The document discusses hearing aid technology and the hearing aid fitting process. It explains that patients should choose an audiologist for their provider due to their advanced education and training. The fitting process involves testing, device selection based on hearing loss and needs, programming, and orientation. Follow-ups allow for fine-tuning. A variety of hearing aid styles and technologies are reviewed to address different types of hearing loss. The importance of wearing aids full-time for adaptation is stressed.

1. Understanding Hearing Aid
Technology and other Assistive
Listening Devices
University Ear, Nose, and Throat
Specialists
Center for Audiology and Hearing Aids
Eye and Ear Institute

2. Choose your hearing health care
provider carefully
 Audiologist
– 2-4 years post-graduate work
– Masters or AuD (clinical doctorate)
– Licensed by the state
– Required continuing education
 Hearing Aid Dealer
– High school education
– No criminal record
– Registered by the state

3. State Laws regulating hearing aid
provision
 30 day adjustment period
 Ability to return the devices with your money
returned (minus $150.00 per device)
 State form to be signed at the time the
hearing aids are ordered and when they are
delivered
 No money is to be collected until the hearing
aids are delivered

4. Process
 Full, diagnostic hearing evaluation (you
need an order or script from your PCP
for this to be covered by your
insurance)
– including ability to hear in noise
 Medical referral if needed

5.  Hearing Aid Discussion
– Discuss test results
– Examination of the size and shape of ear canal
– Communication needs assessment and
expectations
– Matching style and technology to hearing loss,
communication needs, environment, ear size, and
financial considerations
– Earmold impression

6.  Hearing Aid Fitting
– Physical Fit
– Programming/Adjusting the hearing aid response
based on measures of the output of the hearing
aid in the ear canal (the hearing aid is connected
to the computer and there is a small, soft
microphone placed in your earcanal with the
hearing aid)
– Soft, moderate, and loud sounds are mapped
against your hearing thresholds to return correct
loudness (it will not sound correct on the first day)
– Test of tolerance for loud sounds

8.  Hearing Aid Orientation
– Insertion and removal of the hearing aids
– Insertion and removal of the batteries
– Manipulation of the controls
– Care and cleaning of the hearing aids
– Use with the telephone
– Warranty information (1 year loss/damage/repair
at a minimum)
– Wearing schedule to get used to fit and new
sounds

9.  If the hearing aid if tuned correctly, you will
not like it for the first week or so…
 We know that the brain must adapt to the new
input and the only way to adapt is to be
exposed to the sound
 The brain is not good at trying to hear two
different ways. Individuals who try to wear
hearing aids part time are not successful
(they continually have difficulty in noise and
other more difficult listening situations).

10.  Follow-up (3 weeks)
– Fine-tuning based on patient perceptions after full
time use for at least 2 weeks
– Discussion of residual difficulties, identifying other
solutions if needed
 Future appointments
– Based on patient need
– Change in hearing
– Prior to end of warranty (insurance)

11. Price of Hearing Aids
 Bundled price includes the device and
all services for a year.
 The device is useless without an expert
to program it for your hearing loss and
communication needs.
 Hearing aids range from approximately
$900 to $3000 per aid depending on
technology and style

12. Insurance
 Many insurances do not cover hearing
aids
 Security Blue (a few other High Mark
products as well)
 UPMC for Life

13. Programs for free hearing aids
 Lion’s Foundation
 HEAR NOW

14. Hearing Aid Considerations
 One ear vs. two ears
 Need to choose a style
 Need to then choose what technology
will be inside the hearing aid

15. Before you choose a style
 Degree of hearing loss
 Special features needed
 Ear size
 Lifestyle needs
 Manual dexterity
 Cosmetic preferences
 Daily care
 Telephone needs
 Cost

16. Hearing Aid Styles
 Behind the ear
 In the ear
 In the canal
 Completely in the ear

17. Behind the ear style
 Fits snugly behind your ear
 Can fit any degree of hearing loss
 Attached to a custom earmold
 Fewest repairs due to wax
 May be connected to assistive devices via telephone
switch

18. Hearing Aid Types

19. New…
 Slim tube
 Open canal
 Mini BTE

23. In the ear style
 One-piece instruments custom designed to fit
within the bowl of outer ear
 Fits mild to moderate degrees of hearing loss
 Some repairs due to wax
 Can also be connected to assistive devices
via telephone switch

24. In the canal style
 Custom instrument that fit almost entirely in
the canal of the ear.
 Fits mild to mildly-moderate degrees of
hearing loss
 Many more repairs due to wax
 Cannot be connected to assistive devices due
to size limitations

25. In-the-Canal
 More discrete
 Often cannot fit a
telecoil
 Requires
finger/hand
dexterity

26. Completely in the canal style
 The smallest, most cosmetically appealing
hearing instrument
 Fits mild to moderate hearing degrees of loss,
especially for high-frequency losses
 Greatest number of repairs due to wax
 Works well with phone due to deep insertion,
no need for T-coil

27. Completely in the Canal (CIC)
 Currently very popular
 virtually invisible
 can’t have T coil
 use on phone normally
 high maintenance
 takes advantage of
natural gain from auricle
and EAM

28. Hearing Aid Technologies
 All Hearing Aids now use Digital
Technology

29.  Advanced feedback solutions
– Feedback is when amplified sound can
leak out of the ear canal and reach the
hearing aid microphone
 Processes speech and noise differently
(helps with comfort, not understanding
in noise)
Fully Digital Technology

30. Do you want to hear in noise?
Solution:
 Wear your hearing aids full time
 Wear 2 hearing aids
 Multiple microphones (Directional Mics)
 Assistive Listening Devices (ALD’s)
– Put the microphone near the thing you want to
hear, the signal is sent to a receiver attached to
your hearing aids

31. Matching the technology to your
needs
 You do not want to over purchase
 The clinic should be using evidence
based practice and therefore be able to
explain the technology level choice
based on your test results

32. We hear for…
 Communication
 Safety
 Enjoyment

33. If a family member cannot use
hearing aids…
 Cannot manage them
 Confined to bed

36. Safety/Alerting Devices
 Telephone ring
 Door bell/door knock
 Hearing a dependent individual calling
 Alarm Clock
 Smoke detector

39. Telephone Solutions
 Hearing aid should have a telecoil program
that allows the hearing aid to pick up the
electromagnetic signal from a hearing aid
compatible telephone
 Individuals with hearing loss need to
purchase good phones (phones should be
“hearing aid compatible”)
 Make sure you can hear on a land line phone
and on your cell phone before you leave the
clinic
 Consider using the speaker phone in some
situations

40. Other helpful solutions
 Moisture problems
 Retention problems
 Insertion challenges
 Cleaning products

46. Remember
 You need to wear the new hearing aids
for two full weeks, full time
 You need to be a full time user of
amplification; part-time users are rarely
successful