What is occupational therapy?

According to the American Occupational Therapy Association, “occupational therapists and occupational therapy assistants help people…participate in the things they want and need to do through the therapeutic use of everyday activities.” Occupational therapy helps people with physical, mental, or cognitive disorders most effectively live their lives.

The AOTA emphasizes client interaction. The client is always involved in the decision making process. Therapy is determined and implemented according to their own personal goals.

An example of an occupational therapist

Natalie Bruno is the owner and therapist of Cardinal Kids Therapy in Cherry Hill, NJ. According to her website she “specializes in the evaluation and treatment of children with variety of diagnoses and/or disorders, including ADHD/ADD, Autism Spectrum Disorders, Brain Injury, Down Syndrome, Developmental Delays, Sensory Processing Disorders, Auditory Processing Disorders, Nonverbal Learning Disorders, Visual Perceptual/Motor Delays, Praxis Difficulties, Fine Motor Delays and Handwriting Challenges.”

Bruno works with children. Her goals, naturally, involve working through learning and behavior difficulties. Her end goal? Improvement and maintenance in everyday life.

Personally, she focuses on sensory integration, which is how an individual processes external stimuli. From Bruno’s website: “Sensory integration is the ability to register, organize, and adapt to different sensations that occur in everyday life.

Determining how her patients process their environments, she can then create an approach to therapy.

How can occupational therapy and audiology work together?

Sometimes, when a child has a certain type of processing problem (such as auditory integration deficits or auditory processing disorders) an occupational therapist will need the help of an audiologist.

Auditory processing disorders (or APDs) are not easy disorders to boil down. Essentially, though, an auditory processing disorder can be understood as “a weakness in the ability to quickly understand information an individual hears.”

Working together, the occupational therapist and the audiologist can determine strengths and weaknesses in their patient’s learning profile.

What is the goal?

The goal is optimizing how a child or an adult with an auditory integration deficit learns. Existing strengths may be leaned on, while further therapy – through the occupational therapist – will uncover compensatory strategies to work for the weaker areas.

All of this will, of course, differ case to case. And that’s no surprise, given how intimately occupational therapy is keyed into the individual’s life, goals, and mindset.


How long should hearing aid batteries last?

One of the questions we at REM Audiology get asked the most is: “how long should my hearing aid batteries last?” The answer: it depends. Your battery life is dependant on variables such as degree of hearing loss, if your battery is powering other devices (such as Bluetooth streamers or FM receivers), and hours worn daily.

Our baseline answer is 7 – 10 days. You shouldn’t really expect a hearing aid battery to last longer than a week and a half. If use is heavy, that time could even be significantly lower.

Starkey provides a good rundown, and also gives battery life a greater spread (3 to 22 days – mainy because older body aids with AA batteries had a life span extending into nearly 3 weeks).

How do I know when it’s time to change batteries?

Also on the Starkey website: “Change your batteries if the sound becomes distorted or if you have to turn the volume up more than usual.”

Some hearing aids will beep (Phonak instruments) or give a warning sound 30 to 60 minutes (and every 15 minutes after that) before the battery needs to be changed (Oticon). Older model hearing aids will just shut off when the battery dies.

The Widex digital hearing aids can be programmed to actually tell our clients (in one of 22 different languages) when the battery is low.

What type of batteries should I use?

Batteries are designated by a number such as 10, 312, 13, or 675. You must use the number that goes with your particular hearing aid. Generally speaking, the smallest aids run on a 10 battery while the behind the ear aids are either a 13 or 675 battery.

Battery Tips:

All batteries on the market are mercury free.

You should look for the 1.45 volt.

Make sure that once the sticker is taken off, the battery is exposed for 30 seconds before inserting in the hearing aid. The battery needs to be activated by air before insertion.

If the battery has 1.4 volts, do not purchase (1.4 is an older battery with less than efficient functio).

What batteries and battery programs does REM provide?

REM Audiology has several battery plans:

When a hearing aid is purchased with complete hearing healthcare, you get batteries for 5 years.

