AU2009222611B2 - Preprogrammed hearing assistance device with program selection using a multipurpose control device - Google Patents

Abstract

A user programmable hearing aid allows a user to select acoustical configuration programs that provide optimum performance for the user. The user may cycle through and evaluate various available programs by rotating a scroll wheel on the hearing aid housing to switch from one program to the next. When a preferred program is active, the user can press a push button on the housing for an extended time to select the currently active program. The user can then use the scroll wheel to adjust the audio gain for the selected program. The hearing aid may also operate in a Configuration Mode wherein configuration settings may be changed using the scroll wheel and the push button. In the Configuration Mode, a clinician or patient may easily change configuration settings manually, with no need to connect the apparatus to a computer or other programming interface. WO 2008/134345 PCTIUS2008/061235 C% IL >0 E 0> Z C14m 0~ (U. IL-

Description

Regulation 3.2 AUSTRALIA Patents Act 1990 COMPLETE SPECIFICATION STANDARD PATENT APPLICANT: DANIEL R. SCHUMAIER Invention Title: PREPROGRAMMED HEARING ASSISTANCE DEVICE WITH PROGRAM SELECTION USING A MULTIPURPOSE CONTROL DEVICE The following statement is a full description of this invention, including the best method of performing it known to me: PREPROGRAMMED HEARING ASSISTANCE DEVICE WITH PROGRAM SELECTION USING A MULTIPURPOSE CONTROL DEVICE [00011 This application is a continuation-in-part of and claims priority to U.S. patent application serial number 11/739,781 filed April 25, 2007, entitled "Preprogrammed Hearing Assistance Device with Program Selection Based on Patient Usage," U.S. patent application serial number 12/017,080 filed January 21, 2008, entitled "Preprogrammed Hearing Assistance Device with Program Selection Based on Patient Usage," and U.S. patent application serial number 12/325,604 filed Dec. 1, 2008, entitled "Preprogrammed Hearing Assistance Device with User Selection of Program," which claimed priority to provisional patent application serial number 61/036,594 filed March 14, 2008, entitled "User Programmable Hearing Assistance Device with Configuration Mode." FIELD 100021 This invention relates to the field of hearing assistance devices. More particularly, this invention relates to a system for programming the operation of a hearing assistance device based on program selections made by a patient. BACKGROUND [00031 Hearing loss varies widely from patient to patient in type and severity. As a result, the acoustical characteristics of a hearing aid must be selected to provide the best possible result for each hearing impaired person. Typically, these acoustical characteristics of a hearing aid are "fit" to a patient through a prescription procedure. Generally, this has involved measuring hearing characteristics of the patient and calculating the required amplification characteristics based on the measured hearing characteristics. The desired amplification characteristics are then programmed into a digital signal processor in the hearing aid, the hearing aid is worn by the patient, and the patient's hearing is again evaluated while the hearing aid is in use. Based on the results of the audiometric evaluation and/or the patient's comments regarding the improvement 1 in hearing, or lack thereof, an audiologist or dispenser adjusts the programming of the hearing aid to improve the result for the patient. [00041 As one would expect, the fitting procedure for a hearing aid is generally an interactive and iterative process, wherein an audiologist or dispenser adjusts the programming of the hearing aid, receives feedback from the patient, adjusts the programming again, and so forth, until the patient is satisfied with the result. In many cases, the patient must evaluate the hearing aid in various real world situations outside the audiologist's or dispenser's office, note its performance in those situations and then return to the audiologist or dispenser to adjust the hearing aid programming based on the audiologist's or dispenser's understanding of the patient's comments regarding the patient's experience with the hearing aid. [00051 One of the significant factors in the price of a hearing aid is the cost of the audiologist's or dispenser's services in fitting and programming the device, along with the necessary equipment, such as software, computers, cables, interface boxes, etc. If the required participation of the audiologist and/or dispenser and the fitting equipment can be eliminated or at least significantly reduced, the cost of a hearing aid can be significantly reduced. 100061 The complexity and cost of fitting hearing assistance devices in general also applies in the fitting of tinnitus masking devices. Tinnitus is a condition wherein a person experiences a sensation of noise (as a ringing or roaring) that is caused from a condition, such as a disturbance of the auditory nerve, hair cells, temporal mandibular joint or medications, to name a few. Tinnitus is a significant problem for approximately 50 million people each year, and some people only find relief with tinnitus maskers. A tinnitus masker looks like a hearing aid, but instead of amplifying sensed sound, it produces a sound, such as narrow-band noise, that masks the patient's tinnitus. Some of these instruments have a trim pot that is used to change the frequency of the masking noise. Such instruments may also have a volume control so the user may select the intensity of the masking that works best. 10007] Most tinnitus maskers are prescribed to patients who do not have significant hearing loss, and the masking sound is designed to be more acceptable to the patient than the tinnitus. 2 For most patients that have significant hearing loss, hearing aids can also provide tinnitus relief. However, there are some patients that need both amplification and tinnitus masking. [0008] The most appropriate masking stimuli to be generated by a tinnitus masker is usually determined by an audiologist or dispenser during a fitting procedure. Like the fitting of a hearing aid, the fitting procedure for a tinnitus masker also tends to be an iterative process which significantly increases the overall cost of the masking device. [00091 What is needed, therefore, is a programmable hearing assistance device that does not require a fitting procedure conducted by an audiologist or dispenser. To obviate the necessity of the programming equipment and the necessity of an audiologist or dispenser fitting procedure, a programmable hearing assistance device is needed which is automatically programmed based on selections made by a patient while using the device or based on usage patterns of the patient. This need applies to hearing aids as well as to tinnitus masking devices. SUMMARY [0010] The above and other needs are met by programmable apparatus for improving a person's perception of sound. In one embodiment, the apparatus includes one or more housings configured to be worn in, on or behind an ear of the person. Disposed within one or more of the housings is memory, a processor, a multipurpose control device, a digital-to-analog converter and an audio output section. The memory stores a plurality of available audio processing programs that may be used in processing digital audio signals. The processor is operable to execute one or more of the available audio processing programs to process the digital audio signals. The multipurpose control device, which may be a scroll wheel digital control, can be used in a program switching mode or in a volume control mode. In the program switching mode, the user may use the multipurpose control device to switch between the available audio processing programs. In the volume control mode, the user may use the multipurpose control device to adjust the volume of audible sound generated by the audio output section. Combining these functions in one control device simplifies operation and reduces the number of needed control devices. 3 [00111 In some embodiments, the apparatus also includes a push button connected to the processor. In these embodiments, the processor switches between the program switching mode and the volume control mode when the push button is pressed for at least some extended period of time. For example, if the apparatus is in the program switching mode when the push button is pressed for at least ten seconds, the processor selects the currently active audio processing program to be a selected audio processing program, and the processor changes from the program switching mode to the volume control mode. If the apparatus is in the volume control mode when the push button is pressed for at least ten seconds, the processor changes from the volume control mode to the program switching mode to allow the user to switch between and select audio processing programs. BRIEF DESCRIPTION OF THE DRAWINGS 100121 Further advantages of the invention are apparent by reference to the detailed description in conjunction with the figures, wherein elements are not to scale so as to more clearly show the details, wherein like reference numbers indicate like elements throughout the several views, and wherein: [0013] FIG. 1 depicts a functional block diagram of a hearing assistance device according to a preferred embodiment of the invention; [00141 FIGS. 2 and 3 depict a functional flow diagram of the programming of a hearing assistance device according to a first embodiment of the invention; 100151 FIGS. 4 and 5 depict a functional flow diagram of the programming of a hearing assistance device according to a second embodiment of the invention; [0016] FIG. 6 depicts a functional block diagram of a tinnitus masking device according to a preferred embodiment of the invention; [0017] FIG. 7 depicts a functional flow diagram of the programming of a tinnitus masking device according to a preferred embodiment of the invention; 4 [00181 FIG. 8 depicts a functional block diagram of components of a hearing assistance device according to a preferred embodiment of the invention; [00191 FIGS. 9A and 9B depict state diagrams for program selection modes of a hearing assistance device according to a preferred embodiment of the invention; [0020] FIG. 10 depicts a state diagram for a configuration mode of a hearing assistance device according to a preferred embodiment of the invention; and [00211 FIG. 11 depicts a hearing assistance device according to a preferred embodiment of the invention. DETAILED DESCRIPTION [0022] FIG. I depicts one embodiment of a hearing assistance device 10 for improving the hearing of a hearing-impaired patient. The device 10 of FIG. 1 is also referred to herein as a hearing aid. Another embodiment of a hearing assistance device is a tinnitus masking device as shown in FIG. 6 which is discussed in more detail hereinafter. 100231 In the following description of various embodiments of the invention, certain manual operations are described as preferably being performed by a wearer (or user or patient), and certain manual operations are described as preferably being performed by an audiologist (or clinician or dispenser). However, it will be appreciated that the wearer or audiologist or both may perform any of the manual operations described herein, and that the invention is not limited to any particular person's contribution to the performance of these operations. [00241 As shown in FIG. I the hearing assistance device 10 includes one or more microphones 12a-b for sensing sound and converting the sound to analog audio signals. The analog audio signals generated by the microphones 12a-b are converted to digital audio signals by analog-to digital (A/D) converters 14a-14b. The digital audio signals are processed by a digital processor 16 to shape the frequency envelope of the digital audio signals to enhance those signals in a way which will improve audibility for the wearer of the hearing assistance device. Further discussion of various programs for processing the digital audio signals by the processor 16 is provided below. Thus, the processor 16 generates digital audio signals that are modified based on the 5 programming of the processor 16. The modified digital audio signals are provided to a digital to-analog (D/A) converter 18 which generates analog audio signals based on the modified digital audio signals. The analog audio signals at the output of the D/A converter 18 are amplified by an audio amplifier 20, where the level of amplification is controlled by a volume control 34 coupled to a controller 24. The amplified audio signals at the output of the amplifier 20 are provided to a sound generation device 22, which may be an audio speaker or other type of transducer that generates sound waves or mechanical vibrations which the wearer perceives as sound. The amplifier 20 and sound generation device 22 are referred to collectively herein as an audio output section 19 of the device 10. [0025] In some embodiments of the invention, the volume control 34 comprises a scroll wheel digital volume control 34a mounted on an outer surface of a housing 50 of the device 10 as depicted in FIG. 11. In an exemplary embodiment, the scroll wheel digital volume control 34a is a model number DCU 193 manufactured by Pulse Engineering, Inc. The scroll wheel digital volume control 34a is also referred to herein as a multipurpose control device because it may be used as a volume control and as a control for switching between available audio processing programs. As described in more detail below, it may also be used in a configuration mode to change various configuration settings of the device 10. [0026J With continued reference to FIG. 1, some embodiments of the invention include a telephone coil 30. The telephone coil 30 is small coil of wire for picking up the magnetic field emitted by the ear piece of some telephone receivers or loop induction systems when the hearing assistance device 10 is disposed near such a telephone receiver or loop induction system. Signals generated by the telephone coil 30 are converted to digital signals by an A/D converter 14c and are provided