Patent Publication Number: US-8542857-B2

Title: Bone conduction device with a movement sensor

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application is a continuation-in-part of U.S. patent application Ser. No. 12/355,380, filed Jan. 16, 2009, which claims the benefit of U.S. Provisional Patent Application No. 61/041,185, filed Mar. 31, 2008, which are each hereby incorporated by reference herein. 
    
    
     BACKGROUND 
     1. Field of the Invention 
     The present invention is generally directed to a bone conduction device, and more particularly, to a bone conduction device having a movement sensor. 
     2. Related Art 
     Hearing loss, which may be due to many different causes, is generally of two types, conductive or sensorineural. In many people who are profoundly deaf, the reason for their deafness is sensorineural hearing loss. This type of hearing loss is due to the absence or destruction of the hair cells in the cochlea which transduce acoustic signals into nerve impulses. Various prosthetic hearing implants have been developed to provide individuals who suffer from sensorineural hearing loss with the ability to perceive sound. One such prosthetic hearing implant is referred to as a cochlear implant. Cochlear implants use an electrode array implanted in the cochlea to provide an electrical stimulus directly to the auditory nerve, thereby causing a hearing sensation. 
     Conductive hearing loss occurs when the normal mechanical pathways to provide sound to hair cells in the cochlea are impeded, for example, by damage to the ossicular chain or ear canal. Individuals suffering from conductive hearing loss may still have some form of residual hearing because the hair cells in the cochlea are generally undamaged. 
     Individuals suffering from conductive hearing loss are typically not considered to be candidates for a cochlear implant due to the irreversible nature of the cochlear implant. Specifically, insertion of the electrode array into a recipient&#39;s cochlea destroys a majority of hair cells within the cochlea. This results in the loss of residual hearing by the recipient. 
     Rather, individuals suffering from conductive hearing loss typically receive an acoustic hearing aid, referred to as a hearing aid herein. Hearing aids rely on principles of air conduction to transmit acoustic signals through the outer and middle ears to the cochlea. In particular, a hearing aid typically uses an arrangement positioned in the recipient&#39;s ear canal to amplify a sound received by the outer ear of the recipient. This amplified sound reaches the cochlea and causes motion of the cochlea fluid and stimulation of the cochlea hair cells. 
     Unfortunately, not all individuals who suffer from conductive hearing loss are able to derive suitable benefit from hearing aids. For example, some individuals are prone to chronic inflammation or infection of the ear canal and cannot wear hearing aids. Other individuals have malformed or absent outer ear and/or ear canals as a result of a birth defect, or as a result of common medical conditions such as Treacher Collins syndrome or Microtia. Furthermore, hearing aids are typically unsuitable for individuals who suffer from single-sided deafness (total hearing loss only in one ear) or individuals who suffer from mixed hearing losses (i.e., combinations of sensorineural and conductive hearing loss). 
     When an individual having fully functioning hearing receives an input sound, the sound is transmitted to the cochlea via two primary mechanisms: air conduction and bone conduction. As noted above, hearing aids rely primarily on the principles of air conduction. In contrast, other devices, referred to as bone conduction devices, rely predominantly on vibration of the bones of the recipient&#39;s skull to provide acoustic signals to the cochlea. 
     Those individuals who cannot derive suitable benefit from hearing aids may benefit from bone conduction devices. Bone conduction devices convert a received sound into a mechanical vibration representative of the received sound. This vibration is then transferred to the bone structure of the skull, causing vibration of the recipient&#39;s skull. This skull vibration results in motion of the fluid of the cochlea. Hair cells inside the cochlea are responsive to this motion of the cochlea fluid, thereby generating nerve impulses, which result in the perception of the received sound. 
     SUMMARY 
     In one aspect of the invention, a bone conduction device is provided. The bone conduction device comprises a coupling configurable to form a coupling with a bone, a transducer module configurable to vibrate in accordance with one or more operational characteristics of the device, and a sensor module configurable to adjust the one or more operational characteristics in response to one or more of a reorientation of a portion of the device and a movement of the portion relative to the coupling. 
     In another aspect of the invention, a method of operating a bone conduction device is provided. The bone conduction device comprises a sensor, a coupling and a transducer. The method comprises vibrating a bone, via the coupling, in accordance with one or more operational characteristics of the device, and adjusting the one or more operational characteristics of the device in response to at least one of a reorientation of a portion of the device and a movement of the portion relative to the coupling. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Illustrative embodiments of the present invention are described herein with reference to the accompanying drawings, in which: 
         FIG. 1  is a perspective view of an exemplary medical device, namely a bone conduction device, in which embodiments of the present invention may be advantageously implemented; 
         FIG. 2  is a functional block diagram of a bone conduction device, such as the bone conduction device of  FIG. 1 , in accordance with embodiments of the present invention; 
         FIG. 3  is an exploded view of an embodiment of a bone conduction device in accordance with one embodiment of  FIG. 2 ; 
         FIG. 4  illustrates a bone conduction device, in accordance with embodiments of the present invention, wherein operational characteristics of the bone conduction device may be adjusted by movement of the bone conduction device; 
         FIG. 5  illustrates another exemplary bone conduction device, in accordance with embodiments of the present invention, wherein operational characteristics of the bone conduction device may be adjusted by movement of the bone conduction device; 
         FIG. 6  is a schematic diagram of one embodiment of the bone conduction device of  FIG. 3 ; 
         FIG. 7  is a schematic diagram of another embodiment of the bone conduction device of  FIG. 3 ; 
         FIGS. 8A and 8B  are schematic diagrams of another embodiment of the bone conduction device of  FIG. 3 ; 
         FIGS. 9A and 9B  are schematic diagrams of another embodiment of the bone conduction device of  FIG. 3 ; 
         FIG. 10  is a flowchart illustrating one way of operating a bone conduction device in accordance with embodiments of the present invention. 
     
    
    
     DETAILED DESCRIPTION 
     Embodiments of the present invention are generally directed to a bone conduction hearing device (“bone conduction device”) for converting a received sound signal into a mechanical force for delivery to a recipient&#39;s skull. The bone conduction device includes a sensor module that enables the recipient to alter various operational characteristics in the bone conduction device by moving the device itself. 
     Conventional bone conductions devices allow recipients to control some features or operational characteristics of the device, such as the volume setting of the device, certain aspects of the programming of the device, and the power setting of the device (e.g., turning the device on or off). Typically, conventional bone conduction devices include one or more mechanical buttons or wheels on or in the housing of the device by which a recipient may adjust operational characteristics of the device. Some recipients, especially those having reduced or impaired motor functions, may find these mechanical controls difficult to operate, or at least difficult to operate quickly, especially when the mechanical controls are relatively small. Additionally, the typical position of the bone conduction device behind the recipient&#39;s ear and toward the back of the head may add to the difficulty of locating as well as manipulating the mechanical controls, which may be relatively small. As such, a recipient may remove the bone conduction device from his or her head in order to manipulate the mechanical controls of the device. Removing the device to manipulate the controls is not only time-consuming, but also puts undue strain on the interface between the bone conduction device and the recipient&#39;s tissue. In addition, spaces may exist in the housing around mechanical controls such as buttons and wheels, which may provide a pathway for water or other contaminants to enter the bone conduction device. 
