https:/.../28c3-4669-en-bionic_ears_h264.mp4

[APPLAUSE]

HELGA VELROYEN: Hi.

Can you hear me?

Ah, nice.

That's what it's all about.

Welcome to my talk.

I will talk about hearing
aids and what the

state-of-the-art is.

There will be a little hacking,
but not my own.

I know that there are some
people interested in my talk

that can not hear very
well or not at all.

So I will publish slides that
have very detailed speaker

notes so that you can
read it afterwards,

if you missed anything.

I hope there will be a
recording available.

And if it's possible to add
subtitles, I will do those.

OK.

First, a few words about me.

I'm a software engineer.

I am based in Munich.

Some people might know me from
my time in Cologne, as well.

I'm more a software geek
than a hardware hacker.

So all this is also new to me.

From university, I have a
background in data mining and

signal processing.

I worked in the medical
industry for a while.

But that had nothing to
do with hearing aids.

Also, my current job
has nothing to do

with hearing aids.

So this is really just
my personal project.

I'm hearing impaired for
about 3 and 1/2 years.

So this is when I started
to dig into the topic.

And well, yeah, that's just
what I will talk about.

Since I haven't seen many talks
about audiology here at

the Hacking Congress, I will
start with a short

introduction and the process
of how you get

hearing aids, actually.

Then what are the current
hearing aid models, and what

can they actually do.

Some words about the peripheral
hardware.

There's quite a lot
of it outside.

And there is some hacking.

And another point is
self-tuning, that are people

that tune their own hearing
aids, although they are not

audiologists.

So this is an audiogram.

This is a result of a hearing
test that you usually do at

ENT doctors.

The x-axis shows the frequency
in kilohertz, and the y-axis,

the loudness, level of volume.

The silence is at the
top, the really loud

sounds at the bottom.

And the green line you see
here is that result of a

normal-hearing person.

And this is obtained by the
audiologist. Or the doctor

plays sounds in the different
frequencies.

It starts at a very
low volume.

And as soon as you hear it, you
hit a buzzer or say, yes.

And then they create
this curve.

So the blue curve is a
typical curve of a

hearing impaired person.

So what you can see here-- that,
at the low frequencies,

their hearing is quite well.

That's very typical.

Their hearing starts to get
worse in the high frequencies.

And bear in mind that the
decibel scale is actually

logarithmic.

So if you have a hearing loss of
60 decibels, it's 1 million

worse than 10 decibels.

So it's not linear.

Another thing that gets measured
at an audiogram is

actually the maximum that
you can hear or that

you can stand hearing.

So the audiologist raises the
volume more and more, and you

have to say yes until
it hurts.

So what you see here
is the red curve.

It's the level of discomfort.

And also the typical thing is
that it raises exactly at the

areas where the hearing
goes bad.

This is a very complicated thing
for tuning aids because

they can not just amplify
everything.

Because you would hurt people
very soon, as soon as you get

below the red line.

Another thing is the area where
speech takes place.

This is called speech banana.

Actually, that's the technical
term for it.

It will rise, of course,
according to the language and

the speaker.

For example, female speakers
have a little slightly

different curve than
male speakers.

And this is the area where
hearing aids target, which is

they are used to make you
understand speech again.

So they focus on this
area, actually.

And you can see the
blue line here.

So half of the banana
is actually cut.

And this is the high
frequencies, which, in speech,

are the consonants like
S and F, for example.

The vowels are usually
understood quite well.

To give you an impression how
I hear, I made a sample.

So this is a song called, "Sad
Robot" from Pornophonique.

It's a nice band which
makes music with a

Game Boy and a guitar.

And the original--

[SAD ROBOT, BY PORNOPHONIQUE]

HELGA VELROYEN: --has
really nice high

frequencies at the beginning.

This is why I use
it for testing.

And later, there's also
some singing.

So this is the original.

And now I'm going to play my
version, so with less high

frequencies and a tinnitus
as well.

There's actually a web site
where you can download

tinnitus sounds.

[LAUGHTER]

HELGA VELROYEN: And it says that
you should actually turn

down the volume when you start
broadcasting that because it

can hurt the audio equipment.

So I hope I don't destroy
anything.

So I will turn it down first,
then slightly increase it.

[SAD ROBOT, BY PORNOPHONIQUE]

HELGA VELROYEN: So this
is not a feedback

loop, it's the tinnitus.

And without the high
frequencies,

this is how it is.

So it's really hard to actually
hear the high

frequencies.

Yeah, so this is just an
impression of what hearing

aids have to work with.

Getting hearing aids,
I like to compare

it to getting glasses.

So one day you wake up and
everything is really blurry.

And you decide well, this
is very not so good.

I should go to a doctor.

And then you go to a doctor.

You make some tests.

Then he sends you to an
optometrist. He makes some

more tests.

Then you choose a model
for your glasses.

And the optometrist orders
the glasses and puts

them into the frame.

And then you're happy,
seeing nerds.

And then you can see ponies.

[LAUGHTER]

HELGA VELROYEN: Getting hearing
aids, unfortunately,

is not that easy.

So one day you realize you can
not hear very well any more.

You go to a doctor.

You make some tests.

He sends you to an audiologist.
He makes some

more tests.

You choose from the shop
of the audiologist

some hearing aids.

And then the audiologist has
to adjust the hearing aids

according to your audiogram.

And then it doesn't stop.

So then, actually,
the work starts.

