An Audiologist's View of the AirPod Pro 2 Hearing Aid Feature
If you haven't heard the hype, Apple has introduced a hearing amplification feature in its latest upgrade of AirPods2. The media has published much about how the free, downloadable feature can test your hearing and amplify sounds as an effective tool for individuals with mild to moderate hearing loss. But is it effective?
Apple AirPods are known for their sleek design, impressive sound quality, automatic phone pairing, touch control, and noise cancellation. This new feature expands their accessibility offering and cements their top standing in personal audio technology.
A Silent Plight: More People Are Hearing Impaired Than You Realise
Hearing loss, said to be the second most common sensory impairment worldwide, affects over 12 million South Africans (Department of Health). Numerous people go undiagnosed for many years, while another significant portion choose not to treat their hearing loss or consider hearing aids.
Meanwhile, seasoned hearing aid users rely on their devices for daily communication—enabling work commitments, enhancing relationships, and feeling connected.
One typically needs to see an audiologist or acoustician to have their hearing evaluated and treated with prescription devices. This practice is the gold standard for hearing healthcare treatment because:
An audiologist or acoustician formally assesses all the frequencies (pitches) required for us to hear conversation.
The assessment is performed in a soundproof/treated room for this specific purpose.
Hearing loss forms part of a holistic picture, so the practitioner can often assist with additional pathology diagnoses beyond hearing alone.
An audiologist can assess for:
vertigo
dizziness, and
identify anomalies in the outer and middle ear.
This is done via visual inspection and machinery that evaluates the function of these parts of the ear.
Emerging Hearing Technologies That Improve Accessibility
We have recently seen a rise in Over-The-Counter (OTC) hearing devices. This is not yet legislated in South Africa, but it is a matter of time. Even though they aren't available for purchase on our shores, more South African patients are buying OTC devices online, from overseas, or they are gifted a set from abroad. As they aren't supported here, practising audiologists cannot adjust those OTC devices. This sadly means being stuck with unoptimised—and probably—uncomfortable devices.
In anticipation of the day OTC devices will be available, and now with the AirPod Pro 2 hearing aid feature, I think this is an opportune time to explain the hidden threats of living with untreated hearing loss and the benefits of OTC and other Apple AirPod-type technologies that will inevitably emerge.
Understanding the Options For Improved Hearing: Are AirPods Right For You?
If OTC exists, it must be viable—so that option or even Apple AirPods can't be wrong, right? There is no straightforward answer.
This is why it is essential to fulfil my primary role of educating you on your options. Audiologists and acousticians have studied the intricacies and differences between:
hearing technologies,
personal amplifiers,
prescription hearing devices, and
surgically implantable devices.
Opinion: Pros And Cons Of The AirPod Pro 2 Hearing Aid Features
Here is a breakdown of the various features and what they mean in my opinion as an audiologist. This breakdown is not medical advice; a consultation is required to assess your unique needs.
Amplified Sound For Mild To Moderate Hearing Loss
Various studies show that AirPods deliver and amplify sound remarkably well, especially for a multi-functional device. However, they often don't perform as well as professionally programmed devices.
Conversation Boost improves speech clarity when there is background noise, but it does not match the adaptive processing capabilities of conventional hearing aids (particularly in challenging listening situations).
Verdict: Not suitable for severe hearing loss, but the amount of amplification will match the needs of someone with a mild or moderate hearing loss. Having said that, colleagues in The United States tested the devices with a mild to moderate age-related hearing loss. They observed that these devices under-amplify. Therefore, it would be a good idea to ensure that the user has had their ears diagnostically assessed before to confirm benefit and then tested with them on, to confirm accurate benefit.
The Cost Advantage
I'll give it to Apple that the AirPods cost is more palatable than conventional hearing aids, which will always be coupled with testing time and consultation fees. This means there are no appointments, prescriptions, or medical aid approvals for AirPods, making them more accessible. However, in my time as an audiologist, I can say without hesitation that a patient almost never gets their hearing aid to fit comfortably and be perfectly programmed after a "first fit". Most of my patients will need domes or moulds adjusted to be more comfortable and settings adjusted to suit their active, dynamic lifestyles. This is important to bear in mind when purchasing an OTC device or something online.
Breaking Prejudices While Growing Awareness
Thanks to its accessibility, the Airpod Pro 2 hearing aid feature will potentially:
1) Remove the stigma of hearing aids being for cognitively challenged or older adults.
In-ear pods are a common sight, so they wouldn't draw attention. However, they may create an awkward social situation if someone assumes they can't talk to you because you're listening to music.
2) Educate more people about their hearing challenges (when they otherwise wouldn't know or seek an audiologist).
A feature like the built-in hearing screener takes into account 500Hz, 1000Hz, 2000Hz and 4000Hz. Positive test results may prompt people to seek medical advice. It's a positive start. Sadly, the app can't identify acoustic neuromas (non-cancerous brain tumours) that can cause hearing loss. So, people must not view this feature as replacing regular audiology check-ups.
Not Suitable for All-Day Wear
People typically wear their hearing aids all day, from waking up to bedtime. Hearing aids professionally prescribed are tested for these conditions, allowing all-day comfort and uninterrupted hearing. They also have sufficient battery time to last. One needs to know how long the battery of Apple AirPods2 will last on one single charge, with streaming. It would be a problem if they die prematurely because of a limited battery lifespan.
As a clinical audiologist, I can guarantee that there is no "one size fits all" with hearing aids regarding comfort and fit. As such, I'm concerned that the rubber tips of the AirPods may irritate the ears, particularly if used for prolonged periods.
General Earbud Health and Hygiene
Any in-ear earphones—earbuds—are breeding grounds for bacteria, fungus, and other pathogens. They are also responsible for impacted earwax, a more prevalent problem as younger people spend more time streaming music and podcasts via earbuds.
Hearing aids have wax filters, which can be replaced once clogged. I am unaware of AirPods doing the same (so they may get clogged over time). This raises questions about protecting the ear from wax and debris and the canal from fungus. The latter is significant for residents of coastal regions, like KZN, where high humidity proliferates fungus growth.
Final Verdict: A Bridge But Not The Be-All
Ultimately, AirPods and other OTC devices cannot fully replace all the features of conventional hearing aids, particularly for those people with complicated hearing issues and severe impairment.
They may bridge a gap for people who feel they hear less well than they used to but aren't ready to seek professional help.
It's exciting to see a global company like Apple potentially enhance the general public's awareness of hearing loss and reduce the stigma of wearing a "hearable." We hope that progress like this continues so that, if needed, people will more readily adopt prescriptive devices verified or validated according to their ears and individual hearing.