     Accordingly, a bone conduction device in accordance with embodiments of the present invention includes a sensor module that enables the recipient to alter various operational characteristics in the bone conduction device by moving the device itself. For example, a bone conduction device in accordance with embodiments of the present invention may sense the movement caused by a recipient touching the device. In such embodiments, the recipient is able to adjust and/or alter various operational characteristics of the device by touching the housing of the device. Thus, in certain embodiments, this sensor module may replace the various mechanical controls, and thereby eliminate many of the above-described drawbacks associated with those controls. In some embodiments, eliminating buttons and wheels from the device housing may make the device more resistant to water and other contaminants. In addition, certain such embodiments are less mechanically complex than devices with mechanical controls, which may improve device reliability. Moreover, in some embodiments, the sensor module may occupy less space in the device than various mechanical controls, which may allow a reduction in the size of the device, or a reallocation of that space for other features. 
     Additionally, a bone conduction device allowing a recipient to adjust and/or alter various operational characteristics of the device by touching the housing of the device, in accordance with embodiments of the present invention, may also be simpler to operate than the mechanical controls of a conventional device. In such embodiments, recipients may find the device easier to operate while positioned on the head, and recipients with impaired motor function may find the device easier to operate as well. Mechanical controls also experience wear and tear over the life of the device. However, eliminating these mechanical controls in certain embodiments of the present invention may provide a device that experiences less wear and tear and may require less repair. Additionally, new bone conduction device designs often include new mechanical control layouts, which may be due to difficulty finding sufficient space to accommodate mechanical controls in new devices. A sensor module of a bone conduction device in accordance with embodiments of the present invention may be used as a standard component across many bone conduction device designs, since mechanical controls may be eliminated. 
       FIG. 1  is a cross sectional view of a human ear and surrounding area, along with a side view of one of the embodiments of a bone conduction device  100 . In fully functional human hearing anatomy, outer ear  101  comprises an auricle  105  and an ear canal  106 . A sound wave or acoustic pressure  107  is collected by auricle  105  and channeled into and through ear canal  106 . Disposed across the distal end of ear canal  106  is a tympanic membrane  104  which vibrates in response to acoustic wave  107 . This vibration is coupled to oval window or fenestra ovalis  110  through three bones of middle ear  102 , collectively referred to as the ossicles  111  and comprising the malleus  112 , the incus  113  and the stapes  114 . Bones  112 ,  113  and  114  of middle ear  102  serve to filter and amplify acoustic wave  107 , causing oval window  110  to articulate, or vibrate. Such vibration sets up waves of fluid motion within cochlea  115 . The motion, in turn, activates tiny hair cells (not shown) that line the inside of cochlea  115 . Activation of the hair cells causes appropriate nerve impulses to be transferred through the spiral ganglion cells and auditory nerve  116  to the brain (not shown), where they are perceived as sound. 
       FIG. 1  also illustrates the positioning of bone conduction device  100  relative to outer ear  101 , middle ear  102  and inner ear  103  of a recipient of device  100 . As shown, bone conduction device  100  may be positioned behind outer ear  101  of the recipient; however it is noted that device  100  may be positioned in any suitable manner. 
     In the embodiments illustrated in  FIG. 1 , bone conduction device  100  comprises a housing  125  having at least one microphone  126  positioned therein or thereon. Housing  125  is coupled to the body of the recipient via coupling  160 . Bone conduction device  100  may comprise a signal processor, a transducer, transducer drive components and/or various other electronic circuits/devices. 
     In accordance with embodiments of the present invention, an anchor system (not shown) may be implanted in the recipient. The anchor system may be fixed to bone  136 . In various embodiments, the anchor system may be implanted under skin  132  within muscle  134  and/or fat  128  or the hearing device may be anchored in another suitable manner. In certain embodiments, a coupling  160  attaches device  100  to the anchor system. As used herein, the term “coupling” may refer to one or more components that attach a bone conduction device to an anchor system, or to those one or more components and the anchor system. 
     A functional block diagram of one embodiment of bone conduction device  100 , referred to as bone conduction device  200 , is shown in  FIG. 2 . In the illustrated embodiment, sound  207  is received by sound input elements  202 , which may be, for example, a microphone configured to receive sound  207 , and to convert sound  207  into an electrical signal  221 . Or, for example, the sound input element  202 , or an additional sound input element, might be an interface that the recipient may connect to a sound source, such as for example a jack for receiving a plug that connects to a headphone jack of a portable music player (e.g., MP3 player) or cell phone. It should be noted that these are but some exemplary sound input elements, and sound input element  202  may be any component or device capable of providing a signal regarding a sound. Although bone conduction device  200  is illustrated as including one sound input element  202 , in other embodiments, bone conduction device may comprise any number of sound input elements. 
     Bone conduction device  200  further includes a sensor module  213  that comprises a sensor  212  and an electronics module  204 . Sensor module  213  detects certain movements of housing  225  of device  200  using sensor  212 . As described further below, in certain embodiments sensor module  213  may sense a reorientation of housing  225  or sense the movement of housing  225  relative to a portion of anchor system  208 . As used herein, by sensing certain movements of housing  225 , sensor module  213  may allow the recipient to interact with device  200  by moving housing  225 . For example, sensor module  213  may allow the recipient to adjust one or more operational characteristics of the device by moving housing  225 . Settings for the operational characteristics of the device may be stored in electronics module  204 , and exemplary operational characteristics of a bone conduction device are described in more detail below. Additionally, sensor module  213  communicates with electronics module  204  via signal line  228 . 
     As shown in  FIG. 2 , electrical signal  221  is output by sound input element  202  to an electronics module  204 . Electronics module  204  is configured to convert electrical signals  221  into an adjusted electrical signal  224 . Electronics module  204  may include a signal processor, control electronics, transducer drive components, and a variety of other elements, including electronic circuits/devices. Based on adjusted electrical signal  224 , transducer module  206  provides an output force to the skull of the recipient via anchor system  208 . Additionally, in certain embodiments, sound input element  202  may transmit information indicative of the position of the sound input element  202  (e.g., its location in the bone conduction device  200 ) in electrical signal  221 , in addition to sending information regarding sound  207 . 
     As shown in  FIG. 2 , a transducer module  206  receives adjusted electrical signal  224  and generates a mechanical output force that is delivered to the skull of the recipient via an anchor system  208  coupled to bone conduction device  200 . Delivery of this output force causes one or more of motion or vibration of the recipient&#39;s skull, thereby activating the hair cells in the cochlea via cochlea fluid motion. In embodiments, the mechanical output force that is delivered to the skull is generated in accordance with the operational characteristics of device  200 . Additionally, in certain embodiments, after adjusting one or more operational characteristics of the device, as described above, the mechanical output force that is delivered to the skull may be generated in accordance with the adjusted operational characteristics of device  200 . 
       FIG. 2  also illustrates a power module  210 . Power module  210  provides electrical power to one or more components of bone conduction device  200 . For ease of illustration, power module  210  has been shown connected only to sensor  212  and electronics module  204 . However, it should be appreciated that power module  210  may be used to supply power to any electrically powered circuits/components of bone conduction device  200 . 