You have to go through all the
difficult hearing situations

to test if it works with
that tuned hearing aid.

So you drive a car.

You listen to music or other
people in the car.

You try to have someone whisper
something in your ear.

You listen to the TV. Or you go
to a party where a lot of

people are talking to each
other, and you have to make

out the person that's talking
directly to you.

Or you listen to a talk like
that where this speaker is

actually quite far away from
your hearing aids.

And if you have done all that,
you go back to the

audiologist. And you have to
tell him why it doesn't work

or in what situations it
doesn't really work.

And then he does some changes
in the parameters.

And then you have to
do that again.

And sometimes you switch
to a different

hearing aid, as well.

So this whole process, these
iterations, it takes weeks or

months until you have something
that is actually

fitting to your ears.

And after that, you're
sort of happy.

Actually, I haven't met a person
that has hearing aids

that actually compensate for the
hearing loss completely.

So whenever you are done with
that, you're usually just

stopping because you don't
want to spend any

more time on that.

And it works well enough.

Compared to glasses, this is
actually a lot more effort and

a lot more frustrating.

Another thing is that hearing
aids are really expensive.

A good hearing aid starts at
like, 1,500 up to 3,000.

And I only have the numbers for
the German health system.

The normal German insurance
pays 500.

So there's a lot of money you
have to pay for yourself.

Hearing aid models and
their features.

There are roughly three types,
in-ear units that go

completely into the ear canal.

A more common one is behind-ear
hearing aids.

They are for mediocre to
severe hearing losses.

The main part is
behind the ear.

And another special thing are
cochlear implants where parts

of it are implanted into the
head and some is attached from

the outside.

I will mostly talk about the
behind-ear hearing aids,

because that's what I have and
where is a lot of variety on

the market.

Hearing aids got pretty
invisible.

These are pictures of me wearing
my hearing aid and not

wearing it.

So except for this little wire
on the right side, you can not

really see it.

Most people that don't
have hearing aids

find this an advantage.

People who have a hearing aid,
actually, are not that sure

about it, because sometimes,
when you have to ask someone

to repeat a sentence, if they
know you're wearing a hearing

aid, they think, OK,
she didn't get it

because of the acoustics.

And if they don't see it, they
think, she didn't get it

because she was stupid.

So it's really not
that obvious.

And sometimes it just helps that
people see that you have

a handicap.

They also got pretty small.

This is an example of my hearing
aids with a $0.50

piece, so you have an impression
of the size.

And you can see that, actually,
have just by the

battery compartment.

Out of curiosity, I took
my hearing aids apart.

And--

[LAUGHTER]

HELGA VELROYEN: Of course.

[LAUGHS]

[APPLAUSE]

HELGA VELROYEN: You can see they
have shells which you can

take off, which is like
for mobile phones.

You can switch the color and
choose a different one.

And the body--

so I know this picture
is not really good.

There's still a lot of
plastic around it.

And the white part there is two
microphones, the signal

processor and antenna.

That's useful peripheral
hardware.

I will come to that.

And the speaker is actually
at the part that

goes into the ear.

And what you can also see here,
the part that goes into

the ear has also holes where
the natural sound can still

come to the ear.

So if you still hear low
frequencies, then you can

receive them naturally.

And the hearing aids only add
what you can not hear.

This is called open
hearing aid.

And it has the advantage that
you still hear natural sounds,

which is really nice if you're
really sort of an audiophile

person that likes to
listen to music.

And so the first thing you do
is actually choose that one.

Yes.

I think in the last
two centuries,

hearing aids got digital.

And with that, they come with a
lot of new features that you

couldn't do with analog
hearing aids.

And right now, they
are standard in

most first world countries.

And the most important thing is
that they can analyze the

situation and react to it
instantly, since they have

signal processing in it much
more sophisticated than analog

hearing aids did.

Coming back to the audiogram,
this is actually a feature

that can also be done by
analog hearing aids.

I don't know in what
extent, actually.

So if you have a look at this
audiogram and only consider

one frequency band, like for
four kilohertz, here the

hearing loss is between
60 and 90 decibels.

Over 90 decibels, it
gets too loud.

And the input of the environment
still has the

whole range.

So the hearing aid has to map
0 to 130 decibels to this

small area between 60 and 90.

It can not just amplify
everything,

because that will hurt.

And this is called
compression.

This should not be mistaken
with compression in audio

files like MP3 or something.

It's a little bit different.

And if you have a look at the
software that is used to

adjust hearing aids,
it looks like that.

This controls here at
the amplification.

And this here reduces
the maximum level.

So my hearing aids can, at
maximum, do 108 decibels.

And if you have minus 12, you
just subtract it from that.

This has the problem that, if you
compress it, the volume

gets increased and decreased
all the time.

And this can actually make it
harder to understand speech,

because the hearing aid is
adjusting all the time.

And so to avoid that, they don't
compress every time.

So the first area here is
linearly amplified.

And only after a certain level,
they start compressing.

And this is called knee point.

So they usually try to avoid
compressing the speech signal

and only something above that.

And hearing adjusting software,
it looks like that.

This is actually an example
only from Siemens.

Every branch has their
own adjusting

software or tuning software.

So this is just an example.

So here you have the knee point
in the first row and the

factor by what it
is compressed.

And the third row is a
factor regarding how

fast it should react.

So within one syllable, it's
adjusted to the right volume.

Ah, OK.