REM Audiology has battery clubs for those clients not purchasing complete hearing health care. The Battery Club costs $95.00 for which you receive 60 batteries and two complementary hearing aid cleanings – a savings of $60.00

Hearing aid batteries can be purchased separately for $1.00 per cell

Please don’t hesitate to contact us with any questions.


Last week, 7 team members from REM Audiology Associates flew down to Orlando, Florida to attend AHAA’s (American Hearing Aid Association’s) 2015 Convention. It was a productive weekend for all, and despite being stranded in Florida for a few days due to snow back home, everyone returned with a renewed sense of purpose and a lot of new ideas.

Convention classes began on February 18. REM attended seminars on cognition and hearing, office management software, and marketing strategies.

Over the weekend, front office personal attended classes on patient contact. Jeannine from the Evesham office and Robin from Philadelphia learned the importance of both community outreach and process management (phone call protocols, strategic scheduling, and communication with fellow REM team members) so patient followup and care could remain top priority.

Audiologists learned strategies on patient education. They also discussed new technology with the 20 plus vendors who came to and presented at the convention.

The owner track was attended by Liz Patterson, and the management track by Roxanne Mori. Discussions ranged from a breakdown of office processes to implementation of new processes to performance monitoring and clear communication. An owner and an office manager in sync is key.

REM was also pleased to accept an award for organizational excellence, an award given to the office that best exemplifies a team that works together, a team that can communicate while giving the best care possible to their patients.

Elizabeth Patterson was honored to serve on an expert panel discussing community outreach. Various strategies consisting of direct mail, internet, and newspaper ads were brought up. Other audiologists and centers on the panel all shared their best ideas and practices.

When the convention ended, and the snow in Philadelphia died down, the REM team members went back to work with a big takeaway: when talking with patients, when talking to each other, always identify what is necessary and do what is possible. Before long, everything is possible.


About 6 months ago, we posted a blog on kids going back to school, where we talked primarily about the importance of classroom arrangement and learning aids for hard of hearing students. Under the Classroom Tips section, we listed proper seating arrangements, light and sound sources, and education resource ideas as ways to improve comprehension and retention. This time, we want to focus a little more on the acoustics side of things.

As usual, ASHA provides a good summary of what classroom acoustics is, why its important, and who it affects:

“A student’s ability to hear and understand what is being said in the classroom is vital for learning. Unfortunately, this ability can be reduced in a noisy classroom. Poor classroom acoustics occur when the background noise and/or the amount of reverberation in the classroom are so high that they interfere with learning and teaching.”

The Acoustical Society of America goes into a bit more depth, and supplies some helpful pictures. It also cites a few important studies.

One such study focused on a public school district in Iowa. In this district, research showed that “…elementary school children tended to have lower scores on reading comprehension performance tests if they were learning in classrooms serviced by noisier mechanical cooling systems (Ronsse and Wang, 2010).”

A Typical Classroom

Also on the study page of the Acoustical Society of America:

The standard classroom.

Of course, not every classroom will be the same, but this picture offers a view of everything that helps and hurts classroom acoustics and learning, matters both teachers and students will have to contend with every day.


Figuring out the ideal layout of a classroom is not easy. It’s further complicated when you realize how little control you sometimes have over what can be added, adapted, or changed. So It’s important to not only have the correct practical information, but to also know your rights and resources.

Let’s turn to ASHA again, where the American National Standard on Classroom Acoustics is discussed:

“The American National Standards Institute (ANSI), along with the efforts of the U.S. Access Board, Acoustical Society of America, created the ANSI S12.60-2002, Acoustical Performance Criteria, Design Requirements and Guidelines for Schools standard. Through specific design requirements and acoustical performance criteria, the standard tries to create a classroom environment that optimizes speech understanding.”
Though compliance with the ANSI standard is voluntary, it’s a good resource to have in your pocket, and a starting point in realizing the best possible learning environment for your child.