to the processor 16. As discussed in more detail below, the converted digital signals from the telephone coil 30 may be used in some embodiments of the invention for resetting or reprogramming the processor 16, or controlling the operation of the hearing assistance device 16 in other ways. [0027] Some embodiments of the invention also include a wireless interface 32, such as a Bluetooth interface, for receiving wireless signals for resetting or reprogramming the processor 16. In some embodiments, the wireless interface 32 is also used to control the operation of the 6 device 10, including selection of acoustical configuration programs or masking stimuli programs. The wireless interface 32 may also be used to wirelessly deliver an audio signal to the device 10, such as a music signal transmitted from a wireless transmitter attached to a CD player, or the audio portion of a television program transmitted from a wireless transmitter connected to a television tuner. In various embodiments, the wireless interface 32 comprises a WiFi link according to the IEEE 802.11 specification, an infrared link or other wireless communication link. 100281 As shown in FIG. I, a manually operated input device 28, also referred to herein as a momentary switch or push button, is provided for enabling the wearer to control various aspects of the operation and programming of the hearing assistance device 10. The push button 28 is preferably very small and located on an outer surface of the hearing aide housing in a location that is easily accessible to the wearer while the wearer is using the device 10. [00291 For example, as shown in FIG. 11, the device 10 may be configured as a behind-the-ear (BTE) instrument, with the push button 28 located on an accessible surface of the housing 50 of the BTE instrument. An example of a hearing aid having BTE and in-the-ear (ITE) portions is described in U.S. Patent Application Publication 2006/0056649, where reference number 34 of FIG. 1 of that publication indicates one possible location for a push button switch on the BTE portion of a hearing aid. The push button 28 may also be located on the ITE portion. It will be appreciated that the invention is not limited to any particular configuration of the device 10. In various embodiments, the device 10 may comprise an open fit hearing aid, a canal hearing aid, a half-shell configuration, a BTE device, an ITE device or a completely in canal (CIC) device. [0030] The push button 28 is electrically connected to a controller 24 which generates digital control signals based on the state (open or closed) of the switch of the push button 28. In a preferred embodiment of the invention, the digital control signals are generated by the controller 24 based on how long the push button 28 is pressed. In this regard, a timer is included in the controller 24 for generating a timing signal to time the duration of the pressing of the button 28. Further aspects of the operation of the controller 24 and the push button 28 are described in more detail below. 7 [00311 A second push button 328 may be included in embodiments of the invention that combine hearing aid functions with tinnitus masking functions. In these embodiments, a push button 328 is used to control the selection of tinnitus masking programs as described in more detail hereinafter. Alternatively, a single push button may be used for first programming the hearing aid functions and then programming the tinnitus masking functions. 10032] Nonvolatile memory 26, such as read-only memory (ROM), programmable ROM (PROM), electrically erasable PROM (EEPROM), or flash memory, is provided for storing programming instructions and other operational parameters for the device 10. Preferably, the memory 26 is accessible by the processor 16 and/or the controller 24. [0033] According to preferred embodiments of the invention, the hearing assistance device 10 is operable in several different modes as determined by its programming. As the terms are used herein, "programs" and "programming" refers to one or more sets of instructions that are carried out by the processor 16 in shaping the frequency envelope of digital audio signals to enhance those signals to improve audibility for the wearer of the hearing assistance device 10. "Programs" and "programming" also refers to the instructions carried out by the processor 16 in determining which of several stored enhancement programs provides the best improvement for the wearer. FIGS. 2-5 depict the process flow of some exemplary methods for selecting the most effective hearing enhancement program for the wearer. [0034J FIGS. 2 and 3 depict a process flow according to one preferred embodiment of the invention wherein the selection of the most effective enhancement program is based upon a "trial and error" interactive and iterative method, where the wearer of the device evaluates several options for enhancement programs and chooses one or more programs that provide the best enhancement for the individual wearer. As shown in FIG. 2, a first step in the method is to store in memory 26 some number (N) of primary acoustical configuration programs for shaping the acoustical characteristics of the hearing assistance device 10 (step 100). This step may be performed at the time of manufacture of the hearing assistance device 10 or at a later time, such as during a reprogramming procedure. In a preferred embodiment of the invention, seven primary acoustical characteristic configuration programs are loaded into the memory 26 (N = 7). 8 However, it will be appreciated that any number of programs may be initially loaded into memory 26, and the invention is not limited to any particular number. [0035] As the phrases are used herein, a "primary acoustical characteristic configuration program" or a "initial-tuning program" is an algorithm that sets the audio frequency shaping or compensation provided in the processor 16. These programs or algorithms may also be referred to by audiologists or dispensers as "gain-frequency response prescriptions." Examples of generally accepted primary acoustical configuration programs include NAL (National Acoustic Laboratories; Bryne & Tonisson, 1976), Berger (Berger, Hagberg & Rane, 1977), POGO (Prescription of Gain and Output; McCandless & Lyregaard, 1983), NAL-R (NAL-Revised; Byrne & Dillon, 1986), POGO II (Schwartz, Lyregaard & Lundh, 1988), NAL-RP (NAL Revised, Profound; Byrne, Parkinson & Newall, 1991), FIG6 (Killion & Fikret-Pasa, 1993) and NAL-NL 1 (NAL nonlinear; Dillon, 1999). It will be appreciated that other primary acoustical configuration programs or initial-tuning programs could be used in association with the methods described herein, and the above list should not be construed as limiting the scope of the invention in any way. [0036] A "secondary acoustical characteristic configuration program" or a "fine-tuning program" as those phrases are used herein refer to a variation on one of the primary programs or initial-tuning programs. For example, in one of the primary programs or initial-tuning programs, a parameter for gain at 1000 Hz may be set to a value of 20 dB which is considered to be in or near the center of a range for an average hearing loss patient. In an example of a related secondary program or fine-tuning program, the parameter for gain at 1000 Hz may be set to a value of 25 dB which is just above the "standard" value. Accordingly, another related secondary program or fine-tuning program may have the parameter for gain at 1000 Hz set to a value of 15 dB which is just below the "standard" value. There may be any number of secondary programs or fine-tuning programs that include various variations of parameters which in the associated primary program or initial-tuning program are set to a standard or average value. Preferably, 2xN number of secondary acoustical configuration programs are loaded into memory at step 100. For example, there may be two secondary programs associated with each primary program. 9 [0037] In the preferred embodiment of the invention, a feedback canceller algorithm is also stored in the memory 26 of the device 10. An example of a feedback canceller algorithm is described in U.S. Patent Application Publication 2005/0047620 by Robert Fretz. As described in more detail below, such an algorithm is used to set the acoustical gain levels in the processor 16 and/or the amplifier 20 to avoid audio feedback in the device 10. [0038] At some point after the initial programming of the device (step 100), a wearer inserts the device 10 into the ear canal (in the case of an ITE device) or places the device 10 behind the ear (in the case of a BTE device) with the associated connections to the ear canal (step 102). Once the device 10 is in position, the wearer presses the button 28 for some extended period of time TI, such as 60 seconds, to activate the device 10 and initialize the feedback canceller program (step 104). According to a preferred embodiment of the invention, the feedback canceller program generates and stores acoustical coefficients that will be applicable to all of the primary and secondary acoustical configuration programs stored in the memory 26. [0039] Once the feedback canceller program has performed its initialization procedure, the wearer can cycle through the N number of available primary acoustical configuration programs and try each to determine which provides the best enhancement for the wearer's hearing loss. The wearer does this by pressing the button 28 for at least some period of time T2, such as one second, to switch from one program to the next (step 108). For example, a first program may be executed by the processor 16 when the device 10 is first powered on. When the wearer presses the button 28 for at least one second, a second program is executed by the processor 16 (step 120). In some embodiments, the device 10 generates two beeps (step 118) to indicate to the selection of the second program. When the wearer presses the button 28 again for at least one second, a third program is executed by the processor 16 (step 120) and the device 10 generates three beeps to indicate that the third program is selected.. This continues until the wearer has cycled through the N number of programs (such as seven). If the wearer presses the button 28 again for at least one second, the first program is loaded again. This process is represented by steps 108-122 of FIG. 2. To cycle through programs quickly, the wearer may press the button 28 several times consecutively until the desired program is selected. At this point, some number of beeps are generated to indicate which program is selected. 10 100401 If it is determined that the button 28 is pressed for less than one second (step 110), then no new program is loaded and the process waits for the next button press (step 122). This prevents inadvertent switching from one program to the next due to an accidental press of the button 28. [0041] Once the wearer has had a chance to evaluate all of the available primary programs, the wearer may find that some smaller number of the programs, such as two, seem to be used most because they provide the best hearing enhancement for the user in various situations. For example, one of the programs may provide the best performance in normal quiet conversation settings. Another of the programs may provide the best performance in a noisy setting, such as in a crowded room. A preferred embodiment of the invention allows the user to eliminate programs that are not used or rarely used, and to evaluate some secondary programs that are variations on the best performing programs. As described below, this is accomplished by pressing the push button 28 for a time T3, such as 30 seconds, which is longer than the time T2. 100421 As shown in FIG. 2, if it is determined that the button 28 is pressed for a time T3 or longer (step 124), such as 30 seconds, the processor 16 sets a flag or stores a value indicating that the currently-loaded primary program has been designated as a chosen program (step 126). At this point, the device 10 generates a distinctive sound (step 128) to indicate to the wearer that a program has been chosen. In a preferred embodiment, the device 10 allows the user to choose two of the N number of primary acoustical configuration programs. However, it will be appreciated that the device 10 could accommodate designation of more or fewer than two primary acoustical configuration programs as chosen. If it is determined at step 130 that two programs have not yet been chosen, the process waits for the next press of the button 28 (step 122). [0043] In an alternative embodiment of the invention, instead of pressing the button 28 to choose a program, the wearer presses the button 28 for at least time T3 to deactivate a non chosen program. Thus, it will be appreciated that the invention is not limited to the manner in which programs are designated as chosen or not chosen. 