The problem is what do you do
when your hearing loss is so

bad that the red and the blue
curve actually meet each other

or the blue curve goes
all the way down?

And this is actually a problem
because then you can not do

compression any more, at least
not in the original sense.

So this is a simplified
audiogram.

This is the area that is dead.

So instead of compressing in
one frequency band, you

compress the frequencies.

So you reserve a part of
the still alive hearing

frequencies and map it there.

This is called frequency
compression.

And it works only if you have
closed hearing aids, meaning

those where you can not hear
natural sound any more, where

the ear canal is really blocked
by the hearing aid,

because, otherwise, it would
be really confusing.

And this is actually offered by
only one brand right now,

by a company called Phonak.

And it's actually quite hard
to get used to that.

The brain has to adjust to that
for a very long time.

What I heard.

I mean, I don't have this.

But still, it's interesting
that they try

to do it like that.

A very common problem with
hearing aids is feedback

loops, especially if you
have open hearing aids.

Then it can happen that the
hearing aid captures its own

sound and amplifies it a lot.

There is just this squeaking,
what you get when you get too

close to them.

And this is really annoying.

It happens every time
something gets

close to your ears.

It can simply be hair,
wearing open.

Or you put on a hat.

Or you hold a telephone handle
next to your ear.

Or you just want to lie
down on the sofa.

Or especially when you hug
someone, you start squeaking.

Like you give bionic feedback.

[LAUGHTER]

HELGA VELROYEN: Yeah, this is
really, really annoying.

And what the hearing aids
do, they try to

detect feedback loops.

So they look for clear
sinus signals.

And when they detect one, they
send an un-hearable flag.

So oh, I detected one.

And then the affected
frequencies get damped until

it doesn't squeak any more.

They can adapt in real time.

So it actually works
really fast,

but it's still hear-able.

So the problems with that is
that music contains clear

sinus signals.

And those get then damped,
which make your music

experience a lot worse.

And also the damp frequencies
can be in the speech banana.

And then that means whenever you
put on a hat, then you get

a feedback loop.

Then the frequencies
get damped.

And then you can not understand
anyone any more.

Analog hearing aids did not have
a measure against that.

So this is something that is
clearly new with the digital

hearing aids.

The screenshot here
is also taken

from the tuning software.

When you have tuned your hearing
aid, you can make a

feedback loop test, where you
place a lot of different

sounds and tries if it detects
the feedback loop.

And then it reduces the maximum
power of the output of

your hearing aid.

That means you spend hours
tuning your hearing aid, and

then everything gets
reduced by that.

A very common problem for people
with hearing impairment

is the cocktail party problem.

This is when you're in an
acoustic setting where a lot

of people are talking and you
have some background noise.

And then someone is
talking to you.

And you have really problems to
figure out the person that

is talking to you.

And there are several
factors in that.

And hearing aids react to
that in several ways.

So first of all, directional
hearing is impaired when you

have a hearing impairment.

The human ear uses two
ears and the brain

to locate the sound.

And we use the pinna, that is
actually the outer part of the

ear, ohrmuschel, in German.

If you have behind-ear hearing
aids, of course, most of the

microphones and everything
else is behind the ear.

So you can not use the pinna.

You have to simulate that
in a different way.

And this is why both hearing
aids have two microphones.

So you have four microphones
in total, when you have a

hearing impairment
in both ears.

And this way, they can detect
if the sound comes

from front or back.

And they talk to each other, so
they can also detect if the

source of the signal is
right or left to you.

Additionally, they try to
recognize the situation and

automatically focus on the
person that is talking to you

and also to reduce the
background noise in general.

The in-ear hearing aids I
showed before, they, of

course, still can use the
features of the pinna.

This is also a screenshot from
the tuning software.

You can actually test
your directional

hearing in real time.

So you can wear your
hearing aids

connected to the software.

And then you can do something
like that, and see if it's

recognized correctly.

It works, more or less,
in a silent room.

But yeah, not in a
cocktail party.

Yeah, generally, it's really
hard to extract foreground

from background noise, because
foreground noise has all the

high frequencies and background
noise doesn't.

And if you don't hear high
frequencies at all, everything

is one blob of sound.

Hearing aids help with that
because they mostly focus on

high frequencies.

And they have filters
to filter out

the background signal.

But actually, that doesn't
really help so much, because

those situations, recognitions,
they tend to

fail as well.

So sometimes it's likely that
a person that is talking to

you gets faded out because it
is considered as noise.

[LAUGHTER]

HELGA VELROYEN: But sometimes
they also work very well.

I mean, it's also coincidence.

Sometimes you're in a setting
which has exactly the

situation that the hearing
aid can work well with.

So sometimes you are here with
a hearing person, actually,

and then you hear
him quite well.

And then you start talking in
a normal voice, because you

can actually understand
everything.

And then that hearing
person is asking

you to repeat a sentence.

This is really weird
sometimes.

The tuning software for hearing
aids also has a real

time monitor where you can
see some parameters.

So you wear your hearing
aids and then, for

example, listen to music.

And then you can see here the
dark areas are where the

hearing aid actually
started to work.

Below that, it doesn't
need to amplify.

And the grey thing here
is the speech banana.

So you see that it's optimized
in a way that it starts

amplifying in the
speech banana.

It also has the situation
recognition

and different settings.

And one of those is
music, actually.

I tried it with different
types of music.

Actually, if you like heavy
metal, you will never see

music here.

It's usually noise.