     In the embodiment illustrated in  FIG. 2 , sound input element  202 , electronics module  204 , transducer module  206 , power module  210  and sensor module  212  have all been shown as integrated in a single housing, referred to as housing  225 . However, it should be appreciated that in certain embodiments, one or more of the illustrated components may be housed in separate or different housings. Similarly, it should also be appreciated that in such embodiments, direct connections between the various modules and devices are not necessary and that the components may communicate, for example, via wireless connections. 
       FIG. 3  illustrates an exploded view of one embodiment of bone conduction device  200  of  FIG. 2 , referred to herein as bone conduction device  300 . As shown, bone conduction device  300  comprises an embodiment of electronics module  204 , referred to as electronics module  304 . As illustrated, electronics module  304  includes a printed circuit board  314  (PCB) to electrically connect and mechanically support the components of electronics module  304 . Further, as noted above, electronics module  304  may also include a signal processor, transducer drive components and control electronics. For ease of illustration, these components have not been illustrated in  FIG. 3 . 
     A plurality of sound input elements are attached to PCB  314 , shown as microphones  302   a  and  302   b  to receive a sound. As illustrated, the two microphones  302   a  and  302   b  are positioned equidistant or substantially equidistant from the longitudinal axis of the device; however, in other embodiments microphones  302   a  and  302   b  may be positioned in any suitable position. By being positioned equidistant or substantially equidistant from the longitudinal axis, bone conduction device  300  can be used on either side of a patient&#39;s head. The microphone facing the front of the recipient is generally chosen as the operating microphone using a selection circuit, so that sounds in front of the recipient can be heard; however, the microphone facing the rear of the recipient can be chosen, if desired. It is noted that it is not necessary to use two or a plurality of microphones and only one microphone may be used in any of the embodiments described herein. 
     Bone conduction device  300  further comprises a battery shoe  310  for supplying power to components of device  300 . Battery shoe  310  may include one or more batteries. As shown, PCB  314  is attached to a connector  376  configured to mate with battery shoe  310 . This connector  376  and battery shoe  310  may be, for example, configured to releasably snap-lock to each other. Additionally, one or more battery connects (not shown) may be disposed in connector  376  to electrically connect battery shoe  310  with electronics module  304 . 
     In the embodiment illustrated in  FIG. 3 , bone conduction device  300  further includes a two-part housing  325 , comprising first housing portion  325 A and second housing portion  325 B. Housing portions  325  are configured to mate with one another to substantially seal bone conduction device  300 . In certain embodiments of the present invention, the housing of a bone conduction device may include one or more physical divisions. In some embodiments, the housing is physically divided into multiple containers configured to be physically attached to one another, each of which is capable of at least partially containing one or more elements of the bone conduction device. 
     In the embodiment of  FIG. 3 , first housing portion  325 A includes an opening for receiving battery shoe  310 . This opening may be used to permit battery shoe  310  to inserted or removed by the recipient through the opening into/from connector  376 . Also in the illustrated embodiment, microphone covers  372  can be releasably attached to first housing portion  325 A. Microphone covers  372  can provide a barrier over microphones  302  to protect microphones  302  from dust, dirt or other debris. Bone conduction device  300  further may include sensor module  212  (not shown in  FIG. 3 ), embodiments of which will be discussed in further detail below with reference to  FIGS. 6-9B . 
     Also as shown in  FIG. 3 , bone conduction device  300  may comprise a transducer module  206 , referred to as transducer module  306 , and an anchor system that is an embodiment of anchor system  208 . Transducer  306  may be used to generate an output force to the skull of the recipient via the anchor system, which causes movement of the cochlea fluid to enable sound to be perceived by the recipient. In embodiments, the anchor system comprises a coupling  360  configured to be operably attached to a component disposed in the recipient (not shown). In the embodiment illustrated in  FIG. 3 , the component disposed in the recipient is an implanted anchor that transfers vibration from coupling  360  to the skull of the recipient. In embodiments, the implanted anchor may include an abutment attached to the recipient&#39;s skull by a screw such that the abutment is disposed at least partially above the recipient&#39;s skin. In some embodiments, the abutment and the screw may be integrated into a single implantable component. The abutment and the screw may each be formed from titanium. Coupling  360  comprises an outer portion  636 , an inner portion  364 , and a screw  366  that attaches inner portion  364  to second housing portion  325 B. Coupling  360  is configured to be releasably attached to the implanted anchor to create a vibratory pathway between transducer  306  and the skull of the recipient. Using coupling  360 , the recipient may detach the hearing device  300  from the implanted anchor, and subsequently releasably reattach the hearing device  300  to the implanted anchor using coupling  360 . In the embodiment illustrated in  FIG. 3 , bone conduction device  300  utilizes the percutaneous transfer of mechanical energy (e.g., mechanical force or vibration) to the recipient&#39;s skull. In other embodiments, a bone conduction device may utilize the transcutaneous transfer of mechanical energy. 
     In alternative embodiments, the anchor system of device  300  may include any type of coupling and corresponding component disposed in the recipient, wherein the coupling is configured to be operably attached to the component disposed in the recipient. In certain embodiments, for example, the component may be a metallic object disposed in the recipient and the coupling may include a magnet that operably attaches to the metallic object through magnetic attraction. In other embodiments, the component disposed in the recipient may be an implanted magnet, and the coupling may include a magnet or other metallic object that operably attaches to the implanted magnet through magnetic attraction. In such embodiments, the bone conduction device  300  utilizes the trancutenous transfer of mechanical energy (e.g., mechanical force or vibration) to the recipient&#39;s skull. A sensor module in accordance with embodiments of the present invention may be utilized in these alternative bone conduction devices as well. 
     In still other embodiments, the anchor system may include a coupling configured to be operably attached to the recipient without being attached to any component implanted in the recipient. In such embodiments, the bone conduction device  300  utilizes the trancutenous transfer of mechanical energy (e.g., mechanical force or vibration) to the recipient&#39;s skull. In some embodiments, the bone conduction device may be held in place on the recipient&#39;s head by a band placed around the recipient&#39;s head. In embodiments, this band may hold the bone conduction device, and specifically a coupling, against the outside of the recipient&#39;s head with sufficient force to transfer vibration (or other mechanical force) from the coupling to the head. The band may be a soft band, or a relatively more stiff metallic headband. As another alternative, the bone conduction device may be held to the recipient&#39;s head by the arm of a pair of eyeglasses configured to hold the coupling of the device to the head of the recipient&#39;s head with sufficient force to transfer vibration to the head. In other embodiments, the bone conduction device may be held to the recipient&#39;s body by a neck loop. A sensor module in accordance with embodiments of the present invention may be utilized in these alternative bone conduction devices as well. 