1 1 [00441 If it is determined at step 130 that two primary acoustical configuration programs have been chosen, then the primary programs that have not been chosen are deactivated (step 132 in FIG. 3). Deactivation in this sense means that the non-chosen programs are made unavailable for selection and execution using the procedure of repeated pressing of the button 28. Thus, at this point, two primary programs are available for selection and execution. [00451 After the wearer has used the device 10 for some extended period of time T4 (step 134), such as 80 hours, two secondary acoustical configuration programs are activated for each of the prioritized primary programs. For example, if two primary programs have been chosen by way of the user selection process of steps 124-130, then four secondary programs are activated at step 136, resulting in a total of six available programs (N = 6). Activation of a program in this sense means to make a program available for selection and execution. In a preferred embodiment of the invention, each of the two newly-added secondary programs are variations on a corresponding one of the chosen primary programs. This allows the wearer to make a more refined selection so as to "fine tune" the desired acoustical response. At this point in this example, the wearer has six available programs to evaluate and the user can cycle through the six programs using the button pressing procedure depicted in steps 138-152 of FIG. 3. This procedure is essentially the same as the procedure of steps 108-122 of FIG. 2. [0046] Once the wearer has had a chance to try and compare the six available programs (two primary and four secondary), the wearer can choose the two programs that provide the best performance and deactivate the rest. This is accomplished by pressing the push button 28 for a time T3, such as 30 seconds. As shown in FIG. 3, if it is determined that the button 28 is pressed for a time T3 or longer (step 154), the processor 16 sets a flag or stores a value indicating that the currently-loaded program has been designated as chosen (step 156). At this point, the device 10 generates a distinctive sound (step 158) to indicate to the wearer that a program has been chosen. In a preferred embodiment, the device 10 allows the user to choose two of the N number of available programs. However, it will be appreciated that the device 10 could accommodate the choice of more or fewer than two programs. [0047] If it is determined at step 160 that two programs have not yet been chosen, the process waits for the next press of the button 28 (step 152). If it is determined at step 160 that two 12 programs have been chosen, then the other four non-chosen programs are deactivated (step 162 in FIG. 3). At this point, the two best-performing programs as determined by the wearer are available for continued use. (N - 2, step 164.) The wearer can now switch between the two available programs using the button pressing procedure of steps 138-152. [0048] In some embodiments of the invention, there is no process for activating and choosing secondary acoustical configuration programs. In such embodiments, the wearer chooses some number of best performing primary or secondary programs (such as N = 2) and the thereafter the wearer can switch between those chosen programs. This is represented by the dashed line from the box 132 in FIG. 2 with continuation at step 122. Thus, in these embodiments, processing does not proceed to step 134 in FIG. 3. [0049] In preferred embodiments of the invention, the programming of the hearing assistance device 10 can be reset to default (factory) conditions. In one embodiment, the reset is initiated by pressing the push button 28 for an extended time T5, such as two minutes, which is significantly longer than T3. In another embodiment, the reset is initiated by closing a battery compartment door while simultaneously pressing the button 28. This embodiment includes a switch coupled to the battery compartment door, where the status of the switch is provided to the controller 24. In another embodiment, the reset is initiated by a Dual-Tone Multi-Frequency (DTMF) telephone code received by the telephone coil 30 or microphone I2a or 12b. In yet another embodiment, the reset is initiated by a coded wireless signal received by the wireless interface 32, In some embodiments, more than one of the above procedures are available for resetting the programming of the device 10. [0050] As described above, in preferred embodiments of the invention, a wearer switches between available programs and chooses programs using the manually operated push button 28 mounted on a housing of the device 10. In alternative embodiments of the invention, the wearer switches between available programs and chooses programs using a wireless remote control device 33, such as an infrared, radio-frequency or acoustic remote control. In these alternative embodiments, a push button is provided on the remote control device 33, and the program selection and choosing process proceeds in the same manner as described above except that the wearer uses the push button on the remote control device 33 rather than a button mounted on the 13 housing of the device 10. In an embodiment including an acoustic remote control, coded acoustic signals, such as a series of clicks in a machine recognizable pattern, may be used to deliver commands to the device 10. Such acoustic control signals may be received by one or both of the microphones 14a-14b and provided to the processor 16 for processing. [0051] In yet another embodiment incorporating voice recognition technology, the wearer switches between available programs and chooses programs by speaking certain "code words" that are received by one or more of the microphones 12a-12b, converted to digital control signals and processed by the processor 16 to control operation of the device 10. For example, the spoken phrase "switch program" may be interpreted by the processor 16 in the same manner as a push of the button 28 for a time T2, and spoken phrase "choose program" may be interpreted by the processor 16 in the same manner as a push of the button 28 for a time T3. 10052] FIGS. 4 and 5 depict a process flow according to another preferred embodiment of the invention wherein the designation of the most effective enhancement programs is based upon a method wherein the wearer of the device evaluates several options for enhancement programs and the device 10 keeps track of how long the wearer uses each program. With this embodiment, the basic assumption is that the program which provides the best performance for the wearer will be the program used most during the evaluation period. As described below, a variation on this embodiment allows the wearer to "override" the time-based designation process and manually choose one or more programs that provide the best performance. This override feature may be provided as an optional operational mode. [0053] As shown in FIG. 4, a first step in the method is to store in memory 26 some number (N) of primary acoustical configuration programs and 2xN number of secondary programs (step 200). This step may be performed at the time of manufacture of the hearing assistance device 10 or at a later time, such as during a reprogramming procedure. In a preferred embodiment of the invention, seven primary programs and fourteen secondary programs are loaded into the device memory 26 (N = 7, 2xN = 14). However, it will be appreciated that any number of programs may be initially loaded into memory 26, and the invention is not limited to any particular number. In the preferred embodiment of the invention, a feedback canceller algorithm is also stored in the memory 26 of the device 10 at step 200. 14 [0054] At some point after the initial programming of the device (step 200), a wearer inserts the device 10 into the ear canal (in the case of an ITE device) or places the device 10 behind the ear (in the case of a BTE device) with the associated connection to the ear canal (step 202). Once the device 10 is in position, the wearer presses the button 28 for some extended period of time Ti, such as 60 seconds, to activate the device 10 and initialize the feedback canceller program (step 204). According to a preferred embodiment of the invention, the feedback canceller program generates and stores acoustical coefficients that will be applicable to all of the primary and secondary acoustical configuration programs stored in the memory 26. [0055] Once the feedback canceller program has performed its initialization procedure, the wearer can cycle through the N number of available primary acoustical configuration programs and try each to determine which provides the best enhancement for the wearer's hearing loss. The wearer does this by pressing the button 28 for at least some period of time T2, such as one second, to switch from one program to the next (step 208). For example, a first program may be executed by the processor 16 when the device 10 is first powered on. When the wearer presses the button 28 for at least one second, a second program is executed by the processor 16 (step 220). In some embodiments, the device 10 generates two beeps (step 218) to indicate to the selection of the second program. When the wearer presses the button 28 again for at least one second, a third program is executed by the processor 16 (step 220) and the device 10 generates three beeps to indicate that the third program is selected. This continues until the wearer has cycled through the N number of programs (such as seven). If the wearer presses the button 28 again for at least one second, the first program is loaded again. This process is represented by steps 208-228 of FIG. 4. To cycle through programs quickly, the wearer may press the button 28 several times consecutively until the desired program is selected. At this point, some number of beeps are generated to indicate which program is selected. [00561 As with the previously described embodiment, if it is determined that the button 28 is pressed for less than one second (step 210), then no new program is loaded for execution and the process waits for the next button press (step 228). This prevents inadvertent switching from one program to the next due to an accidental press of the button 28. 15 100571 In the embodiment of FIG. 4, a timer circuit is used to time how long each selected primary program is used (step 222). The total time of use of each primary program is logged in memory and is continuously updated as the wearer switches from one program to another. After the wearer has used the device 10 for some extended period of time T5, such as 80 hours (step 226), a calculation is made based on the logged time information to determine which two primary programs have been used most during the T5 period (step 230). The two primary programs having the highest usage time are then designated as chosen (step 232) and the remaining primary programs are deactivated (step 234). The wearer then uses the device 10 with the two chosen primary programs activated for a period of time T6, such as 80 hours (step 236). During this time, the wearer can switch between the two programs as desired. [00581 At the end of the T6 period, the wearer has used the device 10 for a total time of T5 + '6, such as 160 hours total. At this point, two secondary acoustical configuration programs are activated for each of the two active primary programs, resulting in a total of six available programs (N = 6) (step 238). In a preferred embodiment of the invention, each of the two newly added secondary programs is a variation on a corresponding one of the two most-used primary programs. This allows the wearer to make a more refined selection so as to "fine tune" the desired acoustical response. At this point in this example, the wearer has six available programs to evaluate and the wearer can again cycle through the available programs using the button pressing procedure depicted in steps 208-228 of FIG. 4. [0059] During the evaluation period of the N number of available primary and related secondary programs, the timer circuit is again used to time how long each program is loaded for use (step 222). The total time of use of each program is logged in memory and is continuously updated as the wearer switches from one program to another. After the wearer has used the device 10 for a total period of time T7 (such as 240 hours, which is significantly greater than the sum of T5 + T6) (step 224), a calculation is made based on the logged time information to determine which two of the N number of available programs have been used most since the secondary programs were activated (step 240). The two programs having the highest usage time are then designated as chosen (step 242) and the remaining programs are deactivated (step 244). At this point, the two most-used programs as determined by the time-logging procedure are available for 16 continued use. (N = 2, step 246.) The wearer can now switch between the two available programs using the button pressing procedure of steps 208-228. [0060] As mentioned above, a preferred embodiment of the invention allows a wearer to override the time-based selection process and to manually choose one or more programs that provide the best performance for the wearer. This override option is depicted in FIG. 5 and the dashed box portion of FIG. 4. At step 248, if it is determined that the button 28 is pressed for a time T3 or longer, such as 30 seconds, the processor 16 sets a flag or stores a value indicating that the currently-loaded program has been designated as chosen (step 250 in FIG. 5). At this point, the device 10 generates a distinctive sound (step 252) to indicate to the wearer that a program has been chosen. In a preferred embodiment, the device 10 allows the user to choose two of the available acoustical configuration programs. However, it will be appreciated that the device 10 could accommodate the choice of more or fewer than two acoustical configuration programs. [00611 If it is determined at step 254 that two primary programs have not yet been chosen, the process waits for the next press of the button 28 (step 228 in FIG. 4). If it is determined at step 254 that two primary programs have been chosen, then the non-chosen primary programs are deactivated (step 256 in FIG. 5). Thus, at this point, two primary programs are available for use. If the wearer has not yet used the device 10 for at least a total period of time T6 (such as 80 hours) (step 258), then processing continues at step 236 of FIG. 4. [00621 After the wearer has used the device 10 for a time T6 (such as 80 hours) with two primary programs designated as chosen, two secondary programs are activated for each of the two active primary programs, resulting in a total of six available programs (N = 6) (step 238). At this point in this example, the wearer again has six available programs from which to choose, and the wearer can again cycle through the six available programs using the button pressing procedure depicted in steps 208-228 of FIG. 4. In this embodiment, the time-logging processing continues as described above unless and until the wearer overrides the procedure by pressing the button 28 for longer than time T3 (step 248). This transfers processing back to step 250 of FIG. 5 where the processor 16 sets a flag or stores a value indicating that the currently-loaded program has been designated as chosen. Once two programs have