[LAUGHTER]

HELGA VELROYEN: A problem
with hearing aids

is humidity, actually.

So most hearing aids
are not waterproof.

That doesn't sound so bad, but
actually, a lot of things are

related to that.

So that means no swimming with
friends, no pool parties, no

water sports where you'll
have to talk to someone.

Sweat is a problem, especially
for people

who do a lot of sports.

No audio books in the bathtub.

No heavy rain.

So if you go to an open air
concert and it starts raining,

you will really have to
take care of that.

Also, just like wet hair, when
you go out of the shower, you

have to wait until your hair is
dry until you can put your

hearing aids in again.

A very recent development is
that Phonak also offers

hearing aids that are waterproof
or water-resistant.

They claim that you can hold it
under water for 30 minutes,

and then there will be no
irreparable damage.

I'm not really sure
what that means.

So I guess you probably
have to dry it.

[LAUGHTER]

HELGA VELROYEN: Or if you have
to give it into repair for

weeks until you get it back.

Oh yeah, by the way, you don't
have a spare hearing aid.

So whenever your hearing aids
break, you have to go to an

audiologist. And you get spare
hearing aids, which is like,

when you drive a Porsche,
you get a tractor.

And also, audiologists have
opening hours for the elderly.

So if your hearing aids break
on Friday night, you have to

wait until Monday until you
actually can hear again.

Yeah, those were the important
features of hearing aids.

But there is some peripheral
hardware that I

would like to present.

So there are different
interfaces for which you can

use to plug into your
hearing aids.

So the oldest one is the direct
audio input, which is

just here, a cable.

So it looks like that.

And it's usually connected to
the hearing aid with some sort

of shoe, which looks
like that.

And it has the pros and cons of
cables, of course, if you

like being on the leash.

But you also have no
interference with other

wireless stuff.

It's usually used to plug
something else in, for

example, FM or Bluetooth
adaptors.

And yeah, this is pretty
old technology,

but it's still around.

Although, for really small ones,
the plug is actually too

big, so they leave
it out there.

Another very common technology
is FM systems. You can buy

those from several vendors.

You have receivers
and transmitters.

They have different setups like
for a meeting, that you

can put a microphone on the
meeting table and hear all the

participants talk, or for
lecture halls like that, that

you can connect the microphone
to the transmitter

and listen to it.

There are some standards,
but most receivers and

transmitters don't work with
others from other companies.

But at least, if you plug them
in with these direct audio

input, you can choose an FM
system from a different vendor

than from your hearing aids.

The sound quality is said
to be quite good.

I actually could never try it.

But I heard that, actually, in
schools, hearing impaired

students listen to music while
actually they should listen to

the teacher.

And teachers call the
audiologists and ask, could

you make this stop?

They don't listen to
what I am saying.

A really common problem for
hearing impairment is calling

on the phone.

The problem is, first of all,
most people do lip reading.

So they don't rely only
on the audio input.

We use the visuals as well.

And of course, you don't
have that on the

radio or the telephone.

And also, for technical reasons,
the frequency range

of the phone line is reduced.

In Germany, it's like 300
hertz to 3.4 kilohertz.

That's the blue box
in this audiogram.

Also the background noise that
you have in the room where you

are talking on the phone, it
does have the full range.

So you get, actually, background
noise in a better

quality than the signal from
your person that you're

talking to.

Then, often, the signal is
altered and unnatural.

Sometimes you have
bad reception.

And also, you hear it only in
one ear if you just use a

usual telephone.

And if you hold it to your ear,
you get a feedback loop.

So a lot of things make
it really annoying

to talk on the phone.

And there are some technical
solutions for that.

The most old one is the
telecoil or T-coil.

And the source is connected
to an induction loop.

And you take off the
electromagnetics.

And this is from the telecoil.

It's there in the picture,
a really small antenna.

And there are different setups
for the induction loop.

So there are adapters that
have the induction loop

actually used to hang
it around your neck.

Or there are induction
loops installed in

lecture halls like this.

I don't know if there
is one here.

It's widely used in Europe,
especially in Scandinavia.

They even have laws where every
public building has to

have one or these public
lecture halls.

You have some pros and
cons, of course.

You have interference.

When you move inside the
induction loop, the level of

volume changes.

So it's nothing where you should
dance or something.

But if you sit still
in a theater or

something, it works.

Installing an induction
loop in a lecture

hall is quite expensive.

But there are actually
DIY kits available.

It's quite common that people
build their own ones.

And telephones also have
an induction loop,

even very new ones.

So all telephones which are
called hearing aid compatible,

they have an induction loop
that can be used with a

telecoil, even the new
iPhone, for example.

And then there's Bluetooth.

There are, right now, no hearing
aids that can do

Bluetooth directly because,
mostly, of the batteries.

Usually, hearing aid batteries
last one week to 10 days.

But with Bluetooth, I think
they would only

last a couple of hours.

Although there are no
Bluetooth-enabled hearing aids

on the market right now,
I've heard that they

are working on that.

Siemens is located in Erlangen,
which is not that

far from Munich.

So I have heard about people
who would test prototypes.

Right now, you have to use a
Bluetooth adapter to use your

hearing aids, attach that.

And there's different
versions of it.

So this is an example
of Phonak.

They built a really
nice thing.

This piece, you hang it
around your neck.

And the ribbon is actually the
induction loop that is used

with a telecoil.

And to this gadget you can
connect several things.

It has direct audio input, which
you can use to plug in

an FM system.