Further resources:

– ANDI Standard S12.60 in depth

– “About the Classroom Acoustics Rulemaking” from the United States Access Board: “The Board is undertaking rule making to supplement the ADA and ABA Accessibility Guidelines to address acoustics in classrooms.”

– ASHA’s list of resources

– Acoustical Society of America standards and booklets


4. What technology is available to help train my brain?

In part 1, we talked about the concept of brain training. We touched on the importance of audiologists in the process (how they help patients understand the unique particulars of their hearing loss, how they help decide on an aid to best help them hear, listen, and retain information in noise) as well as the patient (listening vs. hearing, the importance of not withdrawing).

In part 2, we want to focus on specific technology.

LACE technology (which we’ve written about before) is one of the most important pieces of brain training technology on the market.

LACE stands for Listening and Communication Enhancement, and helps re-teach the brains of those with hearing loss:

“Conceived by leading audiologists at the University of California at San Francisco and implemented by silicon valley software veterans, LACE® Auditory Training programs retrain the brain to comprehend speech up to 40% better in difficult listening situations such as:

  • Noisy Restaurants
  • Rapid speakers
  • Competing speakers

Just as physical therapy can help rebuild muscles and adjust movements to compensate for physical weakness or injury, LACE will help develop skills and strategies to deal with situations when hearing is inadequate.”

REM offers our patients the opportunity to utilize LACE to improve understanding in noise. If interested, patients will be given a special promotional code for the web based program, which they will enter at This will afford them 11 sessions that they can complete in the comfort of their own home. Patients will not be charged for this program unless they do not complete all 11 sessions, in which case they will be charged $50.

The patient’s results and progress can be monitored by their hearing professional, remotely. Additionally, patients will take a speech-in-noise test at the outset of their LACE training. They will be reassessed in 6 weeks following the completion of the course to monitor progress. If patients found the sessions helpful, they are able to purchase the “LACE Home Edition Software or DVD” that offers 20 sessions with unlimited review.

5. What hearing aids are best?

This is a big topic. Hearing aids span a wide range, from the basic to the premium. Each aid will have its own advantages and its own technology.

Most premium aids, however, have something called aid to aid communication. Aid to aid communication allows hearing aids to work in synchrony to mimic the normal function of your ears, resulting in a more natural and beneficial sound quality. When the hearing aids communicate with each other, they communicate better with your brain.

Several premium hearing aids that REM offers include the Widex Dream 440, the Oticon Alta 2 Pro, and the Phonak Audeo V 90. Aids can be purchased in a a variety of styles.

6. Technology outside of aids

Any technology that helps your hearing plays a role in brain training. Somewhere between LACE Technology and hearing aids are assisted listening devices. These are devices that can pair with your aids to help in noisier than average situations.

One of the most effective assistive listening devices on the market today is the remote microphone. Most manufacturers that REM works with have some form of remote microphone, and this device can help dramatically improve the “signal to noise ratio” of a person’s voice over the background noise.

The remote mic is either worn on a lapel or placed near a desired sound source, which will then send the signal to a receiver to be processed in the hearing aids. This overcomes the obstacle of distance, and gives listeners the ability to clearly hear an individual sitting across the table from them, even in a noisy restaurant.

The Phonak Roger Pen is the most advanced version of the remote microphone on the market today, and can even stream bluetooth audio or TV to the hearing aids. The Roger Pen also has a directional microphone that changes its range of detection based on the orientation of the pen. This allows for individuals to hear well in any listening environment from a group meeting to a one-on-one dinner conversation.

The technology and industry behind helping people cope with hearing loss is a topic no one could fully explore in one blog post, but we hope this is a good overview of the brain-aid interface. And always remember: no matter how much trouble you have with your hearing, there are always ways, devices, and practices to help you improve.


Hearing Aids and Brain Training, Part 1

1. How does wearing a hearing aid affect your brain?

Treating hearing loss is often thought of in terms of providing amplification. How can sound be increased so listening is easier and speech is better? Amplification is provided through hearing aids or hearing devices, but testing, configuration, and supply can be complicated.

Why is that?

