Hearing tests wearing hearing aids

@hesling96 said:

Can someone explain why my audi can’t perform a hearing test with me wearing hearing aids. I would think this would help us determine where the problem lies with the hearing aid. Thanks for your help.

You can’t perform a tonal test as the aid will know it isn’t speech and turn the sounds down.

You can perform a Real Ear Measurement which will show the amount of gain the aids supply in situ.

How important is Real Ear Measurement? Two Audis at the U. of Washington say it is VERY important. Costco now uses REM on every hearing aid sold. Question: is this so important that I should not use a fitter who does NOT use real ear measurement?

Thanks for any advice.

elijah

@doubledown said:

At first I thought the REM test was the be all end all of all tools an audi could have. but when I saw one used in practice I realized it was not very practical. literally all you do is stick a probe in your ear that picks up sound coming out of your aid. I would imagine the only real use for the devise is to determine if you got a dud of an aid that needs to be sent back. with quality control this is not going to happen often. It can be used to fine tune the aid in very specific situations but with 1 hour appointments being the norm, I can’t imagine anybody having the time to use these devices to its full potential. and how do you generate the sounds for those difficult situations you want to fine tune to in an audi’s office?

in the end one can use this device to set the better audi apart from the others. but I’ve had bad audis who used rem machines. and the best audi I’ve had never had this machine.

It can be a great tool for checking the function of an aid - it can also show you exactly where you’re getting feedback under certain circumstances. I’m a big fan of the real ear especially when doing programs for people who do a lot with music.

@grantb5 said:

Well if the tone starts at a very low volume and has warble characteristics it should (by)pass the noise reduction should it not? Otherwise you could try a “music” program or turn the noise reduction down/off for the duration of the test.

Not at all: if it isn’t speech, it isn’t likely to be amplified by the same extent.

@hesling96 said:

Can someone explain why my audi can’t perform a hearing test with me wearing hearing aids. I would think this would help us determine where the problem lies with the hearing aid. Thanks for your help.

You most certainly can do a hearing test with hearing aids in the ears, provided you have a soundfield equiped booth. Before the days of separate verification tools, Soundfield tests were a great way to measure the effectiveness of hearing aids. Most offices these days don’t equip their booths with them now.

As for REM machines (AudioScan etc…), these tools are effective as a measure of SPL in the ear canal based on threshold audiometry. Sure these are based on various formula rationales which use averages, but that is hardly individualized to the patient. There are times that the exclusive use of REM will produce an absolutely terrible sound to the patient.

As one of my instructors in school said way back in the day, “This job we do, is an art and a science.” To do one without the other, doesn’t make too much sense.