It also has aux-in that
you can directly

plug in your MP3 player.

And it has Bluetooth.

It actually also has a warning
to combine this with

pacemakers.

And I have a friend who has a
pacemaker and this thing.

He just ignored the warning.

But I think this is--

[LAUGHTER]

HELGA VELROYEN: Luckily,
he's still alive.

And I think this is a good
example for what we are

heading in the future.

We will get more and
more cyborgs.

And I doubt that every hearing
aid vendor is trying their

adapters with every pacemaker
there is.

So we will get a lot
of compatibility

problems in the future.

And if this really works, it
might be an option to kill

people really, really
silently, remotely.

[LAUGHTER]

HELGA VELROYEN: I mean, you
have to think of that.

[LAUGHS]

Siemens' solution was, of
course, not to use any of the

existing standards.

Just build something new.

[LAUGHTER]

[APPLAUSE]

HELGA VELROYEN: So they built
something called Siemens Tek.

And it hooks Bluetooth to the
phone, or to whatever you're

connected to, and some wireless
NFC protocol to the

hearing aids.

So the hearing aids also have
a small antenna in it, which

looks kind of like a telecoil,
but it is not.

And it is not compatible to
anything the telecoil is

compatible to.

So you can only use
it with this.

And it has a signal around
3.3 megahertz.

You can see it on
that picture.

I tried that.

And it's compatible with
every Bluetooth

speaking device, in theory.

And practically, you have to
check it with everything.

So whenever I get a phone at
work or whatever, I have to

check if it will
actually work.

So of course, it works best with
Siemens mobile phones.

But you can imagine
how old they are.

And yeah, they also are supposed
to work with land

line phones.

But on their websites, they say,
I think, it was only to

Siemens land line phones,
of course.

And other than that, they don't
guarantee that it works.

It comes with an additional
transmitter that you can

connect to your source that
is more far away.

The Tek itself has a
range of one meter.

So if you want to have a flat
screen TV, I don't know, five

meters away from you, you could
use the transmitter.

This thing costs about 400 euros
for just turning one

wireless protocol
into the other.

And no insurance is going
to pay for that.

So you have to pay for
this on your own.

If you have a generous
employer, you might

get some for it.

They also released a
new version of it.

This is on the right
side here.

It's called miniTek.

And it has, actually, less
features than the old one

because they removed
the display.

And they still want 400
euros for that.

And you don't get a discount
if you bought the old one.

Well, but I guess that's
marketing.

This is the sender with
the transmitter.

So you connect it to the
computer, and you wear the Tek

around your head.

It also has some patents for
the different programs. So

hearing aids have different
programs that you can change

manually so that you have one
for listening to music, or one

for your living room, and one
for outside, or whatever.

Of course, I took that
apart as well.

[LAUGHTER]

HELGA VELROYEN: You have to
couple this Tek with the

tuning software of
hearing aids.

So there is some kind of
authentification via a

7-character serial number.

I doubt that there is actually
a lot of encryption in there,

because the latency
is crucial.

Bluetooth already
has a latency.

And you don't want to
add that much to it.

But I also tried to use a
different Tek with my hearing

aids, and it actually
doesn't work.

So some kind of authentication
must be in there.

But if you're too lazy
to hack that, you can

still hack the Bluetooth.

There are lots of talks
about that here.

And of course, the PIN is 000.

And something that is not
directly about the Tek, but

the hearing aids also
communicate with each other.

So if I switch the program--
there's actually a small

switch on my hearing aids--

if I switch between the programs
on one ear, it also

tells that to the other ear.

And that one doesn't use
authentification.

I have heard that, when people
have the same model of hearing

aids and they're close to each
other-- for example, this

happens when couples buy
the same hearing aids--

then you switch your program,
and your spouse also gets the

program switched.

[LAUGHTER]

HELGA VELROYEN: And this can
actually only be changed by

the audiologist by changing
the channel.

So they have, like for wireless,
different channels.

And you'd set it to
a different one.

That's the security
about that.

Yeah, hacking.

When I started to dig into
that topic, I was really

disappointed that there is
not very much hacking.

So there's one forum called
hearingaidhacks.

livejournal.com.

This is the biggest
one I found.

But if you go through the
entries, it's mostly people

asking for technical advice,
So, I bought this and this

hearing aid.

What peripheral hardware
can I use with it?

I guess the reason for
that is that the

devices are really expensive.

And the warranty and the
insurances are really not that

nice if you break your
own hearing aids.

And you still have this problem
that audiologists

don't have opening hours.

They can not be used by people
who still have a life.

So people are a little resistant
to actually hack the

hearing aids.

But there is a little hacking
on the peripheral hardware.

I will show two examples
for that.

There's one guy called
Gertlex who built his

own Bluetooth adapter.

And he posted this on Flickr,
quite detailed.

And what you can see here, he
used a Sony wireless Bluetooth

headset, and hacked it in a way
where you can connect the

direct audio input cables
from the hearing aids.

The picture here in the
upper-right corner shows the

setup when he tested it.

So he actually didn't
test it with his

original hearing aids.

He used an old one
that he had.

And he even used an old MP3
player because he was afraid

of frying that as well.

So this is the precaution that
you have to do when you start

frying your hearing aids.

You can not only fry your
hearing aids, you can also fry

your hearing even more.

So you should be careful.

And there's another guy who also
made a Bluetooth adapter.

And he also took the DYI cables
here, those shoes that

you use to connect them, and a
Bluetooth mono thing here.