     In certain embodiments, as illustrated in  FIG. 3 , coupling  360  may be configured to attach to second housing portion  325 B. As such, vibration from transducer  306  may be provided to coupling  360  through housing  325 B. As illustrated, housing portion  325 B may include an opening  368  to allow a screw  366  to be inserted through opening  368  to attach transducer  306  to coupling  360 . In such embodiments, an O-ring  380  may be provided to seal opening  368  around the screw. As used herein, the term “attach” refers to both the direct and indirect attachment of components. In certain embodiments, one or more components may be disposed between transducer  306  and coupling  360  such that transducer  306  and coupling  360  are indirectly attached, with the one or more components providing a rigid connection between transducer  306  and coupling  360 . In other embodiments, coupling  360  may be directly attached to transducer  306 . In certain embodiments, such as those illustrated in  FIGS. 6-9B , housing portion  325 B may include an opening to allow coupling  360  to pass through housing portion  325 B to attach to transducer  306 . In certain such embodiments, coupling  360  and transducer  306  are directly attached and transducer  306  applies vibration directly to coupling  360 . In alternative embodiments, coupling  360  is indirectly attached to transducer  306 . 
       FIG. 4  illustrates a bone conduction device  400  wherein operational characteristics of the bone conduction device may be adjusted by movement of the bone conduction device. In embodiments of the present invention, a recipient may adjust operational characteristics of the device by moving any portion of the device that is typically stationary, such as the housing of the device. Additionally, in certain embodiments, the recipient may adjust operational characteristics of the device by moving the device in accordance with certain controlling movements. As used herein, a “controlling movement” is a movement of a bone conduction device that the device is configured to detect for the purpose of adjusting an operational characteristic of the device. Exemplary controlling movements for a bone conduction device are illustrated in  FIG. 4 . In the embodiment shown in  FIG. 4 , operational characteristic of the device may be adjusted and/or altered by tilting bone conduction device  400  up or down in the direction of arrows  408 . Operational characteristics may also be adjusted and/or altered by tilting the device to one side or the other as indicated by arrows  410 . Further operational characteristics may be adjusted by tilting and holding the device in a particular orientation for a predetermined amount of time. In the embodiment illustrated in  FIG. 4 , tilting bone conduction device  400  up or down in the direction of arrows  408  and tilting the device to one side or the other as indicated by arrows  410  are “controlling movements” for device  400 . As described in more detail below, these movements may be detected by an appropriate sensor module, such as sensor module  213  of the embodiment illustrated in  FIG. 2 . 
     Exemplary operational characteristics that may be adjusted and/or altered by movement of the bone conduction device include, for example, volume, power state (e.g., on/off state, sleep mode, etc.), amplification (e.g., the amount of amplification of various frequency ranges), compression, maximum power output (i.e., a restriction of the maximum power output related to the recipient&#39;s ability to hear at each frequency or frequency band), noise reduction, directivity of the sound received by the sound input elements, speech enhancement, damping of certain resonance frequencies (e.g., using electronic notch filters), the frequency and/or amplitude of an alarm signal, etc. In certain embodiments, control settings for the various operational characteristics may, for example, be organized in folders to aid the recipient in locating the appropriate control settings for adjustment of a desired operational characteristic. In such embodiments, bone conduction device  400  may, for example, include a speaker, vibration device, and/or use the transducer to provide audible and/or vibration information/instructions to the recipient in adjusting operational characteristics of the bone conduction device. Sensor module  213  may also allow the recipient to program the bone conduction device through movement of the bone conduction device. 
       FIG. 5  illustrates another exemplary bone conduction device  500  wherein operational characteristics of the bone conduction device may be adjusted by movement of the bone conduction device. In this example, a recipient may adjust operational characteristics of bone conduction device  500  by twisting or moving the bone conduction device in the direction of arrows  512 . Further operational characteristics may be adjusted by twisting and holding the device in a particular orientation for a predetermined amount of time. Additionally, the recipient may adjust operational characteristics by, for example, pulling the hearing device outwardly or pushing the hearing device inwardly. In embodiments of the present invention, a bone conduction device may allow a recipient to adjust operational characteristics of the bone conduction device through movement of the device in any one or more of the exemplary directions shown by arrows  408 ,  410  and  512 . Additionally, although the embodiments are discussed with reference to the recipient making the adjustments, it should be understood that any user (e.g., the recipient, a doctor, a family member, friend, etc.) may move the bone conduction device to make these adjustments. 
       FIG. 6  is a schematic diagram of one embodiment of bone conduction device  300  of  FIG. 3 , referred to herein as bone conduction device  600 . As shown, bone conduction device  600  comprises a transducer  606  disposed in housing  625 , and a coupling  660  that is attached to transducer  606  and extends through housing  625 . In certain embodiments, coupling  660  is fixed to transducer  606 , but moveable relative to housing  625 . For example, in some embodiments, transducer  606  is attached to housing  625  such that it is free to one or more of rotate, pivot, and otherwise move relative to housing  625 . 
     Bone conduction device  600  further comprises an embodiment of sensor module  213  that includes an accelerometer  612  electrically connected to an electronics module  604 . Electronics module  604  is also electrically connected to transducer  606 . Accelerometer  612  is an embodiment of sensor  212 , and is mounted inside housing  625 . Because accelerometer  612  is mounted inside housing  625 , accelerometer  612  is able to detect certain movements of housing  625 . Specifically, accelerometer  612  is able to detect changes in orientation of housing  625 . Accelerometer  612  may be a conventional accelerometer capable of measuring acceleration in one, two or three dimensions. In certain embodiments, the conventional accelerometer is capable of measuring acceleration as a vector (i.e., including magnitude and direction) and is also capable of measuring gravity. In the embodiment schematically illustrated in  FIG. 6 , accelerometer  612  detects the acceleration of a lower portion of housing  625 , where accelerometer  612  is mounted. In other embodiments, accelerometer may be mounted elsewhere within housing  625  and measure the acceleration of another portion of housing  625  when mounted elsewhere. 
     By detecting the acceleration of housing  625  where accelerometer  612  is mounted, accelerometer  612  is able to detect changes in orientation of housing  625 . By detecting these changes in orientation, accelerometer  612  is able to detect controlling movements of housing  625 , thereby allowing the recipient to alter/adjust operational characteristics of bone conduction device  600  by moving bone conduction device  600 . After adjusting one or more operational characteristics of device  600 , transducer  606  may generate mechanical force for delivery to the recipient&#39;s skull (e.g., vibrate) in accordance with the one or more adjusted operational characteristics. 
     When coupling  660  is attached to an abutment implanted in the recipient&#39;s skull, a recipient may tilt housing  625  up (as shown by arrows  408  in  FIG. 4 ) by, for example, pressing on the top of the device. In certain embodiments, when housing  625  is tilted up, accelerometer  612  detects the magnitude and direction of the acceleration of the lower portion of housing  625  as the lower portion of housing  625  accelerates away from the recipient&#39;s skull. Bone conduction device  600  then determines whether the detected acceleration is indicative of a pre-defined controlling movement of housing  625 , such as tilting the housing up, as described in relation to  FIG. 4 . In some embodiments, accelerometer  612  provides an indication of the detected acceleration to electronics module  604 , which determines whether the detected acceleration is indicative of a pre-defined controlling movement of housing  625 . In other embodiments, accelerometer  612  may include control electronics configured to determine whether a detected acceleration is indicative of a controlling movement of housing  625  and indicate to electronics module  604  that there has been a controlling movement of housing  625 . In certain embodiments, in response to the detection of a controlling movement of housing  625 , electronics module  604  may adjust and/or alter an operational characteristic of device  600 , such as increasing the volume of the device. 
