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Re: Dispensing digital aids to 60dB+ loss existing aid users?

Thanks Barbara,
I'll check the fitting data when I'm back in the office. The aids I dispensed have fully auto everything which certainly seemed to get in the way.
Turning OFF adaptive beam steering and turning DOWN Dynamic Noise Reduction seemed to make speech clearer for the user.
I'll try out your tips if the px wants to continue the trial. [He has old but apparently very effective digital aids already]
----- Original Message -----
Sent: Wednesday, October 20, 2004 9:04 PM
Subject: RE: Dispensing digital aids to 60dB+ loss existing aid users?

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 users?
>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 well]
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