The Better Hearing Institute gets to the heart of the matter: “We don’t really hear in our ears; we hear in our brain.” What you hear, how you listen, and how sound is processed in your brain are all connected. Each person’s hearing loss and adaptation is unique to them. This is true even in people with similar levels of hearing loss.

2. How do audiologists go about selecting a hearing device? How does REM?

In order to determine the best aid and best settings, an audiologist will try to determine the most efficient aid-brain interface. They will test your hearing, ask you questions about your past, determine the environment in which you’ll be using the aids the most.

REM chooses the hearing instrument based on what the brain needs, what the auditory processing centers need to process speech and information. We test for both hearing and retention in silence and noise, identification of speech details (such as consonants and vowels), and how well you can locate sound in space.

3. Listening vs hearing

That’s what audiologists do. There’s training you can do as well.

The Better Hearing Institute article linked to earlier goes on to define listening vs hearing:

“Good listening skills are one of the components essential for effective communication. As technically advanced as modern hearing aids might be, they alone cannot produce the listening skills needed for communication. There are a number of reasons for this. For example, to be a good listener, one must integrate a number of skills including attention, understanding, and remembering.”

By practicing listening skills and comprehension, you’re in fact training your brain.

Once you get hearing aids, wear them every day, be confident in engaging in social situations. Communicate with people. Involve yourself. Don’t withdraw. Engage in conversation, as boldly as you can.
Next post we’ll be discussing the specific technology of brain training, and we’ll touch more on what you can do to strengthen your hearing.



Hearing is incredibly important to overall health and welfare, and we at REM Audiology are always on the lookout for new ways to demonstrate the latest in hearing technology to as many people as we possibly can.


We strongly believe that everyone, young and old, should have their hearing tested at least once. On its own, hearing loss is a challenge. Without proper care, it can get worse, or at the very least, more and more frustrating.

Sometimes, hearing loss is not an isolated issue at all, and can be the first symptom of an even greater health problem.

A few months ago we invested in a hearing kiosk, a portable hearing station to take around to health fairs and community events. We wanted to bring the hearing test to you.

How it works is simple. You go up, put on special noise canceling headphones, and follow simple prompts and instructions on the Kiosks’s iPad. Within 5 minutes, your hearing is tested. Afterwards, if you provided an email, the results are directly forwarded to your account. Afterwards, you are given the opportunity to forward the results to us at REM.

Why is this important? If you have never had a hearing test, establishing a baseline is crucial. By having a baseline test, future results can be compared, and problems can be easier diagnosed down the line.

Office Listening Stations

We’ve also been installing listening stations in our offices.

In our Voorhees office, we have a dedicated room. In Evesham and Philadelphia, we have stations set up in the waiting area.

What are listening stations? Listening stations are where we can demonstrate the latest in Bluetooth and telephone coil technology. Here you can test how your hearing aid communicates with televisions and other streaming devices, and experience firsthand how their sound can be directly transmitted to your personal aid.

We want to create a “WOW” effect, and what better way is there to show you our technology than by demonstrating it first hand.

The Future

We’re always on the lookout for ways to improve hearing healthcare, and we hope to have more exciting technology for you to try out soon.


Before you know it, summer vacation will be in full swing. But just because it’s summer doesn’t mean your kids have to stop learning. For those who are hard of hearing, or have speech difficulties, the summer months can be a vital time for brain training.

A few weeks ago, we released our annual Summer Speech and Hearing Newsletter, a collection of links and resources we send out to local educators as part of our bi-monthly education newsletter subscription.

Among the links included are:

1. Five Easy Activities to Prevent Brain Drain, via the ASHA Leader

2. Summer camps and programs, from Gallaudet University/National Deaf Education Center. (Note: though it might be too late to sign up for this summer, it’s always good to keep these on your radar.)


One of the most important things to keep in mind is socialization. For hard of hearing kids especially, summer month socialization is crucial. Allowing kids to retreat from interaction is comparable to suddenly stopping exercise after 9 months of near constant workouts. When the new year starts in September, you don’t want your kids to have to play catch up to a level they already achieved.