     Similarly, when housing  625  is tilted down, accelerometer  612  detects the magnitude and direction of the acceleration of the lower portion of housing  625  as the lower portion of housing  625  accelerates toward the recipient&#39;s skull. In response, device  600  may determine that there has been a controlling movement of housing  625  (i.e., tilt down), and electronics module  604  may adjust and/or alter an operational characteristic of device  600 , such as decreasing the volume of the device. Device  600  may similarly use accelerometer  612  to detect a large number of other controlling movements of housing  625  including, but not limited to, tilting housing  625  side to side in the direction of arrows  410 , tilting housing  625  diagonally in one or more directions between arrows  408  and  410 , twisting housing  625  in the direction of arrows  512 , snapping the device onto and off of an implanted abutment, etc., each of which will produce a characteristic acceleration that may be identified by device  600 . 
     In addition, by analyzing the magnitude of the acceleration detected by accelerometer  612 , device  600  may distinguish between controlling movements of different forces experienced by housing  625 . For example, accelerometer  612  may detect an acceleration of lesser magnitude when housing  625  is tilted up by a relatively light touch on the upper portion of housing  625  than when housing  625  is tilted up by a harder touch on the upper portion of housing  625 . As such, electronics module  604  may provide different controls of operational characteristics based on the force of controlling movements of housing  625 . For example, electronics module  604  may increase the volume of device  600  by a relatively small amount in response to a light touch on an upper portion of housing  625  (i.e., a light upward tilt), and increase the volume of device  600  by a larger amount in response to a more forceful touch on an upper portion of housing  625  (i.e., a more forceful upward tilt). Similarly, electronics module  604  may decrease the volume of device  600  by a relatively small amount in response to a light touch on a lower portion of housing  625  (i.e., a light downward tilt), and decrease the volume of device  600  by a larger amount in response to a more forceful touch on a lower portion of housing  625  (i.e., a more forceful downward tilt). 
     Electronics module  604  may also provide different adjustments of operational characteristics based on a number of consecutive controlling movements of housing  625 . For example, performing one controlling movement of housing  625  in a certain period of time may adjust one operational characteristic of device  600 , while performing the same movement twice in a predetermined period of time may adjust another operational characteristic of device  600 . For example, tilting housing  625  up once in a predetermined period of time may cause electronics module  604  to adjust the volume of device  600 , while tilting housing  625  up twice in the predetermined period of time may cause electronics module  604  to adjust the power state of the device. 
     Electronics module  604  may also provide different adjustments of operational characteristics based on whether a controlling movement of housing  625  is performed and held. Such a manipulation of housing  625  may be detected by accelerometer  612  by, for example, detecting a characteristic acceleration for the controlling movement and then detecting little or no acceleration in the opposite direction for a predetermined period of time. For example, performing a controlling movement of housing  625  and immediately releasing housing  625  may adjust one operational characteristic of device  600 , while performing the same movement and then holding housing  625  in a specific orientation for a predetermined period of time may adjust another operational characteristic of device  600 . For example, tilting housing  625  up and then quickly releasing housing  625  may cause electronics module  604  to adjust the volume of device  600 , while tilting housing  625  up and then holding the device in the upwardly-tilted orientation for a predetermined period of time may cause electronics module  604  to adjust the power state of the device. 
     In embodiments of the invention, any of the controlling movements described above may be mapped to the adjustment of any operational characteristics of device  600 . This mapping of adjustments to controlling movements may be defined in the software (or firmware) of device  600 . For example, in some embodiments, the mapping may be specified in software for electronics module  604 . In addition, the mapping for device  600  may be change when the mapping is specified in software. In addition, a controlling movement performed multiple times, at a greater force, or performed and held may be considered to be a different controlling movement than the same controlling movement performed once, with lesser force, or performed and not held, for example, and these different controlling movements may be mapped to the adjustment of different operational characteristics. 
     In some embodiments, device  600  may use accelerometer  612  to detect when there has been no movement of device  600  for a predetermined period of time. No movement of device  600  for a predetermined period of time may indicate that device  600  is no longer connected to the recipient and should therefore be turned off. In embodiments, upon determining that there has been no movement of device  600  for a predetermined period of time, device  600  may turn itself off or enter a sleep mode, for example. In some embodiments, accelerometer  612  may provide an indication to electronics module after accelerometer  612  has experienced no acceleration (relative to when accelerometer  612  is at rest, for example) for a predetermined period of time. In response to the indication from accelerometer  612 , electronics module  604  may power down device  600  or cause device  600  to enter a sleep mode. In other embodiments, electronics module  604  may monitor the output of accelerometer  612  and power down device  600  or cause device  600  to enter a sleep mode when no indication of acceleration has been received from accelerometer  612  for a predetermined period of time. In some embodiments, electronics module  604  may monitor accelerometer  612  in sleep mode and cause device  600  to enter an operational mode (i.e., a mode in which device  600  is fully operational) in response to an indication that accelerometer  612  has detected acceleration of housing  625 . 
     Alternatively or in addition, device  600  may use accelerometer  612  to detect a stationary orientation of housing  625 . Housing  625  being stationary in a particular orientation may indicate that device  600  is not currently being worn by the recipient and should be turned off or enter a sleep mode. In certain embodiments, electronics module  604  may cause device  600  to enter a sleep mode when accelerometer  612  indicates that device  600  is lying flat on back side  627  of housing  625 . Back side  627  is a side of housing  625  that is disposed opposite the side of housing  625  from which coupling  660  exits housing  625 . In such embodiments, accelerometer  612  may be an accelerometer designed to detect gravity and may determine the orientation of the device by detecting the direction of the Earth&#39;s gravity. In other embodiments, the orientation of device  600  may be detected using a separate gravity detector, such as a gravimeter. Electronics module  604  may be configured to cause device  600  to enter sleep mode immediately upon detecting a particular orientation of device  600 . 
     In addition, in certain embodiments, accelerometer  612  or one or more additional accelerometers may be used to sense vibrations of housing  625 . Electronics module  604  may use the sensed vibrations to cancel feedback from the sound signal output from a sound input element (e.g., sound input element  202  of  FIG. 2 ) of device  606 . In addition, feedback noise may be generated when the recipient makes contact with the device in order to change operational characteristics of the device, or when the recipient is wearing a hat that makes contact with the device, for example. In some embodiments, accelerometer  612  may be used to sense these and other types of contact with the device, and electronics module  604  may increase feedback cancellation when such contact is detected. In other embodiments, electronics module  604  may reduce the volume, mute the device, or adjust some other operational characteristic of the device when such contact is detected. Additionally, electronics module  604  may reverse these changes when accelerometer detects that the detected contact is no longer present. 
     Alternatively or in addition, the sensed vibrations could also be used to monitor the functioning of transducer  606 . For example, in some embodiments, transducer  606  is configured to vibrate housing  625  directly and includes a vibrating mass and a suspension. In such embodiments, the functioning of the suspension could be monitored by comparing the sensed vibrations of housing  625  to a control signal driving transducer  606 . If the sensed vibrations depart from the vibrations specified by the control signal driving transducer  606 , it may be determined that the suspension is not working properly. 