been chosen (step 254), the 17 non-chosen primary and secondary programs are deactivated (step 256), leaving two programs available for selection. [0063] At this point, the wearer has used the device 10 for at least a total period of time T6 (such as 80 hours) (step 258), so that processing continues at step 246 of FIG. 4. Two programs are now available for continued use. These two programs were chosen based on the time logging procedure, or the override procedure, or a combination of both. The wearer can now switch between the two available programs as desired using the button pressing procedure of steps 208-228. If so desired, the programming of the device 10 may be reset to default conditions as described above using the button 28, the wireless interface 32 or the telephone coil 30, as described above. [0064] FIG. 6 depicts one embodiment of a hearing assistance device 300 for masking tinnitus. The device 300, which is also referred to herein as a tinnitus masker, includes a digital processor 316 for processing digital audio signals, such as masking stimuli signals. In one preferred embodiment of the invention, the masking stimuli signals comprise narrow-band audio noise. The audio frequencies of these noise signals generally fall into the human audible frequency range, such as in the 20-20,000 Hz band. In one sense, "processing" these masking stimuli signals means accessing digital audio files (such as .wav or .mp3 files) from a digital memory device 326 and "playing" the files to generate corresponding digital audio signals. In another sense, "processing" the masking stimuli signals means to determine which digital audio files to access from memory 326 based on which frequency ranges of narrow-band noise have been designated as chosen. In yet another sense, "processing" the masking stimuli signals means to generate the masking stimuli signals using an audio masking stimuli generator program executed by the processor 316. In any case, the masking stimuli signals are provided to a D/A converter 318 which converts them to analog audio signals. The analog audio signals at the output of the D/A converter 318 are amplified by an audio amplifier 320 where the level of amplification is controlled by a volume control 334 coupled to a controller 324. The amplified audio signals at the output of the amplifier 320 are provided to a sound generation device 322, which may be an audio speaker or other type of transducer that generates sound waves or mechanical vibrations which the user perceives as sound. The amplifier 320 and sound 18 generation device 322 are referred to collectively herein as an audio output section 319 of the device 300. [0065] In a preferred embodiment of the invention, the masking stimuli signals comprise narrow-band noise signals. However, it will be appreciated that other types of masking stimuli could be generated according to the invention, including frequency-modulated noise or speech babble noise. Thus, the invention is not limited to any particular type of masking stimuli. [0066] As shown in FIG. 6, a manually operated momentary switch 328, also referred to herein as a push button 328, is provided for enabling the user of the device 300 to control various aspects of the operation and programming of the device 300. The push button 328 is preferably very small and located on an outer surface of a housing associated with the device 300. In an embodiment wherein the device 300 is worn on or in the ear of the user, the push button 328 is located on a portion of the housing that is accessible to the user while the user is wearing and using the device 300. For example, the device 300 may be configured as a behind-the-ear (BTE) or in-the-ear (ITE) instrument, with the push button 328 located on an accessible surface of the instruments. In an alternative embodiment of the invention, the wearer switches between available masking stimuli programs and chooses programs using a wireless remote control device 333, such as an infrared, radio-frequency or acoustic remote control. [00671 In one alternative embodiment, the tinnitus masking device 300 is disposed in a housing suitable for tabletop use, such as on a bedside table. In this "tabletop" embodiment, the push button 328 and volume control 334 may be located on any surface of the housing that is easily accessible to the user. The sound generation device 322 of this embodiment is preferably a standard audio speaker such as may typically be used in a tabletop clock radio device. It could also have an extension pillow speaker. [0068] The push button 328 is electrically connected to a controller 324 which generates digital control signals based on the state (open or closed) of the switch of the push button 328. In a preferred embodiment of the invention, the digital control signals are generated by the controller 324 based on how long the push button 328 is pressed. In this regard, a timer is included in the controller 324 for generating a timing signal to time the duration of the pressing of the button 19 328. Further aspects of the operation of the controller 324 and the push button 328 are described in more detail below. {0069] Nonvolatile memory 326, such as read-only memory (ROM), programmable ROM (PROM), electrically erasable PROM (EEPROM), or flash memory, is provided for storing programming instructions, digital audio sound files and other operational parameters for the device 300. Preferably, the memory 326 is accessible by one or both of the processor 316 and the controller 324. [00701 FIG. 7 depicts a process flow according to one preferred embodiment of the invention wherein the selection of most effective masking stimulus for tinnitus masking is based upon a "trial and error" interactive and iterative method where the user of the device 300 evaluates several options for noise frequency and chooses a frequency range that provides the best masking experience for the individual user. As shown in FIG. 7, a first step in the method is to store in memory various parameters for generating some number (N) of "programs" for generating narrow-band noise using the device 300 (step 350). When referring to the operation of the tinnitus masking device 300, a "program" may refer to various stored commands, values, settings or parameters that are accessed by masking stimuli generation software or firmware to cause the software or firmware to generate masking stimuli within a particular frequency band or masking having particular spectral aspects. In another sense, "program" may refer to a specific digital audio file (.wav, .mp3, etc.) containing masking stimuli, such as audio noise in a particular frequency band or having particular spectral aspects. The step 350 may be performed at the time of manufacture of the device 300 or at a later time, such as during a reprogramming procedure. [00711 A user of the tinnitus masking device 300 can cycle through N number of available masking stimuli programs and evaluate each to determine which provides the best masking for the user's tinnitus condition. The user does this by pressing the button 328 for at least some period of time T2, such as one second, to switch from one masking program to the next (step 356). For example, a first masking program may be activated when the device 300 is first powered on. When the wearer presses the button 328 for at least one second, a second masking program is loaded from memory 326 to the processor 316 and the device 300 generates two 20 beeps (step 366) to indicate to the user that the second masking program is loaded. When the wearer presses the button 328 again for at least one second, a third masking program is loaded from memory 326 to the processor 316 and the device 300 generates three beeps to indicate that the third masking program is loaded. This continues until the user has cycled through the N number of masking programs. If the wearer presses the button 328 again for at least five seconds, the first program is loaded for execution again. This process is represented by steps 356-370 of FIG. 7. [00721 If it is determined that the button 328 is pressed for less than one second (step 358), then no new masking program is loaded and the process waits for the next button press (step 370). This prevents inadvertent switching from one masking program to the next due to an accidental press of the button 328. {0073] Once the user has had a chance to evaluate all of the available masking stimuli programs, the user may find that some smaller number of the programs, such as one or two, seem to be used the most because they provide the best masking performance for the user in various situations. For example, one of the masking stimuli programs may provide the best masking when the user is trying to sleep. Another of the masking stimuli programs may provide the best masking when the user is trying to concentrate while reading. A preferred embodiment of the invention allows the user to eliminate masking stimuli programs that are not used or rarely used, and to evaluate some additional masking stimuli programs that are variations on the best performing programs. This is accomplished by pressing the push button 328 for a time T3, such as 30 seconds, which is longer than the time T2, as described below. [0074J As shown in FIG. 7, if it is determined that the button 328 is pressed for a time T3 or longer (step 372), the processor 316 sets a flag or stores a value indicating that the currently loaded masking stimulus program has been designated as chosen (step 374). At this point, the device 300 generates a distinctive sound (step 376) to indicate to the user that a preferred masking stimulus program has been chosen. The masking stimuli programs not chosen are then deactivated (step 378). Deactivation in this sense means that the non-chosen programs are no longer available for selection using the procedure of repeated pressing of the button 328. 21 [00751 After the user has used the device 300 for some extended period of time T4 (step 380), such as 40 hours, the frequency band of the chosen program is "split" to provide two additional masking stimuli programs (step 382). In the preferred embodiment of the invention, the two new programs provide masking stimuli in two frequency bands that are sub-bands of the frequency band of the chosen masking stimuli program. For example, in a case where the chosen program provides masking stimuli in the 1000-3000 KHz band, one of the newly activated programs may cover 1000-2000 KHz and the other newly activated program may cover 2000-3000 KHz. At this point, three masking stimuli programs are available for continued use and evaluation (N - 3, step 384). [0076] The user can now switch between the three available masking stimuli programs using the button pressing procedure of steps 356-370 to decide which of the three provides the best masking performance. As described above, the user designates one of the three masking stimulus programs as chosen by pressing the button 328 for at least the time T3 (step 372). The process steps 374-384 are then performed based on the newly-chosen masking stimulus program. This selection procedure may be repeated any number of times to allow the user to "tune in" on the most effective masking stimulus program. 100771 Once the user is satisfied with a particular masking stimulus program, the user presses the button 328 for a time T4, such as 30 seconds (step 386), at which point all non-chosen masking stimuli programs are removed or deactivated (step 388). From this point forward, the tinnitus masking device 300 operates indefinitely using the one selected masking stimulus program. 100781 In an alternative embodiment of the invention, instead of pressing the button 328 to choose a masking stimuli program, the wearer presses the button 328 for at least time T3 to deactivate a non-chosen program. Thus, it will be appreciated that the invention is not limited to the manner in which masking stimuli programs are designated as chosen or not chosen. [0079] As with the hearing assistance device 10, the tinnitus masking device 300 may be reset to default (factory) conditions by the user. In one embodiment, the reset is initiated by pressing the push button 328 for an extended time T5 which is significantly longer than T4, such as two 22 minutes. In another embodiment, the reset is initiated by closing the battery compartment while simultaneously pressing the button 328. In yet another embodiment, the reset is initiated using the wireless remote control device 333. [00801 In one alternative embodiment, the invention provides a hearing assistance device which is combination hearing aid and tinnitus masker. This embodiment comprises components as depicted in FIG. 1, which include the push button 28 for controlling the selection of hearing aid acoustical configuration programs for the hearing aid function (as described in FIGS. 2-5) and a second push button 328 for controlling the selection of masking stimuli programs for the tinnitus masking function (as described in FIG. 7). Alternatively, a single push button may be used for first programming the hearing aid functions and then programming the tinnitus masking functions. Those skilled in the art will appreciate that the processor 16 and controller 24 may be programmed to implement the hearing aid functions and the tinnitus masking functions simultaneously. 