It occurred to me the other day that hearing aids are probably among the most sophisticated pieces of electronics in the rehabilitation marketplace. Yet, the quantitative evaluation of the effectiveness of is among the most subjective of all devices in that marketplace. How well your hearing will be improved is completely determined by the competence of your audiologist. Overall, it’s a very expensive crap shoot. Why isn’t there a widely known protocol for fitting and adjusting HAs to a new customer?
the quantitative evaluation of the effectiveness of HAs is among the most subjective of all devices in that marketplace. How well your hearing will be improved is completely determined by the competence of your audiologist.
and more importantly, by the amount and nature of your hearing loss
Hearing involves a two-part process: the ears collect sound waves and convert them into electrical signals, while the brain processes and interprets these signals into meaningful sound.
You can measure sound waves physically, but you can’t measure how the brain processes and interprets them. There’s no definitive test to determine how well someone will hear in different environments or how they’ll interpret those sounds. Without those measurements, evaluations tend to be more qualitative than quantitative, and qualitative evaluations are not exact .
I have been wearing aids for 21 years. I have to say that an audiologist that goes the extra mile is more important than the hearing aids. For if the audiologist doesn’t do the proper fitting the aids are worthless. But the audiologist doesn’t know that the fitting was proper or not if the hearing aid wearer doesn’t voice their concerns and likes. It takes a partnership between the audiologist and patient for the correct fitting of hearing aids.
I think you bring up a very good point. The widely known protocol is to use as part of the fitting process and there is plenty of chatter on this forum, amongst other places, about that. But the real question I think you are asking is why there isn’t a standard to which hearing aid adjustments done by audiologist, or practitioners, that programming can be measured against.
It is generally expressed that hearing aids cannot give back a listener perfect hearing. At least not for those of us who have moderate to severe hearing loss. And what is perfect hearing? Presumably someone who can have an audiological test done and come out with near zero hearing loss.
But is an audiological test the definitive measure of whether or not hearing aids have been programmed as well as possible given one’s hearing loss. None of the audiologists I’ve ever been to have ever re-tested me after fitting and adjusting my hearing aids to measure how much better they’ve been able to make my hearing with the hearing aids. Indeed, unaided my hearing loss is around 70% but when I take a Mimi test using my hearing aids my hearing loss is reduced to around 40%. I’m not sure if this tells me anything or not. With the hearing aids I wear, I can hear birds in the trees, the creaks in the floor as I walk around my house, and most speech fairly accurately if not 100% in quiet places. Music sounds as good as I’ve ever heard it with every instrument clearly identifiable.
I have been a DIY HA programmer for over a decade, have experienced a number of audiologists and have had REM performed a number of times. In the end I believe my current HA tuning has my HAs as good as they can be and they are amazing.
But, this is my subjective opinion. Your question is valid in that an objective measurement standard doesn’t seem to exist that would show each HA user how well (or how bad) their aids have been programmed.
I hope one or more of our experienced Audiologists who visit this forum will chime in on this subject.
I realize there is no that can restore hearing loss 100%. It just seems that there should be some standard protocol (and maybe there is, who knows?) that the audiologist goes through in setting up the HAs. My experience at Costco was spotty, as I have written about on this blog. My first audiologist set the HAs up and told me to wear them and to come back in a few months, and they would be adjusted. When I did just that, I got a response from the guy at the desk, which was, “What problems are you having? If you don’t have problems, why are you here?” After wearing them for two years, I made an appointment for a checkup. That audiologist made some pretty dramatic changes in my frequency response curve. Before that adjustment, if asked, I would say the HAs were minimal help in hearing. After that adjustment, I would say they made a significant difference.
It’s that experience that moves me to wonder if there is not or should not be some standard protocol for setting up the HAs for new users.
I was given a word recognition test by my audiologist prior to getting fitted. I don’t think I got one after getting the fitted , which was fitted with .
I think a good test would be a Sentence Understanding Score (if there is such) given with several different noise environments. My Oticon Real 3 HA would have done well in word recognition in quiet, but flunked badly in sentence recognition in a noisy environment.
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