What to Expect at Your Hearing Aid Fitting

Posted by Jhhearingaids @jhhearingaids, Oct 11, 2019

What to Expect at Your Hearing Aid Fitting

A successful hearing aid fitting is more than just selecting the correct device for your hearing needs. The hearing aids need to be properly fitted to your ears so that they provide the correct amount of amplification to maximize hearing aid benefit.

Prior to fitting the hearing aids, your audiologist will conduct a thorough hearing test to measure the softest sound you can hear at different pitches and record the volume of sound that is uncomfortably loud for you. Based on these tests, your audiologist will know how much gain the hearing aid needs to provide in order to amplify soft sounds so they are audible and how much to compress loud sounds so that they are not uncomfortable.

Different styles of hearing aids, levels of technology, and cost will all be discussed at your Hearing Aid Evaluation appointment. Your various listening environments and expectations of hearing aids will also be discussed. Your audiologist will discuss different features available in hearing aids and make recommendations based on your hearing evaluation and communication needs. You will select the hearing aids you want to order. Earmold impressions will be taken of your ears (if necessary) to order the hearing aids. About two weeks after you order the hearing aids, you will return for the hearing aid fitting.

At the hearing aid fitting appointment, your audiologist will verify that the hearing aids are providing the correct amount of amplification by doing Real Ear Measures. Real Ear Measures allow the audiologist to know how loud sounds are in your ear canal. First, a thin tube will be inserted into your ear canal. This tube is connected to a microphone that will measure the volume of sound near your eardrum without any hearing aid device in your ear.

Next, your hearing aid will be inserted in your ear taking care not to move the probe tube microphone already in your ear canal. Once the hearing aid is turned on, your audiologist will measure how loud the sound is at the output of your hearing aid in your ear. It is important for your audiologist to play different volumes of sound from soft to very loud in order to verify that soft sounds are amplified so you can hear them, that moderate-intensity sounds are amplified to a comfortable listening level, and that loud sounds are considered loud, but do not exceed your discomfort level.

Proper verification of your hearing aid settings is integral to a successful hearing aid fitting. If these measures are not completed, then the audiologist will not know whether your hearing aids are programmed properly. Real Ear Measures ensure that you are getting the appropriate amount of amplification in accordance with the severity of your hearing loss. Once the hearing aids are programmed, your audiologist will then review the care and maintenance of the hearing aids. Tasks, like inserting the hearing aids and changing the batteries, will be practiced in the office.

barbb, if you replied to either imallears' post or the one I just did, you've arrived!

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@barbb

Ooops, how do I find the reply you moved? i.e. find that thread you moved to? You are making me think some of my comments may belong there…

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@barbb
If you still have the Mayo Daily Digest showing on your email…go down to Just Want To Talk and click on the discussion about Going off the Topic. Otherwise you can find all the Groups on the home page and then just choose the discussion you want to join.
It helps to put @ before the name of the person you want to reply to so that shows it up in their email.

FL Mary

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@barbb

Ooops, how do I find the reply you moved? i.e. find that thread you moved to? You are making me think some of my comments may belong there…

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@barbb It's in Just want to talk . I followed your post to reply to and it went here as Fl. Mary posted here

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@imallears

@barbb
If you still have the Mayo Daily Digest showing on your email…go down to Just Want To Talk and click on the discussion about Going off the Topic. Otherwise you can find all the Groups on the home page and then just choose the discussion you want to join.
It helps to put @ before the name of the person you want to reply to so that shows it up in their email.

FL Mary

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Thanks for your very helpful reply!

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Thanks @jhhearingaids for the information on Real Ear Measures. That practice is new to me. Is it considered standard practice these days?

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@maryella7

Thanks @jhhearingaids for the information on Real Ear Measures. That practice is new to me. Is it considered standard practice these days?

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Some do REM some don't. If your audiologist doesn't offer it to you ask (insist) for it.

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For anyone considering getting new hearing aids – please read on to see a way to test whether your aids are working the best for you.

Consider Speech Audiometry tests. I have had these tests for over 50 years (I first heard these administered by my ENT doctor) then by audiologists before and after fitting my hearing aids. Hearing for me – one of the critical things is understanding speech. These tests use a standard set of words, you test the fitted hearing aids to see your comprehension of those words and sentences. Armed with this information, you can better adjust the hearing aids for your individual hearing loss. I find that my friends have had their aids set up to a standard (I'm sure it's a great baseline) but then still don't hear properly. I have severely (L) and profoundly (R) impaired hearing , but my speech comprehension level for ordinary speech (with my aids) is close to 95%. It does drop significantly on addition of white noise, but I also can read lips so that helps.