     In certain embodiments, device  600  may further comprise a recording device for recording the movements of housing  625 , as measured by accelerometer  612 . The recording device may be any memory device suitable for recording the output of accelerometer  612 . The recorded output of accelerometer  612  may be useful during diagnosis or repair of device  600 . For example, if device  600  has been dropped, the change in acceleration experienced upon impact with the ground may be detected by accelerometer  612  and recorded in the recording device. This recorded change in acceleration may be used by a technician to determine that device  600  has been dropped. Similarly, the lack of any such recorded change in acceleration may indicate that the device was not dropped, which may assist the technician in diagnosing a problem with device  600 . As such, recorded accelerations may assist a technician in identifying a correct diagnosis or failure mode of device  600 . 
     In some embodiments, an additional accelerometer may be attached to coupling  660 . Electronics module  604  may compare the acceleration detected by the additional accelerometer to the acceleration detected by accelerometer  612  during the same period of time to sense the movement of housing  625  relative to coupling  660 . In such embodiments, electronics module  604  may detect various controlling movements of housing  625  by detecting certain movements of housing  625  relative to coupling  660 . For example, if electronics module  604  determines that a lower portion of housing  625  has been moved away from coupling  660 , electronics module  604  may determine that housing  625  has been tilted up in the direction of arrow  408  of  FIG. 4 . Similarly, if electronics module  604  determines that a lower portion of housing  625  has been moved toward coupling  660 , electronics module  604  may determine that housing  625  has been tilted down in the direction of arrow  408  of  FIG. 4 . 
     In other embodiments of the present invention, a sound input element of device  600  may be an accelerometer that detects sound via vibration of a surface such as housing  625 . Alternatively, a sound input element of device  600  may be a microphone that includes an accelerometer to cancel any effect of acceleration on the microphone so that the microphone is insensitive to acceleration. In such embodiments, the accelerometer of the sound input element may be used to perform the functions of accelerometer  612  described above, and accelerometer  612  may be omitted from the device. Alternatively, the accelerometer of the sound input device may be used in conjunction with accelerometer  612  described above. 
     Alternatively or in addition to other features describe herein, operational characteristics of a bone conduction device may be adjusted and/or altered in response to the detection of one or more characteristic sounds. For example, the sound of a recipient tapping on housing  325  of bone conduction device  300  may be received via one or more of microphones  302 A and  302 B. In certain embodiments, electronics module  304  is configured to distinguish the characteristic sound of a recipient or other user tapping on housing  325  from other sound received by a microphone  302 . In such embodiments, electronics module  304  may be configured to adjust and/or alter one or more operational characteristics of device  300  in response to detecting, via one or more of microphones  302 A and  302 B, the characteristic sound produced by the recipient tapping on housing  325 . Alternatively or in addition, electronics module  304  may be configured to adjust and/or alter one or more operational characteristics of device  300  in response to detecting any one of a plurality of predefined patterns of tapping on housing  325 , such as two or more consecutive taps. As one example, electronics module  304  may cause device  300  to enter a sleep mode in response to detecting two consecutive taps on housing  325 . In other embodiments, a sound input device including an accelerometer, as described above, may be used to detect tapping on the housing by using the accelerometer to detect vibrations of the housing caused by tapping on the housing. 
     In other embodiments, electronics module  304  is configured to distinguish the characteristic sound of a recipient moving a finger or other object across a specially textured portion  315  of housing  325  of  FIG. 3 . In embodiments, portion  315  is configured with a texture that causes a characteristic sound to be generated when an object is slid across portion  315 . In such embodiments, electronics module  304  may be configured to adjust and/or alter one or more operational characteristics of device  300  in response to detecting, via one or more of microphones  302 A and  302 B, the characteristic sound produced by sliding an object across textured portion  315 . In embodiments, textured portion  315  is designed to produce a characteristic sound that is picked up by one or more of microphones  302 A and  302 B and which electronics module  304  is able to distinguish from other sounds picked up by microphones  302 A and  302 B. The characteristic sound may be distinguished by signal processing electronics in electronics module  304 . As one example, electronics module  304  may cause device  300  to enter a sleep mode in response to detecting an object moving across textured portion  315 . 
     In still other embodiments, electronics module  304  is configured to distinguish the characteristic sound of coupling  360  being snapped onto and off of abutment  364 . In such embodiments, electronics module  304  may be configured to adjust and/or alter one or more operational characteristics of device  300  in response to detecting, via one or more of microphones  302 A and  302 B, the characteristic sound produced by snapping coupling  360  onto and off of abutment  364 . For example, electronics module  304  may cause device  300  to enter a sleep mode in response to detecting an the sound of coupling  360  being snapped off of abutment  364  and may cause device  300  to enter a fully operational mode in response to detecting an the sound of coupling  360  being snapped onto abutment  364 . 
       FIG. 7  is a schematic diagram of another embodiment of bone conduction device  300  of  FIG. 3 , referred to herein as bone conduction device  700 . As shown, bone conduction device  700  comprises a transducer  706  disposed in housing  725 , and a coupling  760  that is mounted to transducer  706  and extends through housing  725 . Bone conduction device  700  further comprises an embodiment of sensor module  213  that includes a sensor  712  that is electrically connected to an electronics module  704 . Electronics module  704  is also electrically connected to transducer  706 . 
     Sensor  712  comprises a plate  752  and electrically-conductive contacts  754 A and  754 B mounted to the inside of housing  725 . In the embodiment illustrated in  FIG. 7 , coupling  706  is mounted to plate  752 , and plate  752  is mounted to transducer  706 , thereby connecting coupling  760  to transducer  706 . In alternative embodiments, coupling  760  may be mounted directly to transducer  706 , and plate  752  may be mounted to coupling  760  such that it is separated from transducer  706 . In embodiments of the present invention, plate  752  is at least partially electrically conductive. Contacts  754 A and  754 B are disposed around the portion of housing  725  at which coupling  760  exits housing  725 . Plate  752  and each of contacts  754 A and  754 B are electrically connected to electronics module  704 . While two contacts  754 A and  754 B are shown in the embodiment illustrated in  FIG. 7 , it will be appreciated that one or more than two contacts may be provided inside housing  725 . 
     In the embodiment shown in  FIG. 7 , coupling  760  is fixed to transducer  706  such that there is substantially no movement of coupling  760  relative to transducer  706 , and coupling  760  and transducer  706  together are moveable relative to housing  725 . In some embodiments, transducer  706  is attached to housing  725  such that it is free to one or more of rotate, pivot, and otherwise move relative to housing  725 . This movement of transducer  706  relative to housing  725  allows relative movement of housing  725  relative to coupling  760 . 
     In embodiments of the present invention, the sensor module is able to detect controlling movements of device  700  by detecting movement of housing  725  relative to coupling  760  using sensor  712 . In embodiments, the movement of housing  725  relative to coupling  760  is detected through the contact of plate  752  with one of terminals  754 A and  754 B. When coupling  760  is attached to an abutment implanted in the recipient&#39;s skull, a recipient may tilt housing  725  up (as shown by arrows  408  in  FIG. 4 ) by pressing on the top of the device, for example. In certain embodiments, housing  725  may be tilted such that an electrically conductive portion of plate  752  makes contact with terminal  754 A. 