100811 In some preferred embodiments of the invention, instead of or in addition to using a clock signal to determine elapsed operational time of the hearing assistance device 10 (or tinnitus masking device 300), elapsed time is determined based on counting the number of times various events occur during the lifetime of the device. For example, since the battery of a hearing assistance device must be replaced periodically, one can count the number of times the battery is replaced to approximate the elapsed operational time of the device. Also, since hearing assistance devices are typically removed and powered down each evening, one can count the number times a device has been cycled on and off, either by opening the battery compartment or by operating an on/off switch, to approximate the elapsed operational time. [0082] Various batteries used in hearing assistance devices have operational lifetimes ranging from. about 3 days to about 30 days, where the exact lifetime depends on the capacity of the particular battery and the power demand of the hearing assistance device. Accordingly, if the expected lifetime of a particular battery in a particular hearing assistance device is 10 days, and the battery has been replaced three times, then one can estimate that the hearing assistance device has been in use for about 30 days. In a preferred embodiment of the invention, the expected lifetime of the battery is a value that is stored in the memory 26 of the hearing 23 assistance device. This value may be updated depending on the particular model of battery in use and the expected power demand of the particular hearing assistance device. [0083] As shown in FIG. 8, the opening and closing of battery compartment door contacts 42 provide an indication that the battery compartment door has been opened and closed. For example, a set of electrical contacts are provided which are closed when the battery compartment door is closed and open when the compartment door is opened. A door contact detection module 44 monitors the battery compartment contacts 42 and generates an "on" or "high" logic signal when the contacts 42 are open and an "off' or "low" logic signal when the contacts 42 are closed. This logic signal is provided to a counter 40 which is incremented each time the signal goes high. A counter value of n indicates that the battery compartment door has been opened n times, indicating either n number of battery replacements or n number of times that the device has been powered down by opening the battery compartment. The counter value is preferably stored in the nonvolatile memory device 26. For a typical device (having no separate power on/off switch) that is powered down at the end of each day by opening the battery compartment door, a value n may indicate a total use time of n days. If a device does have a separate on/off switch, and the battery is typically removed only when it is being replaced, a value n may indicate a total use time of n x x days, where x is the expected lifetime of the battery in days. 100841 As also shown in FIG. 8, a voltage level detection module 38 may be provided which monitors the voltage of the battery 36. The voltage level detection module 38 may generate an "on" or "high" logic signal whenever the battery voltage increases by some number of volts, indicating that an old battery has been replaced with a fresh one. This logic signal is provided to the counter 40 which is incremented each time the signal goes high. Similar to the battery replacement example above, a counter value of n indicates that the battery has been replaced n times, which indicates a total use time of n x x days. [0085J With continued reference to FIG. 8, a momentary on/off switch 48 may be provided to turn the hearing assistance device 10 on and off. For example, the switch 48 may be pressed once to turn the device on and once again to turn the device off. An on/off switch detection module 46 monitors the on/off switch 48 and generates an "on" or "high" logic signal each time 24 the switch 48 is operated. This logic signal is provided to the counter 40 which increments each time the signal goes high. A counter value of n indicates that the device 10 (or the device 300) has been cycled on and off n times. For example, if a device is typically turned on and off once 2 per day, a counter value of n indicates the device has been in use for -n days. 2 [0086] Accordingly, in each operation depicted in FIGS. 2-5 and 7 wherein a value for the total elapsed operational time of the device is needed, this time value may be determined based on the counter value generated by the counter 40. For example, the counter value may be used to determine the time value in step 134 of FIG. 3, the time value in step 222 of FIG. 4, the time value in step 258 of FIG, 5, and the time value in step 380 of FIG. 7. [00871 It will be appreciated that a combination of two or more counter values may be used to calculate an elapsed operational time value. For example, one counter value may keep track of the number of times the battery compartment door contacts have opened/closed and another counter value may keep track of the number of times the battery voltage goes from a low value to a high value. In this example, if one counter value indicates that the battery compartment door has been opened/closed once and the other counter value indicates that the battery voltage has not changed significantly, this may indicate that the battery compartment door was opened to power down the device, but the battery was not replaced. [00881 In another example, the on/off switch counter value may indicate that the device has been in operation for 30 days, and the battery voltage level counter value may indicate that the device has been in operation for 40 days. In various embodiments, an average of these two time values, the greater of these two time values, or the lesser of these two time values may be selected as the elapsed operational time value. [0089] FIG. 8 depicts the detection modules 38, 44 and 46 and the counter 40 as components of the controller 24. It will be appreciated that in other embodiments, any or all of these components may be in provided in circuitry which is separate from the controller 24. 25 [00901 FIGS. 9A and 9B depict state diagrams for program selection modes of a hearing assistance device (such as the device 300 in FIG. 6) according to a preferred embodiment of the invention. As shown in FIG. 9A, when the device is powered on (step 400), the processor 316 determines the current status of Fit State (step 402), which may be either InitialFit or Fine Tuned. (When the device 10 is powered-up for the first time after delivery to the user, Fit State = InitialFit.) If FitState = Fine Tuned at power up (step 406), the processor 316 executes the process depicted in Fig. 9B and described hereinafter. [00911 If FitState = Initial Fit at power up (step 404), the processor determines the current status of IF_State (step 414), which may be either Start Selection, QSelected or NSelected. If IF-State = StartSelection (step 416), the processor loads some number of quiet acoustical condition programs (step 422) from nonvolatile memory 326. In a preferred embodiment, five quiet acoustical condition programs QI - Q5 are available. These programs are also referred to herein as initial-tuning programs or primary acoustical programs. While wearing and using the device, the user can switch from one of the programs QI-Q5 to the next by pressing the push button 28 once for a relatively short duration (step 424), such as less than five seconds. The push button 28 is also referred to herein as the push button control 28. When switching from one Q-program to the next, the audio output section 319 emits an auditory indicator of the active program, such as some number of pure-tone beeps indicating the number of the program. At any time during use of the Q-programs, the user can select one of the programs Q1-Q5 to be designated as a selected or preferred program by pressing and holding the button 28 for five seconds or longer (step 426). The selected program is referred to herein as quiet acoustical condition program QS. At this point a long tone sounds to indicate to the user that the QS program is selected and the StartSelection state is completed (step 428). Once QS is selected, the non-selected Q-programs are deactivated. In preferred embodiments, the non-selected Q programs are not erased, but are available for reactivation by resetting the device using the Configuration Mode described below. At this point, IF_State is set to QSelected (step 430). [0092] With continued reference to FIG. 9A, if IFState = QSelected (step 418), the processor loads the selected QS program and some number of noisy acoustical condition programs (step 432) from nonvolatile memory 326. In a preferred embodiment, five noisy acoustical condition programs N1-N5 are available. These programs are also referred to herein as initial-tuning 26 programs or primary acoustical programs. While wearing and using the device 300, the user can switch from one of the programs N -N5 to the next by pressing the push button 28 once for a relatively short duration (step 434), such as less than five seconds. When QS is activated, a pure-tone beep is emitted through the audio output section 319. When any one of the noisy environment programs Nl-N5 is activated, a noise pulse train is emitted through the audio output section 319, with the number of pulses corresponding to the choice of NI -N5 (e.g. one pulse for Nl, two pulses for N2, etc.). Any one of the programs NI-N5 may be designated as a selected or preferred program by pressing and holding the button 28 for five seconds or longer (step 436). The selected program is referred to herein as noisy environment program NS. Once NS is selected, the non-selected noisy environment programs are deactivated (but not erased) and are available for reactivation by resetting the device using the Configuration Mode described below. At this point a long tone sounds to indicate to the user that the NS program is selected and the QSelected state is completed (step 438). IFState is then set to NSelected (step 440). 100931 If IFState = NSelected (step 420), the processor loads from nonvolatile memory 326 the selected quiet environment program QS, the selected noisy environment program NS and one of the telecoil programs (T I -T5) (step 442). The selected telecoil program (designated as TS for purposes of this description) is automatically selected based on the selection of the program QS, with the selection of program TI-T5 corresponding to the selection of program of Ql-Q5. For example, if QS - Q5, then TS = T5. While wearing and using the device, the user can now switch between the programs QS, NS and TS by pressing the push button 28 once for a relatively short duration (step 444), such as less than five seconds. If program QS is selected, a pure-tone beep is emitted from the audio output section 319. If program NS is selected, a noise pulse is emitted. If program TS is selected, a dial-tone pulse or a ring sound is emitted. 100941 If the device is operating with Auto Mode off, which is the preferred factory-default setting, the device continues operating in the initial-tuning mode until the device is activated in the Configuration Mode, which is described in more detail hereinafter (step 448). Using the Configuration Mode options, Auto Mode may be set to on or off by an audio logist/dispenser. If the device has been set by an audiologist/dispenser to operate with Auto Mode on, the device continues operating in an initial-tuning mode (with the selected programs QS, NS and TS 27 available) until the battery compartment door has been opened and closed more than X number of times (step 446). [00951 Referring back to steps 400-404 of FIG. 9A, if at power-up, FitState = InitialFit and Auto Mode is on and the initial selections of QS, NS and TS have been made and the battery compartment door has been opened and closed more than X number of times, the processor determines the current status of FTState (step 450), which may be either FTStart or FTQSelected. If FTState = FTStart (step 452), the processor loads from nonvolatile memory 326 a pair of additional quiet acoustical condition programs QSL and QSH that are slight variations on the program QS (step 456). This provides the user five available programs (QS, QSL, QSH, NS and TS) to can try out indefinitely. In a preferred embodiment, the programs QSL and QSH are secondary acoustical characteristic configuration programs, such as described above. These programs are also referred to herein as fine-tuning programs. While wearing and using the device 300, the user can switch between the programs QS, QSL, QSJ, NS and TS by pressing the push button 28 once for a relatively short duration (step 458), such as less than five seconds. Once the user has developed a preference for one of the quiet environment programs (QS, QSL or QSH), the user can designate the preferred quiet environment program as a selected program by pressing and holding the button 28 for five seconds or longer (step 460). The program so selected is then designated as program QS and the two non-selected Q programs are deactivated. The TS program is automatically updated and activated to match the selected QS program. At this point a long tone sounds to indicate to the user that the FTStart state is completed (step 462), and FTState is set to FTQSelected (step 464). [00961 If FTState = FTQSelected (step 454), the processor loads from nonvolatile memory 326 a pair of noisy environment acoustical condition programs NSL and NSH that are slight variations on the program NS (step 466). This provides the user five available programs (QS, NS, NSL, NSH and TS) to try out indefinitely. In a preferred embodiment, the programs NSL and NSH are secondary acoustical characteristic configuration programs, such as described above. These programs are also referred to herein as fine-tuning programs. While wearing and using the device 300, the user can switch between the programs QS, NS, NSL, NSH and TS by pressing the push button 28 once for a relatively short duration (step 468), such as less than five seconds. Once the user has developed a preference for one of the noisy environment programs 28 (NS, NSL or NSH), the user can designate the preferred noisy environment program as a selected program by pressing and holding the button 28 for five seconds or longer (step 470). The program so selected is then designated as program NS and the two non-selected N programs are deactivated. At this point a long tone sounds to indicate to the user that the FTQSelected state is completed (step 472), and FT_State is set to Fine Tuned (step 474). [00971 Referring back to steps 400-406 of FIG. 9A, if at power-up, FitState = FineTuned, the processor loads from nonvolatile memory 326 the selected quiet environment program QS, the selected noisy environment program NS and the selected telecoil program TS (step 476 in FIG. 9B). While wearing and using the device, the user can switch between the programs QS, NS and TS by pressing the push button 28 once for a relatively short duration (step 478), such as less than five seconds. In a preferred embodiment, the device continues operating in this state (FitState = Fine Tuned) until the device is reset (step 480). Resetting of the device may be accomplished in the Configuration Mode as described below. [0098] FIG. 10 depicts a state diagram for the Configuration Mode of a hearing assistance device (such as the device 300 in FIG. 6) according to a preferred embodiment of the invention. In the Configuration Mode, an audiologist or dispenser can configure several options which determine how the device operates. These options are described in more detail below. Although anyone, including the user of the hearing assistance device, could perform the operations described herein to change the configuration of the device, it is anticipated that in most cases an audiologist or dispenser of the device will perform these operations for the user. 10099] The device enters the Configuration Mode when the audiologist/dispenser presses the push button 28 while closing the battery compartment door and continues to press the push button 28 for at least 30 seconds (step 500 in FIG. 10). A long pure-tone beep sounds to indicate that the device has entered the Configuration Mode (step 502). Once in the Configuration Mode, the device option to be configured may be selected based on how many consecutive times the push button 28 is pressed. Each press of the push button 28 will step to a next configuration option in a sequence of options, and will eventually wrap around and start through the sequence again when the last configuration option is passed. 