Not sure what to make of comments by new Costco audiologist

I know I wasn’t asked the question but I’ll throw in my take. To get an idea of how these different systems work I’d start with Audiology Online 20 questions courses on Frequency lowering. If you want more then try the link I posted above (which happens to include the audiology online courses as well).

I think it’s largely trial and error. I’ll throw in my guesses. If “sound quality” is one’s priority I’m guessing Demant’s approach to be preferable. If one has profound high frequency losses and especially the lower those losses extend then I think Sonova’s approach is more likely to appeal (especially if one is doing everything they can to avoid a cochlear implant. But it’s all subjective. Most audiologists don’t want to mess with frequency lowering.

Update: I hate the Phillips. Firstly, the one button system is not logical and removes control. Secondly, lots of problems connecting to the app, which meant I couldnt adjust the volume when I wanted. Thirdly, not compatable with my android phone for streaming. Furthermore, despite 3 in person adjustment sessions, plus 3 remote adjustments, the fitters were not able to get a satisfactory fitting. I believe none of the 3 fitters whom I saw are sufficiently experienced or knowledgeable to adjust my HAs adequately. They didnt perform the REM. Finally, they have thrown the towel in, and suggest I return the Phillips, which I had already decided on anyway, and try the Seinnheiser. Costco in Madrid employ young people, and the staff change a lot. The one I have dealt with most has been consistently patronising, spoken to me as if I were a doddery old lady trying a HA for the first time, despite knowing I have worn HAs for 12 years. However, I don’t feel I can escape them as the alternative of paying 5000€ is out of the question. Ho hum. The battery in my k10 only lasts til 10pm now, which is infuriating. Anyway, I will go to Madrid next month and start the process over again. Good night!

Research on frequency lowering approaches is small (this is the common refrain in this very small field) but frequency compression comes out on top. I don’t think I’ve really seen much more come out since Phonak did SR2 and then likely patented the hell out of it. Whichever one is set up should be verified. Research in children also shows that adapting to frequency compression such that it sounds normal again takes time and then can happen in a slow way or in a sudden way across a few months. So it’s another one of those things where you have to decide how long you’re willing to be annoyed by it before deciding that it’s not going to work for you.

@MDB said:

I think it’s largely trial and error.

It can be verified by REM. Some procedures are described in this approach.

True actually: I often attempt a bit of frequency compression with the steepest sloping losses.

It’s really hit and miss, some describe extra sharpness, some describe more scrambling, some others don’t really notice. It’s a real mixed bag which I guess depends on the relative state of decay of the higher sensing hair cells and the degree of offset used in the compression/transposition.

Even on flatter losses I’ve toggled it on and off, but that usually just upsets the higher speech clarity.

I can prove that the client is getting more sound in audible ranges through REM, but that doesn’t necessarily equate to the individual feeling they ARE getting better clarity, or even translate to better free-field Word scoring.

@Um_bongo said:

but that doesn’t necessarily equate to the individual feeling they ARE getting better clarity, or even translate to better free-field Word scoring.

Does that apply even after a period of time when the user has rehabilitated and gotten used to it?

The difficulty is, if the client perceives that it’s subjectively worse at the initial fit, we’re pretty unlikely to proceed with it.

So the ones that don’t like it at inception never proceed further to a ‘forced acceptance’ position. The other issue I have with it, is that the output enhancements are proprietary, this locks the client in to a certain type of sound. What if the client has a change of circumstances and cannot afford the same top end aids next time around, or worse, has them fitted for free as a child and then is bumped out of the ’free’ system at 18 and finds that insurance schemes don’t cover pre-existing conditions?

@Um_bongo said:

output enhancements are proprietary, this locks the client in to a certain type of sound

How is this different than each brand having a certain sound in general?