And this is actually the result,
that you connect it

directly to the hearing aids.

He also provided some nice
diagrams for that.

The slightly bigger scene is
actually the self-tuning

scenes for hearing aids because,
as I said, it's kind

of frustrating to get
hearing aids.

You have to go to the
audiologist a lot of times.

And he asks you, yeah,
what's wrong?

And then you have to describe
the situation.

But you're sitting in this
silent cavern at the

audiologist, so the adjustment
is not really done in

realistic circumstances.

And a lot of people get
frustrated about that.

So they spend weeks tuning
their hearing aids at the

audiologist. And still they're
unhappy with it.

So they try to get the hardware
and software that is

necessary for it.

And those are actually only
sold to doctors and

acousticians or audiologists.

And they are not sold
on eBay because

it is medical equipment.

And that is not supposed
to be sold on eBay.

So you have to use
other channels.

There's a black market for it.

It's kind of hard to put a price
on that, but I've seen

offers for the hardware,
which is called Hipro.

And there are different
versions for

serial use via Bluetooth.

And it starts with a couple
of hundred euros.

So you can imagine the pain
that people have when they

already spent 5,000 euros
for two hearing aids.

And then they spend even more
money, because they want to

tune them themselves.

And there is this self-tuning
scene.

And people really
hack the system.

The effort for people who
actually installed a fake

business, so they register a
business for an audiologist to

buy this hardware and then
stop the business again.

So there are actually people
doing a lot of effort to get

this hardware and software.

But of course, then you have
no customer support.

And when you fry your ears or
your hearing aids, then it's

your own fault.

There's one exception.

In America, there's a hearing
aid manufacturer called

America Hears.

They sell quite low-budget
hearing aids, up to

$1,000, if I'm right.

Then you send in an audiogram
of yours.

And they tune it at their place
for the first time.

And then you can download the
software and tune it a little

bit more at home.

Unfortunately, I've never
seen that software.

You can only order
it in the US.

But I would be interested to
have a look at that as well,

if someone has channels
for that.

Of course, some of this hardware
ended up in my hands.

This is a serial Hipro.

This looks really fancy, like
a modem from the '80s.

It's connected via serial.

And you connect the hearing
aids to it.

I have some close-up
pictures for that.

So you take out the battery and
put on a small cable which

has a contact of the battery,
the size of the battery, a

very flat cable.

And this is connected
to a bigger cable.

And that is connected
to the Hipro.

The Hipro is the same for nearly
all hearing aid brands,

so you can use it for Siemens,
and Phonak, and whatever.

But these small, flat cables,
they are different for nearly

every hearing aid.

So if you try to buy this Hipro
on the black market, you

also have to buy those cables.

There's also a Bluetooth
version that also

ended up in my hands.

It looks like that.

And it has the advantage
that you are not

connected to it via cable.

So you don't feel
like on a leash.

And I haven't really
used that much.

But this way, you could actually
go outside and tune

it in the subway or at
your office, because

you just need a laptop.

And it works without
your powerful wire.

The tuning software, I showed
you some excerpts from it.

This is just another
screenshot.

On the right side here, you see
the different programs. So

the universal one, here is one
for music, and one for the

tech, if you work with that.

When I was playing with the
tuning software, I found

something very interesting.

That it's actually
spying on me.

So it locks some stuff
and, for example,

how much I wear it.

Although I find 14 hours
a day a little bit--

I think I'm awake, actually,
longer than 14 hours.

But they use this, actually,
because people come and

complain, yeah, this doesn't
really work much.

And then they see they only wear
it half an hour a day.

And so, of course, you can
not get used to it

and adapt to it.

And you can also see what
different programs are used.

So mostly I use the
universal program.

And sometimes I have another one
called universal that is

actually tuned to have
less feedback loops.

That's the one I use when I put
on a hat so that I still

hear a little bit, but don't
have too many feedback loops.

And it also tracks how often I
was in a noisy environment or

was listening to music.

And since I like to listen to
heavy metal, this is actually

not correct.

Yeah, I found it really
interesting

what you can see here.

And yeah, I hope that it doesn't
record anything what I

talk about or what
I listen to.

We have a little bit more time,
so I will talk about the

cochlear implants, as well.

I mentioned that those are the
ones that are half implanted

in the head and also have
an external device.

This shows this part
is implanted.

And we have a wire that is
drawn into the cochlea.

And it's connected
to the nerve.

So actually, the whole
ear is circumvented.

Only the wire goes directly
to the nerve and

then through the brain.

And cochlear implants are what
I find really fascinating.

They really make deaf
people hear.

It's only applied to people
who have a really severe

hearing loss, like less
than 20% or something.

So they hear only
less than 20%.

Of course, it's a surgery
to insert that.

It destroys any remaining
hearing, because you poke a

wire into the nerve.

So everything else
is gone then.

It can also affect
other nerves.

So I have a friend who
had this surgery.

And they touched some taste
nerves as well, so everything

tastes as metallic.

It was kind of weird.

But it actually went
away after a while.

The signal is really
different.

The brain has to adjust
to that very long.

There are actually hearing
courses after you get this

surgery and the device
is started.

You have to really get used
to that, because it's like

electrical signals directly
[? intruded. ?]

And the technology of this
device, this is usually behind

the usual hearing aid
technology, because it has to

be well-tested before you put
something into your head.

And like for the other hearing
aids, there are not many

standards, no interoperability
between the brands.