Socialization is important, but it’s also a big topic. We hope to cover it in a blog later this month. For now, there is no shortage of articles on the internet, and you can always call our main office to find out more information.

If you would like to be a part of our education newsletters (or any of our newsletters), please don’t hesitate to sign up.


Every second Wednesday of the month, the Voorhees and Medford branches of REM Audiology will be holding a Tips and Sips hearing cafe get together.

What is a Tips and Sips hearing cafe get together? We’re glad you asked. Tips and Sips is an opportunity to socialize, a space where patients can ask questions and inquire about any services or technology they’ve been curious about. It’s a place where once a month, people can stop by and learn from each other regarding strategies and technologies they’ve found useful in addressing their hearing needs.

There’s no set plan to a Tips and Sips meeting. Your needs come first so at the start we’ll address your concerns. Afterwards, there’ll be demonstrations of new technology, and plenty of time to mingle and share.

Our hearing cafe get together, like we said before, is every second Wednesday of the month, from 4 pm to 6 pm. It’s free to attend, but we do ask that you make an appointment, so we can know how many people to expect. Complimentary wine and cheese will be served.

If this is something that sounds fun, or useful, or interesting, please don’t hesitate to call us at 888-710-5734 for the Voorhees office, or 888-709-5565 for Evesham. We hope to see you there!


In our Summer Speech and Hearing blog earlier this month, we touched a little bit on the importance of socialization for hard of hearing kids during the summer months. We wrote:

“One of the most important things to keep in mind is socialization. For hard of hearing kids especially, summer month socialization is crucial. Allowing kids to retreat from interaction is comparable to suddenly stopping exercise after 9 months of near constant workouts. When the new year starts in September, you don’t want your kids to have to play catch up to a level they had already achieved.”

One thing we didn’t mention is how socialization is just as important for hard of hearing adults.

First things first, though: what is socialization?

Socialization is probably what you think it is. It’s interacting with people and attending events. Socialization is for everybody. People diagnosed with a hearing deficit, however, sometimes have a tendency to withdraw. But to withdraw can often impede hearing even more. No matter how severe your hearing loss, not letting your hearing impact who you talk to and where you go is crucial.

Why? What can you do?

The more you talk to people, the more you’ll be able to exercise your ability to understand, to hear in noise, and to acclimate your hearing-hearing aid comprehension in various environments. It may not be easy going, not at first, but just like running a marathon, the more you practice the farther you’ll go.

Socialization is important for the brain, which is why most socialization articles online deal with hearing impaired kids. A growing brain needs stimulus. But any brain, regardless of age, is always changing and adapting. Challenging your brain, your comprehension, is important for any age.

Development wise, however, socialization may be more important for kids. The Success for Kids with Hearing Loss website has a good section about social issues for hard of hearing children. It goes into some important specifics, starting with how hearing impaired children’s social communication skills often develop more slowly than their peers:

“Social skills are typically learned by children with little effort starting at a young age. These skills are shaped by children watching others and having other people react to their behavior. How we learn social skills is based on very subtle cues, such as facial expression, body posture and quiet auditory cues. Because of their smaller “listening bubbles” children with hearing loss do not pick up language and the subtle aspects of interactions going on around them as fully as their peers with typical hearing.”

Further, adults can always push themselves to socialize, and though support systems are recommended (friends or relatives to make the “exercise” easier), an adult has more individual control over what they do or don’t do than a child often does. Socialization for kids often falls to the parents to enforce. School provides built in opportunities, but these need to be supplemented with outside activities and maybe speech therapy. This is especially important during the summer months, as we touched on briefly above.

There are no set rules for how you should strengthen your hearing through practice. The important thing is to understand the time that it will take, and the ability you have to adapt.

Links and Tips

Socialization Tips for Noisy Get Togethers
For Parents: How do I socialize my hard of hearing child?
Socialization for kids, from Oticon
My Hearing Loss Experience, a personal blog about hearing loss and socialization