Maslow 2.0

Carol and her husband, Hal, started Interpersonal Communications in 1985. Hal, a psychologist, and Carol, a nurse, saw hearing aids as more than just a device that aids hearing. It’s about communicating and being close to friends and loved ones. Hearing loss isolates people. It affects cognitive health. Even more importantly, it affects emotional health.

Maslow’s famous “Hierarchy of Needs” was re-examined by Dr Ed Diener and I think the results support what Carol and I think: that connection with other people is a bit more important for happiness that Maslow’s theory says it is.

The Atlantic wrote an article about the study in 2011:

“As it turns out, the needs that are most linked with everyday satisfaction are interpersonal ones, such as love and respect.” The study author writes, “It shows clearly the importance in all societies of human connections and social supports, something that’s been ignored in recent years.”


I thought this article was interesting. It talks about two eras in medicine and the need to evolve into a third. First there was the era of “professional trust and prerogative” and then there was the era of “accountability, scrutiny, measurements, incentives, and markets.” Dr Donald Berwick suggests we need to move on to a third era where we focus on quality instead of revenue.

I studied the first era a bit out of an interest in the history of ethics in clinical trials. So much of the knowledge we have today about cardiology, anesthesiology, nephrology, and cancer was learned at major universities, that conducted dangerous clinical experiments on patients without their knowledge or consent. Dr. Maurice Pappworth finally blew the whistle in 1967 and things started to change.

Carol, an RN, has some funny stories about the start of the second phase. Hospitals were evaluated for competence and efficiency. Some conclusions were funny, like expecting a nurse not to make an unscheduled stop at a patient’s room if a patient had fallen down, because it’s inefficient. Or the recommendation that the department needed to hire two and a half nurses.

Anyway, Carol and I agree with Dr Berwick that medicine needs to focus quality over revenue.

Central Processing Disorder

Hearing starts with sound vibration, which becomes neural signals, which are brought up to the brain, where the sounds become all kinds of things we recognize, including words. Kids with hearing loss can be misdiagnosed. Without a hearing test, hearing loss can be confused with developmental delay, ADD, or defiance. And if there is a Central Processing Disorder, hearing can be difficult even when the standard pure tone hearing test is normal. That’s because the problem is higher up in the brain where speech sounds are decoded into words.

About Central Processing Disorder

Here is an online screening test:

Central Processing Disorder screening questionnaire

If there is any question about hearing loss, get it checked out by an audiologist and an ear, nose, and throat doctor.

Affordable Hearing Aids


A hearing aid can cost $3000. The expensive ones are better in tough listening situations, give me more options to tailor it to my patient, and the sound quality is better. But $1000-3000 is too much for most of us, so here are some more affordable options.

I have basic hearing aids starting at $900 and so does Costco.

I can get refurbished hearing aids from Starkey for around $500 and they have a 1 year warranty.

A PSAP (Personal Sound Amplification Product) is an amplifier.  There are lots of manufacturers of varying quality.  Etymotic Research is a reputable manufacturer. They make an PSAP called the “Bean”. It even comes with a telecoil for looped rooms. Etymotic is well known by conventional hearing aid manufacturers and hearing aid dispensers and has been designing compression circuitry used in conventional hearing aids for decades.  (There is a section on Telecoils and looped rooms on the Hearing Loss tab of this website.)

The first two are actually programmed and validated with testing to fit your hearing loss. PSAPs are designed for people with mild hearing loss and are not custom fit.

Donating Old Hearing Aids

Don’t throw out old hearing aids. A few options for old aids:

I called Starkey and left a message with their Hearing Foundation director asking what international hearing missions use their donations. We have a box in our office that you can put old dead aids. When we get a bunch we send them in to Starkey.

Friends and Family
You can also give an old hearing aid to a family member or friend if it’s a hearing aid that goes behind the ear. It can be reprogrammed to fit their hearing loss. Call me if you have questions about this.

Santa Barbara Audiology
You can donate them to us too. I program them and give them to people who don’t qualify for Medical (CenCal).

Pocket Talker

I have something called a William’s Sound Pocket Talker. I need it to talk to people who have severe to profound hearing loss, but don’t have hearing aids. I recommend it to families with a loved one in urgent care or hospice. I don’t sell it, but you can get it online and it runs about $130. If you can’t afford one and need to borrow it, let me know. In terms of human needs, I think right under food and shelter is connection with people. When people are sick or at the end of life, it’s even more important.

Hearing and Speech Developmental Milestones

For birth to 5 years is the most critical period for children to learn language. Unidentified hearing loss during this time has long term effects on language and academic progress, so it’s critical that hearing loss is identified early. Diagnosis rates used to be abysmal and the universal hearing screening program in hospitals has helped.

Even a mild hearing loss has an effect on language and learning. Here are the hearing and speech milestones from birth to 5 years that parents should know.

Hearing and Speech Milestones