29 [00100] If the audiologist/dispenser presses the push button 28 only once after entering the configuration mode, the "Read-out/Listen-out" option is selected (step 504). Using this option, the audiologist/dispenser can determine which of the fifteen quiet environment condition programs (Qi-Q5 and two fine-tuning programs QSL-QSH for each program Qi-Q5) is the current selected program QS and which of the fifteen noisy environment condition programs (Ni-N5 and two fine-tuning programs NSL-NSH for each program NI-N5) is the current selected program NS. If the volume-up control 334a is pressed, some number of tone beeps are sounded to indicate which of the fifteen quiet-environment programs is the current selected program QS (step 506). For example, if the program Q3 is the selected program QS, then three tone beeps may be sounded when the volume-up control 334a is pressed. Likewise, if the volume-down control 334b is pressed, some number of tone beeps are sounded to indicate which of the fifteen noisy-environment programs is the current selected program NS (step 508). If the battery compartment door is opened and closed, the device exits the Configuration Mode (step 510). If the push button 28 is pressed once while the "Read-out/Listen-out" option is selected, then the "Volume Control Setting" option is selected (step 512). 1001011 If the push button 28 is pressed only twice after entering the Configuration Mode, the "Volume Control Setting" option is selected (step 514). Using this option, the audiologist/dispenser can control whether the volume control 334 will be activated or deactivated when the device is next operated in the standard operational mode. If the volume-up control 334a is pressed, the volume control 334 will be activated (step 516). Likewise, if the volume-down control 334b is pressed, the volume control 334 will be deactivated (step 518). If the battery compartment door is opened and closed, the device exits the Configuration Mode (step 520). If the push button 28 is pressed once while the "Volume Control Setting" option is selected, then the "Telecoil Setting" option is selected (step 522). 1001021 If the push button 28 is pressed only three times after entering the Configuration Mode, the "Telecoil Setting" option is selected (step 524). Using this option, the audiologist/dispenser can control whether the telephone coil 30 (FIG. 1) will be activated or deactivated when the device 300 is next operated in the standard operational mode. If the volume-up control 334a is pressed, the telephone coil 30 will be activated (step 526). Likewise, if the volume-down control 334b is pressed, the telephone coil 30 will be deactivated (step 528). 30 If the battery compartment door is opened and closed, the device exits the Configuration Mode (step 530). If the push button 28 is pressed once while the "Telecoil Setting" option is selected, then the "Directional Mode Setting" option is selected (step 532). f00103] If the push button 28 is pressed only four times after entering the Configuration Mode, the "Directional Mode Setting" option is selected (step 534). Using this option, the audiologist/dispenser can control whether the Directional Mode is activated in which the device uses two microphones, or deactivated so that the device uses a single microphone. If the volume-up control 334a is pressed, the directional mode will be activated (step 536). Likewise, if the volume-down control 334b is pressed, the directional mode will be deactivated (step 538). If the battery compartment door is opened and closed, the device exits the Configuration Mode (step 540). If the push button 28 is pressed once while the "Directional Mode Setting" option is selected, then the "Maximum Power Output Setting" option is selected (step 542). f00104] If the push button 28 is pressed only five times after entering the configuration mode, the "Maximum Power Output Setting" option is selected (step 544). Using this option, the audiologist/dispenser can control the maximum output power level of the audio section 319 (FIG. 6). Each time the volume-up control 334a is pressed, the maximum power output level is incremented one step and one beep sounds (step 546). Each time the volume-down control 334b is pressed, the maximum power output level is decremented one step and one beep sounds (step 548). If the battery compartment door is opened and closed, the device exits the Configuration Mode (step 550). If the push button 28 is pressed once while the "Maximum Power Output Setting" option is selected, then the "Auto Mode Setting" option is selected (step 552). [00105] If the push button 28 is pressed only six times after entering the configuration mode, the "Auto Mode Setting" option is selected (step 554). Using this option, the audiologist/dispenser can control the event that triggers the transition from the initial-tuning mode to the fine-tuning mode. As described above in reference to FIG. 9A, if Auto Mode is activated, the device automatically transitions from the initial-tuning mode to the fine-tuning mode after the battery compartment door has been opened and closed some X number of times. If Auto Mode is not activated (which is the preferred default condition), this automatic transition does not occur. When the Auto Mode Setting option is selected, the audiologist/dispenser can 31 activate the Auto Mode by pressing the volume-up control 334a (step 556). If desired, once the Auto Mode is activated, the audiologist/dispenser can cause the device to transition from the initial-tuning mode to the fine-tuning mode by opening/closing the battery compartment door X number of times. If Auto Mode is activated and the volume-down control 334b is pressed, Auto Mode will be deactivated (step 558). If the battery compartment door is opened and closed, the device exits the Configuration Mode (step 560). If the push button 28 is pressed once while the "Auto Mode Setting" option is selected, then the "Reset" option is selected (step 562). 1001061 If the push button 28 is pressed only seven times after entering the Configuration Mode, the "Reset" option is selected (step 564). Using this option, the audiologist/dispenser can reset the device to its factory settings by pressing the volume-up control 334a (step 566). If the battery compartment door is opened and closed, the device exits the Configuration Mode (step 568). If the push button 28 is pressed once while the "Reset" option is selected, then the device cycles back to the "Read-out/Listen-out Setting" option (step 570). 1001.07] In some embodiments, a Clinician-Assisted Fitting Mode is also provided as an option accessible through the Configuration Mode. In these embodiments, the Clinician-Assisted Fitting Mode may be activated to allow a clinician to assist a patient in fine-tuning the hearing assistance device. In this mode, the clinician may use the push button 28 or 328 to select an optimum set of quiet environment, noisy environment and telecoil programs for the patient. Other configuration settings may also be available in the Configuration Mode, such as gain increase/decrease, noise reduction on/off, and feedback canceller fast/slow, to name a few examples. [00108] In some embodiments of the invention, the hearing assistance device 10 may be used to record audio memos. A memo recording function may be activated using one or more push buttons, such as the button 28, and the volume control 34. With reference to FIG. 1, the microphone 12a receives the vocal sounds of the user, the A/D 14a converts the microphone signal to a digital audio signal, the processor 16 converts the digital audio signal to an appropriate digital audio file format for storage, such as a .WAV file, and the memory 26 is used for storage of the digital audio file. At a later time, the one or more push buttons, such as the button 28, and the volume control 34 may be used to access the stored digital audio file and play 32 it back through the audio output section 19. Such a function would be quite useful for quickly and easily recording information for later recall when other recording means are not readily available. For example, the memo function could be used to record a list of items to pick up at the grocery store, or a telephone number of a friend or acquaintance. [00109j In a preferred embodiment of the invention, the scroll wheel digital volume control 34a is used to switch between available quiet environment programs and to switch between available noise environment programs. For example, if during normal operation the wearer presses the push button 28 for some extended period of time, such as ten seconds, a pure-tone beep is sounded and the scroll wheel 34a becomes operational to allow the wearer to switch between the available quiet environment programs. For example, if the QS program is active and the scroll wheel 34a is rotated down one increment, the active program changes from QS to QSL. Similarly, if the QS program is active and the scroll wheel 34a is rotated up one increment, the active program changes from QS to QSH. As the wearer continues to rotate the scroll wheel 34a in one direction, the programs continue to cycle through, such as from QS to QSL to QSH to QS, and so forth. It will be appreciated that the scroll wheel can be used to cycle through any of the quiet environment programs that are available at a particular stage of programming. Thus, it is not limited to the QS, QSL and QSH programs. The wearer can select or "lock in" the currently-active quiet environment program by pressing the push button 28 again for some extended period of time, such as ten seconds. A pure-tone beep is then sounded to let the wearer know that the currently-active quiet environment program has been selected. At this point, the scroll wheel 34a again becomes functional as a volume control which allows the wearer to adjust the audio gain up or down for the selected quiet environment program. [00110] At this point, if the wearer again presses the push button 28 for some extended period of time, such as ten seconds, a noise pulse train is sounded and the scroll wheel 34a becomes operational to allow the wearer to switch between the available noise environment programs. For example, if the NS program is currently active and the scroll wheel 34a is rotated down one increment, the active program changes from NS to NSL. Similarly, if the NS program is active and the scroll wheel 34a is rotated up one increment, the active program changes from NS to NSH. As the wearer continues to rotate the scroll wheel 34a in one direction, the programs continue to cycle through, such as from NS to NSL to NSH to NS, and so forth. It will be 33 appreciated that the scroll wheel can be used to cycle through any of the noise environment programs that are available at a particular stage of programming. Thus, it is not limited to the NS, NSL and NSH programs. The wearer can then select or "lock in" the currently-active noise environment program by pressing the push button 28 again for some extended period of time, such as ten seconds. A noise pulse train is then sounded to let the wearer know that the currently-active noise environment program has been selected. At this point, the scroll wheel 34a again becomes functional as a volume control which allows the wearer to adjust the audio gain up or down for the selected noise environment program. The next time the wearer presses the button 28 for ten seconds or more, the scroll wheel 34a again becomes functional to scroll between the available quiet environment programs. [001111 The foregoing description of preferred embodiments for this invention have been presented for purposes of illustration and description. They are not intended to be exhaustive or to limit the invention to the precise form disclosed. Obvious modifications or variations are possible in light of the above teachings. The embodiments are chosen and described in an effort to provide the best illustrations of the principles of the invention and its practical application, and to thereby enable one of ordinary skill in the art to utilize the invention in various embodiments and with various modifications as are suited to the particular use contemplated. All such modifications and variations are within the scope of the invention as determined by the appended claims when interpreted in accordance with the breadth to which they are fairly, legally, and equitably entitled. 34

