Hearing Aid Limitations
Summary
With hearing aids and cochlear implants:
- Hearing aids alone do not restore hearing.
- Hearing aids are very useful in quieter situations and one-on-one situations (though individual hearing ability varies widely).
- Effective range (for most) is under 10’ (for some < 2-3’). And some hearing loss is so severe – that understanding speech is very limited.
- Hearing aid microphones pick up all background sounds
How do assistive listening systems help?
- Improves signal-noise-ratio that people with hearing loss need.
- Hearing instruments increase SNR up to 6 dB.
- Remote microphones increase SNR up to 12 dB.
- Assistive listening systems increase SNR up to 30 dB.
- Augment hearing aids.
- Works for people with and without hearing aids.
- Clarify sound by eliminating the negative effects of distance, noise, and reverberation.
Hearing Aids Themselves
- Lesica, N. (May 2018.) Hearing Aids: Limitations and Opportunities. The Hearing Journal
- Remensnyder, L. (September 2013). Used Alone, Hearing Aids Fail to Deliver. Audiology Practices. . . “All hearing aids and all CIs use microphones. The microphone is the first component followed by sound processors that are fully dependent upon microphone input. And all microphones have three annoying characteristics: they pick up what is loudest, they pick up what is closest and they have absolutely no idea which sound is important to the listener.” (pdf)
- Hearing Aid Benefits and Limitations FDA.
Hearing Aid Stores and Clinics
- Some hearing aid retail stores and clinics sell “locked” hearing instruments, meaning only offices of that particular brand (such as Beltone, NuEar, Kirkland, and Miracle Ear but there are others) can adjust/reprogram these instruments.
Hearing Aids Not Fitted Well by Audiologists or Hearing Instrument Specialists
Introduction to Real Ear Measurements and why they are important when you purchase new hearing aids. Approximately 30% of hearing professions provide this service. (9:45)
Articles
- Beck, D. (March 19, 2024). Hearing Aid Programming: Pearls and Pitfalls. Hearing Matters Podcast. Imagine discovering that the key to optimal hearing isn’t just in choosing a hearing aid, but in the precise individual calibration. This episode features a conversation with Dr. Ron Leavitt, a renowned audiologist who shines a light on the critical gaps in “best fit” settings provided by hearing aid manufacturers, compared to the National Acoustic Laboratories (NAL) targets. (webpage)
- Sterkens, J. and Whyman, W. (May 13, 2022, Aug 29, 2024). Hearing Health for Older Adults: What Older Adults Need to Know About Hearing Loss. National Council on Aging (NCOA). “While using hearing aids results in significant benefits for most users, it is not automatic that the most expensive hearing aids and advanced sound features will always be better for you. Unless the provider listens to you and adheres to a fitting protocol known as “Best Practices,” you might end up with hearing aids that do not meet your needs (webpage)
- Bell, R. (July/August 2021). Real-Ear Verification for the New Professional. Audiology Today. “using real-ear measures continues to be a critical piece in providing comprehensive clinical care to our patients“
- Clutterbuck, S. (October 2017) A premium clinic is more important than a premium hearing aid. Audiology Worldnews. EUHA Congress special.
- Clutterbuck, S. (October 2016). Real world outcomes for basic and premium hearing aids: Is there a difference? Audiology Now. “This analysis highlights the importance of the audiologist in mediating a successful outcome from hearing aid
fitting, regardless of the level of technology.” - Bloom, S. (September 2010). Are you a Paramecium Racer? An acronym points the way forward in hearing care. The Hearing Journal. (5 pages, pdf). “Of all those interviewed for this article, Sergei Kochkin, PhD, executive director of the Better Hearing Institute, is the most critical of the incompetence he sees as insidious throughout the industry. He believes that many hearing aids are not fitted properly; that based on letters he receives, discomfort and dissatisfaction among patients are rampant; and that the benefit of amplification when not properly fitted is often minimal. “Upgrade your skills,” Kochkin urges, calling on the professional organizations to police their members and audit their practices.”
- Hickson, L., S. Clutterbuck, and A. Khan. (Jun 2, 2010). Factors associated with hearing aid fitting outcomes on the IOI-HA. International Journal of Audiology. These findings highlight the importance of focusing rehabilitation on improving satisfaction with aided listening across a range of environments
- Kochkin, S. et al. (April 2010). Correlations between dispensing protocols and successful patient outcomes. The Hearing Review.
- Kochkin, S. (February 2000). MarkeTrak V: “Why my hearing aids are in the drawer”: The consumers’ perspective” The Hearing Journal
Audiology Professional Best Practices
Standards
- Current Audiology Standards (webpage) Audiology Practice Standards Organization (APSO)
- Practice Guidelines and Standards (webpage). American Academy of Audiology (AAA)
- Accreditation Standards (webpage). Academy of Doctors of Audiology (ADA)
Certification
- Certification (webpage). American Speech-Language-Hearing Association (ASHA)
Articles
- Turton, et al. “Guidelines for Best Practice in the Audiological Management of Adults with Severe and Profound Hearing Loss.” Seminars in Hearing 41, no. 03 (August 2020): 141–246. “Unless contraindicated, the hearing care professional should activate the t-coil where fitted and arrange for the client to experience a good working inductive loop, as this remains the most widespread and effective way to hear well in public spaces.”
- Marcos-Alonso S (June 13, 2023) Journal of Clinical Medicine. Factors Impacting the Use or Rejection of Hearing Aids—A Systematic Review and Meta-Analysis