     The contact between plate  752  and terminal  754 A is detected by electronics module  704 , which is electrically connected to both plate  752  and terminal  754 A. Sensor  712  may be configured such that an electrical circuit is completed when plate  752  makes contact with terminal  754 A, and electronics module  704  may detect the completion of the electrical circuit. In accordance with other embodiments of the present invention, electronics module  704  may detect contact between plate  752  and terminal  754 A by checking the impedance of a line connected to plate  752  or terminal  754 A, or by any other currently known or later developed method. 
     Electronics module  704  determines that there has been a controlling movement of device  700  when it detects contact between plate  752  and terminal  754 A. In certain embodiments, in response to the detection of a controlling movement of device  700 , electronics module  704  may adjust and/or alter an operational characteristic of device  700 . In embodiments, operational characteristics of device  700  may be the same as those described above in relation to device  600 . Similarly, electronics module  704  determines that there has been a controlling movement of device  700  when it detects contact between plate  752  and terminal  754 B, which may occur when the recipient tilts housing  725  down (as shown by arrows  408  in  FIG. 4 ) by pressing on the bottom of device  700 , for example. In the embodiment illustrated in  FIG. 7 , terminals  754  are electrically isolated from one another and electronics module  704  determines whether the housing has been tilted up or down based on which terminal  754  is contacted by plate  752 . After adjusting one or more operational characteristics, transducer  706  may generate mechanical force for delivery to the recipient&#39;s skull (e.g., vibrate) in accordance with the one or more adjusted operational characteristics. 
     In other embodiments, the inside of housing  725  may include additional terminals  754  that are electrically isolated from one another and oriented at various locations around the portion of housing  725  where coupling  760  exits housing  725 . In this manner, electronics module  704  may detect additional controlling movements of device  700 . For example, when terminals  754  are placed on the inside of housing  725  on left and right sides of coupling  760 , electronics module  704  is capable of detecting tilting of device  700  to one side or the other as indicated by arrows  410  in  FIG. 4 . In embodiments, electronics module  704  is able to detect additional controlling movements of device  700 , such as various degrees of diagonal tilting, when additional terminals  754  are disposed on the inside of housing  725 . 
     Additionally, in embodiments, plate  752  may be subdivided into a plurality of conductive areas that are electrically isolated from one another by one or more non-conductive dividers, for example. Each of the conductive areas may be separately connected to electronics module  704 . The number of conductive areas and their positions may correspond to the number and positions of terminals  754  of device  700 . In such embodiments, electronics module  704  is able to detect, for example, the completion of a circuit between a specific terminal and a specific conductive portion of plate  752 . In alternative embodiments, each of terminals  754  may be electrically connected to one another. In such embodiments, electronics module  704  detects controlling movements of device  700  but does not distinguish between certain controlling movements. For example, in such embodiments, such that electronics module  704  would not distinguish between tilting device  700  up and tilting device  700  down. 
     Electronics module  704  may also provide different adjustments of operational characteristics based on whether a controlling movement of housing  725  is performed and held. Such a manipulation of housing  725  may be detected by sensor module  704  by, for example, detecting contact between plate  752  and a terminal  754  that is maintained for a predetermined period of time. For example, performing a controlling movement of housing  725  and immediately releasing housing  725  may adjust one operational characteristic of device  700 , while performing the same movement and then holding housing  725  in a specific orientation for a predetermined period of time may adjust another operational characteristic of device  700 , as described above in relation to device  600 . 
       FIGS. 8A and 8B  are schematic diagrams of another embodiment of bone conduction device  300  of  FIG. 3 , referred to herein as bone conduction device  800 . As shown, bone conduction device  800  comprises a transducer  858  connected to housing  825  by support structures  827 A and  827 B. Bone conduction device  800  further comprises an embodiment of sensor module  213  that includes a sensor  812  that is electrically connected to an electronics module  804 . Electronics module  804  is also electrically connected to transducer  858 . A coupling  860  extends through housing  825  and is mounted to transducer  858  via sensor  812 . 
     In the embodiment illustrated in  FIGS. 8A and 8B , sensor  812  includes first and second plates  852 A and  852 B coupled by a fulcrum  856 . In embodiments, first plate  852 A is attached to transducer  858  such that there is substantially no movement of first plate  852 A relative to transducer  858 , and second plate  852 B is attached to coupling  860  such that there is substantially no movement of second plate  852 B relative to coupling  860 . Fulcrum  856  enables the movement of housing  825  relative to coupling  860 . More specifically, in embodiments, fulcrum  856  enables plates  852 A and  852 B to pivot or rotate about fulcrum  856 , as shown in  FIG. 8B , and fulcrum  856  substantially prevents the relative translation of plates  852 A and  852 B toward or away from one another along axis  872 . 
     In embodiments of the present invention, the sensor module is able to detect controlling movements of device  800  by detecting movement of housing  825  relative to coupling  860  using sensor  812 . In embodiments, the movement of housing  825  relative to coupling  860  is detected by detecting the contact of plate  852 A with plate  852 B. When coupling  860  is attached to an abutment implanted in the recipient&#39;s skull, a recipient may tilt housing  825  up (as shown by arrows  408  in  FIG. 4 ) by pressing on the top of the device, for example. In embodiments, housing  825  may be tilted such that a portion of plate  852 A makes contact with a portion of plate  852 B, as illustrated in  FIG. 8B . In certain embodiments, each of plates  852 A and  852 B is at least partially electrically conductive and each of plates  852 A and  852 B is electrically connected to electronics module  804 . In such embodiments, electronics module  804  detects contact between conductive portions of plates  852 A and  852 B. For example, sensor module  812  and electronics module  804  may be configured such that an electrical circuit is completed when a conductive portion of plate  852 A makes contact with a conductive portion of plate  852 B. In accordance with other embodiments of the present invention, electronics module  804  may detect contact between conductive portions of plates  852 A and  852 B by checking the impedance of a line connected to plate  852 A or plate  852 B, or by any other currently known or later developed method. 
     In certain embodiments, electronics module  804  determines that there has been a controlling movement of device  800  when it detects contact between conductive portions of plates  852 A and  852 B. In such embodiments, electronics module  804  may adjust and/or alter an operational characteristic of device  800  in response to the detection of a controlling movement of device  800 . In embodiments, operational characteristics of device  800  may be the same as those described above in relation to device  600 . After adjusting one or more operational characteristics of device  800 , transducer  858  may generate mechanical force for delivery to the recipient&#39;s skull (e.g., vibrate) in accordance with the one or more adjusted operational characteristics. 