Claims (22)

1. A programmable apparatus for improving perception of sound by a person, the apparatus comprising: a portable housing configured to be worn behind the ear or in the ear of the person; a processor disposed in the portable housing for executing one or more available programs for processing digital audio signals based on control signals; a digital-to-analog converter disposed in the portable housing for generating output analog audio signals based on the digital audio signals; an audio output section disposed in the portable housing for receiving and amplifying the output analog audio signals, generating audible sound based thereon and providing the audible sound to the person; memory disposed in the portable housing for storing a plurality of preloaded programs for processing the digital audio signals, the memory accessible to the processor, wherein the preloaded programs stored in the memory are designated as available programs or unavailable programs; means disposed in or on the portable housing that is operated by the person for generating a first control signal to switch from one of the available programs to another of the available programs; means disposed in or on the portable housing that is operated by the person for generating a second control signal to designate at least one of the available programs as a chosen program; the processor for ceasing execution of one of the available programs and commencing execution of another of the available programs based upon the first control signal; and the processor for designating at least one of the available programs as a chosen program and designating available programs that are not chosen programs as unavailable programs based upon the second control signal.

2. The apparatus of claim 1 where the means for generating the first control signal and the means for generating the second control signal comprise: 35 a momentary push button switch which changes from a first state to a second state when activated by the person; and a controller in communication with the momentary push button switch and the processor, the controller for generating the control signals based on periods of time during which the momentary push button switch is in the second state, the controller for generating the first control signal when the momentary push button switch is in the second state for a period of time exceeding a first time, and for generating the second control signal when the momentary push button switch is in the second state for a period of time exceeding a second time.

3. The apparatus of claim I wherein: the memory stores an least N number of the preloaded programs, including at least a first available program, a second available program, a third available program, an Nth - I available program and an Nth available program; the processor ceases execution of the first available program and commences execution of the second available program upon a first receipt of the first control signal, the processor ceases execution of the second available program and commences execution of the third available program upon a second receipt of the first control signal, the processor ceases execution of the third available program and commences execution of the fourth available program upon a third receipt of the first control signal, the processor ceases execution of the Nth - I available program and commences execution of the Nth available program upon an Nth - 1 receipt of the first control signal, and the processor ceases execution of the Nth available program and commences execution of the first available program upon an Nth receipt of the first control signal.

4. The apparatus of claim 1 wherein: the processor designates one of the available programs as a first chosen program upon a first receipt of the second control signal; the processor designates another of the available programs as a second chosen program upon a second receipt of the second control signal; and 36 the processor designates available programs that are not the first chosen program or the second chosen program as unavailable programs upon the second receipt of the second control signal.

5. A method for improving perception of sound by a person, the method performed by components of a hearing aid apparatus contained in a portable housing configured to be worn behind the ear or in the ear of the person, the method comprising: (a) storing in a memory device in the portable housing one or more preloaded programs for processing digital audio signals, the storing performed during manufacture of the hearing aid apparatus, wherein the preloaded programs stored in the memory are designated as available programs or unavailable programs; (b) processing the digital audio signals based on execution of the one or more available programs; (c) generating output analog audio signals based on the digital audio signals processed in step (b); (d) receiving and amplifying the output analog audio signals to generate audible sound based thereon; (e) generating a first control signal to switch from one available program to another available program based upon operation by the person of a momentary push button switch on the portable housing; (f) generating a second control signal to designate at least one of the available programs as a chosen program based upon operation by the person of the momentary push button switch on the portable housing; (g) ceasing execution of one of the available programs and commencing execution of another of the available programs based upon the first control signal; (h) designating at least one of the available programs as a chosen program based upon the second control signal; and (i) designating available programs that are not chosen programs as unavailable programs.

6. A programmable apparatus for improving perception of sound by a person, the apparatus comprising: a portable housing configured to be worn behind the ear or in the ear of the person; 37 a processor disposed in the portable housing for executing a plurality of available programs for processing digital audio signals; a digital-to-analog converter disposed in the portable housing for generating output analog audio signals based on the digital audio signals; an audio output section disposed in the portable housing for receiving and amplifying the output analog audio signals, generating audible sound based thereon and providing the audible sound to the person; memory disposed in the portable housing for storing the plurality of available programs for processing the digital audio signals, the memory accessible to the processor; and a counter disposed in the portable housing for counting occurrences of events that are indicative of the application of power to or the removal of power from the programmable apparatus, and for generating a counter value based thereon, wherein the processor determines after a predetermined elapsed time which one of the plurality of available programs has been used for the longest total time in processing the digital audio signals, the determination of elapsed time based at least in part on the counter value.

7. The programmable apparatus of claim 6 further comprising a battery for providing power to the programmable apparatus, wherein the counter is operable to count occurrences of events that are indicative of the removal and replacement of the battery.

8. The programmable apparatus of claim 6 further comprising a battery compartment door and a contact switch attached to the battery compartment door, wherein the counter is operable to count a number of times the contact switch is electrically opened or closed.