So if you decide to take the
cochlear implant of one brand,

you can never switch
to another one.

So yeah, you have to
think that through.

I have an example
of how it sounds

with a cochlear implant.

So it sounds kind of spooky.

It starts with a normal sample
that everyone can hear it.

And then they have different
channels and reduce the number

of channels.

And then it gets less
and less hear-able.

[AUDIO PLAYBACK]

-A boy fell from the window.

A boy fell from the window.

A boy fell from the window.

A boy fell from the window.

A boy fell from the window.

A boy fell from the window.

[UNINTELLIGIBLE].

[END AUDIO PLAYBACK]

HELGA VELROYEN: Yeah, so you
can imagine that it takes a

while until you actually can
understand speech with that.

Yeah, I'm coming to an end.

So there are a lot of things
that I want from the industry.

First of all, better service.

And that goes into the
consideration of young

people's needs, because you can
feel it every time, that

everything is designed
for the elderly.

They don't consider that people
actually have to work,

and have a life, and actually
want to go out and talk to

people, and not only in a
silent room one-on-one.

And there are a lot of things
where you miss the support

when you have hearing aids and
are not 60 or something.

Generally, I'd like to have
better signal processing.

Of course, regarding the size,
they already did a really good

job, if you consider what
they do already.

But actually, the cocktail party
problem is not solved.

So a lot of people who have
hearing aids and then who also

have really good hearing aids,
they just avoid social

situations.

So they don't go out.

They don't go to the Congress.

They don't go to parties.

So whenever you would ask them
to go for dinner, they'd

really carefully choose the
restaurant, if it's a more or

less crowded one so you can
understand people, actually.

What I'm really missing
is some standards.

It would be even cool if it was
open standards, because,

this way, you feel really
trapped as a patient.

There's this saying, "If you
can't open it, you don't own

it." And I really miss that
when having hearing aids.

So I have a lot of ideas
how to improve that.

But I don't see most of it
coming in the next 500 years,

because the companies are not
very open source friendly.

So what would be really cool,
to have something like a

hearing aid app market that you
can download the newest

feature for a background noise
remover or something, and that

you can write you own filters
and share those, and

especially exchange those
between different brands.

And the funny thing is, when
I was browsing through the

websites of the vendors, the
marketing of some hearing aid

companies actually got
this idea already.

They just call their
features apps.

So this is just an enumeration
of what the

hearing aid can do.

But they just call it app.

[LAUGHTER]

HELGA VELROYEN: And it would
be really cool if there was

something like that.

You can exchange those.

What I would also like, hearing
aids do not use

reoccurring situations.

Most people have a rather
steady lifestyle.

You live in the same
apartment.

Most of the time, you work
in the same office.

You take the same subway
to work every day.

And hearing aids are only tuned
for a general situation.

But I think signal processing
works well the more you know

about the surrounding.

So it would be really cool if
you have one program for the

office and one program for at
home and one for the journey

to the office.

And we carry something around
that knows all this.

I mean, we have smartphones, and
they have a calendar, and

it shows where you are.

And it knows the people that
you're talking to and even if

you talk to them on the phone.

So there could be parameters
for each person

that you talk to.

And that could be saved on the
smartphone, if there wasn't

enough space in the memory in
the hearing aids themselves.

So all the information
is actually there.

But I don't see any
of the hearing aid

vendors adapting to that.

And what I also think, there are
people building 3-D models

of houses, and you could take
this information into

consideration as well.

So if I have never been to the
BCC, but someone has made a

3-D model, you could also get
the characteristics of the

acoustics here.

And then, before you go to the
Congress, you could download

the acoustic settings for
your hearing aids.

That would be really cool.

But, well, this is just ideas.

Yeah, and then also regarding
the hardware, it would be nice

if there were some
open standards.

It would be cool if you could
print your own hearing aids

with a 3-D printer, at least the
part that goes into your

ear so that it fits
really well.

And there are a lot
of possibilities.

But the market is really,
really slow.

And they still try
to figure out how

do we connect Bluetooth.

And for me, it's just
way too slow.

I'd like to see more
progress in that.

Yes.

Actually, with that, I would
like to conclude.

And I have to thank some people
who helped me with this

work, with the talk itself and
all the stuff I talked about.

And yeah, I think we have some
minutes for questions.

FEMALE SPEAKER: Yeah,
and that's--

[APPLAUSE]

FEMALE SPEAKER: Wonderful.

So before we come to the
questions, I need to say three

things, which means please stay
seated while the question

and answers are going on.

Then please pick up your trash
and your water bottles and

take them out with you.

And then please leave through
the front door here, while the

last door over there is the
entrance for the new people.

So now we can go over to the
question and answers.

We have a signal angel again
in the IRC sitting and

watching Twitter.

And we have an audio angel in
the back running around with a

microphone.

So please, questions now.

AUDIENCE: Hi.

I have a question about the
cochlear implant [? hat. ?]

I'm a neuropsychologist. And I
know that, with eyes, there's

an approach to re-engineer
the signal

processing of the retina.

And with this kind of knowledge,
you can make better

retina implant [? hats ?]

to enhance the possibilities
of seeing with

this kind of aid.

And is there a similar approach
for hearing aids and

the cochlear implant
[? hat ?]?

HELGA VELROYEN: There
are different

types of cochlear implants.

And this is really not much
of my field of expertise.