     In some embodiments, each of plates  852 A and  852 B may be subdivided into a plurality of conductive areas that are electrically isolated from one another by one or more non-conductive dividers, for example. Each of the conductive areas may be separately connected to electronics module  804 . The number of conductive areas in plates  852 A and  852 B may correspond to the number of controlling movements of device  800  that sensor  812  detects. In such embodiments, electronics module  804  detects a specific controlling movement of device  800  by detecting contact between specific conductive areas of plates  82 A and  852 B. In one exemplary embodiment, for example, electronics module  804  may detect that housing  825  is tilted in one direction relative to coupling  860  (e.g., as shown in  FIG. 8B ) by detecting contact between a first conductive portion of plate  852 A and a first conductive portion of plate  852 B. Similarly, electronics module  804  may detect that housing  825  is tilted in another direction relative to coupling  860  (e.g., opposite to the movement shown in  FIG. 8B ) by detecting contact between a second conductive portion of plate  852 A and a second conductive portion of plate  852 B. In other embodiments, plates  852 A and  852 B may each be divided into more than two conductive areas to allow detection of more than two controlling movements of device  800 , such as various degrees of diagonal tilting of device  800 . In still other embodiments, only one of plates  852 A and  852 B may be divided into conductive areas, while the other is a single conductive plate. In such embodiments, electronics module  804  distinguishes between different controlling movements based upon which portion of the divided plate the other plate contacts. 
     Electronics module  804  may also provide different adjustments of operational characteristics based on whether a controlling movement of housing  825  is performed and held. Such a manipulation of housing  825  may be detected by sensor module  804  by, for example, detecting contact between plates  852 A and  852 B that is maintained for a predetermined period of time. For example, performing a controlling movement of housing  825  and immediately releasing housing  825  may adjust one operational characteristic of device  800 , while performing the same movement and then holding housing  825  in a specific orientation for a predetermined period of time may adjust another operational characteristic of device  800 , as described above in relation to device  600 . 
       FIGS. 9A and 9B  are schematic diagrams of another embodiment of bone conduction device  300  of  FIG. 3 , referred to herein as bone conduction device  900 . As shown, bone conduction device  900  comprises a transducer  958  connected to housing  925  by support structures  927 A and  927 B. Bone conduction device  900  further comprises an embodiment of sensor module  213  that includes a sensor  912  that is electrically connected to an electronics module  904 . Electronics module  904  is also electrically connected to transducer  958 . A coupling  960  extends through housing  925  and is mounted to transducer  958  via sensor  912 . 
     In the embodiment illustrated in  FIGS. 9A and 9B , sensor  912  includes first and second magnetic plates  952 A and  952 B. In embodiments, first magnetic plate  952 A is attached to transducer  958  such that there is substantially no movement of first plate  952 A relative to transducer  958 , and second magnetic plate  952 B is attached to coupling  960  such that there is substantially no movement of second magnetic plate  952 B relative to coupling  960 . Magnetic plates  952 A and  952 B are configured to be magnetically attracted to one another. 
     In embodiments of the present invention, the sensor module is able to detect controlling movements of device  900  by detecting movement of housing  925  relative to coupling  960  using sensor  912 . In embodiments, the movement of housing  925  relative to coupling  960  is detected by detecting the separation of magnetic plate  952 A from magnetic plate  952 B. When coupling  960  is attached to an abutment implanted in the recipient&#39;s skull, a recipient may tilt housing  925  up (as shown by arrows  408  in  FIG. 4 ) by pressing on the top of the device, for example. In embodiments, housing  925  may be tilted such that the magnetic attraction of plates  952 A and  952 B is partially overcome and a portion of plate  952 A is separated from plate  952 B, as illustrated in  FIG. 9B . In certain embodiments, each of magnetic plates  952 A and  952 B is at least partially electrically conductive and each of plates  952 A and  952 B is electrically connected to electronics module  904 . In such embodiments, electronics module  904  detects the separation of conductive portions of plates  952 A and  952 B. For example, sensor  912  and electronics module  904  may detect that an electrical circuit is broken when a conductive portion of plate  952 A is separated from a conductive portion of plate  952 B. In accordance with other embodiments of the present invention, electronics module  904  may detect the separation of conductive portions of plates  952 A and  952 B by checking the impedance of a line connected to plate  952 A or plate  952 B, or by any other currently known or later developed method. 
     In certain embodiments, electronics module  904  determines that there has been a controlling movement of device  900  when it detects the separation of conductive portions of plates  952 A and  952 B. In such embodiments, electronics module  904  may adjust and/or alter an operational characteristic of device  900  in response to the detection of a controlling movement of device  900 . In embodiments, operational characteristics of device  900  may be the same as those described above in relation to device  600 . In some embodiments, each of plates  952 A and  952 B may be subdivided into a plurality of conductive areas that are electrically isolated from one another to allow electronics module  904  to distinguish between different controlling movements of device  900  similar to the manner described above in relation to device  800 , except that electronics module  904  detects the separation of plates  952 A and  952 B rather than contact of the plates. In certain embodiments, electronics module  904  may also be configured to detect the twisting housing  925  (as shown by arrow  512  of  FIG. 5 ) by detecting the twisting of plates  952 A and  952 B, which may be detected by detecting changes in the alignment of the subdivided conductive areas of plates  952 A and  952 B. After adjusting one or more operational characteristics of device  900 , transducer  958  may generate mechanical force for delivery to the recipient&#39;s skull (e.g., vibrate) in accordance with the one or more adjusted operational characteristics. 
     Electronics module  904  may also provide different adjustments of operational characteristics based on whether a controlling movement of housing  925  is performed and held. Such a manipulation of housing  925  may be detected by electronics module  904  by, for example, detecting a separation of portions of plates  952 A and  952 B that is maintained for a predetermined period of time. For example, performing a controlling movement of housing  925  and immediately releasing housing  925  may adjust one operational characteristic of device  900 , while performing the same movement and then holding housing  925  in a specific orientation for a predetermined period of time may adjust another operational characteristic of device  900 , as described above in relation to device  600 . 
       FIG. 10  is a flowchart illustrating one way of operating a bone conduction device in accordance with embodiments of the present invention. At block  1010  of  FIG. 10 , bone conduction device  200  vibrates the recipient&#39;s skull in accordance with operational characteristics of device  200  by generating a mechanical output force that is delivered to the recipient&#39;s skill via an anchor system  208  coupled to bone conduction device  200 , as described above. At block  1020 , electronics module  204  detects movement of housing  225  via sensor module  213 . The sensor module may be any one of the sensor modules described above in relation to embodiments of the invention, and may detect movement of housing  225  in any of the ways described above in relation to embodiments of the invention. Once electronics module  204  detects movement of housing  225 , electronics component  204  adjusts one or more operational characteristics of device  200  at block  1030  of  FIG. 10 . The one or more operational characteristics may be any of the operational characteristics described above. After one or more operational characteristics are adjusted at block  1030 , bone conduction device  200  may again vibrate the recipient&#39;s skull in accordance with the adjusted operational characteristics of device  200  at block  1010 . Additionally, while the above flowchart has been described in relation to bond conduction device  200 , any of the bone conduction devices described above in relation to embodiments of the present invention may be operated in accordance with the flowchart illustrated in  FIG. 10 . 
     While various embodiments of the present invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. It will be apparent to persons skilled in the relevant art that various changes in form and detail can be made therein without departing from the spirit and scope of the invention. Thus, the breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims and their equivalents. The present embodiments are, therefore, to be considered in all respects as illustrative and not restrictive.