9. A programmable apparatus for improving perception of sound by a person, the apparatus comprising: a portable housing configured to be worn in, on or behind an ear of the person; memory disposed within the portable housing, the memory for storing a plurality of audio processing programs including initial-tuning programs and fine-tuning programs that may be used in processing digital audio signals; 38 a processor disposed within the portable housing and connected to the memory, the processor operable in an initial-tuning mode wherein the processor executes one or more selected initial-tuning programs to process digital audio signals, and operable in a fine-tuning mode wherein the processor executes one or more selected fine-tuning programs to process digital audio signals; a single momentary push button switch disposed on the portable housing and connected to the processor, the single momentary push button switch operable by the person to cycle through the initial-tuning programs and select one of the initial-tuning programs to be used in processing the digital audio signals while in the initial-tuning mode; means disposed within the portable housing for causing the processor to switch from operating in the initial-tuning mode to operating in the fine-tuning mode; the single momentary push button switch further operable by the person to cycle through the initial-tuning program selected in the initial-tuning mode and the one or more fine-tuning programs, and further operable by the person to select the initial-tuning program selected in the initial-tuning mode or one of the fine-tuning programs to be used in processing the digital audio signals while in the fine-tuning mode; a digital-to-analog converter disposed within the portable housing, the digital-to-analog converter for generating output analog audio signals based on the digital audio signals; and an audio output section disposed within the portable housing, the audio output section for receiving and amplifying the output analog audio signals, generating audible sound based thereon and providing the audible sound to the person.

10. The programmable apparatus of claim 9 wherein the means for causing the programmable apparatus to switch from the initial-tuning mode to the fine-tuning mode comprises: a counter disposed within the portable housing and connected to the processor, the counter for counting occurrences of events that are indicative of the application of power to or removal of power from the programmable apparatus while in the initial-tuning mode, and for generating a counter value based thereon; and 39 the processor further for determining whether the counter value exceeds a predetermined value, and when the counter value exceeds the predetermined value, the processor for operating in the fine-tuning mode wherein the processor accesses one or more of the fine-tuning programs that are related to the initial-tuning program selected in the initial-tuning mode.

11. A method for improving perception of sound by a person using a hearing assistance device, the method performed by components of the hearing aid apparatus contained in a portable housing configured to be worn behind the ear or in the ear of the person, the method comprising: (a) storing a plurality of audio processing programs in a memory device disposed in the portable housing, the audio processing programs including initial-tuning programs and fine-tuning programs that may be used in processing digital audio signals; (b) making the initial-tuning programs available for selection by the person; (c) selecting one of the initial-tuning programs to be used in processing the digital audio signals while the hearing assistance device is in an initial-tuning mode, the selecting accomplished by operation of a momentary push button switch on the portable housing by the person wearing the hearing aid apparatus; (d) operating the hearing assistance device using the selected initial-tuning program while in the initial-tuning mode; (e) after a period of time operating in the initial-tuning mode, making one or more of the fine-tuning programs and the initial-tuning program selected in step (c) available for selection by the person; (f) selecting one of the fine-tuning programs or the initial-tuning program selected in step (c) to be used in processing the digital audio signals, the selecting accomplished by operation of the momentary push button switch on the portable housing by the person wearing the hearing aid apparatus; and (g) operating the hearing assistance device using the program selected in step (h).

12. A method for controlling a hearing assistance device disposed in a housing having a battery compartment door, wherein the hearing assistance device has three controls that are operable to control the hearing assistance device, the three controls consisting of a volume 40 up control, a volume-down control and a push button control, a controller for sensing open or closed states of the battery compartment door and states of the three controls, and a processor for operating in a configuration mode and in one or more other operational modes, wherein the processor is operable to execute a configuration control routine selected from a plurality of configuration control routines while in the configuration mode, the method comprising: (a) pressing one or more of the three controls continuously for an extended time while closing the battery compartment door; (b) the controller sensing the one or more of the three controls being pressed continuously for at least a predetermined time during and after the closing of the battery compartment door; (c) the controller generating a first control signal based on completion of steps (b); (d) the processor entering the configuration mode based on the first control signal; (e) the controller sensing the opening and subsequent closing of the battery compartment door; (f) the controller generating a second control signal based on completion of step (e); and (g) the processor exiting the configuration mode and entering one of the other operational modes based on the second control signal.

13. The method of claim 12 wherein between steps (d) and (e) the method further includes pressing the volume-up control or the volume-down control to change a configuration control setting while the processor executes a selected configuration control routine.

14. A programmable apparatus for improving perception of sound by a person, the apparatus comprising: a housing configured to be worn in, on or behind an ear of the person; memory disposed within the housing, the memory for storing a plurality of audio processing programs that may be used in processing digital audio signals; a processor disposed within the housing and connected to the memory, the processor operable to execute one or more selected audio processing programs to process digital audio signals; a selection device disposed on the housing and connected to the processor, the selection device operable by the person to select one of the audio processing programs to be used in processing the digital audio signals; 41 a digital-to-analog converter disposed within the housing, the digital-to-analog converter for generating output analog audio signals based on the digital audio signals; and an audio output section disposed within the housing, the audio output section for receiving and amplifying the output analog audio signals, generating audible sound based thereon and providing the audible sound to the person, the audio output section further for generating one or more audible sounds that indicate to the person which one of the audio processing programs is currently selected for processing the digital audio signals, whereby the currently selected audio processing program can determined without having to connect the apparatus to any external device.

15. A method for controlling the configuration of a hearing assistance device, wherein the hearing assistance device is disposed in a housing and includes at least three controls on the housing that are operable to control the hearing assistance device, the three controls consisting of a volume-up control, a volume-down control and a push button control, the hearing assistance device including a controller for sensing states of the three controls, and a processor that is operable to execute a configuration control routine selected from a plurality of configuration control routines, the method comprising: (a) operating the push button control a number of times to select one of the plurality of configuration control routines; (b) the processor executing a selected one of the plurality of configuration control routines as determined based on the number of times the push button control is operated; (c) operating the volume-up control or volume-down control to change a device configuration setting associated with the selected configuration control routine; and (d) the processor changing the device configuration setting based on the operation of the volume-up control or volume-down control.

16. A programmable apparatus for improving perception of sound by a person, the apparatus comprising: one or more housings configured to be worn in, on or behind an ear of the person; 42 memory disposed within at least one of the housings, the memory for storing a plurality of available audio processing programs that may be used in processing digital audio signals; a processor disposed within at least one of the housings and connected to the memory, the processor operable to execute one or more of the available audio processing programs to process the digital audio signals; a multipurpose control device disposed on one of the housings and connected to the processor, the multipurpose control device for operating in a program switching mode in which the multipurpose control device is operable by the person to switch from one of the available audio processing programs to another of the available audio processing programs, the multipurpose control device further for operating in a volume control mode in which the multipurpose control device is operable by the person to adjust the volume of audible sound generated by an audio output section; a digital-to-analog converter disposed within at least one of the housings, the digital-to-analog converter for generating output analog audio signals based on the digital audio signals; and the audio output section disposed within at least one of the housings, the audio output section for receiving and amplifying the output analog audio signals, generating audible sound based thereon and providing the audible sound to the person.

17. The programmable apparatus of claim 16 wherein the multipurpose control device comprises a scroll wheel digital control device.

18. The programmable apparatus of claim 16 further comprising: a push button disposed on one of the housings and connected to the processor and operable by the person; and the processor for changing from the program switching mode to the volume control mode when the push button is pressed for at least some extended period of time, and for changing from the volume control mode to the program switching mode when the push button is pressed for at least some extended period of time.

19. The programmable apparatus of claim 16 further comprising: 43 a push button disposed on one of the housings and connected to the processor and operable by the person; and when in the program switching mode, the processor for selecting a currently active one of the audio processing programs to be a selected audio processing program when the push button is pressed for an extended period of time, wherein the currently active audio processing program was determined by operation of the multipurpose control device by the person, and for changing from the program switching mode to the volume control mode upon selection of the selected audio processing program.

20. The programmable apparatus of claim 16 further comprising: a push button disposed on one of the housings and connected to the processor and operable by the person; and when in the volume control mode, the processor for changing from the volume control mode to the program switching mode when the push button is pressed for at least some extended period of time.

21. The programmable apparatus of claim 16 wherein the multipurpose control device is further operable in a configuration mode in which the multipurpose control device is operable by the person to change configuration settings of the programmable apparatus.

22. A programmable apparatus for improving perception of sound by a person, the apparatus comprising: one or more housings configured to be worn in, on or behind an ear of the person; memory disposed within at least one of the housings, the memory for storing a plurality of available audio processing programs that may be used in processing digital audio signals; a scroll wheel digital control device disposed on one of the housings, the scroll wheel digital control device for operating in a program switching mode in which the scroll wheel digital control device is operable by the person to switch from one of the available audio processing programs to another of the available audio processing programs, the scroll wheel digital control device further for operating in a volume control mode in which the 44 scroll wheel digital control device is operable by the person to adjust the volume of audible sound generated by an audio output section; a push button disposed on one of the housings and operable by the person; a processor disposed within at least one of the housings and connected to the memory, the scroll wheel digital control device and the push button, the processor operable to execute one of the available audio processing programs to process the digital audio signals, when in the program switching mode, the processor for selecting a currently active one of the audio processing programs to be a selected audio processing program when the push button is pressed for an extended period of time, wherein the currently active audio processing program was determined by operation of the scroll wheel digital control device by the person, the processor for changing from the program switching mode to the volume control mode upon selection of the selected audio processing program, and when in the volume control mode, the processor for changing from the volume control mode to the program switching mode when the push button is pressed for at least some extended period of time; a digital-to-analog converter disposed within at least one of the housings, the digital-to-analog converter for generating output analog audio signals based on the digital audio signals; and the audio output section disposed within at least one of the housings, the audio output section for receiving and amplifying the output analog audio signals, generating audible sound based thereon and providing the audible sound to the person. 45