I know there are those who still
use the membrane in the

ear or some directly, the ones
that I showed, that directly

insert the wire into
the nerve.

But I am not that familiar with
the field, so I don't

know what's coming there.

AUDIENCE: OK, there's a question
from the front row.

I wonder, is there any
connection of research in

companies like Siemens or
whoever builds these parts?

Is that, in any way, connected
with other

consumer good research?

I'm not hearing disabled.

But if somebody would come up
with a decent set of in-ear

headphones that would fit and
would be able to have some

noise cancellation also, I'd
be quite interested in

spending money on that.

But this seems to be totally
uncorrelated altogether.

HELGA VELROYEN: Yeah,
that's true.

I mean, it's pretty close
to in-ear headphones.

But it's still, from what I've
seen, a different market.

You still can buy new
hearing aids, if you

don't really use them.

No one can prevent
you from that.

But I don't see any trend in
merging that very much.

Is there any more questions?

AUDIENCE: Hello.

I would like to add two things
to your wish list. One thing,

I would like the hacker
community to find out what the

real differences in devices from
different price ranges

are, what is done in hardware
and what is

actually only firmware.

My audiologist reported devices
coming back from

repairs or programming to
report as more expensive

devices, for instance, where
it's just a firmware thing.

And the other thing is I see an
interesting hacking attack

angle for hacking in the
protocol that the devices use

to communicate with each other,
with the devices which

transfer Bluetooth into the body
area network that really

speaks to the devices.

So do you know any off-the-shelf
components that

can speak these body area
network protocols?

HELGA VELROYEN: For the Siemens
thing I showed, I

haven't found anything.

So this is just that gadget
that I have. But I think

people are experimenting with
the audio induction loops and

the FM systems. But yeah, it's
not that much that you can see

documentation of that.

So I'd like to see more here.

I made this talk because I would
tell you hackers what's

on the menu.

And it would be really nice
if there was more

activity in the scene.

And it's kind of hard to start
that if you're all alone.

So I hope I've risen some
interest. And if you have any

pointers for me or anything I
didn't mention here, I'm also

happy if you send me an email.

Or I will be around the
next couple of days.

FEMALE SPEAKER: Before we
finish, there are some

questions from the internet.

The first one is Gilligan who
asked, does the fact that you

have tinnitus make the process
of tuning a hearing aid for

you harder?

Does a hearing aid have a
negative or positive effect on

your tinnitus when
you wear it?

HELGA VELROYEN: Of my what?

Sorry.

A positive or negative--

FEMALE SPEAKER: Does the hearing
aid have a negative or

a positive effect on your
tinnitus when you wear it?

HELGA VELROYEN: Actually,
yeah.

There are hearing aids that
claim to [? counter-fy ?]

the tinnitus, that
they generate the

counter-frequencies
against that.

I also asked my acousticians or
my audiologists about that.

They actually don't work.

I mean, they usually are
not really offered.

And even if you ask for it, they
tell you, yeah, usually

they don't really make
a difference.

My choice was actually just to
make a normal hearing aid.

And because the frequencies that
you don't hear very well

are amplified, the tinnitus,
in relation, gets as loud.

And you learn to ignore it.

That's not really magic, but
that's the only thing that

seems to work.

FEMALE SPEAKER: OK, the next one
is from [? Schpegmada ?]?

Are there hearing aids with
documented RP for the tuning

official doc reverse
engineered?

Can you get the official
tuning software to tune

yourself that you write
through any people who

manufacture them?

HELGA VELROYEN: I haven't found
anything about that.

The only thing you can do is get
the software on the black

market and disassemble
it, if possible.

But there are no API
system thing.

That's really what I'm
missing as well.

FEMALE SPEAKER: OK, the last
one is from Lucy, I guess.

What frequency range can
you usually hear

using a cochlear implant?

How fine can you resolve
frequencies?

HELGA VELROYEN: They are about
the range that you have in the

speech banana.

But actually, I'm not
that familiar

with cochlear implants.

So I can not give the
details here.

AUDIENCE: OK, hi.

You showed us the programming
tool for changing the settings

on the hearing aid.

I've forgotten the name,
but the 1980's modem.

Have there been any attempts
to clone that hardware or

reverse-engineer the spec?

HELGA VELROYEN: I'm not sure
if I understood correctly.

You mean like how you get
the hardware for this?

AUDIENCE: Yeah, so the moment
you have to buy the

programming tool,
as I understand,

to update the software.

HELGA VELROYEN: Since it's only
delivered and sold to

audiologists and doctors, you
have to be friends with

audiologists or doctors.

And somehow they can
give you that.

But there's no official
channel.

So you have to find
the black market.

AUDIENCE: Yeah, sorry, my
question was has anyone tried

to create an open hardware
variant?

HELGA VELROYEN: No.

AUDIENCE: Has anyone copied?

HELGA VELROYEN: No,
I haven't found

anything like that either.

So that was actually also on my
wish list, that makes the

tuning hardware open
source as well.

That would be really nice.

But it's a serial device, so
you could actually do some

sniffing there.

But I haven't seen any
approaches there.

AUDIENCE: Yeah, because
it looks pretty

easy, I would say.

[LAUGHTER]

AUDIENCE: Yeah.

FEMALE SPEAKER: So we are
running out of time.

Is there any really, really
important question left?

I mean, because she's around,
so you can meet her in the

next days on the Congress
again and

ask her more questions.

And thank you very much
for the talk.

It was very interesting.

[APPLAUSE]