Douglas L. Beck, AuD, speaks with Dr. Chasin about musicians’ clinics at the State University of New York at Buffalo, hearing protection devices, auditory rehabilitation, musical expertise, the brain of the musician, speech-in-noise, learning to listen, ear training, and more.
Academy: Good morning, Marshall. Always nice to chat with you.
Chasin: Hi, Doug. Thanks. Good to speak with you, too.
Academy: Marshall, I heard a rumor that my alma mater (The State University of New York at Buffalo, SUNYAB) is opening a musicians’ clinic—is that correct?
Chasin: Yes, it’s true. We helped to open a musicians’ clinic at the University of Pittsburgh several years ago, and now we’re helping to open another one within the audiology clinic at SUNYAB. As you know, Doug, they already have a tinnitus clinic and a hyperacusis clinic, there, too—so it’s a very exciting department and very well respected.
Academy: That’s fantastic. Who will be staffing the new facility?
Chasin: Well, 90 to 95 percent of everything you need to know to effectively staff a musicians’ clinic is already known to the audiologists on staff. The clinic will actually be managed by two of your long-term friends and associate audiologists, Nancy Stecker and Susan Roberts, but the day-to-day core clinical information is pretty straightforward with regard to hearing protection and/or hearing aids. In fact, while the staff audiologists are getting oriented to the clinic protocols and processes, I usually tell them they’re not going to learn anything new!
Academy: I suspect you’re right…it’s not really about new knowledge; it’s more about applying what they already know to the specific needs of the musicians—is that right?
Chasin: Correct. Musicians are a little (or a lot!) different from the mainstream patients we each see in the clinic. That is, although musicians are born with the same hearing thresholds as everyone else, as you would certainly expect, after years of practice and exposure to loud sounds, musicians are often at greater risk for occupational noise exposure and of course, “music-induced hearing loss.”
Academy: And so that gets us to one of the major issues—hearing protection for musicians. What are your thoughts with regard to musicians and their need for hearing protection?
Chasin: Doug, you and I have had several conversations about this over the years and my thoughts and opinions in 2011 are pretty much the same as they were years ago. Specifically, the majority of musicians don’t need drastic solutions while performing—they need small and efficient solutions to maintain a high quality sound while attenuating the overall sound pressure level—in some cases—by just a few decibels. So if we lower the sound pressure by just 3 to 5 dB, the musician can listen to that same sound for twice as long without increasing the risk of hearing loss.
If musicians wear hearing protection devices (HPDs) with only 15 dB of attenuation, and they wear them correctly, and if they get the full attenuation of 15 dB, they can listen 32 times as long without increasing their risk of hearing loss…so it’s very impressive and it’s also just that simple. For most musicians, I most often recommend the Etymotic Research (ER) 15s, as they offer 15 dB of UNIFORM attenuation without really sacrificing sound quality. For drummers, I usually recommend the ER-25s. However, there are quite a few excellent HPDs out there, and the “best” one is the one someone will wear!
Academy: Absolutely. And so the take-home message is that by lowering the overall sound pressure just a little, we can listen to it for much longer without additional risk of hearing loss, which is also called the “time versus intensity” trade-off?
Chasin: Right. If a musician lowers the overall loudness by 3 to 5 dB, the musician can be exposed twice as long without increasing her risk for hearing damage. Another important issue for musicians is many of them have an extraordinary ability to do very well with speech-in-noise, as their auditory system has been enhanced through years of practice and critical listening. Musicians are often more able to use acoustic information better than non-musicians listening to the same sounds.
Academy: Yes, there have been quite a few excellent articles on that same topic lately. It seems that because musicians spend some 10,000 hours developing their craft, listening to and practicing on their own instrument in isolation and with others, they develop an extraordinary ability to hear their own instrument, whether they’re playing it or listening to someone else playing the same instrument, and they can selectively listen to their instrument within a cacophony of sound from the orchestra or band—and this unique listening ability has “carry-over” with regard to listening to speech in noise.
Chasin: Yes, that’s the essence of it. Musicians can very often hear tiny, fine, discrete subtleties in very complex harmonic structures—which most non-musicians could never hope to perceive!
Academy: And musicians are also different in that their brains adapt and change over years, or perhaps decades, with respect to their listening ability. However, while listening to speech-in-noise, non-musicians can change their listening ability very quickly, perhaps within 10 hours or so?
Chasin: Yes, that’s true with regard to being able to be trained to improve listening skills for speech sounds. That is, non-musicians can use tools such the Listening and Communication Enhancement (LACE) program, and the majority of people will improve their listening skills within 10 hours, based on 30 minutes per day, five days a week for four weeks.
Academy: That’s very impressive—if they’ll do the work, they’ll very likely get the result.
Chasin: Right. The literature indicates the vast majority of non-musicians will improve their listening skills if they have the desire to do so and if they put in the work required. That’s the wonderful thing about musicians—they’re motivated to improve their ear-training and musical ability and they put in the time and effort over many years. For non-musicians, they too, can improve their listening skills for speech, and it takes much less time—and it would be referred to as auditory-training.
Academy: And the acoustic challenges required to attentively listen to music versus speech are quite different, too. Can you elaborate on some of them?
Chasin: Sure. With speech there’s usually quite a bit of redundancy in the speech sound and most of the time there’s additional redundancy in the visual signal, too. That is, we can get lots of information through speech reading and body language, all of which might serve to supplement the acoustic message. With music, the acoustic redundancy is quite a bit less, as it might be presented with quarter or half-wavelengths and the visual cues might range from ambiguous to non-existent—so one really has to perceive the acoustics, to accurately perceive music. Music has a lot more variability than does speech, and that’s why it takes so long to master music.
Academy: Okay, Marshall. Once again, we’ve run through some very interesting topics and pragmatic suggestions. Thanks again for your time and expertise! And for the musician looking for more information, can you give us some Web sites and downloadable PDFs that you’d recommend?
Chasin: Absolutely (see below). Thanks for your interest, Doug!
Marshall Chasin, AuD, is the director of research at the Musicians
Douglas L. Beck, AuD, Board Certified in Audiology, is the Web content editor for the American Academy of Audiology.