UPDATE: DSL v5a Pediatric Fitting as an Adult

@monke said:

Has anyone else worn hearing aids since childhood struggled with other fitting formulas?

No, but I’m going to give this a try with one of my pairs

Please let me know what you notice

@monke
OK, I’ve changed the fitting programmes on 3 of my pairs, and will be going out socially tonight. This will involve being a car passenger, then in a Snooker club for a couple of hours, and then a slightly roudy pub. I shall be trying the different aids throughout the evening, sometimes just changing one at a time. For what it’s worth, these are the aids, and the revised fitting formula:

Naida L90 SP - Adaptive Phonak Digital
Sky Naida M70 SP - DSL v5a Pediatric
Naida M30 SP - DSL v5a Adult
Bolero M70 M - NAL-NL2

In all pairs I have Autosense disabled and just use: Music and Speech in noise.

It may be worth noting that in all 3 alterations, Target enabled SoundRecover2. I’ve disabled it.

Peter

I’ve been wearing hearing aids for about 30 years.

My first digital HA was a Siemens, then I moved to Phonak, and for the past decade or so, I’ve been with Oticon.

The first audiologist who ever talked to me about fitting rationale was actually the one who convinced me to try Oticon in the first place. Before that, I honestly have no idea what rationales I was using - probably just the manufacturer’s proprietary settings.

With Oticon, I stuck with VAC+ for a long time. Then I crafted myself a music program using DSL v5 for adults. I loved it so much that I started using DSL adult in my main program as well.

Later, after reading a post from @Neville, I decided to give DSL v5 pediatric a try.

Long story short: by far, DSL v5 pediatric in my Oticon Intent 1s has given me the best results in terms of speech comprehension, environmental awareness, and music enjoyment. I’ve been using it for nearly a year (?) and never looked back…

My i90 Sphere’s are setup with DSL 5 and they are phenomenal. I agree with everything the original poster said. Be sure to do REM testing and adjustment too.

Jordan

Guys, just a caution: we know that DSL child targets are safe, but we don’t know that exceeding child targets is safe. (We don’t know it’s unsafe, it’s just unresearched.) When you’re DIYing and messing around with adult targets, chances of getting into the unknown danger zone are low because they are just so much quieter than child targets. When you’re messing around with child targets there’s a higher chance that without REM you’re exceeding target gain in some places.

There’s a idea floating around even among providers that MPO determines safely, but this is incorrect. REM becomes more important when you’re trying to maximize audibility.

So if you like it, great. If you want to stay on it without risking progressive loss due to noise damage, find a clinician who will check this for you.

I was hoping someone would say this (I shared my concern in another similar thread created by the OP). Thank you

I’m a pediatric audiologist. If I get a chance before my patients move on to adult providers, I tell them to request the DSL formula! It’s what you are used to!

I say stick with pediatric - with new aids, I’ll let my young adult patients try the different fitting formulas in the office to see what they think. They always prefer pediatric

@Neville said:

So if you like it, great. If you want to stay on it without risking progressive loss due to noise damage, find a clinician who will check this for you.

100% agree with you - nothing beats a competent professional following best practice and guided by precise empirical data. It makes the whole process far less subjective and biased.

That said, sometimes that option just isn’t available for one reason or another. I’ve been self-programming for a while now, and given the options where I live, it’s been well worth it.

I got a system though:

1. Everything I do is based on my most recent in-situ audiogram (which I run with my hearing aids). My results haven’t really changed since I started monitoring it.
2. I never overprescribe MPO, ever. The only exception is for my guitar program, since compression really kills the tone. This guitar program mirrors my general program but with much less compression, at least 10 dB less gain overall, and the entire gain spectrum sitting below the prescribed “loud” curve.
3. In my general program, gains are always set a few dB lower than Genie’s target, with an even bigger gap in the “loud” prescribed curve.
4. I have an audio file with pure tones that match my hearing aid adjustment bands. This file follows an equal-loudness contour (Fletcher–Munson curves), and I play it through my reference headphones (DT 770 Pro) with EQ applied to compensate for the headphones’ frequency response. I use it to check for excessive gain in my stripped-down guitar program. Pure tones shouldn’t really be used as a reference when all the “bells and whistles” are on, but my guitar program has everything turned off. So I take it, better than nothing I suppose. If I spot any red flags there, I make the necessary adjustments in my other programs as well.

That said, this will never replace the expertise of a competent professional. Plan A should always be good professional care. The DIY process is complicated, with too many variables to control, and things can easily go wrong. It took me a long time to get to where I am, and I’ve only done it because I don’t currently have access to a viable Plan A.

@monke said:

Question for Others
Has anyone else worn hearing aids since childhood struggled with other fitting formulas?

Yes. Probably me. I have power domes since 4th March when I received my Sphere 90 (previously had Paradise 90 with 1mm vent and NAL-NL2).

The power domes are leaky, so I am underfitted despite choosing DSL 5.0 Pediatric.

19th Aug I’ll receive deep placed titanium cShell with 0.6mm vent, so I hope I’ll get the most of DSL v5 Pediatric!

Happy to see your results!

You read my previous posts about it?

ActiveVent Receiver: Is my hearing loss too bad?

I don’t have much fair experience with DSL 5.0 Pediatric, because I has still power domes, which means I am underamplified due to low feedback threshold. The power of the DSL 5.0 formula is more gain at abot 4-8 kHz. I will receive my titanium cShell with 0.6 mm diameter vent 19 Aug. I am 36 yo. DIYer since Sept 2024. Until March I was in NAL-NL2. I came to DSL 5.0 Pediatric, because: I have hearing loss (the same) since I was 4 (note I has my first HA when I was 12) so I assume if I were …

@monke said:

DSL v5a Adult is also inaudible to me

It’s 10 dB quieter than pediatric, so no wonder.

@monke, have you finally got new cShell/earmold with tiny vent? Which diameter of the latter?

@PeterH said:

I think I’m in for some sensory overload tonight, compared to what I’m used to.

Yeah, one night isn’t enough, you have to train at least a few weeks with DSL 5.0 Pediatric and volume control for occasional relieve.