-
[APPLAUSE]
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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.
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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.
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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.
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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--
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[SAD ROBOT, BY PORNOPHONIQUE]
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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.
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[LAUGHTER]
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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.
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[SAD ROBOT, BY PORNOPHONIQUE]
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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.
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[LAUGHTER]
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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--
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[LAUGHTER]
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HELGA VELROYEN: Of course.
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[LAUGHS]
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[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]