Some hearing fitters refuse to use this sort of testing once the aids are fitted- I suggest you try to find someone who does work with you to get this to happen. The key thing is to test the hearing aids when you are wearing them – are you understanding words and sentences?
https://www.interacoustics.com/guides/test/audiometry-tests/speech-audiometry
And do get all the features you can with your hearing aid as required- you can get a special program for tinnitus, do get a t-coil (refer to discussions elsewhere) bluetooth should be standard by now (for cell phone).

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@lucyg

For anyone considering getting new hearing aids – please read on to see a way to test whether your aids are working the best for you.

Consider Speech Audiometry tests. I have had these tests for over 50 years (I first heard these administered by my ENT doctor) then by audiologists before and after fitting my hearing aids. Hearing for me – one of the critical things is understanding speech. These tests use a standard set of words, you test the fitted hearing aids to see your comprehension of those words and sentences. Armed with this information, you can better adjust the hearing aids for your individual hearing loss. I find that my friends have had their aids set up to a standard (I'm sure it's a great baseline) but then still don't hear properly. I have severely (L) and profoundly (R) impaired hearing , but my speech comprehension level for ordinary speech (with my aids) is close to 95%. It does drop significantly on addition of white noise, but I also can read lips so that helps.

Some hearing fitters refuse to use this sort of testing once the aids are fitted- I suggest you try to find someone who does work with you to get this to happen. The key thing is to test the hearing aids when you are wearing them – are you understanding words and sentences?
https://www.interacoustics.com/guides/test/audiometry-tests/speech-audiometry
And do get all the features you can with your hearing aid as required- you can get a special program for tinnitus, do get a t-coil (refer to discussions elsewhere) bluetooth should be standard by now (for cell phone).

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Thanks Lucy. Good information. You and I both go back to the time when audiologists did not fit hearing aids. The prescribed them and certified hearing instrument specialists fit them. That changed in the 90s when audiologists lobbied for the right to be involved in the entire procedure. Much has changed since then because hearing instruments have gone from analog to digital. They have added BlueTooth for streaming, etc. It's been a fascinating experience to participate in these changes.

Now, we have audiologists and hearing instrument specialists doing basically the same thing in most states when it comes to fitting hearing aids. Our dilemma becomes one of figuring out whether or not we are being properly tested for fitting. We are going to see more and more advertisements for over the counter hearing aids now too; those that come without any testing at all. They may help people who have mild to moderate hearing loss and need only slight amplification, but will do little for people whose hearing loss is moderately severe or worse when they need clarity and amplification.

People should know that those who call themselves audiologists with an AuD behind their names, have doctorate level degrees from accredited university programs. Those with MS-CCC-A after their names have master's degrees plus certification from university programs. Those with no credentials, or HIS (hearing instrument specialist) behind their names do not have degrees in audiology. They are licensed in most states, but may have little more education than a high school diploma with a brief internship with another HIS. Many of those people are employed at big box stores that sell and fit hearing aids. Some of the big box sellers do have AuD or MS-CCC-A audiologists, but that's not common. The only way you know what kind of training a provider has, is to ask them and be aware of those credential initials.

To make this more confusing, I will say that many HIS providers are good at what they do. They understand technology because they are technology oriented and trained. It's kind of like 'learning computers'. Some people just 'get it' while others don't. The modern hearing aids are a lot more like computers today then they were 30 years ago. Regardless of where you go, or what kind of education/training your provider has, know that you have a mandated trial period to try hearing aids. If they are not helping you enough to justify their cost, take them back. Ask to try something different. Ask for your audiogram/test results so you can go to a different provider if you wish to. You have a right to that piece of paper. Google for information about real ear measurement testing. And, talk to other people who use hearing aids successfully about their experience. Getting a proper fit is challenging, but well worth the time for trial and error to get it right.

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@julieo4
Great post. Everyone should print this out and keep for future reference. Thanks.

FL Mary

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@imallears

@julieo4
Great post. Everyone should print this out and keep for future reference. Thanks.

FL Mary

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I ditto Mary's comment!

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I've said this before, and will repeat it: what you really want is to find someone so interested in improving your hearing that they keep abreast of what's new and the various kinds of hearing loss. The HIS I use at the nearest Costco is far more aware of current developments AND my disease (Meniere's) than either of the "real" audiologists I've seen…or the surgeon at the CI clinic. This is because she constantly keeps herself informed of new things available and has spent some time studying various hearing problems. Just as with any medical person, the letters behind their name may…or may not…indicate that they know a lot about your problem and how to enable you to hear better. Since there's no risk to trying Costco (very liberal total return policy), there's no charge for visits to adjust your aid, and the aid will cost roughly half of what it would bought elsewhere, I think it's well worth trying Costco. If the woman I see ever leaves that Costco and I don't like her replacement, there are several other Costcos I could try. The one I use is the closest…about 60 miles away, but there are several more within a hundred miles of my home. Don't be confused by the "brand" names at Costco: my Bernefon is actually an Oticon, for example.

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