Sometimes patients may not like the new aids because they often have too
much compression. In severe hearing losses, patients still like a more
linear hearing at with compression ratios of no more than 2.0. I usually
raise the kneepoint high (65dB) and keep somewhere between 1.5 to 1.7
compression. They can also tend to be power junkies wanting more low
frequency tones than newcomers. A lot of the "first fit" programs,
underamplify low frequencies in the belief it will cut down background noise,
which in theory is true, but you lose more of the melodius tones and
fundamental frequencies that those with severe hearing losses need. Try
not to overamplify the high frequencies. Fit to their psychological
comfort, have them adjust for 1 to 2 months and see them back again for any
acoustic modifications. By 1 to 2 months, their auditory system at the
brain level with have adapted to the new sound and may require a boost or a
fine tuning to try to maximize their hearing processing. Remember, there
is a brain attached to the ears and patients experiences differ including
history, medications, personality, etc. which can impact their experience with
the aids. Do not marry yourself to fitting by prescription formula -
they are only an initial guideline, which may not match the individual's
comfort or performance.
Barb Reynolds, M.S.
Clinical Audiologist and Dispenser for 16 years.
>From: "Richard H." <auditory@AUGMENTICS.COM>
>Reply-To: "Richard H." <auditory@AUGMENTICS.COM>
>Subject: Dispensing digital aids to 60dB+ loss existing aid
>Date: Wed, 20 Oct 2004 19:14:20 +0100
>I have just opened a dispensing practice in the UK, having
passed my dispensing exams.
>All is going well ... except that I am failing to "convert"
existing aid users with a fairly heavy loss.
>They expect a major increase in speech discrimination from the
latest top-end digital aids .... but 2 patients in the last week have
>stuck to their old aids [one analogue, 1 digital] after a trial
of a new aid. Any additional benefit has been so mild that they have
>decided to save their money.
>Is this a standard result? Should I assume that modern
technology runs out of steam in such cases?
>Or am I not being exact enough with the
fittings? [All my other fittings for lesser losses have gone very
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