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When to test BOTH aided and unaided hearing?

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For hearing aid wearers, what is the normal practice for periodic hearing tests: should you not normally be tested both for aided and unaided hearing always? Or is there some other recommended convention for this?

(OK, if I was just tested for both, then got new hearing aids…in that case just testing aided performance makes sence, but otherwise I would expect to always have BOTH tests).

Thanks.

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But assuming you’re a hearing aid wearer, my question is do you always test BOTH aided hearing and UNAIDED hearing at your (yearly) testing session?

My audiologist did a complete hearing test with a printed “after” I got my Marvel M90-R but only at my request. The “after” test was done after my Marvels were finally programmed to agree with my (Real Ear Measurement).

In reply to @cpchisholm

What would be the point of testing your unaided hearing at the yearly test? Assuming the initial finding that you needed was correct I don’t reckon there’s any likelihood you now wouldn’t. As a wise person once said, the only things that get better with age are wine and cheese.

In reply to @turners1962

@turners1962 said:

Because your hearing might have gotten worse and your hearing aids need to be readjusted.

To my simple thinking: as your hearing declines (mine sure will), this will appear in the Aided test. Aided is Unaided plus Boost. When Aided test results droop a little, it is reasonable to bump the aid adjustment for a better fit on the current hearing.

If Aided test results change sharply (or if new aids are being sold), it probably makes a lot of sense to run an Unaided test again.

But everybody is different. I have a steep slope in midband with flat either side. It is really quite hard to correct “well”. And it moves a little further left every year. If after a while a small tweak at 1.5kHz isn’t fixing a “hole” in my hearing I would ask for an Unaided baseline again to re-define the goal.

In reply to @cvkemp

same here too to make sure I’m not left behind and the earwax isn’t playing up (I have excessive earwax and sometimes it can get really SPOOKY with an updated to see if that’s affected or now) it’s weird how that doesn’t affect it unless it’s a tiny drop

I have never had an aided hearing test, though I think it is a good idea. Especially word recognition. I suspect the Audiologist doesn’t really want to know if the aids they just fitted are really providing any improvement. I firmly believe that in my case, word recognition would be worse in an aided test. I have used an audio generator app on my phone to see what frequencies I can hear aided, and I can easily hear 8 KHz with Sound Recover 2 turned on. Going out into the real world with my aids has not improved my speech recognition though.

Thanks for all the replies.
So I guess the one other question the responses raise is in regards to real ear measurements:

I guess instead of an aided test you can instead do real ear measurements and I presume the point of that is to confirm the levels are appropriate for the unaided hearing loss: e.g. if you have a steep loss starting at 1500 Hz, then presumably you want real ear measurements that show your aids are producing a significant gain starting at 1500 to properly compensate for your hearing loss pattern.
Right?

Aided pure tone testing isn’t actually a terribly accurate measure. Aided speech testing is okay, and done regularly in some situations. is generally faster and more accurate. I’d 100% do aided speech tests with John if he were in my area though, just because he’s an interesting case. :grinning:

REM confirms that gain is appropriate for loss and also identifies whether hearing aids are functioning properly.

In reply to @John_Green

@John_Green said:

I can easily hear 8 KHz … not improved my speech recognition…

8kHz is not “speech”. (Yes, when I worked with speakers/singers PA, I would tweak 8kHz to put a little “sparkle” on the voice to stand-out over the band, but for “flavor” not intelligibility{*}.)

With your curve, I’d be thinking that under 1kHz is masking over 2kHz; in fact each part-octaves masks the one above. You should hear vowels fine, and with that 8kHz plateau you may hear sizzle, but the /s/ /t/ /th/ /f/ sounds fall 1kHz-5kHz, and on steep slope, so a lot of words all sound alike. (You probably know, but for lurkers: search “speech banana” or “ count the dots”.)

{*}(However “up to 8000 to 9000 Hz can be extremely important for … /s/ and /z/, especially for female talkers.” Dots, 9kHz: Killion But I doubt women’s s/z is your biggest issue.)

Paulrreid,
I just mentioned 8 KHz to show that the aids, with SR2 enabled do make it possible for me to hear that high. Whether there is anything up there I want or need to hear is another thing altogether. I have adjusted SR2 to lower anything above about 1.8 KHz, which is where the steep part of the loss curve begins. I don’t know the lowest level I can hear, with SR2, at high frequencies because I don’t have a good way of measuring the level. Direct doesn’t turn on SR2. I would like to get an aided word recognition test done. Wonder if the would do one. It wouldn’t be difficult since they have booths and all they would have to do is read the list while I has aids on.

@John_Green said:

I would like to get an aided word recognition test done.

I know why audiologists use controlled lists/levels and quiet booths. However for non-research/diagnostic testing, a rough-n-ready test has some real-world validity. Have mate and/or friends speak lists at you, in typical settings, at average voice,with and without aids. Google “audiometry word lists images”. (More lists appear as images than as text, for some reason.) The results are not comparable to numbers from standardized booth tests. But it may inform you if you do/do-not understand better with aids.

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