAP, is a one-size-fits-all electronic device that amplifies soft sounds. These devices are regulated by the FDA, just as hearing aids are regulated. In a statement on their website, the FDA advises that these devices are not intended to be used by individuals with a decreased capacity to hear. Instead, they are intended for use by people with normal hearing ability who want to heighten their ability to hear for certain recreational activities, such as hunting or bird watching.

At first glance, a PSAP has some design similarities to a hearing aid, such as a microphone, a loudspeaker, an amplifier and a battery-driven power supply. They usually bear a resemblance to BlueTooth devices or the earphones used with MP3 players, though the style does vary depending on the make and model.

However, because PSAPs are not designed for or intended to be used by individuals with hearing loss, they are not regulated by the FDA in the same manner as a hearing aid. Some individuals have likened PSAPs to "cheater" eyeglasses that you can buy at the drugstore, and it's not an unfair comparison. Much like over-the-counter eyeglasses aren't set for your visual abilities, PSAP devices aren't custom fit for your ears or your hearing loss.

How is a PSAP different from a hearing aid?

Unlike PSAPs, hearing aids are FDA-approved medical devices that are prescribed and fitted by licensed hearing healthcare professionals. The technical capability and programming of a hearing aid goes far beyond simple amplification of sound. Current hearing aid circuitry includes features for reducing background noise, using multiple microphone arrays to provide directional enhancement and improve localization, wireless connectivity for accessing other personal devices and multiple programs to improve hearing ability according to the environment. Many of these features can be automated.

So while a PSAP takes all sounds and increases the volume of them, a hearing aid uses sophisticated algorithms to precisely divide sounds according to volume and pitch. It then makes volume increases according to the individual’s hearing ability across all pitches. What's wrong with increasing all sounds? Nothing, if you're bird-watching. But for having conversation, this can create problems. Most hearing losses are not the same across all frequencies. This means for most people with hearing loss, a PSAP may increase the volume of sounds that the person does not actually need amplified. This can lead to lots of difficulty understanding speech.

What are the risks associated with PSAPs?

For many people, the risk may be to the wallet. While hearing aid sales are regulated by state laws which mandate a return period of at least 30 days, PSAP sales are unregulated and may not have a money-back return policy at all.

PSAP users may also be risking their health by not first seeking the advice of a licensed hearing care practitioner to properly evaluate their hearing loss. Sometimes hearing losses are caused by an earwax blockage of the ear canal which can be easily resolved while other hearing losses are caused by a medical emergency that requires immediate treatment by a physician. By skipping a professional hearing evaluation, a serious medical condition could be overlooked.

Another risk is that a person with hearing impairment who could benefit from a hearing aid might buy a PSAP instead and not see any improvement in understanding speech. This could cause the user to develop a negative bias towards hearing devices and prevent them from exploring hearing aids that could make a huge difference for them.

Perhaps most importantly, hearing aids have customized output limits to make sure that the sound is not delivered at a level high enough to cause further damage to the already impaired hearing of the individual.

Why do hearing aids cost more than PSAPs?

Hearing aids are sophisticated FDA-approved medical devices designed specifically to treat hearing loss and are manufactured to rigorous standards. Hearing aid manufacturers employ highly-educated audiologists, engineers and scientists who conduct ongoing research to continuously improve sound processing algorithms and hearing aid design. Hearing aids are fitted and programmed by educated individuals who are tested and licensed by their state. These hearing care professionals are required to undergo continuous training and professional development.

By comparison, PSAPs are relatively simple electronic devices that are purchased "over the counter" and aren't designed for people with hearing loss.


While in the short term, PSAPs may seem to be a cheaper alternative to a clinically prescribed hearing aid, you have to consider the risks as well as the savings. Is the device really going to meet your needs? If you think you might have a hearing loss, find a hearing professional near you and get a complete hearing evaluation. Then decide whether a PSAP is right for you.